News and analysis on Coronavirus.

Originally posted by The Gray Man at American Partisan

Over the last several days there have been a lot of updates, almost daily in fact, on the global situation with the Novel Coronavirus (nCoV). The reported numbers of infected have gone up significantly, the mortality numbers have gone up and several more countries outside of Asia have found cases or suspected cases inside their own borders. Person-to-person transmission has been observed in several places. Not much progress has been made in actually combating the virus itself, as it appears the entirety of effective treatment modalities are still focused on supportive treatment, that is to say that healthcare providers are treating the symptoms rather than the cause.

As of February 4th, China is reporting almost 21,000 cases with about 430 dead. This increase in both infected and dead is a significant increase in just a few days. The CDC is now reporting 27 countries with confirmed nCoV cases. As of right now, all of the deaths from nCoV have occurred in China, except for one that occurred in the Philippines. As of February 3, there are 11 cases in the United States, those cases being in California (6), Illinois (2), Arizona (1), Massachusetts (1) and Washington (1). The patients in Illinois were a husband and wife, and that is believed to be the first transmission between people in the US. Charts produced by various outlets are displaying the virus spread in China at nearly exponential rates. Keep in mind that in order for someone to be counted, they have to get sick, go to the hospital, get tested specifically for nCoV, test positive and get reported to their national health system (In the US, it would be the CDC). In China, the government actually has to then let the rest of the world know. That last step in China is not a guaranteed proposition, but neither are any of the other steps. It is a near certainty that the numbers of infected and the numbers of dead are lower than reality.

The increased spread may be due to the actual infectious processes, or it may be partially due to surges in reporting. We are dealing with an information-averse, totalitarian police state who's number one goal is the image of the power and control of the state above all else. The unprecedented reaction by China to quarantine over 50 million people (according to the last count I could find from a few days ago) is a telling message in itself. Imagine the Soviet Union suddenly evacuating a 100 mile exclusion zone around Chernobyl instead of the 6 mile zone they initially cleared out, all the while claiming the situation was under control. This reaction would have been disproportionate to the claims. This is how I feel about the Chinese reaction versus what they've been saying. Never before has the world seen a quarantine (however ineffective it may be) of 50 million people, let alone the larger numbers it must have risen to by now without my knowledge.

I do have some experience in the East Asian medical systems, as a patient. In 2012 I was hospitalized for a short time in Korea with an illness that I've deduced resulted from their drinking water. I recall being placed in a large ward with a large number of other patients and a janitorial storage corner. There was little concern shown for the possibility of passing germs from one patient to another. It's one thing to have the knowledge and training and research like they do, and entirely another thing to actually put it into practice.

I have serious reservations about China being forthcoming about the numbers, but I suspect that they aren't going to be able to cover up any part of the situation for much longer. The Chinese Communist Party has been working it's censorship apparatus overtime deleting Weibo and other social media posts as fast as they appear. A Chinese man was arrested for posting a photo of a pile of body bags at one location. Fortunately the rest of the semi-free internet has been able to take screenshots and repost the videos and photos.

nCoV is a respiratory virus that has an incubation period ranging from two days to as long as two weeks. It's believed that a person can be highly contagious during the incubation phase without having shown or felt any signs or symptoms. People often develop a cough and shortness of breath with a fever. It appears that most of the patients who have died had progressed to severe pneumonia-like complications. I suspect the odds are high that some people, probably mostly elderly, have been dying from pneumonia-like symptoms caused by nCoV, but may have never been tested for the virus at all. The virus spreads from person to person through airborne droplets coughed or sneezed into the environment, and some physicians in China, though later censored, claimed they had evidence that the virus can spread via contact with mucous membranes. This means it could possibly infect you if it contacts your eyes.

So, this is all good information to have, and the situation is changing pretty much daily. But you may be asking "What are they doing, what are we doing, what do I need to do?"

