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BREAKING: Is the 1934 Bayer anti-malarial, Chloroquine, a potential Covid-19 breakthrough treatment?

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And, why is that (which was announced yesterday by Mr Trump) not top- of- fold headline news everywhere?

Bayer, US, has announced, March 19:

>>Bayer today announced it is joining the U.S. Government’s fight against COVID-19 with a donation of 3 million tablets of the drug Resochin (chloroquine phosphate).

Resochin, a product discovered by Bayer in 1934 and indicated for prevention and treatment of malaria, also appears to have broad spectrum antiviral properties and effects on the body’s immune response. New data from initial preclinical and evolving clinical research conducted in China, while limited, shows potential for the use of Resochin in treating patients with COVID-19 infection.

Bayer in recent days has been in talks with the White House, HHS, CDC, and the FDA, offering any assistance we can provide with a focus on donating Resochin to help in the government’s efforts to combat the virus.

Currently not approved for use in the United States, Bayer is working with appropriate agencies on an Emergency Use Authorization for the drug’s use in the U.S.

Bayer thanks the Trump administration for moving quickly to enable this donation and will continue to work closely with the administration to support its efforts in the fight against COVID-19. >>

Here is Mr Trump’s announcement during what seems to be the now daily Covid-19 White House Covid-19 task force briefing:

No, ABC, it is not merely touting. In recent days, a leading researcher in France has posted a breaking news peer-reviewed report on a clinical test, which has shown remarkable success, which is all over the French language Youtube space, e.g. AP:

Yes, March 4, TWO WEEKS AGO.

The Paper’s Abstract:

>> Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open- label non-randomized clinical trial

Abstract

Background

Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the role of hydroxychloroquine on respiratory viral loads. 

Patients and methods

French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day 6-post inclusion was considered the end point.

Results

Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.

Conclusion

Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/ disappearance in COVID-19 patients and its effect is reinforced by azithromycin.  >>

Going back 15 years, this should not be surprising, as SARS — a closely similar corona virus [some call Covid-19, SARS2], was reported in the virology literature as responsive to Chloroquine:

>>Virology Journal
2, Article number: 69 (2005)
Research Open Access Published: 22 August 2005

Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

Abstract
Background
Severe acute respiratory syndrome (SARS) is caused by a newly discovered coronavirus (SARS-CoV). No effective prophylactic or post-exposure therapy is currently available.
Results
We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection of primate cells. These inhibitory effects are observed when the cells are treated with the drug either before or after exposure to the virus, suggesting both prophylactic and therapeutic advantage. In addition to the well-known functions of chloroquine such as elevations of endosomal pH, the drug appears to interfere with terminal glycosylation of the cellular receptor, angiotensin-converting enzyme 2. This may negatively influence the virus-receptor binding and abrogate the infection, with further ramifications by the elevation of vesicular pH, resulting in the inhibition of infection and spread of SARS CoV at clinically admissible concentrations.
Conclusion
Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds. >>

In short, there has been reason to look seriously at Chloroquine, for fifteen years. That’s why John Delingpole has a point, and a right to ask a pretty pointed question:

>>It ought to be no surprise that chloroquine is effective against both SARS and COVID-19. After all, they are both coronaviruses and COVID-19 has often been described in medical and research sources as SARS-2.

Chloroquine works by enabling the body’s cells better to absorb zinc, which is key in preventing viral RNA transcription – and disrupting the often fatal cytokine storm.

As at least one person has noticed, the implications of this are enormous. If the medical establishment – including CDC – has been aware of the efficacy of chloroquine in treating coronavirus for at least 14 years, why has it not been mass produced and made available sooner?>>

So, should we be focussing significant attention on Chloroquine? Should we be asking pointed questions on how our polarised media may distort our consideration of crucial issues? END

U/D: There is a further report, giving a summary, vid:

Money shot clip of remarks by US Rep Mark Green, a former US Army Flight Surgeon:

The old reliable Malaria drug chloroquine, the newer version hydroxychloroquine has shown really good, three studies, one in Australia, one in China and now one in France mixed with azithromycin, just the old Z-Pac that we take for bronchitis, has had 100%.  It cleared the virus, in some cases in three days,  that cocktail in every one of the patients in that study . . . It’s very promising, 100% of the virus gone in six days!

Let’s see if this holds up. If so, a breakthrough.

U/D, Mar 22: US vs other per capita Covid-19 death rates (HT, PowerLine):

Clipping:

Our friend Brian Sullivan has updated the international mortality table that I posted a few days ago, through yesterday. It shows deaths per million of population in 12 Western European countries, South Korea and the U.S. The blue bar shows the per capita death rate (per million) as of March 16, the orange bar as of March 20 . . . . Italy has the highest mortality rate by far, at 67 per million. It is too early to gauge the ultimate course of the epidemic, but in crude terms it looks as though Italy is heading for a death rate of something like 100 per million. It could easily go higher than that . . . . let’s assume the U.S. ultimately sees a mortality rate of 100 per million. That would be 143 times the current U.S. rate, not outside the realm of possibility. Do the math: if we have around 330 million people, and 100 die per million, that equals 33,000, which would be equivalent to the deaths from an average seasonal flu season. Maybe it’s worse than that; maybe by the time it runs its course, the death toll from COVID-19 rises to 200 per million, 286 times the current rate. That would still be less than the death toll from flu in the U.S. just two years ago.

That gives us some perspective that should help us to turn from over-wrought, deeply polarised rhetoric and political posturing. Then, let us refocus the key point here, there are hopeful potential treatments.

U/D Mar 23: From European CDC, trackers on rate of growth of cases to March 20, in days since hitting 100 cases:

Notice, how China is an outlier on the high side, and Singapore on the low side. Both Canada and the US are in the general European band, Canada happens to lag the US as things got out of containment there later it seems.

U/D Mar 24: As there was a debate overnight on “bell” curve impulses, let us look at the impulse-cumulative effect curve for “serious” cases of Covid-19 for South Korea, which seems to be among the best for statistical records:

We here see a lin-lin plot [cyan] of the cumulative cases, showing a sigmoid with of course statistical noise. Superposed, to a different scale, is number of fresh cases, shown as a bar chart. The pattern is clear, and is as expected. Notice, the jump in slope at the 909 peak, topping off the concave up part, then the emergence onward of a concave down pattern. The worst day, ironically, marked the point of inflexion where the cumulative case curve began to flatten out.

Next, with that in mind, let us look at the general pattern, using log-lin plots that allow read-off of growth rates etc as we explored yesterday:

The general sigmoid pattern still appears, obviously, but in a different format. Here, we see that the general pattern once initial lodgement achieves breakout is an early, quasi-exponential growth. In effect, we face an invasion and the first cases form bridgeheads that are prone to breakout, posing a challenge to stabilise by imposing a saturation before the natural one of infecting enough for herd immunity to stop further spread.

Stabilisation is obviously a major challenge.

Notice, too, the “main stream” at doubling every 2 – 3 days that was discussed yesterday. It is notable that the low-rate outliers are asian countries with experience of earlier dangerous epidemics or at least outbreaks, within the past 20 years. That suggests, institutional learning that we may find it advisable to tap. And, it suggests that the policy consensus for Europe and North America is significantly less effective.

Finally, as a reminder, here are impulse-bells for China and South Korea, overlapped in time:

135 Replies to “BREAKING: Is the 1934 Bayer anti-malarial, Chloroquine, a potential Covid-19 breakthrough treatment?

  1. 1
    kairosfocus says:

    BREAKING: Is the 1934 Bayer anti-malarial, Chloroquine, a potential Covid-19 breakthrough treatment?

  2. 2
    kairosfocus says:

    Let’s see how we respond to positive news of potential hope. I see from Vivid’s link in another thread: >>On Thursday, Trump spoke at length on specific treatments to combat the virus, including the anti-malaria drug chloroquine. “We’re going to be able to make that drug available almost immediately,” Trump said at Thursday’s briefing.>> KF

  3. 3
    Seversky says:

    Obviously, any promising therapeutic agent should be tested as soon as possible.

    Should we trust the scientific knowledge of a President who claimed the F35 fighter is fitted with something like a Romulan cloaking-device?

    Should we rely on the word of a scurrilous Breitbart/tabloid journalist on such issues?

    Not without confirmation from more competent sources, I think.

  4. 4
    ET says:

    They are already using chloroquine to treat covid 19. It is being used in China, Italy and the USA.

  5. 5
    Truthfreedom says:

    @3 Seversky

    Obviously, any promising therapeutic agent should be tested as soon as possible.

    And obviously you are not going to tell those scientists you love so much that all their efforts and millions of lives being saved thanks to them amount to no-thing and bear no merit because, according to evo-materialism, they are meat-robots.

    “Your decisions result from molecular-based electrical impulses and chemical substances transmitted from one brain cell to another. These molecules must obey the laws of physics, so the outputs of our brain—our “choices”—are dictated by those laws”.
    Jerry Coyne, the dim-witted biologist
    https://www.chronicle.com/article/Jerry-A-Coyne-You-Dont-Have/131165

    Or will you?

