Why do people point to the China response as being a model response, as though that is easily seen. China has had an order of magnitude more deaths and instances than any other country. While you can point to many factors showing why it is disingenuous to look at those raw numbers without context, it seems to me that the burden of proof is on the other side, to show that the China model is actually effective, because naively it looks like it didn't work out too well.
Because China is a good month ahead of the rest of the world, and is much denser populated in the cities (which are also much larger than ours).
The initial cover up didn't help either. Once they instated the lockdown, they could test the backlog of people. That took quitea while. But now the spread has pretty much stopped, while everywhere else on this planet it increases day by day.
After the initial cover-up got public, the West couldn't get enough of reporting about it, and how this is the reason it could spread so fast, how irresponsible it was, and how it's typical for evil China. Now we have that virus here, plus two month of knowledge about it, and we're still mostly being reactive instead of proactive. In China's defense, when they tried to cover it up, much less was known about the disease, like it's asymptomatic spread. Now the cards are on the table and we're being ignorant, as if ignoring a problem makes it go away. But hey, when things are getting really really ugly for us, we can still go back to blaming China for their initial cover-up.
Watch Italy closely the next days, and compare it to China when they were at a similar stage. It will tell you what's to come in your country too. Another thing that's suspicious about Italy is the high CFR of around 6%. It most likely means they're not doing enough testing, only the severe cases, so the rest wanders around the country happily spreading it further.
It's worth noting that South Korea also was able to engage in such mass mobilization. Moreover, if the trends continue for a few weeks, China's not going to have an order of magnitude more death anymore.
Italy's high CFR sounds like a health care that's broken far more than the Chinese health care system, a system which essentially isn't taking any specific extreme measures (which would be building more hospitals, importing more health care workers, etc).
If you don't mind, Where did you find this information? I've been searching for a breakdown of all fatalities so far by age group (raw numbers, not just average percentages) and could not find it.
You may want to reconsider relying on /r/COVID19 as a source of information. There's been a lot of criticism on how they are applying censorship, and no transparency around it.
Because they're still treating them in some regard(before being overwhelmed).
However once things get even more overwhelmed, you have bad cases become critical leading to more fatalities.
The going figure seems to 20% are badly impacted, with 5% of that critical. Some of that 15% will become critical without treatment that might not be available. Thus impacting people <70.
Thus far. Most of the younger critical patients are not out of the woods yet. Also, many of those are left to die without treatment or assessment because there aren't enough ventilators for them.
I'm not sure "advanced" is what's needed for healthcare systems to cope with this. It's relatively low-tech care scaled up quickly. My fear is that the amount of institutional inertia, and where in time the inflection point of overcoming that inertia lies will determine outcomes.
> After the initial cover-up got public, the West couldn't get enough of reporting about it, and how this is the reason it could spread so fast, how irresponsible it was, and how it's typical for evil China. Now we have that virus here, plus two month of knowledge about it, and we're still mostly being reactive instead of proactive. In China's defense, when they tried to cover it up, much less was known about the disease, like it's asymptomatic spread. Now the cards are on the table and we're being ignorant, as if ignoring a problem makes it go away. But hey, when things are getting really really ugly for us, we can still go back to blaming China for their initial cover-up.
I think you're combining two largely-unrelated factors. The news in any country is only going to be interested in the most salacious stories in countries 12 time zones away. This is just how the market operates. A tiny percentage of china dying from a new kind of flu is not as headline-grabbing as people dying due to govt misbehavior.
Meanwhile our govt isn't blind, they have people and plans in place for everything and they think they are ready and in control. Then, it turns out it's a clusterfuck anyway that takes way longer than expected to implement. They need to have dealt with the exact same disaster in recent years to get it right. It's a problem with implementing a large-scale system you can't test until it's needed.
Having plans in place is great, but we're already running out of masks, gloves etc. here in Germany and it's only about to start. We didn't even try to stock up on this, since "lol China flu, won't concern us". Germany actually just intercepted a shipment of gloves from China to Switzerland and kept them. That's how desperate they are over here.
