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COVID-19 Epidemic FAQ: Coronavirus Symptoms, Duration of the disease, Prognosis, Mortality, Treatments


Version 2.70 (May 19, 2020)

Caution is advisable but panic is unacceptable. Mainstream media companies discovered that endlessly replaying (and sometimes plain inventing) lurid tales of horrible things happening  was good for ratings and required no real journalistic effort or talent.  It now seems apparent that insistence that masks were not effective at containing the spread of the disease was part of a purposeful disinformation campaign by some public health officials and elements of the media. The reason for this was to prevent a run on masks when they are most needed by medical personnel. “Scary-looking, big, contextless numbers” tactic used by MSM creates Corona Stockholm syndrome among population and amplify already substantial economic difficulties. At the same time real facts about COVID-19 disease are difficult to come by.  The first question we do not know is "Do you get natural immunity to this disease, and if you have had it for how long it last?'" (WHO: No evidence that recovered COVID-19 patients cannot be reinfected)

News Neoliberal war on reality Recommended Links COVID-19 prevention measures The threat of "Coronavirus recession" Chinagate: the USA government attempt to blame China for the COVID-19 epidemic COVID-19 as a bioengineered virus hypothesis
COVID-19 fearmongering COVID-19 epidemic handing in the USA The second stage of the crisis of neoliberalism Chronic Unemployment Chronic Unemployment Medical workers problems Abuse of "Nation under attack" meme
Fauci and his blunders CDC blunders in handling of COVID-19 epidemic in the USA Federal bureaucracy blunders in handling COVID-19 epidemic in the USA Navy problems COVID-19 hoarding epidemics  Diamond Princess Absurdity of bureaucracies
Health issues Media as a weapon of mass deception  Stability is destabilizing: The idea of Minsky moment Manufactured consent Groupthink The importance of controlling the narrative Trumpcare scam
US Presidential Elections of 2020 Trump's impulsivity and incompetence Nineteen Eighty-Four  Over 50 and unemployed The Real War on Reality Propaganda Quotes Humor

Abstract

The effect of information overload has been to disorientate the great majority of us who lack the time, the knowledge and the analytical skills to sift through it all and make sense of the world around us. It is hard to orient yourself when there is so much information – good and bad alike – to digest and you can not trust neoliberal MSM. .

The US MSM Media Narrative is deceptive and amounts to a toxic mix of domestic hysteria and propaganda war against China. While it looks like the danger of the disease was exaggerated, even falsified, the crisis caused by it, internationally and locally is obviously real. The current lethality from SARC-CoV-2 is probably much lower then 2 to 3% which was registered in  China. It represents a serious danger mostly to the old (over 60) males, medical personnel, and/or people  with "sensitivized" lungs (the category which includes people in areas with very bad air quality, smokers, asthmatics, and a subset of people with hypertension who are taking ACE inhibitors). Only around 7% of infected develop virus pneumonia. After you get pneumonia other medical conditions such as coronary come into play and determine your prognosis.  In China already over 90% of its 81K Coronavirus patients have made a full recovery. Unfortunately, virus can attack other organs then lungs and cause death in relatively young patients too. Mechanisms of this are unknown but might be connected with virus usage of ACE2 receptors for entrance into the cell.

Neoliberal MSM are creating artificial hysteria trying to use this issue to damage Trump. Worst-case predictions would not come true; but the  economy damage from hysteria, for which MSM are partly responsible for would be huge.  COVID-19 doesn't spread as easily as first thought: most infected were infected in closed spaces populated by infected individuals (ships. military camps, hospitals, families, religious gatherings, conferences, etc).  Outside mass gathering chances of getting virus in open space, for example during walk,  are virtually non-existent. Supposedly, you need approximately 15 min conversation and/or being in close proximity of the infected person to became infected, if you and infected individual are not wearing mask and infected individual is asymptomatic.  But in now way it is instant: it looks like you need to get a critical viral load which differ one individual to another. At this point quantity turns into quality and you became sick.  Somewhat similar with accumulation of a critical dose in places like Chernobyl or Fukushima. That's why most infections acquired in family clusters (around 80%): the most vulnerable person catch it somewhere else, and than he/she infects all the members of the family.

The Coronavirus hits mostly urban areas preferring metropolises with high density of population like NY metropolitan area.  Religious nuts can change this picture a little, like happened with some obscure cult in Korea,  Jewish orthodox worshipers in NY and NJ, and evangelicals. In a way, religious nuts along with military brass and reckless teenagers who partied during Spring brake and the brought infection to their communities proved to be a perfect Trojan Horses for the virus in the USA and made the epidemic  worse.  Perfumed princes of Pentagon also behave arrogantly and recklessly and engager the lives of troops: Esper’s decision to continue training camps for recruits  and dismissal of the captain of the aircraft carrier USS Theodore Roosevelt, on which the virus was reportedly spreading reflect a deeply ingrained Pentagon habit of protecting its parochial military interests at the expense of the health of American troops. To prioritize non-critical military objectives over public health. History repeats: they acted with even greater callousness toward the troops being called off to war in Europe during the devastating “Spanish flu” pandemic of 1918, which killed 50 million people worldwide. The real character of the US military brass running the WWI is clearly revealed by the fact that more American soldiers were killed and hospitalized by influenza (63,114) than in combat (53,402).

Bureaucratic incompetence of the US government also played role. The USA failed to distribute masks to population via pharmacies and enforce wearing of masks in public places for everybody. CDC blunder with the test for this virus added to the problem. As the result of this blunder the tests availability during critical period (Feb 26-March 26) in the USA was very low.  San Francisco ordered a shelter in place only on 3/16, California on 3/19, and New York as late as 3/20.  In other words they waited for more then a month since it became clear that the virus is highly infections.

While we can argue about actual mortality (probably in a range from 0.2 to 2%; with steep increase fro this level for older people to ~15% of people over 80), still, this new coronavirus is much worse and more dangerous than seasonal flu, not because it produced more deaths or infections (it is not so far; then number of death is ten times less), but because it cause acute virus pneumonia for larger percentage of people then the seasonal flu.  Unconfirmed data suggest that virus might attack hemoglobin (like malaria parasite) and cause stroke and heart disease in small percentage of infected. But damage to the lungs (fibrosis) remains the main for patients infected with the disease.

To understand the real level of the danger we need to know the facts. Facts do not cease to exits because they are ignored by MSM.  Unfortunately we are short on them and create overreaction in some areas of the country. In this sense Fauci and led by him institute of infections disease proved to be subpar. Fauci himself oscillated from "All is well folks" stance to "Wolf, Wolf" cries in the media in the matter of a two months. The fact the we understand very little about this virus explains "excessive zeal" with which quarantine was implemented in states outside such hotspots such as NY metropolitan area, where the most strict measures are completely justified.  The NY metropolitan area currently accounts for around 50% of all death in the USA  (26K out of 49K as of April 22)

Introduction

“Courage is not the absence of fear, but rather the assessment
 that something else is more important than fear.”

Franklin D. Roosevelt

The list of people [in MSM] that we can trust with insider insights
 that know the secrets of the epidemics seems endless. ~Ignacio


 

We need to know the enemy.  We need to know objective facts without usual MSM hype and fearmongering.  For example now it seems apparent that insistence that masks were not effective at containing the spread of the disease was part of a purposeful disinformation campaign by some public health officials and elements of the media. The reason for this was to prevent a run on masks when they are most needed by medical personnel.

But questioning MSM and checking the facts we can better protect ourselves, and people who are communicating with us.  Don't take the information below uncritically. Check the facts.  Now it is responsibility for all citizens to think.  But if you do not find errors then you need to agree that the situation with this epidemics is quite different from the situation depicted by MSM.  And that the neoliberal media is engaged in unnecessary and counterproductive fearmongering to raise number of clicks and get some additional money.  Mainly by abusing statistical data, especially the number of infected, and the number of deaths.  Mark Twain attributed to Disraeli famous quote: "There are three kinds of lies, lies, damned lies and statistics."  The meaning of this quite is not obvious. One that I suggest is that the graphs and other data from government agencies and subservant MSM constitute some form of propaganda. It is certainly possible to arrange and present data in such a way that they will pain completely distorted picture of events. How long is it going to take for people to realize that neoliberal media reporters main (and often only) job is to manipulate the facts to suit their own agenda !

Predictably, such daily accounting triggered fear and led politicians to make hasty, ill-advised decisions. Add to this staggering level of corruption of academic science and even international institutions under neoliberalism (with it "Greed is good" mantra):

The 2009 swine flu epidemic killed hundreds of thousands, mostly in Africa and Southeast Asia. But in Europe, where the threat was comparatively small, the media updated the death toll and the number of suspected cases on a daily basis. In the United Kingdom, the government predicted that as many as 65,000 citizens might die from the disease. In the end, fewer than 500 died.

Predictably, such daily accounting triggered fear and led politicians to make hasty, ill-advised decisions – such as stockpiling medication – without examining the evidence. All eyes were focused on the new, unknown virus, and not on protecting people from more lethal threats, such as seasonal influenza, which in 2009 killed orders of magnitude more people than swine flu. It still does – as would be clear if the media bombarded us with hourly updates of the flu-related death toll.

Similarly, millions of people, particularly in developing countries, die from malaria and tuberculosis each year. And in the United States alone, hospital-acquired infections kill some 99,000 patients annually. Yet, these unlucky people get next to no attention.

Why are we more scared of what is less likely to kill us?

[…]

[W]hen swine flu spread, many governments followed the World Health Organization’s advice and stockpiled Tamiflu, a medication that was marketed to protect against the severe consequences of flu. Yet, many expert advisers to the WHO had financial ties to drug manufacturers, and there is still no evidence that Tamiflu is effective. The US wasted over $1 billion, and the UK over £400,000 ($522,000), on this medication – money that instead could have been invested in improving health care.

Why What Does Not Kill Us Makes Us Panic, Project Syndicate, 12th March 2020

Fear is an enemy for developing and maintaining a critical perspective. The more we are frightened by graphs, by deaths, the more we are likely to submit to arbitrary measures which supposedly will keep us safe. Even if they are counterproductive to fighting the epidemic.  At the same time they hide the facts that were really alarming (Make America Defend Itself Again The American Conservative, Apr 15, 2020):

Americans were surprised to discover America doesn’t produce basic items such as medical facemasks, surgical gowns, and ventilators.

That also holds true for many of the medicines we depend on every day. The majority of antibiotics, blood pressure medications, even over-the-counter medicines like ibuprofen and aspirin are made overseas—and, to an unsettling degree, in China. A comprehensive list of the many recalls of defective pharmaceutical products and their source country would be enlightening for all of us.

So far we can assume that this is the disease of old and fat people, which disproportionally hits poor.  From The Lancet, a study of New York patients... Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study ( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31189-2/fulltext  )

Between March 2 and April 1, 2020, 1150 adults were admitted to both hospitals with laboratory-confirmed COVID-19, of which 257 (22%) were critically ill.

The median age of patients was 62 years (IQR 51–72), 171 (67%) were men. 212 (82%) patients had at least one chronic illness, the most common of which were hypertension (162 [63%]) and diabetes (92 [36%]).

119 (46%) patients had obesity.

As of April 28, 2020, 101 (39%) patients had died and 94 (37%) remained hospitalised.

203 (79%) patients received invasive mechanical ventilation for a median of 18 days (IQR 9–28), 170 (66%) of 257 patients received vasopressors and 79 (31%) received renal replacement therapy.

The median time to in-hospital deterioration was 3 days (IQR 1–6).

In the multivariable Cox model, older age (adjusted hazard ratio [aHR] 1·31 [1·09–1·57] per 10-year increase), chronic cardiac disease (aHR 1·76 [1·08–2·86]), chronic pulmonary disease (aHR 2·94 [1·48–5·84]), higher concentrations of interleukin-6 (aHR 1·11 [95%CI 1·02–1·20] per decile increase), and higher concentrations of D-dimer (aHR 1·10 [1·01–1·19] per decile increase) were independently associated with in-hospital mortality.

Lies, damned lies, and statistics

Neoliberal MSM concentrate reporting on total number of positive tests implicitly equating them with the number of infected.  But, to compare # of cases, we should take extra effort to factor in “per capita” and even “population density”. If we plot data from qualitatively different geographic units on the same chart, we should never use absolute data -- they are implicit propaganda.  Another critical omission is that neoliberal MSM do not provide us with the first and the second derivatives of daily cases (speed and acceleration). For example as of April 7, 2020 the acceleration is negative 6% and the speed  dropped from the top 32% a day (doubling in three days) on in first half of march 22,  to less then 10% (doubling in 20 days) in the first half of April.   On April 14 the acceleration is -8% and speed in increase is only 4.5% per day (5 days average.) The virus is losing its breath and can the move as fast as it did before, so to speak.  And as of April 20 the USA is clearly past peak (The New York Times, Apr 20, 2020):

Again only normalized per million of population number gives an opportunity to compare different countries.  For example, as of April 14, 2020  170K cases in Spain (population 46 millions) is much  more serious situation then 587K cases in the USA (population 331 million) as 3.7K cases per million is twice higher then 1.6K cases per million.  And in turn Spain situation is better the situation in Iceland for which there 5K cases per million. A classic example of alarmist propaganda disgusted as information is John Hopkins university site ( Burning Down The House Zero Hedge )

The graphic from John Hopkins is a perfect example of globalist produced propaganda that would make Edward Bernays so proud. There are 7.8 billion people on the planet and the Covid-19 graphic gives the impression 7.5 billion people have it. The entire U.S. is covered in blood red, as if the country is being overwhelmed in disease. Of course that narrative is entirely false.

Let’s put this over-hyped manufactured panic in perspective:

  • .0300% of the worldwide population has contracted the virus
  • .0020% of the worldwide population has died from the virus
  • .2250% of the U.S. population has contracted the virus
  • .0120% of the U.S. population has died from the virus

The current death rate projection in the U.S. is in the range of 65,000. In 2018 it was reported by the CDC that 82,000 Americans died from the flu. Now that their scary models have proven to be worthless, the medical “experts” are now trying to boost the death figures with no proof people died from the China flu. Since the incompetent boobs at the CDC, who told you not to wear a face-mask in March, but now want everyone to wear a mask, still aren’t close to having a method for testing everyone, we know many more people have been infected by the virus with minimal or no impact.

The death rate from this nasty virus is only marginally higher than the yearly flu. But the fear mongering has served the purposes of bankers, politicians, and corporate CEOs. The real catastrophe has been set in motion by the actions of the ruling class. Wall Street, once again, has used this contrived crisis to pillage and screw over Main Street.

Death also are pretty difficult to estimate correctly as statistics count both "death from coronavirus" (from virus pneumonia) and death "with coronavirus" (for patients who had one or more serious medical conditions, such as cardiovascular disease)  in a single bucket. Over 70% of death in NYC were people over 65 with serious medical conditions.  In other words most of them would die from a regular flu too. In this sense only difference in mortality with the previous year or with the average for the last five years shows the real picture. 

AGE Number of Deaths
 
Share of deaths With underlying conditions Without underlying conditions Unknown if with underlying cond. Share of deaths
of unknown + w/o cond.
0 - 17 years old 3 0.04% 3 0 0 0%
18 - 44 years old 309 4.5% 244 25 40 1.0%
45 - 64 years old 1,581 23.1% 1,343 59 179 3.5%
65 - 74 years old 1,683 24.6% 1,272 26 385 6.0%
75+ years old 3,263 47.7% 2,289 27 947 14.2%
TOTAL 6,839 100% 5,151 137 1,551 24.68%

[1] Underlying illnesses include Diabetes, Lung Disease, Cancer, Immunodeficiency, Heart Disease, Hypertension, Asthma, Kidney Disease, and GI/Liver Disease. [source]

Almost 50% of COVID deaths in Europe are as a result of the practice in richer EU countries of confining the elderly to nursing homes.  That explains  truly staggering differences in death rates between Eastern and Western Europe.  In the USA too nursing homes became real hotspots of this epidemic although the percentage of death is difficult to find. COVID-19 reveled often dismal condition and substandard care of inhabitants. 

A very interesting feature of this pandemic that in many countries average weekly mortality in February and March actually is lower then in previous years (GB, EU).  That means that the people who are dead are mostly the same who would be dead during any seasonal flu epidemic.  At the same time we can't deny that CODIV-19 virus pneumonia is a very dangerous disease indeed and unlucky fold who get it might be crippled for the rest of their lives due to scarring in lungs. But the actual percentage of people younger then 45 who get it is very small indeed (around 5% of total in NYC)  

If so, that means that just keeping retirees isolated would have approximately the same effect on flattening the curve as keeping all the population quarantined.  Without huge adverse effects on the economy we are now experiencing, when the level of unemployment exceeds that level reached during the Great Depression.  As neoliberalism destroyed social protection installed during the New Deal and switched most occupation to contractors losing employment is now as serious hit as it was in 1928.  Twenty-two million Americans are now unemployed. Experience of  Switzerland and Germany shows that it is the elimination of large gatherings together with mask wearing and social distancing that have had the main impact on reducing the infectivity of covid-19, not the lockdowns.

Experience of  Switzerland and Germany shows that it is the elimination of large gatherings together with mask wearing and social distancing that have had the main impact on reducing the infectivity of covid-19, not the lockdowns

The overwhelming number of people dying are very elderly and have many accompanying health problems. That seems to confirm the Swedish approach which is to protect the elderly and vulnerable with special laser-like protective measures, not destroy the economy and civilization with sledge hammer approach. Once again this exceptional neo-liberal nation is utterly failing so far as caring for their elderly and vulnerable citizens. Neoliberalism has developed a sickcare system that maximizes profits, not health. This means USA is particularly vulnerable. But now due to economic difficulties the pressure to "open" America will be pretty substantial and growing day by day.

To report the total number deaths rather than the number of deaths per million of inhabitants is obviously slanted.  It's also abundantly clear that the UK is following the same system as the US, Italy and others and erroneously treating deaths with Corona as deaths from. This is not standard medical practice and cannot be used as the basis for an accurate comparison with other mortality stats. The problem is that this almost certainly is not a mistake.  But it make comparison with average weekly or monthly morality for previous year the only valid metric to asses the danger.

Instead of providing truthful information, we are subjected daily endless tallies of infections and deaths, rocketing graphs, stories of young people, along with the elderly, battling for survival.   This is all nice, but average weekly mortality actually fells in GB and EU. And probably in the USA too (the average number of death in winter months in the USA is around 8K a day.) Such a  very strange, lives-saving, pandemic.  Also reporting just absolute number of deaths for a particular country is highly misleading. First of all countries have different population sizes, so the number should be reported along with normalized per million of people number. Secondly, it should be provided along with "natural" number of death per day for particular country, which for the USA is around 8K.  Weekly average for the previous year would be even better but that would distract neoliberal MSM  from seeking clicks and profit way too much ;-)

While the virus itself is less destructive that it was initially assumed, its effects on the population are amplified by the flaws of neoliberalism as a social system and that creates in some aspects a dangerous social situation with millions of unemployed and paralyzed by neoliberal ideology Trump administration.  Also neoliberal "for profit" medicine is far from the best medical organization to fight any such epidemic and it immediately showed.

In reality the term COVID-19 corresponds to a spectrum of illnesses, with virus pneumonia being the most severe but pretty rate outcome (around 7% of all cases). Out of those unlucky 7% only around one third (or around 2-3% of all tested positively) and mostly elderly and people with other serious medical conditions require ventilator. Unfortunately, a large number of them dies anyway (around 40%.)

Most infected people (over 98%) get a flu like symptoms which disappears in two to three weeks, or acute bronchitis type of disease which disappears in a month or six weeks. Around 88% of all infected does not require hospitalization. Only around 12% land in hospitals and  around 2.5% in intensive care.  That means that the number of hospitalizations is a more important metric then the total number of infected. But it is not reported. May be intentionally.  Still we can estimate them as 12% of all cases. And it is clear that in the USA we are far from overflowing hospital system.  Similarly, if we assume that all ICU patients are on ventilators (which is definitely not true)  it looks like the USA is well stocked with ventilators till then end of this epidemics and Cuomo cries about 40K ventilators that NY needs is overinflated nonsense.  Moreover it looks like ventilators are abused by hospitals as then get more money for patients with ventilators.  There is some information that most patients are better off on oxygen only.

It is the number of hospitalizations that determines whether we need to flatten the curve or not: only a large scale increase in the average number of hospitalization per week creates is a danger the patient intake overflow available hospital beds. So far with only around 40K hospitalizations in the USA  COVID-19 is very far from this state.  If there are only 40K hospitalizations nationwide, and in no way you need more then  25% ventilators  out of the number of hospitalized so Governor Cuomo cry about additional 30K just for NY is a little bit suspect ( see New York Governor Cuomo pleads for 30,000 ventilators - CBS News.) Actually he asked for 40K (NEW YORK GOVERNOR CUOMO SAYS HAS ORDERED 17,000 VENTILATORS FROM CHINA) The question arise: is Cuomo cries about possible lack of ventilators an attempt to hoard more "just in case" or stupid political posturing ?

