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When the Centers for Disease Control and Prevention (CDC) assured President Trump that the risk of a coronavirus (COVID-19) outbreak in the U.S. was very low, only about 500 persons had been tested.

This was because the CDC controlled all testing and restricted it at first to persons with a known contact who had been in China, later liberalized to persons who were severely ill.

In addition, CDC declined to use the test approved by the World Health Organization (WHO), insisting on its own test, which proved to be defective. Many laboratories are capable of developing a protocol to do tests but fear FDA/CDC enforcement actions and loss of their laboratory license.

Meanwhile, other nations are testing extensively. South Korea has 500 test sites, which have screened 100,000 people. The number of confirmed cases surged from 31 to more than 4,200 in two weeks. Some sites offer drive-through testing; one reportedly tested 384 people in one day.

Continue reading “Coronavirus Rate in U.S. May Suddenly Jump”

The official death toll has surpassed 1,000, according to official figures. The actual toll may be far higher in China. Bodies may be cremated without a diagnosis, and Chinese authorities are ruthlessly censoring nonofficial reports. A whistleblower, Fang Bin, who shot videos of corpses in Wuhan, has reportedly been arrested.

Some may downplay the severity of the problem, noting that seasonal influenza kills tens of thousands every year. But these are some ways in which 2019-nCoV is different:

• Influenza has been everywhere for a long time, so most people have some degree of immunity. The “n” in 2019-nCoV stands for “novel.” The whole world is a “virgin population” for this newly emerged virus.
• The incubation period for influenza is up to 4 days. While 2019-nCoV may cause symptoms relatively soon, infected but apparently healthy people may be contagious for 14 days or even 24 days.
• Influenza infects the upper respiratory tract. If a patient gets pneumonia, it is likely a bacterial superinfection curable with antibiotics. The 2019-nCoV targets the lower respiratory tract, causing severe viral pneumonia, which may not manifest until a week into the illness.
• Older patients with pre-existing illnesses are the most likely to die of influenza. Young, healthy persons may also succumb to 2019-nCoV. The Chinese eye doctor who first sounded the alarm is dead at age 34.
• Influenza survivors are expected to recover completely. The coronavirus may cause scarring in the lungs. The receptor targeted by 2019-nCoV in lung cells is also in the kidneys, so severely affected patients may have renal failure or multiorgan failure.

Unless the disease can be contained, The coronavirus epidemic could spread to about two-thirds of the world’s population, according to Hong Kong’s leading public health epidemiologist, Prof Gabriel Leung.

The importance of effective quarantine is shown by the history of American Samoa and Western Samoa in the 1918 influenza pandemic. American Samoa, which enforced rigid quarantine, had no fatalities. Western Samoa permitted commerce to continue, lost 24% of its population, including half of the most productive age group, and collapsed.

Africa is especially vulnerable. About 1,500 passengers from China arrive in Ethiopia every day. Africa is only now receiving 2019-nCoV test kits.

For more about pandemic preparedness and links to information on protecting yourself and your family, see Doctors for Disaster Preparedness Newsletter, September 2019.

The number of confirmed cases of coronavirus (2019-nCoV) has reached 20,209, with 426 deaths, according to the interactive map provided by Johns Hopkins CSSE (Center for Systems Science and Engineering).

Another city has been quarantined: Wenzhou, which is nearly 600 miles from Wuhan. Only one designated person within each family household will be allowed to go outdoors, once every two days, to shop for basic necessities.

Crematoria are working constantly. Hong Kong-based Initium Media reported on Jan 26 that all 14 cremation chambers in one large funeral home are operating 24 hours a day, seven days per week, rather than four hours per day, five days per week, as before the outbreak.

China is furious about the expanding U.S. travel ban, claiming that it is unnecessary, in the opinion of the World Health Organization (WHO).

For all the claims about transparency, police reportedly arrested the Chinese doctors to raise the alarm about a disease they at first suspected of being SARS (severe acute respiratory distress syndrome) on WeChat, a popular social network. The authorities said these eight doctors and medical technicians were “misinforming” the public, and that everyone in the city must remain calm. Authorities are still actively censoring social-media posts and news articles that question the government’s response to the outbreak.

In the U.S., Facebook is censoring what it deems to be misinformation. Facebook’s head of health, Kang-Xing Jin, said in a blogpost Thursday that it has a third-party team of fact-checkers reviewing content related to the virus. Google and Twitter are directing traffic to official sources such as WHO and the Centers for Disease Control and Prevention (CDC), and Twitter said it would remove users “who attempt coordinated spreads of disinformation about the health crisis.”