But in fact I doubt there really is a plan in place at all. It seems most countries ignored this, hoping they'll be spared of this, then stumbled along with adhoc measures, and only now slowly start to listen to experts.
Saying there is nothing we could have done better from just looking at what unfolds in China is very questionable.
> The news in any country is only going to be interested in the most salacious stories in countries 12 time zones away. This is just how the market operates.
... for about a month, and still bringing it up to this date.
Compare [1] to [2]. Notice anything? Western, especially US media is becoming more and more of an echo chamber trying to strengthen that simplistic world view that we are the good guys and they are the bad guys. But it's not overly surprising really, considering the financial struggles of traditional media over the last decade. As you said, the focus shifts more and more towards stories and headlines that sell, even for once renowned outlets like the NYTimes.
In the US the most notable problem is the tests. They had this grand plan to gets millions of them produced and be available at every local testing clinic, which ran into one misstep after another.
Do you recall the international coverage of Hurricane Katrina? It was dominated by the stories about rape gangs and anarchy which all ultimately turned out to be false rumors. Media everywhere sucks like that to some degree. As an american, I probably notice the bias towards stories that make the US look bad a lot more than you might.
Though I get what you're saying. US media may be one of the worst in the developed world. I don't even look at it anymore. Lucky I learned about coronavirus from here and adjusted my plans for it. And the NYT in particular seems to be really anti-China since they got blocked in China a long time ago.
Fully agree except that Italy’s CFR is most likely caused by its large proportion of elderly people. Compare to South Korea where the majority of infected are young and thus CFR is sub 1%.
The difference in age demographics isn't nearly enough to account for the differences in outcomes, unless you believe the proportion of people in Italy >70 years old is 5-10x that of South Korea. (Spoiler alert: it's not).
The issue has to do with preparedness and healthcare capacity. South Korea has 3x the number of hospital beds per capita than Italy.
Japan has an even more elderly population than Italy, yet a lower CFR than South Korea. Is Japan testing enough? Are they somehow self-isolating way better than anyone else?
Japan isn't really doing much and many suspect that they are deliberately looking away from the coronavirus outbreak because of the 2020 Olympics later this year. IMO, the gov't willful neglect and concealment is exactly what enabled the coronavirus outbreak in Wuhan, China and I fear this might come back to bite them later.
Well, look at this chart which speaks volume about how successful China is in containing the outbreak, with new cases per day decreasing dramatically since February: https://pbs.twimg.com/media/ESywcEKUwAADhcQ?format=png&name=... And look in particular how cases in other countries are starting to explode since the last week or so.
Or look at cumulative deaths (outside China): https://pbs.twimg.com/media/ESyyxfiUMAEwMVa?format=png&name=... The growth follows a perfect exponential curve, which suggests other countries have so far been completely unable to even bend the epidemic curve a little bit. It is obvious given this data that we will see 10k deaths outside China by March 20. I have a perfect track record at making such predictions in the past: https://twitter.com/search?q=from%3Azorinaq%20%23PredictionW... (short-term predictions are easy to make, long-term not so much)
You also have to take into account that China probably took the right actions, but their big failure was in timing them poorly. If they'd implemented travel restrictions before Chinese New Year, we probably wouldn't be talking about a pandemic right now.
Considering the lack of action, or the very delayed manner in which we, the West, start to put up measures to prevent spread, I very highly doubt so.
Consider the incubation time of 5 days avg, 14 days max during which you're already infectious. Even if China had reacted quickly, not trying to cover it up, we still wouldn't have known about that for a while. Even without the Chinese new year, I'm pretty sure given how dense and large Chinese cities are, this would have spread eventually either way. And I doubt the rest of the world would have reacted any different in that alternate reality than now. We still have travel with China and Italy today. Why would that have been any different had China handled that differently? It would have been slower, but it would have spread to other countries, I have no doubt about that.
> Consider the incubation time of 5 days avg, 14 days max during which you're already infectious."
I have seen several comments like this on this thread suggesting people are contagious during the incubation phase. Do you have a source for this? AFAIK this has not yet been confirmed, other than perhaps a few anecdotal cases.