All-in-all statistically COVID-19 epidemic is not that different from 2017-2018 flu season. We also endure 250,000 annual deaths from medical negligence. The question arise why to instill this regime of fear and so badly damage the US economy?

The exponential growth of new "tested positive" cases that was the fuel for neoliberal MSM hysteria was actually typical for any early stages of any flu epidemic.

Farr’s Law is observed with all viral diseases and describes the rate at which a viral infections increases and then declines in a given population. Initially, the virus has practically unlimited hosts and the rate of increasing infection is exponential.

As more people become infected that rate declines. The numbers still increase but the rate of that increase drops sharply. Once the rate starts to decline virologists and epidemiologists can then predict the scale of the outbreak with some confidence.

It ended in around four weeks, around March 22 but the damage by neoliberal MSM was already done. All-in-all there are some reasons to think that COVID-19 will be similar to 2017-2018 influenza epidemic and will have around 60K death in the USA. But comparison with the 2017-2018 flu season were never was an important part of the story told by neoliberal MSM. They preferred raw number of daily deaths and number of people tested positive to fuel hysteria.  The question now when we see the peak after which the number of new cases with stably decline. From a simple model that I created it looks like such peak should happen around late April, early May if the current dynamic will continue.

The same conclusions can be inferred from JP Morgan charts reproduced below:

And here is an updated curve from the same source as of Apr 4 (funny they remove Iran, which also probably entered recovery phase):

A question arise: Which country among those which are in advance stages of epidemic the USA resembles more closely? China, Italy, or some other country? If the USA is more-or-less close to China curve starting with the day with 100 new cases (March 7) then the lag is approximately 9 weeks and the peak can be expected somewhere in the second half of April:  in China the period from 100 new cases a day to the peak was around 6 weeks: from early January to mid February.

The question also arise, if we went into lockdown what will happen if lockdown is lifted and people return to work. Will the epidemic re-emerge and invalidated sacrifices caused by the lockdown? Hopefully not.  Please note that social distancing was a norm when mankind dealt with tuberculosis epidemic. and that quarantines were imposed on  affected cities since Roman empire or even earlier.

Is this a new Spanish Flu? Farr's law of epidemics

First of all, nothing is new under the sun. Epidemics, like wars and financial crises, have been a recurrent occurrence for all written history of human civilization. Often they start the decline of empires like, for example,  The Antonine Plague:

The extent of the epidemic has been extensively debated: the majority of authors agree that the impact of the plague was severe, influencing military conscription, the agricultural and urban economy, and depleting the coffers of the State.

,,,This period, characterized by health, social and economic crises, paved the way for the entry into the Empire of neighbouring barbarian tribes and the recruitment of barbarian troops into the Roman army; these events particularly favoured the cultural and political growth of these populations. The Antonine Plague may well have created the conditions for the decline of the Roman Empire and, afterwards, for its fall in the West in the fifth century AD.

They go though several well defined and more-or less symmetrical phases (on figures above it is "Early development", "Acceleration", "Late Accumulation", "Recovery") and eventually phase out. There is so called Farr’s Law of Epidemics (discovered by Dr. William Farr  in 1840). He showed that during the smallpox epidemic, a plot of the number of deaths per quarter followed a roughly bell-shaped or "normal curve", and that recent epidemics of other diseases had followed a similar pattern.

Farr’s Law of Epidemics states that epidemics tend to rise and fall in a roughly symmetrical pattern or bell-shaped curve. The flu season operates under the same curve. It rises is fall and descends in spring. That also has something to do with the weather.

Hundreds of horrible epidemics have killed countless millions of people during middle ages (Black Death, cholera, etc)  and even quite recently Spanish Flu (1918) which caused virus pneumonia somewhat similar to virus pneumonia observed now with COVID-19.  Each lasted a certain time usually less then a year.  There might be several waves or the disease  the subsequent years. That was the case with the Spanish Flu with the second wave that more devastating.

This epidemics can't even be classified as something similar to the Spanish Flu epidemic (Before lockdown, Britain quietly downgraded status of coronavirus threat - Washington Times )

...health officials in Britain quietly lowered the official threat level for the pandemic, saying the COVID-19 virus did not meet the criteria to qualify as a “high consequence infectious disease” (HCID).

...“Now that more is known about COVID-19, the public health bodies in the UK have … determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.”

The statement said a government body that deals with pathogens agreed the virus did not merit the HCID designation, but also added that the risk to the U.K from the outbreak “has been raised to high.”
 

Yes it is pandemic, but the mortality so far is very modest and in many countries (GB, EU and probably the USA too) average weekly mortality droped not increase.  Or increases statistically insignificantly (winter months already have higher mortality, sometimes drastically higher).

In other words this is not Spanish Flu II. Far from it. And we are much better equipped to fight it than in 1918. For one thing we now have is Internet. Another is genomic sequencing and the modern bioscience (which might contribute to the emergence of this virus if it was accidently leaked from one of biolabs). 

The video, which had racked up over 5 million views on YouTube, featured Dr. Dan Erickson and Dr. Artin Massihi, co-owners of Accelerated Urgent Care in Bakersfield, Calif.

In the clip, Erickson asserts that there is only a 0.03% chance of dying from COVID in the state of California,” prompting him to ask:

“Does that necessitate sheltering in place? Does that necessitate shutting down medical systems? Does that necessitate people being out of work?”

In any case, contrarily to the opinion of governor Cuomo and some neoliberal MSM,  it looks like the USA now entered at the stage of deceleration of daily infections speed - JPM called it "late accumulation phase" in pictures above (we are  down from 34% increase per day in mid March to less then 10% as of Apr. 7, 2020). Crying wolf at daily number of death is very disingenuous. On average 8K people dies in the USA at any given day ( a day not a month). The evidence suggests that this virus so far it failed to rose to the level of danger of a dozen of common infection, which do not make any headlines. I will name just three:

  • Tuberculosis. In 2018 10 million people worldwide fell ill with tuberculosis worldwide (5.7 million men, 3.2 million women and 1.1 million children). TB  kills approximately 1.5 million per year (WHO). Neoliberal MSM for some reason are completely silent about it.
  • Influenza. The overall burden of influenza for the 2017-2018 season in the USA was around 45 million influenza illnesses, 21 million influenza-associated medical visits, 810,000  hospitalizations, and 61,000 deaths (Table: Estimated Influenza Disease Burden, by Season — United States, 2010-11 through 2017-18 Influenza Seasons). So far CODID-19 has less then 30K hospitalizations and less then 10K deaths )as of April 5. 2020.) In other words this is an event of lesser magnitude. This will change with time, but to cover 10 times gap that exists on April 5,  2020 (approximately a month since the epidemics started in the USA in full force)  for COVID-19 will be not that easy.  It might eventually become equal, but that's it.
  • Swine flu epidemic of 2009-2010. Although everyone seems to have forgotten the swine flu epidemic which lasted from spring 2009 through early 2010 it infected nearly 61 million people in the US . And it claimed as many as 18,000 lives, according to a Centers for Disease Control study published in 2011. In total, the disease is now believed to have caused more than 200,000 deaths worldwide.

The question arise: why the USA reacted more clumsily now that in case of Spanish flu.  The answer is that neoliberalism is the social system that denied the value of human solidarity and exaggerates that value of profit motives and competition. It is also a social system based on elaborate system of myths maintained by neoliberal MSM and that prevents honest reporting. None of those is helpful in fighting epidemic and the USA blunders shows this quite vividly.

None of drastic measure taken were implemented properly. Why first responders, police officers, and grocery shore employee did not received masks from the government. None of them can keep social distance and they all have increase chance to get infected and infect others.

Why there was no mandated splash on sanitizer on hands of customers who entered the store?  Where are the strategic stockpiles of masks and sanitizer, anyway.  Or they do not have them in a country with one trillion military budget ? And why Pentagon is sending million masks to Israel IDF, if it can't provide masks to its sailors on infected ships? 

Nursing homes were not properly protected and that created several cases when almost all inhabitant and medical personnel got COVID-19. See for example Pennsylvania nursing home says all 800 patients and staff have COVID-19

Why Trump administration slept all January and February despite warnings from intelligence agencies (OK the first half of Jan was spoiled by idiotic impeachment proceedings initiated by this aged Trump nemesis Pelosi). I would understand that the measures were taken in the second half of January (especially at NY metropolitan area -- the natural USA hotspot for such an infection). But they were taken only on April 11, or so.  Rollout of test was completely botched. Even air travel restriction were implemented only in March, when the horse left the barn. They have full information about China situation from all sources including not only intelligence agencies, but open sources and WHO. My God, even on Fox news there was information about China situation.

If this bureaucratic incompetence or criminal negligence?  Why doctor Fauci was sitting on his butt, and did not fly to Korea to understand the situation?  Why the USA did not establish the virus task force in Korea in January to learn how to fight the infection?

And what about CDC botched rollout of test. That was really criminal negligence in full glory.  And I do not even want to start to talk about lack of masks and other protection equipment. For a country with one trillion military budget this means textbook example of bureaucratic incompetence and hubris.

BTW cherished private sector was also caught without pants. Why this greedy billionaire Bezos did not provided masks for his wage slaves? He has direct commercial contacts with China. See  An Amazon Warehouse Is Dealing With a Coronavirus Outbreak - Bloomberg  And why when this was discovered we did not put him under criminal investigation for intentional spreading of deadly disease?  In no way Amazon can provide secure social distancing for its workers. Why senators who sold stocks after briefing about coronavirus still are present in the Senate? Why mandatory wearing of masks in public places and selective closure of  entertainment  venues such as night club, bars was introduced so late  With mandatory wearing of masks some level of social distances can be achieved by less drastic measure then closing. For example, in China restaurants staff put a glass divider  between two persons sitting on opposite side of the table to that they can't infect each other. And spacing between tables increases to more then a meter. Simple and effective.

Questions, questions...

Of course, nobody is insured against getting the virus pneumonia. And some people unfortunately will die of it. But in case of coronaviruses,  which infects humans  for 3500 years (or more) even minimal and well known hygienic measures as outlined in popular materials drop chances to get infection by an order of magnitude. Ten times ! We now know that the most infections occurs in closes spaces such as homes, offices, conference rooms, churches, etc  so you need to wear a mask to diminish changes of getting a virus doze that will provoke infection.  And the place where 80% of infections occur is families, not public places.  Why CDC mandated wearing mask to exposed workers only on April 8:

He said the new guidelines, for essential workers who have been exposed to coronavirus and are asymptomatic, is to wear face masks, take their temperature, and practice social distancing.

You also have a moral responsibility to protect other people and that means wearing a mask in public places. So even in the absence of vaccine and proved treatment for this infection we are not powerless. As most coronaviruses are seasonal spending more time on sun and fresh air to boost your immune system might also help a little bit.  In 1918 this method was also used for sick patients during epidemic of Spanish flu (which, paradoxically, was more deadly for young then for old people) with very good results. 

Does virus spread in selected "hot spots" or it spreads all over the given country like "wild fire"?

The current MSM mantra is that COVID-19 will spread evenly across the USA like wild fire so that each major city eventually will become like New York is deeply wrong.  The percentage of deaths by Covid19 in the USA is 17.8 per million citizens, which corresponds to the usual percentage of seasonal influenza. And hot spots are mostly limited to densely populated cities with subway and high rise housing.   In less populated areas regions social distances is easier to implement and is more effective.

COVID-19 hospitalizations and deaths  rates per 1,000 inhabitants reveals important clustered patterns: COVID-19 clusters in few hot spots according to principles of communicability. In the USA infections with coronavirus  are clustered in single interconnected  region of two states NY, NJ (New York metro area). This region with around 16 million people accounts for ~ 50% of all tested positively. Similarly, 60% of Italian deaths occurred in the Milan metro area, and this trend continues. Where to allocate resources is always a tough choice. But the  military axiom is that "he who defends everywhere defends nothing" is fully applicable [ COVID-19 is occurring in clusters, making good data and resource allocation crucial TheHill ]

Is neoliberal MSM coverage of epidemic "prurient, intrusive, unbalanced and designed to cause hysteria"?

All that means that we should resist unsubstantiated attempts by neoliberal MSM to create panic and promote false narrative. As Craig Murray  stated "The coverage is prurient, intrusive, unbalanced and designed to cause hysteria." (see also Dr. Wolfgang Wodarg Confirms this is an Insane Panic video). They have their own agenda (probably two: money and the desire to depose Trump)  that does not correlate with the interests of American people.  Think about the fact that they report total number of tested positively (which is large number which contain probably around 30% of false positives), but not the number of hospital admissions, cases requiring ICU,  or other relevant metrics outlined by WHO:

  • Weekly number of new COVID-19 cases hospitalised
  • Weekly number of new COVID-19 cases treated with mechanical ventilation or ECMO or admitted in intensive care unit (ICU)
  • Weekly number of new cases and new deaths, by age-group in year (using: 0<2, 2<5, 5<15, 15<50, 50<65 and 65 and above; or similar)
  • Cumulative sex ratio of confirmed cases and deaths
  • Total number of laboratory tests conducted
  • Total number of tests that are positive for COVID-19

You will never find this data in neoliberal MSM.  Weekly statistics comparing number of deaths in February and March 2020 in the USA with the corresponding number from previous years (or, better,  the average for ten previous years) is absent.  That is another clear sign of the bias of neoliberal MSM, and the sign that they are trying to inflate the threat.

Weekly statistics comparing number of death in February and March 2020 in the USA with the corresponding number from previous years (or, better,  the average for ten previous years) is absent.  That is another clear sign of the bias of neoliberal MSM, and the sign that they are trying to inflate the threat.

So far only Italy recently showed a statistically significant excess number of deaths. At the same time 85% of those who died in Italy are over 70 and they died from other medical problem aggravated by coronavirus infection : ~88% of patients who have died have at least one pre-morbidity - many had two or three. Also Italy has an older population, the largest in Europe and second only to Japan.

European total mortality continues to decline since Feb. 10. This might be the rare pandemic that saves lives, since mortality has declined throughout the crisis.

European total mortality continues to decline since   Feb. 10. This might be the rare pandemic that saves lives, since mortality in EU has declined throughout the crisis.

Let’s put it straight: as for the capacity to kill people SARS-CoV-2 is a weak, inferior to Spanish flu, virus.

Let’s put it straight: as for the capacity to kill people SARS-CoV-2 is a weak, inferior to Spanish flu, virus. As of March 25, 2020 the total number of deaths worldwide from coronavirus worldwide ( around 22K for approx. three months period ) is comparable with the number of births in three hours ( ~10-16K per hour )

As of March 25, 2020 the total number of deaths from coronavirus worldwide ( around 22K for approx. three months period ) is comparable with the number of births in three hours ( ~10-16K per hour )   (Sic Semper Tyrannis):

In one hour there are 16,000 new births around the world. And how many have died from the Corona virus since the first of January? 15,328 (from John Hopkins as of 10:40 am). That works out to roughly 8 deaths per hour globally. Catch my drift? If someone you love and care for dies of Corona virus it is a sad, tragic loss. I get it. But the reality of Mother Nature is that life is far more potent than death.

...Please also consider that as a percentage of the global population, the number who have tested positive is .00004 % (in other words, 4/10,000 of a percent). That number barely registers.

...More perspective - literally thousands of people around the world die every day due to Hep B and C. Literally thousands die every day due to TB. AIDS kills thousands a day. These are all contagious diseases that fester in the third world. Yet those almost incredible death rates don't even register in the US and up to a couple of weeks ago, the Democrats were calling for open borders; which would have allowed those contagious diseases into the country unmonitored. Why no hysteria over any of those (all of which have been increasing prevalence in the US in recent years)?

Does the damage to the economy caused by the overreaction exceed the damage to human health caused by the virus?

Some public health professionals have been pleading with authorities to consider the implications of the unreasonable, disproportional response (Could the Covid19 Response be More Deadly than the Virus – OffGuardian) including total quarantine instead of obligatory wearing of masks in public places.

This is a strong scientific evidence as for irrationality of prohibition of such outdoor recreation as running, closure of parks, persecution of fishmen, etc: virus infection predominantly (99%) happen indoors, especially in family setting. So isolating infected family members is more important then closing parts and other recreation areas. Moreover people who spend most of the time indoors have a weaker immune system that makes them more vulnerable to the infection (that is typically true for large cities dwellers even without any epidemic).

This fact is also a strong argument for enforcing universal wearing mask indoors, especially in grocery stores which otherwise became a vector of transmitting infections.  That was not done in the USA 9even store personal did not wear masks until mid April) with corresponding consequences.

Many experts have spoken out publicly, criticizing the overreaction to COVID-19. A professor of medical microbiology, for example, has written an open letter to German Chancellor Merkel in an attempt to draw attention to the concerns.

The real problem we face today is not a virus. The greater problem is that people have failed to engage in critical thinking due to the fear promoted by some media and government officials. Ultimately, the fear of COVID-19 and the lack of critical thinking that has arisen from it are likely to cause far more deaths than the virus itself. The level of fearmongering in US MSM does not correlate with the known facts about the virus and suggests the neoliberal elite (aka bankers and the Deep State)) decided to use this tragic event as a cover-up for organizing "soft landing" of the USA economy, which was on the brink of economic recession since September 2019.

Is MSM fearmongering a yet another attempt to depose Trump and/or the neoliberal elite decided to use this tragic event as a cover-up for organizing "soft landing" of the USA economy, and first of all its overextended and overleveraged via derivatives banking sector (financial oligarchy rules this country.) As Senator Durbin aptly said: " The banks — hard to believe in a time when we're facing a banking crisis — that many of the banks created — are still the most powerful lobby on Capitol Hill. And they frankly own the place." Interview by Bill Moyers, Bill Moyers Journal, PBS, May 8, 2009.

While the virus might be natural,  despite widespread rumors that it was bioengineered and escaped from the lab accidentally, corona panic is definitely not a natural phenomenon. It is artificially created (Wake Up! Your Fears Are Being Manipulated The American Conservative):

There are many reasons to take prudent action. There are no good reasons for fear and panic. The fear being promoted has no rational basis compared to regular influenza and the swine flu of 2009. We have a terrifying example in 9/11 of how easily manipulated fearful people are. Remaining calm and helping others do so is a big part of what your contribution to the disaster relief could be.

... ... ..

robt -> Ossian the Bard 11 hours ago

From the UK Government: Status of COVID-19

As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK....They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.
https://www.gov.uk/guidance...

Yes, virus pneumonia caused  COVID-19 is a very dangerous, often life threatening disease, with possibly long term negative health effects for some of the affected individuals (fibrosis of the lungs).  But it hits a very small percentage of all infected (serious cases in the USA are around 2-3% of all tested positively), mostly (but not exclusively) people over 60.  Most deaths occur in an "over 70" age group and it is difficult to say whether they die "from the coronavirus", or "with the coronavirus" as most have other serious medical conditions.  In other words in most such cases COVID-19 infection was just "the last straw that broke the camel back", and they would die if infected with regular seasonal flu too. 

It looks like R0 (number of people that an infected person will infect) for this virus is unusually high, which makes this virus the most infectious among its predecessors and seasonal flu. And that guarantees the initial exponential curve of cases.  But this is not the whole story.  What MSM do not tell us is that the percentage of population that is susceptible to the virus. Among Wuhan medics only 60% became infected. Among Diamond Princess cruse ship population only 20%. It is logical to assume the for the USA population the figure is closer to 20% then to 60% of the  total population.  Please note that the USA population is much younger then the population of Diamond Princess which improves prognosis.

Also while the US government fell flat on its face as for testing (and distribution of masks),  many European countries which are testing all contacts and family of confirmed cases in addition to wider “random” testing (starting with medical personnel, supermarket staff etc.) also report growth of cases. But more and more countries entered "deceleration phase" and some are over the peal. In such circumstances , the R0 is probably less than one, and might be as low as 0.1.

The mortality of the virus is probably overhyped ( based on cruise ship epidemics data it is probably around 0.2%, not 2-3% figure propagated by MSM) as most of the deaths of older people tested positive for the virus are attributed to the virus.  The question is why ?  This is not the first virus pneumonia that hit the USA. Why this time the reaction is completely different?  Is this because the virus provides justification for drastic measures and as such help to ensure "soft-landing" for the USA economy which was about to enter the recession? I  do not know. Speculations are rampant.  See The threat of "Coronavirus recession"

In the current situation, when neoliberal MSM are engaged in fearmongering,  humor greatly helps, serving as a powerful antidote.  One outstanding example of COVID-19 related humor is  Torn - Natalie Imbruglia (#Coronavirus Parody)   Another great parody is Covid-19 Global Lockdown  by CJ Hopkins. Softpanorama political humor section contains some related items too.

