Seattle's Patient Zero Spread Coronavirus Despite Ebola-Style Lockdown (bloomberg.com) 139
First known U.S. case offers lessons in how and how not to fight the outbreak. From a report: The man who would become Patient Zero for the new coronavirus outbreak in the U.S. appeared to do everything right. He arrived Jan. 19 at an urgent-care clinic in a suburb north of Seattle with a slightly elevated temperature and a cough he'd developed soon after returning four days earlier from a visit with family in Wuhan, China. The 35-year-old had seen a U.S. Centers for Disease Control and Prevention alert about the virus and decided to get checked. He put on a mask in the waiting room. After learning about his travel, the clinic drew blood and called state and county health officials, who hustled the sample onto an overnight flight to the CDC lab in Atlanta. The patient was told to stay in isolation at home, and health officials checked on him the next morning.
The test came back positive that afternoon, Jan. 20, the first confirmed case in the U.S. By 11 p.m., the patient was in a plastic-enclosed isolation gurney on his way to a biocontainment ward at Providence Regional Medical Center in Everett, Washington, a two-bed unit developed for the Ebola virus. As his condition worsened, then improved over the next several days, staff wore protective garb that included helmets and face masks. Few even entered the room; a robot equipped with a stethoscope took vitals and had a video screen for doctors to talk to him from afar. County health officials located more than 60 people who'd come in contact with him, and none developed the virus in the following weeks. By Feb. 21, he was deemed fully recovered. Somehow, someone was missed. All the careful medical detective work, it's now clear, wasn't enough to slow a virus moving faster than the world's efforts to contain it.
The test came back positive that afternoon, Jan. 20, the first confirmed case in the U.S. By 11 p.m., the patient was in a plastic-enclosed isolation gurney on his way to a biocontainment ward at Providence Regional Medical Center in Everett, Washington, a two-bed unit developed for the Ebola virus. As his condition worsened, then improved over the next several days, staff wore protective garb that included helmets and face masks. Few even entered the room; a robot equipped with a stethoscope took vitals and had a video screen for doctors to talk to him from afar. County health officials located more than 60 people who'd come in contact with him, and none developed the virus in the following weeks. By Feb. 21, he was deemed fully recovered. Somehow, someone was missed. All the careful medical detective work, it's now clear, wasn't enough to slow a virus moving faster than the world's efforts to contain it.
Only 60 people? (Score:5, Insightful)
It sounds like they aren’t even considering the people who were with him on the plane.
I realize asymptomatic spread is not thought to be the primary means of contagion, but it is considered something which likely does happen with this virus.
Re:Only 60 people? (Score:5, Insightful)
Or the House rule....
Everyone lies.
Re:Only 60 people? (Score:4, Insightful)
Or the House rule....
Everyone lies.
Everyone lies, but everyone does not lie about everything. Forgive me but I'm going to give someone who voluntarily submitted himself to be checked because he thought he may be a danger to others the benefit of doubt.
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Or he wasn't actually patient zero.
There may have been someone else that contracted the virus but their symptoms were mild enough that they just thought it was a cold or the flu so didn't seek medical help.
Stats, stats, stats (Score:5, Informative)
at least 40% don't have $400 bucks in the bank
80% of households have at least $860 in savings [cnbc.com]. Where is your 40% number from?
most folks don't have sick leave let alone paid time off
76% of workers have paid sick leave, according to the BLS [bls.gov]. That's certainly a majority.
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With the way the market has been writhing and diving, pretty soon many people will have substantially less savings.
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If I read that document correctly, that "76% of workers have paid sick leave" only referred to "full time workers". So it didn't cover, e.g., most people who work at Wallmart. Etc.
I wouldn't be surprised if less than 50% of the population has paid health care that will let them schedule an appointment. In fact I wouldn't be surprised if less than 50% of the workers have health insuance, since the proportion of "less than full time" workers has been rising over the last several decades.
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Coronavirus live updates: Italy-wide lockdown comes into force [theguardian.com]
Italy's population is ~60.4 million people.
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80% of households have at least $860 in savings [cnbc.com]. Where is your 40% number from?
His ass most likely. He spouts off shit like that all the time in his posts and never bothers to change his ramblings even after people like you post statistics or other information disproving his claims. Ask him to back up any of his nonsense with citations and he'll just accuse you of making "strawman arguments" [slashdot.org] because you won't "google it" so just have a chuckle and move along.
