Think this is pandemonium?
Changing by the hour:
- Israel stopped allowing Koreans and Japanese visitors to enter while planes were in the air.
- Turkey and Pakistan closed borders with Iran. (Some Iraq did yesterday). Afghanistan followed.
- Italy now has 134 cases. Two days ago it thought it had only 3. 26 people have been hospitalized.
- Iran has 43 official cases — up from 3 on Saturday.
- South Korea has 602 cases, including 6 deaths. Up from 31 cases on Feb 18th.
- Nine Korean nationals who visited Israel tested postive so now 200 people are in quarantine in Israel.
- Jordan has barred entry to the country to any citizens of China, Iran, and South Korea
This is the danger of too many open borders and not enough testing. If things are this far advanced in Italy and Iran and South Korea what’s happening under the veil in Africa and Indonesia, and so many other places?
Choices for the West include closing risky borders now, or later perhaps closing schools, events, football matches, movies, parties, and maybe elective surgery.
Italy –a lesson in how fast things move
Current tally: 2 dead, 134 infections and 26 are severe (that’s 19%, and who knows what the lag is, or if this will get worse?)
Football matches and the Venice carnival are being closed. There’s a ban on public events in 10 municipalities.
In Italy, strict quarantine restrictions are in force in two northern “hotspot” regions close to Milan and Venice.
Around 50,000 people cannot enter or leave several towns in Veneto and Lombardy for the next two weeks without special permission. Even outside the zone, many businesses and schools have suspended activities, and sporting events have been cancelled including several top-flight football matches.
Italy still can’t find patient zero. So they don’t know if this quarantine of two regions will be enough.
International quarantines are no fun, but domestic quarantines are worse
Look at what’s happening in Italy (let alone China):
Italian authorities have implemented draconian measures to try to halt the coronavirus outbreak in the north of the country, including imposing fines on anyone caught entering or leaving outbreak areas, as cases of the virus in the country rose to more than 130. Police are patrolling 11 towns – mostly in the Lombardy region, where the first locally transmitted case emerged – that have been in lockdown since Friday night.
The Italian prime minister, Giuseppe Conte, said: “We have adopted a decree to protect the health of Italians, which is our priority and which ranks first in the list of constitutional values.” He urged people to “have faith in the political and scientific institutions, which are doing everything possible”.
Locals wearing facemasks were already lined up outside a supermarket in the town of Casalpusterlengo, a 10-minute drive from Codogno, on Sunday morning. Shoppers were made to wait, then allowed to enter in groups of 40 inside the store to stock up on provisions.
Three days ago the people living in these areas probably didn’t think they would suddenly be quarantined.
Should we build holiday homes or new hospitals?
As I said a week ago we have a choice. A two week mandatory quarantine is not the end of the world, and rocks and hard places are all around us.
We could start building emergency hospital ICU rooms like China has, or we could start building quarantine cabins which are infinitely cheaper and ask all entrants from countries with uncontrolled cases of Covid 19* (or SARS CoV 2, whatever it is called) to go through a two week quarantine. This will limit traffic drastically, affecting weddings, conferences, holidays and all kinds of business. It will be costly and inconvenient, but it will possibly save people and quite a lot of money. (ICU care is $5000 a day). Separated families can still be reunited after the two week delay. Am I mad, stopping all flights to nations at risk seems like the cheap conservative option?
Hope: Singapore infections are only growing slowly — but 5% need critical care
Singapore did exhaustive thorough tracking and testing with isolation and have slowed the exponential curve significantly. Perhaps it’s possible to avoid closing borders, but it is a risky game, and Singapore hasn’t defeated it yet, though this curve is about as good as we might have hoped for last week.
Source: Ministry of Health, Singapore. | See also CNA
The problem with this reactive approach is that if it doesn’t work, we risk running out of hospital beds, as well as domestic quarantines.
Consider the ICU “critical” rate — there have been no deaths in Singapore so far, but fully 30% have been hospitalized, and 5% are critical.
Singapore has about 12,000 hospital beds (of all sorts). With a ten day doubling rate all the hospital beds will be taken in about nine weeks and that’s just with coronavirus patients. It’s not clear how many of those beds are ICU. But it is clear that we need to put our thinking caps on.
The range progressing to severe after an 8 day lag now ranges from 0 – 25%.
Worldometer statistics with calculations of the proportion who need severe hospitalized care, with and without an 8 day lag.
The China figures are underestimates because it’s China.
| 23-02-20 | |||||||||
| Country, | Total Cases | New | Total | New | Total | Serious, | % “severe” | Cases 8 days ago | % severe aftereight day lag |
| Other | Cases | Deaths | Deaths | Recovered | Critical | ||||
| China | 76,940 | 652 | 2,443 | 98 | 23,163 | 11,477 | 15% | 64000 | 18% |
| Diamond Princess | 691 | 57 | 3 | 1 | 17 | 36 | 5% | ||
| S. Korea | 602 | 166 | 6 | 4 | 18 | 7 | 1% | 28 | 25% |
| Japan | 146 | 12 | 1 | 23 | 7 | 5% | |||
| Italy | 134 | 55 | 2 | 2 | 26 | 19% | 3 | 867% | |
| Singapore | 89 | 51 | 5 | 6% | 58 | 9% | |||
| Hong Kong | 74 | 4 | 2 | 12 | 6 | 8% | 53 | 11% | |
| Iran | 43 | 14 | 8 | 2 | |||||
| Thailand | 35 | 21 | 2 | 6% | 33 | 6% | |||
| USA | 35 | 6 | 15 | 0% | |||||
| Taiwan | 28 | 2 | 1 | 2 | 1 | 4% | 18 | 6% | |
| Australia | 22 | 1 | 11 | 15 | 0% | ||||
| Malaysia | 22 | 18 | 0% | 19 | 0% | ||||
| Germany | 16 | 14 | 16 | 0% | |||||
| Vietnam | 16 | 15 | 16 | 0% | |||||
| U.A.E. | 13 | 3 | 2 | 15% | 8 | 25% | |||
| France | 12 | 1 | 10 | 0% | 11 | 0% | |||
| Macao | 10 | 6 | 10 | 0% | |||||
| Canada | 9 | 3 | 0% | 7 | 0% | ||||
| U.K. | 9 | 8 | 0% | 9 | 0% | ||||
| Philippines | 3 | 1 | 2 | ||||||
| India | 3 | 3 | 5 | 0% | |||||
| Russia | 2 | 2 | 2 | 0% | |||||
| Spain | 2 | 2 | |||||||
| Belgium | 1 | 1 | |||||||
| Cambodia | 1 | 1 | |||||||
| Egypt | 1 | 1 | |||||||
| Finland | 1 | 1 | |||||||
| Israel | 1 | 0% | |||||||
| Lebanon | 1 | 0% | |||||||
| Nepal | 1 | 1 | |||||||
| Sri Lanka | 1 | 1 | |||||||
| Sweden | 1 | ||||||||
| Iraq | 1 | ||||||||
| Total outside China | 2016 | 311 | 25 | 255 | 92 | ||||
| % | 3% | 36% | 1% |
EDIT!: Sums in last row of the table were obviously incorrect for totals outside China.