Concentration on fearmongering ("K infected and N dead for a day in country XXX.  Horror!") leaves the public with a new health concern to worry about, but no useful knowledge of the actual factors involved in this epidemics.  I wonder if anyone has data about the number of deaths this year and the number of deaths in the same period in previous years? I suspect such data might well show no excess deaths. For example, coronavirus actually reduced mortality in GB:

Steve Hayes ,

According to the Office of National Statistics, in the week ending the 6th of March 10 895 deaths were registered in England and Wales. The average number of deaths registered for the corresponding week over the previous five years was 11 498. So the coronavirus appears to be reducing mortality. https://www.ons.gov.uk

Over 90% of infected individuals have only mild symptoms and almost none in case of the infected are children and teenagers. If so, what was the criteria of closing schools (children usually are not infected in school settings or public places; China data suggest that they are infected mostly in family settings). Former Presidential candidate Andrew Yang  made the following apt observation (https://www.politico.com/news/magazine/2020/03/17/coronavirus-universal-basic-income-andrew-yang-134922):

YANG: That’s what freaks me out about the whole thing. What we’re doing is saying things like, “Keep your social distance,” and trying to stop the spread that way, which is fine. But we have shit for data. Like, we don’t know what the infection rate is. And so, there’s no reason we would ever be able to give the ‘all-clear.’ If you don’t have any data, this whole thing is a nightmare that doesn’t end.

When you close schools, what gives you the all-clear to say, “OK, open them again”? Nothing. There’s no data to compare it to. This whole thing is a fear-based approach with no end in sight. There’s no catalyst to ever sound the all-clear. This whole thing is so fucked up.

... ... ...

We need to know now what the future can look like under different scenarios and then be presented with what scenario we’re in when that time comes. We’ve been on lockdown for half a week. Right now, the American people don’t have any visibility into whether it’s going to be four more weeks or four more months, and we don’t know how those judgments are going to determined. As president, I would say, “Look, here’s the information, here’s the dashboard, here’s what we’re lining up, here’s what we’re hoping for, here’s how circumstances could change, and thank you for doing your part — if you proceed with like the rest of the country in flattening the curve and keeping things under this level, then we can look forward to this.” You know, so we could actually have a sense of accomplishment and purpose.

It is impossible to make informed judgments without definitive data about lethality of the this virus. Which probably is considerably less in Western countries than the current inflated number of 2-3%.  The latter is the result of counting "deaths with the virus" instead of "deaths from the virus".

Pft says: March 25, 2020 at 4:51 am GMT • 100 Words

...Report shows up to 88% of Italy’s alleged Covid19 deaths could be misattributed

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,”

– Professor Walter Ricciardi, scientific adviser to Italy’s minister of health
Report in English:

https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf 

Does COVID 19 spread mostly indoors with most of infections within family settings?

The answer us yes. Moreover the virus acts very selectively: it predominantly affects people in dense urban areas with immune system weakened by stress and poor air quality, hitting hard city poor (who are often obese).  In NYC Afro-Americans in the USA constitute almost 50% of hospitalized.

As for the spread we seem to define a terminology first. The term “aerosol” is generally taken to mean small water droplets dispersed in air carrying virus – and WHO has emphasized from the very beginning that this is the primary means of transfer. By contrast, the term “airborne” is used to describe free dry virus particles floating in the air at sufficient levels to cause infection.

Transmission  of coronaviruses is usually via droplets to the nasal mucosa or saliva of the affected person.  So it is transmitted via aerosol. 

According to the WHO, the primary mode of transmission is via respiratory droplets that people cough or exhale.[257] According to the CDC, it is thought to spread when people are in close contact, via these droplets, often during coughing or sneezing.[258][259]

The European Centre for Disease Prevention and Control (ECDC) concurs that it seems to spread via these droplets, during coughing, sneezing or exhaling, but "[t]here is not enough epidemiological information at this time [21 March] to determine how easily and sustainably this virus spreads between people."[260]

But the virus is not airborne -- there is no evidence that you can became infected via viruses in dry state spreading over the air. The working assumption is that when the drop of water dries the viruses in it became less active (you need much higher dose to be infected) or inactive (you can't be infected).  If droplet landed on some surface it might take some time for the virus to disintegrate (see below) and you can infect yourself by touch first infected surface and then you nose, eyes or mouth.  But how common is this infection path (outside people with  dry nose, dry eyes problem who often touch nose/eyes with hands) is completely unclear.

A Chinese study found that more that 99% of all infections happen indoor:

A Chinese study found that more that 99% of all infections happen indoor:

Home outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport (108; 34.0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases.

Conclusions: All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk.

A non-scientific study by Quillette has looked a super spreading events during which dozens or hundreds were infected at one time in one place. The result in short is that everything that is fun should now be prohibited:
When do COVID-19 SSEs happen? Based on the list I’ve assembled, the short answer is: Wherever and whenever people are up in each other’s faces, laughing, shouting, cheering, sobbing, singing, greeting, and praying.

This is a strong evidence as for irrationality of prohibition of such outdoor recreation as running, closure of parks, persecution of fishmen, etc.

The virus can be transmitted by infected individuals before the symptoms develop (incubation period). And first of all that means by children, students and young adults among which this virus of often looks like a light flu.  They are kind of Trojan horses in this situation. As incubation period can be quite long from 2 to 14 days with five days as the average.  That makes wearing masks in public places an important safety measure designed to protect those who are not infected from those who are already infected, but do not know about it:

"A new analysis by a team of Canadian and international researchers suggests that the novel coronavirus can be transmitted by infected individuals before symptoms develop – a possibility that could explain why the spread of the epidemic has proved so difficult to contain after it first appears in a new location. “It means we would not be able to stop all the transmission events by focusing on cases who have already developed symptoms.”  -GlobeandMail.ca

The World Health Organization released a study on how China responded to COVID-19.  The results of their research show that COVID-19 doesn't spread as easily as first thought. The majority of viral infections come from prolonged exposures in confined spaces with other infected individuals. While there is no direct evidence it looks like you need several minutes of contact, if not more.  That's why most infections acquired in family clusters (around 80%.)  From the WHO report, https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

"When a cluster of several infected people occurred in China, it was most often (78-85%) caused by an infection within the family by droplets and other carriers of infection in close contact with an infected person.

Routes of transmission

COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission based on available evidence; however, it can be envisaged if certain aerosol-generating procedures are conducted in health care facilities.

Household transmission

In China, human-to-human transmission of the COVID-19 virus is largely occurring in families. The Joint Mission received detailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces. Among 344 clusters involving 1308 cases (out of a total 1836 cases reported) in Guangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families. Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong estimate the secondary attack rate in households ranges from 3-10%.

It looks like the virus can spread with the aerosol exhaled by asymptomatic person (without any coughing and sneezing), but this is unproven and in any cases such infection constitute a very small percentage of all infection. But if true, this make virus very dangerous indeed (Marc Wathelet, a virologist and specialist in coronaviruses and respiratory diseases )

I worked in an institute dedicated to respiratory diseases and there the work on aerosols, chemical or infectious, is done every day, it is perhaps 10% of their activities; I have absolutely no doubt that this virus is transmitted by aerosol, if I can leave my reserve as a scientist who must doubt everything. In an emergency situation, we follow the preponderance of evidence.

The stability of the SARS-CoV-2 virus in the air and on various surfaces is believed to be comparable to that of other coronaviruses.[261][262][263]

In any case the primary mode of transmission is via respiratory water droplets that infected people cough or exhale. And they are quite large, much larger than the viruses. In no way to  filter the viruses you need a special N95 mask. So regular surgical masks are very effective and essentially block infection lowering you risk at least five time as they do not allow for the virus to acquire "a critical mass":  

The virus starts to replicate in significant numbers (billions per milliliter) on day 2 after the infection. The virus first replicates in the upper throat and the infected person starts to spread it to others simply by breathing, talking or coughing.

Only on day 5 the infected person starts to develop first symptoms. The virus migrates into the lower lung and replicates there. The virus load in the upper throat will then start to decline. The immune system intervenes and defeats the virus but also causes additional lung damage which can kill people who have already other preexisting conditions. (Interestingly smokers seem not to develop a cytokine storms during a COVID infection and are thereby less prone to end up in the ICU.)

On day 10 only few viruses will be found in the upper throat and the person will generally no longer be infectious.

The typical hospitalization point in China was only on day 9 to 12 after the onset of symptoms. At that point a test by swabs is nearly useless as the infected person will normally no longer have significant numbers of the virus in the upper throat. Reports of "defective tests from China" were likely caused by a lack of knowledge about this phenomenon. The diagnose in these later cases should be done by a CT scan which will show the lung damage.

That's why 100%  wearing regular surgical masks in confined spaces is of paramount importance. It is not important and even harmful to wear masks in open spaces: you are fighting nonexistent threat, unless you are standing in line or other high concentration of people. 

Wearing regular surgical masks in confined spaces is of paramount importance. It is not important and even harmful to wear masks in open spaces: you are fighting nonexistent threat, unless you are standing in line or other high concentration of people. 

Also if everybody is wearing mask infected people spread diseases much less, which is important for fighting this epidemic.  Quarantine alone does not solve this problem: For an infected person staying at home, R0 simply becomes the number of other people in their household. Which suggest the focus should be on critical classes of workers, like hospital employees, grocery store clerks, first responders, etc.  They (and not the office worker staying home) are the most vulnerable population that is spreading the virus and theoretically should wear masks at home to prevent infections of other members of the household.

The USA government make a blunder when it does not supply citizens with a couple of masks and enforce wearing of masks in public places they can be easily disinfected by putting them in over and setting 70F for half an hour). 

The USA government make a blunder when it did not supply citizens with a couple of masks via pharmacies and enforce wearing of masks in public places like China did.  They can be easily disinfected by putting them in oven and setting 70F for half an hour).  Fauci should be fired for incompetence.

They protect uninfected people from infected and also diminish that doze of the virus uninfected people inhale if you are in contact with the infected person. If infected person is wearing no mask and you are wearing the mask, the dose is probably five time less, then if both are without the mask.  If both are wearing the masks the dose is probably hundred times less and might not cause the disease at all.  Comment from Unz.com. March 31, 2020):

Enormous numbers of medical staff can still be seen wearing the simple type of face mask and, of course, this will be a pretty good first line of defense by catching those aerosol droplets. However, a droplet caught by the gauze will quickly evaporate leaving the virus behind and there is a reasonable chance this will then be inhaled.

Still, simple masks are surely better than none and these are likely to be the only type readily available at this time for most of us – WHO downplays their value except for people who are themselves infected.

I am shocked to see supermarket check-out clerks still without any sort of mask.

The inability of the USA government to supply masks for frontline personnel like supermarket clerks is really damning. They actually do not care one bit about the people. In view of the size of the USA military expenses that makes textbook case of bureaucratic incompetence: there should be a stockpile of masks that provide at least two masks per person in case of such emergences. They can be distributed based on driver license.  

The inability of the USA government to supply masks for frontline personnel like supermarket clerks is really damning. They actually do not care one bit about the people. In view of the size of the USA military budget that's a really inexcusable blunder

That main danger of the respiratory coronaviruses is that they can cause disease of the lower airways including virus pneumonia,  but it is unlikely that this is due to direct infection via droplets. Most probably this is Stage II of the disease after the virus replicates locally in cells of the ciliated epithelium, causing cell damage and inflammation and releasing a new generation of viruses, which propagates down into lungs. 

Some specialists suggest that there is a strong association between the intensity of exposure to virus (which is highest in family and hospital settings) and the severity of subsequent disease is seen in other infections like measles (How Does the Coronavirus Behave Inside a Patient- - The New Yorker). In other words there might be a "critical mass" of virus particles that you need to inhale to become really sick:  

“If you acquire measles through household contacts, where the density and dose of exposure is the highest—you might be sharing a bed with an infected child—then you typically have a higher risk of developing more severe illness,” he said. “If a child contracts the disease through playground or casual contact, the disease is usually less severe.”

That hypothesis explains why medical workers  are affected more severely than the rest of the population -- they have much more severe cases than that control group.

That also suggests that the person who bought the virus into particular family might have suffer from a lighter form of the disease while the other members of the same family who he/she infected will have more severe cases.  But this is not proven fact, just a speculation.

If we could identify pre-symptomatic patients who were likely exposed to the highest doses of viruses—someone cohabitating or socializing with multiple sick family members (as with the close-knit Fusco family of Freehold, New Jersey, which has had four deaths), or a nurse exposed to a set of patients shedding large amounts of the virus—we might predict a more severe experience of the disease, and give them priority when it came to limited medical resources, so that they could be treated faster, earlier, or more intensively.

There is still a controversy whether people who have no symptom (asymptomatic cases) can shed the virus into their surrounding and if yes, how (on their skin, breathing, via kisses, handshakes, fecal masses, etc). See, for example, Presumed Asymptomatic Carrier Transmission of COVID-19 Global Health JAMA JAMA Network (February 21, 2020) in which transmission to relatives in a family cluster is assumed.  If the findings in this report of presumed transmission by an asymptomatic carrier can be replicated, the prevention of COVID-19 infection would prove very challenging indeed.  But for now the working hypothesis is -- "no symptoms, no transmission." Respiratory droplets may be produced during breathing but right now the virus is not considered airborne.

Typical incubation period for older coronaviruses is three days. For Covid-19 it is longer with the average of 5 days ( and range 2 to 14 days.) On what day the infected person starts to produce viruses is unclear, but probably not before he/she develops at least minor symptoms like running nose or dry cough. The patient definitely spread the disease, if his are affected with pneumonia.  Approaching such a patient without protective clothing and face mask is dangerous. But that typically what is happening in family settings.

The most important current assumption about this new virus is: the virus does not spread with the breath of an infected person that has no symptoms. He/she needs to cough or sneeze and in this case droplets can travel long distance.

But sneeze and cough germs travel farther than you may think (Business Insider, November 2018)

  • The main path of infection is via air droplets from infected person to nasal surfaces of affected persons.  .  The infected person does not generate the virus all the time, only when he cough of sneezes.  That's why, unless you are and/or infected person is wearing mask it is dangerous to be within 6 feet (2m) from infected person, who is coughing or sneezes. That also means that a simple and effective measure against  spreading of the virus is uniform 100% wearing of face masks in public places with great concentration of people, where you can't keep the social distance. Such as shops, trains, buses, etc. 
  • It is still unclear is how long infected droplets exist in aerosol (they probably gradually fall to the found under influence of gravity) and what time is time when the air clears of them, if at all.  Probably they can remain suspended for up to 10 minutes. Some sources claim that this period is much longer -- 2-3 hours.
  • It is unclear whether they are propagated via air conditioner Air conditioners have filters which can't filter the virus (which is several hundred nanometers)  but are good enough for droplets.  As so on as droplet dry the virus dies.
  • It is unclear why in highly humid places such as Taiwan  infections are more rare. Probably in humid area droplets do not travel as far as in dry air, but they can survive longer before evaporating.

How long it take the virus to disintegrate on various surfaces

The virus consists only of RNA in a coat of lipid molecules. RNA isn’t very stable. It instantly disintegrates when heated above 56°C, the coat is quickly dissolved with soap (less then a minute) and the virus collapses,  or disinfectants such as alcohol (20 sec or less).  That’s one of the reasons why those viruses outside the host survive mostly within the buildings and  just a couple of days at best. The body also has various mechanisms to quickly eliminate it. Human skin, for example, produces enzymes that quickly degrade RNA samples. Direct sun kills them in an hour or so.

There some problem with the estimation of life of the virus on various surfaces, because this is an exponential decay (Dylan Morris twit)

 This is why we estimated decay rates/half-lives. The virus decays exponentially: every hour makes you safer, but the biggest changes happen in the first few hours.

@TomAvril1

did a great job summarizing these points in the

@PhillyInquirer

While for ordinary people inhaling infected air droplets is the most common infection path, "hands into eyes or nose" is an important path of infection  for people suffering from dry nose or dry eyes.

While for ordinary people inhaling infected air droplets is the most common infection path, "hands into eyes or nose" is an important path of infection  for people suffering from dry nose or dry eyes.

For this category of people it is important not to touch your nose and eyes, before they washed your hands.  And generally avoid touching face with hands.  Those who regularly touch their nose or eyes (people suffering from dry nose or dry eyes problem) now belong to the most vulnerable subset of the population independent of their age.  They should now carry saline spay or gel  and/or eye moisturizer with them. They can also try to wear a mask (any mask will suit) in shops and public transportation to prevent touching their nose or eyes instinctively, without any conscious control. Wearing gloves might also help. 

Proper hand washing with regular soup kills or disable the virus and as such is an important safety measure  (COVID-19-09). In the case of viruses, the soap basically dissolves or penetrates the outside boundary of the virus and it collapses.

Those who often touch their nose (people with dry nose problem),  or eyes (dry eyes)  are extremely susceptible to the disease.  Smokers and seniors are two the most vulnerable general categories.

Travel history is strong predictor of chances of being infected. Hong Kong has made it a criminal offence to lie to a health care provider about one’s travel or exposure history; the US should do the same.

Spending more time on sun improves resistance for the virus for healthy people and improves prognosis for those who are sick. In the USA this method was widely use to fight Spanish Flu epidemic and it still has great value today.  

Spending more time on sun improves resistance for the virus for healthy people and improves prognosis for those who are sick. In the USA this method was widely use to fight Spanish Flu epidemic and it still has great value today. 

First of all a virus is not alive as it does not have any metabolism.  So when we use the term "die" is should be taken figuratively as a synonym of "disintegrate". Still using words like “live”, “kill”, “survive” make perfect sense, whether or not one considers viruses alive. It is generally better to use short words to carry across important meanings.

SARS-CoV-2 behaves like a typical respiratory coronavirus in the basic mechanisms of infection and replication.  The virus start to disintegrate  on surfaces from a couple of hours to several days depending on the surface. The process of disintegration starts immediately,  so at the end on a given period only a very small number of virus instances remains intact. So what we say that it lasts for 48 hours on a particular surface is does not means that 100% survive. That means that at least 5% of virus instances survive and preserve their infection properties ( https://hub.jhu.edu/2020/03/20/sars-cov-2-survive-on-surfaces/ )

According to a recent study published in the New England Journal of Medicine, SARS-CoV-2, the virus that causes COVID-19, can live in the air and on surfaces between several hours and several days. The study found that the virus is viable for up to 72 hours on plastics, 48 hours on stainless steel, 24 hours on cardboard, and 4 hours on copper. It is also detectable in the air for three hours.

... ... ...

Machamer: What's getting a lot of press and is presented out of context is that the virus can last on plastic for 72 hours—which sounds really scary. But what's more important is the amount of the virus that remains. It's less than 0.1% of the starting virus material. Infection is theoretically possible but unlikely at the levels remaining after a few days. People need to know this.

While the New England Journal of Medicine study found that the COVID virus can be detected in the air for 3 hours, in nature, respiratory droplets sink to the ground faster than the aerosols produced in this study. The experimental aerosols used in labs are smaller than what comes out of a cough or sneeze, so they remain in the air at face-level longer than heavier particles would in nature.

... ... ...

You are more likely to catch the infection through the air if you are next to someone infected than off of a surface. Cleaning surfaces with disinfectant or soap is very effective because once the oily surface coat of the virus is disabled, there is no way the virus can infect a host cell. However, there cannot be an overabundance of caution. Nothing like this has ever happened before.

Touching  infected surfaces on which droplets landed and you touched by hands is believed to be an important secondary path of infection, at least for  people who are regularly  touching their nose (dry nose) or eyes (dry eyes).  Such people also should wear  a mask and a spectacles, which prevents touching nose and eyes, correspondingly.  

What is the time of virus to enter the human cell after it lands on infernal surface in the nose. Is this hours or minutes? If this is hours that washing of you nose after coming from public places might be a useful hygienic procedures. If it minutes, it is less useful, but still worthwhile as an elementary precaution. 

So disinfection of often used surfaces and personal items like cellphones is highly desirable and should be a daily ritual. Things that can transmit the virus include your cellphone and keyboard. Steam can be used to disinfect winter cloth, or any cotton clothing.  Ironing kill the virus instantly.

Soap also kill the virus instantly both on hands and clothing.

Alcohol  can be used for disinfection of plastic and metal surfaces (keyboards, phones, remote control, toilet seats, door knobs,  countertops, tables, etc).  See How Long Does Coronavirus Live on Surfaces  WebMD advices to keep surfaces clean, even if everyone in your house is healthy.