There was some speculation and possible evidence [slashdot.org] that it might just be a sock puppet account. I don't think the evidence was
Re:Stats, stats, stats (Score:5, Informative)
"40% of Americans donâ(TM)t have $400 in the bank for emergency expenses: Federal Reserve" https://abcnews.go.com/US/10-a... [go.com] Article appears to be sourced from https://www.federalreserve.gov... [federalreserve.gov]
The CNBC report appears to be sourced from data based on savings accounts, so if I'm understanding it right, it wouldn't take into account people like me who don't have a savings account at all.
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80% of households have at least $860 in savings [cnbc.com].
You're probably right, but how far will $860 get you in a quarantine situation? For the vast majority of people that's less than a single house or rent payment. Add in food and other consumables and most people would be upside down in no time.
Re: Stats, stats, stats (Score:2)
$860 buys a lot of toilet paper, but not a lot of hand sanitizer at current Amazon marketplace prices.
As for rent, I don't think too many landlords will evict you same day of you've got SARS-CoV-2 or Ebola or whatever. But I may be giving capitalism too much credit.
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$860 buys a lot of toilet paper, but not a lot of hand sanitizer at current Amazon marketplace prices.
Agreed, but if you factor in food, utilities, and other consumables then $860 won't last long for a family of 4.
Frankly I think toilet paper is the least of everyone's worries. You can get by without toilet paper but not without food (and meds for a lot of people). .
As for rent, I don't think too many landlords will evict you same day of you've got SARS-CoV-2 or Ebola or whatever. But I may be giving capitalism too much credit.
A lot of people in the US are just a paycheck or two away from being on the street. They might not evict you immediately but if you're behind a couple of months, digging yourself out from the debt that quickly mounts up can be real uphill battle
Re: Stats, stats, stats (Score:2)
It's almost like people with a narrative to sell make shit up, and then get all huffy when their bullshit gets mixed with reality and the whole shit stack gets called "fake news".
You would think that by now people would know to take the 10 seconds to get the real numbers from Google, or just not post instead of doing their cause and beliefs disservice with exaggeration and flat-out made-up horseshit which only serves to dilute the problems and make them easier to dismiss.
Re:Only 60 people? (Score:5, Insightful)
It's possible he hadn't started to shed viruses in his breath until the cough developed. Most of the strains of flu and common cold have a fixed number of days where you are actively shedding virus into the environment. These days usually start before symptoms fully develop, but not always and it's going to be a little different for everyone.
Given the flight he was on, he might not have been the only infected person on the plane nor be the person that infected everyone else. Unless people come forward and get tested there is no way to know if they are infected. The US government can't go door to door and demand testing at gun point like China can.
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Sure they can, 'General Welfare' and Commerce clauses.
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Re: Only 60 people? (Score:3)
Yep. The history of quarantine law in the US goes back to the 1600s and the establishment of "pest houses" for individuals with communicable diseases like TB or smallpox. Early hospitals didn't even admit people with communicable diseases, which was probably a good thing before the germ theory of diseases.
My late mother in law was involuntarily quarantined for TB in the 1930s. Until the middle of the 20th century quarantine was a routine government measure.
The interesting twist here is that except at the bo
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In the U.S., state and local governments are responsible for public health as a right granted by the 10th Amendment (because there is no federal healthcare function spelled out in the Constitution). The federal government only has interstate healthcare powers under the Commerce Clause.
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Canada, the feds are responsible for natives (through treaties), refugees (your feds may have signed a treaty about that) and vets. Territories too though they're allowed to do healthcare themselves, they're not sovereign. Treaties are pretty high law according to your Constitution.
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It's possible he hadn't started to shed viruses in his breath until the cough developed.
I don't know about you, but I sometimes sneeze even when I'm not sick and I don't always catch it in time to block it with some sort of fabric. If he was infected, then he would have some viruses in his respiratory tract, which would come out in a sneeze or cough. The only way to stop it is for even asymptomatic people to be wearing masks.
Unless people come forward and get tested there is no way to know if they are infected.
Even if they show up at the hospital, they're not going to get tested unless they have severe symptoms. There aren't enough kits to go around.
