dk9000 comments

How will they check if someone visited Daegu? Another fool-proof questionnaire to be filled in at the airport? Sounds legit.

At a higher level, could this be what you get when the same party rules virtually unopposed since 1955, which selects all its prime ministers from its inner factions, and that consists almost exclusively of an aging generation of men that has been sitting on the comfortable laurel's of power for generations?

Complacency hidden by thick layers of bureaucracy and a spineless media. Everything looks fine until pressure is applied and the cracks start to show.

There is no cure for ANY Virus.

Hepatitis C is considered curable.

I wonder if HIV drugs being effective point towards a man made source of this virus.

Nope. It merely points towards the fact that both HIV and the novel coronavirus are both single-stranded, positive-sense, enveloped RNA viruses that share fundamental features in their enzymatic machinery and can therefore hopefully be targeted by the same drugs.

I wonder if the tests are specifically for the 2019-nCoV or include the 4 coronaviruses which have been around since years.

Tests are based on amplification of the 2019-nCoV RNA, so the trick to make it specific is to look for areas of the genome that don't change rapidly over coronavirus evolution but have changed enough in this novel branch of the family that they can be used as a distinctive signature. Since coronaviruses probably diverged around the last ice age 8000 years ago, differences are substantial and this is quite doable. 2019-nCoV closest's relative that is also active in humans is Sars (about 80% similar at the protein/genetic level).

More details on how these tests work: https://arstechnica.com/science/2020/02/how-does-one-test-for-coronavirus-anyway/

From NHK yesterday:

When the ship docked in Naha, Okinawa, nobody was found to have symptoms, and about 10 passengers got off. Officials plan to look into whether any of them had close contact with the Hong Kong resident.

Might want to hurry up with those plans, officials. Better yet, please ask them very kindly to be tested, regardless of whether they were sipping cocktails on the deck with our coughing friend from Hong Kong or not. I'm heading to Okinawa soon and would like to know whether I should pack swim shorts or a hazmat suit, cheers.

Not doubting you, just wondering who has collated this info? Linky...

Clear data from China is hard to come by, but here's an early report that looked at 41 patients with confirmed 2019-nCoV in Wuhan. 13 ended up in the ICU, 6 didn't make it.

Median age of ICU-admitted patients was 49, but there have been report of younger people ending up in the ICU as well (a couple in France, the patient in the USA from the Lancet report, etc.)

http://www.thelancet-press.com/embargo/coronavirus1.pdf

Also that being the case, then China have built enough temp isolation facilities (for now) then?

Given the reports of many people being sent home for lack of hospital space, I very much doubt it.

I hope Japanese doctors are keeping up with the latest research and case reports. This can turn ugly even for young, healthy people, with a high complication rate (~20% ICU) requiring oxygen and ventilation treatment. If this were to spread widely, demand for oxygen and ventilation could easily overwhelm available supply, and Japan needs to be prepared and stock up while there is still time.

Moreover, several existing antiviral drugs have shown efficacy and have been used on a compassionate use basis with good results (e.g. remdesivir). Hopefully there is enough of an English-literate contingent in the Japanese medical community to widely disseminate this important information.

https://www.nejm.org/doi/full/10.1056/NEJMoa2001191

https://www.nature.com/articles/s41422-020-0282-0

As long as you have perfect immune system, you have nothing to worry about.

Ok great, glad we all have 'perfect' immune systems. I'll just make some extra kale shakes.

The virus will die in 14 days by itself. 

Nope. Incubation time is up to 14 days. How long it takes for the body to clear the virus after symptoms appear is far from clear.

Pretentious people are more dangerous than uneducated ones.

You sound both pretentious and uneducated. Please stop.

Interesting study that appeared in the Lancet two days ago, one of the foremost scientific medical journals:

*In our baseline scenario, we estimated that [...] 75,815 individuals have been infected in Wuhan as of Jan 25, 2020. We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (227–805), 113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks.*

Followed by:

*Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally.*

If this is anywhere near accurate (there is uncertainty, but the fact this appeared in the Lancet certainly lends credibility), then you can 100% add Tokyo to the list of large overseas cities with close transport links to China that could become outbreak epicenters.

After all, asymptomatic transmission has been confirmed in multiple cases, and incubation times can be up to 14 days. If travel from major cities in China proceeds unhindered, asymptomatic cases will inevitably end up in Japan, and I find it hard to imagine a scenario in which Tokyo does not become a major outbreak center.

So, want to contain the economic impact of this virus? Save the olympics. Cancellation would be a disaster of unprecedented proportions, but what if Tokyo gets hit hard in weeks to months from now? Good luck containing that in the most populated metropolitan area on earth.

In other words, now is the time to follow the USA, Australia, and Singapore and temporarily bar all foreigners who have recently visited any place in China.