After you visit the drugstore or supermarket, or bring in takeout food or packages, wash your hands for at least 20 seconds with soap and warm water. Do the same thing after you pick up a delivered newspaper, especially it is wrapped into plastic bag. The virus lives on plash much longer then on paper.

  • Coronavirus generally is not transmitted via mail as it lives of paper and cardboard surfaces only around 24 hours, so it dies "in transit"
  • Coronavirus doesn't seem to spread through exposure to food. Still, it's a good idea to wash fruits and vegetables under running water before you eat them.

Here is an old (Mar 13, 2020) but still useful article from Yahoo Sport You’re Most Likely To Contract Novel Coronavirus From An Infected Person’s Cough Or Sneeze (originally from Women's Health ):

Q: What about touching stuff? How long does novel coronavirus live on surfaces?

A: It's thought that the new coronavirus can live on surfaces, but the answer is still not totally clear. There are mixed reports about what types of surfaces it can live on (e.g., stainless steal, plastic, glass), as well as for how long on each type of surface. The World Health Organization (WHO) estimates that it can live on some surfaces for anywhere from a few hours to several days, but the reality is that “this is still an evolving science,” says Dr. Lin.

The CDC states: "It may be possible that a person can get COVID-19 by touching a surface or object ... but this is not thought to be the main way the virus spreads." Still, you want to be extra cautious about handling common-touch objects, like railings, elevator buttons, and door handles.

Q: Can you get COVID-19 from touching mail and packages?

A: The answer is similar to the one above—researchers still aren't sure if (and for how long) the virus can survive on and be picked up from mailing materials, like paper and cardboard. According to the CDC, "because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures." And yes, that includes packages coming from areas where there are novel coronavirus outbreaks.

It might well be that such cases are mainly limited to family settings. If they are small or insignificant then gigantic effort for disinfection surfaces in public places are wasted and can cause additional harm to humans as chemical used are not exactly benign. 

From 2019–20 coronavirus pandemic - Wikipedia

A single study of how long SARS-CoV-2 (COVID-19) remains infectious on various surfaces, "show[s] that when the virus is carried by the droplets released when someone coughs or sneezes, it remains viable, or able to still infect people, in aerosols for at least three hours."[264]

They also tested SARS-CoV-2 on plastic, stainless steel, copper, and cardboard, and found that although SARS-CoV-2 decayed exponentially over time in all five environments they tested, the virus was viable for infection for up to three days on plastic and stainless steel, for one day on cardboard, and for up to four hours on copper.[265][266][267]

A survey of research on the inactivation of other coronaviruses using various biocidal agents suggests that disinfecting surfaces contaminated with SARS-CoV-2 may also be achieved using similar solutions (within one minute of exposure on a stainless steel surface), including 62–71% ethanol, 50–100% isopropanol, 0.1% sodium hypochlorite, 0.5% hydrogen peroxide, and 0.2–7.5% povidone-iodine; benzalkonium chloride and chlorhexidine gluconate are less effective.[261]

The WHO has stated that the risk of spread from someone without symptoms is "very low". However, if someone has early symptoms and a mild cough, there is a risk of transmission.[268] An analysis of infections in Singapore and Tianjin, China revealed that coronavirus infections may be spread by people who have recently caught the virus and have not yet begun to show symptoms, unlike other coronaviruses such as SARS.[269][270]

Estimates of the basic reproduction number (the average number of people an infected person is likely to infect) range from 2.13[271] to 4.82.[272][273] This is similar to the measure typical of severe acute respiratory syndrome-related coronavirus (SARS-CoV).[274]
 

Is testing error free and what is the percentage of false positives in the tests?

There are three separate issues here and three types of tests:

  1. Detection of virus pneumonia
  2. Detection of virus infection
  3. Detection of the fact that the person recovered from the virus infection (antibody test)

Let's start with the most dangerous part -- the virus pneumonia. Virus pneumonia is the most dangerous effect of the virus. It happens only in small number of infected but if it happens it can lead to death. Better chances for survival have people for whom virus pneumonia was detected early who were administered drugs and other treatment early on.  Fortunately it can be diagnosed with 99% reliability in hospital and with significant reliability at home.

The easiest method of detecting COVID-19 virus pneumonia at home is to use oximeter (which is around $30-70 on Amazon; many models are available, use reviews for selection ).  Normal oxygen saturation for most persons at sea level is 94-100%.  If that level dips below 90%, that can be an indicator that the person has COVID-19. Generally level below 90% indicate hypoxia and is a dangerous condition outside short interval during   exercise. Also interesting your reaction to standard load, for example walking a brisk pace.  You oxygen level in this case also should not drop below 90%. For example patients with Chronic obstructive pulmonary disease (COPD) such as chronic bronchitis or emphysema have low oxygen saturation only under load. In this case at rest the patient can hit 97% but mild exertion can knock it down to 80% rapidly. And any such person can benefit from the supply of supplementary oxygen. In severe cases of Covid pneumonia oxygen saturations can be as low as 50 percent but because it happen gradually a person can adapt to it, especially women. But it can lead to organ failure. Opinion The Infection That’s Silently Killing Coronavirus Patients - The New York Times

Covid pneumonia causes a form of oxygen deprivation we call “silent hypoxia”:  patient has it but does not feel it. "Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays... Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. "

With oximeter this condition can defected well before "shortness of breath" symptom. That means that widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices — could provide an early warning system for Covid pneumonia.

Detection of virus infection is considerably more complex and involved. It is also much less reliable with  common test having only 70%-80% reliability (see below).  It is also less useful as without COVID pneumonia this disease is similar to a bad flu.

All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70% accurate.

We need to distinguish between new cases of positive test for COVID-19 and actual disease. There are two types of tests available for coronaviruses:

  • Reverse transcription polymerase chain reaction (rRT-PCR)  This test is not without flaws and produces a lot of false positives(around 20%) and some false negatives (see below). It can be used alone or, preferably, along with X-ray of CT scans which can detect pneumonia with over 97% accuracy. All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. Patients with typical CT findings but negative rRT-PCR results should be isolated. https://www.sciencedirect.com/science/article/pii/S0720048X20301509
  • Antibody test for COVID-19 virus. This type of tests allows to determine if the person is immune to the virus. But it is not useful for initial screening of people. It is more reliable then is more reliable Reverse transcription polymerase chain reaction but as they are multiple tests of this type your mileage may vary. Of the 14 tests on the market, only three delivered consistently reliable results. Even the best had some flaws.

    In the new research reported by NYT on Apr 24, 2020, researchers found that only one of the tests never delivered a so-called false positive — that is, it never mistakenly signaled antibodies in people who did not have them. Four of the tests produced false-positive rates ranging from 11% to 16%; many of the rest hovered around 5%.

The most popular is  Reverse transcription polymerase chain reaction  test which allows to determine if you are infected with the virus and can be taken in multiple ways:

1. Swab Test - Most common. Under this test, a sterile cotton swab will be used to collect a sample of the secretions produced in the back of your throat.
2. Nasal Aspirate - In this test, secretions from your nose will be collected by inserting a small tube into your nostrils. The tube will be attached to a suction device.
3. Tracheal Aspirate - This test involves collecting a sample from the inside of your lungs with the help of a thin, light-weight tube called a bronchoscope.
4. Sputum Test - The doctors will acquire a variation of mucus from your lungs which can either be found in your cough or in a sample from your nose.
5. Blood Test - A small sample of your blood will be collected and tested.

Notably, the detection of influenza viral RNA or nucleic acids by molecular assays does not necessarily indicate detection of viable virus or the fact that you are infected. The sensitivity of initial rRT-PCR is around 80%.There are four possible outcomes of your COVID-19 test

  1. Positive: you are infected and diagnosed with coronavirus
  2. False positive: you are not infected but you are diagnosed with coronavirus
  3. False negative: you are infected and not diagnosed with coronavirus
  4. Negative: you are not infected and not diagnosed with coronavirus

As test need to be made quite sensitive to avoid many "false negatives", it necessary produced a lot of false positives. A positive test for coronavirus does not mean necessarily that this patient is infected (so called false positives).  CDC explicitly warns:

Results are for the identification of 2019-nCoV RNA. The 2019-nCoV RNA is generally detectable in upper and lower respiratory specimens during infection. Positive results are indicative of active infection with 2019-nCoV but do not rule out bacterial infection or co-infection with other viruses. The agent detected may not be the definite cause of disease.

Current screening tests for COVID19 (a PCR test, not an antibody test) have a rather high rate of false positives (around 20%)  in order to exclude false negatives.  

Japanese investigators estimated that around 30% of those infected (or, more correctly, those with positive test results)  do not develop disease. As the reliability of tests for the virus is unknown  (and might be only around 80%)  it is possible that most false positives are misclassified as "asymptomatic infected persons" slightly inflating the counters (2019–20 coronavirus pandemic - Wikipedia )

Infection by the virus can be provisionally diagnosed on the basis of symptoms, though confirmation is ultimately by reverse transcription polymerase chain reaction (rRT-PCR) of infected secretions (71% sensitivity) and CT imaging (98% sensitivity

 It is quite possible that  most of "asymptomatic " cases are the result of the deficiency of test used.

Very few papers so far were devoted to this important problem. One paper that I have found suggests a lower, 47% probability for the false-positive rate among asymptomatic individuals who are in close contact with infected patients  Potential False-Positive Rate Among the 'Asymptomatic Infected Individuals' in Close Contacts of COVID-19 Patients . In other words half of "asymptomatic" cases are false positives:

Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention.

Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings.

Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%.

Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives.

The author conclusions are really important and are worth restating: In the close contacts of COVID-19 patients, nearly half or even more of the ‘asymptomatic infected individuals’ reported in the active nucleic acid test screening might be false positives.

We need to distinguish between new cases of positive test for COVID-19 and actual disease:

In infectiology – founded by Robert Koch himself – a traditional distinction is made between infection and disease. An illness requires a clinical manifestation. [1] Therefore, only patients with symptoms such as fever or cough should be included in the statistics as new cases.

In other words, a new infection – as measured by the COVID-19 test – does not necessarily mean that we are dealing with a newly ill patient who needs a hospital bed. However, it is currently assumed that five percent of all infected people become seriously ill and require ventilation. Projections based on this estimate suggest that the healthcare system could be overburdened.

My question: Did the projections make a distinction between symptom-free infected people and actual, sick patients – i.e. people who develop symptoms?

When the patient dies and the test was positive in no way this means that the virus is always primarily responsible for a patient’s demise (A Swiss Doctor on Covid-19, Mar 19, 2020) :

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 30% of the deceased are women.

But there are clues which will hint at a COVID-19 infection and which can increase the reliability of the test among them:

  • Location: there will be different probabilities of infection for people living in different places. People near the epicenter are more likely to be infected. People living near popular tourist destinations are more likely to be infected than people from isolated places like rural Alaska.
  • Travel history: travelers from places near the epicenter or other outbreak locations are more likely to have the infection (hence, why travelers are screened).
  • Social contacts: people who have close contact with the infected/those at risk of infection are more likely to be infected themselves.
  • Symptoms: people who have symptoms characteristic of coronavirus, such as fever, cough, and shortness of breath are more likely to be infected.
  • Imaging: people who show imaging features of coronavirus on an X-ray and/or CT scan are more likely to be infected.
     

Is virus spreading exponentially ?

It is not outside a small initial period of approximately 30 days in a given country. After that initial period the daily rate of growth drops. They effect is due to both growing "herd immunity", countermeasures, and increased people awareness about the danger, which lead to lifestyle changes. Human societies are very adaptable.   In case of China peak was achieved somewhere between Feb 3 and Feb 15 or  approx in 45 days from the beginning of the epidemic.

Like in neoclassical economic we see "mathiness" flourishing: flawed assumptions, poor & flawed math, invalid statistical analysis, failing to account enough pertinent scientific considerations (and failing to discount the invalid pseudo-medical/pseudo-scientific crap emitted by medical stooges serving neoliberalism).

There is a saying "Models are as good as underling assumptions are, and assumptions are often wrong." That means that "naive" models are highly deceiving and represent "fearmongering via mathiness", especially if they assume that all population is susceptible to the infection. In reality probably only somewhere between 10 to 30% are susceptible.  Diamond Princess cruse ship cruel experiment (where all passengers and crew were tested)  gave us 20% which should probably be assumed as working assumption. Wuhan medics represent an extreme case and they have 60% susceptibility which should be the upper bound for adult population (not total population, but only adult) 

The “garbage in, garbage out” effect is fully applicable to all these mathematical models that are scaring the daylights out of the public.  I would refer readers to the following article by John Ioannidis - Wikipedia , a prominent epidemiologist:   In the coronavirus pandemic, we're making decisions without reliable data  Ioannidis’s 2005 paper “Why Most Published Research Findings Are False” has been the most downloaded technical paper from the journal PLoS Medicine and is considered foundational to the field

In other words number of people infected with this virus probably will stay lower then the number of people infected with seasonal flu.

Also human societies are highly adaptable and communications patterns of people are strongly group oriented.  Random communication does not happen outside of air travel, international travel and such. Which limits infection to a particular set of  groups to which the infected individual belongs. In other words there is no random propagation outside very early period of the spreading of the virus (say the first 30 days), when the virus is easily finds susceptible individuals. After approximately the first 30 days part of the people are already immunized or removed from contacts, and part is not susceptible so finding new victim became much more difficult and the speed of transmission slows down. Even in a bus traveling, say, to NYC from suburbs  passengers soon  start recognize each other. In the USA the speed of transmission slowed down from approximately March 24, 2020 when is dropped to 25% a say from the average of 32% a day. 

utu , says: Show Comment March 25, 2020 at 11:20 am GMT

@Agathoklis
"Italian deaths are not rising exponentially. "

I am pretty sure they were in the initial period but once the epidemic spreads into areas with different population densities where doubling periods are different and when new countermeasures are being implemented you will see departures from the exponential growth.

Even w/o countermeasures when more and more people get infected the reproduction number R0 will be getting smaller resulting in a steady decrease of the exponential coefficient.

Zhanwei Du et al. studied the exponential growth in Wuhan in the period before quarantine was imposed. See the Appendix in

https://wwwnc.cdc.gov/eid/article/26/5/20-0146_article
The COVID-19 epidemic was growing exponentially during December 1, 2019– January 22, 2020, as determined by the following: dI(t) = I0 × exp(λ × t) in which I0 denotes the number of initial cases on December 1, 2019, and λ denotes the epidemic growth rate during December 1, 2019–January 22, 2020.

What is important about Ron Unz approach is that by looking at daily death increments one can gage the number of new infections and as the epidemic progresses the changes in doubling period would be adjusted from daily death increments.

In times when very few tests are being done to asymptomatic patients and no serum tests are performed to determine who already went through infection and recovered this approach is very useful and simple method to estimate the extent of the epidemic.

Who probably will get infected  and who will not?

The short answer is old males.  The dominant affected category are people over 55. Men became infected three-four time more frequently then women.  The other fact is ethnicity: Afro-American and Asians for some reasons are affected more (can be social faction not ethnicity per se). In any case obesity and diabetes are more common among Afro-American. High blood pressure is also pretty common among Asians.

Paradoxically it is unclear if smoking affect your chances to get the diseases.  Obesity doubles your risk.

It looks like people who were vaccinated with BCG are less affected.

There is some connection of infections with the deficiency of vitamin D.  This is still hypothesis but some  data do support it.  Older men often have vitamin D deficiently.

But in any age category the virus in not capable to infect everybody. Percentage of susceptible people is around 20-60%  depending on conditions (60% for medical workers who are constantly exposed to high viral loads probably represents upper bound). People with normal immune system who have already been exposed to other viral infections may have enhanced immunity against this coronavirus. This hypothesis is based on the fact that "it was recently shown that in an effort to limit viral infections, host cells that are infected by a number of viruses provoke an interferon response to inhibit the enzymatic activity of furin-like enzymes."

Air pollution is definitely a factor. This is this the hot spot of this epidemic are typically large cities with their extremely high density of population and poor air quality.

 In any case much epends on locality: Virus spreads in a few hotspots within a given country. A large portion of the USA cases are centered on New York City. Since March 20, New York state, Connecticut and New Jersey have accounted for around 50% of all US cases. As of April 9, nearly 60% of all deaths from COVID-19 have been in these three states. The same is true for Italy. When Italy experienced its Corona carnage in Lombardy, every health ‘expert’ predicted that when the ‘virus’ slipped out of the rich Lombardy region and made it to the poor south, we would see real genocide. It didn’t happen.

Like most infections it hits poor much harder then wealthy. It goes without saying.  It also hit obese much harder than people with normal weight and obesity is concentrated on lower income population group.  So countries with  tremendous wealth discrepancies fare much worse  then more equal countries (the USA has Gini coefficient over 40  while Finland, Belgium, Austria --  less then 30; List of countries by income equality - Wikipedia.) Add to this that in the USA there are many uninsured who simply are afraid to go to the hospital and you now can understand why the USA was hit so hard.

How you can became infected ?

From formal standpoint corona viruses are classified as common colds rather than influenza. According to the CDC, symptoms of this new coronavirus include fever, dry cough, and shortness of breath, which can appear anywhere between two days and two weeks after the exposure. Nausea is also occurring, but is not the leading symptom.  The most distinctive pair of symptoms is dry cough, and later shortness of breath. Like all such viruses this virus causes an infection in the respiratory tract, or nose, throat and lungs (in mild cases mostly upper part  -- brouchs (acute bronchitis), but is severe cases lower part -- alveoli causing pneumonia). The virus is iether inhaled with infected aerosol or transmitted, usually via your fingers, to the mucous membranes of the mouth, nose or eyes.

99% of infections happen in closed spaces. People who do not wear mask in closed spaces has higher chances to get infected, and, what is more important, to infect others.  So the requirement that all people in public places wear masks is the logical first step is controlling the epidemic.  That was not done in the USA and the country paid the price for the incompetence of its leaders.

The virus "travel" in droplets which make regular surgical masks or handmade masks very effective. They drop the probability of being infected at least five times (of course, they do not eliminate it) and to infect other by at least 10 times.  In this sense N95 masks are an overkill: they do not filter exhausted air and an infected person in N95 mask will spread the virus too although nor as actively and on shorter distances as a person without such a mask.   for a person without mask droplets will travel long (up to 2 meters) distance as in case of cough of sneezing.  You can wear surgical or handmade mask only for approximately two hours; after that it becomes wet and should replaced with a new dry mask. 

As immune system weaken with age (especially after 50) this category of people is at higher risk and should behave accordingly. 

Washing your nose with the saline solution after being outdoor (only after cleaning your hands) might slightly help and generally is a good hygienic measure if used properly. See  Is Rinsing Your Sinuses With Neti Pots Safe FDA Search web for "nasal irrigation" for more information. 

COVID-19 infects men more frequently then women (around 66% of infected persons are men). Which might suggest that mans immune system deteriorates much quicker with age then for women.

There is only limited clarity about the groups of high risk. You can be certain that the virus prefers poor people. That's given. In addition it prefer men, especially over 55.

C.D.C. Releases Early Demographic Snapshot of Worst Coronavirus Cases

The agency’s study of hospitalizations for Covid-19 in March shows heightened numbers for those with underlying conditions, men and African-Americans.

There are few other relevant factors that are discussed The current working hypothesis is elderly (which is an established fact), smokers (less established fact) and people with hypertension (even less established fact) are more susceptible. 

Among three major groups of risk for pneumonia are

  1. Older people as they have weaker immune system;  each ten year of age after 60 increase the risk and for people over 80 around 15% develop pneumonia and die. Both Chinese and Italian data suggest that men over 50 are at higher risk. For old people the risk is especially high and increase dramatically with each decade of lifespan (In Italy, Coronavirus Takes a Higher Toll on Men - NYT) For example,  China CDC Weekly published data that among a subset of 44,700 infections confirmed through lab tests as of mid-February, more than 80% were at least 60 years old, with half over 70. The role of smoking is especially interesting in view of the mysterious "vaping pneumonia" epidemics that hit the USA in August  of 2019 (see below). It is difficult to find this information on the Internet, and I suspect I know why.
  2. People living in areas with very bad air quality and, especially,  smokers (including smokers of electronic cigarettes) and people with chronic lung conditions such as asthma, emphysema, TB, etc ;  this is a little bit speculative but generally the weaker lungs you have them worse is your prognosis. Part of high fatality of virus in Iran might be bad air quality plus the fact that most people over60 were subjected to effects of poison gases used by Iraq in the war with Iran. Plus that smoking is still quite widespread among Iranian men. 
  3. People with hypertension especially those who use ACE inhibitors : nearly 40% of the Italian fatalities were using ACE inhibitors (and this may be an underestimation as pre-admission medication charts were lacking). The virus binds to the pulmonary ACE2 receptor. Conceivably the use of ACE-inhibitors (or the related AT-receptor antagonists) induces upregulation of this receptor, but this is purely conjecture on my part. Anecdotally, use of this medication class is lower in Germany, which has been proffered among reasons for its lower fatality rates.
For people over 50 being male is a risk factor which doubles the risk. Especially if you are a smoker. The gender gap disappears  only at 90, probably because there are much fewer men in this age group. In Italy, men represented over 60% of  coronavirus cases, and over 70% of the deaths.

