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China Coronavirus Watch: Updated – Another Chinese City Locked Down to Prevent Spread

Summary:
It isn’t yet clear how serious a health threat China’s new coronavirus outbreak will be. The 17 deaths attributed to it so far pales in comparison to annual winter flu mortality. [See update at end: Chinese authorities clearly very worried…and per the theme of the post, do they know more than they are letting on, or is this the public health version of fog of war?] Note that as of now, the WHO has not declared this coronavirus outbreak to be a global health emergency. But the speed and severity of China’s reaction, taking the unprecedented step of cordoning the city of Wuhan, is enough to lead worry-warts to think officials might know something they haven’t yet ‘fessed up to. WATCH: Wuhan train station cordoned off as the city of 11 million goes on lockdown to stop the spread of

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It isn’t yet clear how serious a health threat China’s new coronavirus outbreak will be. The 17 deaths attributed to it so far pales in comparison to annual winter flu mortality. [See update at end: Chinese authorities clearly very worried…and per the theme of the post, do they know more than they are letting on, or is this the public health version of fog of war?]

Note that as of now, the WHO has not declared this coronavirus outbreak to be a global health emergency. But the speed and severity of China’s reaction, taking the unprecedented step of cordoning the city of Wuhan, is enough to lead worry-warts to think officials might know something they haven’t yet ‘fessed up to.

Even though Wuhan is a provincial capital, it has a population of 11 million and 600 to 800 daily flights, including direct flights to San Francisco, Tokyo, London, New York, Paris, and Moscow. The Chinese measures are on the order of halting air, train, and other public transport travel from New York City right before Christmas.

However, the “lockdown” wasn’t absolute:

But other images suggest that getting out by car is difficult:

And this suggests road exits are being shut down:

Input from readers who can read Chinese and provide more intel would be very much appreciated. For instance, it would be useful to know if other sources confirm that locals are concerned that the travel limits will affect daily life, or if this is what Lambert likes to deride as “Web evidence”:

China Coronavirus Watch: Updated – Another Chinese City Locked Down to Prevent Spread

Note the figure of 554 cases is confirmed infections; many press reports now estimate the number of infections as in the thousands. There have also been confirmed cases in the US, Macau, Hong Kong, Taiwan, and Thailand.

This tweet gives more confirmation of the strictness of measures within Wuhan:

Recall that the coronavirus is believed to have started at a market for exotic meat; researchers believe it might have originated with snakes. Chinese don’t like eating formerly frozen meat, so these foods are regularly transported in trucks unfrozen; only the bourgeois shop at stores with refrigerator cases. When I visited Bali in the early 1990s, I was disconcerted by similar norms: local markets, with the food market the big draw and stalls with clothing and crafts on the periphery, with vegetables and (hopefully slaughtered that day nearby) raw chicken parts piled up in baskets in the equatorial heat.

This gives an idea of the much more modern, urban version of that type of market in Wuhan:

The Chinese response could come out of post mortems of the 2002 SARS (“severe acute respiratory syndrome”) outbreak. I could easily see that if you are dealing with a new disease that has proven itself to be a killer, an aggressive response early on would be a more prudent approach than waiting to have better data about communicability, vulnerability, and infection modes. In other words, the potential for this outbreak to be SARS 2.0 is ample reason for caution. From Wikipedia:

…an outbreak of SARS in southern China caused an eventual 8,098 cases, resulting in 774 deaths reported in 37 countries, with the majority of cases in China and Hong Kong (9.6% fatality rate) according to the World Health Organization (WHO). No cases of SARS have been reported worldwide since 2004.

A 10% death rate is enough to focus the mind. And again, based on the data out of China so far, it does not yet appear that this new coronavirus is that lethal.

Nevertheless, Mr. Market didn’t like the look of medics in hazmat suits attending the sick and inspecting planes.

The ban on travel out of Wuhan, a city of 11 million, triggered a drop in the Shanghai index of 2% and Hong Kong, 3%. The Nikkei and the ASE also fell.

Bloomberg has some detail on the fatalities:

At least nine victims had pre-existing conditions such as diabetes, coronary artery disease and Parkinson’s disease, the National Health Commission said. Eight were aged 80 or over, two were in their seventies, five in their sixties and one in his fifties. The youngest was a 48-year-old woman with a pre-existing condition. Four of the victims were women and the rest were men.

Causes for concern:

One expert thinks the extent of this coronovirus spread could be much worse than SARS. From Shanghaiist:

In an interview with Caixin, Guan Yi, a Hong Kong University professor specializing in infectious diseases, feared that the scale of the Wuhan virus may be 10 times greater than that of SARS, adding that the situation left him feeling “powerless.”

”I’ve experienced so much. I’ve never felt scared, most of them are controllable, but this time, I’m scared,” he told the news outlet on Thursday in regards to his recent trip to Wuhan to help discern the source of the virus.

Arriving in the city on January 21, Guan was critical of what he saw there including the alarming uncleanliness of local wet markets and the airport, even as the city was on high alert. After only a day in Wuhan, he decided that he needed to get out. He has since put himself into isolation.

When asked for his opinion, Guan was skeptical about how much good the Wuhan lockdown would do, noting that many residents had already left the city for the Spring Festival holiday and that the optimal time for quarantine had already passed.

He also explained that this new virus may prove more difficult to trace than SARS, which was chiefly transmitted by so-called “superspreaders.” So far, health authorities haven’t been able to trace the spread of the virus.

Some of the people who died did not exhibit a fever. This is particularly troubling since it would make it well nigh impossible to determine who has been infected. Again from Bloomberg:

Several people who’ve died from a new virus in China didn’t display symptoms of fever, potentially complicating global efforts to check for infected travelers as they arrive at airports and other travel hubs.

Details released by China’s National Health Commission show five of the 17 people who died after being infected with novel coronavirus displayed other symptoms such as breathing difficulty, chest tightness and coughing. The joint-oldest victim, an 89-year-old male, was suffering from drowsiness and incontinence, as well as a fever. He sought medical help on Jan. 5 and died on Jan. 18. He had pre-existing conditions, including hypertension.

There are rumors of new cases in Hong Kong (note one has been confirmed so far):

And the greater extent of air travel in and out of China greatly increases the risk if this coronavirus proves to be as deadly as SARS:

However, Chinese officials really are not messing around:

But what about people with no fever in China and abroad?

Update 6:00 AM: Via a Wall Street Journal news alert:

On Thursday, authorities in Huanggang—a city of 7.5 million people—said they won’t let long-distance trains and buses run from the urban center and will shut its public transportation system in the lockdown zone, effective midnight Friday local time. Ezhou, another neighboring city with just over a million residents, said it would enact similar restrictions.

Huanggang is about 35 miles east of Wuhan, a city of 11 million and a major hub for travel, where the new pneumonia-causing coronavirus originated. Wuhan just hours earlier halted outbound trains and flights and shut down its public-transportation system.

The Huanggang local government also said movie theaters, internet cafes and other entertainment and cultural facilities in the city center would temporarily halt operations and a central market would be shut down for an indefinite period.

Starting Thursday, the local government said it would inspect every person and car entering and exiting the urban center.

The new restrictions and shutdowns effectively represent a doubling down by Chinese authorities of a high-stakes strategy that experts describe as an untested approach to dealing with infectious diseases.

The BBC is running a live blog.

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