What do I need to know about coronavirus?

[Birdstrike]

We just got a huge box of TP
60 rolls
$85 bucks

View attachment 302343

That's straight up gangsta

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Members don't see this ad.

 

[Groove]

So, just to rewind to other week when we were all arguing over mortality statistics, volume surges and ventilator shortages.....

anybody run out of those vents yet???

 

[Birdstrike]

So, just to rewind to other week when we were all arguing over mortality statistics, volume surges and ventilator shortages.....

anybody run out of those vents yet???

The hospital I'm on staff at has 6 total COVID patients, 2 in the ICU and 0 on vents. A 350+ bed hospital that put a $1 million emergency COVID-19 hospital tent in the parking lot, shut down of 6 patients, zero needing a vent.

 

[thegenius]

So, just to rewind to other week when we were all arguing over mortality statistics, volume surges and ventilator shortages.....

anybody run out of those vents yet???

we made more so no
we did good!

 

[Birdstrike]

The hospital I'm on staff at has 6 total COVID patients, 2 in the ICU and 0 on vents. A 350+ bed hospital that put a $1 million emergency COVID-19 hospital tent in the parking lot, shut down of 6 patients, zero needing a vent.

@Groove

PS: I just looked out my state's COVID demographic data update. Out of 5 million people, there are 2 deaths under age 50, and 0 under age 30.

0.0004% chance of dying from this if under age 50 in my state, so far. 0% if under 30.

cc: @VA Hopeful Dr

 

[hundreddaysoff]

Article from NY Post says that more than 100 S. Koreans have been re-infected with the virus, after having it and having defeated it.

Either they are getting reinfected, or the virus lays dormant in their system and gets reactivated. Like shingles.

Lovely.

Coronavirus has ‘reactivated’ in more than 100 South Koreans who recovered

Means Chronic Lyme-style freakouts all over again. Whether or not it actually gets reactivated.

Sure hope it doesn't.

 

[Groove]

@Groove

PS: I just looked out my state's COVID demographic data update. Out of 5 million people, there are 2 deaths under age 50, and 0 under age 30.

0.0004% chance of dying from this if under age 50 in my state, so far. 0% if under 30.

cc: @VA Hopeful Dr

Surprise, surprise.

You might enjoy this interview with Dr. Bhattacharya from Standford who is working on research that hopefully shows a much lower mortality rate and makes some interesting arguments on the prudence of making hasty policy decisions based on worst case models that use "doomsday" scenarios that lack solid empirical data for those models. It's about 30 mins but a pretty good interview if you've got time to kill. I'll be interested to see the results of his research.

Jay Bhattacharya: Questioning Conventional Wisdom of the COVID-19 Crisis

Jay Bhattacharya questions the conventional wisdom that the coronavirus would kill millions without shelter-in-place orders and quarantines.

fsi.stanford.edu

 

[VA Hopeful Dr]

@Groove

PS: I just looked out my state's COVID demographic data update. Out of 5 million people, there are 2 deaths under age 50, and 0 under age 30.

0.0004% chance of dying from this if under age 50 in my state, so far. 0% if under 30.

cc: @VA Hopeful Dr

So you're twisting the numbers a little bit.

First, our current mortality rate from this is 2%. That's people we know had it. Now given how long it took to ramp up testing, its almost certainly lower than that. We just don't know how much lower.

Second, you're taking general population numbers which is misleading. What matters is "if you catch coronovirus, what's the chance you're going to die" with a corollary "what are the odds you're going to catch coronavirus". If either of those is very low, its not a huge deal. Its why people don't freak out about the flu - its very easy to get but not all that deadly. For this one, we don't have a solid handle on either.

 

[evilbooyaa]

I hope cooler heads prevail next time a novel infectious disease comes about. I’ve said since the beginning that the people at risk should be the ones isolating themselves from the rest of the population (fasting insulin levels, LFT’s, and baseline CRP being good biomarkers to look at to define “healthy”).

Everyone with DM, HTN, Asthma or any other respiratory baseline conditions, or more serious co-morbidities, as well as those who are obese would be recommended to stay at home? That's isolating 40-50% of the population. People who go out then come home and spread it amongst those who they visit. People keep saying this but I don't think it's realistic.

