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Comment by thisistheend123 | Hacker News Reader

President Xi has warned that the virus is spreading. His intervention seems to be unprecedented. Is it worse than what it seems to be?

They have quarantined whole cities and are building a hospital at war scale especially for this.

Maybe the Chinese know something that the world doesn't know yet.

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Anecdotal (not official) reports suggest as many as 100,000 infections in Wuhan area. There are claims the virus may be spread through eyes as well as inhalation. Additional unsubstantiated claims suggest low to no fever during incubation period, making detection difficult. The most sensationalist claim making the rounds is that a known Wuhan area PLA biolab may have failed to contain this pathogen.

In the end none of the above matters at all. What matters is the willingness globally to take political and economic action to contain transmission. The World Health Organization's failure to declare this a global emergency is risky if the characteristics stated above turn out to be accurate. Timing is key.

Is transmission through eyes that odd?

The common cold already is. You rub your eyes, the virus enters your tears, which drain to your nose.

Yeah, the "this one spreads through eyes!!!!!!!" shit I keep seeing pop up is actually helping to moderate my panic, somewhat.

It reminds me how much of the "panic!" signal I've been really starting to see explode in the last ~24h, which humans are highly sympathetically attuned to when they suddenly see it spreading everywhere around them, is just from a sheer mass of other idiots who actually don't know anything either coming online on the issue, and reflects internet meme virality, and only very indirectly the uptick in actual danger (ie, from having been loosely following the outbreak, prior to this latest popularization).

Still looks pretty fucking bad, though.

It matters because face masks are not enough to prevent transmission, which matters relative to the common cold only because this virus kills. The common cold does not.

But this is taken care of by face marks and hand washing, because what would be happening is you touch your eyes.

If you're using a face mask, you should be washing your hands anyway, because if you think it's working, the moment you touch it you've come in contact with virus.

Indeed. In addition, the best thing you can do beyond hand washing is don’t touch your face.

Hard to do, I know, but it eliminates a major source of transmission.

how long can a virus live on a face mask?

For an enveloped virus like this? "Awhile". I'm sure there's estimates for SARS or Influenza somewhere that are probably pretty correct for this too.

No, it isn't odd at all.

So what you are saying the mortality rate is comparable to the flu at those infection rates. Why the panic

No, because there are also many social media reports that patients dying of "viral pneumonia" are not being attributed to Coronavirus - simply due to the overwhelming of medical professionals and the inability to sequence everyone's samples.

They aren't spending time confirming that dead patients had coronavirus when they are in crisis mode.

What do you mean anecdotal? I'm really confused at how you even came up with that number. Unless you have some type of firsthand experience.

A few experts in the field have tweeted this speculation.

"In the end none of the above matters at all."

It matters critically if China, or anyone else, is in any way lying about anything.

Official reports are 2K infected, if it's actually 100K and they are not telling the WHO, it's really, really bad.

What the 'put on the news' is another matter and gray area concerning information control in crisis times (i.e. trying to stop mass panic). But with the WHO and other governments, it's another story.

It's not like they can entirely hide these things, I really wonder what kind of other 'interested parties' are making their own clandestine measurements.

So far the virus is believed to have a two week incubation period with unknown transmissability during that time, which makes it particularly hard to contain, especially with a migration like Chinese New Year.

The lockdown is unprecedented in China but the Soviet Union used to do similar lockdowns (at a smaller scale) during cholera outbreaks. I think this is just a massive overcorrection due to China's 2003 SARS outbreak but we'll start seeing more and more of these large scale quarantines as our civilization comes to terms with the realities of cheap air travel.

In 1963 during last outbreak of smallpox epidemic in Europe Wroclaw in Poland had been quarantined for 47 days.

[] https://www.reddit.com/r/europe/comments/6nhzqd/54_years_ago...

Correction - 1972 Yugoslav smallpox outbreak was the last in Europe

[1]https://en.wikipedia.org/wiki/1972_Yugoslav_smallpox_outbrea...

Actually it was in the UK. This was also (hopefully) the last death ever.

https://en.wikipedia.org/wiki/1978_smallpox_outbreak_in_the_...

I would be more concerned if the ones that are outside of China were dying at high rates. So far I haven’t heard any of those quarantined people actually dying. The ones in the US have been listed in fair condition and recovering.

