Preparing For The Inevitable Coronavirus Disease 2019 Outbreak

Jim here.

I am quite late to getting to a post on the new coronavirus, but headlines yesterday finally forced me to move ahead and gather info today. First, watch this incredibly informative video from the World Health Organization. It gives very good information on the biology of the virus and what’s going on in the outbreak:

Although Donald Trump and his media partners have been denying that Coronavirus Disease 2019 (COVID-19) is a real cause for concern, there were multiple statements yesterday from US health officials that ranged from quite alarming to somewhat more reassuring. The announcements were summarized well by the Washington Post. Perhaps the most attention was paid to portions of what Dr. Nancy Messonnier provided in a telephone briefing yesterday morning. Dr. Messonnier is the Director of the National Center for Immunization and Respiratory Diseases. A recording of the briefing and a full transcript can be found here.

Of most note from the briefing is when Messonnier stated:

Ultimately, we expect we will see community spread in this country.  It’s not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness.

So, yes, spread of COVID-19 in the US is inevitable. Messonnier continued, discussing what can be done to try to contain the disease. Because there’s no vaccine or specific treatment for the virus, control has to be through what is termed non-pharmaceutical interventions or NPIs:

There are three categories of NPIs.  Personal NPIs which include personal protective measures you can take every day and personal protective measures reserved for pandemics.  Community NPIs which include social distancing measures designed to keep people who are sick away from others.  And school closures and dismissals.  And environmental NPIs which includes surface cleaning measures.

It’s in the category of potential community NPIs where the biggest concerns start to appear:

Now I’d like to talk through some examples of what community NPIs look like.  These are practical measures that can help limit exposure by reducing exposure in community settings.  Students in smaller groups or in a severe pandemic, closing schools and using internet-based teleschooling to continue education.  For adults, businesses can replace in-person meetings with video or telephone conferences and increase teleworking options.  On a larger scale, communities may need to modify, postpone, or cancel mass gatherings.

Messonnier expanded on the disruptions:

Secondary consequences of some of these measures might include missed work and loss of income.  I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe. But these are things that people need to start thinking about now.

So, yes, there may well be significant disruptions to everyday life in parts of the US. We of course don’t know when this would occur, or where in the US it would be. But this is a good time to start thinking about how a disruption to moving around for a couple of weeks would affect you. Here in Florida, we regularly have to prepare for a week or more of loss of electricity during hurricane season. Preparing for community control measures would be a bit different. Right now, my thoughts for our household are that I will stockpile a few extra large cuts of meat in the freezer. These are things I’d eventually use anyway, so it won’t hurt to have them around. I’ll increase a few of the pantry items that I wouldn’t otherwise increase until the start of hurricane season. I’ll beef up my supplies for baking bread. If a disruption starts looking more likely locally, I’ll even add some frozen veggies to my stockpile, but for now I’m going to rely mostly on my ongoing CSA supply.

But I’m not going to rush out and buy an N95 respirator facemask. The current recommendations from CDC do not recommend facemasks for the general public. They are only recommended for people who are sick or for those who are caring for someone who is sick. This and the other CDC recommendations for treatment and prevention can be found on this helpful page.

The key thing to remember in trying to avoid catching COVID-19, as described in the video above and on the CDC page linked just above, is to avoid being very close to sick people. The guideline mentioned is six feet. If you see someone who looks symptomatic, it shouldn’t be too hard to stay six feet from them. Also, if the virus is known or suspected to be in the area where you are, be especially careful to keep your hands below your shoulders at all times and to wash your hands frequently if visiting public places. As CDC describes here, transmission is thought primarily to be through aerosol droplets such as sneezes and coughs, but it remains possible that the virus could be picked up by touching contaminated surfaces.

Finally, people are also quite concerned about the prediction discussed here by Professor Marc Lipsich, an epidemiologist at Harvard. He has stated that it’s possible that a COVID-19 pandemic could result in 40-70% of people world-wide becoming infected. As Lipsich points out, however, that estimate must be coupled with the realization that we currently have no good estimate for what percentage of people who become infected develop few or no symptoms. In fact, moving out from his discussion, there currently are widely ranging estimates of what percentage of infected people die. Inside Wuhan, where the virus first emerged, estimates now are that 2.8% of those infected die. Outside Wuhan, however, that number drops to 0.18%, a difference of over 15-fold. For a discussion of how early we are in the process of understanding the epidemiology of this virus and why these numbers differ, see this paper.

For perspective, it appears that COVID-19 spreads far more efficiently than SARS and MERS, but conversely, SARS and MERS killed a higher percentage of those infected. We see more COVID-19 deaths because many more people have been infected.

The featured image for this post is in the public domain and comes from CDC. Here is the caption CDC provides: “This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).” Credit for the image goes to Alissa Eckert, MS, Dan Higgins, MAM.

355 replies
  1. Pete T says:

    Thanks Jim.

    I have been following Chris Martenson of Peak Prosperity who has been doing near daily YouTube updates on COVID-19 based on info he collects – and that is sent to him – on a worldwide basis. He can be located on his YouTube channel under Peak Prosperity or via his WEBsite

    He’s not a big fan, so far, of the info response from WHO and CDC.

    My son has been following Dr. John Campbell of the UK – latest vid:

    Wife has a 10 day trip planned to London (Miami-Heathrow) mid March with a teacher friend as an escort for a college group on a study junket. What are they studying? Ironically part of the history of the Black Plague. Go figure. It’s insured so the plug can be pulled at last minute, if necessary, with minimal financial impact.

    • Jim White says:

      I trust the pros at CDC and WHO. We’re still very early in the process and with the initial outbreak being in China, collecting accurate info is extremely hard. As the disease spreads to other countries and as time passes, our information will get much better.

      • BobCon says:

        The CDC and for that matter a lot of state and local health agencies are filled with pros, even in red states that aren’t always friendly to public health issues.

        The legacy of 9/11 and Katrina has tended to be positive in terms of emergency prep, even when it it has suffered in other regards.

        The federal political leadership is another story, but I have a decent amount of faith in the professionalism of the people implementing policies at the ground level, as long as they don’t suffer too much interference.

        • CCM says:

          Second that, FDA comes out with some oddly reasoned decisions, but as a practicing MD, I take the CDC very seriously. Of any of the organizations that issue recommendations the CDC’s seem the best reasoned.

    • Katherine M Williams says:

      I’m listening to Peak Prosperity and Dr. Campbell; they’re making a lot more sense than our government agencies.

  2. OmAli says:

    Thanks, Jim. We have also picked up extra cat food. I bought some gloves to use as need presents itself, simply to remind myself not to touch my face while out in public.

    • earlofhuntingdon says:

      Yep, paper products and cleaning supplies might be in short supply. It would be helpful if those who can share would do so.

    • Frank Probst says:

      That’s a really good idea to do with the gloves, and if you have them, I would also suggest wearing them for a while when you’re at home. Most people touch their faces far more often than they think they do, and becoming conscious of the behavior is key to minimizing the number of times that you do it.

  3. earlofhuntingdon says:

    Community NPIs which include social distancing measures designed to keep people who are sick away from others.

    So, that would mean not subjecting a planeload of healthy passengers to hours’ long exposure from other passengers who have tested positive, separating them by a few sheets of plastic and, presumably, a common aircraft hvac system?

    Shirley, no government would be so cheap or so much into denial as to charter only a single aircraft to repatriate such a mixed group of its citizens. Tell me it ain’t so.

    • Pete T says:

      That appeared, from what I have heard, to have been a DHS over CDC call. CDC seemed to be pretty upset with the apparent last minute decision. But, hey duct tape can do (almost) anything.

      • earlofhuntingdon says:

        In a normal government, DHS would never have employed managers who would make that irrational call or been allowed to overrule CDC’s call.

        But those in charge of this government value appeasing Donald Trump more than in doing their jobs. Trump’s courtiers, especially his 29-year old White House director of personnel – his Loyalty Czar – are in the process of physically removing those who do not share that priority.

        Their neocon preferences also limit their ability to make reasonable public health choices, as they limit their ability to establish reasonable policies on immigration. Having committed themselves to the latter, they will ensure they do the former.

        • Peterr says:

          It was the State Department that overruled the CDC, not DHS. From the Washington Post (via Diplopundit):

          In Washington, where it was still Sunday afternoon, a fierce debate broke out: The State Department and a top Trump administration health official wanted to forge ahead. The infected passengers had no symptoms and could be segregated on the plane in a plastic-lined enclosure. But officials at the Centers for Disease Control and Prevention disagreed, contending they could still spread the virus. The CDC believed the 14 should not be flown back with uninfected passengers.
          The State Department won the argument.

          HHS was part of the conversations, siding with the “bring ’em back” folks and against the CDC, but the decision was ultimately Mike Pompeo’s. See the State Dept Q&A at the link above for more.

          • earlofhuntingdon says:

            Thanks for that. I wholeheartedly agree with the repatriation of Americans to the US. Leaving them to the whims of various foreign governments would be an abandonment. That said, this country has the resources to test those coming back, and to separately bring back the sick and the healthy.

        • BobCon says:

          I don’t expect any kind of action by these people based on the public interest.

          But I still wish the GOP would remember how badly it hurt them in the 2006 elections after they gutted FEMA and put it in the hands of the hands of the chief of a horse association.

          The idiots in charge now are no better than the dopes who were only concerned with telling Michael Brown to always take off his jacket before he appeared on camera.

          Nobody would go to Bush and tell him to order Rumsfeld to get with the program before Katrina hit. Nobody will go to Trump today and tell him to get Limbaugh, AEI, and the rest of the conspiracy theorists to shut the hell up. The GOP would rather see thousands die than try to pop the bubble.

        • Katherine M Williams says:

          The US wants to cut our contribution to WHO by 50%, and we’ve already shut down pandemic monitoring and response teams set up by Obama.

          Understandable WHO is not giving anyone the true story about COVID-19 (Covfefe-19). They are, as are most government people in the US, (I know WHO isn’t US gov) terrified of insane Trump & his moronic goons.

          The transmission rate -as of mid-Feb- is 5+ people are being infected by 1 person. The death rate is 5x the flu. And the incubation period can be 4 weeks. It is a virulent virus we’ve never seen before. China which produces ⅓ of the goods which are part of the world-wide supply chain the US relies upon, is working at zero to one-half factory capacity.

          So stock up for more than a week. And DO get N94 or better face masks if you can find them. They are sold out on Amazon.

          • P J Evans says:

            Face masks are for health care workers. There aren’t enough for everyone else. Best practice is keep hands away from face, and wash them thoroughly.

          • quickbread says:

            Where are you getting your statistics on this virus’ fatality rate? From the sources I’ve read, COVID-19 is less deadly than the flu and significantly less deadly than both SARS and MERS. If you divide the number of COVID-19 deaths by the number of cases, it tallies up to about 2.5%, or it did a few days ago. That’s less than half the death rate from the flu.

            • earlofhuntingdon says:

              You might want to check your stats. The infamous influenza pandemic, from about January 1918 through December 1920, had a mortality rate of about 2.5%, about the same as that tentatively predicted for COVID-19.

              That rate may have seemed higher to contemporaries for many reasons, one being that that flu was unusual in affecting young adults rather than the more typical very young and very old.

              That rate is more than double the usual mortality rate for the annual flu. Closer to your 5% is the mortality rate for the annual flu for hospitalized adult patients – a small subset of the total – which was 5-10%.

              • P J Evans says:

                I’ve read that COVID-19 seems to have a much lower infection rate in the young. Possibly it affects them less strongly. (This is from reliable sources.)

        • posaune says:

          Ah yes, the courtiers. The Loyalty Tsar — Actually, politico reported, “The White House has hired a college senior to be one of the top officials in its powerful Presidential Personnel Office, three administration officials familiar with the matter told me. His name is James Bacon, 23, and is a GW senior.” So, the new fed purger is likely in his first job while completing an undergraduate degree. Wonder what his connections are. Every day more surreal.

    • earlofhuntingdon says:

      Fortunately, most of us have more common sense than that. For many people, the question will be resources. Churches and community centers will be vital components to limit the spread and to care for the sick.

      Federal and state governments must step in, however, to bridge the gap between a rapacious private health insurers and those who need immediate help.

      Employers, too, must temporarily set aside their usual rigid employment rules. Many companies offer little or no health care, many offer little or no paid sick time off. Those who take time off anyway are often summarily dismissed.

      FMLA will be inadequate, so temporary congressional relief should incentivize and subsidize employers willing to do the right thing. State governments have a similar role to play. Similarly, there should be tax and/or financial penalties for those who fail to suspend their rapaciousness for the duration.

      Price gouging laws should be resurrected for those companies who use the emergency of a significant outbreak to boost their profits at the expense of the sick and dying. Those will include communities, not just families and individuals, the same ones most affect by job blight and the opioid crises.

      • posaune says:

        Great points, Earl — you really give a sense of the scale of impact. This could redefine public health. Years ago (1980s-1990s), I was working as a new-graduate health care architect at Bellevue Hospital on the Aaron Diamond AIDS lab project. The unknowns, at least at the beginning, resulted in massive changes to A&E, HVAC design for labs and clinical settings. I would expect more this time. (The McKim Mead & White structure at Bellevue was superb for reuse: 15-foot ceilings could take any and all mechanicals.

        • earlofhuntingdon says:

          I’m sure all that and more is in the comprehensive response plans the administration has prepared to defeat an unprecedented epidemic.

  4. Valley girl says:

    I was discussing this corona virus with an M.D. friend yesterday. In the context of air travel, I mentioned that I had gotten the pneumonia vaccine a few years ago. He said it wasn’t clear that this would be helpful b/c some deaths in China had resulted from massive organ failure. But he said his knowledge was anecdotal, coming from discussions with other M.D.s.

    I don’t know of a down-side to getting a pneumo-vax, so/but don’t take what I say as a medical recommendation. I only mention this b/c I didn’t know that there was such a vaccine until a few years ago. This was discussed on a college email list I am on (someone was in hospital with pneumonia)- and it seemed that most in the group were unaware of the vaccine.

    • P J Evans says:

      I got one in December – mostly because it was about the only one on the CDC’s recommended list I hadn’t already gotten. Like the flu shot, it may not help with this virus – but it won’t hurt, either.