 

[VA Hopeful Dr]

Everyone with DM, HTN, Asthma or any other respiratory baseline conditions, or more serious co-morbidities, as well as those who are obese would be recommended to stay at home? That's isolating 40-50% of the population. People who go out then come home and spread it amongst those who they visit. People keep saying this but don't realize it's not realistic.

:troll:

 

[Birdstrike]

If we reopen the country in the 98% of it where hospital systems are not overwhelmed, is there any reason those uncomfortable or at risk can’t continue to stay home hiding as long as they want?

 

[Groove]

In the meantime, I'm continuing to set new records for how many times I can fold my square of toilet paper in half.

 

[Birdstrike]

So you're twisting the numbers a little bit.

First, our current mortality rate from this is 2%. That's people we know had it. Now given how long it took to ramp up testing, its almost certainly lower than that. We just don't know how much lower.

Second, you're taking general population numbers which is misleading. What matters is "if you catch coronovirus, what's the chance you're going to die" with a corollary "what are the odds you're going to catch coronavirus". If either of those is very low, its not a huge deal. Its why people don't freak out about the flu - its very easy to get but not all that deadly. For this one, we don't have a solid handle on either.

0 dead under age 30 to date.
2 dead ages 31-50, to date, in the whole state.

No numbers twisting needed. I’ll DM you the link.

 

[Angry Birds]

In the meantime, I'm continuing to set new records for how many times I can fold my square of toilet paper in half.

I don't know what you mean by this but I am down to one-ply TP.

 

[VA Hopeful Dr]

0 dead under age 30 to date.
2 dead ages 31-50, to date, in the whole state.

No numbers twisting needed. I’ll DM you the link.

The percentage you're getting is from the total population, as I explained in my original response that's not a good comparison without knowing just how infectious this disease is and because of the bad job our state in particular did ramping up testing we have no idea the true number of cases.

 

[BAM!]

If we reopen the country in the 98% of it where hospital systems are not overwhelmed, is there any reason those uncomfortable or at risk can’t continue to stay home hiding as long as they want?

Because this disease is extremely infectious with a mortality rate of at least 2% and an unknown rate of disability. There is a lag time between inoculation and symptoms which adds to spread. With exponential growth of cases, it doesn't seem like there are many case until all of the sudden there are.

Don't isolate/distance unless overwhelmed? Seems like such a bad idea!

 

[Birdstrike]

Because this disease is extremely infectious with a mortality rate of at least 2% and an unknown rate of disability. There is a lag time between inoculation and symptoms which adds to spread. With exponential growth of cases, it doesn't seem like there are many case until all of the sudden there are.

Don't isolate/distance unless overwhelmed? Seems like such a bad idea!

“Stay closed forever because we aren’t overwhelmed but might be 4 weeks ago, no 3 weeks ago, no maybe in a week, and if not maybe the week after that. Oops, no, maybe be after that,” seems like a pretty bad idea, too. Maybe worse.

I’ve been told “Your town will be like Italy in a week!” for many, many weeks now.

Not saying COVID isn’t terrible. It is.

I’m not saying my town won’t get more cases. It will.

I’m not saying I won’t get it. I might.

I’m not saying life should go back to normal today, everywhere.

I am saying, we can’t be in hiding forever. Like I’ve been saying since the very first announcement of these shutdowns, which I agreed with, COVID will be around long after any enacted shutdown ends.

 

[dadaddadaBATMAN]

“Stay closed forever because we aren’t overwhelmed but might be 4 weeks ago, no 3 weeks ago, no maybe in a week, and if not maybe the week after that. Oops, no, maybe be after that,” seems like a pretty bad idea, too. Maybe worse.

I’ve been told “Your town will be like Italy in a week!” for many, many weeks now.

Not saying COVID isn’t terrible. It is.

I’m not saying my town won’t get more cases. It will.

I’m not saying I won’t get it. I might.

I’m not saying life should go back to normal today, everywhere.

I am saying, we can’t be in hiding forever. Like I’ve been saying since the very first announcement of these shutdowns, which I agreed with, COVID will be around long after any enacted shutdown ends.

a gradual repopening is inevitable and needed. We should start small, and scale back as necessary after we see the results. Things will worsen again.

If we could feasibly keep things closed until a vaccine were available I’d be all for it. But we can’t.