I'm also just aware of a few anecdotal cases, but I guess this is very hard to scientifically confirm by its nature. There have been several cases in the US where it could not be traced back where they could have been infected (which could or could not be asymptomatic, or just incomplete knowledge of contacts). The first case in Germany was also asymptomatic spread[1]. Even if this just happens in few cases it would still be devastating, especially if it also happens with those that go completely asymptomatic for the entirety of their infection, which is currently said to be about 10 to 20% of all infections.
I check out John Campbell on YouTube every couple days. He has this unique style of presenting current developments and research papers in a no-bs manner and commenting on them, currently urging for more proactive measures mostly.
People need to stop talking about this as a binary yes or no fact. It is almost guaranteed that it is possible to infect someone else while not showing symptoms and this probably has actually happened. The question is how common it is. Most credible sources I've seen seem to say that it is unlikely/uncommon.
It seems likely that if we fully controlled most of the cases that had visible symptoms, the spread would stop, even if we failed to control the cases which did not show symptoms.
The same is true for spread via surfaces: while I'm sure it's possible and happens, it seems like the primary mechanism of infection is breathing infected respiratory droplets from someone else.
Last guidance I saw from the CDC was that people without obvious symptoms were likely to only be contact-infectious, as opposed to airborne-infectious (droplets) once symptomatic.
If true, social distancing, hand hygiene, and not touching ones face would bring asymptomatic transmission down to almost zero.
Hindsight is 20/20. It’s hard to know ahead of time whether you should cancel your nation’s equivalent of Christmas + Thanksgiving because you have preliminary and incomplete information about a disease outbreak somewhere.
Regulation doesn't have to be binary. The point of it isn't to eradicate behavior, just lessen it so the risk can be mitigated and contained. Perhaps I should have said "lessened wildlife trade" to be more specific.
Number of deaths is a lagging indicator while number of PUI (patients under investigation) would be a leading indicator. But since number of deaths is the number that can be easily aggregated let's hope in a few weeks we will find out that the curve has already started to bend.
I mean, don't just look at the absolute numbers, arguable China has 1/5 of the world's population.
I believe the argument to be made here is that most parts in China, excluding Hubei, has a lot less cases than Korea or Italy, when Korea's population is about 3-4% that of China. In most provinces in China there were 0 deaths.
Ideally, European countires like Italty are far further away and should have fewer cases than those regions closer to the epicenter, but reality suggest otherwise.
China seems to have done well to contain the virus in Hubei. The other major cities like Beijing and Shanghai, while affected by the containment measures were relatively lightly affected by the virus itself. If we can manage that I’d call it a success.
Not to mention that China was pretty slow to properly react (nearly 2 months between the start of the outbreak and the start of Wuhan's quarantine, by which point it had already spread to South Korea and Thailand, and likely to Italy), and even outright suppressed the doctors/whistleblowers who originally publicly raised concern about the virus (which the Supreme People's Court even admitted was a bad idea; you know the PRC government done goofed when they're actually willing to admit they made a mistake).
The US should be looking at China as a case study on how not to handle the early stages of a pandemic. Instead it seems like we're making the same mistakes (though thankfully at least some areas are being proactive about e.g. shutting down schools).
The earliest case was found at the start of December but it wasn't correctly identified till the end (they went back and tested existing patients).
It wasn't confirmed as being able to spread person to person until the 17th although there was some evidence that it should have been identified on the 11th. (So a delay of either 5 or 10 days rather than 2 months)
The doctor didn't raise public concern. He told a few friends and told them not to tell people. The official announcement was made the following day.
If you look at the timetable it is significantly better than the SARs response or the N1H1 response so we seem to be learning and making progress which is good.
