Number of new cases dropping off in Australia

Number of new cases dropping off in Australia. By the Australia Govt Dept of Health.

This might just be statistical fluctuation, but it is a good sign.

However, it may just be that only the exponential rise due to people bringing the disease in from overseas has been broken — due to border closures enacted a week or more ago. The separate exponential rise due to community spread within Australia might now take over as the main driver. We might just be seeing the lull between those two curves.

UPDATE: Here for comparison is daily new cases graph for South Korea, which went to a strong tracing regime while avoiding lockdown, and has contained its outbreak to just a few thousand:

New York Turns Into “War Zone” As City’s 911 System Faces Overwhelming Onslaught

New York Turns Into “War Zone” As City’s 911 System Faces Overwhelming Onslaught, by Tyler Durden.

Some patients are being left behind in their homes as the healthcare system becomes overwhelmed with calls relating to the virus, according to the New York Times. …

The volume has put Emergency Medical Personnel in the position of having to determine which cases should receive time-consuming medical measures, like CPR and intubation, and which cases are “too far gone”.

One paramedic told the New York Times that a woman had “drank a liter of vodka” to try and commit suicide after her cancer treatments were delayed because hospital beds were being occupied by coronavirus patients. Another paramedic said that the battery on her defibrillator died from responding to so many cardiac arrests on one shift. …

Paramedics said that weeks ago, coronavirus calls were mostly for respiratory distress or fever. Now many of these same patients are dealing with organ failure and cardiac arrest after being sent home from the hospital.

One Brooklyn paramedic said: “We’re getting them at the point where they’re starting to decompensate. The way that it wreaks havoc in the body is almost flying in the face of everything that we know.”

How COVID-19 coronavirus attacks your body

How COVID-19 coronavirus attacks your body, by Sumathi Reddy.

It starts, most often, with a cough or a sneeze. Thousands of tiny, often invisible droplets of saliva or mucus disperse in the air. You walk by — within about 1.8m of the offender — and inadvertently inhale the droplets. …

The virus most commonly enters the nose through minuscule droplets from someone’s mucus or saliva … It can also enter through the eyes or mouth.

Once the virus’s particles enter the body, they begin to attach to a particular receptor on the surface of the body’s cells, usually starting with cells in the mucous membranes in the nose and throat. The coronavirus is distinguished by spiky proteins on its surface; these spikes latch onto cell membranes. The virus then enters the cells and disassembles so its RNA — molecules that carry instructions from DNA to the body’s cells — can start to reproduce. …

Though most people likely start with an upper respiratory infection, it’s also possible that respiratory droplets are inhaled more deeply and go directly into the lungs, says Brian Garibaldi, an associate professor of pulmonary and critical care at Johns Hopkins University. “It has a special protein that binds more tightly to cells in the lower respiratory tract,” he says.

Wherever it lands, the virus hijacks cells and starts replicating, ultimately producing millions of viral particles that flood the body. …

Once the virus has attacked enough cells in the upper respiratory system, most people will start to feel symptoms. This happens on average five days after being exposed to the virus but it can be sooner or as many as two weeks later, studies show.

These early symptoms usually include a dry cough and fever, and sometimes a sore throat, as well as aches and fatigue. Loss of taste and smell have also been reported as early signs of infection.

For the majority of people — roughly 80 per cent according to reports from China — the symptoms end there and dissipate in a few days or weeks.

But for some people, predominantly older people and those with other medical conditions, the virus keeps travelling down and invading cells in the lungs.

When the cells start moving down the respiratory system into the lungs it becomes a lower respiratory illness, which is considered more serious. That could happen two to seven days after symptoms start …

Once the virus starts infecting the cells that line the air sacs in the lungs, viral pneumonia develops, which is inflammation of the lungs. Shortness of breath is an indication that the virus is damaging the lungs. …

And the lungs often face a two-way assault. There is damage from the virus but a second equally debilitating response takes place: The body’s own immune system goes into overdrive, causing more lung damage. …

When the lung becomes progressively more damaged, that triggers what is known as acute respiratory distress syndrome, or ARDS. This typically develops seven to 14 days into the course of the illness.