General consensus so far seems to be about twice as fatal as the annual flu. (Which says nothing about transmissibility rate / R0, which they are still figuring out.) Really rough numbers, annual flu is around 0.1% , while the spanish flu was more like 2.5%

So, not a pandemic in terms of fatality. General sense so far seems to be it's more of a big deal than the (run-of-the-mill) flu, less of a big deal than SARS. (Keep in mind that the run-of-the-mill flu is kind of a big deal.)

Care to quote a source for "twice as fatal as the flu"? Everything indicates it's way worse.

6 of the first 41 identified patients have died. That's a mortality rate of 15%. https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Caveat: 41 is a very small sample, and the first patients are likely to have been the most severe cases (pre-existing conditions, weak immune systems, etc).

And when you take publicly reported statistics, 42 deaths out of 1441 confirmed cases, that's a mortality rate of 2.9%. But the confirmed cases are probably under-reported (but so are deaths)...

15% or 2.9% are 150-30 times worse than the flu mortality rate.

Because the 1441 confirmed cases are likely to be far lower than the number of people who actually have it. Carriers, latency, people recovering on their own. This ratio is the number that will get much more accurate over the next couple of weeks.

There are far more confirmed cases now, by the way. That number has almost doubled in the last two days.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

Need better data to get better mortality rate. Stop hyperbole, let the epidemiologists call it.

Of course, we need better data. But tunesmith was downplaying numbers with unsourced claims, so he needed to be corrected.

The latest stats: 54 deaths out of 1764 cases → 3.1% mortality rate https://bnonews.com/index.php/2020/01/the-latest-coronavirus...

All things considered, it's highly likely that there are more unreported cases than unreported deaths, which means that the actual mortality rate is lower.

What we need is stats on cured vs died for confirmed cases, but I haven't seen recent figures on that for a while, plus there's an inevitable delay on declaring somebody cured.

«it's highly likely that there are more unreported cases than unreported deaths, which means that the actual mortality rate is lower.»

I don't think so, because deaths lag infections. When the outbreak is rapidly growing, if it takes about 5 days for the virus to kill, then even if you knew all the stats perfectly, you actually need to look at the ratio of "deaths as of day D" over "infections as of D-5" to calculate the mortality rate. If you do this math right now (291 infections as of Jan 20, 56 deaths as of Jan 25) you find the mortality rate is 19%. Assuming infections are underreported by a factor of 5, the mortality rate is still high at 19/5 = 3.8%.

This is highly speculative. What if the under reporting is 10% &c. It's just an exercise in arithmetic, we're going to have to wait for more data.

Mortality rate is compared against recoveries, not confirmed cases. Your figure is wrong.

The spanish flu killed way more than that, at least according to wikipedia. Something like 10-20%. It was a monumental event that killed a percentage of the entire global population. The kind of thing you can only call a true plague. Think like the black plague, where a substantial percentage of some populations where wiped off the face of the earn. Imagine 1/3 or 1/2 of your community dying.

I keep seeing this 2.5% number, and I don't understand what people are talking about.

You're right - it's strange, this article seems to contradict itself within one paragraph. 500 million afflicted, 50 - 100 million deaths, at least it says ">" 2.5% fatality.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291398/

Dying at a high rate doesn’t matter if they do so quickly. That’s why Ebola has failed to become a global pandemic: it’s too potent and kills hosts before they have a chance to infect enough others.

Ebola is also not airborne it’s spread by bodily fluids. You can’t get it from someone coughing. People flew on planes infected with Ebola and didn’t spread it. It was overhyped by the media. In 1st world nations, it had no means to really spread like cholera.

Ebola was also contained because of tremendous effort of many people, often risking their own lives. Thanks to them you now have the luxury to call it overhyped.

The deaths are mostly among older ages, 60s, 70s, 80s. This group is probably less likely to be traveling.

But does that matter when young infected people are traveling.

Here is a map I made of the spread yesterday (only). https://github.com/globalcitizen/2019-wuhan-coronavirus-data...

While making it, I was watching the numbers quite closely. An observation I made is that the official statistics were ~900 officially confirmed cases on the 24th evening, ~1200 officially confirmed cases 25th (morning), yet only 1300 officially confirmed cases on the 25th (evening). Why ~50% jump then nothing? All previous figures had followed this hyperbolic path.

A few possible reasons (conjecture): overwhelmed doctors, possible low level bureaucratic pressures not to report or admit new cases, people dying at home, undiagnosed infections, geographic spread and Chinese New Year resulting in slower diagnosis.

All we can really take from this is that clearly the official statistics are only part of the story. In terms of the speed of the domestic geographic spread, it is horrifying. The cat is truly out of the bag.