However, opening everything simultaneously would be as bad as doing nothing would have been. Opening small venues and stores makes sense in the near future, with appropriate precautions.

 

[Rekt]

I'd rather be dead than be locked in my house for a year.

 

[Birdstrike]

44% of COVID-19 patients get it from someone who has no symptoms - NATURE, 4/15/20

 

[fldoctorgirl]

Thoughts on the articles that keep cropping up about universities closing for the fall 2020 semester, or that we may be social distancing until 2022?

 

[Birdstrike]

In March, a homeless shelter in Boston started to get a few COVID-19 cases. So they decided to test all 408 people in the shelter, sick or not. 147 (36%) tested positive. Even more shocking, "Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals." That's right, cough, shortness of breath and fever, were uncommon. (MedRxIV) Look at how low those percentages are. >90% of positives had no symptoms.

It's everywhere, people. Symptoms or not. Everywhere.

 

[Birdstrike]

Thoughts on the articles that keep cropping up about universities closing for the fall 2020 semester, or that we may be social distancing until 2022?

I've seen the articles. If you can function at full capacity online (like a university) sure, go ahead. But a full nation shut down for 2 more years? Absolute insanity and pointless. This virus is everywhere already, symptoms or not. See the last two papers I posted, above.

 

[Birdstrike]

44% of COVID-19 patients get it from someone who's not yet symptomatic - NATURE, 4/15/20

In March, a homeless shelter in Boston started to get a few COVID-19 cases. So they decided to test all 408 people in the shelter, sick or not. 147 tested positive! A full 36% were positive. Even more shocking, "Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals." That's right, cough, shortness of breath and fever were uncommon! (MedRxIV)

It's everywhere, people. Everywhere. Symptoms or not. Everywhere.

Half the people that get it, get it from someone with no symptoms. The virus is everywhere, even when we don't suspect it or have symptoms. Is containment even possible at this point? To the very small extent it might be, does it even gain us anything at this point?

 

[Birdstrike]

What we need to do now, right now, is to also test as many people as possible who aren't sick. If we test 10,000 asymptomatic people and find 36% are infected or already have been infected with most showing no symptoms, we're done. "Done," meaning everything we're doing is futile at this point and time to gradually transition back to normal life. If, that is.

 

[fldoctorgirl]

What we need to do now, right now, is to also test as many people as possible who aren't sick. If we test 10,000 asymptomatic people and find 36% are infected or already have been infected with most showing no symptoms, we're done. "Done," meaning everything we're doing is futile at this point and time to gradually transition back to normal life. If, that is.

I share this mindset with you. My concern is that this seems to be a minority thought, and decisions seem to be being made rashly. I mean, we're in April and schools are already cancelling their fall 2020 semesters...based on what data? There are talks about a nationwide ban on all away rotations for next year's M4s and doing all interviews on Zoom....again, we're in April. I don't see why any of that is necessary. It just seems very rash to me but I admit my own shortcomings in knowledge, so I've appreciated reading everyone's thoughts on this thread.

 

[Rekt]

44% of COVID-19 patients get it from someone who has no symptoms - NATURE, 4/15/20

In March, a homeless shelter in Boston started to get a few COVID-19 cases. So they decided to test all 408 people in the shelter, sick or not. 147 tested positive. A full 36% were positive. Even more shocking, "Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals." That's right, cough, shortness of breath and fever, were uncommon. (MedRxIV)

They didn't say "Most had symptoms, but not all were severe." They said it was uncommon to have any symptoms at all.

It's everywhere, people. Everywhere. Symptoms or not. Everywhere.

It's amazing how these types of articles/research are continuously ignored and people, even physicians, are just focusing on the the hysterical articles and anecdotes. Very similar to how everyone stuck with the 2 million death predictions and ignored the other >10 experts saying it won't even be close.

 

[Birdstrike]

..based on what data?

Based on models with very little reliability, that commonly are of by orders of magnitude.

There are talks about a nationwide ban on all away rotations for next year's M4s and doing all interviews on Zoom....again, we're in April. I don't see why any of that is necessary. It just seems very rash to me but ...

Like many things, such proposals look great on paper. The reality is, pretty soon people are going to be so broke there will be mass protests. It's already started.