      • pdaly says:

        WRT Valley Girl’s mention of the vaccine for pneumonia.
        There are no recommendation changes in light of the new coronavirus spread. But here is some general information about the pneumonia vaccines.
        There are TWO pneumonia vaccines for adults,
        PCV-13 (Prevnar) and PPSV23 (Pneumovax-23).

        PPSV23 has been around since 1983, mainly as a vaccine for adults
        PCV-13 has been around since 2010, mainly as a vaccine for children.

        From 2014 until November 2019, both PCV-13 and Pneumovax-23 were recommended for ALL adults aged 65 and above to help prevent pneumonia and invasive pneumococcal disease (i.e., pneumococcal bacteria in the blood stream, infection in the bones and brain). The pneumonia vaccines are only about 45-50% effective at preventing lung infection, but they are much better at preventing the invasive blood infections by the same bacteria.

        PCV-13 and/or PPSV23 are also given to adults under the age of 65 years if they have severe immunodeficiency. I add a link below that goes into more detail.

        In late November 2019, the vaccination recommendations were revised by the Advisory Committee on Immunization Practices (ACIP).

        All adults 65 years and older should continue to receive a one-time PPSV23 vaccine. However, for adults, the PCV-13 is recommended only for high-risk patients. Any other adult 65 years and older can obtain the PCV-13 if they want to, after going through a shared medical decision-making conversation with a doctor, but the benefit to this group of the PCV-13 vaccine is less clear than for the high-risk group. The PCV-13 is still routinely given to children.

        The PCV-13 and PPSV23 CANNOT be administered at the same time, because it will lower the body’s antibody response to each vaccine. Instead, the vaccines should be administered 12 months apart (or in special circumstances separated by at least 8 weeks in which case the PCV-13 should always be administered first, followed by the Pneumovax-23 8 weeks later).

            • pdaly says:

              My comment above was meant to reinforce the point that anyone aged 65 years old and older should consider obtaining the pneumococcal vaccinations.

              I should highlight something about adults aged 19-64 years old in case readers here don’t have time to click the above link:

              19-64 year olds are at higher risk for pneumococcal disease and SHOULD obtain a PPSV23 (Pneumovax-23) vaccine IF they have diabetes, asthma, emphysema, alcoholism, chronic liver disease (hepatitis C, cirrhosis, etc), or if they smoke cigarettes (smoking marijuana does not seem to be a concern at this time).

              Then these same people should obtain the PPSV23 again after they reach age 65. If fewer than 5 years have elapsed since their ‘pre-65 years old’ vaccination date, then they should wait until the full 5 years have passed before getting the vaccine again.

              The above list of 19-64 year olds does NOT require the PCV-13 pneumococcal vaccine.

              By contrast, the following people (also aged 19-64 years) should obtain BOTH the PCV-13 vaccine and then at least 8 weeks later the PPSV23 vaccine, because they are very high-risk for complications from pneumococcal disease:

              19-64 years olds with cochlear implants, chronic renal failure, cerebrospinal fluid leaks, HIV infection, no spleen (asplenia), sickle cell disease, immunodeficiencies (whether due to chemotherapy, immunosuppressant medications, or genetic causes), cancers, leukemia, lymphoma, solid organ transplant.

              • pdaly says:

                And I forgot to mention that people aged 19-64 with chronic heart disease should also consider obtaining the PPSV23 pneumococcal vaccine.

  5. earlofhuntingdon says:

    Meanwhile, what’s most on Trump’s mind is suing the NYT for defamation over a year-old story that claimed he had “an overarching deal” with Putin’s “oligarchy.”

    Trump has quite a burden. First, he has no reputation to protect, but that issue goes to damages. Before he gets there, he has to prove that the claimed statements were defamatory – that they were published, were false, caused harm to Trump, and were made without reasonable evaluation of whether they were true.

    Since Trump is a public figure, he must also prove that the NYT acted with “actual malice.” That is, mere falsehood is not sufficient, because many statements can be accidentally or incidentally false. To prove actual malice, Trump must show that the NYT knew its claims were wrong at the time it published them or that it acted with reckless disregard about whether they were true.

    That legal standard comes from a 1964 case, NYT v. Sullivan. So I presume the NYT’s lawyers are well-versed on the limits of what it can say without running afoul of a legal standard named after their employer. That and the year-long delay suggest Trump is doing what Trump always does when he’s on the mat and his opponent is on top. He sues.

    It’s a Roy Cohn thing. Truth and good faith belief are irrelevant to Trump. He uses the pressure, distraction, and theater of a major lawsuit as weapons. If the suit goes South, he assumes he can walk away or settle, so he thinks his strategy is always a win-win. I suspect that’s no longer true.

    • BobCon says:

      NPR is pushing for sanctions against Steven Biss, the lawyer for a Fox News commentator who filed a ridiculous defamation suit against NPR.

      The article notes that Biss also represents Devin Nunes, previously had his law license suspended for a year, followed by another one month additional suspension, followed by a public reprimand from the Virginia Bar disciplinary board.

    • P J Evans says:

      Even more fun, the suit was filed by his campaign organization. That may make it even harder, especially since one of their claims is based on Mueller’s report, which came out a month *after* the editorial they’re suing about.

      • earlofhuntingdon says:

        The reputational damage would be to Trump. The campaign and his various businesses might suffer collateral damage, but that complicates the proof problems tremendously. It also opens up discovery to an inquisitive, well-heeled defendant. Even Trump normally avoids that.

        My first impression is that Trump is doing what he always does, besides sue and not keep his promises. He’s getting someone else to pay his bills, while disclaiming any cost or benefit for tax, campaign finance, or other laws.

  6. earlofhuntingdon says:

    Trump’s make-up people have modified his usual orange racoon look. They’ve added pinkish eye shadow, to avoid the obvious white circles.

    Trump is typically overstating his concerns, his achievements, and his optimism about managing the response to COVID-19.

    He cites a supposed Johns Hopkins “study” which claims that the US is “rated number one, most prepared,” to handle a pandemic response. He held up a colored chart, but I didn’t see the Sharpie marks. Then he gave Mike Pence the poisoned chalice of being spokesperson about America’s handling of its response to the Coronavirus.

    • FL Resistor says:

      Trump’s pink eye shadow matched his pink tie in the COVID-19 news conference. My impression was that he is going for a minor deity luster after his visit to India.

  7. Rapier says:

    Musings from just another schmuck on the internet.

    This is the first time I heard a mortality number of (point) .18%. The widely quoted 2% allowed my imagination to run wild, lots of other people too I suppose. Now at least it’s easy to see how it could be much lower because mild cases or even totally without symptoms cases are probably never counted in the totals.

    If it is point something percent we are talking about flu levels. We can hope. Still keep in mind that another widely reported item is that the incubation period before the onset of symptoms, while being contagious, is longer than for flu. Flu 2 days and Cornonavirus 4 to 7,or so I have seen. Which translates into a lot more people exposed.

    One oddity is that a few days ago it was widely reported new cases in China are falling. That makes no sense in relation to the above. That is the Coronavirus is more likely to be passed along. I don’t know what to make of this logical, to me, discrepancy. I am not inferring doctored numbers either. Maybe aggressive quarantine and mindful people can really slow the spread. Preventing an explosion of cases which would swamp systems. Of course mindfulness and Americans are mutually exclusive.

    • P J Evans says:

      I’ve seen reports of a transmissibility period of up to three weeks, which is in line with several other viral diseases.

      • earlofhuntingdon says:

        I believe there’s disagreement about whether it’s ten days, three weeks, or something else. More research will be needed to establish the correct number, which comes from a greater incidence of the disease. That’s not likely to be a problem.

    • CCM says:

      The mortality rate is really unknown. I would not trust the Chinese and their data. We need to wait until the virus spreads to a country with an open society and free press.

  8. earlofhuntingdon says:

    Dr. Fauci, Director of the National Institute of Allergy and Infectious Diseases, is up next, talking about routine vaccine trials over the next six months or more. His time frame is really a year to a year and a half. Pre-vaccine measures will have to cover that gap.

    This dog and pony show is distraction in the guise of “good news.”

  9. earlofhuntingdon says:

    Trump insists a Coronavirus outbreak in the US is “not inevitable,” if it happens it could be at a “low level.”

    Trump is in condo selling mode, and is hiding his fury that someone might leak that the building is empty because it is less than half completed.

    The format and content give no reasonable basis for Trump’s optimism.

    • P J Evans says:

      He also plans to take money from existing (and necessary) social programs for some of the funding, rather than from his useless wall.

    • earlofhuntingdon says:

      Well, the $2.5 billion Trump supposedly asked for from Congress is off by at least an order of magnitude. Possibly two, if things get bad. That assumes what’s allocated goes where Congress intended. The potential economic consequences, direct and indirect, could be substantially more.

      • OmAli says:

        I worry about supply chains, medical, in this case, becoming severely disrupted. What if masks and gowns are simply unavailable. IV bags and tubing. Ventilators and the things needed for intubation. Antibiotics for secondary infections. $$$$$ may be the least of our worries there. Let’s just hope that the first line medical professionals have the protective gear they will require. Can we trust that there really is a strategic stockpile of supplies, under this “administration”?

        • bmaz says:

          They already are. You cannot find masks already, everywhere is sold out, even Amazon I am told (though I have not looked). And where are most of these “white masks” made you ask? Lol, China and maybe Vietnam. So, yeah, there is a bit of a disruption already.

          • ducktree says:

            After spending Thanksgiving Day 2018 in the ER for respiratory therapy due to the wildfire smoke (long time asthmatic here), I purchased a case of N95 masks from Amazon (80 count em, 80 masks). I still have more than 65 boxed up. . . Maybe I should go on eBay?

          • vvv says:

            I have a college buddy in the import business of medical supplies. Syringes, tubing, containers, etc. He even married one of his main supply contact’s representative. She’s Chinese, and all of his business is with China, as, I understand, is the majority of his competitors’.

        • CCM says:

          Hospitals, especially ICU’s have very little excess capacity as measured in rooms, staff, equipment, and medications. If this hits hard we are up shits creek.

        • Geoguy says:

          My wife works for an organization that provides tissue recovery services for recovery partners such as the Gift of Life program. They are having problems procuring items such as gowns, masks and gloves for the processing facilities. Apparently price gouging has already begun. Hopefully supplies are being diverted to where they will be most needed.

          • Eureka says:

            That’s disturbing to hear, that sort of an outer band but still a legit medical purpose-use of supplies is disrupted.

            • CCM says:

              Many hospitals have gone to “Lean” management style. Purchasing is just in time with little excess stock. Works well when there is not a pandemic. Also we are in the mist of a nursing shortage, ICUs in particular are lacking in experience and numbers. North Carolina has in winter months been faced with no iCU beds available at times, largely flu based. Not easy to ramp things up for a pandemic.

    • Donna says:

      Look at it this way:

      the doorman of a hotel knows the owner of the hotel. And they, in turn, know the owner of another, more prestigious hotel. He or she, in turn, knows a senior government official who happens to know the president. through only five connections, you have gone from the hotel doorman to the president. Note that, such connections don’t necessarily have to be too close or intimate.

      Trump doesn’t understand the theory of Six Degrees of Separation

      According to the theory, each person in the world knows about 100 people among friends, family, and co-workers –although in principle, it may be difficult to list a hundred people we know.
      Well, if each one of your 100 acquaintances is connected somehow to another 100 people, then, the number would increase to 10,000 in just the second link in the chain.
      In the third link you could increase the number of people you could possibly meet to 1,000,000 and 100,000,000 in the fourth link. In the fifth one you would reach 10,000,000,000 people and 1,000,000,000,000 people in the sixth level.

      Far beyond the total population of the planet.

      • Mooser says:

        So, a problem has arisen, the coronavirus which effects all Americans equally, and from which money and whiteness is no protection. Trump has no idea what to do.

        • LeeNLP says:

          “Trump has no idea what to do.”

          Actually he does have an idea: Deny everything. Purge non-loyalists. Blame Obama. Sue the Times.

          It’s rather simple, actually. Being a parasite is so much easier than being a fixer. Which a president is supposed to be.

  10. earlofhuntingdon says:

    Trump: “We may not need a vaccine,” against the COVID-19 virus.

    Useful to remember that Donald Trump denies that he has any obligation to tell the truth.

    Trump has suddenly discovered that “we should all work together.” And then he says that Speaker Pelosi is incompetent, in response to a question from an unnamed reporter. So, back to normal.

    • Katherine M Williams says:

      Keep in mind everything Trump says is a lie. Because he is delusional, as well as a con man, as well as being stupid as a stump, as well as being surrounded by moron lickspittles who lie to him because he is infuriated by the truth, Because he is delusional.

      • MB says:

        I’d give him a tad more credit: 80% lies. The other 20% relates to indisputable mundane facts of daily existence that he shares with the rest of us humans, like “we’ll be meeting to discuss that later this afternoon”. But it is quite astonishing to see the huge variety of subjects, large and small, important and not, that he automatically lies about.

        • e.a.f. says:

          It may the dementia at play. The “filter” is broken and he simply says the first thing which pops into his head. If questioned an hr. later, he would not remember what he has said. he has difficulty stringing a sentence together. at the press conference he was standing their “swaying” back and forth. Some times you see animals doing that right before they die or are seriously ill.

  11. earlofhuntingdon says:

    About that closing the borders claim. A reporter just mentioned Brazil and carnival, which draws people from all over the world. Brazil, like many countries, is made up of large immigrant populations. Africans, of course (originally and for hundreds of years, slaves), Europeans, and so on. It also has what may be the largest population of Japanese descent outside Japan.

    That suggests global population movements that would not be obvious to the typical racial profiling this administration seems to use. How do you close the borders against that, Mr. President? My point is that the facts do no support Trump’s blithe assertion that the US will escape the spread of the Coronavirus. He’s just making stuff up. SNAFU.

    • e.a.f. says:

      the man is sick, dementia or some such thing. The U.S.A. can’t avoid it, it has already landed. any one who believes different, has problems.

  12. 200Toros says:

    In his attack on the Fed, IMPOTUS actually said that buyers of US Treasury bonds should not be paid interest, for the “privilege of borrowing our money”!!!!