It jumped to 1900 again in the morning. That is just a reporting pipeline delay I think. Not diverging from "hyperbolic growth" as far as I can tell.

My guess is, this is done because of Chunjie. For Chinese New year, people usually travel home to visit relatives. If the Chinese government wants to limit that, they need a very good reason, otherwise people will freak. So they have to exaggerate the danger, in order to be able to keep social peace when they quarantine cities.

I have a friend who teaches in China and according to him everyone is extremely worried. People aren't going out, wearing masks when they do, and so forth.

For what it's worth I'm flying back home to the US from the UAE and at the airport as I was waiting to check my bag I saw many (10+) groups of Chinese tourists checking entire boxes of 3M N95 masks. My guess is that they're running out at home and these tourists saw an opportunity to make some money or help people out (or both).

Can an N95 mask prevent viral infection? Those things are typically for particulates and are charged so things like dust attach to the fibers. I’m not sure they’re effective for aerosolized particles

I did research this topic many years ago during the bird flu panic, and the short answer is yes, a PROPERLY USED N95 mask prevents infection. The properly used part is quite tricky though, for example you touch the outside of the mask with your fingers when you remove it, and then rub your eyes... There's a reason those guys are in a full suit and not just a mask.

But even if it's not 100% effective, even if it's just 90% it's still a massive win.

There's very little evidence N95 masks work better than surgical masks, which are cheaper and easier to use.

Umm, properly used N95 masks have been shown to filter particles <10 nm...

N95 masks are better when there's dust, or smog, but don't make preventing getting sick any better than surgical masks. The idea behind surgical masks is to prevent you from getting sick when people sneeze, cough, etc. So the effectiveness is basically the same providing you use them properly.

Never touch the front of the mask. Wash your hands after removing. Dispose of mask after use.

And repeated studies have failed to show that N95 masks reduce transmission more than surgical masks do.

One of many studies: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/

- Wearing masks is normal because of air pollution. A lot of people wear really loose non-N95/n99 masks though, but there's definitely an uptick in people wearing better masks because of the virus.

- An acquantince of mine went to a supermarket today. Everything seems fine (they live not too far from Beijing where there are confirmed cases).

- There are still people entering Wuhan to see family. (https://youtu.be/cmgPVhubmQA?t=208)

I'm not saying people don't care. My family is worried for me because I left Hanoi the same day an infected individual arrived in Hanoi. I have friends that are worried for their families back home. But I still see a lot of friends celebrating the new year, albeit not in any quarantined areas.

There's reports of people leaving the quarantined areas with symptoms. I wish they would team up with Tencent to flag individuals who have been active in the quarantined regions and left such regions since then.

In Shanghai (at least, Pudong and Puxi), mask usage has jumped dramatically since last week. I haven't actually kept score, but my impressions of usage from walking around a lot are:

- Summer/spring (lower pollution — Chinese AQI around 60–100, with spikes to 150): 5-10% of people wear masks outdoors. The indoor rate is lower (2-3%?).

- December/early January (AQI typically above 120): 20-30% outdoors. The indoor rate is much lower.

- As of January 23/24: 80-90% outdoors. The indoor rate is at least as high. This time period includes a couple of anomalously low-pollution days (AQI 30 — the lowest I've ever seen in Shanghai), when I might otherwise expect mask usage to be even lower than that 20–30% from before the Wuhan events escalated.

This is just people walking around and shopping. As of a few days ago, some businesses, such as Starbucks and Didi (Chinese Uber/Lyft), require employees to wear respirators (and they've messaged to customers on WeChat and in the Chinese Starbucks and Didi apps).

This is consistent with my observations in the Jiading area - low pollution days but mask usage around 80% for general populace and 95% for service workers (store clerks, etc).

We’ve decided to leave China before things get any worse. I’m not looking forward to bringing my family through the airport this week though...

Good luck and safe travels!

Masks are sold out the couple of places I've been to in Beijing. Girlfriend's family cancelled CNY celebrations for fear of the virus.

People are taking it very seriously.

> An acquantince of mine went to a supermarket today. Everything seems fine

What would it look like if it wasn't fine...?

Massive shortages from people mass panic buying?

They built a 1,000 bed isolation hospital for SARS too, near Beijing. Also in a week. It was demolished about ten years ago.

They had to deal with SARS and are trying a more aggressive approach this time.

It's clear that there are many infected people who have not been confirmed, possibly on the scale of 100,000. Most will probably show mild to moderate symptoms but expect total deaths to rise into four figures.

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