A report on travelers returning to Germany from China  states that digestive symptoms occur in some patients, presenting another mode of transmission. Infective virus in diarrheal fluid may be aerosolized when flushing a toilet. (Closing the lid is suggested.)

It is becoming difficult or impossible to buy personal protective items. Home Depot informed a customer that it was unable to process an order for N95 protective masks “due to the  drastic increase and restrictions put in place by the [CDC].”

For further information, with links to information on protecting yourself and your family, see Doctors for Disaster Preparedness Newsletter, September 2019.

The number of confirmed cases of coronavirus (2019-nCoV) has reached 9,776, with 213 deaths, according to the interactive map provided by Johns Hopkins CSSE (Center for Systems Science and Engineering).

But is it plausible that China has locked down 17 cities because of 213 deaths?

A Jan 28 directive issued by China’s Ministry of Public Security ordered all police departments throughout the country to make “wartime preparations.” The police are to help “control the disease” by enforcing quarantine orders and helping to speed the distribution of medical supplies, while at the same time “maintaining social stability” by “severely” punishing any public or online reporting about the spread of the epidemic.

A Twitter post read: “The [Wuhan] city government and Hubei Provincial Civil Affairs Ministry have dispatched vehicles, staff, and protective gear to each funeral house [in Wuhan].” The post went on to offer “free cremation for the corpses of coronavirus victims” who died on January 26 or later. The reason the city was deploying these new resources, it said, was “To improve the capacity of transporting and dealing with corpses.”

The post obviously didn’t please the censors, writes Steven Mosher. An hour later the above sentences were deleted from the text.

Crematorium workers in the city of Wuhan claim that bodies are being sent from hospitals without being added to the official record.

The first wave of cases must have occurred in December or earlier because by Jan 2, 41 cases admitted to hospital in Wuhan had a laboratory-confirmed diagnosis of 2010-nCoV. But Wuhan was not placed under quarantine until 5 million people had left to celebrate the New Year, carrying the virus all across China.

Before the 1918 influenza epidemic, a solo, horse-and-buggy physician in Kansas, Dr. Loring Miner, made the correct diagnosis of an unusually lethal outbreak of influenza and did all he could to sound the alarm. The U.S. Public Health Service ignored him, writes John M. Barry in his 2004 book, The Great Influenza: the Epic Story of the Deadliest Plague in History. Might social media have stopped that epidemic in its tracks?

China’s Great Firewall is the most sophisticated internet censorship operation in the world. Google’s secret Project Nightingale to facilitate the Chinese dictatorship’s censorship has apparently been stymied for now. However, U.S. providers of online services have yielded to pressure from Rep. Adam Schiff to suppress material he deems inappropriate for the public access. At the moment, this is restricted to information on vaccine adverse reactions. The suppression of free speech and public access to government-disfavored views is the subject of a lawsuit by the Association of American Physicians and Surgeons (AAPS).

The 2019-nCoV may be unstoppable in China by now. Protecting the rest of the world requires vigilance and free communication.

For further information, with links to information on protecting yourself and your family, see Doctors for Disaster Preparedness Newsletter, September 2019.

The World Health Organization (WHO) is meeting to decide whether to declare the 2019-nCoV a Public Health Emergency of International Concern (PHEIC).

An interactive map shows the progress of the disease: 7,783 confirmed cases at this moment, and 170 deaths. Since diagnostic test kits are not widely available, the number of actual cases is unknown.

Also still unknown: how easily is the virus transmitted, can it be transmitted by a person who has no symptoms or fever, and what is the mortality rate? So, should we be more or less worried than we are about the usual seasonal influenza, which has reportedly caused 8,200 deaths and 140,000 hospitalizations so far this year?

Even if public health authorities in both China and the U.S. are being completely transparent, projections could be massively wrong if the virus mutates to become more or less lethal or transmissible.

Two things are certain:

(1) The U.S. is not prepared to cope with a 1918-scale epidemic and urgently needs to remedy the lack of surge capacity for medical facilities, personnel, and supplies. Citizens need to have an insurance policy: supplies they need to self-isolate at home, and knowledge to care for a sick family member. See Three Seconds until Midnight by Dr. Steven Hatfill, et al., and its on-line self-help sources (here and here).