    I shouldn’t be surprised, that Dear Leader doesn’t understand bonds, that the issuer is the borrower, that WE are the borrowers!

    He stood there with all the experts at his back, and answered all the questions himself, like the idiot he is. What a disaster.

    • earlofhuntingdon says:

      For a guy who never stops bragging about having gone to Wharton (its real estate, not its finance or MBA program) and brags about making billions, much of it via borrowed money, he’s dumb as a post.

      In his latest gaffe, he confuses the most basic of debtor-creditor relations. The buyer of a US Treasury bond lends money to the United States. He’s the creditor. The US is the debtor.

      The mistake is so fundamental, it confirms concerns about Trump’s significant mental decline. That no one in his administration calls him on it confirms the decline in the competence of his government.

      • P J Evans says:

        Right up there with assuming that tariffs on imported goods are paid by the country from which they’re imported.
        How *did* he get that bachelor’s degree, anyway?

        • earlofhuntingdon says:

          I don’t think Trump takes uprecedented steps to hide his transcripts, medical records, and tax and financial statements because he’s proud of them. I imagine he does it because he thinks they make him vulnerable.

          As for his grades, and that he was admitted to Penn as a legacy, his pattern would be to intimidate professors – he punched one teacher in grade school – get others to sit his exams, and bury the school in donations – that is, make it an offer they can’t refuse.

          None of that is new to Trump, but Trump does things in combination and to extremes few can match.

      • 200Toros says:

        YES. His stupendous ignorance of even the most basic concepts of how capital markets work puts the US at an unimaginable disadvantage whenever he is trying to “swing a deal.” ALL foreign players understand these things orders of magnitude better than he does.As you know, the Chinese hold a large chunk of their foreign currency reserves in US Treasuries. There are many strategic implications of this, in terms of what they can, and just as importantly, cannot do, to impact currency markets with these holdings. We have a president who is incapable of even understanding the basic concept of a BOND, let alone the nuances I’m talking about here. Xi Jinping gets this. Trump couldn’t get it if I drew it in crayon…

        • e.a.f. says:

          If things went really “south” in China they could want to trade in all their bonds for cash. what will trump do then?

      • Katherine M Williams says:

        And China is the biggest buyer of our T Bills. I wonder if they’ll try to cash them in to pay for their epidemic, since they’ve shut down a lot of their factories?

        • 200Toros says:

          Important distinction – China is one of the largest *foreign* holders of US Treasuries, with about $1 trillion. Foreigners hold about 39% of our debt. Japan actually holds the most. Most of our debt is held by US entities. Foreign holdings of our debt is not necessarily a bad thing, as it’s largely a function of our currency being the single most important reserve currency in the world. It gives us options literally no other country has. It would be nice to have a president who was capable of understanding any of this.

  13. Eureka says:

    Good idea to look into and have some vitamin d3 on hand: well-established “antiviral” (colloquially said; a general immunological booster vs multiple pathogens) (multiple mechanisms (still) under investigation). For decent reviews, scroll at e.g.:

    vitamin d antiviral at DuckDuckGo

    vitamin d antiviral – PMC – NCBI

    Not medical advice: some healthcare workers are known to take 15k to 20k IU for a day or few at first signs of a general respiratory infection. (Tho also look into having good vit d status in the first place, and everyone that can spend as much time outdoors and in the sun gets props, too.)

    • Eureka says:

      As a general, practical (i.e. what to actually do) reference point re nutrients — whether via whole foods or supplements — and health concerns, I’ve liked (PhD in nutrition; evidence-based content). [He is — at least was — an active blogger, so might have something addressing this outbreak.]

    • earlofhuntingdon says:

      Please be careful in recommending supplements, even something as simple as a well-recognized vitamin. Their efficacy depends on many factors, including the quality of their manufacture.

      • Eureka says:

        Thank you for the reminder that so-called nutritional supplements are virtually unregulated in this country. Besides being sold as a “nutritional supplement”, Vitamin D is also available by prescription: the big pharma versions would be regulated differently.

        To clarify, I felt the topic worth raising, and did so in the context of folks investigating the general issue themselves, including with one’s physician ( that’s what ~ “looking into vit d status” refers to, along with the non-specific links). That vitamin d status relates positively with immunological performance is well established at this point, in the literature and extending to clinical practice.

        Given that it’ll likely be over a year for a vaccine, per Fauci re clinical trial standards, it seemed to me worth researching while preparing for the coming months. As indicated above: NOT MEDICAL ADVICE; I would take the sunshine, if/when available.

        At the same time as I am trying to give care to this comment because of eoh’s concern, I also don’t want to hyper-medicalize or paternalize it. People take supplements for all sorts of reasons, like how vegans et al. often take B12, and somehow negotiate these landscapes of broken regulation and information. Thus, my comment assumed that any interested reader would be performing the usual “caveat emptor” and “consult with your physician.”

    • holdingsteady says:

      Thanks for the reminder, Eureka! Our house will stock up on supplies – here in Alaska our food comes from far away, especially this time of year and I don’t want to err on the side of complacency.
      I’m thinking of canned fish for one thing. (I know this isn’t maybe on topic, so please forgive)

      If anyone knows of a nutrition-from-food blog of a quality equal to Emptywheel, please post.
      I will check out

      • Eureka says:

        Yep — fish, things like sun-dried tomatoes and sun-dried mushrooms came to mind for me.

        [The reason I mentioned that guy’s blog was because his PhD was on fat-soluble vitamins, to boot. His was also the best nutrition-from-food one I could think of (as we all know, the internet is full of hokum on a variety of topics…)…]

        • holdingsteady says:

          Thanks for more good tips, sun-dried mushrooms reminds me of Paul Stamets, a mushroom guru who spoke at our garden conference a few years back emphasizing the vitamin d in mushrooms… he was inspiring.
          I’m looking forward to getting to know the masterjohn blog, and thanks cavenewt for also corroborating.

  14. earlofhuntingdon says:

    As AOC notes on twtr, extreme fundamentalist Mike Pence does not believe in science. “As governor, his science denial contributed to one of the worst HIV outbreaks in Indiana’s history.” He lost his governorship because he was too conservative for conservative Indiana.

    What does a guy who refuses to be alone in a room with a woman not his wife know about basic anatomy and physiology, let alone epidemiology, pharmacology, and the intricate decision trees and flow charts one would expect to find in the so-called master plans this administration has supposedly prepared?

    Mike Pence’s extreme fundamentalism and science denial suggest, too, that he does not believe in evolution. That might be a problem in evaluating how to fight a virus as it mutates across the globe.

    To the extent Pence does believe in science, it is a distant priority behind promoting his religious beliefs. He thinks, for example, that Donald Trump is president because God willed it. I’d love to confirm that with her, but she’s not taking my calls.

    • P J Evans says:

      A know-nothing in charge, who is willing to let the experts make decisions and stamp them as okay, would be fine, It’s the idea of someone who believes that “goddidit” is a valid answer to everything having control over people who actually know what needs to be done that scares me.

      • earlofhuntingdon says:

        That Pence knows nothing Trump must find reassuring – few people are as ignorant as he is.

        That Pence is an abject toady and will reinvent reality to suit every Trump whim must also reassure Trump. Most people retain some grasp of reality.

        But know-nothing toadies do not let experienced professionals make decisions. They follow their patron’s desires.

        • drouse says:

          The only reason he was assigned this is to try to prevent anything from splashing back on Trump. Good luck with that.

          • e.a.f. says:

            As soon as Trump announced that, my first reaction was, gee this is going to be a really bad epidemic. Trump wants to insure there is no blow back which will effect his run for President. He’ll dump Pence and have one of this kids run as V.P.

            • Katherine M Williams says:

              Fox news is already accusing China of germ warfare: creating a pandemic to “hurt Trump”.

              • P J Evans says:

                There’s a theory going around that it escaped for a ‘secret virus lab’. The fact that there’s zero evidence for it … makes some people more willing to buy into it.

              • orionATL says:

                a very neatly cut out little piece of paper was taped to our mailbox last week:


                Learn about the origin of the illness spreading throughout the planet at


                “All tyranny needs to gain a foothold is gor people of good conscience to remain silent?” – Thomas Jefferson ]

                ah, patriotism, the refuge of idiots and scoundrels and trump supporters – but i repeat myself.

                i do not recommend chasing this web address, though i have. doing so yields this unsurprising coverage, which suggests to me co-ordination with the hidden arms of the trump propaganda machine:


                • Eureka says:

                  You remind me, orion, that Carolyn Orr was recently tweeting about some Bannon plan to keep an eye on, re how they are somehow weaponizing coronavirus to *re-elect* Trump:

                  “This is worth paying attention to: Steve Bannon is now calling his show “WarRoom Pandemic”, and today he explicitly forecast his plans to use #coronavirus as a political strategy to help re-elect Trump. He did it with Ebola, too, so he has some experience in this area. #COVIDー19 [screenshot; thread]…”

                  • orionATL says:

                    thank you, eureka.

                    that may be the source of this deliberate and dangerous propaganda which serves to discredit official warnings to discredit science-based warnings to our citizens. “irresponsible” and “shameful” are far too kind terms to use.

                    if the immoral steve bannon is involved he needs to be made to pay when the opportunity presents itself.

                    frankly, i went hunting with hopes i could catch a russian bot doing this😄. but no such luck 😟.

                    enter the http://www... address and you will get a crescendo of right wing sites discussing this from your search engine.

                  • orionATL says:

                    you know what?

                    think of the sites on the internet now that “rate” products these days. you know how so many now say something like “if you click on our site to go to amazon we get a small payment.”

                    imagine this:

                    imagine if some PAC or super-PAC covertyly paid $10.00 for each click which every commenter made on any one of the very long list of rightwing sites on the internet who cite this fable (and other similar trump fables). that might explain the long list of trump-loyal cites, which do not ordinarily show up on political info reporting or dem political questions.

                    some part of the trump machine might be paying for this coverage.

                    • bmaz says:

                      Interesting. Don’t know how many here also read Eschaton by Atrios, but he does that. Not the rating part, but will occasionally name a product that he likes and provide a link if you are interested in buying it from Amazon, because some kind of kickback goes to the blog. Not too often, and always widely usable things like external hard drives or headphones etc. Stuff pretty much everybody uses. It is not obnoxious at all, but kind of interesting. On a constant scale, I’d probably not like it, but occasionally, it is fine.

                    • Eureka says:

                      Well their “creativity” knows no bounds, so nothing would surprise me… but they are cheap* :) so I’d move that decimal over (and over…and over) (but seriously, you could take your insight and imagine a lot of ways they could launder money chunks, too…).

                      I am more alarmed for your sake that you’ve been effectively ‘visited’ by the Bloomies *AND* Trumpers within the space of a few weeks. *Shivers*, stay safe, you are clearly in some type of ‘battleground’ (aren’t we all, lol). (Also I thought there were all manner of fed laws re even looking at mailboxes the wrong way.)

                      And re bmaz comment: I don’t mind those types of affiliate links, especially from people who are working to give people good information about whatever products they link (it does get out of hand on some sites, though, such that the posts become sponsored by manufacturers, a lot on some blogs, mainly cooking-type ones as far as I have seen for that level of sponsorship, though.)

                      *reminds me of the auctions of our info, eg:

                      Escaping the Algorithm: David Carroll Talks Data Privacy

                    • Eureka says:

                      and now you remind me of a bunch of Trumper accounts that also link to amz. to sell “e-books” … there were a bunch of accounts put out by a “clairvoyant” purporting to predict events re people in Trump circle, people involved in Trump- Russia — saw them during Ukraine mess, accounts of various ages.

                      Anyway, another source of money-movement and info-tracking / -sourcing for lists.

            • John K says:

              That was my initial thought. He’s setting Pence up as a fall guy so he can replace him with somebody extra special- you know, like Jared or Ivanka. We can’t blame a pandemic on Trump but now he can blame a bad response on Pence. Trump was getting out ahead of his own poor planning by shoving Pence under the Covid-19 Express Bus.

          • Fran of the North says:

            Assigning the Veep as a way to avoid the blame is definitely a Trumpian technique.

            However, the citizenry has a penchant for seeing through the fog when the matter is of a personal nature. As the category five feces storm after the Katrina debacle demonstrates.

    • Katherine M Williams says:

      These type of people are also mistrustful of scientists and doctors, and often just won’t listen to their advice (see: Pence and the advice of doctors regarding needle exchange).

  15. 200Toros says:

    I gotta say, that if this thing spreads, it will not surprise me to hear the orange hell-beast say that the only people getting sick are Never Trumpers.

  16. Peterr says:

    I’m already getting spam emails: “Buy our masks now, before things get worse.”

    I’m sure there’s a Nigerian prince behind them somewhere.

    • MB says:

      Furthering that ironic fantasy: the virus crashes the stock market, he can’t blame the Fed, he loses the richie-rich part of his base (maybe 10%?) and thereby loses the 2020 election to…whomever. Perfect Rube Goldberg machine.

    • Vicks says:

      For a guy who seems to have outplayed Karma his entire life, it would be hard not to see the irony if a commutable disease ends up being the thing that blows up everything the corrupt germaphobe has built.
      What’s going to happen if there is even a small outbreak in the district of, say a congressperson like Devin Nunes, or Pence’s wife catches it from one of her private school students?
      What if we learn there are precautions being taken to protect these students and Ms Pence that aren’t being taken at the local public schools?
      I just realized this is the first time in a long time I have to clarify that “we” is the all inclusive “we” the entire country, both parties, all of us, everybody…..

  17. Mary M McCurnin says:

    Having grown up in hurricane country and now living in earthquake country, I have always had a week’s worth of nonperishable food put aside. Today I went shopping for another week’s work. Canned meat, dried and canned beans, a big bag of rice, broth, dog food, cat food, paper products, and more. Next week when our SS checks show up, I will go buy another week’s worth of goods. All of the appropriate masks are sold out. I figure if it gets bad, we will be staying home anyway. And if one of us gets sick that person is banished to their room. The only thing I don’t have yet is water but I figure the water won’t be turned off. I do have a dozen plastic containers that I can fill with h20. Good luck everyone.