Another question is air quality. It looks like places with  very bad air quality such as large cities (NYC, Los Angeles, etc) and industrial regions with high level of smog (Northern Italy, Wuhan) are more affected. The same is true about people who spend most of their day in badly ventilated spaces (most people in the USA). Spending 30 min or more on sun is an important prophylactic measure (Coronavirus and the Sun a Lesson from the 1918 Influenza Pandemic):

Patients treated outdoors were less likely to be exposed to the infectious germs that are often present in conventional hospital wards. They were breathing clean air in what must have been a largely sterile environment. We know this because, in the 1960s, Ministry of Defense scientists proved that fresh air is a natural disinfectant.[5] Something in it, which they called the Open Air Factor, is far more harmful to airborne bacteria — and the influenza virus — than indoor air. They couldn’t identify exactly what the Open Air Factor is. But they found it was effective both at night and during the daytime.

Their research also revealed that the Open Air Factor’s disinfecting powers can be preserved in enclosures — if ventilation rates are kept high enough. Significantly, the rates they identified are the same ones that cross-ventilated hospital wards, with high ceilings and big windows, were designed for.[6] But by the time the scientists made their discoveries, antibiotic therapy had replaced open-air treatment. Since then the germicidal effects of fresh air have not featured in infection control, or hospital design. Yet harmful bacteria have become increasingly resistant to antibiotics.

Sunlight and Influenza Infection

Putting infected patients out in the sun may have helped because it inactivates the influenza virus.[7] It also kills bacteria that cause lung and other infections in hospitals.[8] During the First World War, military surgeons routinely used sunlight to heal infected wounds.[9] They knew it was a disinfectant. What they didn’t know is that one advantage of placing patients outside in the sun is they can synthesise vitamin D in their skin if sunlight is strong enough. This was not discovered until the 1920s. Low vitamin D levels are now linked to respiratory infections and may increase susceptibility to influenza.[10] Also, our body’s biological rhythms appear to influence how we resist infections.[11] New research suggests they can alter our inflammatory response to the flu virus.[12] As with vitamin D, at the time of the 1918 pandemic, the important part played by sunlight in synchronizing these rhythms was not known.

  How big is the statistical difference between place with good air quality and places with bad air quality is unclear. Similar questions arise about different climatic zones. Are hot and humid places less susceptible to this virus epidemics?

The majority of cases in China are were mild (Data as of February 17 from https://www.worldometers.info/coronavirus/ ):

  • Currently Infected Patients: 58,625
  • in Mild Condition 46,830 (80%)
  • Serious or Critical 11,795 (20%)
  • Cases which had an outcome: 14,711
    • Recovered / Discharged 12,837 (87%)
    • Deaths 1,874 (13%)

#COVID19 China CDC releases largest dataset to date with >55,000 confirmed cases as per @WHO press briefinghttps://t.co/gIrb3iCsKK

Case fatality rates with significant sex and age difference

  • – Male 2.8%
  • – Female 1.7%

Data confirm children appear less susceptible to infection pic.twitter.com/1DYi98H1Dr

— Andy Biotech (@AndyBiotech) February 17, 2020

Here’s an interesting breakdown of cases on the cursed cruise ship (passengers likely are significantly older than the general population):

From this report on #diamondprincess

  • 454/1,723 positive ~ 26%
  • 19/454 critically ill ~ 4%
  • 181/454 asymptomatic ~ 40% (!)

Leaves 254 symptomatic of them 19/254 (7.5%) critically ill Still not final outcomes but this will be an important cohort analysis on clinical spectrum of #COVID19 https://t.co/8yU9xgImrZ

— Matt Kuehnert MD (@drkuehnert) February 17, 2020

Those people who have "bystander" infections are probably in particular danger: “Bystander” infection is a medical term for having a preexisting infection, which, when one is exposed to a new pathogen, might reduce one’s ability to combat the new pathogen. I wonder whether regular cold increases corona susceptibility or severity.

What percentage of population is initially susceptible to the virus; lessons of Diamond Princess cruise chip epidemics and Wuhan

Not all people are susceptible to this virus. In Diamond Princess cruise chip epidemics only around 20% were infected. Among the initial members of Wuhan medical personnel (really worst case scenario) only 60% were infected. Those are two worst case scenario where everybody was exposed to the virus in huge doses. Moreover, in Diamond Princess AC might help to spread the virus to all cabins  and the passengers were served by the crew that included asymptomatic carrier of the virus. In case of Wuhan medical personnel the concentration of virus was extremely high, while initially protective measures were not taken at all. They were literally flooded with the virus. 

We can expect lesser percentage for less tough situations. For example, within the extended family set of people only around 10% develop any symptoms.

In other words 60% of population looks like the upper bound of the number infected (cases when one travels in infected person,  prolonged contact in family, etc)  while 10%  or less looks probable for the "community" type of infections (grocery shops, churches, meetings, etc) 

The number of people susceptible to the virus probably also decrease with the establishment of warm weather as immune system became stronger and they are more exposed to direct sunlight. 

Not all people are susceptible to the virus. In Diamond Princess cruise chip epidemics only 20% were infected. Among  Wuhan medical personnel  only 60% were infected. Those are two worst case scenario  were everybody was exposed to the virus (in Diamond Princess AC might help to spread the virus to all cabin) so we can expect lesser percentage for less tough situations.

The number of people susceptible to the virus probably decrease with the establishment of warm weather.

Looks like some politicians like Angela Merkel became too pessimistic: "60-70% of the population will be infected" - Angela Merkel about the COVID-19.  In other words she does not believe in German people resilience and think that they will fare worse than Wuhan medics ;-)

The danger to the medical personnel and complete inaptness of the US government in this area

And one of the most affected and the most neglected subgroup of population in this regard is medical personnel.  One obvious measure is to try train medical personnel to use optimal defense measures (and providing all the necessary for that materials). What is unclear is what are optimal defense measures.

The pressure faced by medical staff in the centers of epidemic is enormous and Chinese social media was flooded with posts showing exhausted workers struggling to cope. Posts tell about doctors and nurses working without much food or rest for long hours while wearing poorly ventilated hazmat suits. The initial  chaos in cities under lockdown across Hubei has led to shortages of virus testing kits and face masks. In late January the situation improved  and drug stores started giving out five free masks to everyone. Paranoid people can buy N95 type masks but need to pay for them.

Among initial batch of medics in Wuhan around 60% became infected so this is serious threat, which should not be discounted. And it can lead to the depletion of the medical personal as recovery takes one month or so. More than 1,700 medical workers have been infected by the coronavirus, according to China’s National Health Commission, while 26 have died. Among them was  51-year-old Liu Zhiming, the director of Wuhan’s central hospital, a 29 year old doctor Peng Yinhua, who postponed his wedding to fight the epidemics, and ophthalmologist Dr Li Wenliang, 33 who raise one of the first alarm about the virus. Most victims are men, but one 29 female doctor Xia Sisi, a gastroenterology physician also died.  Most medical staff have been infected in Wuhan and the broader Hubei province, where the virus first emerged in December.

China has mobilized medical workers from across the country to help treat and care patients, as the virus spread and overwhelmed local hospitals. More than 25,000 medical workers, including top-line doctors and nurses from the country’s best hospitals in Beijing and Shanghai, have been dispatched to Hubei. The extra staff sent to Hubei included 450 military medics with experience of battling SARS and Ebola, state media said, who arrived in Wuhan on Jan 24, 2020.

Hazmat suits that were used by Chinese medics is probably an overkill as they cause quick exhaustion which make medical personnel more susceptible to the virus and also cause some unrelated deaths from pure exhaustion.  Wuhan medic used adult pumpers as even visiting bathroom became complicated task.

For married medical personnel who are tested positive it might make sense to organize special quarters in order not to infect family members and to speed up recovery. That's what China actually did -- all tested positively went to hospitals,  not to self-isolation.

For married medical personnel who are tested positive it might make sense to organize special quarters in order not to infect family members and to speed up recovery. That's what China actually did -- all tested positively went to hospitals  not to self-isolation.

Like in case of war there should be some rotation of personnel in hot zones, so the medical personnel did not suffer infections of even death from exhaustion (China experience can help; they did infuse hot zone with medical personnel from less affected areas; I do not know whether they practiced rotation or not) 

Elderly as the most vulnerable group

Current estimates suggest that mortality starts with 0.1% for teenagers, less then 1% for people younger then 40. It dramatically picks up for people over 50,  reaching 15% for patients over 80 (who usually have other serious medical conditions; there are very few healthy 80+ year old).

As elderly dominate serious cases and deaths from this virus protective measures should be varied by age categories. California was the  first state which made the decisive step in this direction and recommended to all seniors to stay home. But there are moral problems here as was pointed by a commenter in off-guardian.org:

Indefinite rolling lockdowns for the elderly – who in many cases will be in imposed solitary confinement – is a virtual death sentence for many. With emergency powers to detain, restrain (with reasonable force), and contain absconders in ”appropriate” and ”secure” facilities …surely a short fever and a 14% chance of mortality are more humane?

First of all elderly should wear masks and provided special hours for shopping (for example the first hour as most older people get up early).  It they order home delivery the order should be left at the door and direct contact is avoided.  But lengthy lockdown might have for them negative effects too: it might gradually turn into torture. Where is the respect for the elderly? In a long term this might well be worse than the disease:  the imprisonment potentially far more deadly than the  virus.

But international travel for them (and may be all air travel) definitely should be prohibited. Traveling internationally to the countries known to be affected dramatically increases the risk.

Draconian countermeasures have been adopted in many countries. If the pandemic dissipates — either on its own or because of these measures — short-term extreme social distancing and lockdowns may be bearable. How long, though, should measures like these be continued if the pandemic churns across the globe unabated? How can policymakers tell if they are doing more good than harm?

Implemented properly those measure help to protect seniors and "flatten" the curve and avoid overcrowding of hospitals by elderly patients as well as give authorities some time to extend the number of necessary beds and ventilators within hospitals.  Including creating temporary hospitals in severely affected areas like Chinese did.  

Who will die or suffer serious health consequences from the infection?

First of all this is not a normal flu. It is more a serious disease. “A normal flu” does not entail acute hypoxemia and typically has no long term consequences for those who recovered. Here the picture is fuzzy but definitely more dark.  One thing is certain: the fatality is probably in the ballpark of seasonal influenza.

In the USA the scope of epidemic was dramatically increases by the CDC blunder with tests.

CDC blunder with the production and distribution of virus test really borders with criminal negligence

Good YouTube presentation that presents most available facts as of late February 2020 (as well as some historical background) is by Dr. Forest Arnold  COVID-19 (SARS-CoV-2) Epidemic with Dr. Forest Arnold

There are two prognoses for the disease. Kind of two separate diseases under one roof, if you wish. And mangling them into one as done by the US MSM is a junk science.

  • Flu-like scenario. This scenario affects over 93-98% of patients. In such cases people develop only acute bronchitis and fully recover. There is no any long term consequences for their health. That's a typical case especially among younger people. That does not means that reckless people who ignore the danger and expose themselves will fare well if they caught it. A certain percentage of young people, especially among medical personnel treating patients, are not that lucky.  Asymptomatic people and light cases (in which virus infects only upper respiratory tract) also serve as Trojan horses for the virus helping it to infect more people and prolong the epidemics.  My fear is, that after 30-40 years of neoliberal indoctrination, no solidarity, or social responsibility exists anymore here.

    This fly-like form the disease remains pretty rare. As of April 28, 2020 one million people or 0.3% of the USA population(331 million)  was tested positively for the COVID-19 infection and around 57K died ("from it"  + "with it"). In comparison, every year, from 5-20%  (20 to 70 million)  of the USA population become infected with influenza virus. An average of 200,000 of these people will require hospitalization and up to 50,000 will die. Older folks over the age of 65 are especially susceptible to virus infection, since the immune system becomes weaker with age. In addition, older folks are also more susceptible to long-term disability following virus infection, especially if they are hospitalized.
     
  • A new type of destructive virus pneumonia similar to one caused SARC and, paradoxically,  similar to pneumonia observed during "vaping epidemic" in the USA in august 2019. This condition affects around 2-7% of infected people ( more in t he large populated cities like NYC). Virus pneumonia usually starts from the ninth day to the 14th of the disease. At this point the condition of the patient changes abruptly and qualitatively and becomes really life threatening. Here prognosis is very serious and there are long term health consequences for those who manage to recover (fibrosis of lungs or various degree). Some unknown but very small percentage of people with virus pneumonia suddenly develops Acute Respiratory Distress Syndrome (ARDS) which occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs.  Such patient typically requires oxygen and if conditions deteriorate  sometimes even need to be put on ventilator. Around 40% of people with ARDS dies. Fortunately (or unfortunately depending on your age) this scenario concentrates among seniors and people with some predisposition, although we do not know exactly what they are (two supposed groups of risks are obese and people with high arterial pressure). It has to do something with their lung receptors "affinity" to the virus.

MSM hysteria about the total number of cases which is deceptive in a sense that they greatly overhype the treat.  The cases that really matter are

  • “Serious and critical cases” (which all are cases of virus pneumonia. ) In those cases  COVID-19 is very similar to SARC.
  •  The “medical workers who are in serious or critical conditions.” The last set of data (about medical workers) is important because this virus really is a serious threat for medical personnel which is overexposed to the virus and who as Wuhan proved will suffer consequences.  It can cause the depletion of medical person which complicate prognosis for "commoners" This is the area where the  behavior of the US government was clearly incompetent as it does not provide medical workers with training and clear instructions as for the use of protective gear as well as sufficient virus tests (there was a reported case, when a possibly infected nurse waited for a test for week or more.) CDC blunder with the production and distribution of virus test really borders with criminal negligence.  
    • Also government should provide a shelter for medical personnel, so that they do not infect their families.  Telling a probably infected person to shelter with their family, as is now done in the US will only kill more people. Around 80% of the cases in China got infected through direct family contact. The family chain must be broken to effectively stop the epidemic.
 

Who among infected will get pneumonia?

Pneumonia is a very common and pretty severe disease. Pneumonia affects approximately 450 million people globally (7% of the population) and results in about 4 million deaths per yea or around 2% of total death.

Virus pneumonia usually affects two lungs, while bacterial pneumonia usually affect more one lungs. Otherwise virus pneumonia is similar to severe cases of regular flu caused bacterial pneumonia.

Patient positioning maneuvers (having patients lie on their stomach and sides) open up the lower and posterior lungs most affected in Covid pneumonia. Oxygenation and positioning helped patients breathe easier and seemed to prevent progression of the disease in many cases.

"Who will get virus pneumonia?" after being infected with COVID-19 is a very important question as currently there is no medicines that treats it directly. Because "regular" pneumonia vaccines target bacteria, they would not prevent pneumonia caused by a virus. Antibiotics also would not be effective.

So far the working hypothesis is that three factors are important: your age, status of your lungs tissue ( whether you live in the area with very bad air quality -- typical for large cities),  possibly your ethnicity,  and whether you take ACE inhibitors for hypertension

So far the working hypothesis is that the following   factors are the most important: your sex (males are in large disadvantage), your age, status of your lungs tissue (one factor probably is living in area with a very bad air quality; another chronic diseases such as diabetes, asthma, hypertension),  In case of hypertension you prognosis became worse if you take ACE inhibitors for hypertension. Weakened immune system and patients who take  or any drugs that affect immune system is another clear group of risk.  Deficiency of vitamin D might also be a factor (old males typically have deficiently of vitamin D.) According to a 2011 study, 41.6% of adults in the US are deficient. This number goes up to 69.2% in Hispanics and 82.1% in African-Americans ( 3Trusted Source).

One interesting but unproven fact is that smokers  infected with COVID-19 tend not to develop Acute respiratory distress syndrome (ARDS) which occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. Those who get ARDS has on average 40% death rate with older people over 50%

Less reliable factors that are mentioned are

  • Climate zone that you live in  (In the whole of Africa there are only 7000 cases, and very few serious cases ). But the level of pollution probably plays more important role then the climate zone. People from highly polluted areas (especially close to steel mills) tend to be more susceptible to the virus. Most host spots are industrial centers or highly polluted cities with high density of population. 
  • Your blood group. There was a study done in China the results of which suggested that people with blood group A were at higher risk of needing hospitalization if they were infected with COVID-19 compared to people with blood group O. The research was done on three groups of patients in two hospitals in Wuhan and one hospital in Shenzhen, and those groups may not be representative of Chinese people as a whole. The research did not study people who had COVID-19 but who did not need hospitalization.

Pneumonia is usually diagnosed by the presence of liquid in the lungs.  The good news is that well over 90%  COVID-19 cases exhibit only mild to moderate symptoms (acute bronchitis with severe dry cough) that don’t require hospitalization. Doctors recommend that these patients self-isolate, stay hydrated, eat well, and manage their symptoms as best they can.

But not all infected are that lucky. In some case a new type of pneumonia ( atypical pneumonia  or virus pneumonia ) develops approximately a week after the disease started. Which is a serious disease that can have long term health consequences for survivors (lung fibrosis). For those for whom lung fibrosis affects a substantial portion of lungs a large percentage will die in approximately five years period.

It disproportionally affects so called "high risk groups"  What is known is that for people younger then 70 men are trice more severely affected then woman (66% vs. 33%). This ratio gradually equalizes at 90 as there far fewer men in this category then women.

Here is write-up of the development of virus pneumonia from  the National Geographic Here’s what coronavirus does to the body

In the early days of an infection, the novel coronavirus rapidly invades human lung cells. Those lung cells come in two classes: ones that make mucus and ones with hair-like batons called cilia.

Mucus, though gross when outside the body, helps protect lung tissue from pathogens and make sure your breathing organ doesn’t dry out. The cilia cells beat around the mucus, clearing out debris like pollen or viruses.

Frieman explains that SARS loved to infect and kill cilia cells, which then sloughed off and filled patients’ airways with debris and fluids, and he hypothesizes that the same is happening with the novel coronavirus. That’s because the earliest studies on COVID-19 have shown that many patients develop pneumonia in both lungs, accompanied by symptoms like shortness of breath.

That’s when phase two and the immune system kicks in. Aroused by the presence of a viral invader, our bodies step up to fight the disease by flooding the lungs with immune cells to clear away the damage and repair the lung tissue.

When working properly, this inflammatory process is tightly regulated and confined only to infected areas. But sometimes your immune system goes haywire and those cells kill anything in their way, including your healthy tissue.

“So you get more damage instead of less from the immune response,” Frieman says. Even more debris clogs up the lungs, and pneumonia worsens. (Find out how the novel coronavirus compares to flu, Ebola, and other major outbreaks).

During the third phase, lung damage continues to build—which can result in respiratory failure. Even if death doesn’t occur, some patients survive with permanent lung damage. According to the WHO, SARS punched holes in the lungs, giving them “a honeycomb-like appearance”—and these lesions are present in those afflicted by novel coronavirus, too.

Medical personnel is also high risk group for virus pneumonia, as they are exposed to the virus in quantities far exceeding the rest of the population. 

Once inside the cells, the virus hijacks the protein manufacturing machinery of the cell to generate its own viral proteins and create more viral particles which when released infect other cells. While this process causes some lung injury, most of the symptoms and damage are actually caused by the immune response to the virus (What the flu does to your body, and why it makes you feel so awful):

The initial immune response involves cells of the body’s innate immune system, such as macrophages and neutrophils. These cells express receptors that are able to sense the presence of the virus. They then sound the alarm by producing small hormone-like molecules called cytokines and chemokines. These alert the body that an infection has been established.

Cytokines orchestrate other components of the immune system to appropriately fight the invading virus, while chemokines direct these components to the location of infection. One of the types of cells called into action are T lymphocytes, a type of white blood cell that fights infection. Sometimes, they are even called “soldier” cells. When T cells specifically recognize influenza virus proteins, they then begin to proliferate in the lymph nodes around the lungs and throat. This causes swelling and pain in these lymph nodes.

After a few days, these T cells move to the lungs and begin to kill the virus-infected cells. This process creates a great deal of lung damage similar to bronchitis, which can worsen existing lung disease and make breathing difficult. In addition, the buildup of mucous in the lungs, as a result of this immune response to infection, induces coughing as a reflex to try to clear the airways. Normally, this damage triggered by arrival of T cells in the lungs is reversible in a healthy person, but when it advances, it is bad news and can lead to death.