  6. 6
    FourFaces says:

    The US FDA (filled with Obama appointees) is trying to delay fast action on the use of chloroquine on COVID-19 patients. There are powerful lobbyists and representatives of vaccine research companies that stand to lose a lot of money if a cheap medication can eradicate COVID-19. Corruption is rampant in the health industries. It’s ugly.

  7. 7
    bornagain77 says:

    Seversky, seeing as you believe, without any real evidence, in the ‘magic’ of Darwinian evolution to turn microbes into man, perhaps you can excuse me for not being too overly impressed by your personal ‘expert’ opinion on who is being scientific and who is not being scientific.

    Thus, of the ten characteristics of pseudoscience listed in the Skeptic’s Dictionary, evolution meets nine. Few other?pseudosciences—astrology, astral projection, alien abduction, crystal power, or whatever—would meet so many.
    https://creation.com/is-evolution-pseudoscience

  8. 8
    john_a_designer says:

    Antibody therapy is another promising, yet overlooked, approach to combating the COVID-19 pandemic.

    Distributed Bio co-founder and CEO Dr. Jacob Glanville revealed on “The Story with Martha MacCallum” Thursday that his company’s laboratory is three to four weeks away from engineering a therapeutic antibody to combat the coronavirus.

    “What my company is doing is adapting antibodies to recognize and neutralize the novel coronavirus. So this would … [be] sort of skipping what a vaccine does,” Glanville said. “Instead of giving you a vaccine and waiting for it to produce an immune response, we just give you those antibodies right away. And so within about 20 minutes, that patient has the ability to neutralize the virus.”

    https://www.foxnews.com/media/dr-jacob-glanville-antibody-neutralize-coronavirus

    I talked to my doctor at a scheduled appointment yesterday. He told me that while antibody therapy is not as overall as good as a vaccine it does give patients very good temporary or “passive” immunity not the long lasting “active” immunity one gets from a vaccine. However, on the other hand, according to Glanville the response to the antibody therapy is very rapid. It can take days or weeks for the immunity from a vaccine to take effect. With antibody therapy it’s virtually immediate– “20 minutes.”

    Another approach is to use blood plasma from recovered COVID-19 patients to be used in transfusion. This therapy was first pioneered over 100 years ago during “the 1918 Spanish flu outbreak.”

    Scientists also turn to the blood of patients who have recovered from COVID-19 as a possible stopgap treatment for the most at-risk people. Because their blood plasma is presumably full of protective substances like antibodies, if it’s injected into sick people, it may help them fight off disease. It’s an old strategy and dates back as far as the 1918 Spanish flu outbreak in the United States, when doctors reported that it helped reduce the number of deaths in seriously ill patients. Recently, it’s been used on an experimental basis to treat people with MERS, H1N1, and Ebola.

    https://www.theverge.com/2020/3/19/21186569/blood-coronavirus-patients-treatments-infection-covid-19

  9. 9
    kairosfocus says:

    Sev, you obviously did not read the OP; which was about two peer reviewed papers and a donation by Bayer because of effectiveness. As for Mr Trump, he is obviously — obviously — speaking based on expert advisors, several of whom were standing around him. Start with the Surgeon General and Dr Fauci. I suggest, you may find it helpful to read. And, Mr Trump is in a position to know about expediting approval. KF

  10. 10
    Seversky says:

    I watched the press conference and it was obvious that Dr Fauci was trying to damp down the unrealistic expectations that Trump was trying to raise. Fauci called the data from these small trials “anecdotal”. Larger trials are in the works.

    I’ll make one prediction here. Based on the history of the Trump administration, don’t expect Dr Fauci to be around much longer if he continues to contradict the narrative Trump is trying to push.

  11. 11
    kairosfocus says:

    Sev, Of course, hope here is not certainty, however it is equally the case that the relevant papers I cited, 15 years apart, are far more than “anecdotal” or just so stories. Next, Bayer didn’t give 3 million tablets to the US on a whim, nor has it notified regarding potential on a whim. Observe here, too:

    . . . Recently, the China National Center for Biotechnology Development indicated that chloroquine is one of the three drugs with a promising profile against the new SARS-CoV-2 coronavirus that causes COVID-19. Chloroquine repurposing was investigated in hospitals in Beijing, in central China’s Hunan Province and South China’s Guangdong Province. According to preliminary reports [50,51] from the Chinese authorities suggesting that approximately 100 infected patients treated with chloroquine experienced a more rapid decline in fever and improvement of lung computed tomography (CT) images and required a shorter time to recover compared with control groups, with no obvious serious adverse effects, the Chinese medical advisory board has suggested chloroquine inclusion in the SARS-CoV-2 treatment guidelines. As a result, chloroquine is probably the first molecule to be used in China and abroad on the front line for the treatment of severe SARS-CoV-2 infections.

    That is a tad more than anecdotal, and it offers legitimate hope. Of course, drugs are poisons in small doses and due cautions are to be noted. Where, the history of this drug with malaria points to onward issues of drug resistance. Such duly noted, this is a hopeful prospect, given the further point from this article:

    In vitro, chloroquine appears as a versatile bioactive agent reported to possess antiviral activity against RNA viruses as diverse as rabies virus [16], poliovirus [17], HIV [12,[18], [19], [20]], hepatitis A virus [21,22], hepatitis C virus [23], influenza A and B viruses [24], [25], [26], [27], influenza A H5N1 virus [28], Chikungunya virus [29], [30], [31], Dengue virus [32,33], Zika virus [34], Lassa virus [35], Hendra and Nipah viruses [36,37], Crimean–Congo hemorrhagic fever virus [38] and Ebola virus [39], as well as various DNA viruses such as hepatitis B virus [40] and herpes simplex virus [41].

    Basic antiviral chemical potential is not seriously in doubt. The question is to bridge from glassware to the living body. That’s what the initial trials are supporting. And it seems this drug is hitting Covid-19 hard. (Of course, reducing virus load to an observed zero point is not the same as being effective . . . significant reduction without necessarily eliminating would buy time for bodily defences to act through the ordinary immunity response. Though calling that “ordinary” is a bit understated.)

    It remains the case, further, that Mr Trump is in a position to know about expediting, never mind dismissive language. KF

  12. 12
    kairosfocus says:

    PS: I cannot but note how you have tried to pull a discussion on a serious possible antiviral for a pandemic into Trump bashing. I think you need to look at focus, priorities and tone.

  13. 13
    Truthfreedom says:

    @Seversky
    If there is no ‘goal/ purpose’ in anything according to naturalism:
    – Why is H. sapiens fighting against COVID-19 with all its might? Lots of people are risking their lives to stop the virus.
    Would you say they are not exhibiting a clear purpose? Some have died helping others. And more suffering is yet to come.

  14. 14
    bill cole says:

    Seversky
    March 20, 2020 at 6:31 pm
    I watched the press conference and it was obvious that Dr Fauci was trying to damp down the unrealistic expectations that Trump was trying to raise. Fauci called the data from these small trials “anecdotal”. Larger trials are in the works.

    Hospitals have ordered as much hydroxychloroquine in the first 17 days of March as they did in all 2019. Bottomline is the scientists are not businessmen. The global data is overwhelming that it works and doctors can prescribe it off label as the medication is 70 years old.

  15. 15
    Ed George says:

    I certainly hope that this proves to be a wonder drug. Fingers crossed.

  16. 16
    kairosfocus says:

    BC, interesting. Consistent with pickup in news. BBC had big concerns from Nigeria over people self medicating and poisoning themselves. I am hearing Chloroquine may be OTC in some jurisdictions, like Acetaminophen . . . notoriously hepatotoxic. I see in searches stuff about Pakistan sending 300,000 tabs to China; consistent with trials. I also note that on that ship in Japan, a fair number with infections were asymptomatic. KF

  17. 17
    kairosfocus says:

    EG, these days, sadly, there are no enduring wonder drugs. This virus has already split into two forms that can be caught in succession. My guess is no one drug will fix it as drug resistance will be coming. I have even seen issues over antiseptic/disinfectant resistance. We need an arsenal of antivirals and alternative treatments. It’s an arms race out there. But, with some good grace, this drug will save lives and help to flatten the surge of infections, allowing health services and facilities to avoid being saturated and overwhelmed. I am also hoping that fast moves to a vaccine will be successful, but note how 35 years on, there is no vaccine for HIV. I am also seeing where this virus may lurk for years, threatening to re-emerge, doubtless in a mutated form. KF

  18. 18
    kairosfocus says:

    Clip from comment in corona thread, Doctors are already moving on using Chloroquine in the US. https://videos.files.wordpress.com/ZGnxuWby/dr-william-grace-says-chloroquine-is-already-being-used-in-us_dvd.mp4?fbclid=IwAR2C_-eBA0IjeDfE4tr7mpjQR6G3t493BAwxpsVILuK7LNRnMotAFr2b1pQ Dr Wm Grace suggests “we are all using it” [appar, esp. for serious cases] KF

  19. 19
    BobRyan says:

    We don’t need a wonder drug for something less lethal than the flu. The average age of death by COVID-19 in Italy is 81. They have the oldest population in Europe. It would be like an outbreak occurring at a large retirement community and expecting the same death toll at a college town. The media has caused panic and governments overreact to panicked people.
    COVID is not a new virus and most people in the world have antibodies for the current mutation. That’s why 80%, at least according to the WHO, who get COVID-19 will show mild to moderate symptoms.

