UKH

The air quality must be so much better in regions under lockdown, especially large cities like Wuhan. I wonder if the citizens will mourn the return of diesel and petrol fumes to their streets as thr sanctions are eased.

Has the mortality rate in such cities actually risen, given the amount of deaths that arise from significant air pollution or even motor / traffic accidents?

actually this isn't necessarily true,  many cities have been experiencing worse pollution than normal.  In order to try and boost the economy back into shape the government  relaxed large amounts of environmental restrictions so pollution has increased.

Loads of positive side-effects, e.g.

- It's basically killing the elderly and infirm at a much higher rate than the middle-aged and vigorous, so the NHS should see a drop in demand and a corresponding drop in waiting times, etc. after Covid19 has finished sweeping through.

- Similar bump to disposable cash for the government when a lower proportion of the population as a whole are claiming state pension.

- Decreased overcrowding on all the planes, trains, roads, buses and so on with 2% (about) less people. And very possibly a drop in prices precipitated by this for some things like plane tickets.

- Drop in the prices of home and second hand vehicles as all the people taken by covid19 will leave these behind.

I'm sure one could go on for a long time.

Of course, normal, well adjusted people might think this kind of discussion was incredibly offensive in the face of the prospect of a million dead and mass graves all over the country. I heard it discussed as "bad flu" at some point in the last few days and then I looked up the mortality rate for covid19 vs the flu and trust me, saying covid19 is like "bad flu" is like saying the sun is "a bit warm".

You wouldn't notice.  It would only eliminate about 150,000 of us over 60 wrinkly, bed hogging, pension claiming parasites, by my fag packet calculations.

If you take Spanish Influenza as the base mark bad flu (which is about as bad as flu gets) then that killed between 1 in 4 and 1 in 10. A normal flu kills about 1 in 700. Covid19 kills about 1 in 40. So saying it's like a bad flu isn't too far off the mark.  So if this virus follows a Spanish flu patern then it could infect a quarter and kill 1 in every 160 people on the planet. So if you are standing in a group of 160 people aged 1-80 and add another similar group I wouldn't like to be one of the 80 year olds. 

Based on that it could kill almost 50,000,000 people. 

Best thing I can think of is that it's kept at least one cruise liner off the oceans

But your comparing it to the statistics from a flu epidemic in an immediately post war era with a health system that was 100 years behind our current one. So Covid19 is probably considerably worse than Spanish flu if untreated (and living in squalid conditions). Unfortunately there are many people in the world living in exactly those conditions today.

The world is probably due a population reduction, is about the only one I can think of.  The sad thing is that it'll be quite unfair in how it happens, as poorer countries will be hit much harder.

I think normal people look for a bit of grim humour, something to detract from the potential etc. in the face of bad news. That may not have been clear from my OP. I'm keeping a close eye on the whole outbreak as my own dad would not likely survive an infection and even my wife (given underlying chronic health) could be at risk. The current spread is now quiet worrying. 

It should have a temporary effect on global GHG emissions as a result of less travel and less manufacturing, in a similar way to the global financial crisis back in 2007/8. Unfortunately it's unlikely to last long and will probably be followed by a 'rebound' as countries try to catch up on missed GDP.

Unfortunately many of the seriously/ critically ill patients who go on to survive ARDS will likely have long-term respiratory problems, and my understand is that that Covid can be quite damaging to the kidneys, so that could leave people in need of dialysis (very expensive!!). So these people will fill the openings in nursing homes, social care and NHS budgets. 

Spanish flu killed more like 2-3% not one in 4, and most estimates put covid19 at less than 1 in 40.  But what really is scary is that what ever figures you look at Spanish flu started out much less deadly than the current covid 19 is and it wasn't until the following Autumn that it mutated and became super deadly.  This is why we should get on the quarantine in Europe now while we still have a chance.   Two weeks of intense but small scale quarantine now might save months on end of widespread quarantine down the line. 

The positive I see is that each contained outbreak of a new virus gives more information, impetus and funding to the work going on to understand enough to let humanity “solve” viral infections once and for all.  So each Coronavirus outbreak may contribute towards eliminating all as a threat.  Or this one could be one mutation away from disaster.

IIRC the air quality in the US improved during the flight ban after 9/11.