Firstly, countries like Russia are closing border crossings and US airlines are cancelling flights and suspending services to the Chinese mainland. No word yet on what will be done on the US border, assuming that we still have a border at all. It's debatable. The World Health Organization has declared a global health emergency based on the spread to other countries and there are fears of what the disease could do if it spread to a poorer country that lacks the tools of modern medicine. Of course I think we are mostly talking about Africa, but a lot of people don't realize that most of China is still very much a third world place with third world hygiene. I think this is one reason we've seen it spread so rapidly. Imagine this virus arriving in San Francisco, where achieving third world status would be an improvement.

Another note of interest is that there are reports from Thailand and India that the virus appears to respond to re-purposed HIV medications, which is quite curious. Apparently one of the later stage problems with this virus is the progression from leukopenia (a critical reduction of your white blood cells) to full blown pancytopenia (a critical reduction in your white blood cells, red blood cells and platelets). My wife and mom both have years of experience treating patients with leukopenia and pancytopenia, and these patients are often lost to illnesses totally unrelated to their cancer. Pneumonia, once again, strikes hard in these cases.

As far as your own household:
-You need to have a supply of face masks, like the regular surgical masks, and some 3M brand N95 respirators if you can find any. In my opinion, the N95 masks are something you should already have if you are a prepper of any sort. It's not time to wear them, but when it is time, there won't be any on the shelves.

-Make plans to spend more time at home and less time in town. Once upon a time not everyone in America traveled into town every single day for whatever minor items they needed. There was a time when you had to plan and prepare and make lists before going into town on your horses or carts, and stock up for a longer period of time, because trips into town happened much more rarely. Adopt a similar mindset and cluster your errands. My wife and I try not to go into town (the actual town about 40 minutes away) more than once every couple of weeks. During the two weeks leading up to it, we make a list of the things we need to get done and try to put it off for that day. Obviously you will have to attend to more urgent and emergent needs, but if you can reduce you trips into town by half or more, you'll probably save gas, time and maybe save yourself from catching a bug.

-Wash your hands. This may sound obvious but I'm not just talking about hand sanitizer. The alcohol based hand gel "kills" bacteria. You can't use it to "kill" a virus. You need to use soap, water and friction to dislodge the infectious particles and wash them down the drain. Here is a 90 second video to show you how.

-Stock up on food, water and medication. I currently work in an emergency room and before that I made my bones on a trauma/surgery floor. It seemed like every time there was an earthquake somewhere on earth, or a typhoon, or a tornado, or a tsunami, or some random civil unrest, we would go on "nationwide backorder" for something, because everything is either made elsewhere, or part of it is made elsewhere, or the container is made elsewhere, or the packaging, etc. Some medication or medical supply or material would go short and we would have to go without. I've seen our hospital (based in a modern city of nearly 60,000 people) go empty on dilaudid, morphine, nubain, normal saline bags, plastic urinal cans, protonix, etc. at various times due to storms in the Caribbean or Typhoon in Asia, or whatever else was happening in the world, and we would often be dealing with the shortages for months. I'm sure you know that the society of the United States run largely on the flow of cheap Chinese garbage and cheap Chinese/SE Asian labor. If this virus has already affected the world markets, don't you think it could have an effect on our supply chain? Your family needs at minimum one gallon of water per person, per day. You can either buy water or you can buy containers and fill them yourself. Go shopping for some Mountain House meals, or buy in bulk and store rice and beans long term. Buy flats of canned goods cheap. Talk to your doctor and let them know you'd like an extra refill or two to cycle through at home. A lot of docs would be happy to give it to you if it's not a controlled substance.

-Put some cash away for a bad day. The world's economy runs through the US and China, and our two economies run through each other. Already Chinese stock markets have had their worst day in at least four years, and markets are continuing to drop. Of course, Chinese state media is telling everyone there is no need to worry. US stocks dropped initially but rallied afterward, and showing gains at this point. For now. Having cash on hand and other tangible assets (ahem) is always a good plan, but if you can put some more away right now, you'll still be ahead of the game.

-You need a good medical bag and a way to take a full set of vital signs. If you can learn to use a stethoscope to listen for adventitious breath sounds, then you can get a friend or family member, or yourself, to the doctor faster or quarantine people as needed. There are people in the US who have recently returned from China and imposing self quarantines away from their family for two or three weeks.

More updates to come as they happen. We haven't seen the worst of it yet. Stay away from crowds.