    • Katherine M Williams says:

      Same here: beans, rice, dried and canned vegetables and fruit. Condensed milk, tomato paste, dried soup mix. Toilet paper, several gallons of chlorine bleach. Gallon jugs to store water in. Thinking about a small propane grill. If the virus fizzles out, and I hope it does, the stuff won’t go to waste.

    • OmAli says:

      We have done the same. We are retired and can somewhat shelter at home. Also picked up some OTC pain meds, expectorant and cough syrup and things that might help keep us from a trip to the doc if we have a mild case of something. Lemon juice, honey and a bottle of bourbon, too. A friend reminded me to have a thermometer. I bought some exam gloves simply to wear if I have to go out for some reason – they will remind me not to be touching my face until I can get home and wash my hands.

    • skua says:

      If practicable, getting anyone sick with coronavirus to a hospital looks like it would be a beneficial approach.
      They’d get modern nursing and medicine and others in the house would probably get reduced exposure.

    • P J Evans says:

      In the freezer: bread and veggies. I can fit five bags of veggies in. Tortillas will fit better than loaves, for the same weight, and leave more for veggies. I usually have half a dozen or more small burritos – those are breakfast. A couple of jars of peanut butter – those are on my shopping list anyway.

      • Eureka says:

        Tortillas are a great idea. For shelf-life and storage-space reasons, I’m glad Jim mentioned bread-baking supplies, too. Have to pick up some extra yeast packets and flour.

        • P J Evans says:

          I have some yeast – but I also have sourdough starter. And dry milk (that’s what I use when feeding it), and most of a five-pound bag of whole-wheat flour. (I think I have another small bag of regular flour – need to get more, then.) Bread is kind of limited for me, so I don’t have much need to make it.

          • Eureka says:

            Ooh, I almost ordered some of that ‘ancient’ San Francisco sourdough starter awhile back; I’d really prefer to make sourdoughs but haven’t made any starter because it’s mold-palooza around here and I’m not convinced it wouldn’t become contaminated (really haven’t been doing anything lately that involves fermentation/ sitting out for days+ needing an opening. Or babysitting/care and feeding beyond what I’ve got going on right now, lol).

            • Mary Mccurnin says:

              My hubby makes most of our sourdough bread. He gets his started from SF, too. Interestingly, he used to get it from Bahrain. He is making kombucha, tempeh, and pickles now.

              I am off to the store for flour. And bacon. I love bacon.

        • e.a.f. says:

          When I purchased my up right freezer, the largest ones were on sale, yes, that is what I bought. Its the can fit 3 ex’s into it if necessary. Its usually stocked with an extra turkey or two and side stripped prawns. Rice is easier to store than bread, but a half dozen loaves would be good.

          • Eureka says:

            Yes, I am very grateful right now for the extra upright freezer we got for seasonal bounties and obscure ingredients that keep better cold (like nut/seed flours, etc). I still have to get out (and cook some) to fill it, though. I am feeling the stress of things to do tomorrow!

      • RLHall says:

        If you are stuck in the house for a couple of weeks. You might as well learn to make bread. The ingredients are cheap and don’t take up too much space.
        I’ve taken it up recently. There is a learning curve, but when you get the hang of it, it’s deeply satisfying. In depressing times, it’s empowering – and good for you.

        • P J Evans says:

          I describe kneading bread as “when it fights back, it’s done”. That’s what they mean by “smooth and elastic”.

          • bmaz says:

            My wife has taken to making bread. Like, she is addicted to it to an extent where she makes more than we can consume. Even up and bought a solar cooker for the summer months so as to not heat up the house. Like you guys have said, there seems to be something cathartic about the process.

      • holdingsteady says:

        Thanks all for the great ideas.
        I’m going shopping today too, and want to suggest picking up Masa since corn tortillas are so easy, delicious and nutritious:)

    • P J Evans says:

      I have about a week’s worth of bread and peanut butter, plus cheese and lunch meat. I need to get more PB and veggies – the PB was already on my list. My assorted prescription meds are at various points in their 90-day allotments, and I deal with those as they come up. (most of them I can manage a week or so without, but I’d rather not.)
      Right now, I think there’s a lot of panic buying going on, as people assume they must stock up with two months of everything RIGHT NOW or they’ll surely run out during the emergency that hasn’t actually started.

  18. e.a.f. says:

    In Canada it has been reported, from information gained from China, children are less impacted by the disease and recover well. Fewer women die of the disease than men, who have it. People most likely to die are those who are older and have an underlying medical condition, especially those with diabetes.

    There are now two cases where the person who has spread the disease to others had no symptoms themselves.

    Staying away from others might be a good strategy, but I can also see those who aren’t going to be told what to do, go out and do what they want. My impression is that there are large areas of the U.S.A. which do not have a lot of hospitals or where people have health coverage. That is not going to work well, if people are treated on the basis of who has health care cards and who doesn’t. Wonder how Puerto Rico will be treated this time?

    People will go to work because if they don’t who will pay them? In Canada, our federal government’s unemployment insurance plan provides for funding while unemployed due to illness.

    Watched Trump at his press conference and if that is the best the U.S.A. can do, it has a problem. The man is not competent. If he put Pence in charge, that would be a mistake. He didn’t do so well while Govenor in 2014, when there was an out break of HIV. His dithering resulted in over 200 people acquiring the disease. His putting Pence in charge indicates to me, the Republicans expect this epidemic is not going to go well for the U.S.A. Trump is putting Pence in charge so he can take the blame.

    Another blog posted Trump wants the money for dealing with this to come out of the funding provided for people who need financial assistance with heating their homes. If that is correct, what a great choice, you can freeze to death or die of the virus. Perhaps Trump, Pence, and a few others will develop it, They don’t need to die from it, just have the hell scared out of them.

    Jim’ suggestions regarding being ready for an epidemic is good. Living in an earthquake zone, in B.C. we have always kept a supply of food, water, and medications. (booze helps also–its not medicinal, but I’ve always maintained there is no way I’m going through an earthquake without a couple of bottles of B & B and some good books)

    People may think they can take comfort in the 2% death rate, but if even 50
    % of the population develops the disease and 2% die, its will make a lot of funeral homes rich.

    When Ebola became an epidemic there were those who were able to avoid contacting the disease by following strict guidelines. Those same guidelines will be helpful with this virus, if it really takes off. Our governments are not prepared for a virus such as CO VID 19 nor are we as citizens.

  19. Mitch Neher says:

    So who has Trump not already fired for some other reason [e.g. Bolton] whom Trump could someday fire [Pompeo “?”] so as to take the fall for the “whole government response” to the inevitable COVID-19 outbreak in the US?

    Will Trump have to fire a fall guy for a US COVID-19 outbreak whom Trump has not yet hired?

    Does Trump have any other strategy for any crisis besides hiring fall guys for the express purpose of firing them to take the fall for Trump?

  20. OmAli says:

    I am just wildly and irresponsibly speculating here, but under what circumstances would Trump be able to declare martial law, or suspend elections?

  21. Wildebeest says:

    First time commenter. Have enjoyed and learned from the commentary and interaction while lurking from the shadows. With Trump being a known germaphobe, to what degree can we expect cancelled rallies and/or modified handling procedures to keep our dear leader germ/virus free? I would bet that there is, or will be, evidence of a pull back from “community” exposure via schedule changes. While he may downplay the risk of a pandemic in public, he won’t be able to hide his inner fear of exposure to the virus in public venues. A liar and hypocrite to the core.

    • bmaz says:

      Hi Wildebeest, welcome to Emptywheel and join us often.

      Thats an interesting question. Possible! Certainly think they would not stage all those stooges behind him on the podium anymore and very tightly control his entrance and exit. Can’t imagine he can give up his precious rallies though.

    • earlofhuntingdon says:

      An indicator suggesting that the CDC is being hamstrung by DC, that’s its protocols are too conservative, that it has far too few kits, and cannot make, buy, beg, borrow or steal enough any time soon. Why else would it deny a major California medical center one kit?

      So much for Trump’s claim that the US is the best prepared country in the world. His science denial is very 1930s Soviet Russia Lysenkoism. He operates as if the world is nothing but images he can manipulate, like changing channels on cable TV.

    • e.a.f. says:

      that was covered on the Rachel Maddox show this evening, 27 Feb. and boy its scary. What it boils down to is the virus has had a head start in the U.S.A. because trump and his stooges didn’t rely on professional medical advise. If the woman dies, the law suite is going to huge.

      My take on it is, trump doesn’t want testing because once they have that they will be able to extrapolate how many may have the disease in the U.S.A. Then all bets are off. It was reported there are only a million hospital beds in the U.S.A. When you consider all those who are not insured and won’t be able to get medical assistance, it will not turn out well.

      It would not be surprising if the Govenor of California decides to simply ignore the feds and have the state purchase kits so they can start testing.

      Currently the U.S.A. looks like a voodoo palace when it comes to this disease. Couldn’t believe that a President of a modern country was at a press conference saying the disease might just go away. Don’t know what that boy smokes, but its better than what we can buy here. He is nuts.

      South Korea has a great system, people drive up in their cars and have the test done. South Korea is also producing 100K test kits per day.

      • Eureka says:

        OK, at this I did laugh out loud:

        “Currently the U.S.A. looks like a voodoo palace when it comes to this disease.”

        When do we start taking bets on ‘voodoo palace — better place?’

    • Mary M McCurnin says:

      I wonder if the UC Davis patient was in contact with corona virus infected humans that landed at the Travis AFB. The plane was unloaded by people wearing no appropriate safeguards.

      • Rayne says:

        It’s not impossible given the timeline, though public health might then have to change the “community acquired” determination.

      • Rugger9 says:

        Travis is near Vacaville (Fairfield is the next town over) and it is not at all implausible given that the official 2-week period for transmission looks more like something longer that she met someone who was infectious but asymptomatic.

        California reported having 200 kits to test 8400 potential cases in addition to problems with false positives when the CDC doesn’t do the work in house. That’s why the “community patient” wasn’t tested, the kits had to be rationed to check “probable cause” cases (for lack of a better term).

        Yesterday HHS Secretary Azar (recently of Eli Lilly) wouldn’t commit to the eventual vaccine being affordable. So, not only is the GOP lying about their response to Ebola (see, it’s Obama’s fault) it would seem that they’ll fundraise off of it in due course or at least let the corporate world monetize it.

  22. OldTulsaDude says:

    The best NPI to stop the impact of this virus will be to vote Trump and his cronies out of office in November.

  23. paulpfixion says:

    I live in China, luckily in one of the provinces that has not yet been hit hard. The CDC has not been allowed into the country as far as I know. The recent visit from the WHO was concerning in regards to their findings. I’d point you towards Anna Fifield, the Washington Post’s Beijing bureau chief (2/24):
    “WHO expert Bruce Aylward says the number of cases of coronavirus a reported in China a day has dropped from 2,500 when he arrived two weeks ago to 406 today. ‘That’s an 80 percent decline and the decline that we are seeing is real.'”

    She goes on to state “After the WHO’s Bruce Aylward lavishly praises China’s response to the coronavirus and says other countries are wrong to impose travel/trade restrictions on China, Chinese officials and journalists literally applaud him.”
    James Palmer, Senior Editor at Foreign Policy comments:
    “I’m going to say the obvious; unless he toured provincial areas on his own for a week, speaks Chinese, and understands Chinese bureaucracy there’s no actual way he can speak to this being ‘real’ – he’s simply regurgitating what he’s been told by the handlers of his visit.”

    There is cautious optimism here, because of the relaxation of the extraordinarily draconian response tactics. The buses and trains are back online in my province (which has been downgraded to a medium to low threat level), construction has restarted on the subway line near my home, and we are again allowed to have visitors at home. Schools are still closed indefinitely, and all restaurants and bars are closed–they are allowed to serve take-out food only (of course, this depends on the neighborhood police and how careful they are being–this is China, some restaurants will serve you). A friend tried to find a dentist 3 days ago–no luck. However, many China watchers do not believe anything that is reported by the domestic news organizations. Because of this it is far too early to determine the mortality rate–clearly the danger to elderly populations is much higher than 2%. Check out Bill Bishop’s newsletter, “Sinocism,” for an excellent aggregation of news related to China.

    My main point in this is that I am not at all happy about the WHO’s recent news from China as, like Palmer suggests, it clearly was simply a regurgitation of the country’s recent official propaganda effort. The economy here is going to be totally fucked. There isn’t any other way to put it. The risk to the party and of unbelievably great civil unrest is, in my opinion, currently being weighed against further outbreaks and deaths from the virus. Catch-22.

    One final quote from Fifield regarding the WHO rep:
    “I just asked Bruce Aylward, who was in Wuhan over the weekend, why he was not in quarantine. He said he didn’t go to any “dirty” areas in Wuhan and that he was tested for coronavirus this morning. He hastily left the press conference because he has a plane to catch…”

    • orionATL says:

      i don’t know that this flu/virus epidemic will be the breaking point, but there will be one some day in which the ccp loses control of china. you can only keeep masses of humans penned up for so long. whatever the final straw, it has to involve a situation that spontaneously brings tens of millions into the streets across the country at the same time. no one person or group wants to stand against the machine of the state; that would be self-destructive folly.

      • Fran of the North says:

        ‘no one person or group wants to stand against the machine of the state; that would be self destructive folly.’

        Sounds like an accurate description of the situation the GOP finds themselves in. Perhaps when their constituents start being admitted to ER’s in droves they might find some spine?

      • orionATL says:

        the other two considerations are when sufficiently large numbers of chinese adults have educational levels sufficiently high and a sense of economic well-being sufficiently adequate that they can envision and are willing to risk a new form of government.

  24. Frank Probst says:

    Facemasks aren’t necessary for the general public, and you’re probably not going to be able to find them anyway. But here’s something I would suggest that people try: One day when you’re going to spend the entire day at home, take a bandana and tie it around your nose and mouth. Make sure you can breathe comfortably wearing it. Then go about your normal routine. What you will notice VERY quickly is that you touch your nose and your mouth a lot more often than you think you do. As the day goes on, you’ll start to become more and more conscious of it, and that will be enormously helpful in learning NOT to do it.

    • OmAli says:

      That sounds like a good exercise. I bought a box of exam gloves for the same reason. I hope that wearing them when out in public will make me less likely to unconsciously touch my face.