Am I being over-optimistic in presuming that we'll have a vaccine before the Autumn? 

This would suggest you are.

https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/

A year?

It could have a more dramatic impact than expected....

https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v1

like mumps?

Seems to be a very different pathophysiological mechanism, but I don't really understand the whole "ACE2 receptor" thing (need to do some more reading). 

No, I'm not that keen, thanks.

However those with long term complications are likely to die younger so in this respect less to be supported in old age, less work and state pensions to be paid out. Their offspring MAY have more/earlier inheritance to buy overpriced houses.

Surely that opportunity has past. It seems inconceivable that, with present probably global infections which are likely to be around for the foreseeable future, even island populations would have to totally isolate themselves from the rest of the world. As said on another thread, the best we can do is keep infections as low as possible, hope infection rates decrease in warmer summer months (but southern hemisphere will then be in winter), and hope vaccine available by next winter.

Interesting...I'd be a bit more concerned about that than about getting a bad bout of the sniffles...

Seems unlikely we’ll get one before next year. It’s not even guaranteed at all we find one that is effective, there are 4 other Coronaviruses going around and we never found any vaccine for them.

Regardless of any other considerations, it will have negligible impact on the population numbers.

Well if it kills 2/3% then that’s quite a significant impact, if it infects 60% of the world population then we would have even a small world population decrease

Also if it takes up hospital resources then folk with other illnesses will see reduced healthcare. If medical staff are off work ill themselves or quarantined, you have less health workers. Global supply of food and pharmaceuticals will be impacted. There is a chain reaction of events. 

That's the whole point I think. immunisation for instance doesn't need to be 100% applied, applying it to a randomly distributed proportion of the population has a dramatic effect on the speed of spread, simply because there are less transmission routes. We of course don't have an immunisation but quarantine does the same. Its not there to prevent damage to the carriers, its there to reduce the number of possible transmission routes. and slow down the spread. Health workers will therefore be under less stress because the rate of infection is lower. And then the health workers can more effectively protect themselves. etc etc.

Grown up decisions to come. Quarantine to protect or delay the deaths of a few percent, versus risk recession and many suffer. 

A neighbour of ours works in German healthcare, he says the decision will be over who gets the ventilator, doctors will potentially be deciding the fate of many. 90yr old granny might be allowed to slip away in favour of the overall healthier 50yr old. 

Pretty much every estimate of death rates I have seen puts the figure as 1% death rate which corresponds to one years growth. I wouldn't say that is significant in terms of world population. 

Listening to an economist on the radio yesterday and he was saying that the areas of the world most, economically, affected are those that have implemented some sort of lock down (regardless of whether infections exist) . He seemed to be advocating just ignoring it and carrying on as a few deaths are neither here nor there compare to 'The Economy'.

Well it isn’t on the timescale of civilisation but in the timescale of our lifetimes, yes.

What a load of pish.

1% death rate assumes a large "iceberg" of undiagnosed cases that vastly push up the overall number of infections. WHO are now saying that they don't believe this is the case in China. They think this as it would be impossible for China to have achieved the dramatic downturn in new cases using the containment methods they have if there were loads of undiagnosed people. But they won't know for sure until large scale serology tests are rolled out. 

Search youtube for "Coronavirus WHO" live streamed by the guardian on the 25th (can't seem to do a clicky link on my phone).

If you want a viewpoint on death rates, pathogens, pandemics, hospital priorities  etc.. would you really be trusting global planning on the opinion of an economist?

If I wanted a useful viewpoint on the economy I would be trusting an economist...

I wouldn't but it seems to me that such thinking seems to be becoming more and more prevalent in any talk relating to healthcare

Did you miss out an "n't" there?

Well I suppose the fact it is destroying the markets worldwide will help hide the damage of Brexit.

Did you know economists have predicted nine out of the last five recessions?

The stock market has taken a kicking. Which means that your pensions have taken a kicking. Government growth and spending targets are all over the place (more so than usual). Some economists are saying buy shares on the dip i.e. whist the price is low. Others are saying wait it out, as the dip will be much longer and wider than people may have considered; years rather than months to get back to the baseline.