  20. 20
    kairosfocus says:

    BR, it seems there are several mortality issues at work. This is highly novel and highly virulent, in ways tied to viability in air for hours and on surfaces for days. Already, that trends to 20 – 70+ percent of population getting it on SIR-derived models, if it breaks out of containment for this first spreading. Next, if an impulse of infections is high enough, it saturates and overwhelms staff, equipment and facilities for care for cases with severity and complications. There is an age and precondition issue with deadly cytokine storm threat, biasing dangers to older people. Pneumonia lurks. Such then triggers a surge in deaths. That’s why something that makes it easier to successfully treat is immediately a life saver in multiple ways. Buy time for vaccinations to be developed, which then pushes up incidence of immunity and creates herd protection. We have a fight, but the signs are, a winnable one. KF

  21. 21
    bornagain77 says:

    Dr. William Grace of Lenox Hill Hospital in New York City discussed the benefits of the drugs with host Laura Ingraham. – video

    Grace says the data shows the drugs work.
    “And the results of those tests that show that hydroxyl chloroquine alone and the synergism between the drugs hydroxychloroquine and azithromycin, the results of that testing was only one chance in ten thousand that that could have happened by chance alone,” Grace said. “That’s highly significant data.”
    https://www.foxnews.com/media/malaria-drugs-touted-by-trump-can-work-against-coronavirus-top-doc-tells-laura-ingraham

    “there appears to be an effect of hydroxychloroquine, and a notably stronger effect (down to zero virus as measured by nasal swab) of the hydroxychloroquine – azithromycin combination. That’s the result that’s getting the attention, and justifiably so.”
    – Graph
    https://blogs.sciencemag.org/pipeline/wp-content/uploads/sites/2/2020/03/HCQ-768×410.png
    Coronavirus: Some Clinical Trial Data
    https://blogs.sciencemag.org/pipeline/archives/2020/03/19/coronavirus-some-clinical-trial-data

  22. 22
    kairosfocus says:

    U/D: I added a vid clip to OP on how Chloroquin with Z-Pac has had dramatic effect. Let’s see if this holds up. Could be, very good news indeed. KF

  23. 23
    kairosfocus says:

    BA77, thanks. Amazing, how what looks like promising news, is not getting positive, top of fold headlined coverage. Orange man bad is “touting,” exaggerating, lying seems to more be the focus for the usual suspects. KF

  24. 24
    Jim Thibodeau says:

    So, it just came out that intelligence officials warned Trump about this virus in January.

  25. 25
    ET says:

    And what else was going on in January? Anyone? The ignorant house democrats’ impeachment.

    Way to take the focus off of real world problems and pursue your personal agenda.

  26. 26
    Jim Thibodeau says:

    What else happened in January is that Trump held rallies in Miami, Toledo, Milwaukee, Wildwood, and Des Moines, and spent time at his resort, while refusing to do his job.

  27. 27
    ET says:

    So the impeachment didn’t take any resources away from the government? Or is Jim just an ass?

  28. 28
    Ed George says:

    KF

    EG, these days, sadly, there are no enduring wonder drugs. This virus has already split into two forms that can be caught in succession.

    If I didn’t know better I might conclude that evolution is going on here. 🙂

  29. 29
    ET says:

    Acartia Eddie never fails to see a moment to equivocate.

  30. 30
    Jim Thibodeau says:

    If Trump had time for 5 political rallies in 5 different states in one month he had time to do his job. And time to tell his officials not to go on tv in Feb and lie about how the virus is being contained.

  31. 31
    Truthfreedom says:

    Do not forget that the ‘theory of evolution’ can not explain viruses, the most abundant organism on Earth. Common descent does not work with viruses.

    If viruses are not alive, they are not part of the ToE (‘species’ are groups of living organisms).
    If viruses are alive and the ToE can not explain them, the ToE fails.

  32. 32
    Seversky says:

    Ed George @ 28

    If I didn’t know better I might conclude that evolution is going on here.

    We’d better hope so.

    The only other explanation is that the Designer or designers really have it in for us.

    Verse:

    “Infamy! Infamy! They’ve all got it in for me!”

  33. 33
    Ed George says:

    An interesting comparison is Canada and the US. Infections started at roughly the same time. As such you would expect the number of infections and deaths in Canada to be approximately one tenth of that in the US. But US has ~20,000 (276 deaths) as compared to ~1,000 (12 deaths) in Canada. It would be interesting to see how the two countries differed in their responses.

  34. 34
    kairosfocus says:

    Folks, this is not a thread about political points scoring but about an epidemic and possible treatment; cf. OP. That said, by about end Jan IIRC there was a US travel ban that targetted the country of emergence. KF

  35. 35
    Truthfreedom says:

    Didier Raoult, eminent french microbiologist and the more prolific French scientist, anytime, in any field, is a rabid anti-Darwinian:
    https://www.thethirdwayofevolution.com/people/view/didier-raoult

  36. 36
    Truthfreedom says:

    @32 Seversky

    The only other explanation is that the Designer or designers really have it in for us.

    Or that ‘reality’ is ‘not real’ (Novella dixit.)
    Is COVID-19 ‘real’, Seversky? 🙂

  37. 37
    ET says:

    Acartia Eddie:

    An interesting comparison is Canada and the US.

    Apples and oranges. The population density of Canada is no where near that of the USA. And population density is the key.

  38. 38
    Truthfreedom says:

    Calm down people. Materialists are solving the crisis. COVID-19 is 50 ‘real’ and 50% ‘not real’.
    Schrodinger’s COVID 🙂

  39. 39
    Ed George says:

    KF

    That said, by about end Jan IIRC there was a US travel ban that targetted the country of emergence. KF

    Closing the barn door after the horse has fled.

    But banning direct flights did not stop people from making connecting flights. I think we can all admit that stopping international travel was too late, and the only impact it had was to delay it.

  40. 40
    ET says:

    Had Trump declared an emergency in January the left would have went more bananas than they are now. When he put the travel ban in place the left went bananas.

    AGAIN- Trump is NOT a doctor. Trump is not a scientist. And Trump is not a technician. He acted swiftly to institute a travel ban. And if the left weren’t so ignorant we would have had a solid southern border that couldn’t be breached.

    China smooched the pooch. Not Trump.

  41. 41
    ET says:

    Acartia Eddie:

    Closing the barn door after the horse has fled.

    China’s fault. And it prevented more infusion of the virus.

    I think we can all admit that stopping international travel was too late, and the only impact it had was to delay it.

    And yet the left berated Trump for doing it too soon.

  42. 42
    kairosfocus says:

    JT, it was an emerging threat so Intel briefings are in order. Action followed by end of month. It looks like the US has had a bigger breakout from attempted containment than Canada so far; with the level of contagiousness, that is unsurprising. KF

  43. 43
    Truthfreedom says:

    To COVID-19 or not to COVID-19 in the materialist ‘Matrix’. Shakespeare pass the joint 🙂

  44. 44
    Truthfreedom says:

    I have a doubt: if we not perceive reality ‘as it is’, how can you materialists know it?
    Is COVID-19 as we are perceiving it? Or is it only an ‘approximation’?
    Science needs all your philosophical wisdom 🙂

  45. 45
    Truthfreedom says:

    *do not perceive*.

  46. 46
    Ed George says:

    Illinois has a population of ~13 million. Ontario’s has a larger population, ~15 million. Both have similar urban/rural densities. Illinois has 585 cases and five deaths. Ontario has 318 cases and two deaths.

  47. 47
    kairosfocus says:

    EG, notice that Govt ministers and their families are catching this? Take it as a sign of novelty joined to contagiousness. That this is hard to contain is manifest. That said, Americans are far harder to regulate than other similar countries historically. KF

  48. 48
    Ed George says:

    KF

    EG, notice that Govt ministers and their families are catching this?

    Case in point, the wife of Canada’s Prime Minister.

    That said, Americans are far harder to regulate than other similar countries historically. KF

    That is because of fear of reelection, not lack of government authority and power.

  49. 49
    Truthfreedom says:

    Hundreds of thousands of feminista spreading COVID-19 on 8-March manifestations (Spain, 3rd country with more infections right now), lots of them already with symptoms.
    Maybe feminism is an ‘evolutive strategy’ to spread COVID-19?
    Who knows, who knows…
    Ed George, is this behavior moral or amoral? You were very worried about churches and the ‘oldies’. People are dying thanks to the 8-M festivity.

