A collection of key developments in the fight against COVID-19 (the actual virus is SARS-COV-2), posted throughout the week for those who just want the signal and not the noise. If there’s something you think we should include, sound off in the comments thread attached to the post.
Visit our Wuhan coronavirus status page and learn how to prepare for possible spread to your area. Scenarios, shopping lists, background info, and everything else you need, all in one place.
Previously: The previous day’s key developments post is here.
[8:52 pm] Chinese film director Chang Kai and family die from coronavirus.
A Chinese film director, his sister, mother and father have all died from the coronavirus, the latest high-profile victims of the disease in Wuhan, the city at the centre of the outbreak.
Chang Kai, 55, died on 14 February. His parents died over the previous two weeks, after the family spent days together in self-quarantine, the Chinese magazine Caixin reported. Chang’s sister died hours after he did, and his wife is in a serious condition.
Again, it seems you really do need a functioning healthcare system with ICU beds to see the kinds of low-single-digits fatality rates (e.g. 2 percent) being thrown around for this. Otherwise, you get whole families wiped out.[8:46 pm] The WSJ has a video on the topic of the Chinese numbers and the likely massive undercounting.
To the extent that the numbers coming out of China reflect some underlying reality — at least maybe directionally, if not in terms of magnitude — then it looks like their extreme lockdown and quarantine measures are working, and the number of new cases outside of Hubei continues to decline. Caixin has a detailed piece on what the regions seeing declines in new cases have done right.
The Guardian also has a piece on how the measures seem to have worked, which poses a problem for the WHO because they’re officially opposed to rights-limiting measures like those carried out by the Chinese government.
Related is this is a report that Nanjing, a major city, will ease restrictions and let people return to work. There are also hopeful scenes from Beijing circulating online, where people report more traffic and more activity in public spaces.
— Eunice Yoon (@onlyyoontv) February 18, 2020
I am really skeptical of the Chinese numbers, but also hopeful and concerned. Hopeful because maybe these extraordinary measures really are working, and concerned because if they are working then they’ll provide a template that the rest of the world will use to deal with this.
So if the Chinese really have reined this in outside of Hubei, and if this looks like it’s threatening to spread, here, then we should expect something like the Chinese lockdowns to hit US cities. Keep an eye on the news, then, and plan accordingly.[8:44 pm] A backgrounder on the Norwegian company that plays a critical role in vaccine development: The Road to a Coronavirus Vaccine Runs Through Oslo [8:37 pm] This article on a new study gives the following stats:
About 14% of the illnesses were severe, which included pneumonia and shortness of breath, and about 5% have critical disease, marked by respiratory failure, septic shock, and multi-organ failure. The overall case fatality rate was 2.3%, and of 1,023 deaths included in the study, the majority were in people age 60 and older or those with underlying medical conditions.
This tracks roughly with the 18 percent severe rate from the Wuhan study, and the 26 percent severe rate seen in another study. So in these studies so far, the rate of severe illness, where they are likely to need an intensive care unit bed, falls roughly in the same ballpark of 15 to 25 percent.
As a thought exercise, let’s join these numbers with some numbers we have for the US. There are 100,000 ICU beds in the US, and 331 million people. Those ICU beds are typically two thirds full, but let’s ignore that for the moment. If the virus infects 25 percent of the public, that’s 83 million people infected. Optimistically, if just 5 percent of those need an ICU bed, then that’s 4 million in need of one of those 100,000 ICU beds.
That math is not good. If it spreads here in a big way, the US healthcare system can’t handle it by an order of magnitude. If it spreads at the rate of normal flu (about 10 percent of the population infected), we still need a little under 2 million ICU beds and are still an order of magnitude off.[8:37 pm] Another study adds to the evidence that the virus can be transmitted during its incubation period, before symptoms arise. [8:34 pm] Russia to ban entry of Chinese nationals to halt virus. Issues of international law aside, there is some controversy around whether these travel restrictions work or not. Some say they do more harm than good, while other responsible experts say they do delay the spread and give countries time to prepare. [8:32 pm] In a previous update we mentioned that the WHO has finally been allowed to send a team into China to investigate and help with the outbreak. Well, the latest news is that this team is not being allowed into Hubei, where the virus originated and is at its worst. [8:30 pm] Here’s how long coronaviruses may linger on contaminated surfaces, according to science. The answer appears to be, “as long as nine days.” We’ve linked the study this news report is based on in a previous update. [8:27 pm] The disruption to global commerce has been a theme in these updates, but this story takes a deep look at the disruption to science that is caused by the virus. Canceled conferences, paused collaboration with Chinese colleagues, deadlines extended — parts of the scientific world have ground to a halt.
This article also has a very good section on the impending drug shortages that we’re all due to start feeling, soon:
[8:26 pm] The first full COVID-19 lung pathology published in The Lancet. I’m not expert enough to know what to make of us, but perhaps a physician can weigh in in the comments. [8:24 pm] Speaking of countries with close ties with China and who incredibly claim zero coronavirus infections: N. Korea reaffirms no new coronavirus infection [8:23 pm] The answer to the question in this headline is surely, “no, it is not the whole picture.” Indonesia Has No Reported Coronavirus Cases. Is That the Whole Picture? “Experts find it astonishing that Indonesia has yet to announce a case despite hosting some 5,000 Chinese tourists a day in Bali before halting flights last week.”
Concern is also rising that the availability of medicines could soon face disruptions worldwide. An estimated 80% of all active pharmaceutical ingredients (APIs)—the raw materials for drugs—are produced in China and India, according to recent testimony by Rosemarie Gibson, author of China Rx, before the U.S.-China Economic and Security Review Commission in Washington, D.C. They include the compounds used to treat everything from bacterial infections and cancer to heart disease and diabetes. With many factories in China still shuttered, stockpiles of many medicines could soon run short.