China has closed factories to reduce transmission. They cant make the widget that company X needs. Company X closes down for a while, until the supply problem resolves. Company Z buys bits from company X etc, etc. The supply chain issue, will take many months to resolve itself. Even if China starts up tomorrow, a container on a ship will take a month to get to Europe. Unless they fly, and the airlines will be happy to do so, as they are down on passenger numbers. So there goes the clean air theory.

On top of all this, global chaos, we have our self inflicted brexit chaos. Plus the normal, run of the mill, NHS in winter chaos. People are panic buying, just to add stress to the stretched supply chains.

The US could be a world leader on on the prevention side, but Trump has put Pence in charge of the US response. So that will work out well. Pence introduced a policy that increased the number of HIV infections in Indiana, and he doesn't think that smoking causes cancer. Who needs science anyway? Doctors are over paid and overrated, everyone knows that.

Good point well made.

We had already started a process if de-globalisation.

The pause button was hit after the GFC, brexit was the signal to go in reverse gear, and this Coronavirus is just going to accelerate this process tremendously.

Not entirely for the worse. Globalisation for all its benefits has created an extremely interdependent and fragile world. 

In the meantime, assuming this goes pandemic, which looks likely, the economic consequences will be brutal.

We are extremely dependent on consumer demand. Think of all the businesses that have only a few weeks of cash on hand. You could easily see a cascade of bankruptcies. Add to that the fact that we are governed by idiots, and that the markets were already in a massive FED induced bubble in the first place, and it doesn’t look good at all.

Interesting conundrum, what is worse, a global recession, or global pandemic killing loads of people?  I wonder what the economist would say if someone in his family was guaranteed to be killed by the virus if it was left unchecked?

Yup, I've just wasted 2 1/2 hours of my working day trying to extract a shipment to Hong Kong from a freight system as DHL are no longer accepting goods for shipment to China, HK and Macao. The spare capacity by air has completely dissapeared due to the large exporters from Europe buying it all up, there is a shortfall of 300,000 containers coming from China which means the same aren't going back. It's f#cking chaos at the moment and won't get better soon. Amazon and the like must already be planning layoffs.

In the short term maybe.  But the more people that catch this the more virus there is out there and the more chance of a mutation which is even worse.   There's a medium and long term aspect to this as well, if we don't get on top of the problem we will get a new disease established like the flu and cold that comes back every year and kills people and has the potential for nastier mutations.  It's also not just immediate deaths, there will be people who survive but with long term health issues.  

I've a feeling that Boris and Trump aren't taking this anything like seriously enough.  They should be using the last few weeks before the sh*t hits the fan to gear up for a massive response like China put in place with quarantines, buildings seized for use as hospitals, stockpiles of medicine, wartime style direction of industry to make necessary equipment, getting people with medical training who have left the profession on courses so they can fill in when current staff get sick. 

 If we don't prepare its going to be their 'reasonable worst case' prediction of 80% of people catching it and 500,000 deaths.  If we prepare and seriously slow it down maybe we can push it out to the summer where it's harder for viruses to spread and then get a few more months to develop treatment and eventually vaccine.

Interesting BBC programme from a few years back that got a recent repeat since the emergence of Covid19.

https://www.bbc.co.uk/programmes/p059y0p1

"Hannah Fry leads a nationwide experiment to help plan for the next deadly flu pandemic, which could happen at any time. How many will it kill? What can we do about it?"

https://www.sciencedirect.com/science/article/pii/S1755436518300306

https://www.google.com/amp/s/www.bbc.co.uk/news/amp/world-asia-51691967

I'm not sure many of us in the West are taking it seriously enough. A mate arrived home from a conference in Madrid on Friday, a big american health care company annual conference. So that is 600 representatives from all over the world congregating in one place and local hotels, Italian delegates advised not to come but did anyway!

Asking for trouble really, but there we are.

http://news.sky.com/story/nasa-images-show-coronavirus-shutdown-has-cleared...

I live in Italy in the Veneto, just north of one of the two "epicentres", in Montebelluna.
Some random musings...
The death rate in Italy is currently 34, with 1700 cases. That's 2% death rate.
I've read that between 40% and 70% will get it. They're saying death rate from Covid is 1%, about 10 times worse than annual flu. Annual flu kills around 8,000 in Italy, I believe.