Michigan: "People protest Whitmer's stay-at-home order by creating traffic gridlock, not adhering to social distancing"

Ohio: "Large gathering of Ohio protesters demands DeWine end social distancing, reopen economy"

North Carolina: "Protesters rally for NC to reopen. One woman arrested for violating governor’s order."

 

[ShockIndex]

If we reopen the country in the 98% of it where hospital systems are not overwhelmed, is there any reason that those uncomfortable or feel they’re at risk can’t continue to stay home isolated and quarantined as long as they feel necessary?

Singapore, the supposed model of centralized, government-run healthcare in this mess, is back on lockdown after a big uptick in new cases despite their legendary testing and quarantine abilities. Ugh...

 

[VA Hopeful Dr]

Half the people that get it, get it from someone with no symptoms. The virus is everywhere, even when we don't suspect it or have symptoms. Is containment even possible at this point? To the very small extent it might be, does it even gain us anything at this point?

the problem with those studies, I don't see that any of them are following up with these people to see if they develop symptoms.

They appear to do a one round test and if you're positive they don't check up with you in two weeks to see if you actually got sick. this is a major flaw since we know that from time of exposure to symptoms can be as long as 14 days.

 

[Birdstrike]

Singapore, the supposed model of centralized, government-run healthcare in this mess, is back on lockdown after a big uptick in new cases despite their legendary testing and quarantine abilities. Ugh...

That is unfortunate. It speaks to how much of a scourge COVID-19 is, that will not be going away anytime soon. It also doesn't avoid the fact that after being on lockdown, again, Singapore will at some point, have go back off lockdown.

 

[Birdstrike]

the problem with those studies, I don't see that any of them are following up with these people to see if they develop symptoms.

They appear to do a one round test and if you're positive they don't check up with you in two weeks to see if you actually got sick. this is a major flaw since we know that from time of exposure to symptoms can be as long as 14 days.

It's too early for there to even be a follow up paper, as that paper literally come out today. If I see a follow up, I'll post it as soon as I see it.

 

[Birdstrike]

Full disclosure: As a physician who's been in practice for over 15 years, I am financially able to stay in shutdown mode, much longer than your average American. I, personally and financially, don't need this lockdown to end right now. Actually, it's probably in my best interest the longer it goes on, as I don't want COVID spreading around and back to me and my family, any more than anyone else. However, most people are not going to be able to withstand a shutdown long enough to eliminate all risk of COVID-19. Most people, even middle and many upper middle class, live paycheck to paycheck. Once that stimulus check is gone, which is going to be quick because bills haven't stopped mounting, people are going to be desperate. Social distancing and "flattening the curve" were never about eradicating COVID-19 from Earth, or eliminating all risk. That may not happen, ever. It was about allowing healthcare resources to withstand the peak surge of cases. According to the models which is all we have to guide us, as flawed as they are, show we are post peak nationally, and in the worst hotzones of NY, NJ, MI and LA.

 

[Birdstrike]

It's amazing how these types of articles/research are continuously ignored and people, even physicians, are just focusing on the the hysterical articles and anecdotes. Very similar to how everyone stuck with the 2 million death predictions and ignored the other >10 experts saying it won't even be close.

I agree. By the way, that original Imperial College model did include the effects of social distancing, predicting 1.2 million American deaths even if recommended actions were taken (Page 16, paragraph 3, last sentence). Currently, they seemed to have zeroed in on something more like 68K, which if true, means the initial estimate was off by 1,748%. The initial prediction without social distancing was 40 million worldwide.

Should we have expected this model to predict the virus perfectly?

No.

Similarly, we should realize any of these mathematical models that try to predict the future, tend to be inherently unreliable, as a rule. That applies whether it's pandemics, weather, climate, hurricanes, economics, population growth, elections or whatever. And the father out you go, the less reliable they are.

 

[fldoctorgirl]

I agree. That original Imperial College model did include the effects of social distancing, by the way, predicting 1.2 million American deaths even with recommended action. Page 16, paragraph 3, last sentence. The initial prediction without social distancing was 40 million worldwide.

This is the point I keep trying to make to people who keep arguing that the models were correct without social distancing. Nope, still way incorrect.

