The coronavirus is currently sweeping across China. So far, it has all the hallmarks of a potential true pandemic outbreak.

While it could still (and hopefully will) be contained and burn itself out, the chances of that are slipping by the hour.

If an actual pandemic breaks out, expect the following to happen quickly:

• Travel within and especially between countries will be restricted if not completely banned
• Critical shortages of materials will develop, especially medical supplies, doubly especially antivirals.
• In cities with lockdowns or quarantines, food will disappear rapidly from shelves.

Pro tip: N95 face masks are already rapidly disappearing form Amazon and other retailers.If you can’t order online, then get yourself down to Home Depot pronto to get a stash of masks for you and your family (something we’ve recommended as a part of routine preparations for years).However, don’t be a hoarder.Buy only what you really need.The time to responsibly stock up was before now.

A Quick Primer On Viruses

When I was getting my PhD through the Duke Medical school, there was a debate as to whether viruses even qualified as being a lifeform.That debate still carries on.

A virus is a protein encapsulated set of genetic instructions. Just some DNA or RNA surrounded by a complex shell that can ‘dock’ with a specific living host cell.  All viruses completely lack the ability to reproduce themselves.They require the hijacking of the active replicating machinery of a host cell to reproduce and multiply.

Viruses are everywhere.A single drop of clear seawater may contain 10 million virus particles on average.You encounter them everyday.Your body already has natural immunity against hundreds of different virus types.

The problem comes in when a new virus enters the game, one which your body has not seen before, and against which you have no immunity.

An even bigger problem emerges when ‘the herd’ has not seen it before either and there’s no herd immunity to block its spread.

The biggest problem emerges when such a new virus emerges (usually by ‘jumping’ from a non-human species to humans) has the ability to spread easily between humans.By contrast, a virus that requires some sort of a host vector such as a mosquito or a tick is much more easily contained.

The Coronavirus

The coronavirus currently in question derives its name from the spiky crown of proteins (Corona = Crown) that are seen under magnification.

It first erupted on Wuhan China, and is thought to possibly have jumped from a snake species to humans:

Wuhan coronavirus may have been transmitted to people from snakes

Jan 22, 2020

A new coronavirus that has claimed 17 lives in Wuhan, China, may have been transmitted to people from snakes, according to a genetic analysis. The snakes may have caught the virus from bats in the food market in which both animals were sold.

This was bound to happen sooner or later. Especially among a tightly-packed human population with a proclivity for eating many different forms of wild animals.

This virus has all the statistical and virologic markers to be a true pandemic – the sort that the world has been luckily spared for many decades. But which nature and history shows us is always an inevitability.

According to the WHO’s guidance document on pandemics, this new coronavirus is already well on its way to being a full-blown pandemic:

We are already at Phase 4.Things get really serious at Phases 5 & 6.

All we need to move to Phase 5 is for another country to report a sustained outbreak — something that seems all but certain at this point. Then it will be Game On.

It's Contained!”

Early reports on the media have been underselling the severity. This is expected.

For some reason governments across the world long ago decided that ‘not panicking’ people was more important than providing timely, accurate, risk-balanced information.

The straight-up lying about the Fukushima disaster was one example.

China lied like crazy about the SARS outbreak a number of years ago. And they’re certainly being less than fully revealing about this outbreak.

As of this morning (6:35 am, 1/23/20) there are two major Chinese cities under a full quarantine.Wuhan with 11 million people and Huanggang with another 6 million people:

Health officials fear the transmission rate will accelerate as hundreds of millions of Chinese travel at home and abroad during week-long holidays for the Lunar New Year, which begins on Saturday.

The previously unknown virus strain is believed to have emerged late last year from illegally traded wildlife at an animal market in the central Chinese city of Wuhan.

Most transport in Wuhan, a city of 11 million people, was suspended on Thursday morning and people were told not to leave. Hours later, state media in neighboring Huanggang, a city of some 6 million people, said it was imposing a similar lockdown.

(Source – Reuters)

Compounding the difficulty for Chinese authorities is that all of this coincides with the Lunar New Year, when hundreds of millions of Chinese typically travel about.