  50. 50
    kairosfocus says:

    EG, my thinking goes back to April 19, 1775 and beyond. Americans have a distinct, diverse culture and that includes an allergy to regulation by officialdom. For some things, good; here it is a disadvantage. Note, novelty and high contagiousness, that does not mix well with attempts to contain an epidemic. On the other hand, doctors are already prescribing Chloroquine never mind the feds. KF

  51. 51
    Ed George says:

    KF@50, I am not disagreeing with this but I think that the US system of government has contributed to the severity of this.

    Ignoring the orange narcissist who currently resides in the White House, the President has remarkable unilateral powers under a National security emergency. After the January briefing the President had the legal authority to shut the country down. But COVID-19 hit just months before a Presidential election, one in which the sitting President is seeking re-election. Any President who invoked the extensive shut downs in January that we now have would likely be successful in nipping the epidemic in the Bud, at least in the US. But this would almost certainly be at the cost of reelection. A president and government that truly puts its citizens’ interest above their own, may have taken these actions. Rather, we have seen hesitancy and personal gain through insider trading.

  52. 52
    john_a_designer says:

    People like Bob Ryan @ 19 need to understand what flattening the curve means.

    https://healthblog.uofmhealth.org/sites/consumer/files/2020-03/Coronavirus_flattening_curve_1.jpg

    If you look at the image above, you can see two curves – two different versions of what might happen in the United States, depending on next steps.

    The tall, skinny curve is bad – it means that a lot of people will get sick at once, in a short period of time because we don’t take enough steps to prevent the virus from spreading from person to person.

    Most people won’t get sick enough to need a hospital. But those who do could overwhelm the number of beds and care teams that our nation’s hospitals have available.

    https://healthblog.uofmhealth.org/wellness-prevention/flattening-curve-for-covid-19-what-does-it-mean-and-how-can-you-help

    In other words, if we don’t flatten the curve in the U.S. and do so quickly the number of COVID-19 cases could very quickly could overwhelm our medical system which would mean that more people would die than really need to because they couldn’t get the care they needed.

    Of course there is another balance that will need to be addressed at some point: how much damage do you allow to the economy? If we allow business shut downs to go on too long that could cause irreparable long term damage to the economy along with civil unrest, an increase of crime and possibly famine etc. It could even spawn other pandemics. How long is too long? That is a question that we should be concerned about.

  53. 53
    Truthfreedom says:

    @52 John_a_designer:

    If we allow business shut downs to go on too long that could cause irreparable long term damage to the economy along with civil unrest, an increase of crime and possibly famine etc. It could even spawn other pandemics. How long is too long? That is a question that we should be concerned about.

    Reality check. Reality, my dear materialists, is ‘real’. Not your crazy stories about ‘hallucinations’ and related non-sense.
    Actions have consequences. It is something that you can not/ do not want to understand.
    Hunger, sickness, death, suffering.
    Your materialism will not create, never, ever, the utopia you seek out.
    This is a fallen World.
    Pray Darwin.

  54. 54
    kairosfocus says:

    EG, given labour costs, where would there be a major supplier of protective equipment, starting with face masks? What was beginning to happen there, since Dec-Jan? What happened to manufacturing there as a result? And if that is a dominant supplier going effectively off-line at the same time as a demand surge, what is the predictable result on basic economics, the study of scarcity? KF

  55. 55
    kairosfocus says:

    JAD, I have seen gdp falloff estimates up to depression levels. However, if there is a good drug cocktail that is effective enough, that is a potential game changer. That leads to the primary focus above, on a possible candidate. KF

  56. 56
    AaronS1978 says:

    Seversky no offense but this “the designer has it in for us” is remarkably lame

    Please get the actual numbers on the coronavirus and study it, we’ve had five prior to this in the states, this is novel, and it doesn’t imply that the dumb designer has it in for us.

    This is no black plague (some how people still believed in god and the absolute worst Estimates of the coronavirus still don’t even come close to the deaths by the Black Plague) this is no airborne leprosy

    Recent study just found that many people actually carry the damn disease and don’t even know what they are asymptomatic
    This of course will be reported as these asymptomatic people are dangerous and should be treated no differently than John carpenters the thing, It will certainly not be reported that these people are not affected by the virus and have a great chance of survival

    The thing that has it out for us is our lack of knowledge on it, and the panic that is going on about this

    A panic that scares me far worse than that virus

    If anything people have it out for us not the designer

  57. 57
    AaronS1978 says:

    Actually could carry

  58. 58
    Seversky says:

    AaronS1978 @ 56

    Seversky no offense but this “the designer has it in for us” is remarkably lame

    Okay, a lame attempt at levity but humor is a human response to critical situations that helps put them in perspective. Look at “M*A*S*H*” or the brusque humor amongst members of the emergency services or armed forces. It helps.

    The thing that has it out for us is our lack of knowledge on it, and the panic that is going on about this

    A panic that scares me far worse than that virus

    Agreed

    If anything people have it out for us not the designer

    The Magic Designer some people in could stop this pandemic in its tracks with a Jedi-like wave of His hand given His alleged powers.

    But in the absence of Divine providence it’s going to be up to good ol’ materialistic science as usual to find a cure.

    Verse:

    “A person is smart. People are dumb, panicky dangerous animals and you know it.” Agent K, Men In Black

  59. 59
    Belfast says:

    Interesting data points here. Sev, Thib, Eddie are rabid Never Trumpers. On an issue where he is involved they assume the stance irrespective of relevance. More data needed for a hypothesis but do materialists herd politically?

  60. 60
    Ed George says:

    Belfast

    Interesting data points here. Sev, Thib, Eddie are rabid Never Trumpers.

    I’m not American so I don’t get a say in who you elect. That is the job of the Russians. 🙂

  61. 61
    Truthfreedom says:

    @ Seversky

    It is going to be up to good ol’ materialistic science

    Science.
    Not: materialistic science.
    And thanks science for good ole thalidomide. Those monkey brains…

  62. 62
    Ed George says:

    Belfast

    On an issue where he is involved they assume the stance irrespective of relevance.

    Trump was definitely downplaying the risk even after he was briefed by the experts. Being the narcissist that he is, he blamed initial criticism of his response to the virus as a Democrat hoax to make him look bad. On the one day when the market temporarily rebounded he took credit for the ‘LARGEST SINGLE DAY INCREASE EVER’.

  63. 63
    AaronS1978 says:

    ??????? Think of it this way if

    Ye designer is not a genie waiting to full fill all of our wishes and dreams, and according to many religions that doesn’t happen until you make it through this life, Comically in Christianity you will find peace by being with God nowhere in there does it say that God’s going to still fill all of your wishes and dreams

    If much of this test is based off of faith in God coming down and saying yo I am here nothing will harm you because I said so kind of defeats the point it also defeats the point of having our own will and living to our own accord

    Certainly kills any room for opinion on the matter that’s for sure and you really wouldn’t have a choice in any of it either, a Malevolent designer certainly would give you that choice

    Material science and science in general follows the rules that are preset in this universe to begin with

    The fact that science even works is a reason why I believe in God

    I’d rather learn how to deal with something then just haven’t given to me but that’s my personal opinion

    But I know when I do learn I’m better for it and the fact that there’s an answer to everything comforts me

    Lastly any designer that’s capable of creating a universe might be a little bit beyond our comprehension and I am guilty of this too, but placing that designer at a human level is its own fallacy

  64. 64
    AaronS1978 says:

    The ???? Was supposed to be an emoji but it didn’t work

  65. 65
    Truthfreedom says:

    @63 AaronS1678
    Excellent post.

  66. 66
  67. 67
    AaronS1978 says:

    Malevolent designer wouldn’t give a choice, stupid talk text, what happened to the ability to actually correct some of the stuff I notice you can no longer go back and make corrections within 20 minutes

  68. 68
    ET says:

    Materialistic science is an oxymoron.

  69. 69
    ET says:

    The President’s job is to avert panic. He did that. Thankfully Acartia Eddie isn’t a citizen of the USA.

  70. 70
    Truthfreedom says:

    Philosophical naturalism =/= from methodological sciences.
    Dogma vs part of reality.

  71. 71
  72. 72
    Jim Thibodeau says:

    Trump didn’t want to let people with the virus off of that boat because he ‘didn’t want his numbers to go up because it wasn’t his fault.’ They lied and claimed it was contained. The world health organization offered them tests and they refused them. Then he put Pence in charge so he’d have a scapegoat. He’s a narcissist and scared he wouldn’t be reelected and people are going to die who wouldn’t have.

    Revisionist history acting like he took it seriously is high nonsense.

  73. 73
    ET says:

    Easily correcting Jimmie: Fact Check Update: U.S. Never Rejected WHO Coronavirus Tests; They Were Never Offered

    Perhaps you should just shut up, Jim.

