What to do about the Wuhan flu

This was published 27 Jan ’20.  Nothing has been altered (other than this).

What to do about the Wuhan flu?  The short answer is to lay in a month or two of dried food and drink, and have plenty of bottled water around.

The long answer depends on whether the new corona virus (called 2019-nCOV) becomes a pandemic and if the (symptomatic) case fatality rate continues at 3.5% (based on 80 deaths in 2,800 cases as of yesterday).

With a son, Chinese daughter in law and two grandchildren living in Hong Kong, I’ve followed the outbreak ever since hearing of it 1 January.

The best and most current source of info about the outbreak is the South China Morning Post — https://www.scmp.com.  It is in English and is not a government mouth piece.

Here’s the bad news

(1) As of a few days ago the virus had been found in 29/31 Chinese provinces.  This means that confining the virus to China is nearly impossible — how do you cut off a billion or so people from the rest of the world?

(2) Here’s more from today

  • Hong Kong University  faculty of medicine dean Gabriel Leung says research shows self-sustaining human-to-human transmission is already happening in all major mainland cities.   Here’s a link
  • https://www.scmp.com/news/hong-kong/health-environment/article/3047813/china-coronavirus-hong-kong-medical-experts-call
  •  Why is this significant?  You have to know how docs operate.  When I wanted information about some issue or disease, I’d call a doc whose opinion and background I respected.  It is likely that Leung made this statement after calling med school deans he personally knew in major mainland cities.

(3) There is no treatment, in the sense of stopping the virus in its tracks.  All we have is supportive care, oxygen rest, medication for fever, bronchodilators.  This is true for the vast majority of viruses.  Remember the joke that modern medical science can cure a cold in 14 days, but otherwise it takes two weeks.

(4) We know that you don’t have to be clinically ill to transmit the disease.  Screening new arrivals for fever is well and good but that won’t totally prevent spread.

(5) Some individuals are what is called ‘superspreaders’ — one individual infected 15 hospital personnel.

(6) I wouldn’t hope for a specific treatment any time soon — look how long it took to get any treatment for AIDS, despite the huge amount of resources devoted to it.

Here is some good news. It is quite possible that there are many more cases out there with people who were either asymptomatic or  just mildly ill.  The classic example is polio, in which for every case with paralysis there were 99 cases with mild GI illness or nothing at all.

This will need to wait until we can test people for antibodies to 2019-nCOV to find out how many people have had it.  This is probably at least a month away

Vaccines (if they can be made) are even more months away.  We’ll just have to hunker down and hope for the best.

Why lay in dried food ?– in a pandemic people will panic and clear out all food they can get their hands on.  There were pictures of empty bins in a Wuhan food market last week.

People are getting serious about it.  From Reuters -“U.S. President Donald Trump offered China whatever help it needed on Monday”.  It would be nice to have some of our people from the Center for Disease Control over there. Hopefully the Chinese won’t be too proud to accept the offer.

Addendum 28 Jan — apparently the US (in the form of the CDC) is begging China to let them help out — sad — why should they have to beg?  Apparently the first overture was 3 weeks ago ! ! ! ! — https://www.scmp.com/news/china/article/3047967/china-coronavirus-washington-asks-beijing-permission-send-health-team

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Comments

  • Mark Thorson  On January 28, 2020 at 7:58 pm

    It’s not just food. N95 facemasks are in short supply. I know people say facemasks are useless, and I’d agree that the facemasks used in clinics are mostly effective for outgoing droplets when people cough. Incoming air tends to go around those masks. Incoming air is what you want to filter for protecting the lungs, and the masks used by painters and sanders do that. They are N95 masks.

  • luysii  On January 28, 2020 at 9:27 pm

    Quite true — I didn’t put this in because I didn’t want to make the post too long. On my two past trips to China, on most crowded streets you’d usually see someone wearing a face mask. It was explained to me that they were being used to protect people from the wearer.

    On rare occasions I had had to do consultations in an isolation unit. The masks that really protect you are quite uncomfortable.

  • David Crook  On April 14, 2020 at 9:58 pm

    I understand your statement about polio but the 1% of those children ended up in iron lungs.
    As an older man, I remember the pictures of rooms filled with machines children could not live without until a vaccine was developed.
    Good article though.

    • luysii  On April 15, 2020 at 6:21 pm

      Thanks for commenting: I certainly remember Sister Kenny and the iron lungs (https://en.wikipedia.org/wiki/Elizabeth_Kenny). However the 1% in iron lungs refers to the symptomatic cases which are 1% of the total cases, so even if you are infected the chance of winding up in an iron lung is .01%.

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