Based on Italy's population of around 60m, so about the same as UK, and let's say 50% get it. If it turns out to be 1%, that's 300,000 deaths...2% is 600,000.
Do the same maths on the global population and for 1% you come up with 30 million; 2% gives you 60 million, about the same as Wiki's lower estimate for Spanish flu.

So huge, huge increase on annual flu. Feel free to critique my figures, which are probably alarmist, but scare the shite out of me, not because I feel that Corona really presents a threat to me personally, but for my family as a whole, and the social and economic fallout.

My wife has to take an immunosuppressant and my in-laws here are no spring chickens. So starting to get worried. It's coming...I think there's no doubt. The local hospital has erected a marquee tent temporary ward in front of it to serve as a quarantine area for the expected influx. 

I work in a language school. It's one of a group. My boss is CEO of the group. Where I live all the students arrive by car, so the feeling among teachers is let's stay open! It's not in town! Where's the problem? Down the road in Mestre, everyone uses public transport, and the teachers want to close.

One of the other directors said to my boss that he’s never been afraid of death but the prospect of 14 days stuck in the house with his missus scares the shite out of him ))

My take is that it's pretty easy to say people are over-reacting if you have no responsibility for the consequences of that opinion, but my boss is having a torrid time deciding whether to shut down schools because...well...if he decides to stay open and there's an outbreak in the school, where does that leave him from a legal standpoint? And what about his conscience? And I guess that's the problem facing anyone who has to make any decision about public gatherings...schools, supermarkets, restaurants, sporting events, public transport...you name it. So closing things could all be a futile effort to contain the uncontainable, and could have enormously damaging economic consequences, but I'm bloody glad I'm not one of the many people having to decide whether to open or close.

No panic buying here but apparently Padua is a different story. Face masks ran out some time ago. My American mate's mum is sending him a supply from the US!

My wife works in a travel agents...she's had a really tough 10 days what with countries reacting to the news about N.Italy. One client, a technician, flew to Manchester to do some scheduled work on a machine in a factory...turned up at said factory and they wouldn't let him in! Turned round and came back to Italy! She managed to get a holiday group to Miami yesterday 'by the skin of her teeth' by using an Italian airline...because the US airlines are issuing travel bans. Is she being reckless shipping potentially infected people around the globe??

All schools are closed this week...so I can go skiing with my son! So it's not all bad!

I'm wondering if I'll be asked to go back to the NHS, which I would. Keeping a close eye on the situation.

Imperial college published a paper a few weeks ago which was a bit of a master piece in number crunching. There estimates were that if it became a pandemic that 60-70% of the UK's population wound contract it in the first year and 1% would die. So your estimates are cautious if anything.  

From reading stats from China a cfr of 0.7% could be expected if things are kept under control, but the cfr rate from wuhan where demand for medical resources outstripped supply was over 3% (obviously stats from wuhan include deaths from the early days when they were having to make things up as they went along with regard to clinical decisions, so are artificially higher as a result of that). 

I think what it comes down to is how much faith you have in your government and health system!

But let's not forget the poorer countries who will be lucky to get a whiff of oxygen let alone ICU/ventilation, and will certainty have no access to ECMO. Cfr in those countries could be devastating.

I'm part time so waiting for the pressure to increase hours to start.

I wonder if the death rate in China is affected by underlying health problems in the population caused by pollution?  And even the infection rates, if people have poorer health because of environmental factors.

This is interesting. I am UK based and part of my work involves turning up at customer machines to provide operator training. 

We have one customer jumping up and down about some technical delays on their new machine which had pushed my operator training back, now it's all fixed they've been quite demanding and pushy about when someone can get there to do the training (I am the only one in the UK that can do this). 

Or at least they were demanding and pushy until we let them know last Thursday that I was on holiday in Tenerife  

(I got back last night with no fuss)

The 60-70% are the big unknown. Really hard to say how things will develop when spring finally arrives. So far it seems we have dodged the worst case scenario of the seasonal flu and Wuhan coronavirus peaks coinciding.

CB

Problem is covid19 is still going to overwhelm health services regardless.
Just look at situation in south Korea, despite throwing everything at it and having an excellent healthcare system, and having only a relatively low % of the population infected, they still had people dying in the waiting lines.