The proper functioning of influenza-specific T cells is critical for efficient clearance of the virus from the lungs. When T cell function declines, such as with increasing age or during use of immunosuppressive drugs, viral clearance is delayed. This results in a prolonged infection and greater lung damage. This can also set the stage for complications including secondary bacterial pneumonia, which can often be deadly.

For all people who develop pneumonia, preexisting medical conditions instantly come into play. And often determines prognosis.  Some of them such as cardiovascular disease, diabetes and hypertension make prognosis much worse: 

PRE-EXISTING CONDITION DEATH RATE confirmed cases  DEATH RATE all cases
Cardiovascular disease 13.2% 10.5%
Diabetes 9.2% 7.3%
Chronic respiratory disease 8.0% 6.3%
Hypertension 8.4% 6.0%
Cancer 7.6% 5.6%
no pre-existing conditions   0.9%

The current estimate of mortality for people younger then 50 and with no pre-exiting conditions  is less then 1%.

For younger people with healthy lungs typically immune system usually jump into action and kill the virus in lungs, or virus is not able to bind with lung cells ACE2 receptors. Again, only 7% of infected and mostly older males are unlucky. Looks like older men, especially those who live in highly polluted areas (such as major  industrial cities)  are the main risk group. In general, males are twice more susceptible to the virus then women of the same age bracket. Data are based on Italian and China samples and it may well be because there are more smokers among them in those two countries.

Other part of the answer are difference in lifestyle between people. Overweight people with almost zero physical activities are another important risk group. The same, for lesser extent, is true for "coach potato". Especially, if they are living in area with highly polluted air, such as many large cities (traffic) and industrial regions, lungs receptors are more "inclined" to bind with virus  and that  makes this category of people more vulnerable. Several areas heavily affected by the virus are areas with a very bad quality of air (Northern Italy, Iran, Wuhan, NYC )

Spending on fresh air under direct sun 30 or more minutes a day improves you immune system and as such might help to became less susceptible to the virus, and if you got it improves prognoses. During Spanish flu epidemic sick people were moved in beds on flesh air and spend several hour under sun radiation. The results were encouraging. 

Some medical conditions like high arterial pressure also probably increase chances of virus binding with lung receptors.  But this is all speculation. Not reliable data are available.  But there is strong indirect evidence that smoking makes you more susceptible to the development of this type of virus pneumonia

Looks like smoking or living in the area with bad air quality makes people more  susceptible to COVID-19 pneumonia. That means that one of the first thing to do to protect yourself is to stop smoking

Old people generally have higher chances to get pneumonia as they have weaker immune system. After you got it other medical conditions come into play, especially cardiovascular diseases, diabetes and suppressed immune system  (A Swiss Doctor on Covid-19, Mar 19, 2020) :

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 30% of the deceased are women.

It looks like COVID-19 pneumonia is similar to SARC pneumonia. SARS (atypical pneumonia) is characterized by a cyclic course, pronounced intoxication,  destruction of alveolus and in fatal cases the development of acute respiratory failure:

Coronaviruses affect the epithelium of the upper respiratory tract. The main target cells for the SARS virus are the cells of the alveolar epithelium, in the cytoplasm of which the virus replicates. After the assembly of the virions, they pass into the cytoplasmic vesicles, which migrate to the cell membrane and exocytose out into the extracellular space, and before that the virus antigens are not expressed on the cell surface, therefore, antibody formation and interferon synthesis are stimulated relatively late. Sorbing on the surface of cells, the virus contributes to their fusion and the formation of syncytium. In this way, the virus spreads rapidly into tissues. The effect of the virus causes an increase in the permeability of cell membranes and enhanced transport of a fluid rich in protein into the interstitial lung tissue and lumen of the alveoli. At the same time, the surfactant is destroyed, which leads to the collapse of the alveoli, as a result of which the gas exchange is severely affected. ...

Atypical pneumonia has an acute onset, the first symptoms of SARS are chills, headache, muscle pain, general weakness, dizziness, fever of 38°C or more. This febrile (febrile) phase lasts 3-7 days.

...Most patients have a mild form of the disease, and they recover after 1-2 weeks. Depressing patients after 1 week develops acute respiratory distress, which includes dyspnea, hypoxemia and rarely ARDS. Death occurs as a result of the progression of respiratory failure.

... ... ...

Thus, atypical pneumonia is a cyclically developing viral infection, in the development of which three phases can be distinguished.

  • Feverish phase. If the course of the disease is completed at this phase, the mild course of the disease is ascertained.
  • Respiratory phase. If the respiratory insufficiency characteristic for this phase is quickly resolved, the moderate course of the disease is ascertained.
  • The phase of progressive respiratory failure, which requires prolonged ventilation, often ends in a fatal outcome. This dynamic of the course of the disease is characteristic of the severe course of SARS.

In developing countries, and also among the very old pneumonia often shortens suffering among those who are already close to death and has thus been called "the old man's friend."  For people with serious medical conditions, pneumonia always was  the leading cause of death.

For people with serious medical conditions, pneumonia always was  the leading cause of death.

The severe cases predominantly happen to people over 60 and constitute approx 7 to 12% of all COVID-19 infections.   See  https://www.worldometers.info/coronavirus/

Approximately 88-93% of cases of infection are mild and do not require medical attention. Only 7-12% of cases are severe. The Diamond Princess death rate is 0.19% with 7 deaths in a population of 3700 which has was much older then average. Outside of Hubei, Italy and Iran, mortality rate based on confirmed cased is under 1%. For those under 50 its less than 0.2%. 

That fact does not correlate with media hype and many people noticed this discrepancy and reacted accordingly:

Stevie Boy, March 7, 2020 at 15:21

With all the (politically motivated ?) hype, I had a look at the official mortality figures for our annual common flu. Over the last five years the average death rate is 17,000 per year in England, with a high of 28,000 and low of 1,600 !!!

Apparently, we happily live with these large death rates without the “The worlds going to end” hyperbole. People go about their business, going to work, travelling and all the normal trappings of daily life.

What is it with this Corona virus tosh ? What’s going on, who’s benefiting ? Is it part of the [anti] China propaganda ? Utter madness.

Changes to get pneumonia dramatically increase after 80. So there is nothing surprising that large percentage people killed by COVID-19 are people over 80 ( Pneumonia - Wikipedia )

Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke and a weak immune s Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired, such as community- or hospital-acquired or health care-associated pneumonia.

Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include hand washing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.

Pneumonia affects approximately 450 million people globally (7% of the population) and results in about 4 million deaths per year. Pneumonia was regarded by Canadian pathologist William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival greatly improved.

Nevertheless, in developing countries, and also among the very old, the very young and the chronically ill, pneumonia remains a leading cause of death.

Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's

If someone gets pneumonia early in the course of COVID-19 disease (during the first 14 days or so), that’s likely a sign the virus is to blame. If a patient gets pneumonia after he/she seems to recover a bit, the culprit is more likely bacteria.

Bacterial infections sometimes spread to the blood making patients critically ill. In such cases pneumonia can lead to lung or kidney failure. The virus itself, or the inflammatory response it instigates, can also attack heart muscle. That makes people more vulnerable to heart attacks and strokes for three to six weeks after they appear to have recovered

Who will get  ARDS --  the worst case scenario for young people?

This virus pneumonia is really strange in a sense some suggest that shortness of breath is caused not only by fluid in the lungs but is complimented with the destruction of hemoglobin is blood like in case of malaria. That's not proven should be viewed as a weak hypothesis, but if is true, then increase the danger of this virus dramatically.

It’s not known how many people with COVID-19 develop pneumonia and 2-7% of infected is just an educated guess, but of the ones who do, about 20% get severely ill and develop Acute respiratory distress syndrome (ARDS) which occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs and the level of oxygen in your blood drops dramatically damaging other organs. This group has 40% death rate. This is the situation when people need to be put on ventilator.  Putting old people on ventilator often does not improve the prognosis. It just postpones inevitable. 

Whether COBID-19 cause ARDS or it develops as the result of lung trauma of ventilator usage recently was actively discussed  FROM NYC ICU DOES COVID-19 REALLY CAUSE ARDS!!. We can't exclude certain cases of medical malpractice and the desire of hospitals to get more money (patients who are on ventilator bring additional revenue for the hospital). Also

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required… They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease.

ARDS is the abbreviation for Acute respiratory distress syndrome  when your chest muscles are tied so that they can't provided necessary contraction and inflation of lungs (mayoclinic.org ): 

Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.

ARDS typically occurs in people who are already critically ill or who have significant injuries. Severe shortness of breath — the main symptom of ARDS — usually develops within a few hours to a few days after the precipitating injury or infection.

Many people who develop ARDS don't survive. The risk of death increases with age and severity of illness. Of the people who do survive ARDS, some recover completely while others experience lasting damage to their lungs.

Some specialist consider it more like high altitude sickness when you muscles are OK, but your blood can't get enough oxygen due to destruction of hemoglobin  Covid-19 had us all fooled, but now we might have finally found its secret.

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required…

They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease.

The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue.

That might explain why anti-malaria drag are effective New York Post

Holy Shit, This Is Not The Flu Medical Worker Describes Terrifying Lung Failure From COVID-19... Even In Young Patients

I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people.

Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.

They suddenly become unresponsive or go into respiratory failure.

“We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive — these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive.

That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.

The lung is filled with so much fluid, displacing where the air would normally be.

“It’s called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And it’s notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream.

“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you’re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body.

“Typically with ARDS, the lungs become inflamed. It’s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what’s called ‘ground glass opacity,’ like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.

What is the mortality rate?

Life doesn’t go on forever. It is a truism that old people tend to die more frequently. In 2017 people over 55 constitute 87% (2.4 million) of all US deaths (2.8 million)  (cdc.gov). Of them people over 75 are approx half (55%  or 1.5 million).  So in "normal" times 8K of Americans each day move to other world. Of them 6.5K are people over 55 and 4K are people over 70.

Like other coronaviruses, this virus predominantly affects "Over 50"  age category and might speed up death for those who have other serious conditions.

There are there main group of people who dies from the virus

  • People with very serious additional conditions ("the last straw effect")
  • People with  weak immune system (that include anybody over 80)
  • Younger people for whom pneumonia develops into ARDS. This category includes some people younger then 30. 

As of April 5, 2020 COVID-19 deaths currently does not distort the statistics of death in the USA as the number of death from the virus is still  statistically insignificant .  So the question arise, why such drastic measures were taken outside known hot spots such ad New York metropolitan area.  It might make sense to classify regions into three category "high risk (hot spots), medium risk  and low risk and treat them differently.

Another question why politicians like Cuomo overhype the treat and want tremendous amount of ventilators. Ventilator treatment will not make a survival difference to patients who are frail and that's the majority of COVID-19 patients. Typically around 50% on those who were put on ventilator dies while on ventilators (Mortality rate of COVID-19 patients on ventilators Physician's Weekly.) For those who survives signicant percentage will die  too. As of Apr 5 there were only 38K hospitalized patients in the USA. Why Cuomo wants another 40K ventilators is a little bit unclear. Peak ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674) ventilators (https://gineersnow.com/industries/medical/forecast-deaths-hospitals-ventilators-covid-19-impact-usa) "What the authorities know that a regular overseer of events don't? 

Peak ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674) ventilators.

Read more at: https://gineersnow.com/industries/medical/forecast-deaths-hospitals-ventilators-covid-19-impact-usa

Here are Italian data cited from Moon of Alabama blog:

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 25% of the deceased are women.

The mortality figures from the Italian health ministry certain are surprising to say the least, and not in a way that support the MSM hysteria on this.

That suggests that the data we are getting from MSM is incomplete, hyped (especially about R0 and mortality) and does not allow to objectively size the treat. Only very crude numbers of cases and deaths are available and very little information about testing rates,   pre-conditions for development of pneumonia (smoking and poor air quality are two factor suspected but  nothing definitive known), very limited information is provided about the average ages of people who is being hospitalized (probably over 70), and especially those in intensive care. The question is who is dying from it ?

One important finding from the China study  that is ignored by neoliberal MSM is the near absence of cases among children. The 10-19 age bracket comprised only one percent of all infections, and a single death. Children under 10 made up less than one percent, with no deaths reported

One important finding from the China study  that is ignored by neoliberal MSM is the near absence of cases among children. The 10-19 age bracket comprised only one percent of all infections, and a single death. Children under 10 made up less than one percent, with no deaths reported

Difficulties in estimating mortality

 

Oxford’s Centre for Evidence Based Medicine is providing regular updates of an estimate of the infection fatality rate for Covid-19. Their current estimate is 0.20% (95% CI, 0.17 to 0.25).

March 25, 2020

A Single Death is a Tragedy; a Million Deaths is a Statistic ~Stalin

If you shoot one person you are a murderer. If you kill a couple persons you are a gangster. If you are a crazy statesman and send millions to their deaths you are a hero.Watertown Daily Times.

 

Joseph Stalin once said “a single death is a tragedy” and “a million deaths is a statistic.” The observation was chilling because it has a grain of truth about how we process tragedies. The same is sometimes true legally. If a government kills one person, it is a murder.

If it kills thousands of people, it is a policy. That cold fact soon may be evident in a growing number of class action lawsuits now brought against China over its failure to notify the world promptly of the coronavirus, along with renewed allegations that the outbreak may have started in a laboratory in Wuhan.
 

In no way the Coronavirus death statistics are reliable.  One of the big problems is the reliability of the data. To figure out a death toll you need to estimate how many people have the virus, and how many people died as a result. Both of those are very difficult problems, the first because testing is spotty and carries inherent systematic error. The second because of comorbidities and the possibility of attributing deaths from other viruses to this one. Accounting trick of assigning every death with a positive test to COVID-19 has, effectively, reassigned normal (cancer, diabetes, etc.) deaths to COVID-19.

The best way to estimate if a new disease is a significant danger  is to compare death rate with the previous year (or average of 10 previous years) for a week or month with the current. For GB and Italy based on this metric increase of mortality caused by COVID-19 is statistically insignificant:

glib March 25, 2020 at 3:38 pm GMT 

 This is the Euro mortality map for last week. I assume they highlight by standard deviations. Italy shows no excess. What is the weekly death rate in Italy?

On average about 6000/day, higher in late winter every year. the square root of 6000X7 is about 200.

If I read this table right, there have been less than 600 extra deaths in Italy this week. Compare with the winter 2014-2015, when there were 54,000 extra deaths for the whole winter, so some 3000/week.

http://www.euromomo.eu/slices/map_2017_2020.html

But it is clearly looks like the amount of hysteria and panic is utterly disproportionate to the number of deaths. For this amount of panic I would expect hundreds of thousands of dead in the USA alone. Note that over 200K Americans die each year of preventable medical error. Does anyone panic about that, even though many of those errors are far easier to eliminate than a virus?

First of all it looks like that are at least two stains of this virus with different morality: S and L.

Second, the fact that swab tests produce a lot of false positives complicates correct estimation of mortality ?  In any case what is measured is the mortality among tested patients, which is always higher then that mortality among infected patients, because outside cruise ships not all people are tested.

But the most important issue is that most countries include in COVID-19 death statistics all deaths "with the virus" along with all deaths  "from the virus" The best definition would be: novel coronavirus antibodies test positive (proof of recent infection) plus ARDS (radiologically, if not pathologically, confirmed).

This happens because the majority of diseased patients are old and have at least one life threatening medical condition and virus was just the last straw that broke the camel neck. "Real" deaths from virus are deaths from virus pneumonia. They are probably a small fraction of the total deaths, as deaths are heavily biased toward older (over 70) population.

It seems hard to get any hands on this. It’s like a greased pig.

Again, there are very strong reasons to suspect that neoliberal MSM are deceiving us and the mortality figure promoted by MSM are over inflated: Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125% (statnews.com): 

That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.

Could the Covid-19 case fatality rate be that low? No, some say, pointing to the high rate in elderly people. However, even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter.

... ... ...

Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction? How can we tell at what point such a curve might stop?

The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have.

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125% (statnews.com) 

That raises question what if majority whose who died,  died of the coronavirus have such serious medical conditions that the coronavirus just was the last straw that broke the camel back and flu would do for  them the same.  In other words the number of deaths can well be pure hype and the real mortality from this virus is close to mortality from a severe epidemic of the seasonal flu.

That raises question what if majority whose who died, died of the coronavirus have such serious medical conditions that the coronavirus just was the last straw that broke the camel back and flu would do for them the same. In other words the number of deaths can well be pure hype and the real mortality from this virus is close to mortality from a severe epidemic of the seasonal flu. 

What are symptoms and the duration of the disease?

  “It's not a tickle in your throat. You're not just clearing your throat. It's not just irritated. You're not putting anything out, you're not coughing anything up,” Schaffner explained. “The cough is bothersome, it's coming from your breastbone or sternum and you can tell that your bronchial tubes are inflamed or irritated.”

Shortness of breath is another key sign of respiratory infection related to the virus...

Beyond these key signs, Covid-19 can manifest through a number of flu-like symptoms, including aches, pains, a runny nose, congestion, and a sore throat. Some cases may even involve bouts of diarrhea. 

Coronavirus Symptoms What Signs Should You Be Most Concerned About

It looks like there are two main mutations of this coronavirus:  "L" and "S". The L is more common (especially in the USA) and the S (Wuhan mutation) is more lethal. All-in-all there are around two dozens of mutation (Chinese figures)

Symptoms vary. Slightly elevated temperature and early development of dry cough are two more typical symptoms. If shortness of breath is present this is a real warning sign.  Loss of smell is a very important symptom and usually means that the patient is infected. In France they do not even test such people. Those two presentation gives you general information about symptoms:

Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection

blues , Mar 24 2020 4:32 utc | 165

This may be an important new clue:

~~~~~~~~~~~~~~~~~~~~ //
Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection
The New York Times - March 22, 2020

A mother who was infected with the coronavirus couldn't smell her baby's full diaper. Cooks who can usually name every spice in a restaurant dish can't smell curry or garlic, and food tastes bland. Others say they can't pick up the sweet scent of shampoo or the foul odor of kitty litter.

Anosmia, the loss of sense of smell, and ageusia, an accompanying diminished sense of taste, have emerged as peculiar telltale signs of Covid-19, the disease caused by the coronavirus, and possible markers of infection.

On Friday, British ear, nose and throat doctors, citing reports from colleagues around the world, called on adults who lose their senses of smell to isolate themselves for seven days, even if they have no other symptoms, to slow the disease's spread. The published data is limited, but doctors are concerned enough to raise warnings.

Here is one patient story Coronavirus survivor reveals what it's like to have Covid-19  This young and healthy person got a mild form of virus pneumonia, and despite aggravating his condition with alcohol survived.

Three typical symptoms include a slight fever (99-102F, around 98% of patients), dry cough (60% of patients), fatigue (90% of patients). Shortness of breath (labored breathing) allow to distinguish severe form from mild form of the disease and means that lungs are affected

Symptoms usually appear 2 to 14 days after you’re exposed to the virus (incubation period).  Some of the less common symptoms include muscle pain, vomiting, abdominal pain, headache, dizziness and nausea.

Less the a third of patients difficulty breathing, and it takes about five days (on average) for a patient to have difficulty breathing after first showing symptoms. This probably suggest pneumonia.

There are several YouTube presentations of various quality that might help to understand this disease, for example:

Several symptoms associated with common colds – such as a headache or sore throat – were seen in only a small number of cases.

Coronavirus symptoms How the COVID-19 disease progresses day by day - Business Insider

Research from the Chinese Center for Disease Control suggests that about 80% of coronavirus cases are mild. About 15% of patients have gotten severe cases, and 5% have become critically ill.

Here's how symptoms progress among typical patients: 

  • Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority may have had diarrhea or nausea one to two days before.
  • Day 5: Patients may have difficulty breathing — especially if they are older or have a preexisting health condition.
  • Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study.
  • Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome, an illness that occurs when fluid builds up the lungs. ARDS is often fatal.
  • Day 10: If patients have worsening symptoms, this is the time in the disease's progression when they're most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers at about 2%.
  • Day 17: On average, people who recover from the virus are discharged from the hospital after 2 1/2 weeks.

The first symptoms, however, may not come right after a person has been infected. Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, told Business Insider that a typical patient might be infected without showing symptoms for five or more days.

Once symptoms do appear, they can be similar to those of pneumonia. But Paras Lakhani, a radiologist at Thomas Jefferson University, told Business Insider that COVID-19 could be distinguished from [bacterial] pneumonia because of the way it worsened over time.

Here is (rather strange) timeline of appearance of those symptoms from Opinion - U.S. Leaders' fatal error in virus response  It is non-convincing but this is the best I could find:

Typically symptoms are evident on the fifth day of the disease or earlier. Most people recover in 3-4 weeks. Recovered people are immune to the disease.

Historically only around 14% of COVID-19 infections show severe symptoms (which means cases that they require medical attention and prescription drugs.) Some cases are without symptoms. Here are the currently available historical data for the sample of  44 415 cases:

  • Mild (regular flu scenario; no medical attention required):  .............................................. 81% (36 160 cases)
  • Severe (some medical attention and prescription drags (severe cough, etc) are required) : .... 14% (6168 cases)
  • Critical (hospitalization is required ): .....................................................................................   5% (2087 cases)

The main sophisticated feature this virus is that it spread from infected people which show little or no symptoms of the diseases (during incubational period) which is typically from five to seven days with the longest period being  14 day (What Doctors Treating Covid-19 in Wuhan Say About The Virus - Bloomberg, Mar 5, 2020):

“From most of the publications right now the median incubation period is five to seven days, with the longest incubation period as 14 days,” said Du Bin, a member of China’s team of experts overseeing coronavirus treatment. “There’s no data showing that an incubation period longer than 14 days ever existed.”

In some patients, the onset of the virus happened very slowly with only a mild fever before their conditions deteriorated rapidly 10 days later, according to Li Haichao, deputy director of the respiratory department at the First Hospital of Peking University

Some data suggest that  6-10% of infected people show no symptoms. Experience in China revealed that infections occurred in family clusters. The afflicted were tended to by the household, exposing everyone to the infection.

Cynically speaking "this pandemic is nothing to worry about for people of breeding age. If anything, it will reduce long term health care costs by running through the old people." (comment onunz.com)

Effects of COVID-19 are similar to OC43 (one of four other mild coronaviruses probably responsible for 25% of all “common colds”, which causes 15% severe cases and 0.2% fatal cases).  As Marc Lipsitch, an infectious disease epidemiologist at Harvard’s T.H. Chan School of Public Health points out, deaths are the most obvious and easy thing to catch, whereas infected people who stay at home and those with no symptoms are incredibly hard to account for. That tends to skew the fatality rate higher, especially earlier on in an epidemic.

The path of spreading currently is not very clear but probably include both droplets and infected surfaces (shopping cart handles, any ATM or payment device, parking meters) ... and then touching your nose eyes, and face in general:

The best prevention against getting this virus is simple: WASH YOUR HANDS REGULARLY AND DON'T TOUCH YOUR FACE. The virus lived on surfaces for at least Nine  days. Things like public door handles, lift buttons, stair rails, supermarket trolleys, etc. that are touched by thousands of people daily are going to in all probability carry the virus. The virus can't get through dry skin, but if you rub your eye or suchlike the virus can get at your living tissue. Faces may also be a route. Clean toilets.

... ... ...

COVID19 also can infect the victim through a person's eyes. The sphere you want to avoid is up to 6 feet away from a known victim or one you suspect has/is a carrier of COVID19.

... ... ...

I'm told that pharmacists here in England are saying the masks are only useful if worn by an infected person in order to prevent transmission to others.

Median time for recovery is one month.    Observed susceptibility is abound 20-60% of population.  Which means that 40 to 80% of population are immune and is not getting sick after contact with s sick person (worst case was Wuhan personnel where 60% got infects; the other worst case scenario was Diamond Princess cruse chip where only 20% got infected).

The main danger is traveling with the infected person and living in the same household. In households children are as likely to be infected as adults.

Also some percentage of infected people never show any symptoms and the majority (over 80%) of cases never show symptom worse than a typical flu and continue regular life routine. That creates preconditions for a rapid spread of the disease and converting it into pandemic. In countries like the USA the situation is worsened by neoliberals cruel treatment of workers and lack of sick leaves (Wal-Mart and other retail giants ) , when people are often forced to work with flu like symptoms, this spreading the disease both at work and during the commute, if the use public transportation. Those greedy bastards from Wal-Mart merge sick leaves with vacations (which are also not easy to get from mangers) [Slate[.

Part time workers which are now substantial and growing part of the workforce are often work on really slave conditions, without any vacations of pay leaves. There is no national paid leave policy in the USA, making it in this respect a third world country.

The most typical complication is bacterial pneumonia which is often deadly for older people and people with weakened immune system (lasts from 6 to 41 days since admission for fatal cases).

The most typical complication is bacterial pneumonia which is often deadly for older people and people with weakened immune system (lasts from 6 to 41 days since admission for fatal cases):

The median time from their first symptoms to when they became short of breath was five days; to hospitalization, seven days; and to severe breathing trouble, eight days.”

- Coronavirus Live Updates: Offers of Help Go Unanswered by China as Death Toll Grows Again (New York Times, 2/7/20)

Without complication the symptoms of the flu disappears in approximately two to four weeks (four to six weeks if we count incubation period). Like typically for coronavirus recovery includes a period of severe cough. That's a typical scenario for most healthy people. In this sense, it is nothing more then highly infectious seasonal flu. Like is the case with all influenza viruses mortality is higher in older population. China's CCDC found that the virus has the highest fatality rate around 15% for people aged 80 or older with co-occurring medical conditions.

So only for seniors it does represent a "clear and present danger" (with mortality reaching 8.0% for people over 70 I am a little bit concerned about Democratic Candidates in this sense ;-). But such mortality in not atypical -- such people usually have a couple of chronic diseases which make the prognosis far worse.

In many ways this coronavirus looks like a rerun of SARS (sharing approximately 80% of its genome) with four times lower mortality, but higher number of infected persons. So SARC statistic data can serve as a fuzzy guideline:

SARS:

  • Average period from admission to recovery: 23.5 days
  • Average period from admission to death: 35.9 days

- https://arxiv.org/pdf/0801.2261.pdf

Chances of complication are lower for people without chronic diseases, and people living outside densely populated and heavily polluted cities. As this virus can be called "virus pneumonia" it is more dangerous for males. So far we have 2.8% vs. 1.7% morality for make and female, correspondingly. In a sense virus has clear feminist bias.

In any cases mortality for this virus for people below 80 is in single digits ( and on average does not exceed 2 to 3% or approximately 25 times higher then seasonal flu: nearly 1800 people have died for over 70,000 have been infected ). The most compressive data about the epidemics I found do far are provided in the following discussion in Quora How serious is the 2019–20 Wuhan coronavirus - Quora which I encourage to read in full. It does provides a lot of interesting data.

From Quora discussion:

Case-Fatality Rates (CFR) China by Age as of 2/11/20

  • 80+   14.8%
  • 70-79  8.0%
  • 60-69  3.6%
  • 50-59  1.3%
  • 40-49 .4%
  • 30-39  . 24% (18/7,600) 20-29 .19% (7/3,619)
  • 10-19  .02% (1/549)
  •  0 -09   .0 (0/416)

Young and healthy people, meanwhile, typically experience mild flu-like symptoms (some infected people do not display any symptoms -- asymptomatic cases -- dangerous because they still spread the virus) and are not in danger, according to the BBC. WHO recently stated that the virus manifests as only a minor infection in four out of five people who contracted it, according to the Guardian.

The virus manifests as only a minor infection in four out of five people who contracted it“ And 70% of those testing positive are not showing any symptoms at all.” ~ Coronavirus: 99 more cases confirmed on cruise ship - live news (Guardian, 2/17/20)

The most cruel natural experiment with the virus: the epidemic on the Diamond Princess cruise ship

The most cruel natural experiment with the virus was its spread the Diamond Princess cruise ship (closed space, high level of contact between passengers, lack of qualified medical personnel and supplies, etc) Six people died (0.2% mortality) and around 700 people were infected out of 3700. For all other the immune system managed to kill the virus. Which suggests susceptibility rate of around 20%.

One of the defining feature of this virus is high infection rate of people who came into a contact with the virus. But even in this area while the virus is dangerous and protective measure were not taken, it is not catastrophically so.

We can view the epidemic on the Diamond Princess cruise ship as the worst case scenario  (with much older then the average population; very close contact with infected people of the rest population of the ship via common areas) ended

Here is one assessment from the Moon of Alabama blog (note: There are 6 deaths and 696 confirmed infections out of 3,711 passengers and crew):

Hysteria here in NYC is palpable, even more so than usual. I still look to the cruise ship. 600 people on a boat with CoV19. Perfect conditions for virus to spread with common eating and common ventilation/AC. Many, many infected. How many dead? Two, both persons in their 80s.

Posted by: casey | Mar 5 2020 16:15 utc | 10

There is no specific treatment for the virus

Patients are generally given supportive care for their symptoms, such a fluids and pain relievers. In acute cases hospitalized patients may need oxygen to support breathing.

One of the most important countermeasures is respiratory hygiene (Wikipedia)

Those who suspect they are infected should wear a surgical mask (especially when in public) and call a doctor for medical advice. By limiting the volume and travel distance of expiratory droplets dispersed when talking, sneezing, and coughing, masks can serve a public health benefit in reducing transmission by those unknowingly infected.

If a mask is not available, anyone experiencing respiratory symptoms should cover a cough or sneeze with a tissue, promptly discard it in the trash, and wash their hands. If a tissue is unavailable, individuals can cover their mouth or nose with a flexed elbow.

Masks are also recommended for those taking care of someone who may have the disease. Rinsing the nose, gargling with mouthwash, and eating garlic are not effective.

There is no evidence to show that masks protect uninfected persons at low risk and wearing them may create a false sense of security. Surgical masks are widely used by healthy people in Hong Kong, Japan, Singapore and Malaysia. Surgical masks are not recommended by the CDC as a preventive measure for the American general public.[144]

The WHO advises the following best practices for mask usage: respirators at least as protective as NIOSH-certified N95, EU standard FFP2, or equivalent...

Patients are still prescribed existing antiviral drugs which have shown their effectiveness. The main treatment is aimed at reducing the severity of symptoms and is similar to the treatment of traditional seasonal respiratory diseases, but the course of the duration of the disease (with acute period typical for many virus infection around seven days) and the speed of the recovery after it depends on the strength of the individual's immune system.

Planning is the most important aspect of the virus response

Planning is the most important aspect of the virus response,   and countries need to know ahead of time how they are going to handle each patient entering a fever clinic, detect suspected cases, confirm if they have the virus in labs and isolate possible cases. For old people around 15% of cases advance to pneumonia, and it could be really bad

The old patients who actually need hospitalization for the disease often need mechanical ventilation, and this is a highly specialized resource that's in much shorter supply than mere hospital beds.

As old patients are the most  severely affected and tend to overburden the local hospitals, the imposition of a voluntary quarantine on retired population in areas of active spread of infection is a sound measure. Two Japanese passengers - an 87-year-old man and an 84-year-old woman - were the first to die from the disease on February 19 pm Daemon Princess cruise ship.  In the USA out six deaths at least four have been among residents of a long-term care facility called Life Care Center, where more than 50 residents and staff members had shown symptoms of the virus.

As old patients are the most severely affected and tend to overburden the  local healthcare system, the imposition of a voluntary quarantine on retired population in areas of active spread of infection is a sound measure. The imposition of the requirement to wear mask for any person with cough and/or  sneezing is another sound measure.  The mass check of temperature of passengers of mass transit  is a must

Most coronaviruses are seasonal

Coronaviruses do not have such a very high infection rates and typically epidemic is limited to the spring season and subside in summer. So epidemic last three-five months. But the period from infection to first symptom can last a week during which the person possibly can infect other people creating an illusion of high infection rates. The fact that the virus can be infectious even during the incubation period has not been proven

Currently patients are recommended to take medications that are prescribed for the prevention of seasonal respiratory virus infections. These are medications that produce endogenous interferon.

If coronavirus COVID-19 is like other Coronaviruses it probably, like President Trump suggested, will “go away” in April, as temperatures increase and there will be a lot of sunny days. So far is did not reach the size of a typical flu epidemic with 8,000-plus deaths in US alone.

Most Coronaviruses are seasonal, but there was an outbreak in Dominical Republic resorts in summer 2018 which was atypical. So it it’s not yet clear if the new virus will follow the same pattern — and experts caution against banking on the weather to resolve this outbreak (Will the New Coronavirus 'Go Away' in April - FactCheck.org)

Several days later, in a White House meeting with state governors, he repeated the idea and was more specific on the outbreak’s timeline.

Trump, Feb. 10: Now, the virus that we’re talking about having to do — you know, a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April. We’re in great shape though. We have 12 cases — 11 cases, and many of them are in good shape now.

As of March 3, 2020, the epidemics in China is already subsiding:

The health ministry on Tuesday announced just 125 new cases of the virus detected over the past 24 hours, the lowest number since authorities began publishing nationwide figures on Jan. 21. Another 31 deaths were reported, all of them in the hardest-hit province of Hubei. The figures bring China's total number of cases to 80,151 with 2,943 deaths.

China’s U.N. ambassador says the government believes that “victory” over the coronavirus won’t be far behind the coming of spring.

Per country, currently the worst mortality was observed is 4.4% (Iran.) but that only can means that the number  of cases are underreported or there are many cases that are asymptomatic and not included in statistics.  For the graphic map, see

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Panic vs. fatalism vs. realism

Pray as though everything depended on God.
Work as though everything depended on you.

Saint Augustine
 

First of all, there is no reasons to panic. This is not another Black Death epidemics. Far from it.  It looks like healthy people younger then 60 have little to fear but fear itself. Outside New York metropolitan area (and selected hot spots in other large cites) chances to get pneumonia are approximately the same as to get into serious auto crash. Children are rarely infected and typically are infected in family not in school setting:

"One of the striking epidemiologic features of this coronavirus is how little the pediatric population is involved" said William Schaffner, infectious diseases specialist at Vanderbilt University Medical Center.

The main mechanism of transmission is religious congregations, meetings and conferences as well as intra-family transmission.  With minimum precautions chances to get infection in public transport (wearing mask in obligatory safety measure)  and office are minimal.  Transmission "hand to nose of eyes" can be effectively blocked with soup and hand sanitizers.  Most shops now offer iether sanitizer or wipes as a courtesy for customers.

But fear is addictive and it looks like panic, including panic buying had spread in the USA, fueled by irresponsible MSM fearmongering.  For example, reporting deaths from the virus neoliberal MSM do not split it by age groups as this would decrease the level of fear in the population ( and their profits ). In reality only severe and critical cases (when a patient develops virus pneumonia)  matter. All other cases should be  treated like flu cases are treated.  Mortality for this virus is highly age dependent. This coronavirus pandemic is no nothingburger, it is a flu-epidemic-level spike in death of the elderly and infirm.

Another dirty trick that MSM resort to inflate panic to  report just the number of death from the virus, not the deviation from the average number of deaths for a week or a month or so artificially increases panic. Around 8K people  dies in the USA any particular day without any epidemic.  So far maximum deviation from average mortality in any particular day of this epidemics was less then 20%. In many countries (including EU and GB) average weekly mortality is down not up.

Reporting  deaths from the virus neoliberal MSM do not split  it by age groups as this would decrease the level of fear in the population ( and their profits ).   Also reporting just the number of death from the virus, not the deviation form the average number of deaths for a week or a month or so artificially increases panic.

Panic and fear artificially incited by neoliberal MSM are also amplified by cowardice to face the risks immanent in any epidemics (as well as driving the car) is doing more damage than the disease itself.  They provoked the wave of panic hoarding in the USA which started in February with  isopropyl alcohol and hand sanitizer (which in early March reached $60 for 8 ounces bottle on Amazon ;-) As of March 16 it is still in full force with empty shelves in supermarkets as it gradually spread starting from March 10 to many other products categories including paper towels, bathroom tissue, all types of sanitizers and non perishable food. Especially puzzling and irrational is hoarding bathroom tissue. 

Sometime neoliberal MSM coverage of epidemics looks like a complete 100% departure from reality.  More people will die in Yemen and Syria each day going forward, and no one cares. Many old people will serious chronic condition who are die from coronavirus induced pneumonia would die from flu induced pneumonia the same year as they are too weak to resist even flu.  Winter is a very bad season for such people in any case.

Of course, another extreme is fatalism as expressed by Paul Bogdanich in his post at moonofalabama.org (Mar 11 2020 )

I should have clarified, I'm an American living in the United States. That said, it bothers me. The absolute lack of any detectable level of courage or fortitude in the face of diversity (hard times) is just stunning. Old people die. Everyone dies over time. Viruses like the flu or SARS, or COVID-19 accelerate that process from time to time. It's just what viruses do. There is no cure for either death or viruses. If you want, the biblical "Ye shall surely die."

Even in advanced age life has meaning and is exciting when you're solving concrete problems helping your family, or community, or humanity as a whole. Many outstanding achievements were made people over 70 year old (Donald Knuth published The Art of Computer Programming, Volume 4, Fascicle 5 Mathematical Preliminaries Redux; Introduction to Backtracking; Dancing at 81;  Verdi wrote Othello at 74  and Falstaff (1893) being 80). People over 70 now dominate Presidential Elections in the USA ;-)

And unlike fatalists thinking, we do not need to apply to our life the moral metrics which are appropriate only to communities who live on a verge of survival. Loosing some part of annual national income to save lives via quarantine is affordable. Mass testing is a sure way to improve cost efficiency of quarantines and similar measures during virus epidemics. Retired people can and should stay home and avoid situation where they can catch the infection. Reckless behaviour during  virus epidemics is a crime and need to be punished appropriately.

But it is true that the panic can do more damage than the virus itself. And that we need an objective perspective to access the level of threat inherent in this virus epidemics. In the USA a reasonable threshold for classifying the treat as serious  are probably events that exceed car fatalities. In 2016  National Highway Traffic Safety Administration (NHTSA) registered 37,461 killed, an average of 102 per day.

In the USA a reasonable threshold for classifying the treat as serious  are probably events that exceed car fatalities. Which means around 40K people killed per year with the average over 100 per day. The society accepts this level of fatalities as normal, so why this virus epidemics should be treated differently ? Nobody stops driving cars because of this level of risk.

We are still in single digits of victims per day with COVID-19. It did proved high infectious. But there is highly infectious and highly deadly pathogens are two distinct group that do not mix. It is as if viruses  need to make choice between high mortality and high transmission: viruses that kill their host, before the host infects others,  die with the host and this can't kill many hosts without eliminating themselves as well.

With this coronavirus, there seems to be a larger then usual window (aka incubation period) during which a person can be infected and transmitting the virus, without having symptoms. In a way this is a rather "clever" virus. But long incubation period does not eliminates biological reason why highly infectious viruses should evolve to become less deadly in order to succeed.

While the US government of Mar 13 declared  the coronavirus a US national emergency and offered $50 billion for support of state and local governments to fight the virus with FEMA,  additional measures will not have an immediate effect.  But they will definitely slow down the spread of virus "flattening" the epidemics curve and this allowing more patients to survive.