The lungs become less efficient at exchanging oxygen and carbon dioxide and continue to become inflamed. Patients need assistance breathing because there’s no therapy to treat ARDS.

“The ventilator is buying time for the lung to repair itself after a virus has run its course and the immune system response has calmed down, ” Dr Garibaldi says.

Explaining the science behind Sweden’s relaxed coronavirus approach

Explaining the science behind Sweden’s relaxed coronavirus approach, by Paul Franks, Professor of Genetic Epidemiology, Lund University and Peter M Nilsson, Professor of Internal Medicine – Epidemiology, Lund University.

Unlike its Nordic neighbours, Sweden has adopted a relatively relaxed strategy, seemingly assuming that overreaction is more harmful than under-reaction.

Although the government has now banned gatherings of more than 50 people, this excludes places like schools, restaurants and gyms which remain open. That’s despite the fact that 3,046 people have tested positive. …

In Sweden, the public health authorities have released simulations to guide “surge requirements”. This is the extent to which hospitals will need to boost their capacity to deal with the high number of very ill COVID-19 patients that are likely to need specialist care in the coming weeks. From these simulations, it is clear that the Swedish government anticipates far fewer hospitalizations per 100,000 of the population than predicted in other countries, including Norway, Denmark and the UK. …

The reason appears to be that Swedish authorities believe there are many infected people without symptoms and that, of those who come to clinical attention, only one in five will require hospitalisation. At this point, it is hard to know how many people are asymptomatic as there is no structured screening in Sweden and no antibody test to check who has actually had COVID-19 and recovered from it. But substantially underestimating hospital surge requirements would nevertheless be devastating. ….

There are several arguments supporting the current official Swedish strategy. These include the need to keep schools open in order to allow parents who work in key jobs in health care, transportation and food supply lines to remain at work. Despite other infectious diseases spreading rapidly among children, COVID-19 complications are relatively rare in children. A long-term lockdown is also likely to have major economic implications that in the future may harm healthcare due to lack of resources. This may eventually cause even more deaths and suffering than the COVID-19 pandemic will bring in the near term. …

A century ago, Sweden was recovering from the first world war, even though the country stayed neutral. Internal transportation and communication systems were less developed than in many other countries at the time, which helped slow the spread of the epidemic. In the short term, this was perceived to be a good thing, but because herd immunity — whereby enough people have been infected to become immune to the virus — had not been initially achieved, there were at least two additional epidemics of the Spanish flu virus within a year. The second wave of infections had a higher mortality rate than the first wave.

Learning the lesson from this, many people in Sweden are now optimistic that it can achieve herd immunity. Compared with the Spanish flu, COVID-19 is less severe, with many infected people believed to be asymptomatic. While this contributes to a more rapid spread, it also means that the threshold for “herd immunity” is about 60%. This may be quickly achieved in countries that do not have intensive mitigation or suppression strategies.

Belarus, Brazil and Sweden seem to be taking the herd immunity approach. Their citizens are going be either furious, dead, or sick if it fails, or awesomely smug if it works.

According to Chinese statistics (all dodgy), about 0.0065% of the Chinese population has been infected — so they would require 10,000 times as many people to catch it to achieve herd immunity. China went for the crush-the-curve strategy instead.

No country has got anywhere near herd immunity yet. Once the bodies start piling up in hospital corridors, they go for lockdown.

hat-tip Stephen Neil

Coronavirus: Learning curve for leaner, meaner generation ahead

Coronavirus: Learning curve for leaner, meaner generation ahead, by Adam Creighton.

Already, conversations about gender balance and the climate “crisis” have evaporated and such issues will seem less urgent in the wake of the pandemic. …  It’s been a reality check for the national conversation, which had drifted almost to the absurd. While the deluge of news about the coronavirus is relentless, at least it is something real.

Households will become more frugal as they learn how cheaply they can live once frivolous expenditures are excised. Spending $350 on a concert ticket will no longer be the norm. Having learned to exercise outside, that $70-a-fortnight gym membership might not seem such a good deal.