That’s just a recipe for disaster here.

By The Numbers

To truly appreciate and estimate the possible impact of an emerging pandemic there are a few things to know.

First, how lethal is the virus?That is, how many people die as a result of contracting the virus?This is called the “case fatality rate” or CFR in virologist lingo.

Second, how easily does it spread between victims?This measure goes by the name “R0” or “R-naught”, which we’ll get to in a minute.

The CFR of this coronavirus is not really known yet because we don’t trust the numbers coming out of China.But the numbers we’ve got are not encouraging.In Wuhan, there are a reported 444 cases and 17 deaths.

That yields a CFR of 3.8%.There’s also been reports of 555 infections, which would yield a CFR of 3.0%.Let’s use that, while reserving the right to seriously amend these numbers when better data comes along.

The Spanish flu of 1918 which was the last true global pandemic, had a CFR of 2.5%.It was horrible and killed an estimated 50 – 60 million people.True, we’ve got substantially better containment protocols today, but they clearly are not perfect.

If a virus is ‘too lethal’ and kills above a certain threshold, it will burn itself out quickly.The 3% CFR of this coronavirus is in the ‘sweet spot’ for doing a lot of damage.

Next, it’s the contagious aspect of this particular virus that’s most worrying to me.Let’s dive into the R-naught value for a minute:

What do R0 Values Mean?

R0 is pronounced “R naught.” It’s a mathematical term that indicates how contagious an infectious disease is. It’s also referred to as the reproduction number. As an infection spreads to new people, it reproduces itself.

R0 tells you the average number of people who will catch a disease from one contagious person. It specifically applies to a population of people who were previously free of infection and haven’t been vaccinated. If a disease has an R0 of 18, a person who has the disease will transmit it to an average of 18 other people, as long as no one has been vaccinated against it or is already immune to it in their community.

What do R0 values mean?

Three possibilities exist for the potential spread or decline of a disease, depending on its R0 value:

If R0 is less than 1, each existing infection causes less than one new infection. In this case, the disease will decline and eventually die out.

If R0 equals 1, each existing infection causes one new infection. The disease will stay alive and stable, but there won’t be an outbreak or an epidemic.

If R0 is more than 1, each existing infection causes more than one new infection. The disease will spread between people, and there may be an outbreak or epidemic.

Importantly, a disease’s R0 value only applies when everyone in a population is completely vulnerable to the disease. This means:

• no one has been vaccinated
• no one has had the disease before
• there’s no way to control the spread of the disease

This combination of conditions is rare nowadays thanks to advances in medicine.

(Source – Healthline)

Here’s what we know – the R0 of this virus is way above zero.We don’t have a solid value yet, but our clue lies in the fact that a reported 15 healthcare workers in Wuhan contracted the disease from being around their patients.

These would be people using the very latest in protective measures, too – masks, gloves, proper handwashing, and even full hazmat suits.

The one case in Hong Kong turned into 5 as the entire family of an infected person came down with the disease.

So this R0 is pretty worrying.

Finally, it’s those last three bullet points above that set off my alarm bells here:

• no one has been vaccinated
• no one has had the disease before
• there’s no way to control the spread of the disease

Check, check and check.

Combine those with a high R0 and now you know why China has just clamped down and quarantined two major cities with a combined 17 million people in them.

The Nightmare Begins

My personal nightmare is being played out in those quarantined Chinese cities. Locked in with possibly contaminated people whom I have to battle and engage with for rapidly dwindling resources.

Already, within hours, reports of scuffles for food have been reported.

Already, within hours, reports of scuffles for food have been reported.

(

)

People didn’t have much time to prepare or react.It was a matter of hours between “normal” and everything being placed into lockdown:

NZers trapped in China megacity Wuhan as virus spreads

Jan 23, 2020

At least 17 people are dead and more than 500 infected in China alone, as the virus spreads from Wuhan to other provinces and countries.

Public transport in the Chinese mega-city, with a population of more than 11 million, has been suspended. Residents have been advised to stay put as the response to the outbreak ramps up.