On 30 December 2019, genetic sequencing report of the pathogen of a patient indicated inaccurately the discovery of Severe acute respiratory syndrome coronavirus (SARS coronavirus) in the test result.[15] After receiving the test result, multiple doctors in Wuhan shared the information via internet, including Dr. Li Wenliang, an ophthalmologist at Wuhan Central Hospital, who posted a warning to alumni from his medical school class via a WeChat online forum that a cluster of seven patients treating within the ophthalmology department had been unsuccessfully treated for symptoms of viral pneumonia and diagnosed with SARS.[20][21][15] Because these patients did not respond to traditional treatments, they were quarantined in an ER department of the Wuhan Central Hospital.[22] In the WeChat forum, Li posted that this cluster of patients appeared to be infected by SARS. Dr. Li posted a snippet of an RNA analysis finding "SARS coronavirus" and extensive bacteria colonies in a patient's airways according to a chat transcript that he and other chat members later shared online. [...] Dr. Li is widely known for the statement he gave before his death exemplifying how the Chinese government botched the containment of the Wuhan coronavirus, stating "There should be more than one voice in a healthy society."[20]
The Chinese National Health Commission announced later that evening that 8 doctors engaging in this WeChat forum had been arrested by Wuhan Police and charged with "llegal acts of fabricating, spreading rumors and disrupting social order."[25]
Wuhan medical authorities forbade doctors from making public announcements and ordered them to report cases internally.[26]
[...]
(31 December)
Qu Shiqian, a vendor at the Huanan Seafood Market, said government officials had disinfected the premises on 31 December 2019 and told stallholders to wear masks. Qu said he had only learnt of the pneumonia outbreak from media reports. "Previously I thought they had flu," he said. "It should be not serious. We are fish traders. How can we get infected?"[29]
"Chinese state television reported that a team of experts from the National Health Commission had arrived in Wuhan on 31 December 2019 to lead the investigation, while the People's Daily said the exact cause remained unclear and it would be premature to speculate."[28][29][38] Chinese state broadcaster CCTV reported that a team of senior health experts had been dispatched to the city of Wuhan and were reported to be "conducting relevant inspection and verification work."[30]
Tao Lina, a public health expert and former official with Shanghai's Centre for disease control and prevention, said, "I think we are [now] quite capable of killing it in the beginning phase, given China's disease control system, emergency handling capacity and clinical medicine support."[29]
[...]
(1 January)
According to the Chinese state-sponsored Xinhua News, the Huanan Seafood Market was closed on 1 January 2020 for "regulation."[22] However, in the Consortium's report of 24 January 2020, it was stated that the Huanan Seafood Market had been closed on 1 January 2020 for "cleaning and disinfection."[36]
[...]
(2 January)
On 2 January, 41 admitted hospital patients in Wuhan, China, were confirmed to have contracted (laboratory-confirmed) the 2019-nCoV (Wuhan coronavirus); 27 (66%) patients had direct exposure to Huanan Seafood Wholesale Market.[8] All 41 patients were subsequently relocated from the hospital they had originally been diagnosed in to the Jinyintan Hospital in Wuhan, China.[8]
[...]
(3 January)
On 3 January 2020, Dr. Li Wenliang, the Wuhan ophthalmologist who had been arrested for spreading false "rumors" on WeChat, was summoned to the Wuhan Public Security Bureau where he was told to sign an official confession and admonition letter promising to cease spreading false "rumors" regarding the coronavirus. In the letter, he was accused of "making false comments" that had "severely disturbed the social order". The letter stated, "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice—is that understood?" Dr. Li signed the confession writing: "Yes, I understand."[21]
[...]
(4 January)
The head of the University of Hong Kong's Centre for Infection, Ho Pak-leung, warned that the city should implement the strictest possible monitoring system for a mystery new viral pneumonia that infected dozens of people on the mainland, as it was highly possible that the illness was spreading from human to human. The microbiologist also warned that there could be a surge in cases during the upcoming Chinese New Year. Ho said he hoped the mainland would release more details as soon as possible about the patients infected with the disease, such as their medical history, to help experts analyse the illness and to allow for more effective preventive measures to be put in place.[43]
[...]
(7 January)
Since the outburst of social media discussion of the mysterious pneumonia outbreak in Wuhan, China, Chinese authorities censored the hashtag #WuhanSARS and were now investigating anyone who was allegedly spreading misleading information about the outbreak on social media.[51]
[...]