Remember that they were using flawed tests (Score:2)
It is not exactly surprising that the virus escaped into the general population when flawed testing was being carried out.
Comment removed (Score:4, Informative)
Re:Remember that they were using flawed tests (Score:5, Informative)
He had been coughing for FOUR DAYS before he went in for medical care! How many people did he infect before he even got to the hospital?!? That had nothing to do with testing, flawed or otherwise.
To be fair to him - when he was getting sick, knowledge about COVID-19 was just starting to be widely disseminated. I know that, under more typical circumstances, many doctors tell their patients to not come in for common symptoms unless they've had them for a week - the reasoning being if you've had symptoms for a week, you may very well have an opportunistic (follow-up) bacterial infection which may require antibiotics. Typical viral infections aren't treated because your body generally takes care of them just fine, and your doctor isn't going to waste antivirals on a rhinovirus anyway.
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To be fair to him - when he was getting sick, knowledge about COVID-19 was just starting to be widely disseminated.
Bingo. It's almost certain he didn't realize what he had and was just trying to weather what he thought was a common cold or flu.
I mean, if you knew (or even suspected) that you had COVID-19 you wouldn't wait around for 4 days before seeing a doctor.
Re:Remember that they were using flawed tests (Score:5, Interesting)
Whether the tests on his close contacts was accurate is very much a factor. Close contact tracing does no good if the tests you are using to determine whether people are infected does not give correct results. It is absolutely possible that some of the 60 people tested were asymptomatic, gave negative test results, but were actually carrying the virus.
Re:Remember that they were using flawed tests (Score:5, Insightful)
" He had been coughing for FOUR DAYS before he went in for medical care! "
This is shocking to you ?
In the event you don't live in the US, it can cost you a few hundred dollars* just to walk in and SEE a physician ?
Are you willing to shell out a few hundred dollars every time you get a cough, sniffles, etc. ?
*Especially early in the year like this before folks satisfy their deductibles ( even with great insurance ).
Did you know one of the primary reasons people don't take sick days is because many companies REQUIRE a
Doctors Note indicating that you did, in fact, waste a hundred bucks or so just to obtain said note ? Did you also
know this is by DESIGN of said companies as a deterrent to keep folks from taking any sick time they have ?
Hell, the biggest question I have is " How much is the quarantine going to cost him in the end ? "
When he gets that hospital bill, he might wish the damn virus had killed him instead. . . .which is the lesser of two evils here )
( lessee. . . . death or bankruptcy . . . .
Re: Remember that they were using flawed tests (Score:2)
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Even in countries with healthcare, people are encouraged not to use it for a simple cough until you've had it for a week or 10 days.
As for Doctor notes for employment, last time I was at the Doctors, I was reading the price list for stuff the government doesn't cover, Doctors note was $35. This is BC.
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It sounds like Doctors don't want to write the note. If they were serious they would all band together as a group and straight up refuse to write them. That would end the practice.
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The first time was because I couldn't make it to the next morning without antibiotics to stop my tooth from necrosing (I knew wha
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I have had a cough for 4 weeks. 4 weeks ago I took a half-day from work, and my wife took 2 days with bronchitis. Kids did not get sick. I have the sick time, I'm just not feeling sick - I'm fine - just clearing the last of this nonsense from my lungs, and every day the cough diminishes a bit.
It is not uncommon for a cough to linger around for a bit, self-diagnose, and tough it out.
Note that during this time I've also suffered and healed from runners' knee, a pulled transverse abdominal muscle, and a twi
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https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported
(They add the caveat that it may be different for people that have mild symptoms and are therefore never confirmed).
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Sounds like doses that would burn your veins. It is an acid.
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You are right, doses so high don't sound plausible.
A spoon full of Vitamin C in a glass of water is already so acid most people won't drink it.
Relax. (Score:2)
It's just a flu, bro!
Even though he got diagnosed pretty early, there were plenty opportunities to infect others in the airplane, airport or hospital. Unless we can detect everyone before they even show symptoms (theoretically possible with quick tracking and testing, I suppose but no way doable in practice), this is just how it's going to go.
It's still absolutely worthwhile though. If they didn't react quickly to isolate him, there could've easily be twice as many cases by now, if not more. The best we can
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The common cold is a coronavirus.
Only in 15% cases. Rhinovirus is the most common cause of common cold.