  74. 74
    BobRyan says:

    The fact remains the flu is 60 times more lethal than COVID-19. The media caused a panic, which resulted in overreaction by governments, including the Trump administration. It should have been treated the same way as COVID-2, SARS, was. The panic cost the global economy billions. The overreaction from governments will cost trillions.
    California declared a state of emergency before there was a single case of COVID-19. Italy has an aging population, the oldest in Europe, and we know the elderly are more susceptible to the COVID virus, all strains, which means Italy is going to have inflated numbers compared with younger populations. The average age of death via COVID-19 is 81.
    The current mutation did not suddenly make an existing virus the Spanish Flu. The Trump administration is not handling this the right way and has not from the start. In order for the Stafford Act to be used, it has to be on a state by state basis. By enacting it, he has violated the 10th Amendment and the Interstate Commerce Clause, which means he should be impeached for violation of the Constitution.
    The Constitution does not allow for Trump to do what he did and should be removed. Previous impeachment did not show a single US Code violation, which means he did not commit a crime and should never have reached the Senate. You cannot have a high crime or misdemeanor, any violation of US Code, with an actual law being broken.

  75. 75
    AaronS1978 says:

    Bob Ryan I agree with a lot of what you’re saying but where do you get the numbers that the flu is 60 times more lethal then Covid-19
    I would like those numbers actually so I can shove them down one person’s throat and get them to shut up if these are correct because I can’t find these on the CDC

  76. 76
    BobRyan says:

    You have to parse through a lot of data to get there. We know the COVID virus, all mutations included, is highly contagious, but not particularly lethal. Most people already have anti-bodies, which is why the WHO’s own report says 80% of the people who contract COVID-19 will show mild to moderate symptoms, which means the vast majority of people who contract it will never be tested for it. South Korea is the one doing mass testing and they’re the ones showing the low rate of death compared to the flu.
    China claims the number of about 86,000 people infected, but we also know China’s government is less than honest with any information. Wuhan is the 7th largest city in China, with an estimated population of 11,000,000. Considering just how contagious COVID is, it would be impossible to have less than 10,000,000 infected in Wuhan alone. Everyone there goes to the markets and the conditions in China are ripe for transmittal of viruses far worse than COVID, like bird flu.
    China claims there are just over 3200 dead, which is likely a low number considering the population of China. They most likely have deaths throughout the country they aren’t acknowledging are COVID related. Given China’s track record, we’re probably looking at closer to 30,000 dead with at least 300,000,000 infected. If the rate was as high as the WHO claims it could be (not is), than not even China could hide the numbers.
    The WHO gave a similar report with COVID-2, SARS, with much the same predictions. The same people susceptible to SARS are susceptible to COVID-19. Just because a virus mutates, does not guarantee more lethality. According to the NCBI, CDC, WHO, they claim as high as 10% of the people who contract the current virus could die, which is exactly what they said about SARS.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329048/

  77. 77
    AaronS1978 says:

    Thank you for this that was helpful

  78. 78
    BobRyan says:

    South Korea has a lower average age than Italy by about 5 years. Older than the United States, but by about 4 years. South Korea has done a lot of testing for COVID-19 and give a much more honest assessment of the numbers.
    South Korea has 5,884 infected, with 59 in serious or critical condition listed as active cases. This shows 99% of the people with COVID-19 to have mild to moderate symptoms. The closed cases 2909 discharged and 104 dead. Many of these were before serious testing started. Based on the active cases currently in South Korea, the 99% is a more accurate assessment than what the WHO is claiming.
    The WHO is basing their 80% on China being an honest country, as they did with COVID-2. South Korea is far more open with their country and their data is open to independent verification. South Korea’s raw data shows 3% of total dead, but most of the closed cases happened prior to testing, which artificially inflates the numbers much higher than they actually are.

    https://www.worldometers.info/coronavirus/country/south-korea/

  79. 79
    Belfast says:

    More data points from the resident Never Trumpers. Graphs shaping up.

  80. 80
    kairosfocus says:

    U/D: I have appended to the OP a graphic of per capita mortality rates, HT PL. While Canada is not in the list, Italy, S Korea, Germany, the UK, Spain and France are. The US is down with Austria as lowest per capita, though the rate doubled in four days. Maybe Canada on Mar 16 and 20 is even better, but the comparatives suggest that the US is indeed doing fairly well on flattening the curve and has been doing so for the past month or so. We can infer this, as with 14 days incubation and 17 days typical from symptom onset to dying, deaths reflect more or less what was going on with infections a month ago and what has been going on with care since. Polarisation against Mr Trump [an international phenomenon] is distorting perception of the US’ relative performance, and PL’s comparatives to typical annual flu seasons should give us pause before we indulge in overly panicky or polarised rhetoric. At the same time, we should realise that if care facilities and staff are overwhelmed by a surge, death rates will spike and reflect Wuhan and Italy rather than S Korea and Austria. This then brings in the economic and health implications of a linked economic panic. It is possible to trigger far more, displaced deaths if our reaction to the pandemic triggers a serious recession or worse. Those deaths won’t be from Covid-19, but from other causes — typically, chronic complaints — that economic stringency and hardship or disruptions make it harder to manage. We must make well informed prudence into a watchword. KF

  81. 81
    kairosfocus says:

    JT, there is a rather obvious and legitimate reason why cruise ships with surges of infectious diseases, including Covid-19, are subject to quarantine. Here, we can ponder two vessels especially, one in Japan, one in California it seems. Over-wrought polarised rhetoric and accusations are unwarranted and tell us much [again] about how you have dealt with issues here at UD. You are, by your own report, a researcher in relevant fields. Why not refocus on the actual focus for this thread, the possibilities for the apparently promising cocktail of drugs, hydrochloroquine + azithromycin; also, other possibilities? That would be a far more constructive thing to do and might even help us feed things through to policymakers in at least my neck of the woods. KF

    PS: I take it, that you are willing to accept PL’s rebalancing on remarks about how Mr Trump allegedly called Covid-19 a hoax. That was manifestly irresponsible reporting by too many supposedly serious media houses. It is part of why their credibility sinks by the day, in a polarised age in which many operate on guilty by accusation.

  82. 82
    Truthfreedom says:

    @ Seversky, Ed George, Bob O’H, Jim Thibodeau, MatSpirit, Mimus…
    Where exactly are mathematics in our brains?
    Everything is the result of evolution processes and ‘physical’ in nature according to you.
    Please explain the evolutive origen/ story of mathematics?

  83. 83
    kairosfocus says:

    ET,

    great link from WUWT. Looks like the leading climate change narrative critique blog is showing itself to be a useful source on developing sci-tech issues. So much for “climate denier” rhetoric meant to taint with holocaust denialism. I particularly note the reference on lipid coat, which instantly highlights why good old soap and water are highly effective sanitisers.

    Things get serious with this on the envisioned mechanism, a twist on the action of Chloroquine in relieving rheumatoid arthritis:

    The viral S protein binds to the epithelial cell wall’s angiotensin-converting enzyme 2 (ACE2) receptor. Raising lysosomal pH changes (via indirect enzymatic action) the ‘shape’ of ACE2 enough that the S protein cannot bind to it, thus preventing cell infection. Chloroquine changes the cell ‘lock’ so the viral ‘key’ doesn’t work. Does not undo damage from infected cells, nor prevent an infected person from shedding existing viable virus, but does stop the spread in an infected person’s body—a promising therapeutic for those testing positive.

    Notice, too:

    the main FDA legal issue (FDCA Act of 1906 as amended) issue is to determine dosing and duration for this new indication. But for starters, the standard RA 250mg once a day generic cheap pill should suffice for emergency use authorization (EUA). As a ‘Big Pharma’ goodwill gesture, today (3/19) Bayer announced it donated 3 million 250mg chloroquine phosphate pills to the US to get started.

    That of course carries us back to where the OP begins.

    And, bonus, we have a clinical suggestion and a note on the main bad side effect retinal damage esp for the over 50’s:

    the main side affect is retinopathy [vision problems] in 25% of patients over 50 that resolves [slowly] after discontinuation

    We have a start point.

    Let’s hope others will take due note from your contribution.

    KF

  84. 84
    kairosfocus says:

    PS: More substance to chew on, on another possibility:

    Remdesivir

    This is a novel antiviral from Gilead that has a somewhat checkered past. It was originally developed for Ebola, where in African trials a few years ago it was shown reasonably safe but not very effective. It did, however, show efficacy against SARS and MERS in vitro. And, importantly, the NEJM reported a positive case outcome in Seattle patient zero under a compassionate use exception. The patient had visited Wuhan, returned to Seattle, began displaying symptoms, and was hospitalized on symptom day 3. By symptom day 8 X-ray showed clear lower respiratory tract viral pneumonia (diagnostic ‘ground glass’) and supplemental oxygen was started. Patient worsened, and intravenous antibiotics were started day 9. Patient worsened (proving viral pneumonia), so attending physicians consulted with FDA then had Gilead rush the experimental drug by air, with intravenous treatment starting day 10. Patient improved in 24 hours, was saved, and has since been discharged. For those interested, there is this NEJM case report providing a very hopeful proof of principle.