      • e.a.f. says:

        Stephen Cobert wore a lovely pair of blue gloves on his show last evening!

        In case the epidemic lasts for awhile and people want to protect their faces, they might just want to use their motor cycle helmets, which frequently have face guards on them. Here in B.C. most motorcyclists wear full head helmets with these clear face guards which cover the chin. Not a bad to use in an epidemnic. With price gouging it may be less expensive to purchase a motorcycle helmet which can be re used than face masks which don’t protect all of your face

    • BobCon says:

      You can see a big difference in generations because kids starting about 20 years ago started getting taught in large numbers to do the Dracula move, where they cover their mouths with their arm when they sneeze or cough instead of their hand. Some parents with kids over the past couple of decades also adopted it. Many teachers do it, especially the ones with younger grades. It’s worth pushing it harder for the general population.

    • CCM says:

      Don’t worry for a lack of masks. An N95 has to be fit tested to work properly, not a do at home type of thing. I wear one when needed and could stand one for maybe 20 min or so. Not a great population control strategy

      • Frank Probst says:

        Agree, and it’s especially true if you’re trying to put them on seniors with respiratory diseases. It’s just not going to work.

  25. skua says:

    There are some widely suggested steps that offer general improvements in health and immune function.
    Whilst there is no proof the changes that they induce will be specifically effective against coronavius it is reasonable to think the changes will be good for many people. But like everything they are not risk free and might not suit everyone..

    1. Stop/reduce smoking.
    2. Get adequate, not excessive, exercise.
    3. Get adequate sleep/rest.
    4. Avoid excessive alcohol consumption.
    5. Get adequate nutrition. 2 fruit, 5 serves of vegetables a day, cut down on processed foods, is good.
    6. Avoid/reduce on-going high levels of stress.
    7. Maintain/develop social and personal relationships.
    8. Maintain/develop meaningful and purposeful life activities.

    Not all of these are available or a good idea for everyone. That is alright.

    If coronavirus becomes widespread:
    Check that you have good lines of communication with neighbors, family, colleagues, friends, government health authorities and local medical/nursing services. Know what symptoms should have someone seeking medical aid, and where they should seek that aid. Check on people in your social network, especially those vulnerable to illness. Having this stuff sorted is productive of good sleep.

  26. Rugger9 says:

    Two things:
    I have zero hope that Pence will be able to do anything on COVID-19 given his track record in IN for HIV, the Palace’s attention on the stock market instead of the virus marginalizing the CDC and the lackeys in charge of the DHHS. Stay safe, everyone.

    The other is off-topic, and it was raised in First Minister’s Questions in Scotland today. Recall that the golf courses there were bought with cash and the sources of the funds were unclear. Apparently it’s against the law in Scotland to hide such things, and so it looks like the Scottish Parliament will look at getting an “unexplained wealth order” which apparently looks for foreign corrupt practices. Patrick Harvie is part of the Green Party. This might become more interesting as the summer rolls along since there is no way that the Palace can control Edinburgh.

    • Vicks says:

      Scotland seems to have the law on their side here, and certainly they “can” investigate where the money came from, but why on earth should we think the Trump “organization” doesn’t have a plan to prevent them from thinking they “should”?
      Clearly this is nothing compared to what we have seen other governments cave on?
      Sorry to sound so jaded, but I don’t have the heart to start listing the dozens of investigations, many of which should have put a quick end to Trump’s brand of corruption that were “disappeared” once Trump was able to properly organize.

      • Rugger9 says:

        Harvie and the Greens are critical players in the SNP’s government coalition, and are if anything more pro-independence than the SNP. Combine that with Individual-1’s blowup at Boris Johnson on Huawei and it seems to me that Westminster will not be keen on covering for him, especially if the money turns out to be laundered or Russian.

        So, I would expect the Scottish government to follow through.

        • BobCon says:

          The plan in Panama during the takeover of Trump’s hotel seemed to be not much more than shredding papers when the authorities came close. So there may not be any sophisticated response if authorities in Scotland move in.

          • earlofhuntingdon says:

            A Unexplained Wealth Order reverses the normal rule: it requires the subject to prove the lawful source of funds used or invested in the UK. Absent sufficient proof, the funds and the assets bought with them are subject to seizure and forfeiture. Goodbye golf properties.

            So, stonewalling would not be a productive move. Trump would certainly fight to avoid disclosing that information as hard as he’s fighting not to disclose his taxes in the US. It would be a lovely fight to watch, since there’s little evidence that Trump had sufficient legitimate funds to buy his Scottish golf properties.

            Sturgeon is unlikely to agree to request the necessary investigation. BoJo would give her serious grief, as would the FO. Trump would undoubtedly make life hell for the litany of post-Brexit negotiations.

            Plus, bank lenders on these properties would use their influence to avoid this sort of fight. They could lose tens of millions. When Trump loses office, though, all bets are off.

            • Vicks says:

              “Plus, bank lenders on these properties would use their influence to avoid this sort of fight.”
              If i’m not mistaken the suspicion lies in the “king of debt” claim he didn’t need help financing this one….

    • harpie says:

      Here’s the author of the story with an UPDATE:
      10:53 AM · Feb 27, 2020

      UPDATE: @EricTrump has told me @patrickharvie’s comments are “disgusting” and “reckless,” with “absolutely no basis in fact.” He calls Mr Harvie “irrelevant and spineless,” says he should be “admonished and sanctioned” for his conduct & calls on him retract “libellous statements”

      [email protected] also told me the Trump Org has created “thousands of jobs” in Scotland. The most recent accounts filed with Companies House show Turnberry’s parent firm employs 477 staff. @TrumpScotland employs 77. That’s a total of 554.

  27. Pete T says:

    Thought I’d start a thread on (COVID-19) vaccine. Now, clearly there is not one now and optimistically one likely would not be available until sometime in 2021.

    Now those with far more background that I have – near zero – in this area please chime in.

    My intent is not to alarm or misinform, but to show that there is historical evidence that Corona “class” especially SARS-CoV (which is far different that COVID-19 as far as I have read, but perhaps instructive) are sometimes very tricky to get right even when they appear, upon administration of the vaccine, to be preparing the expected anti-bodies.

    In this Chris Martenson video 11:45-20:45 he talks about animal testing surprises of a SARS-CoV vaccine and also references the initially approved RSV vaccine given to children.

    So, constructive criticism welcome from anyone:

      • Molly Pitcher says:

        My question is not for myself, I always vote by mail. My concwern is that this is going to wipe out any tiny reliability in the polls. There is no way to anticipate who is gong to blow off voting because they are freaked out about being in a crowd at the polling stations.

        This is only get worse as the virus spreads and we get further into the election.

      • P J Evans says:

        I switched to vote-by-mail because the county is going to machines with a very bad reputation for changing votes and other problems. Also, in the process, instead of voting at a neighborhood precinct, they have “voting centers”, which may be two or three miles from where you live and otherwise inconvenient.
        (Mailed my ballot last week.)

    • Rugger9 says:

      Or, to be more precise, used to close polling places on public safety grounds? The GOP will leverage this in some way.

    • BobCon says:

      It’s clear that Pence is there as an enforcer and not a decision maker.

      Pence is the one guy under Trump who can’t be fired, which makes it a curious move by Trump to put him in charge. I think his appointment is a sign that Trump doesn’t really trust anyone else to follow orders. I think it’s also a sign that they still think this is a PR issue and don’t get how to handle emergency management.

      I once worked for a place where all communications had to move up the command chain to an exec who had to sign off on everything. It was an absolute mess every time anything urgent happened, because there is simply no way to get the kind of turnaround you need.

      You need to have pre-planned procedures that can be implemented in emergencies without top level oversight. The fact that the White House is only starting to think things through now is a sign of how badly they’ve already screwed things up.

      • earlofhuntingdon says:

        And there’s no one left who can or will unscrew things. The scorpions are in a ring of fire they built themselves.

      • e.a.f. says:

        the information will get out, we will just have reporters saying things such as, a source close to whomever,, people will speak to the press and not be identified and at some point if the disease gets a good head start in some areas, they won’t be able to contain the news. People will be terrified and just talk and states may simply ignore the federal government.

        I don’t think Trump appointed Pence because he’ll follow orders, but rather he wants Pence to fail and then he believes he will have an excuse not to have Pence as his running mate. Trump appears to have entered that mental stage where he thinks he is a monarch and as such will want one of his family to be his “heir”.

  28. harpie says:

    Pence Will Control All Coronavirus Messaging From Health Officials
    Feb. 27, 2020 Updated 1:39 p.m.

    […] The vice president’s first move appeared to be aimed at preventing the kind of contradictory statements from White House officials and top government health officials that have plagued the administration’s response. Even during his news conference on Wednesday, Mr. Trump rejected the assessment from a top health official that it was inevitable that the coronavirus would spread more broadly inside the United States.

    Dr. Anthony S. Fauci, one of the country’s leading experts on viruses and the director of the National Institute of Allergy and Infections Diseases, told associates that the White House had instructed him not to say anything else without clearance. […]

    …to which Ronald Klain responds:
    1:27 PM · Feb 27, 2020

    Presidents Reagan, Bush, Clinton, Bush and Obama trusted Tony Fauci to be their top adviser on infectious disease, and the nation’s most trusted communicator to the public. If Trump is changing that, it is a threat to public health and safety. [my emphasis]

    • BobCon says:

      They’re panicking because the markets aren’t responding to their happy talk, and they can’t understand that their attempts to constrict information from authorities will only make the markets more uncertain and move even harder away from risk.

    • Frank Probst says:

      When Dr. Nancy Messonnier makes a statement about Coronavirus, I think of it in the same terms as Jim does: This is like getting ready for hurricane season. You need to have a few necessary items already, and if something REALLY bad looks like it’s coming, you need to stock up on certain things. You need to hunker down when you’re told to hunker down, start driving when you’re told to start driving, and don’t come back out until you get the “all clear”. You don’t know how bad it’s going to be. Some years, you don’t have to worry about any hurricanes at all, because none of them head your way. Other years, you get a bad one, there’s an enormous amount of property damage to deal with and some people need to be hospitalized, but fatalities are kept to a minimum. You’re essentially hoping for the best but preparing for the worst.

      When Trump or Pence make statements about Coronavirus, I want someone to infect me with it right now, just so I can get it over with, because I know I’m getting false information, I’m not going to know what the hell is going on, and whatever system that’s put in place to deal with an outbreak will be flawed from the start.

      • harpie says:

        Heh…as in the following, from yesterday evening’s presser:
        7:38 PM · Feb 26, 2020

        The President is called out on his repeated attempts to try to downplay the mortality rate of Coronavirus by citing flu deaths… His answer falls short [VIDEO]

        This is who was asking the questions:
        10:19 PM · Feb 26, 2020

        For those who don’t know, that’s @drsanjaygupta, a board-certified neurosurgeon and a medical school professor who is @CNN‘s medical analyst asking the question.

        • Anne says:

          I’ve been watching Italian TV — Rainews24 streaming — and listening to my favorite radio station, Radio Popolare (

          Italy has a few circumscribed areas closed off, and elsewhere (like Milano) have ordered closures of movies, discotheques, sports events etc. and have closed schools in certain areas. They have done hundreds if not thousands of tests on people. Information to the public is authoritative as opposed to the dubious BS we’re hearing from Washington. And there’s lots of it. Like The radio is helping by people calling in to report local info.

          The government is already dealing with issues like unemployment for folks who have to stay home and what the banks should do when people who can’t work can’t pay their rent or mortgage.

          Italy imagines itself disorganized: some other country does it better than the incompetents in Rome or our regional government. Typically, it’s the Germans or the French. Even the US. Instead, it seems like Italy is putting on a show of competence to put Washington to shame.

      • Molly Pitcher says:

        You know that Dr. Nancy Messonnier is the sister of Rod Rossenstein ? That has to immediately discount whatever she says in they eyes of Trump and his minions.

          • Molly Pitcher says:


            The link is to the PDF of Rod Rosenstein’s statement to the Senate Judiciary Committee when he appeared before them as nominee for Deputy Attorney General. In it he specifically mentions “My sister, Dr. Nancy
            Messonnier, traveled here from Atlanta, where she is the Director of the National Center for
            Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.”

            I do not pimp right wing nutjob theories.

            • Geoguy says:

              I apologize for any confusion on my part. I was only pointing out that the relationship of Rod Rosenstein to Dr. Messonnier is being spread far and wide to discredit her.

      • orionATL says:

        we need to heed.

        jim white laid out nancy messonnier’s brutal message about npi’s, non-pharmaceutical interventions. this is not going to be fun if we have to go here which seems wise to consider likely:

        “… there are three categories of NPIs.  Personal NPIs which include personal protective measures you can take every day and personal protective measures reserved for pandemics.  Community NPIs which include social distancing measures designed to keep people who are sick away from others.  And school closures and dismissals.  And environmental NPIs which includes surface cleaning measusures… ”


        “… secondary consequences of some of these measures might include missed work and loss of income.  I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe. But these are things that people need to start thinking about now…”

        ” severe” !

    • earlofhuntingdon says:

      Pence would no more cross Trump than he would his Mommy. Nor would he say anything of his own accord without getting a script from on high. So, he’s a safe cut-out for Trump. Pity that national public health will suffer because of it – and the economy will reel. But he’s more concerned about the Second Coming, so a few lost here and there is no matter.

      As for Trump, he seems more concerned about his portfolio and bank loans than about the citizens of the country he nominally leads. But, I agree. He seems to have no clue that his usual techniques – lying, intimidating, stonewalling, and making shit up – are about to tank public health, the economym and his chances of re-election.

      • harpie says:

        As Marcy says:
        4:19 PM · Feb 27, 2020

        Somehow Wall Street did not respond well to Trump putting Pence in charge of coronavirus so he would put Kudlow on task force.

        Links to:
        4:14 PM · Feb 27, 2020

        BREAKING: Dow Jones plummets nearly 1,200 points, more than 4%, as economic uncertainty over the spread of the novel coronavirus continued to rattle markets.

        Links to:
        U.S. stocks have worst week since 2008
        The Dow, S&P 500 and Nasdaq all tumbled more than 4% Thursday.
        February 27, 2020, 4:40 PM

        • BobCon says:

          The Washington Post’s lead article talks at length about how Trump’s failed response is worsening the reaction of the markets.