(2) The economic consequences will be vast. With 17 Chinese cities already locked down and further restrictions likely, factories are likely to face worker shortages or extended shutdowns. The supply of essential drugs in the U.S. and elsewhere is critically dependent on China—for finished products or precursors, as Rosemary Gibson points out in her book China Rx. The U.S. cannot even make penicillin. Other industries vulnerable to disruptions in the supply chain are defense, computers especially Apple, automobile manufacturers, and suppliers of masks and other protective medical equipment.

For further information, see Doctors for Disaster Preparedness Newsletter, September 2019.

Is a deadly pandemic about to hit us, or is the biggest quarantine effort in human history, locking down many cities in China, an overreaction?

There are now five confirmed cases of coronavirus in the U.S., all associated with travel to China, and about 100 more are under investigation. The Centers for Disease Control and Prevention (CDC) is at present the only source for diagnostic testing.

Where did the novel virus, called 2019-nCoV, come from? Reportedly, the source was the Huanan Seafood Wholesale Market in Wuhan, China, which also offers exotic fresh meat, some from live animals. A bat or other animal virus may have mutated and crossed the species barrier to humans. However, according to a study of 41 patients hospitalized in Wuhan, published in The Lancet, 13 of the 41 had no link to the market, which was closed Jan 1. Human-to-human transmission is surely occurring.

There is speculation that the virus might have been accidentally released from the Wuhan Institute of Virology, located 20 miles from the seafood market. The laboratory is the only declared site in China capable of working with deadly viruses. China is suspected to have a covert biological warfare program.

Recall that in 1979 an outbreak of anthrax in the Soviet Union, originally attributed to tainted meat, was eventually shown to have originated from a biowarfare facility at Sverdlovsk.

Whether bioengineered by nature or by scientists, novel microorganisms for which there is no immunity and no treatment could kill hundreds of millions of humans if not contained.

Virologists and epidemiologists are racing to answer basic questions. How contagious is 2019-nCoV? Can it be transmitted by people who have no fever and no symptoms—and for how long? What is the mortality rate?

Previous threats, such as SARS (severe acute respiratory syndrome) and Ebola, have been contained. But despite these wake-up calls, the U.S. is no better prepared for a lethal pandemic than it was for the great influenza in 1918, according to Dr. Steven Hatfill and coauthors in their new book Three Seconds until Midnight. We lack adequate stockpiles of protective gear, surge capacity in medical facilities and personnel, preparedness to maintain essential infrastructure, and efficient distribution mechanisms for vaccines or drugs if they exist.

Also essential is accurate, timely, uncensored information. A big unknown is the reliability of information on the internet or from government, especially in closed societies such as China. Citizens need to practice meticulous hygiene and avoid sources of exposure.

For further information, see Doctors for Disaster Preparedness Newsletter, September 2019, and self-help sources recommended in Three Seconds until Midnight by Steven Hatfill, M.D., et al.

By the time you read a report it may be outdated. But the most current U.S. government information is at CDC.gov. So far, the Chinese Lunar New Year shares top billing with smoking, seasonal influenza, and raw milk, and the outlook is generally reassuring. Most importantly, the site tells how to contact officials to get reliable diagnostic testing.

Remember that governments have a history of covering up infectious disease dangers, as in the 1918 influenza pandemic, or of exaggerating, as in swine flu scares of 1976 and 2009, and the post-9/11 anthrax panic. Widespread self-isolation is bad for the economy. Or there may be special interests profiting from sales of poorly tested, dangerous vaccines or drugs.

What should the prudent citizen do? “Everyone should have an all-hazards preparedness plan as an insurance policy,” advises Physicians for Civil Defense president Jane M. Orient, M.D. “Many disasters call for shelter-in-place. Do you have what you need to stay home for a couple of weeks?”

“You do not want to be caught in a stampede to obtain food, medicines, or other essentials.”

In case of an epidemic, hospitals will be swamped—with patients who are likely contagious. It may be advisable or necessary to care for sick patients at home. Do you have disposable gloves, masks, batteries, tissues, vitamin C, hand sanitizer, bleach and other disinfecting and cleaning supplies, trash bags, and self-help medical information? Dr. Orient asks.

News from China suggests the time is late:

• The People’s Liberation Army sent 450 medical personnel to Wuhan to help out at local hospitals, which are crammed with patients lying in packed corridors.
• Chinese travel restrictions have grown to encompass more than 50 million people.
• Frightening videos are being taken down.
• Construction workers are reportedly trying to build a 1,000-bed hospital in five days.

For further information, see Doctors for Disaster Preparedness Newsletter, September 2019, and self-help sources recommended in Three Seconds until Midnight by Steven Hatfill, M.D., et al.