 

[evilbooyaa]

In March, a homeless shelter in Boston started to get a few COVID-19 cases. So they decided to test all 408 people in the shelter, sick or not. 147 (36%) tested positive. Even more shocking, "Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals." That's right, cough, shortness of breath and fever, were uncommon. (MedRxIV) Look at how low those percentages are. >90% of positives had no symptoms.

It's everywhere, people. Symptoms or not. Everywhere.

Yes and how many of those patients NEVER developed symptoms? Strong potential for lag time between potential diagnosis of PCR positivity and actual clinical symptomology. Not to guarantee everyone will get symptoms, but still.

This is the issue with 'pre-print'. It means anybody can put something to paper with whatever conclusions and because there is no peer review, there is no challenge to the frequently outrageous conclusions that authors have about their 'data'.

I agree that we should be cautiously opening up economy and society again, but it should be a gradual process, with ability and willingness to go back into lockdown if things start to trend the wrong way (overwhelming of hospital resources) as they are in hot-spots.

That being said, governors need to decide whether they want to get skewered for death rates or skewered for economy issues. I imagine some will choose against what you think is important.

 

[thegenius]

44% of COVID-19 patients get it from someone who has no symptoms - NATURE, 4/15/20

And that’s the reason why the country is still in lockdown.

It’s the reason why kids aren’t back in school.

Didn’t we just debate this about 7-10 days ago? Then we had a nice period of time where all was quiet on SDN.

 

[thegenius]

Thoughts on the articles that keep cropping up about universities closing for the fall 2020 semester, or that we may be social distancing until 2022?

I can certainly see people social distancing until 2022, without question.

There won’t be formal SIP by cities / states / countries though by that time.

But people are going to do what they are going to do!

 

[Birdstrike]

This is the point I keep trying to make to people who keep arguing that the models were correct without social distancing. Nope, still way incorrect.

They're dead wrong. Show them the sources I linked to. I gave you the report link, page, paragraph and sentence.

 

[Birdstrike]

And that’s the reason why the country is still in lockdown.

It’s the reason why kids aren’t back in school.

Didn’t we just debate this about 7-10 days ago? Then we had a nice period of time where all was quiet on SDN.

There's always going to be a lot of asymptomatic people with COVID, though. Isn't there?

 

[Birdstrike]

For those of you upset our President is playing hardball with WHO, this is a really good article from Washington Post, hardly a Trump-centric newspaper, that details how China lied about human-to-human transmission, detained and intimidated doctors who were trying to warn and how the World Health Organization parroted the lies being told by China, despite severe evidence they were not being forthcoming. Whole article below, it you face a paywall.





"China Coronavirus: Trump's Critique of WHO's Response to the Pandemic Is Not Entirely Wrong"

President Trump is not happy with the World Health Organization. He is not the only one.


On Tuesday, in the middle of a global pandemic, Trump announced that he is freezing funding to the United Nations agency, pending a review of its coronavirus response.





To many, Trump’s allegations sound like an opportunistic effort to deflect from criticism of his slow response to combating the virus.


But there is some truth to them.





In the early days of the crisis, the WHO amplified Chinese claims and figures without signaling that they could be inaccurate. The organization was slow to address the risk of human-to-human transmission, slow to declare a public health emergency and slow to use the term pandemic.





Yet it was quick to praise Beijing. As evidence mounted that China silenced whistleblowers and undercounted cases, Tedros Adhanom Ghebreyesus, the WHO’s director general, continued to heap compliments on Beijing and dodged questions about worrying problems with the Chinese response.





“You had the authority, you had the ability to challenge China, to question China as to what they were doing, and you needed to do that for global health,” said David Fidler, an adjunct senior fellow at the Council on Foreign Relations who has written about and worked with the WHO for years, referring to the organization. “You failed to do it.”


Criticism about how the WHO handled China is resonating well beyond the White House. Japan’s deputy Prime Minister recently called the WHO the “China Health Organization.” Nearly 1 million people have signed an online petition calling for Tedros to resign.





This is partly a problem of expectations. The Geneva-based organization does many things well, but it is not particularly well-equipped to guide the world through a pandemic.





The agency, founded in 1948, does best when it is advocating for primary health care and essential medicine, particularly in the developing world. In an emergency — when decisive action is necessary — it can coax and cajole but it cannot compel its members to do much. It also cannot issue fines for noncompliance, for instance.