As for warmer weather, there is no indication that it will help much.

Only thing we can do is to slow the spread as much as possible so that health services can cope better.

But all stakeholders should start planning now, both practically and psychologically.

Unless the virus mutates to something milder the high likelihood is that all of us will know several people who will die from this, and this is likely to be a long drawn battle impacting our daily lives.

The warm weather will end the seasonal flu season, making anyone with flu symptoms an immediate CV suspect. This makes diagnostics and case management much easier. ATM in Germany, the vast majority of CV tests is still negative, as Influenza, RSV, etc., are still doing the rounds.

True but we are entering the stage at which testing doesn’t really matter much anymore.

Don't know, looks a bit too pessimistic to me. Sure, CV already is or will become pandemic, but the 60-70% of the population to be infected over one year seems on the high end of the estimates to me.

CB

Handily that programme used Haslemere as its ground zero which has had several cases of Covid19 already(I am sure some conspiracy theorists are spinning up claims now)

It's got an R value (infection rate) of just over 2 hasn't it? Every person with it infects two others.  Let's take where I live (Guernsey) as an example, 65k population, no cases at present. Let's assume it takes a week to infect the 2 people and someone comes in with it tomorrow. Everyone on island has it within 16 weeks.  Population of the UK (66 million) has it in 26 weeks . All of Europe (741million) has it in 30 weeks. The world (7.5 billion) has it in 34 weeks.  I guess it all depends on the length of time it takes to infect those 2 people.  In a social situation, left unchecked, the infection rate is worse - of 103 people in a social environment in the far east 97 caught it and 8 died.

People worrying about covid19 will probably lead to better hand hygiene that will result in fewer cases of flu and other viruses.

That is a bit simplistic, as R is not a material constant of the virus, but depends on many factors including e.g. population infection levels. In fact, getting R down is the whole point of any public health measures against an agent for which no therapies or vaccinations are as yet available. Get R down, and the epidemy will fizzle out over time. R will also vary across different sections of society, and differently again for different societies (dramatically shown for HIV).

CB

Yes that works quickly and unfortunately in both directions: Fear of HIV caused a drop in classic STDs like syphilis or gonorrhea. Once HAART became widely available, the bacterial diseases bounced right back...

CB

It depends completely on the containment measure we take. 60/70% looks very likely if no measures are taken.

It’s not a matter of being pessimistic or optimistic, it’s risk management. We must plan for the worst case scenario in any case.

At the end of the day we can keep the number of cases open at any one time low enough as long as we keep to doubling time of the number of active cases low enough. But this will require significant disruption to daily life for a long time.

also, there is no guarantee that the thing doesn’t mutate to something deadlier. This is exactly what happened with the Spanish flu, the second wave was much, much deadlier.

Good luck changing people’s filthy behaviours....

Which obviously not what is happening.

Not due to mutation of the virus.

CB

My sister is head of infection control in her hospital and told me yesterday that it has a rating of 11.

What haven’t taken any measures really yet beyond contact tracing.

Wrong. The virus had mutated to a deadlier strain.

Only if you believe wave 1 was more or less the same virus as wave 2, with a few base changes. No evidence at all for that, though, not from sequencing frozen or paraffin embedded samples, not from serum samples, except attributing all flu viruses active at roughly the same time to the same strain. Antigen shift rather than mutation is the big problem with influenza viruses. We had similar events twice in recent years, when the flu strain for the Northern hemisphere winter wave was something new, not the strains already floating around South East Asia, and caught the vaccine guys out. Luckily the new strains jumping in were, if anything, less severe, but that could have ended badly.

CB

From what I’ve read those who got it in the first wave had immunity to the deadlier strain of the second wave.

Presumably this was caused by the circumstances of WWI, very ill soldiers were sent back to the general population whilst those mildly ill would stay away, in effect artificially selecting for a deadlier strain of the virus.

Can somebody explain to me why the airline industry has not been devestated by Coronavirus. 
 

surely with all these “carriers” the airline stewardesses etc would have been severely affected by now. 

Google “Cathay Pacific”

Most of them are able to scale up and down to demand - it’s the nature of their businesses. But nevertheless they are getting absolutely hammered. And we are only at the very start of this.