          Not surprisingly, the NY Times’s lead article skips the issue and talks only in terms of the Federal Reserve, a both sides issue in terms of a tax bill, and an oblique reference to how stemming the spread would help.

          It is astonishing how bad the Times can get when it tries to dodge assigning responsibility to Trump and the GOP.

      • BobCon says:

        You know Trump is freaking about his hotel bookings. He thinks he can ward off cancellations if somehow nobody knows.

    • CCM says:

      Fauci is a very serious guy, enormous respect within the medical community. Doubt anyone is going to be successful trying to tell what he can and cannot say. His word is gold.

      • BobCon says:

        The way federal agencies work, Fauci himself will have relative freedom to speak.

        But a big part of the problem is that Fauci is not the only source of information out of CDC, and the other sources are what are at risk.

        If the LA Times wants an interview with the regional director responsible for the CDC’s response in Southern CA, can they get a prompt turnaround, or does some risk averse political appointee in the PR office hold things up for days?

        Have there been bottlenecks caused by the GOP’s efforts to deliberately gut the civil service which leave communications offices overstretched and unable to meet demand? What kind of planning has been left unfinished due to employee shortfalls?

        People will believe Fauci, but who else can they talk to?

        • CCM says:

          Fauci works for NIAID, not CDC. Different but overlapping areas of responsibility. Both organizations the information flows upwards and I would bet no one would want to be seen as sugercoating info that flows to Fauci or Renfield the head of CDC. I know it may seem odd to say on this site but NIAID and CDC can be trusted to the limits of human failibilty.

    • Eureka says:

      My sense last evening was that Fauci was saying what he could on the national stage _while_ he could, to the broadest audience, and to set expectations exactly because of all this (**waves hands at Trump and the conversations one can imagine Fauci and other experts had with Trump, vs Trump’s “expectations” **).

      Today’s news (more confirmation of the anti-science batshittery) does nothing to quell my concerns about what Trump et al. might think they can press the relevant scientific and broader biomedical communities into (not) doing wrt this (~coming) pandemic.

      I suspect Trump’s idea of “clinical trials” is something like Tuskegee, but with instant gratification.

  29. P J Evans says:

    I had a medical appointment this morning, and they had small signs posted telling people to call their doctors if they had been out of the country or in contact with someone else who had, AND had a fever, sneezing, or coughing.

      • Eureka says:

        I have no notion the intention of the commenter so am not speaking to that, but have seen a lot of non-msm sites pushing the “newer” mRNA – type vaccine (one of many methods cooking right now). The company that is making an mRNA vaccine just announced* (25th IIRC, and relevant stock price went thru the roof) that they sent theirs to gov to start trials. TL; DR: I have some suspicions re (1) pushing a brand preference out of multiple possible — but as yet unknown vaccine options; (2) sites pushing the “rapidity” theme in isolation of facts of trials, etc, because of Trump’s own PR needs / preferences (and the possibility he’d blame the “deepstate” for the time needed due to practicalities and ethics of science here).

        Here’s a month-old but good overview from a well-respected source re different methods pursued by companies funded by CEPI (Coalition for Epidemic Preparedness Innovations), a 2016-founded nonprofit that I would like to know a lot more about (also, there are other companies now in the game besides those cited here, but the mRNA one is discussed):

        Scientists are moving at record speed to create new coronavirus vaccines—but they may come too late | Science | AAAS


    • Frank Probst says:

      The whole experience with the Diamond Princess is going to one day be a textbook example of how NOT to do things. The ship was not under a true quarantine, which led to more and more people getting infected and taken off the ship and into the Japanese hospital system. I have no idea how good the containment protocols are there, but I’ve read that at least 3 health care workers who were working on or near the Diamond Princess got infected, so THEIR protocols were obviously not working. It’s hard to imagine that things got better the further away you got from the ship. The fact that Japan has closed its schools for a month speaks volumes to me. We’ve only recently started hearing about infected kids. There should definitely be enough of them in Wuhan to make some sort of statement about what the infection looks like in children. It’s starting to sound like they get a milder disease than adults. If that’s the case, it’s good for the children, but it makes it MUCH harder to contain the disease. If your kid has a cold but no fever, and they seem like they’re otherwise doing well, most people will send them to school. That could lead to a massive spread among children, who then bring it home to the rest of the family, and that aspect of it is definitely NOT good.

      • e.a.f. says:

        A number of health care workers also died in China. My take on it is, they became over worked and exhausted and thus their immune system deteriorated.
        Kids definitely do better with the disease.
        Japan has closed all schools and expect to see more of it. if the disease can not be contained in Japan, the Os will be cancelled and that is a huge amount of money to loose.

      • CCM says:

        Hard to know what the deaths mean in terms of how virulent the virus is. Cruise ships do have medical facilities but not first world hospital level. My guess is that some for the deaths would be preventable with good ICU care.

        • e.a.f. says:

          the problem is some of those ships have better “hospital” facilities than some areas of the U.S.A. There are parts of the U.S.A. which do not have ICUs. Have a look at Pureto Rico, which doesn’t have hospitals in some areas, because they were never rebuilt after the first hurricane.

          In Canada our small towns have small hospitals, which can keep you alive for a period to time, while they air vac you to a major center, but that is part of our health care system. These small hospitals do not have ICUs. if the virus gets out of control the major hospitals will not be able to take in patients from areas they usually do.

          • CCM says:

            What you are describing in Canada is not much different than the US. Rural hospitals tend to have little in the way of true ICU level care, patients are transferred to tertiary care centers. And yes there is very little tertiary care excess capacity.

    • harpie says:

      New York Times, too:
      U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says
      Team members were not properly trained, lacked necessary gear and moved freely around and off military bases where Americans were quarantined, a complaint says.
      Feb. 27, 2020 Updated 5:20 p.m

      […] In the complaint, the whistle-blower painted a grim portrait of agency staff members who found themselves on the front lines of a frantic federal effort to confront the coronavirus in the United States without any preparation or training, and whose own health concerns were dismissed by senior administration officials as detrimental to staff “morale.” They were “admonished,” the complaint said, and “accused of not being team players,” and had their “mental health and emotional stability questioned.” […]

    • errant aesthete says:


      “Officials at the Department of Health and Human Services sent more than a dozen workers to receive the first Americans evacuated from Wuhan, China, the epicenter of the coronavirus outbreak, without proper training for infection control or appropriate protective gear, according to a whistleblower complaint.

      The workers did not show symptoms of infection and were not tested for the virus, according to lawyers for the whistleblower, a senior HHS official based in Washington who oversees workers at the Administration for Children and Families, a unit within HHS.

      The whistleblower is seeking federal protection, alleging she was unfairly and improperly reassigned after raising concerns about the safety of these workers to HHS officials, including those within the office of Health and Human Services Secretary Alex Azar. She was told Feb. 19 that if she does not accept the new position in 15 days, which is March 5, she would be terminated.

      The whistleblower has decades of experience in the field, received two HHS department awards from Azar last year and has received the highest performance evaluations, her lawyers said.

      The complaint was filed Wednesday with the Office of the Special Counsel, an independent federal watchdog agency. The whistleblower’s lawyers provided a copy of a redacted 24-page complaint to The Washington Post. A spokesman for the Office of the Special Counsel said he could not comment on complaints filed with the office.”

      This may provide an explanation for the case of “unknown origin” recently cited in northern California.

      • chum'sfriend says:

        “The allegations as reported suggest that Americans returning from Wuhan to Travis Air Force Base in Fairfield, California, and March Air Reserve Base in Riverside County, California, were greeted by ACF employees who may have been left without protection against coronavirus transmission.”

        “Travis AFB is located in Solano County, California. Yesterday, the CDC confirmed the first American case of coronavirus in which the origin of the virus was unknown. That patient is from Solano County.”

        At last nights news presser, Trump was explaining how it was OK that he didn’t have a professional staff on hand to deal with an epidemic, because he could just hire the best people when needed. Well it’s too late now buddy.

            • P J Evans says:

              I have family in Davis: brother, his wife, one of their daughters, her kids. (Her partner has been studying to get a certificate as a respiratory therapist, but that has him out of town most of the time.)

              • P J Evans says:

                If you don’t have soap and water, hand sanitizer rubbed for 20 to 30 seconds. (The timing suggestion I’ve heard is “Twinkle, twinkle, little star” and don’t rush it.)

        • e.a.f. says:

          All those scientist he fired when he dismantled medical groups, went elsewhere and they aren’t coming back. trump doesn’t understand scientists, researchers, doctors, etc. are not wait staff, room cleaners, gardeners, etc. There is a demand for them and if they are laid off in one place they can go where they would like.

          Part of the problem was political appointees reporting to Trump decided to put those who were ill on the same flight as those who had not presented as ill. “this was done contrary to the advise of medical professionals. Then the federal government workers were sent in to deal with the people returning and they weren’t medical people.
          One could say if this disease takes hold in the U.S.A. the blame can be laid at the feet of trump and his goons.

          • Frank Probst says:

            ^^^This. And even if you set up some sort of fantasy method of allowing these folks to take a temporary leave from their current jobs in order to work on Coronavirus, you’re going to have problems. The first is that there’s going to be a learning curve in terms of getting them to where they need to be to do the work. The second is that the President of the United States is already lying to people about what’s happening, and scientists are being muzzled by having all of their statements laundered through Mike Pence. That means that the President of the United States might lie to the entire world about the project you’re working on, and you won’t be able to say, “Um, no, that’s not what going on.” You’re also likely to be one of the people who gets the blame if things get even worse than they already are. I used to work at Baylor College of Medicine, and I can tell you right away that such an “opportunity” would get a hard pass from me.

            • e.a.f. says:

              Why any one go back, is a good question. It is doubtful any of them would. Some, like yourself, who work at a University would be better to have our own projects which you can then control and speak freely about.

          • P J Evans says:

            He thinks scientific and medical stuff can be handled like industrial “just-in-time” supply lines. It Don’t Work That Way.

  30. orionATL says:

    a couple of years ago i read about some fascinating research on how sneezes and coughs spread. it was not the classic parabolic path we would expect a cannonball to take. nor was it individualistic (single cannonball) as we might expect. to my surprise, i found a reference to this research which is highly relevant these days:

    the key finding here is droplets can travel VERY FAR – in a gas cloud. you can’t outrun them 😁. some weeks back, p.j. and i had a very interesting conversation with a commenter knowledgable about fluid mechanics. i’d love to have her comments back here.

    also some good basic advise from a primary care doc (very well covered here) who may well be the one to meet you at the gateway to the medical system should you need that:

    • Frank Probst says:

      What happened at the CDC was probably a Quality Assessment/Quality Control issue with something that they got from an outside vendor. QA/QC for a clinical test–meaning a test that’s done on people and will become part of the medical record–is extremely tight, because you don’t want false negatives and false positives. I could probably devise a test for this strain of Coronavirus in well under 8 hours. I could probably have it up and running within a week using pretty basic equipment. And once I had it up and running, it would take about 4 to 6 hours to do to run a sample through it. But I wouldn’t have a clue as to the sensitivity and specificity of my test, which means I wouldn’t be able to give you a false positive or false negative rate, so I wouldn’t know how useful the test really is.

  31. Vicks says:

    There is nothing in our germaphobe of a president’s toolbox of bullsh*t that has a chance of doing anything but make him more vulnerable.
    It’s as if Trump has no clue what to do with an honest opportunity to lead; what is it going to take to make him see you can’t hide, lie about or threaten to sue a pandemic?
    Instead, the leader of the free world instincts tell him to play chicken with a potential pandemic, and go figure, it’s rocking American markets.
    If Trump’s biggest donors have any real power over him, they will get him to shut up.
    What the market needs, what people need, is a leader with a plan.
    Public information from the non-political standard bearers.
    Websites, public service messages, lists of symptoms, hotline numbers, hospitals and doctors offices that are prepared to answer questions.
    People panic because of the unknown; people sell stocks because of the unknown, as soon as we get a cluster somewhere in the country, panic will set in and misinformation will be rampant,
    Unless of course we have been advised that this may happen, and we all know what to do, and we have experts in our community that are ready to get to work because there is a plan,
    It is freaking crazy that the president of the united states kryptonite is unity,

  32. Chaparral says:

    I am truly grateful for all of you. This is the most informed levelheaded discussion of this pandemic that I’ve heard anywhere. We are in good company. Some of you are professionally aware of the situation and I value you knowledge and advice. The awareness of preparedness is worthwhile. Around here, we have restocked since Harvey but a few extra paper goods(like really soft toilet paper) and cleaning supplies is probably a good idea.

    I’m afraid my own plan is a little more basic and primitive than most.

    Wash your hands.
    Don’t touch your face.
    Sneeze in your sleeve.
    Wash your hands some more.
    Don’t touch your face, again(cuz I know you did)
    And practice the basic diet, exercise, vitamins to maintain a healthy immune system.

    As far as I can tell, we are going to have more people than usual down sick for a week or less with what is more or less the ‘flu’. For most people, just a miserable nuisance except that for a lot of us, it costs us a paycheck. Might turn out that the biggest lasting effect is in our willingness to social. That would be a loss.

    Of course there are the vulnerable populations who are at serious risk. The usual suspects. The young, the old, the folks who are already sick. But most of us don’t have to worry about this being deadly or debilitating.

    Ohhh, wait… I’m old. And I smoke like a chimney. And I drink like a steelworker. Ohhh…

    Well alright then. I’m going in loaded for bear. Been nice knowin’ ya.

    In lieu of flowers, send whiskey.

  33. greengiant says:

    Cases with an Italian connection include Austria, Algeria, Brazil, Finland, France,Germany. Greece, Nigeria, Romania. Tenerife Canary Islands, Spain, Switzerland,
    Cases with an Iranian connection include Georgia, Iran, New Zealand, and Pakistan.

  34. e.a.f. says:

    Not only wash your hands but wash every thing you bring into your home. My advise is stock up now, before an epidemic takes hold. If you need to go out for anything once an epidemic takes hold, glove up, cover you hair, when you return home drop your outer clothing at the outside door.
    We don’t know how long the virus lives on anything. Plan on wiping down everything which comes into the house, with a bleach solution–its about all that kills a virus. If the virus has some sort of life span it could remain active on money, bags and goods handled by others.