    The reason Gilead tested it against SARS and MERS even though those two episodes died out naturally has to do with Remdesivir’s novel mechanism of action. The ‘drug’ is just an analog of the amino acid adenosine, one of the 20 amino acid (only, in all life on Earth, proving a common genetic ancestor) building blocks the viral polymerase uses to ‘assemble’ new copies of the viral RNA genetic code. The polymerase does not recognize the small difference between adenosine and the analog. Flood an infected cell with enough remdesivir molecules, and the polymerase will eventually grab one and add it to the ‘building’ RNA copy. Remdesivir is enough different that the polymerase is then blocked from adding any more amino acids to the RNA chain, so viral replication halts. Neat very basic molecular genetics provided at a basic science 101 level.

    What Gilead scientists recognized was that the RNA code for Ebola RNA polymerase was very similar to SARS and MERS RNA polymerase, hence the in vitro testing. And when the Chinese first published the roughly 30,000 base RNA code for Wuhan coronavirus in January, it was evident immediately that it was another good RNA polymerase match, so they started immediate in vitro testing once viral samples were in hand.

  85. 85
    Truthfreedom says:

    I am asking because mathematics are very useful in our everyday lives and to model this pandemic.
    – Evolution gave rise to brains with in-built mathematics.
    – Those mathematics helped H. sapiens to prolongue their lives/ understand their environment.
    – If they helped us, they were ‘beneficial’.
    – Are mathematics subjected to ‘Natural’ Selection? Maybe genetic drift?
    If evolution explains everything, it has to explain mathematics.

  86. 86
    kairosfocus says:

    TF, those who impose a priori evolutionary materialism believe that somehow through natural selection we were programmed with brains capable of mathematics. They fail to demonstrate observed causal adequacy to create required functionally specific complex organisation and/or associated information [FSCO/I henceforward] but if there is only matter and energy in reality, then that programming by blind chance and/or mechanical necessity MUST have happened. This of course is circular but institutional dominance allows getting away with it. Likewise, that this system undermines credibility of mind will be dismissed. As you can see, those beyond the pale who ask questions will normally be dismissed on some handy excuse. Only institutional and even civilisational collapse will force rethinking, as Athens showed. KF

  87. 87
  88. 88
    john_a_designer says:

    Very early on this thread @ #8 I discussed “Antibody therapy [as] another promising, yet overlooked, approach to combating the COVID-19 pandemic.”

    https://uncommondescent.com/ud-newswatch-highlights/breaking-is-the-1934-bayer-anti-malarial-chloroquine-a-potential-covid-19-breakthrough-treatment/#comment-695579

    The LA Times has a recent article “How the blood of coronavirus survivors may protect others from COVID-19,” which makes the point that with “a U.S. vaccine as much as 18 months off and effective treatments still unidentified, some scientists believe that convalescent plasma could provide a bridge to safety.”

    As U.S. scientists race to stave off a tidal wave of COVID-19 patients, they are showing renewed interest in a little-known medicine with ancient roots and many modern applications: convalescent plasma.

    It’s medicine now coursing through the veins of at least 86,690 people in China and elsewhere, all of whom have joined a fraternity of potentially powerful healers. These are people who have been infected with the novel coronavirus and survived.

    Scientists believe the antibodies generated by these recovered patients’ immune systems will protect them from reinfection, at least for a while…

    The use of recovered patients to help the sick and not-yet-infected is widespread in modern medicine.

    Anyone who’s been bitten by a rabid animal, received a bone marrow transplant or given birth to a child has probably received a form of convalescent serum. They’re used to boost the immune response to rabies infection, to protect cancer patients from acquiring the herpes virus during a bone-marrow transplant, and to protect babies from contracting cytomegalovirus from their mothers during childbirth.

    Convalescent plasma was widely used during the three-year West African Ebola epidemic that ended in 2016, though its effectiveness was not rigorously studied. More recently, it has been used to treat people with Middle East respiratory syndrome, or MERS.

    https://www.latimes.com/science/story/2020-03-20/how-blood-from-people-who-survived-covid-19

    In my opinion we need to be trying a shot gun approach in which we are looking at a number of different promising approaches and fast tracking testing and approval for the best of them. Again, the therapy discussed in the LA Times provides a bridge to a viable vaccine which by best estimates is over a year off. Convalescent plasma therapy while it does not provide long term immunization like a vaccine it does fight the same way a vaccination does with antibodies. However in this case it’s not your body’s own antibodies but somebody else’s who has already recovered from the disease. The therapy also has the potential to act as a short term prophylactic to protect those who are a risk.

  89. 89
    kairosfocus says:

    F/N: Yet more https://wattsupwiththat.com/2020/02/14/wuhan-coronavirus-wuwt-update/ Note on spreading:

    The bad news is that Wuhan IS transmissible during some later part of the symptomless incubation period. The definitive clinical proof (there was comment debate about the reliability of previous post evidence from Japan and Germany) is an age 50’s UK male who attended an about 100 person sales conference in Singapore 1/20-1/22 2020. A single individual from Wuhan also attended this conference and was–per Singapore Wuhan containment policies– symptomless on arrival (no fever, no cough). That either symptomless or very early symptomatic individual transmitted Wuhan to the UK citizen in Singapore. The UK individual then flew to France for a 4-day family ski vacation 1/24-1/28 at Le Contamines-Montjoie. During the 4-day vacation the UK male remained symptomless (entire incubation time Singapore plus France at most 8 days) but transmitted Wuhan to 11 other individuals, 5 later diagnosed in UK (family and friends), 5 later diagnosed in France, and 1 later diagnosed in Spain. Clearly this case is NOT family close proximity contact transmission. This case may be a “super spreader” outlier, BUT it means a symptomless R0 as high as 11 cannot be ruled out, with a symptomless transmission period of several days. By comparison, the R0 for measles (absent vaccination) is 12-18, so a horrific Wuhan symptomless R0 of 11 is within the realm of actual possibility.

    This is VERY bad news, as the formal CDC guidance on URI’s is that transmission risk is highest with peak symptoms (equating to peak virion shedding)–as was the case with SARS. Not so with Wuhan, reinforcing the public health necessity of strict 14-day quarantine.

    KF

  90. 90
    kairosfocus says:

    JAD, yup, a serious point, on borrowing someone else’s antibodies. Apparently, that worked for 1918 too, or was at least tried. The timeline to a vaccine may be slow, too, not good. However, the news on drugs is worth watching and and monitoring. KF

  91. 91
    Jim Thibodeau says:

    I’m critical, so I have to give credit where credit is due, I looked back on all of the posts and comments related to coronavirus over the last month on this site, and while several people were downplaying the seriousness of it, saying the flu is much worse, etc., giving the Fox News/Trump line, Kairosfocus was actually taking the virus seriously by late February. So kudos to him.

  92. 92
    kairosfocus says:

    JT, pardon but the issue is not being critical [or, critically aware even] but the deep polarisation of our civilisation that is reflecting in what is now low grade civil war in the US; also, it is echoed in a very condescending and dismissive or demonising attitude to the US [and UK] hinterland “peasants revolt” by ballot box. Messrs Trump, Johnson et al are faces, not the driving force; undermine them and others will rise or worse we will see a faceless mass movement of fatal disaffection that will become just that, fatal. The case of Syria, Palestine and Egypt, post the 628 mutual exhaustion of the Byzantine Empire and the Persians, is a classic with consequences to today. It should be clear, too, that I have a concern regarding the pandemic AND the danger of needlessly triggering global recession which can be damaging and even deadly through displaced deaths. China’s economy dived hard, in part pulling oil with it, there is now an economic contagion secondary to the global epidemic of tickling the dragon’s tail with the world economy. We need very prudent, well balanced action to stay on the tightrope. KF

  93. 93
    Ed George says:

    KF@80, as interesting as this is, you are comparing all countries at two points in time. Italy an Spain saw their first deaths a few weeks before the US did. A better indication would be to track these numbers normalized for the date of the first death. In this way you could possibly determine whether the differences are due to different age demographics, different population densities, different actions taken, etc.

  94. 94
    bornagain77 says:

    NY State to Begin Testing Malaria Drug in COVID-19 Battle
    By Margaret Besheer – March 21, 2020
    NEW YORK – New York’s governor said Saturday that the state would conduct trials immediately on a malaria drug combined with an antibiotic that has showed promise in a French study in treating COVID-19, which is caused by the coronavirus.
    “There is a theory the drug treatment could be helpful,” Governor Andrew Cuomo told reporters Saturday during a news conference.
    He said there were people in serious condition and that the state’s health officials were comfortable trying the treatment on those patients. The U.S. Food and Drug Administration was sending New York 10,000 doses of the drugs, known as hydroxychloroquine (a malaria drug) and Zithromax (an antibiotic).
    “As soon as we get those doses, we will work with hospitals, doctors and families on using those drugs and seeing where we get,” Cuomo said.,,,
    https://www.voanews.com/science-health/coronavirus-outbreak/ny-state-begin-testing-malaria-drug-covid-19-battle

  95. 95
    ET says:

    Earth to Jim, If you were critical then you wouldn’t be an evolutionist. If you were critical you wouldn’t post your easily refuted trope.