The current dynamic of epidemic in the USA and the world so far is exponential growth of cases with most infections clustered in just  half-dozen countries. Which is typical for an early stage of virus epidemic. Excluding China which now is past its peak and is in decline, the other fastest growing  hotspots are Italy, Iran, Spain and France. As of Mar 10, 2020 in the USA -- only three states  --  Washington State, New York, and  California have over 100 cases 

A typical flu epidemic in the USA infects tens of million people and cause approx 20-50K fatalities per year (somewhere between 0.1% and 1%)  but does not create any headlines in neoliberal MSM.  According to the CDC’s weekly US flu report of February 22, 2020,

“So far this season there have been at least 32 million flu illnesses, 310,000 hospitalizations and 18,000 deaths from flu.”

For comparison the mortality rate in South Korea, where more than 1,100 tests have been administered per million residents, comes out to just 0.6% and concentrated in the old and/or with chronic conditions. In view of USA media hysteria about Coronavirus COVID-19, we need to concentrate on facts, not fears.  Here is Craig Murray comparison with the Hong Kong flu pandemic of 1968/9:

The Hong Kong flu pandemic of 1968/9 was the last really serious flu pandemic to sweep the UK. They do seem extraordinarily regular – 1919, 1969 and 2020. Flu epidemics have much better punctuality than the trains (though I cheated a bit there and left out the 1958 “Asian flu”). Nowadays “Hong Kong flu” is known as H3N2. Estimates for deaths it caused worldwide vary from 1 to 4 million. In the UK it killed an estimated 80,000 people.

If the current coronavirus had appeared in 1968, it would simply have been called “flu”, probably “Wuhan flu”. COVID-19 may not be nowadays classified as such, but in my youth flu is definitely what we would have called it. The Hong Kong flu was very similar to the current outbreak in being extremely contagious but with a fairly low mortality rate. 30% of the UK population is estimated to have been infected in the Hong Kong flu pandemic. The death rate was about 0.5%, mostly elderly or with underlying health conditions.

But there was no massive panic, no second by second media hysteria, over Hong Kong flu. Let me start being unpopular. “Man in his 80’s already not very well from previous conditions, dies of flu” is not and should not be a news headline. The coverage is prurient, intrusive, unbalanced and designed to cause hysteria.

Virus epidemic in the USA

See COVID-19 epidemic handing in the USA

Wearing masks in public places is important

Masks are less useful as a protection, but they are very useful for preventing people with no symptom infecting others. Most surgical masks are too loose to prevent inhalation of the virus. But they diminish the number of infected droplets you inhale (with proper fitting and during initial hour or two substantially), and do prevent you from touching your nose, and for many people that alone is a valuable service.

So wearing one is an important service to other people: if you are infected but has no symptoms that helps to prevent infecting others.  In areas where there are active cases such as NYC or Seattle wearing masks is a necessary and useful precaution.

The most effective are the so-called N95 masks, which block 95 percent of very small particles.

Also the dynamic of the disease might be different and more severe if the virus initially gets directly in lungs then when it initially infect via  other parts of the body. 

As they can prevent you from passing along any infection  wearing masks in public places need to be mandatory. Masks can be reusable as to provide disposable masks for all population is a difficult and resources consuming task.  You can wash them.  Detergent and hot water kills the virus instantly.

The advice to avoid masks outright is wrong. There is a place for them, but of course they’re just not a panacea. And it true that if used improperly  without washing/rubbing with alcohol your hands after removing they may actually increase your risk. The general problem is that is difficult to follow a proper "decontamination procedure" or what you do when you replace the mask with a new one or remove it completely create substantial burden on people and that means that few will be following it.

Also the period during which a single mask is effective is limited to approx  two hours or so (enough for commute and shopping). After this period expire it needs to be disposed or disinfected (soap or soaking in 40% or  higher  alcohol mix is enough to kill all bacteria/viruses)

Terry A., February 15, 2019

5.0 out of 5 stars Exactly what I wanted

They fit great, easy to wear. Just an FYI...I was an operating room nurse for most of my career and we were instructed to wear masks for 2 hours and then dispose. As we breathe, the moisture from our airway dampens the mask and acts as a wick, drawing things in, rather than protecting us.

You can probably adapt some electrical purifier for this purpose two. See for example Amazon.com New True HEPA Filter Air Purifier - Anion Activated Carbon Filter Perfect for Smoking and Dust Mite Allergy Suffere. They dilute the stream of air that comes to your lung with purified air and as such diminish the chances of infection.

Officials are against mass wearing mass for several reason, one of which are shortages. As Dr. Sarah Borwein stated in her Exclusive Interview on COVID-19 with SARS Veteran  published on MedLink:

The shortage of masks has many people feeling quite anxious and unprotected. But masks are NOT very effective at preventing transmission of viral infections, particularly when worn by healthy people. They are by no means the most important measure you can take to protect your health. In fact, if you wear a mask incorrectly, touch or adjust it frequently, re-use it, or fail to wash your hands before putting it on and after taking it off, you may actually increase your risk.

Who should wear a mask:

  • People who are sick, to prevent them spreading their viral droplets when they cough or sneeze.
  • People caring for sick people at close quarters.
  • In a health-care setting.
  • People whose occupation requires them to have close contact with clients.

As it has become socially unacceptable in Hong Kong to NOT wear a mask, there may be situations in which you might choose to wear a mask simply to make other people feel comfortable.

But in general, healthy people do not need to wear masks, except when they need to be in crowded places, or with possibly sick people.

Comparison of the USA epidemic of COVID-19 with previous epidemics and COVID-19 epidemic in other countries

In the USA epidemic started much later then in China (in late February, instead of November or early December in China) and as such closer to warm season, which should probably make it less severe. Every industrialized country in the world probably had been studying coronavirus after MERS and SARS. Some purely to defend against outbreaks, others to weaponized it. So a lot of information was available and some of it was used.

What is bad that it looks like the USA did not have a plan how to deal with the coronavirus epidemic. To add insult to the injury Trump disbanded the pandemic group. Trump Berates PBS Reporter Who Asked About Disbanded Pandemic Group - The National Memo 

China made a few missteps at the start so its doubtful they knew what they were dealing with at the start other having a sudden batch of pneumonia due to a new virus. They reacted the same as any rational well organized country would react.

The USA started with full information about the virus and still CDC managed to botch production of test kits, which definitely made the epidemics more severe as fewer infected people were detected at early stages.  Also travel restriction were ad hoc (compare with Israel mandatory 14 days quarantine for all air passengers)

In no way this is a new Spanish flu pandemic which killed by various estimate between 25 and 100 million people (with the majority of deaths from bacterial pneumonia). Here is some information from https://en.wikipedia.org/wiki/Influenza_pandemic#Spanish_flu

Main article: Spanish flu

The 1918 flu pandemic, commonly referred to as the Spanish flu, was a category 5 influenza pandemic caused by an unusually severe and deadly Influenza A virus strain of subtype H1N1.

The Spanish flu pandemic lasted from 1918 to 1920. Older estimates say it killed 40–50 million people while current estimates say 50 million to 100 million people worldwide were killed. This pandemic has been described as "the greatest medical holocaust in history" and may have killed as many people as the Black Death, although the Black Death is estimated to have killed over a fifth of the world's population at the time, a significantly higher proportion.

This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred." The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.

The Spanish flu pandemic was truly global, spreading even to the Arctic and remote Pacific islands. The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.

Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.

This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70). The total mortality of the 1918–1919 pandemic is not known, but it is estimated that up to 1% of the world's population was killed. As many as 25 million may have been killed in the first 25 weeks; in contrast, HIV/AIDS has killed 25 million in its first 25 years.

In comparison in China epidemics slowed down in two month, killing less then 10K people, due to drastic measures taken by the government MoA - Coronavirus - Statistical Change Causes Confusion - New Case Count Continues To Decline

Deaths from is mostly limited to people with pre-existing health problems for whom pneumonia is deadly.

If we compare  with the SARS coronavirus, which caused an outbreak of SARS in 2002-2003, we can state the its mortality rate of this new coronavirus is much lower. 17 years ago, the mortality rate from SARS was about 10%.

Origins of the virus are unclear and probably is not the wet market

  John Bolton declares China 'responsible' for coronavirus outbreak, says world must hold them 'accountable'

Bolton's tweet:

China silenced coronavirus whistleblowers, expelled journalists, destroyed samples, refused CDC help, and concealed counts of deaths and infections. It's fact there was a massive coverup. China is responsible. The world must act to hold them accountable.

AFAICT (after reading it on ZH) it's just part of the CYA propaganda that has appeared after US government's failure. This is just one of many articles posted by ZH that are transparent attempts to blame China.

<> <> <> <> <> <>

These are damning:

  • National Security Council's classifying all discussions about virus preparation (in mid January!);
  • Senator Richard Burr's warning his friends and supporters of the severity of the virus impact;
  • Health officials suppressing testing (as I described @79);
  • Blaming China for the West's failure to prepare - the West had all the info they needed (and kept it secret so they could game the response to benefit their own agenda).
If the Democratic Party were a Party of opposition instead of a Party of collaboration, they would be asking: What did the President know, and when did he know it?

There are four  hypotheses that are circulating as for the origin of the virus:

  1. It is the result of the jump from animal to human in China. This is the official, politically correct  hypotheses.  how true it is is difficult to say, but virus definably did not jump into human due to low sanitary standards and trading of meat of wild animals in Wuhan seefood market  (The Wuhan wet market theory, compelling story it may be, has been debunked)
  2. The virus originated in the USA and was introduced to China by by visiting American soldiers during the Military World Games, which took place in Wuhan in October 19-27, 2019 and also to Italy as first cases in Italy were registered in November-December timeframe.  The most strong arguments supporting this  hypotheses can be found in article  An Alternative Media Selection - The Unz Review and the comments to this article  at The Unz Review, Mar 22, 2020
  3. Bioengineered in China and accidentally leaked from Wuhan lab.  See Leading Bioweapons Expert Says Covid-19 Likely a Weaponized Virus – American Free Press
  4. Bioengineered in the USA and accidentally leaked from Fort Detrick. Fort Detrick's labs are a very scary place  See Last Man Standing, by Godfree Roberts - The Unz Review.
    • Proponents of this hypotheses point out than the USA was engaged in development and using bioweapons for a long time. And the organization behind the anthrax poisoning cases that happened after 9/11 was never uncovered;  some attributed this tragic incident the desire of certain forces within the USA to pass Patriot Act by eliminating the resistance to it, which, if true,  makes this accident suspiciously similar to Reichstag fire.
    • There was some strange accident in this lab in July, 2019 which led CDC to close of the lab due to “biosafety lapses” at the facility:

      «The U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) facility at Fort Detrick, Maryland — the U.S. military’s lead laboratory for “biological defense” research since the late 1960s — was forced to halt all research it was conducting with a series of deadly pathogens after the CDC found that it lacked “sufficient systems in place to decontaminate wastewater” from its highest-security labs and failure of staff to follow safety procedures, among other lapses. The facility contains both level 3 and level 4 biosafety labs. While it is unknown if experiments involving coronaviruses were ongoing at the time, USAMRIID has recently been involved in research borne out of the Pentagon’s recent concern about the use of bats as bioweapons».

      «The decision to shut down USAMRIID garnered surprisingly little media coverage, as did the CDC’s surprising decision to allow the troubled facility to “partially resume” research late last November even though the facility was and is still not at “full operational capability.” The USAMRIID’s problematic record of safety at such facilities is of particular concern in light of the recent coronavirus outbreak in China. As this report will soon reveal, this is because USAMRIID has a decades-old and close partnership with the University of Wuhan’s Institute of Medical Virology» outbreak of the first epidemic explosion, which now seems almost totally overcome in the country.

    • Bioengineered in Canadian biolab in Winnipeg and moved or stolen to China by researchers where it was accidentally released. A variant of the same hypothesis. 

According to the South China Morning Post, the first case of someone suffering from what later came to be known as Covid-19 occurred in China on November 17. The number of cases grew in December,  with the majority cases in Wuhan .  The Chinese informed the World Health Organization of new pneumonia cases of unknown etiology on Dec 30, 2019. This is the 1st mention of the coronavirus before they knew what it was, from Reuters.com, Dec 30 2019:

"Chinese health authorities said they are investigating 27 cases of viral pneumonia in the central city of Wuhan." 

Later they established that  four of the five initial patients that they managed to trace have no contact with the wet market (which since was demolished). While the market was the first 'cluster' of cases it was not the source of the outbreak.  Some suggest that the virus may originate in the USA:

New research by Chinese, Japanese and Taiwanese scientists seems to indicate that the Covid-19 coronavirus did not originate in China. In fact, Japanese and Taiwanese scientists have gone a step further and have stated that the virus came from the USA.

The same scientists claim that they believe the virus first appeared in the USA back in September 2019. At around the same time, two other things occurred.

  • 200 Americans died of pulmonary fibrosis (inability to breathe) but the conditions and symptoms were not typical of the illness (these deaths were blamed on E-cigarettes and then hushed up).
  • Oh, and just before this incident, the bio-weapons research laboratory at Fort Detrick was hastily closed down...

https://richardhennerley.com/2020/03/05/coronavirus-it-just-got-even-weirder/

Posted by: Richard | Mar 5 2020 15:41 utc | 5

As reported in the BMJ, on January 11 and 12, the Chinese authorities shared the virus’ genetic sequence for countries to use in “developing specific diagnostic kits.” 440 deaths had been confirmed by January 21. By the 22nd, seven cases had been confirmed OUTSIDE China, including one in the US. All were travelers from Wuhan. But the USA government was busy with other staff to pay attention to this threat -- they were preparing the assassination of Soleimani (Asleep at the wheel Why didn’t Western politicians act quicker on Covid-19 spread — RT Op-ed):

On January 22, the UK government announced that health teams would meet the three direct flights a week from Wuhan, China, the epicenter of the virus. At the same time, the risk level was raised from ‘very low’ to ‘low’.  But as Neil Ferguson, director of the MRC Centre for Global Infectious Disease Analysis at Imperial College, London, pointed out, flight screening was no panacea.

“This measure will only identify people who have symptoms as they come off the plane. If someone was infected two days before they travelled, they will arrive without any symptoms at all.” He added, and I emphasize in bold:“It’s essential that the entire health system is alert to the possibility that there will be cases here.”

Lo and behold, the first British case was confirmed nine days later, on January 31, 2020, from Chinese nationals staying at a hotel in York. That very same day, the first cases were also confirmed in Italy. Guess what: they were two Chinese tourists in Rome. Italy is now the world’s number one coronavirus ‘hotspot’. Nearly 3,000 have died there and 60mn people are in quarantine.

Wouldn’t it have been better, if instead of ineffective flight screening, all flights to Western countries from China had been stopped in January – and all travelers who had recently visited China been quarantined? France, by the way, got its first three cases on January 24 (a week before Italy and the UK). All three people had just come back from China. You don’t have to be Sherlock Holmes to see the pattern, do you?

In the New Year, the number one priority of Western politicians should have been the new coronavirus and how best to protect their own populations from it. But their minds were clearly on other things.

Trump – egged on by Washington’s Endless War Lobby – was engaged in an utterly reckless escalation of tensions with Iran. While Covid-19 was spreading in China, the New Year began with the assassination of General Soleimani, a man who had been fighting ISIS, but who was now portrayed as the ‘worst terrorist in the world’. The ‘Iran crisis’ dominated the news cycle. Boris Johnson meanwhile began the year on holiday with his girlfriend in Mustique. The opposition Labour Party were focusing on a leadership election which needn’t have taken place for several months. Three of the four candidates declared on television on February 13 – a day after the UN had activated its WHO-led Crisis Management team to deal with a rapidly escalating problem –that their ‘number one priority’ was… tackling ‘anti-Semitism’ in the Labour Party. Yet after all the brouhaha about anti-Semitism being ‘rife’ in Labour, it was reported at the end of February that the police had ended up charging just one person, a former Labour member.

Here is another interesting post (by Walrus) on the origins of the virus ( A Short Note On Coronavirus COVID-19 By Walrus. - Sic Semper Tyrannis )

... ... ...

Comment: The virology timeline dates I saw indicated a very tightly linked set of actions by China, the World Health Organisation (WHO) and researchers once the alarm was raised.. By that I mean that China and the WHO responded and acted almost immediately - within one or two days, as new information was received and have and still are actively and openly communicating and assisting with further research.

In my opinion, such openness, honesty and actions are totally inconsistent with any of the multitude of conspiracy theories currently advanced.

So much for the virology.......

On the epidemiological front, there is also interesting news. The first is researcher opinion that this virus has probably been circulating at least in November and possibly in October.   It is also believed that the mathematical models show that there are perhaps Ten times the cases world wide than are officially recorded. This partly because some cases are asymptomatic and currently available tests indicate false negative results. This is good news for the case fatality rate if proven because it is ten times less lethal than we currently estimate.

The researchers believe that the virus originated in Bats (notorious RNA Coronavirus carriers) and then infected Wuhan wet market produce - Pangolins, which then infected people. The initial cases were a group of men in the Wuhan wet market -which is also the cause of the error that the virus attacks men more than women, there are few female market workers. The apparent evidence for this is that large quantities of the virus have been found on the trading floor of another Wuhan wet market - the original Wuhan wet market was perhaps disinfected and its now demolished. (So much for the "bio weapon" BS.)

The best prevention against getting this virus is simple: WASH YOUR HANDS REGULARLY AND DON'T TOUCH YOUR FACE. The virus lived on surfaces for at least Nine  days. Things like public door handles, lift buttons, stair rails, supermarket trolleys, etc. that are touched by thousands of people daily are going to in all probability carry the virus. The virus can't get through dry skin, but if you rub your eye or suchlike the virus can get at your living tissue. Faces may also be a route. Clean toilets.

Mask are a waste of time and money except in special cases.

Lessons of Wuhan

In China solidarity and nationwide effort, including sending medics to Wuhan, played an important role in eradiating the epidemic:

China suffered through the H1N1 coronavirus epidemic in 2008 largely because the CDC took 6 months to identify it and, as a result, 300,000 died prematurely. SARS (774 deaths) was the clincher. They created a hair-trigger alarm system, mandated post-mortem pneumonia DNA testing nationwide, and promoted the CDC head, Dr. George F. Gao[1] to Demigod.

Their Covid-19 emergency has now passed and must give Dr. Gao a B+ because, though his system contained a potential epidemic it suffered from a weakness: local politicians could delay, (but not stop) the alarm sounding. Doubtless for sound bureaucratic reasons, Wuhan officials delayed notifying Beijing for a few weeks but, after Beijing pried the information from the Wuhan Director of Public Health[2]They fired him the next day. Henceforth local politicians will be out of the loop and everyone will have a CDC hotline number., the system swung into action, everyone pitched in, and they literally killed it.

National cohesion and coordination were amazing, thanks to the Communist Party. They coordinated everything and filled all the gaps, no questions asked. Ninety percent of the frontline volunteer medical staff–of whom 18 died–were Party members sworn to ‘bear the people’s burden first and enjoy their pleasures last.’ Zhang Wenhong, a prominent Party member and Director of the Department of Infectious Diseases at Shanghai’s Huashan Hospital, became a local hero for his pep-talk to Party members [emphasis added]:

The first-aid team put themselves in great danger. They are tired and need to rest. We shouldn’t take advantage of good people. From now on, I’ll replace all the frontline medics with Party members from different sectors. When we joined the Party, we vowed that we would always prioritize people’s interests and press forward in the face of difficulties. This is the moment we live up to the pledge. All CPC members must rush to the front line. I don’t care what you were actually thinking when you joined the party. Now it’s time to live up to what you promised. I don’t care if you personally agree or not: it’s non-negotiable.

Altogether, 40,000 volunteers self-organized and showed up to help Wuhan.

1. Dr. Gao has made contributions to the study of inter-species pathogen transmission. He organized the first World Flu Day on November 1 2018, commemorating the centenary of the Spanish flu. It was also the 15-year commemoration of the severe acute respiratory syndrome outbreak, SARS, which led to China prioritising investment in the public health system. He is a virologist and immunologist. He has served as Director of the Chinese Center for Disease Control and Prevention since 2017 and Dean of the Savaid Medical School of the University of Chinese Academy of Sciences since 2015. Gao is an academician of the Chinese Academy of Sciences and The World Academy of Sciences, as well as a foreign associate of the US National Academy of Sciences and the US National Academy of Medicine. He was awarded the TWAS Prize in Medical Science in 2012 and the Nikkei Asia Prize in 2014.,

 

In China epidemics is past its peak and soon will be eradiated

As of  February 15, 2020 (01:30 UTC), there were 67K confirmed cases of infection, of which 66K were within mainland China. After that epidemics quickly dissipated with less then 200 cases a day reported recently

Wuhan is eleven million city and it has less then 100K cases as of Feb 2020 (approximately two months after the epidemics started;  it started with zero protective measures in place and run wild probably for a month or so ), so we should probably have hope to survive ;-)

As I’ve said in other places about “Kung Flu”: Wake me up when there’s a Small-pox outbreak: As contagious as the common cold with a 30% mortality rate at least… No vaccines, no effective treatment… and I suspect anyone under 50 would be at risk…

As of Feb 18, 2020 the spreading of the virus is decelerating and dropped from the local max of 64% (01/27/2020) to less then 3% a day (since 02/15/2020). Currently less then 100K people are infected. Here is know dynamic of infections (Timeline of the 2019–20 coronavirus outbreak in December 2019 – January 2020 - Wikipedia):

Data of tested cases is sourced from Chinese National Health Commission daily reports. Data of C.D. cases from 2020-02-12 to 2020-02-15 is sourced from Health Commission of Hubei daily reports.

On Mar 17 Washington Post reporter based in Peking provided the first-hand evidence that life in Peking is returning to normal. Restaurants have reopened.

At the same as Pepe Escobar reported:

Shanghai-based Dr. Zhang Wenhong, one of China’s top infectious disease experts, whose analyses have been spot on so far, now says China has emerged from the darkest days in the “people’s war” against Covid-19. But he does not think this will be over by summer. Now extrapolate what he’s saying to the Western world.

Mysterious epidemic of "vaping pneumonia"  in the August of 2019 in the USA

Pneumonia caused by the virus is somewhat similar to "vaping pneumonia" epidemic in the USA in summer of 2019 which was attributed to e-cigarette use: 

As of Friday, there have been more than 450 possible cases of lung illness associated with using e-cigarettes reported to the CDC across 33 states and the US Virgin Islands. The numbers have been changing frequently.

Before the death in Kansas, five deaths were reported in California, Illinois, Indiana, Minnesota and Oregon.

Symptoms were remarkably similar to COVID-19 and while e-cigarettes were around for years epidemic happened in summer of 2019 (What You Need to Know About Vaping-Related Lung Illness - NYT,