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For the million time, "common cold" and "flu" are both diseases; patterns of symptoms. Rhinovirus, coronavirus, and influenza are all frequent causes of both the common cold, and the flu!!!!!!!!!!!
This is basic stuff to learn, especially if you desire the ability to be pedantic.
You're not pedantic, you're an ignoramus.
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This link sums it up well:
https://www.webmd.com/cold-and... [webmd.com]
This is also interesting if not surprising:
"The causes of 20%-30% of adult colds, presumed to be viral, remain unidentified. "
Re: Relax. (Score:2)
Yhea...in several Star Trek books McCoy is asked if medicine will ever reach a final point of development.
His reply is ''Yes, when we manage to cure the common cold''...seems to be the doctor's way of saying 'never' or 'impossible'.
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I know it's not the flu. I was sarcastically making fun of the morons downplaying the issue, but this can be difficult to distinguish in text.
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Unless we can detect everyone before they even show symptoms (theoretically possible with quick tracking and testing, I suppose but no way doable in practice), this is just how it's going to go.
If we had stocked up on masks during the previous SARS outbreak and we had a culture of wearing them like a lot of Asian countries, then we might have had a chance.
Even if the masks were only 33% effective, that could reduce the infectivity rate (new infections per day per existing infected) from the estimated 2 down to 1.3. Over the course of 30 days, that's the difference between infecting 1 billion people and 5,000 people. If the masks were more than 50% effective, then the infectivity rate would drop be
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Ontario just discovered that their stockpile of masks (probably from SARS) had expired. Governments don't like to spend money on that kind of stuff as having a stockpile of masks doesn't get votes, at least until needed.
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What perishable material are they using in these masks anyways? And why would they stock the kind of masks that expire?
That said, even if they did expire, it's still better to have them at a reduced effectiveness than having nothing. As I calculated above, even at 33% effectiveness it would significantly slow the spread of the disease, assuming you had enough for everyone.
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What perishable material are they using in these masks anyways? And why would they stock the kind of masks that expire?
I'm not very familiar with medical equipment specifically, but most PPE has expiration dates. Things like racing harnesses or helmets for example expire after about 10 years: https://www.typhoonhelmets.com... [typhoonhelmets.com]
If your life depends on it, you don't want to risk the effectiveness being reduced wear and tear or even just by materials degrading from UV or oxygen exposure or what not. Obviously the masks might still be 90% effective (no clue) but I know I wouldn't want to be the one distributing expired protective
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Totally worked in China.
Simple Answer (Score:3)
Limple Answer (Score:2)
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There's a hint that it may be because more elderly people are diabetic. There's proof, and if they checked whether the elderly cases that were severe were also diabetic I didn't see that, but there's a hint that that may be involved. Certainly younger folks with diabetes are more likely to get a serious case.
Arrgh!!! Correction: Re:Limple Answer (Score:2)
Correction:
There's noproof, and if they ch
I tried to change "not" to "no" and accidentally deleted the entire word.
Re:Simple Answer (Score:2)
There's an interesting correlation with elevated blood pressure as well--nearly 50%--if a report by a docter in Wuhan is to be believed.
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You can check her and click around a bit: https://www.worldometers.info/... [worldometers.info]
If you scroll down here: https://www.worldometers.info/... [worldometers.info] you get links to age and sex demographics etc.
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Thanks for the link to actual data. It appears the correlation (from a Fortune magazine article yesterday) isn't as strong as the article states. Probably just an artifact of the fact that it's mostly elderly with typical underlying health issues who are the most at risk.
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They already did over a week ago. The community spread appears to be directly descended from the patient in the story (that's why it is a story that his isolation didn't work).
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They did, and that's how they know.
There was a thing linked from Ars.
Most of the infected will never visit any doctor (Score:2)
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... and why should they? From the numbers we know so far, ~70% of the population will be infected sooner or later, most won't notice
Only 20% of infected won't notice not anywhere near most. Even though they won't get the disease they will still spread it.
and a few will be the unlucky ones suffering from severe complications, some of which will die.
If you assume 70% of the US population will be infected sooner or later this means the "few" unlucky ones suffering from severe complications is 11.4 million people.