The organization has been widely praised for some of its technical work during the coronavirus pandemic, most notably quickly distributing a test to more than 70 laboratories worldwide — a test the United States chose not to use. The WHO also has shipped almost 2 million protective gear items to 74 countries, Tedros said, and plans to ship more.





It is not surprising to some who support the WHO’s mission that Trump has chosen to focus exclusively on the organization’s apparent failings during this pandemic. “I think it’s a diversion from the fact that the U.S. did not respond as aggressively or as appropriately as we should have,” said Jimmy Kolker, a former U.S. ambassador who served as assistant secretary for global affairs at the Department of Health and Human Services until 2017.





“There are lots of reasons for that,” he continued. “A minor one is that some of the information about what was happening in China was withheld longer than it should have been.”





But even the organization’s defenders, including current and former advisers, have questioned why the WHO kept lending credibility to China when it could have expressed more skepticism.


“That is what should have happened,” said Lawrence Gostin, a professor of global health law at Georgetown University, who also provides technical assistance to the WHO. “That was WHO’s responsibility.”





A WHO spokesman put the onus on member states to provide truthful information.





“WHO expects all its member states to report data in a timely and accurate manner,” said Tarik Jasarevic, the WHO spokesman. “We have from the very beginning urged all countries to share data in a timely fashion, and we continue to do so.”





Public health advocates responded strongly after Trump’s announcement and worried that the funding freeze could have a catastrophic impact. According to the State Department, the United States has committed to provide the WHO with $893 million during its current two-year funding period. (China has committed to $86 million during the same period.)








“Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds,” Bill Gates, Microsoft founder and co-chairman of the Bill & Melinda Gates Foundation, tweeted Wednesday. “Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever.” Even those who have been critical of the WHO urge the Trump administration to reconsider.





German lawmaker Norbert Röttgen called the organization’s treatment of China “concerning” but said those concerns should be addressed when the crisis is over. This is not the time to freeze funding, he said in a tweet. Doing so “will harm those countries most that are least equipped to help themselves.”


And a freeze, warned Kristine Lee, an associate fellow at the Center for a New American Security, won’t necessarily lead to results that Trump or his administration would welcome. Trump’s retreat from the WHO, she said, “makes it easier for Beijing to step in.”





The WHO’s approach to emergency response was indelibly shaped by China’s attempts to conceal the 2002 SARS outbreak.





In the wake of that crisis, updated rules empowered the organization to consider non-state sources of information, such as information from nongovernmental groups on the ground, to assess threats. The goal: preventing coverups. It is not clear whether that has worked in the coronavirus case.





In late 2019, Chinese doctors in Wuhan started discussing a SARS-like ailment that was spreading through hospitals. They were detained for spreading rumors and shamed on state television. China notified the WHO on Dec. 31 that there was a mysterious pneumonia in Wuhan. On Jan. 5, the organization issued a statement saying that China had reported 44 cases. Chinese investigators reported no evidence of human-to-human transmission, the WHO statement said, or spread among medical workers.





In a Jan. 14 tweet that Trump referenced last week, the WHO said Chinese authorities had still found “no clear evidence” of person-to-person transmission. There was no hint of skepticism or comment about the detention of doctors.





There were also signs that China was undercounting cases. From Jan. 11 to Jan. 17, for instance, Hubei province, then the epicenter of the outbreak, held a Communist Party conclave. Each day during that time, the Wuhan Health Commission claimed that there were no new infections or deaths. At midnight on Jan. 18, it resumed reporting cases — a gap that raised eyebrows among scientists and researchers.


If the WHO was concerned about the figures, it did not say so. “WHO just routinely repeated as if it were its own information, as if it were verifying it,” said Gostin, the Georgetown law professor.





“WHO is reliant on member states for data, but it could have noted gaps in the data or simply noted that they were not able to independently verify it,” he continued. “By uncritically citing Chinese data, WHO officials lent credibility to information that was false.”





In the meantime, the virus kept spreading, unchecked. It was not until Jan. 20 that Chinese officials acknowledged that the virus was spreading person to person. By that time, Wuhan was in crisis and confirmed cases were in multiple Chinese cities, Japan, Korea, Thailand and — later that day — the United States.