  96. 96
    kairosfocus says:

    EG, I gave the info as it came in, I am not source. KF

  97. 97
    Truthfreedom says:

    @86 Kairosfocus:

    TF, those who impose a priori evolutionary materialism believe that somehow through natural selection we were programmed with brains capable of mathematics.

    Which is non-sense. And yes, evolutionary materialism is an imposition.

    They fail to demonstrate observed causal adequacy to create required functionally specific complex organisation and/or associated information [FSCO/I henceforward] but if there is only matter and energy in reality, then that programming by blind chance and/or mechanical necessity MUST have happened.

    Yes. A MUST that needs a logical explanation that never arrives.

    That of course is circular but institutional dominance allows getting away with it.

    Yes. Poor circular reasoning that explains nothing. Materialism is über-dogmatic.

    Likewise, that this system undermines credibility of mind will be dismissed.

    Yes, conveniently dismissed.
    Materialism leads to absurdity because it does not conform to reality.

    As you can see, those beyond the pale who ask questions will normally be dismissed on some handy excuse.

    Yes. The darwinian jihadists ignore, ridicule and bully. Look at what happened to Thomas Nagel (he is not a theist, but dared to attack darwinian evolution).

    Only institutional and even civilisational collapse will force rethinking, as Athens showed.

    Yes. Sooner or later it will have to happen.

  98. 98
    Ed George says:

    KF

    EG, I gave the info as it came in, I am not source. KF

    I realize that. My point is just that it is almost important to draw any significant conclusions from it because of the way it is presented. If it was normalized from the start of infections in each country, it could be used to draw potentially valuable conclusions. As the date of the first infection in each country would be almost impossible to determine, the date of the first confirmed death in each country is a good second best.

    Sadly, this sort of analysis will do little to impact the current pandemic, but it could provide valuable information for the next one.

  99. 99
  100. 100
    kairosfocus says:

    EG, in fact not even categories such as infected with covid-19 or died of it are consistently measured across countries. We have crude statistics and refined numbers will be for academics of the future. That said, the cumulative deaths per capita for the US, to date, is low compared to other leading countries. The further point is, that it is the overwhelming of the health care system that pushes death rates up. With an increasingly credible cluster of potential standard treatments coming online, I am inclined to the view that we are not going to see a runaway pandemic infecting 20 – 70+ percent of the world population. That is why the news on potential standard treatments is a strategic focal point. KF

  101. 101
    kairosfocus says:

    AS78, looks like the low grade civil war proceeds. Sadly. KF

  102. 102
    kairosfocus says:

    BA77, yes, it looks like some progress is ongoing, KF

  103. 103
    AaronS1978 says:

    KF
    agreed
    I believe she committed career suicide to snub Trump

    And sadly you are right I thought the same thing till this will definitely divide the country especially if she tries to say that she blocked it because there weren’t any rights for pro choice in there

    Currently having people being forced to not work and then not having any form of stimulus because of the government forcing everybody not to work is possibly one of the worst things I’ve ever seen

    No matter what her reasoning is this was a very bad decision on her part because diseases don’t care about politics and fear caused by diseases can bring out the worst in people

  104. 104
    BobRyan says:

    For the Stafford Act to be used, a state must be in a state of emergency. No state can claim a state of emergency based on what will be, but what it. A state must show the situation is beyond what the state can handle. Ohio, for example, has 77% occupancy of beds in hospitals and the state has not reached the threshold to qualify as a true state of emergency. Most states have not reached that point, which means most states do not qualify under the Stafford Act.
    Any state receiving funds that do not qualify is an impeachable offense against the president. The House controls the money, which means the House must approve the use of the money in most circumstances. The House should move to immediately impeach President Trump the moment he uses the Stafford Act for any state that does not qualify under the Act.

  105. 105
    BobRyan says:

    The only thing the Trump Administration should be doing is having the Attorney General send a cease and desist order to every governor who has shut down business. By shutting down businesses, it has a negative impact on interstate commerce. No state, for any reason, can do anything that excessively burdens interstate commerce.

  106. 106
    kairosfocus says:

    BR, there is, regrettably, a pandemic. That is the equivalent of a state of global war. If we have a net death rate of 1% and infection rate of 50%, over this year we may see 39 million or so additional deaths, roughly the casualties of the European aspects of WW2. We know this is highly contagious and that it is a killer with bias to the elderly and those with preconditions. We further know that if hospital facilities are overwhelmed, death rates will surge. Such warrants using what is now called social distancing, quarantining and border control to break the spreading cycle, requiring several weeks. Once, this has got out of containment into a community. In much of the US, it has. Unfortunately such a lock-down has financial and economic consequences, and it is a reasonable step to try to provide financial cushions that allow people to survive and allow businesses to avoid going under. Global and national GDPs are going to take a hit, we need to try to avert a down-spiral into depression. Depression, itself is a killer. KF

  107. 107
    kairosfocus says:

    AS78, I think you allude to Ms Pelosi. While I spoke more generally, it is obvious from recent events that we see a degree of polarisation that has led to reckless use of reserve powers of government to impeach, in disregard of the ever-present natural law of justice that governs all of our rational, responsible behaviour, much less government. Principles such as first duties of reason, to truth, to right reason, to prudence [so, warrant], to sound conscience, to neighbourliness, to fairness and justice etc. Those have been disregarded in pursuit of power, manifested in ruthless, nihilist6ic factionalism. Even references to the US Constitution are tainted by the associated legal positivism. let me be clear, through an historical reference: star chamber tactics and guilt by piled on accusations are never acceptable. In this context, to imagine that a crisis must not be allowed to go to waste, to push through a polarising agenda, is manifestly wrong. That sort of behaviour, which is all too manifest in the media and chattering classes as well as among too much of the political class of the US, is manifestly wrong and ruinous. But, once deep polarisation amounting to low grade civil war has set in, that is very hard to break — just look above, where politics and scapegoating were repeatedly injected into a thread of discussion that should have been about serious possible cures. One trusts that enough of the electorate will take due note of what is going on and will make their displeasure so manifest that it will check the folly. KF

  108. 108
    Ed George says:

    KF

    That said, the cumulative deaths per capita for the US, to date, is low compared to other leading countries.

    This is true but there are a couple complicating factors involved. The other countries with high infection rates started their infections a couple weeks before the US. We will have to wait a couple weeks to see. The other factor is that the other countries with high infection and death rates also have high population densities.

    The further point is, that it is the overwhelming of the health care system that pushes death rates up.

    And it is this that the current actions are trying to minimize. Hopefully chloroquine will help with this. But it is likely that it will not be prescribed until people are already in the hospital. If it shortens the time of hospital stays, that will be a great benefit. But I am always skeptical of cures that are spread in the media during times of fear. Even if effective they may cause more harm than good by people mis-using them, as we have already seen in a couple instances.

  109. 109
    kairosfocus says:

    U/D: I found and appended a tracker on growth rate of Covid-19 cases by country. China is high outlier, Singapore low outlier, with both the US and Canada on the general European band. The difference is, Canada seems to have hit 100 cases later than the US, we can take that as a threshold for breakout from containment. KF

  110. 110
    kairosfocus says:

    EG, notice today’s update, which shows the US and Canada are on the same growth path, along with the Europe band. Canada just hit 100 cases later than the US. Eyeball Mk I suggests, about 10 days behind. KF

  111. 111
    Truthfreedom says:

    Ed George
    Are viruses ‘alive’? 🙂
    If they are not, how can your theory of ‘evolution’ explain them? Remember that ‘species’ are groups of living entities.
    *On the Origin of Species*. Am I wrong?

  112. 112
    kairosfocus says:

    TF, viruses are not alive, they are in effect parasites on cell based life. KF

  113. 113
    Truthfreedom says:

    Kairosfocus:
    But parasites are living entities. The theory of ‘evolution’ supposedly explains the arising of new species. (groups of living entities).

  114. 114
    Ed George says:

    KF@110,

    Canada just hit 100 cases later than the US.
    But why is that? Both Canada and the US both saw their first cases at the same time. Both countries have most of their population in large cities. As of March 13, Canada had tested more people per capita, covering a broader range, than the US did. But we should compare populations of similar density. Chicago and Toronto have roughly the same population (~2.8 million). Toronto has 220 cases and Chicago has 519. Toronto has one death. I couldn’t find the total deaths for Chicago but Illinois has 9, and approximately 50% of cases are in Chicago. Interpret that as you would like.

    Illinois has a population of 12.7 million as compared to Ontario’s population of 14.6 million. Illinois has 1049 cases and Ontario has 410.

    In most comparisons, Canada has numbers approximately half of what we would expect based on US numbers, assuming everything else is equal. All I am saying is that these differences are worth looking at. They may not be relevant or significant, but we won’t know until we look.

  115. 115
    Ed George says:

    Sorry, only the first sentence should be in blockquotes.