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Re:Most of the infected will never visit any docto (Score:5, Informative)
Your number is way off. Just because some people with mild symptoms were quarantined in hospitals does not mean they required hospitalization. Actually, about 80% of the infected do not experience any symptoms at all, and of the remaining about 20% only a fraction has symptoms severe enough to require hospitalization (for reasons other than quarantine).
Not really true [worldometers.info]. 80.9% of the cases are mild medically meaning no symptoms (maybe 20%) to severe flu like symptoms with fever, muscle aches, diarrhea, cough, or a combination. Some of these will be sick AF.
13.8% are severe including pneumonia and shortness of breath. All of these require some medical attention even if it’s just some drugs to treat the symptoms like an inhaler or antibiotics if the pneumonia is a secondary infection. About half of these cases need hospitalization or at least oxygen to keep blood saturation up above 90%.
4.7% are critical and can include: respiratory failure, septic shock, and multi-organ failure. ALL of these require medical attention or the death rate for this group climbs up close to 100%.
With the absolute best care available, like is happening in South Korea, it looks like the death rate overall can be kept under 1%, maybe even under 0.8%. If you have a situation like what is developing in Italy where hospitals are being overrun, or Iran, the death rate can easily hit 5-7%.
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Be aware that those numbers are all flakey. They depend on a estimate of the total number of infected cases, and nobody knows that number. Well, South Korea may, and China is getting a handle on it, but the US sure doesn't know.
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Everyone dies. (Score:2)
You, me, everyone else. Does what is likely to kill you worry you more or less than CV?
Never tell me the odds (Score:5, Informative)
County health officials located more than 60 people who'd come in contact with him, and none developed the virus in the following weeks. By Feb. 21, he was deemed fully recovered. Somehow, someone was missed
I’m going to guess the odds the entire US outbreak being related to this guy are about 5 million to one.
Re:Never tell me the odds (Score:5, Informative)
Nobody is suggesting every US case is related to this one. But gene sequencing has shown the Seattle area outbreak does come from this patient. The six week delay before the second confirmed patient (plus no apparent relation) suggests it has been brewing in the community undetected and we have an unknown number of active infections. Hence everybody's working from home and events are cancelled.
Other outbreaks around the country have different sources. The first California community spread was likely from failed isolation of repatriated Americans in one of the military bases. There are others who are known to have got it while traveling to Italy or Egypt.
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Kinda the entire definition of "patient zero".
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I totally agree. I posted roughly the same type of response. I bet it was in the US in mid December and nobody knew it.
Scientists have some evidence [nytimes.com] that it was circulating in Washington since around at least mid January. It would not surprise me at all if eventually we found out it was really in the US mid December.
Clearly he wasn't the only one. (Score:2)
Maybe not even patient zero.
Also, what good is putting on a mask *after* sitting in a plane and rubbing arms with tons of other people, with aircon, moving through a city, entering a hospital and everything? The results would have been different, had everyone been stripped naked, sprayed with disinfectant, and their clothes and bags disinfected, before putting on masks, before entering the disinfected plane.
And ... oh wow, he got sick a bit, then better. You mean like a light flu? Why are they treating it l
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Re:Clearly he wasn't the only one. (Score:5, Insightful)
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Why would the press in most of the world care about your orange man? Do you think Italy is locking things down to make Trump look bad?
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and B) the press ran out of "Orange Man Bad" stories
What on earth makes you think we were or that we'd ever run out of Orange Man Bad stories? He is literally a bottomless pit of material.
Re:Clearly he wasn't the only one. (Score:4, Insightful)
oh wow, he got sick a bit, then better. You mean like a light flu? Why are they treating it like it is the ebola-aids-enhanced T virus then?
Because it is not a "light flu" It has a death rate about twenty to thirty times as high as that of a "light flu".
For people 80 or over, of five who get sick, one will die. For people 30 or over, getting this is more likely to kill than the flu is for all ages combined .
Not only that, but (even for younger people) this is one of those diseases where having it not only doesn't keep you from catching it again, but sets you up so the next time you have it you're FAR more likely to have the bad form.
It's far more contagious than the flu, so once it gets going in a population the exponential explosion is very much steeper. There is no vaccine. There is no effective treatment for the severe form, even to improve things slightly, that can be applied at scale. There won't be until at least next year.