(18 January)
On the same day, the Wuhan City government held an annual banquet in the Baibuting community celebrating the Chinese New Year with forty thousand families in attendance despite the officials' knowledge of the spread of the Wuhan coronavirus. They shared meals, plates and ate together.[83] On 21 January 2020 when Wuhan mayor Zhou Xianwang was asked on state television why this banquet was held even after the number of cases had risen to 312 he responded, "The reason why the Baibuting community continued to host the banquet this year was based on the previous judgment that the spread of the epidemic was limited between humans, so there was not enough warning."[26]
[...]
(21 January)
After 300 confirmed diagnoses and 6 deaths, Chinese state media warned lower-level officials not to cover up the spread of a new coronavirus.[40] Officials declared that anyone who concealed new cases would "be nailed on the pillar of shame for eternity", the political body responsible for law and order said. Local Chinese officials initially withheld information about the epidemic from the public. It later vastly under-reported the number of people that had been infected, downplayed the risks and failed to provide timely information that experts say could have saved lives. In its commentary published online on Tuesday January 20, 2020, the Communist Party's Central Political and Legal Commission talked of China having learned a "painful lesson" from the SARS epidemic and called for the public to be kept informed. Deception, it warned, could "turn a controllable natural disaster into a man-made disaster".[40]
[...]
(28 January)
China's Supreme People's Court ruled that whistleblower, Li Wenliang, had not committed the crime of spreading "rumors" when on 30 December 2019 he posted to a WeChat forum for medical school alumni that seven patients under his care appeared to have contracted SARS. In their ruling, the Supreme People's Court stated, "If society had at the time believed those 'rumours', and wore masks, used disinfectant and avoided going to the wildlife market as if there were a SARS outbreak, perhaps it would've meant we could better control the coronavirus today," the court said. "Rumours end when there is openness."[221][222]
----- END WIKIPEDIA QUOTE -----
So:
> The earliest case was found at the start of December but it wasn't correctly identified till the end (they went back and tested existing patients).
By that timeline, it wasn't even correctly identified by the end of December (though the "rumor" Dr. Li et. al. disseminated about it looking like SARS ended up being pretty close).
> It wasn't confirmed as being able to spread person to person until the 17th although there was some evidence that it should have been identified on the 11th. (So a delay of either 5 or 10 days rather than 2 months)
There's evidence that it should've been recognized as at least potentially spreading person to person by the 3rd, at the very latest (given that not all cases were connected to the Huanan Seafood Market).
> The doctor didn't raise public concern. He told a few friends and told them not to tell people.
He told an online forum of his fellow alumni, and he (among others) posted transcripts online, drawing the ire of authorities.
> The official announcement was made the following day.
Yes, after those "rumors" about SARS forced their hand.
> If you look at the timetable it is significantly better than the SARs response or the N1H1 response so we seem to be learning and making progress which is good.
True, and that's commendable, but even China admits it done goofed. It's great that (as far as we can tell) they've course-corrected and are getting a handle on things, but let's not gloss over how their kneejerk tendency toward censorship and their casual "well we don't know for sure if it spreads human to human so let's pretend we're all safe" attitude around the outbreak directly contributed to what's now officially a global pandemic.
The fact that people outside of China don't know what WeChat is make sense. It isn't an "online forum". It is more like a private Whatsapp group. He also told them the wrong information. He shouldn't have been charged but while he used the "internet" it wasn't public. It was passed around and others did post it publically online.
I don't know why Wikipedia is missing a lot of the public information that happened before the 31st. The local government was notified on the 28th. The National government was notified on the 30th. Other hospitals in the region were notified around this time as well.
His "leak" came while a lot of people were being notified about this problem. It "looks" like they would have notified the public and WHO a few days later once they had more information.
We still don't know if the original source is the seafood market. The fact that not all the cases came from there doesn't mean much. The SARS expert (Guan Yi) from Hong Kong said that there was no proof of human to human transmission on the 3rd.
You've counted time before anyone knew it existed in your 2-month delay. The first death was on the 10th. Less than 50 people have the virus. The probably should have done something then or on the 15th (second death).
There was a delay but more like 2 weeks compared to 2 months. If you are saying that they should have done something before they knew it existed then ... what should they have done?
As it is people are constantly bashing them for doing something.