    Insure you have a 3 month supply of your medications at home. Its not just in case of an epidemic in your area, but the supply chains may be broken–in Canada because of Indigenous protests trains were not running and ships were not being unloaded because some of the ports were blocked. The blockades have been removed, but had they stayed up longer, some goods would have been in shorter supply. Even a lot of ingredients to medication comes from China and India.
    In addition to your food, booze, etc. include a couple of large bottles of bleach.
    Who knows if you self quarantine to avoid the virus, you may get to know your family again. yikes…….

    Now with any luck this will all go away, but if it doesn’t better to be prepared than not.

  35. Eureka says:

    Reuters | Japan February 26, 2020 / 10:12 PM / Updated 16 hours ago

    A woman working as a tour bus guide was reinfected with the coronavirus, testing positive after having recovered from an earlier infection, Osaka’s prefectural government said. Her case, the first known of in Japan, highlighted how much is still unknown about the virus even as concerns grow about its global spread.


    The woman who tested positive twice, a resident of Osaka, in western Japan, tested positive on Wednesday after developing a sore throat and chest pains, the prefectural government said in a statement. The woman in her 40s first tested positive in late January and was discharged from hospital on Feb. 1 after recovering, according to the statement.

    Though a first known case for Japan, second positive tests have been reported in China – one on Feb. 21 – where the disease originated late last year.

  36. Eureka says:

    Hong Kong govt. agency released a statement: an asymptomatic pet dog tested “weak positive” for coronavirus; at this time, they believe its oral and nasal cavities may have picked up environmental contamination from its sick human parent. The dog is being quarantined for fourteen days, with further testing. Per WHO, there is no known infection of pets like cats and dogs, nor transmission.

    [Aside: sounds like these are nice, sensitive test kits they’ve got in HK.]


    Pet dog in Hong Kong found to have ‘low level’ of coronavirus
    Feb 28, 2020 6:21 a.m. ET

  37. harpie says:

    Yesterday evening, [not sure exactly when]:

    California undertakes extensive effort to trace contacts of woman with coronavirus
    Feb. 27, 2020 at 10:14 p.m

    […] The Solano County woman wasn’t tested for the disease for four days, despite an immediate request to the CDC, because she did not meet the strict criteria for the test, according UC-Davis Medical Center, where she is being treated after spending four days at the community hospital in Vacaville.

    The CDC disagreed in a statement Thursday, saying it asked for samples to test the patient for covid-19 on Sunday, the same day the agency was informed about her case. The statement also said clinicians always have discretion to order the test for people who do not meet the criteria. […]

    This is when the UPDATE was reported [via Laura Rozen]: [Health reporter for The Washington Post.]
    11:43 PM · Feb 27, 2020

    UPDATE: Contrary to reports by hospital that says there was delay in testing California coronavirus patient, CDC says hospital informed agency of case on Sunday, the same day CDC asked for specimens.

    • P J Evans says:

      UC Davis Med Center has no reason to lie about this. The woman was reportedly already on a respirator when she was sent there.

  38. mass interest says:

    Thanks to everyone here for information, both news and practical.

    My spouse has chronic cardiac and pulmonary conditions, so being prepared to self-isolate is quite important. The perspective and resources provided here have truly helped cut through the chaff.

  39. harpie says:

    In a similar vein to what I posted yesterday evening:
    BuzzFeed is reporting:
    New York Is Making Its Own Coronavirus Test After The CDC’s Test Has Repeatedly Failed
    Hong Kong is testing over a thousand people a day for coronavirus, while the US has only tested a total of 445 — partially because the CDC’s test didn’t work.
    February 27, 2020, at 6:22 p.m. ET

    …there’s this, from ProPublica:

    Key Missteps at the CDC Have Set Back Its Ability to Detect the Potential Spread of Coronavirus
    The CDC designed a flawed test for COVID-19, then took weeks to figure out a fix so state and local labs could use it. New York still doesn’t trust the test’s accuracy.
    Feb. 28, 12:13 a.m.

    […] This story is based on interviews with state and local public health officials and scientists across the country, which, taken together, describe a frustrating, bewildering bureaucratic process that seemed at odds with the urgency of the growing threat. The CDC and Vice President Mike Pence’s office, which is coordinating the government’s response to the virus, did not respond to questions for this story. It’s unclear who in the government originally made the decision to design a more complicated test, or to depart from the WHO guidance. […]

    • harpie says:

      The final five or six paragraphs of the ProPublica article make me wonder if there is some sort of financial/monetary/commercial consideration involved in this decision making process by someone in one of the agencies.

      • Vicks says:

        Maybe it’s financial, it is the Trump administration after all.
        I think we have also seen enough of the damage done by territory marking bullshit from this organization that when we read two of it’s agencies (CDC and Food and Drug) “shunned the shunned the World Health Organization test guidelines” that any betting person would put have put money on a display of incompetence vs a wonder-test

    • harpie says:


      […] There are other ways to expand the country’s testing capacity. Beyond the CDC and state labs, hospitals are also able to develop their own tests for diseases like COVID-19 and internally validate their effectiveness, with some oversight from the federal Centers for Medicare and Medicaid Services. But because the CDC declared the virus a public health emergency, it triggered a set of federal rules that raises the bar for all tests, including those devised by local hospitals.

      So now, hospitals must validate their tests with the FDA — even if they copied the CDC protocol exactly. Hospital lab directors say the FDA validation process is onerous and is wasting precious time when they could be testing in their local communities. […]

      [Alexander Greninger, an assistant professor in laboratory medicine at the University of Washington Medical Center] said the FDA was treating labs as if they were trying to make a commercially distributed product. “I think it makes sense to have this regulation,” he said, when “you’re going to sell 100,000 widgets across the U.S. That’s not who we are.”

      Commercial manufacturers are working to mass-produce coronavirus tests, but there isn’t a precise timeline for their release. […]

    • Frank Probst says:

      The third and fourth bold-faced lines on the box of the kit in the Buzzfeed article are blurry, but they look to me like they say:

      For Research Use Only [illegible word]
      Not for Use in Diagnostic Procedures

      This does not inspire me with much confidence. And the articles may be simplifying their descriptions of the test so that this part isn’t included, but I don’t see anything that looks like an internal control, which would mean there would be no way to distinguish a negative test result from a test that failed to work at all.

  40. Vicks says:

    From where I’m standing the Trump administration knowingly created a ground zero entry point to allow this virus into our country and then choose to look the other way as it was released into the wild.
    Any f’ing moron would know better. There HAS to be more to this story, if not and this thing gets out of control the world is going to come down hard and in addition to human tragedy there will be a giant finger pointing at the US.

    • P J Evans says:

      I don’t think there’s any way they could prevent it from getting in – you can have it without knowing it.

      • Vicks says:

        but if what the whistleblower is saying is true there was a planeload of people exposed to the virus greeted by government employees that took no precautions to protect themselves.
        Those employees could have then carried the virus anywhere, home, airplane, kids school, sporting event.
        And so on,
        If this is true, our own government will be 100% responsible for any and all outbreaks that result.
        Like I said, it’s just too moronic, there HAS to be more to this story….

  41. Fran of the North says:

    The FDA has announced the first drug shortage due to Covid-19. The release doesn’t have a ton of details, but the unnamed pharma company indicates that the shortage “is related to a site affected by coronavirus. The shortage is due to an issue involved with the manufacturing of an active ingredient used in the drug.”

    The good news is that there are other drugs that treat the condition that this this drug treats.

    How’s that just-in-time inventory system working for you now?

    • Rayne says:

      I resent that we’re not told more about the specific drug. I can see reasons why they’d hold this close the vest and yet EVERY person in the US who is medication-dependent will worry about their own medication when it’s not necessary to do so at this time.

      This is a key risk a global pandemic response team should have addressed a month ago — if Trump hadn’t killed the team in 2018.

      • Fran of the North says:

        You are right, lots of stress for those on any med. And there are some patients that shouldn’t or can’t take other meds, even if they treat the same conditions. Negative interactions, side effects etc.

        It’s getting uglier by the day.

        • P J Evans says:

          And the unpredictable cases where the reaction to the generic isn’t the same as the one to the name-brand drug. Some people have finer-tuned systems than others.

  42. Fran of the North says:

    Seriously, the script writes itself.

    A medical paper published in China indicates that Covid-19 has similarities to both Ebola and HIV.

    Yes, the Ebola that Trump and the frothies tried to turn into a referendum on Obama’s fitness as POTUS.

    AND the HIV that Veepster tried to pray away.

  43. harpie says:

    Quinta Jurecic just retweeted this from Robert Mackey:
    1:32 PM · Feb 28, 2020

    An American man whose father-in-law died of coronavirus in Wuhan was evacuated from China with his daughter and placed in quarantine at a US Marine base in California. He writes on GoFundMe the US government billed him $2,200 for the flight and now asks him to pay for quarantine [link]

    I’m still seeking clarification on what costs the evacuated man is being asked to pay, but it seems to be for the flight and for a mandatory 6-day hospital stay near the base, even though both he and his daughter tested negative for the coronavirus

    • e.a.f. says:

      paying to be in quarantine????? oh, right this is the U.S.A. I can understand governments requiring people to pay for their flights home, but for being quarantined???? Being quarantined isn’t a service they are providing to you, its you being held against you’re will. Wonder if they will want to be paid at the hospital room rate or the hotel room rate.

  44. harpie says:
    3:46 PM · Feb 28, 2020

    Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, was scheduled to go on all 5 Sunday talk shows and then Pence was put in charge of the coronavirus response and he was ordered to cancel.

    Rep. John Garamendi [D-CA-03] retweeted this interview of himself with Hallie Jackson:
    2:15 PM · Feb 28, 2020

    WATCH: Rep. Garamendi tells @halliejackson the CDC “failed to take immediate, aggressive action” when receiving coronavirus evacuees from China at Travis Air Force base in California. [link]

    Partial transcription:

    [3:55] Jackson: I understand that Dr. Fauci was at your briefing. Did he talk at all [about whether he could speak freely]

    Garamendi: Well, insofar as I can repeat what he said, he said I was not muzzled. However, I was to go onto Sunday talk shows, five of them. The Vice President’s office then took over the control of this situation, and told me to stand down, not to do those shows.

    Now, you can draw your own conclusions whether he was muzzled or not, but clearly he was scheduled to do Sunday talk shows and he was told not to proceed with that.

      • e.a.f. says:

        omg, this is going to be some sort of tribal prayer meeting or will he be brining out the snakes? Pence is going to do the talk shows and what hold prayer meetings, tell people this is their punishment for having bathrooms for transgender kids or gay weddings?

        There are other countries which are doing so much better than the U.S.A. and they don’t have the “resources” the americans do. At the rate the trump administration is refusing to do testing, you’d think they are waiting for some financial supporter to get his factory up and running. All the American government has to do is pick up the phone and they can get testing kits from Germany or some other countries. The U.S.A’s unwillingness to test and bring import testing kits indicates there is something afoot and it doesn’t have much to do with insuring the country remains somewhat healthy.

        Some one should shove a sock in Mulvaney’s mouth. Telling people to turn off their t.v.s to improve the stock market?????.
        Americans can only hope that the responsible news media keeps doing their job and dispensing information which will be useful.
        Rachel Maddox’s show was reporting the Frankfort airport employees 20K people and has another 60K affiliated jobs and due to the down turn in the economy–no one flying, they are “offering” leaves. If this impacts the Germany economy, its impacting the American economy.

        When you look at the previous “viruses” such as Sars and mers, etc. ,more have died now due to COVID 19 than those two diseases put together.

        A little over 2% of the population had the Spanish flu. That translated to 500 MILION were infected and 20 to 50 million died of which 675 thousand were Americans. That is more than were killed in the civil war.

        A decade a go I walked through an old cermetary of a town which no longer existed. There were a lot of graves during the time period of the Spanish flu. All ages. It was a very small grave yard.

        Trump is on t.v. saying this is all a Dem. hoax. lets hope he and Pence get COVID 19 soon. Don’t want anyone to die, but if they’re out of commission at least an adult will be in charge and not a couple of snake oil sales men and one a religious wing nut.

        • P J Evans says:

          I do genealogy, and there are a few people in my file who died in that epidemic. One was a nurse in training – she caught it from her patients. Age 21 or so.

  45. Worried says:

    Thank you everyone!
    I’ve learned a lot over the years listening in to the discussions here.
    This coronavirus topic may turn out to be the most important yet, so many ideas on how to alleviate the potential harm.
    I appreciate the collective knowledge that, when shared, improves our lives.

  46. e.a.f. says:

    Worrisome, agreed. With little to no correct information coming from the federal government and the president spreading snake oil spittle shit, blogs such as this will most likely become sources of information for people to help them get through this epidemic. Foreign news sources may also become more reliable than some of the idiot circus dealers.

  47. pdaly says:

    Here’s an editorial (Feb 28, 2020) in the New England Journal of Medicine about the Coronavirus Disease 2019 (Covid-19) by doctors Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

    …“the study [of COVID-19] faces the limitation associated with reporting in real time the evolution of an emerging pathogen in its earliest stages. Nonetheless, a degree of clarity is emerging from this report. The median age of the patients was 59 years, with higher morbidity and mortality among the elderly and among those with coexisting conditions (similar to the situation with influenza); 56% of the patients were male. Of note, there were no cases in children younger than 15 years of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection”…

  48. pdaly says:

    In the editorial (above) the doctors also make some educated guesses about the true case fatality rate. It may be much lower than 2%:

    “On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%. In another article in the Journal, Guan et al. report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.”

    • BobCon says:

      Gates weirdly positions institutional changes as something that need to happen in the future, rather than something that should have happened in the past.

      Gates is pretending that the people who have been dismantling international cooperation and national preparedness will magically change course as a result of this outbreak. There have been plenty of examples in the past of how we should have proceeded, but the GOP has nonetheless doubled down on their efforts to tear apart the WHO, the US agencies responsible for responding, and the other institutions he says we should strengthen.

      What makes Gates think the GOP will do any differently when this is all over? What makes him think they will suddenly increase spending for international projects or US preparedness? The only way they will do this is if he uses a chunk of his fortune to make it happen in the political sphere.