A nation making their own lunches and dinners will become far more apprised of grocery prices. “The pandemic will challenge rampant individualism, reminding us we’re all interconnected,” adds [demographer Hugh Mackay].

So far, the burden of job losses has fallen almost exclusively on workers who, in normal times, we actually need: cafe and retail staff, pilots and taxi drivers, for example.

By contrast white-collar workers, although compelled to work at home, have been insulated. But many of them will start to question the point of their jobs. Shorn of the charade of pointless meetings, it will become clearer who actually does what. Putting in “desk time” to please the boss will no longer be an option.

Businesses will become leaner, and possibly meaner. They’ll question whether acres of commercial real estate are worth the rent. Bosses in large enterprises will question the value of staff who they haven’t seen in weeks, and who have appeared to produce quite little — apart from social media posts with “#WFH”. Workers with little verifiable, individual output should be concerned.

The least affected by the crisis inevitably will be the political class, who have shut the economy down without any risk to their pay and conditions.

Politicians concede privately this is unsustainable politically.

News the upper echelons of the bureaucracy and judiciary will forgo a 2 per cent pay increase in July as a way of sharing the burden is probably not enough to quell the anger that by July will be red-hot. “People will come out of this with a heightened anxiety; they’ll be wounded and cranky,” says Mackay.

Government has never in history tried to shut an economy down; we’ll soon see for how long it is possible in a democracy. …

The slump has thrown up a slew of moral questions too. The inevitable confrontation between tenants and landlords over rent, for instance, has no easy answer. What has happened is neither’s fault, yet the loss is real and must be borne. …

Respect for the economic system will fray too. When the Reserve Bank starts creating money artificially to buy government bonds, many will question the value of money, and the morality of how it can be handed out to favoured constituencies.

Why not give it to households directly, many will ask, preventing the financial sector clipping the ticket on the way? The notion of a free market in the financial system will become more farcical.

Even if our relative performance in managing this disease is along the lines of the Spanish flu 100 years ago, when Australia had the second-lowest death rate in the world, by a large margin, society and the economy will be changed irrevocably on the other side.

In the Spanish flu, Australia managed to quarantine itself in time, closing the borders early. This prevented the disease from getting into our population — initially. Some quarantine breakers got in eventually — probably off ships, by lying about their health — and after about three months the Spanish flu took off in Australia too. However, that three month delay probably meant that we caught a less deadly strain (most diseases mutate towards less deadly versions as time goes by). So overall our deaths rate was relatively low.

British Govt Furious Over China’s Virus Lies, ‘Reckoning’ Expected Post-Pandemic

British Govt Furious Over China’s Virus Lies, ‘Reckoning’ Expected Post-Pandemic. By Kurt Zindulka.

Members of Boris Johnson’s government have disclosed that “anger goes right to the top” of 10 Downing Street — the Prime Minister’s official residence — over the Chinese Communist Party’s mishandling of the coronavirus crisis. The anger stems in large part from a misinformation campaign launched by the regime accusing a United States military delegation in Wuhan of starting the global pandemic.

“There is a disgusting disinformation campaign going on and it is unacceptable. They [the Chinese regime] know they have got this badly wrong and rather than owning it they are spreading lies,” a Downing Street source told the Daily Mail.

Scientific advisors have informed Mr Johnson that it is likely that China is also lying about the number of coronavirus cases in the country, downplaying the figures “by a factor of 15 to 40 times”.

Though any re-evaluation of the relationship with China has been put off until after the pandemic calms down, a senior official told the newspaper: “It is going to be back to the diplomatic drawing board after this. Rethink is an understatement.”

“There has to be a reckoning when this is over,” said another.

At the heart of the re-evaluation will be the status of Boris Johnson’s decision to allow Chinese tech giant Huawei access to Britain’s 5G infrastructure. The Huawei deal placed a stain on the “special relationship” with the United States, which along with Australia has warned that the Chinese would gain back door access into the networks of Britain and her allies.

hat-tip Scott of the Pacific, Stephen Neil

‘Some people will die, that’s life’: Bolsonaro questions Covid-19 crisis, says deaths in Brazil exaggerated for political purposes

‘Some people will die, that’s life’: Bolsonaro questions Covid-19 crisis, says deaths in Brazil exaggerated for political purpose, by RT.