It sucks for everyone, but it may be the only public health intervention that could prevent this from spreading in Japan.

source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext

Interesting study that appeared in the Lancet yesterday, one of the foremost scientific medical journals:

In our baseline scenario, we estimated that [...] 75 815 individuals have been infected in Wuhan as of Jan 25, 2020. We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (227–805), 113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks.

Followed by:

Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally.

If this is anywhere near accurate, then you can certainly add Tokyo to the list of large cities overseas with close transport links to China that could become outbreak epicenters.

Asymptomatic transmission has also been confirmed in multiple cases, and incubation times can be up to 14 days. If travel from major cities in China proceeds unhindered, I find it therefore hard to imagine a scenario in which Tokyo does not become a major outbreak center.

Given the upcoming olympics and the disaster that a potential cancellation would entail, now is the time to follow in the wake of the USA, Australia, and Singapore and temporarily bar all foreigners who have recently visited China. It sucks, but it may well be the only public health intervention that could prevent this from spreading in Japan.

source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext

Funnily enough, a recent article on the situation describes a 'public outcry' to the government's handling, and then proceeds to refer to two twitter posts and the comments on Japan Today as prime examples. Are we really the best available example of criticism? Democracies need independent and critical media to speak out on cases like this, so I hope that the article simply overlooked all Japanese-language news.

source: https://www.scmp.com/week-asia/health-environment/article/3048384/japan-bans-coronavirus-infected-after-outcry-over-lax

@Shimazaki-san

Oh, the power of euphemisms. As soon as the word "quarantine" is used, people can actually forget that what is really happening is a deprivation of liberty. It's for a different reason, but the deprivation is there.

As for the contract idea, you can either say it is permissible or impermissible to deprive people of liberty (for weeks) using contracts. If you say it is permissible, all 100 million plus residents of Japan will have to live with today's choice, long after this coronavirus has receded.

Thank you for your input, but I think your interpretation of the situation is far from correct. By 'service' I was referring to the airplane transportation service. Testing could very simply have been made a requirement for boarding that plane. If people don't want to get tested, they can choose not to board the plane. The liberty to decide to board the plane or not is always maintained, of course.

As for your other point, I'm not even really sure what you're saying the problem is. This does not apply to all 100 million plus residents of Japan. Only to those in the midst of a foreign high-risk virus exposure zone who were given the option of flying back.

"there's only so much we can do"

Ehmm. You could have given it just the slightest thought beforehand and made accepting quarantine and testing a requisite of taking the flight home you muppet. Simply have them sign a contract for accepting the service you provide. Human rights have nothing to do with it.

Seriously, if a government had responded with such incompetence in any other modern liberal democracy, I'd like to think that the media, politicians, and the populace would be all over it. What's the response in Japan? Is there any serious criticism in the mainstream Japanese media?

PS. For those saying the casualty rate is 'only' 2%; keep in mind that you can't just compare current # of infections to deaths in a rapidly developing situation like this, since it takes time to die. Probably more accurate would be to take the number of infections from some time ago, say a few days or a week, and compare that to current deaths. In that case, the casualty rate is starting to look a lot scarier (around 10%).

The good thing is that reported deaths outside of China still seem minimal, but unfortunately so are reported recoveries.

Regardless, this is still a an extremely unclear situation where you don't want to take any unnecessary risks and apply the precautionary principle at all times. Think about upsides and downsides; what's the upside of flying in everyone without requiring testing/quarantine? A small convenience for a small number of people. What's the potential downside? Widespread infection for the entire country. Those are the kind of situations you want to avoid at all costs, but that's exactly what we're seeing in Japan. "Extremely regrettable" indeed.

Good to hear he seems to be doing OK. May they both enjoy life and live many more years in good health.

Ministry of Health is playing with fire here. IF major infection breaks out because of the two people who were allowed to skip testing and go straight home, that'd be a seppuku-category mistake. Of course, these days that mostly means bowing a little deeper, maybe stepping down, and likely getting a well-paid job 天下り style, but still. What's behind this sudden recklessness? Mere incompetence?

The news said everyone on the airplane was not infected? That's great. Explains why multiple of them have been hospitalized for pneumonia, coughing and fever. Also, guess who else was 'not infected' when he first showed up at the hospital? The bus driver who was actually infected. Oops.

But hey, this is just a mysterious new pandemic, who cares right? Perhaps a hot bath at the communal onsen will help everyone who went home. Get those juices flowing!

Australia: 2 weeks quarantine on Christmas Island

England: 2 weeks quarantine in a military base

France: 2 weeks quarantine in isolated facility in Paris

USA: thorough check-up in Alaska, diverts everyone to military base for unknown reason

Japan: please don't cough in the train during rush hour k?