      If he wants to remain officially non-partisan, fine. Channel donations in the same way that other serious interest groups do. If he decides to make international health a priority in this country, he won’t end up funding every Democrat, and he often won’t find a Republican who will primary an incumbent Republican on this basis. But by putting a serious amount of money into the equation, he will change the equation

      Writing this kind of pablum will do nothing.

      • P J Evans says:

        Gates is marginally better than Bloomberg, in some ways, but he doesn’t see how having so much money is the problem. Bloomberg is trying to buy the nomination, rather than spending it in ways that help people, and he’s still going to have more money than he can spend after the election.
        I’m thinking that a 90% tax on everything over $10 million may be the only way we can get them to lower their greed.

  49. 200Toros says:

    Trump is holding a live press conference, he just said there are 22 cases of COVID19 in the US, and “all have been let go and are in their homes” !!!!!!!!! This is a five-alarm fire folks! Just flat-out lying to the public. Many new cases were reported overnight, including the first death. I am seeing 68 cases listed on the John Hopkins site, which is updated every 15 minutes. Pence is now talking, mentioning Trump’s name as much as possible, what a brown-noser.

    • errant aesthete says:

      A person in King County, Washington, near Seattle, has become the first in the country to die after contracting the coronavirus. That’s where I live.

      • readerOfTeaLeaves says:

        I’m generally in Kirkland 4 – 5 days/week these days. The area has lots of immigrants, and tons of people who travel internationally. There are many languages spoken in Kirkland.

        It is the site of the first recorded US death.

        Farther north, also in my stomping grounds, a high school student is ill: this feels like I’m damn close to the eye of this unfolding disaster. I hope that jockobadger is steering clear of the threat.

        The region has some superb medical minds, so the governor (Jay Inslee) has some good resources, and he’ll be prudent. Inslee has vastly more credibility with everyone that I know than Trump and his toadies will ever manage to muster.

        Washington has traditionally been pretty adept at providing public information in multiple translations, and it’s a reasonable guess that plenty of translators will be called upon to do some heavy lifting.

        (Many immigrants are extremely skeptical of government information of any kind, so getting them to act upon information has its challenges.)

        In the past two weeks, several acquaintance have cancelled travel to China for the next few months. Meanwhile, two friends (including one who is Chinese) skipped trips to Vancouver BC this week, because (like Seattle) it has a burgeoning Chinese population (‘Chinese’ roughly meaning: China, Taiwan, and Hong Kong – it’s a huge hodgepodge.)

        I haven’t bothered to count the number of daily flights between airports in Vancouver, BC and Seattle-Tacoma to Asia (many route through Inchon airport in Korea, and the main Tokyo airport [Narita], which are main hubs for Asian airlines). Seattle and BC are major entry points to North America, as well as business and import/export hubs.

        At this point, the Koreans appear to be the most competent people on the planet when it comes to public health responses to an emerging epidemic. In Washington state, bad information meant we are lagging behind the competent Koreans 8(((

        Anecdotally, it feels as if travel plans are being disrupted globally. My spouse returns (early) from Europe this week, having moved to an earlier flight in response to news of the virus. He doesn’t want to be stranded abroad when things seem fairly unpredictable, because he can become immunologically compromised fairly easily. Locally, he has a phenomenal medical team: he just needs to get back here. (If his travel plans are amuck, he’ll rely on Zoom to communicate with his doctor: Zoom is being adopted here by medical clinics whose patients tend to travel abroad. However, he’d still need access to meds, which could become complicated if he’s not at home.)

        Yesterday, in a suburb north of Kirkland, I was not able to purchase any hand sanitizer, and no masks, which have been sold out for days. (I’m told by a hospital exec they aren’t necessary for most of us, but meant to pick some up.) I have not made it to Costco, but hear via friends that there’s been a run on toilet paper.

        States, cities, and counties are going to have to do a ton of heavy lifting this time around. Trump and his crony kleptocrats are not up to the challenge; this fact becoming obvious might be the only silver lining so far.

    • 200Toros says:

      Presser just finished, and I heard not one single reporter ask for clarification on the “22 cases of coronavirus” claim/lie. If you go check the CDC website, the Johns Hopkins site, or the World Health Organization site, you’re not going to find that number. Can’t trust a single word out of his lyin’ mouth…

  50. 200Toros says:

    Now he’s hammering the Fed and arguing for negative interest rates, which is an argument for punishing people for lending their money to the US government. Of course he’s a complete idiot and doesn’t understand that.

    • P J Evans says:

      I I were running Penn’s business department, I’d move to revoke his degree, because he clearly learned nothing from his four years there.

  51. P J Evans says:

    Given all the cases of apparently-unknown origin, I’m wondering if the virus got to the US at least two weeks earlier than anyone has been figuring. People do travel at Christmas and New Year’s, and a mild cold or flu wouldn’t get noticed.

    • Eureka says:

      I agree, and think we’ll eventually see some back-casting estimates or revision (and especially since they were using faulty tests).

    • harpie says:

      This, via Laura Rozen:
      12:27 AM · Mar 1, 2020

      A massively important thread. Upshot: genome sequencing links recent WA case to one on the state 6 weeks ago, strongly suggesting local transmission has been occurring in WA that whole time. A phenomenal failure of surveillance strategy. More to say on this tomorrow. [link]

      links to Trevor Bedford [Scientist @fredhutch, studying viruses, evolution and immunity.]:
      11:20 PM · Feb 29, 2020

      The team at the @seattleflustudy have sequenced the genome the #COVID19 community case reported yesterday from Snohomish County, WA, and have posted the sequence publicly to [link]. There are some enormous implications here. 1/9 /

      • errant aesthete says:


        Thanks for providing this info & links. Started following Trevor Bedford @trvrb and Seattle Flu Study @seattleflustudy last night. Informative, essential. Grateful that this state and community are focusing on health and well being. This is what reassurance feels like.

      • Eureka says:

        A commenter at the top of replies on the Konyndyk thread states that his family may have already unknowingly had it, and that if that was the case, ~they and others so affected might now be immune and that sharing that message might be reassuring to the general public.

        In that vein I want to pull down this reference from the other day about some people testing positive (with illness) for a second time weeks after initial illness/recovery:

        [The “why” would be speculative at this point.]

  52. harpie says:
    9:59 AM · Mar 1, 2020

    Instead of reliable information about COVID-19 from Anthony Fauci, this is what Donald Trump wants US citizens to know.

    …links to:
    9:54 AM · Mar 1, 2020

    On CNN this morning, Mike Pence, who is now in charge of the coronavirus response said it is “understandable” that Donald Trump Jr. said Democrats want millions of people to die from coronavirus / Pence said that everyone is putting politics aside with the exception of “some of the predictable voices in the public debate on the left.”

      • P J Evans says:

        Without wishing actual harm, I hope Pence gets COVID-19. (And all his “friends” in DC.)

        • readerOfTeaLeaves says:

          If this were a novel or a movie, the 86 year old Grassley, and also 78 year old McConnell would be in danger. The irony.

          • P J Evans says:

            Most of the senate, about half the cabinet, and a large part of the House. And the president (not so much from age, as from the rest of his health).

    • e.a.f. says:

      Donnie Jr. is as dumb as his father and just as vicious. Pence of course wanting to remain on the ticket, if just going along with it all.
      What could possibly go wrong with a COVID 19 out break in the U.S.A. It would appear countries which have fewer resources than the U.S.A. are doing a better job.
      The Republicans are clearly out of their league. What I find interesting is no word from Lindsay Grahan, Moscow Mitch and the rest of them. Are they already hiding?

      On Saturday evening the Minister of Health, A. Dix, for the Province Of British Columbia held a press conference so that we could be updated. Reported on how many cases confirmed, tested, in quarantine, in hospital, etc. He then advised, B.C. (pop. 5 million and change) had tested more people in the province that had been tested in all of the U.S (pop. 340 million).

      We’ve heard trump and his spawn mention closing their southern border. At the rate things are going it might be best if Canada closed their southern border. We’ve continued to accept people coming in from S. Korea, China, Hong Kong, Italy, Iran, etc. No one has been restricted.
      People who have come from countries where the disease has been active have self quarantined and then if they became ill, notified the local hospital they would be arriving.

      I expect the State of Washington and California will get through this as will Canada. However, there are sections of the U.S.A. which will have problems
      Don’t forget to wash your hands!

    • readerOfTeaLeaves says:

      I was actually in an epidemic in a rural village in Alaska years ago; people have no inkling how dangerous it is when **everyone** is so sick they can hardly crawl to the sink for water, and have no energy even to brew tea. I was saved by a brave public health nurse + pilot who flew in with powerful antibiotics. At some point, even a young, healthy body can’t fight off a bad virus, particularly when a bacterial infection hops on for the ride.

      • holdingsteady says:

        reader, that sounds awful, so glad you got help in time .

        So many native Alaskans wiped out by diseases like smallpox and measles in the past century and a half . A few years ago, I saw a sad and most beautiful Canadian movie about survival, restaurants and death in the Arctic called Before tomorrow.

        The Iditarod race has started this past weekend, its history is interesting, brave people taking medicine by dogsled to diphtheria patients in Nome back in 1925.

  53. OldTulsaDude says:

    Perhaps the Veep will get his religious pals to develop a thoughts and prayers vaccine that will act like a protective right-wing media bubble.

    • e.a.f. says:

      actually there are reports Pence has been talking prayer and this disease. Pence doesn’t seem to understand prayer only works when you work to do the things necessary to keep people healthy like start a mass testing program, sort of like what S. Korea has. The U.S.A. can purchase testing kits from Germany.

      • LeeNLP says:

        “prayer only works when you work to do the things necessary ”

        … in which case the prayer part is superfluous. Unless it plays some sort of role in helping a person do more of the right things than s/he would without it. Like talking oneself through the solutions to a problem…

      • e.a.f. says:

        Also read the story and its a good read. Hope other papers re print it. Good advise.

        By preparing we will be calmer if more people become ill. We will have read the necessary material, added extra regular medications we require to our storage along with additional groceries. that will all reduce panic buying later. It will also help neighbours who may not be able to financially afford to purchase extra food.
        preparing does include checking with your neighbours to see they’ll be o.k. in the event things become more serious. Preparing may also notifying local groups what you can do to assist if things get worse, like how to support the medical staff who will not have time to deal with their own lives and families. Once you have done everything necessary to prepare, then perhaps some who are religious might want to pray. Pence and his religious zealots ought to know science and medicine got the world through the HIV/AIDs epidemic, not prayer. Same goes for Ebola–extremely hard work and personal sacrifice.

  54. Molly Pitcher says:

    To help the public keep track of the spread of Covid19, the San Francisco Chronicle is compiling an online interactive map of every confirmed case in the US, drawn from reports from dozens of public health sources. The Chronicle relies on reports from the CDC plus state and local public health departments, as well as reports from other media outlets for cases outside of California. All cases are confirmed with at least one government agency.

  55. Eureka says:

    A water idea I forgot to add earlier: those water-cooler carboys that you can get in big-box stores. Spouse thought of this many years ago before a bad hurricane when all the other water was sold out in the stores. They are 5-gallon, I think, and the containers go back to the store to be reused. Main issue with using them to pour out water is if you have physical conditions precluding hefting it about, but if worse comes to worse one of those and a siphon could help.

    Despite intentions, I haven’t gotten jack done yet. And the Soviet bread lines film of Costco lines going around blocks, empty shelves and whatnot on the news isn’t helping with *my* hygge of late.

    • P J Evans says:

      When I was a kid, my parents had a 5-gallon bottle of distilled water sitting on a shelf in the garage, next to the kitchen door. It was for the steam iron, and used a siphon.

      • Eureka says:

        Everything new is old again ;)

        I like when you share anecdotes like that, it makes me feel moored to family and normalcy.

        • P J Evans says:

          I’d feel safer now with the plastic bottles. (I can lift one of those, but I never flipped one over onto the water dispenser – that was asking for trouble.)

          • Eureka says:

            I’m more comfortable wielding the plastic ones, too. We have a glass one (husband brews beer — or used to, not much lately) that I could get a secure lid for, for part of our standing water supply.

            Not sure how to preserve water lacking a septic seal, but it looks like clean water can be safely stored and changed out every six months:

            How to Store Water for Drinking or Cooking

            • P J Evans says:

              A couple of places I worked, I was usually the one bringing the water bottles in from their (outdoor) storage location. Every time I’d get it inside, put it down, and get the dust and stuff wiped off, and *then* one of the guys would show up and wonder why I hadn’t asked one of them to do it. (There was never one around at the time, duh.)

    • Eureka says:

      Adding: I was mainly sharing this because it’s a compact and readily recyclable water-getting method, but also we are still going to go through our (increasingly ir-)regularly scheduled natural disasters amidst the coronavirus-overlain supply chain shortages.

  56. Eureka says:

    From the subject-matter journalist at Science (that’s his article on vaccines I’d linked ^^^ the other day):

    Jon Cohen: “I’m greatly frustrated that my attempts to interview Chinese scientists about COVID-19 lead to cryptic replies or none at all. I’m now increasingly not able to interview U.S. government scientists. HHS Sec. Azar said this calls for “radical transparency.” Let’s get radical.”
    4:56 PM · Mar 1, 2020

    [In the replies you’ll find linked an older (2015) article on our Strategic National Supply of surplus vents. I’d like to see a more recent estimate, status/age of supply etc. ]

  57. harpie says:

    How to Confront the Coronavirus at Every Level
    Tests need to be readied, protection equipment needs to be produced, medication needs to be developed. All of this will take funding.
    Tom Inglesby and Anita Cicero
    [Dr. Inglesby is director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, where Ms. Cicero is deputy director.]
    March 2, 2020, 5:00 a.m.

  58. Frank Probst says:

    Could the mods please start a new thread on this topic? I know that it’s not the typical EW subject matter, but there’s obviously a lot of interest, and a lot has changed since this post went up.

  59. CCM says:

    Symptoms are very non-specific. Fever is the most sensitive finding. Lower respiratory symptoms such as cough and shortness of breath are also common symptoms. Unfortunately there are no clinical findings that allow a healthcare professional to distinguish COVID from the illness we see all the time.

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