In Geneva, an emergency panel convened to decide whether to declare a public health emergency of international concern, or PHEIC, a post-SARS term that signals a health crisis “that poses a public health risk to other countries through international spread.”





On Jan. 23, while the panelists were gathered, Chinese officials began locking down Wuhan. Officials in Geneva wrestled with whether to declare a PHEIC, weighing Chinese pushback about economic damage and assurances that everything was fine.








The committee was split, but decided that it was not an emergency, surprising public health experts.





The panel waited until Jan. 30 — a full month after Chinese doctors issued a warning — to make the declaration. “The Chinese government is to be congratulated for the extraordinary measures it has taken,” said Tedros, the WHO chief. “I left in absolutely no doubt about China’s commitment to transparency.”





Lavishing praise on Beijing








In February and March, as evidence of a coverup intensified, the WHO continued to praised Beijing, baffling some experts.


By late January, for instance, Chinese officials, including the Communist Party chief of Wuhan, were acknowledging that they should have acted sooner. But the WHO and Tedros assured the world that they were doing great.





After meeting privately with Xi on Jan. 28 in Beijing, Tedros not only lauded the country’s handling of the outbreak, according to state-run Xinhua News Agency, but the effectiveness of “China’s system.”


Some argue that all this flattery was strategic to allow an international team of doctors, scientists and observers to enter the country. But when a WHO team finally made it to China in mid-February, Tedros and his team did not modulate their tone.





At a news conference after an international team visited, Bruce Aylward, the head of the mission, called China’s work “stunning,” “extraordinary” and “successful.”





While there were certainly elements of China’s coronavirus response that were worthy of study, WHO watchers were surprised to hear Aylward praising measures, such as travel bans, that the organization has long opposed.





They also wondered why Tedros waited until March 11 to say that covid-19, by then ravaging multiple continents, was a pandemic. In public remarks, the WHO’s leadership sometimes stayed mum on basic matters of human rights.





At one news conference, Tedros was asked about the death of one of the Chinese doctors who sounded the alarm on the virus, only to be detained by police. He first deferred to a colleague, then took the chance to speak. “It is very difficult, given the facts,” he said, “to say that China was hiding.”





In a March 28 interview with Hong Kong’s RTHK, Aylward was asked about the WHO’s position on Taiwan, which is blocked from WHO membership at China’s behest, but has been lauded by public health experts for its decisive and successful efforts to contain the virus. In a now-viral clip, he dodged, declining to answer several times.


In a statement published after the interview, the WHO said the question of Taiwan’s membership is up to members states, not its staff. In an email, a spokesman said the clip was edited to misrepresent Aylward’s remarks.





“I cringe when I see these things,” said Kelley Lee, a professor at Simon Fraser University in Canada who wrote a book about the WHO and co-established the WHO Collaborating Centre on Global Change and Health. “I can see why people see this as, ‘Wow, what are they hiding?’ ”





A question of credibility





The organization’s messaging has been a boon for conservative critics of multilateral organizations, including Trump.





Former national security adviser John Bolton tweeted Friday that the WHO has been “fully penetrated by the Chinese,” echoing conservative claims that the agency and its leader have been co-opted.





There is no evidence that Tedros is directly acting at Beijing’s behest. Trump echoed the WHO’s praise for China by applauding Beijing’s transparency on Jan. 24, brushed off concerns about a coverup on Feb. 7 and on March 4 said China had the situation under control.


What is striking is the extent to which the WHO’s China messaging has overshadowed more successful elements of its response, eroding the agency’s credibility, just when it needed it most.





Some critics have called for the agency to be scrapped altogether. “What would you replace it with?” asked David Heymann, a professor of infectious-disease epidemiology at the London School of Hygiene and Tropical Medicine who also advises the WHO. “Would it ever be possible to have 194 countries agree to a new organization?”


Kelley Lee, the author of the book about the WHO, said the coronavirus pandemic shows the need for a well-funded, capable agency. A robust WHO is “going to be much cheaper than the trillions of dollars we’re seeing splashed out now,” she said.


“It’s pay now or pay later.”





Liz Sly in Beirut and Anne Gearan and Lenny Bernstein in Washington contributed to this report

 

[VA Hopeful Dr]

There's always going to be a lot of asymptomatic people with COVID, though. Isn't there?