The ONLY thing that's better about it is that (so far) it only infects mammals. So migratory birds aren't crossing country boundaries and bombing populations with the contagion. Yet. There's a chance that hair-trigger tracing and quarantine can slow the transmission and perhaps reduce the overall numbers who get it before treatments are developed.
Welcome to a plague year. We haven't had one for quite a while. We have one now.
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https://i.imgur.com/LilelZH.jp... [imgur.com]
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Birds are birds, or you could perhaps argue reptiles.
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Uh, birds are mammals.
How many birds have you seen with nipples feeding milk to their young, you know mammals as in "mammary glands" where they get their name? ... Holy shit man, did you not go to school or something?
Read a book.
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Platypus don't have nipples, and I'm not sure about kangaroos or opossums.
Re: Clearly he wasn't the only one. duh (Score:4, Informative)
Platypus don't have nipples
They do, however, feed their young with milk; it's expressed from modified sweat glands. I think one could argue that nipples are evolved versions of what the platypus has. Platypuses are monotremes, a subgroup of mammals.
and I'm not sure about kangaroos or opossums.
Both groups also feed their young with milk and are counted as marsupials. In their cases the milk comes from nipples and, in fact, some examples can produce two different kinds of milk at once to feed offspring born apart.
Mammals all produce milk. There are three types of mammal: placental, monotreme, and marsupial. Most mammals are placental, including us.
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Mammals all produce milk. There are three types of mammal: placental, monotreme, and marsupial. Most mammals are placental, including us.
Mammal , Apollo 18, TMBG, 1992
Glass of milk / Standing in between extinction in the cold / And explosive radiating growth / So the warm blood flows / Through the large four-chambered heart / Maintaining the very high metabolism rate they have
Mammal, mammal / Their names are called / They raise a paw / The bat, the cat / Dolphin and dog / Koala bear and hog /
One of us might lose his hair / But you're reminded that it once was there / From the embryonic whale to the monkey with no tail / So the warm
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Robert Deniro has nipples, can he feed milk to his young?
With a little hormone treatment, yes!
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Probably even without hormone treatment.
Milk production is triggered also by a reflex caused by sucking at the nipples.
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Are you confusing birds with bats?
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Who Pays??? (Score:5, Interesting)
Isolation treatment would be very expensive, especially in the USA. If the patient did not have top medical insurance this could bankrupt him.
The article suggests that the patient himself did not need any treatment other than bed rest.
If individuals need to pay, then they will be inclined not to be tested. Would you?
Assuming that his symptoms were mild, was there any need to put him in hospital in the first place? Could he have been sent home with nursing care to make sure there was no need for him to leave home or interact with anyone else. Much cheaper.
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Mask up and suit up for every visit in disposable garments. And it's still cheaper.
Plot twist (Score:3)
He wasn't the only one and, other than him, the rest thought "The hell with the rest of the world if I am already infected" like a good American would.
Talking sense (Score:3)
https://youtu.be/E3URhJx0NSw [youtu.be]
Finally.
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Re:By Feb. 21, he was deemed fully recovered. (Score:5, Insightful)
1) very young is not a risk factor
2) I'm very skeptical of your 99.999% number
You'd have to make some extreme arguments for that to hold.
You'd need to assume that none of the active cases (17,000, 5,000 in critical care) resolve in death AND that 30% of the nation's population have been infected for your statement to be true.
Both seem unlikely.
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2) I'm very skeptical of your 99.999% number
Given that there have already been two prominent cases of people in their mid 30s dying you don't need to be skeptical of that number. The GP was outright talking out of his Fox News informed arse.
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Well, if your case is at all serious the standard of treatment is isolation in the ICU and having them repeatedly vacuum out your lungs. I don't think that quite matches any respiratory disease I've ever had. Also recovery is reported to take several months (which seems to me to mean they don't think they've seen any recoveries).
Re: "Perfect is the enemy of the good." (Score:2)
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According to this story, a guy in Britain contracted said virus in NOVEMBER of 2019.
NOVEMBER. . . let that sink in for a moment and consider how much it was already spreading by the time it was noticed and officially announced.
From the article:
" Conor Reed, who is manager at a school in Wuhan, China, became the first British man to catch coronavirus after contracting it in November. "
https://uk.news.yahoo.com/coro... [yahoo.com]
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It was announced in November. ...
However it took China a month to take or consider action