Auckland man Mr Li, who didn’t want his full name used, said on Tuesday people were still shopping and travelling, and the streets were bustling with people.

Roughly 48 hours later, the city had gone into lockdown. For him, it started with friends and relatives cancelling planned parties and gatherings.

“The face masks were all sold out. There were queues in front of every pharmacy. The usually crowded shopping malls are entirely different. The shops are all open but there’s barely any customers. The subway stations, which should be noisy and crowded in the New Year’s season, are almost empty,” he said.

He said anyone seen in public was wearing a mask.

“Starting from yesterday, the whole city started to feel more nervous. All the things and all the conversations in our social media group are around the virus infection.”

Li said he didn’t believe it when he first heard about the likelihood of locking down the city, comparable in size to London.

He had been planning to come back to Auckland in two days, but had to start changing his plans unsure when the travel restrictions would be lifted.

“At five o’clock China time this morning, the Chinese Central Television Station Channel One said from ten o’clock this morning, all of the buses, subways, airport – and I’ve just heard that all the motorways – will be closed down temporarily.”

It was just a matter of hours from the first inklings to complete shutdown.

The Chinese authorities are reacting promptly and vigorously because they’ve got the data.They know how dangerous this all could be if it becomes a full-blown pandemic.We’ll see if their authoritarian government can manage to suppress this.But if not, I expect western governments stand even less of a chance.

More:

Coronavirus: panic and anger in Wuhan as China orders city into lockdown

Supermarket shelves empty and face masks sell out as residents retreat indoors

Jan 23, 2020

A sense of panic has spread in Wuhan as the Chinese city of 11 million people was put on lockdown in an attempt to quarantine a deadly virus believed to have originated there.

On Thursday, authorities banned all transport links from the city, suspending buses, the subway system, ferries and shutting the airport and train stations to outgoing passengers.

Nearby Huanggang and Ezhou suspended buses, subways and ferries and shut the airport and train stations to outgoing passengers.

In Wuhan, supermarket shelves were empty and local markets sold out of produce as residents hoarded supplies and isolated themselves at home. Petrol stations were overwhelmed as drivers stocked up on fuel amid rumours that reserves had run out. Local residents said pharmacies had sold out of face masks.

Few pedestrians were on the street and families cancelled plans to get together for the Chinese New Year holiday. Special police forces were seen patrolling railway stations. Residents and all government workers are now required to wear face masks while in public spaces.

“When I saw the news when I woke up, I felt like I was going to go crazy. This is a little too late now. The government’s measures are not enough,” said Xiao, 26, a primary school teacher in Wuhan, who asked not to give her full name.

Conclusion

We’re going to be tracking this on an hourly basis.  Wherever you live you should be taking standard precautions right now.Stock up on food, get yourself proper face masks, and be prepared should you need to be locked down for days/weeks.

The chance of that happening in your country may yet be small (for now), but it’s well above zero.So, don’t screw around with this one.

This is the most serious pandemic-worthy risk we’ve come across since SARS.

Of course, as we’ve long advised, you should always be prepared for such an event anyway as part of being a prudent adult.

My own personal remedy kit includes a hefty supply of elderberry syrup which I make from dried berries.You can buy it as well.For those who are scientifically-minded there are numerous peer-reviewed, double blind studies showing that elderberry syrup has pronounced anti-viral activities.

See here and here as well as here.

No, elderberry syrup does not prevent one from getting the flu or a cold. But it does knock the symptoms in half, and it reduces the recovery time by half which means it gives you much better odds: 50% x 50% = 25%

With only a quarter of the ‘experience’ a patient has a much better chance for survival, I figure.I have no idea if it works on this coronavirus, but elderberry syrup has prevented me from getting a full-blown flu or any serious cold for more than a decade.I swear by it.

Beyond that, your best chance of avoiding catching something involves staying away from people, washing your hands fastidiously, wearing a mask when you have to be around others, properly shaming those idiots who proudly show up to events/work sick and coughing, not touching public surfaces (railings, knobs, etc), and never, ever wiping your eyes or touching your nose or mouth before washing your hands.

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