That's one of the big problems - we just don't know

 

[thegenius]

That being said, governors need to decide whether they want to get skewered for death rates or skewered for economy issues. I imagine some will choose against what you think is important.

Yup precisely.

Lost money can be made up. You can hand out money to people. You can’t bring back the dead though.

Seems like an obvious point to me.

“Please go back to work....just ignore those dead people over there.”

 

[Birdstrike]

That's one of the big problems - we just don't know

We do know. COVID-19 is here to stay.

 

[thegenius]

There's always going to be a lot of asymptomatic people with COVID, though. Isn't there?

I don’t think there is rampant, massive spread. I think if we had good testing, testing that was reliable and quick, it would show that probably only a few percent of people in the US has it.

For the sake of numbers maybe 5-10x of confirmed. Might be a little bit higher in places like NYC.

I agree with gottleib (former Head of CDC) on this one.

 

[true2life]

I share this mindset with you. My concern is that this seems to be a minority thought, and decisions seem to be being made rashly. I mean, we're in April and schools are already cancelling their fall 2020 semesters...based on what data? There are talks about a nationwide ban on all away rotations for next year's M4s and doing all interviews on Zoom....again, we're in April. I don't see why any of that is necessary. It just seems very rash to me but I admit my own shortcomings in knowledge, so I've appreciated reading everyone's thoughts on this thread.

"Never let a crisis go to waste". This is the reason.

This crisis has beautifically unmasked the many little tyrants we have wielding power in our country (and around the world). It was a mistake to believe in most cases that letting government seize power sufficient to impose defacto lock downs, determination of what businesses are allowed to operate and how, whether you can attend a church service in a car in a parking lot, and even what we are permitted to buy would give the power back simply. How many post 9-11 changes were ever rolled back?

We are treading on very dangerous ground now from a civil liberties standpoint. I think this threat is becoming more dangerous than the material threat of the virus. I agree that for the most part the social distancing orders have helped public health but I'm starting to believe the country may have made a deal with the devil blindly accepting orders from state executives. Exchanging liberty for the illusion of safety. Remember, people have always been permitted to voluntarily social distance. The reason these deadlines keep extending is because to let up social restriction is to give up power. And little tyrants don't like to do that.

 

[Rekt]

Yup precisely.

Lost money can be made up. You can hand out money to people. You can’t bring back the dead though.

Seems like an obvious point to me.

“Please go back to work....just ignore those dead people over there.”

Physicians, politicians, and CEOs have "lost money".

The general population has homelessness and starvation.

 

[thegenius]

Physicians, politicians, and CEOs have "lost money".

The general population has homelessness and starvation.

Uhhh….......OK

death vs homelessness and starvation.

Hmm......

 

[thegenius]

This is the point I keep trying to make to people who keep arguing that the models were correct without social distancing. Nope, still way incorrect.

I love it when people still rag on modeling. There are people who STILL FEEL this is a hoax, made up by the government to control people. There are people on this board who predicted at one point there would be 3-9K deaths in the US.

I agree that it doesn't make sense for most hospitals, around the nation, to sit around at 1/2 capacity for long periods of time. We can probably start doing some elective cases soon. And that's going to happen according to an email I got from our hospital.

 

[ShockIndex]

Yes and how many of those patients NEVER developed symptoms? Strong potential for lag time between potential diagnosis of PCR positivity and actual clinical symptomology. Not to guarantee everyone will get symptoms, but still.

This is the issue with 'pre-print'. It means anybody can put something to paper with whatever conclusions and because there is no peer review, there is no challenge to the frequently outrageous conclusions that authors have about their 'data'.

I agree that we should be cautiously opening up economy and society again, but it should be a gradual process, with ability and willingness to go back into lockdown if things start to trend the wrong way (overwhelming of hospital resources) as they are in hot-spots.

That being said, governors need to decide whether they want to get skewered for death rates or skewered for economy issues. I imagine some will choose against what you think is important.

I think that an equally important question is how many are false positives. I’ve seen amplification run amuck in law enforcement with touch DNA analysis giving false hits (ie Lukis Anderson case) simply because someone came in close contact with a suspect hours before sample collection. It would not surprise me if persons living in close contact with an infected individual have trace viral elements detectable by PCR in their mucus, cilia, etc. but no infection meaning no intracellular entry or replication.