Yep, Ryanair have cut back on flights to Italy drastically I think.

Understand they are being hammered financially.  I was talking about airline personnel catching the virus. You would have thought there would have been quite a few airline pilots and crew with it by now.  No media reports suggesting this which I find surprising. 

That would be expected in an antigen shift event, unless both surface receptors are exchanged. The severity of the disease also depends on the immune response. Surprisingly, in many viral diseases the tissue damage is caused by the immune cells rather than the virus as such (e.g. Ebola and the other hemorrhagic fevers). During the WWI flu, soldiers housed in barracks under crowded condition were more likely to be infected, but also, as generally healthy and relatively well fed young men with vigourous immune responses they often suffered more damage to their lungs.

That they did not have partial immunity that would blunt the disease progress (unlike the generation of their parents) was another contributing factor, which also helped the virus hit such a large fraction of the world population.

Also, back then the flu usually caused a bacterial overinfection (H. influenzae), against which populations in the West today are normally immunized (at least the main strains), and in WWI there were no antibiotics yet, at least not for large scale systemic use.

CB

I believe that doctors noticed that infection rates varied in differing barracks on the same site and eventually deduced it was related to how close the beds were. Rules were put in place and infection rate dropped. 

DHL have stopped deliveries to China/Hong Kong as well (I´ve just "lost" a shipment), they took a €70m hit last month from those routes.

The sea freight industry is much worse hit though, a shortfall of 300,000 containers per week and just two of the ship owners (Maersk and Cosco) have cancelled 140 ships.

Update on this, I have contacted the customer directly and it is all about me having been to Tenerife, and their CEO being a major hypochondriac. They don't want me anywhere near, for two weeks (and then they have some other stuff going on, so I won't be there until the end of the month actually!)

I had a funny thought that if they annoyed you, you could 'keep going on holiday to Tenerife'.

Positive side effects.

Positive if you have some irrational wish to kill off the “Hollywood” movie industry. The new Bond film release has been bumped back 7 months. Cynics will say it’s for fear of having an embarrassing awkward opening weekend box office tally as people opt to stay home. Non-cynics will praise the studio for removing a dilemma for fans.

Will other studios follow suit with their tentpole summer releases, given that big films seem to be measured mostly by their opening weekend grosses? 
 

1 in 33 and rising.  Taking the momentary ratio (dead) vs (infected) during an exponential growth phase will low ball death rates as many of the infected may yet go on to die from it.

I reckon we’ll reach 1 in 25 in six or seven days.

20% for the elderly on the news today and  all my aunts, uncles and parents in-law are in their eighties.

Seeing off a few more Airlines appears to me to be a rather good outcome. Hopefully it will give a boost to Bus operators.

Not so good if you have a business near Southampton, Newquay, Exeter...

The two possible strategies for dealing with the epidemic are the 'get it over with as quickly as possible' approach, which might be less damaging to the economy, except it would completely swamp the available health resources, and the 'flatten the peak' approach, which seeks, by quarantine, social distancing, cancelling big events etc, to prolong the epidemic but lower the peak numbers to something manageable.

I can imagine the political meeting where this is being discussed.  Boris is fidgeting, having lost track at about the point the first graph was shown and eyes have generally glazed over.  Then Dominic Cummings (who has been paying attention) realises that, by pushing the epidemic into the summer/autumn, the economy should be really starting to pick up again in Q1 2021, thereby demonstrating how wrong all the remainer economists have been all along.  

Suddenly he understands how useful epidemiologists can be, and why the public health strategy is such a good idea.     

All ifs and maybes, as even the experts can't quite agree on just how much risk it  is, future immunity, mutations etc. 

We could take the quick hit now.. many die from overwhelmed health services, then next winter we all catch it again because there is no long term resistance. Vaccines might not work. 

It's just a whole bag of unknowns. 

The pool was almost empty last night, only 2 others in the lanes while I was there. Not sure if it's worry or due to parents being told they had to make a world book day costume for today at the last minute!

How can I get a bus to Gran Canaria? 

On a ferry or cargo vessel obviously.

At last a positive side.

I'm told Starbucks nearly empty and muffins only 1 pound.