Brazilian President Jair Bolsonaro has waved off the ongoing coronavirus pandemic, insisting that life goes on. He suggested the death toll in his own country has been overstated for political purposes.

The Brazilian leader has been locking horns with many of the country’s governors, who have imposed bans on non-essential commerce and continue to accuse Bolsonaro of prioritizing the economy over the lives of his citizens.

I’m sorry, some people will die, they will die, that’s life,” Bolsonaro said in an televised interview on Friday. “You can’t stop a car factory because of traffic deaths.”

He remarked that in the state of Sao Paulo the reported fallout from Covid-19 – 1,223 cases and 68 deaths – seemed “too large.”

A real-life experiment commences. Which strategy will prove “better” after a year? Apparently the Netherlands and Sweden are still relying on the herd immunity approach too.

hat-tip Stephen Neil

Whither Coronavirus? When Will It End and What Will Happen Along the Way

Whither Coronavirus? When Will It End and What Will Happen Along the Way, by Philip Giraldi.

The coronavirus story has generated a number of major subplots. First is the origin of the virus. Did it occur naturally or was it created in a Chinese, American or Israeli weapons lab? If bioengineered, did it somehow escape or was it deliberately released? As the governments that might have been involved in the process have become very tight lipped and the mainstream media is reluctant to embrace conspiracy theories, we the public may never know the answer.

Second is the nature of the virus itself. There are inevitably skeptics who choose to compare the affliction to a common head cold or normal winter flu and are able to cherry pick so-called experts to support their case. Many Americans are unwilling to submit to a lockdown or isolation and are flaunting their willingness to go out in public and mix freely while others are claiming that the whole thing is a hoax designed to create a panic that will benefit certain constituencies. …

In spite of all the ideologically driven background clutter, genuinely knowledgeable medical authorities come down overwhelmingly promoting the view that the virus is highly contagious and capable of spreading rapidly, making it a pandemic, and it can be exceptionally lethal to certain demographics, including the elderly and those with weakened immune systems. The way of combatting it also appears to be agreed upon by most genuine experts i.e. that testing must be widespread to determine who is infected and those individuals should be isolated from contact with others for at least two weeks to limit the spread of the contagion. For those whose conditions worsen, hospitalization and treatment for possible respiratory failure are warranted. …

The third big issue is the apparently deliberate failure of the Trump Administration to respond proactively to limit the spread of the virus. Seeking to protect the stock market more than the American public, President Donald Trump initially downplayed the impact of the virus, even calling it a “hoax” [no, see here] during January and February when it first appeared on U.S. soil. It turned out that several institutes affiliated to the Center for Disease Control to deal with epidemics had been dismantled by the Administration and, in spite of the warning provided by what was occurring in Wuhan, the U.S. made no effort to increase its supply of testing kits, masks or ventilators. Meanwhile, congressmen were receiving dire warnings of what was coming from the intelligence community in private briefings, leading to a number of senators selling their stock in anticipation of a market collapse. That is something called insider trading and it is illegal. It is also a measure of the corruption of America’s ruling class. …

There is some speculation that Trump might well follow the example being set by [Israel] … It is using cell phone intercepts provided by the intelligence services to track the comings and goings of Israeli residents. The monitoring is being justified as a mechanism to create a record of who is meeting whom and where to support isolation and lockdown efforts. A similar program is already active in the suburbs around Washington. The National Security Agency (NSA) already has the technical ability in place that would permit monitoring of the movements of much of the U.S. population. It would be an intelligence community dream and would fit quite nicely with Congress’s recent efforts to re-authorization certain Patriot Act aspects of the Foreign Intelligence Surveillance Act (FISA).

COVID-19 and the great Chinese puzzle

COVID-19 and the great Chinese puzzle, by Jacob John.

Virus spread in China reportedly stopped by the end of the third week of March, with no new SARS-CoV-2 infections arising locally since then. China is now gearing up to prevent virus transmission from citizens returning from other countries. If only 90,000 were infected among a 1.4 billion population, the proportion was only 0.0065%.

Here is the puzzle: for any epidemic, its downturn consequent to high herd immunity requires about 70% infected and immune. Every second person in the community will then be a dead-end for virus spread.

What proportion of the Chinese was actually infected? The proportion of 0.0065% is unrealistically low for the visible shift in epidemiology. If 70% were infected, there were 980 million infections. This extraordinary range is the puzzle.

Perhaps they crushed the curve, rather than built up herd immunity? Radical thought, I know…

Or perhaps something more devious went on, and the West got fooled into thinking the virus was much worse than it is. Or perhaps something even more devious. Conspiracy theories abound, but IMHO none are yet rising to the level of reasonably likely.

via malstoner

The British Reversal on Virus Strategy

The British Reversal on Virus Strategy, by Scott Alexander.

A UK critical care doctor on Reddit wrote a great explanation of their recent about-face on coronavirus strategy.

They say that over the past few years, Britain developed a cutting-edge new strategy for dealing with pandemics by building herd immunity. It was actually really novel and exciting and they were anxious to try it out. When the coronavirus came along, the government plugged its spread rate, death rate, etc into the strategy and got the plan Johnson originally announced. This is why he kept talking about how evidence-based it was and how top scientists said this was the best way to do things.

But other pandemics don’t require ventilators nearly as often as coronavirus does. So the model, which was originally built around flu, didn’t include a term for ventilator shortages. Once someone added that in, the herd immunity strategy went from clever idea to total disaster, and the UK had to perform a disastrous about-face. Technocratic hubris vs. complexity of the real world. …

Ventilators:

Britain has 5,000, or one per 12,000 citizens. The US has 160,000, or about 1 per 2,000 citizens …

Elon Musk recently delivered 1,255 ventilators to California from some of Tesla’s Chinese contacts, and promised to make more. Dyson, the British vacuum manufacturer, says it will be able to make 10,000 ventilators in time to help with the crisis …

Ventilators also require trained staff to operate. I never know how far to trust medical people when they say something requires training. You would think doing a lumbar puncture requires training, but the training I received for this in residency was watching one (1) guy do it one (1) time, and then them saying “Now you do it” — which by the way is exactly as scary as you would expect. This is an official thing in medical education, called see one, do one, teach one. So when people say some medical task requires training, I don’t know if they mean “ten years’ experience and a licensing exam”, “watch it once and then we throw you in the deep end” or “we’re going to make you go through the former, but the latter would have worked too”. Hopefully ventilators are more like the latter and someone can train new people really quickly.

Hospitals and ventilators are the big threshold. If the spread can be kept low enough that hospitals are not overwhelmed, and other patients can still use them, then we can wear a bit of the virus. But once the hospitals are overwhelmed, it rapidly goes pear-shaped.

They had one job. To ward off disease. And they were fucking around with video games and diversity bullshit.

They had one job. To ward off disease. And they were fucking around with video games and diversity bullshit. First, Glenn Reynolds:

We’re not very good at preparing for things that happen every hundred years. The last comparable event was in 1918. So we pay people to prepare … nobody has a fire brigade ready to go for something that happens less than once in a lifetime.

Reply from a friend of Glenn Reynolds:

Agreed re fire brigade and once in a lifetime.

Though in fairness, when it comes to beating up the health authorities, we’ve become more sophisticated in the last 100 years — or thought we had.

It wasn’t like we didn’t have warnings. It isn’t like they weren’t wasting resources on nonsense and ignoring timely advice to restock essential supplies.

So fuck them, for failing to be prepared.

They had one job. To ward off disease. And they were fucking around with video games and diversity bullshit.

Six figure salaries. And they played fuck-around

Excuse me. I meant to say, six figure salaries and fat pensions. And they played fuck around. And after this is over, they’ll go back to fuck around.

Yup.

People are starting to ask the question, if only on blogs so far: why didn’t our inept rulers just close the borders earlier and prevent all this health/economic mess? Foreseeable and foreseen.