  116. 116
    kairosfocus says:

    EG, testing makes little difference to when the breakout begins, that is probably a random distribution, the issue is the virus is so contagious. Second, we see that Canada and most European states are following more or less the same track. So, if the US is dismally failing in its efforts, so is Canada, so is the bulk of Europe per the pattern. In fact the real issues of management would be to find a way to lock out, which seems hard. Then, to find a treatment. That is happening now and it is likely that this will dominate the onward path of the epidemic. Beyond, lies a vaccine. KF

  117. 117
    Truthfreedom says:

    Ed George
    Are viruses ‘alive’ or not? 🙂
    How can a drug ‘kill’ something if it that thing is not ‘alive’? 🙂

  118. 118
    Truthfreedom says:

    Can I i.e. kill my laptop?
    Is the immune system morally reprehensible for ‘killing’ viruses? 🙂

  119. 119
    Ed George says:

    KF

    EG, testing makes little difference to when the breakout begins,

    True, but it can make a huge difference in the quick and effective implementation of preventive actions. The infections started in Canada and the US at about the same time. And both countries have similar population densities for the majority of their population (densities, not overall numbers). It still is worth examining why Canada’s numbers are roughly half what would be expected based on relative population alone.

    Note: Ontario, Canada’s most populous province, just announced that they are closing all non-essential businesses until further notice.

  120. 120
    kairosfocus says:

    EG,

    wrong. Kindly, note the U/D to the OP above, showing a log-lin plot across various countries for number of [officially recognised] cases post 100. Observe too, the benchmark lines showing slopes for various doubling times.

    China is an outlier for fastest spread, Singapore for slowest.

    Clustering in the neighbourhood of 2 and 3 day doubling period are the European countries and their North American Extensions, US and Canada. The difference is only that Canada as at Mar 20 was lagging the US in that band by about 10 days.

    With a highly infectious epidemic and well before saturation effects [natural or imposed] come in, effective growth after breakout from confinement will be quasi-exponential. That plots as a straight line with a given slope. Real data will be noisy and wobbly as a result. Then as saturation comes in, the line will curve over, flattening out.

    Further to this, the bloc of countries including US and Canada are exhibiting very similar dynamics; if one reflects alleged mismanagement, so does the other.

    The difference between the US and Canada can be eyeballed, Canada’s breakout from initial containment of the bridgehead lodgement happened about ten days after the American one. Lodgement was not prevented, reflecting a weak point somewhere, and breakout was not prevented, reflecting another weak point somewhere.

    In military terms, with finite resources a defence cannot be strong everywhere, the game is to try to hold off lodgement then impose a saturation as soon as possible, the power of the opponent is beyond our simple control. In that light, the issue is to impose a low saturation, by trying to break the onward transmission. Effective treatment will hopefully suppress death rates, social distancing and quarantine across a full latency cycle will help to impose saturation.

    Beyond, vaccination will impose a strong everywhere defence, via herd immunity.

    This will then lead to an arms race between a high mutation rate, highly contagious RNA virus and onward vaccines. In short, the annual Flu shot game just added a new player.

    KF

    PS: Notice, the various countries plot in recognisable patterns on absolute number of cases, not per population. The spreading is by direct or close [community] contact, on a short-range force basis. Once there is a breakout point from a lodgement and space to expand, expanding will happen until saturation effects block the quasi-exponential growth. And yes, all of these dynamics can be read off from the log-lin curve with an eye to relevant variables and slopes.

  121. 121
    Truthfreedom says:

    By applying chloroquine (or other drugs), we are exerting selective pressures on COVID-19. We are using our hard work to eliminate the virus/ reduce its numbers.
    Are we ‘natural’ selection or not?
    If not, what are we then?

  122. 122
    kairosfocus says:

    TF, artificial and extirpitation selection pressure by intelligent design. KF

  123. 123
    kairosfocus says:

    U/D: US Trials of Chloroquine and z-pac to begin Tue in NY:

    New York Gov. Andrew Cuomo announced Sunday that New York State has acquired 70,000 doses of hydroxychloroquine, 10,000 doses of zithromax and 750,000 doses of chloroquine to implement drug trials to treat patients with coronavirus, which will begin on Tuesday

    Things begin to roll. KF

  124. 124
    Truthfreedom says:

    @122 Kairosfocus:
    For the naturalist, everything is ‘nature’. Therefore, they can not apply the distinction natural vs artificial selection.
    A human can not be ‘artificial’ using their logic (although we know that they do not care at all).
    {A|~A} (nature vs what transcends nature) makes sense for the theist.
    And that is why they face so much problems with their doctrine.

  125. 125
    Truthfreedom says:

    *so many problems*

  126. 126
    kairosfocus says:

    U/D: I have added charts showing the sigmoid and driving impulse pattern for CV19, also the general pattern of growth. KF

  127. 127
    jawa says:

    KF,

    Very informative OP. Thank you.

    Here’s some information I saw at the WHO website today:
    Country: total number of reported cases / total deaths // mortality rate

    China :81747 cases / 3283 // 4.02
    Italy :63927 cases / 6077 // 9.51
    United States of America :42164 cases / 471 // 1.12
    Spain :33089 cases / 2182 // 6.59
    Germany :29212 cases / 126 // 0.43
    Iran (Islamic Republic of) :23049 cases / 1812 // 7.86
    France :19615 cases / 860 // 4.38
    Republic of Korea :9037 cases / 120 // 1.33
    Switzerland :8015 cases / 66 // 0.82
    The United Kingdom :6654 cases / 335 // 5.03
    Netherlands :4749 cases / 213 // 4.49
    Austria :4486 cases / 25 // 0.56

  128. 128
    jawa says:

    Any reasonable explanation for the huge differences in mortality rates?

  129. 129
    kairosfocus says:

    Yes, age profile of victims multiplied by overwhelming of key life preserving health care facilities. That is what the flatten the curve issue is about. Where, the older are far more likely to get deadly complications.

  130. 130
    Ed George says:

    KF, an interesting drug trial being done in Canada.

    https://apple.news/AfYxjYM6UTmS7-PcECAjWmg

  131. 131
    Ed George says:

    Jawa

    Any reasonable explanation for the huge differences in mortality rates?

    It could also be affected by different levels of testing.

  132. 132
    kairosfocus says:

    EG, good to see more possibilities being explored. I would like details on why it is thought that colchicine is a good enough candidate to run such a test but that seems a typical problem with media reports. I suggest, use a technical text box [in a highlight colour or shading] or infographic that gives the next level of detail and where to go for more. KF

    PS: I see from another article that what is targetted is the cytokine storm which is a potentially deadly immune response that reminds of allergies and how immune system reactions out of proper order can kill:

    https://www.cbc.ca/news/canada/montreal/montreal-heart-institute-study-colchicine-1.5506930

    [Dr Jean-Claude] Tardif, a cardiologist and professor of medicine at Université de Montréal, says the drug could mitigate the lung inflammation which leaves many COVID-19 patients struggling to breathe. That can escalate into an “‘inflammatory storm” which can in turn [rapidly] lead to death.

  133. 133
    kairosfocus says:

    Jawa & EG: As already noted in other threads there is a lack of consistency in even definitions/diagnosis of who has the disease, how one determines its contribution to death, attribution of cause of death etc etc. In addition, the big issue is that if facilities and staff are overwhelmed, death rates will shoot up [and triage in the military sense will kick in, leading to prioritising who to treat based on likelihood of survival and further utility]. KF

  134. 134
    kairosfocus says:

    F/N: I am thinking, the hyper-spreading incident in S Korea may help explain the way a breakout can happen and it then shows how hard it is to get back to saturation or slowed growth. Here is a clip:

    https://thegroundtruthproject.org/timeline-how-south-korea-reacted-to-the-covid-19-outbreak/

    An anonymous, middle-aged woman known as “Patient 31” tested positive for COVID-19 in South Korea after developing a fever. As a member of a fringe church called Shincheonji Church of Jesus — which has a self-reported membership of roughly 200,000 worldwide — Patient 31 incidentally spread the virus to dozens of other Shincheonji congregants in the Southeastern city of Daegu.

    This quickly caused a massive outbreak. Within days, Patient 31 became known in South Korean media as “Super Ajumma” for spreading the virus to so many others (a play on the word “ajumeoni,” which is a title of respect normally given to middle-aged women). News organizations also began reporting that Patient 31 had originally refused a coronavirus test, though she later denied these allegations in an interview.

    In a matter of three days, South Korea’s confirmed coronavirus cases multiplied more than six-fold, from 31 to 204 by Feb. 21. Less than two weeks later, the number of cases surpassed 6,000, according to the KCDC.

    “It was a bit of a shock when we got Patient 31, and it was a bit crazy watching it all escalate from there,” said K. Roberts, a 31-year-old English teacher living Daegu. “But I think [South Korea] has been doing the best it can to deal with this.”

    We see here how lodgement can break out and how hard it is to manage breakout.

    The article goes on to discuss various measures, leading up to this:

    March 9, 2020: The fight is still going

    South Korea continues to battle its COVID-19 outbreak, with confirmed cases of novel coronavirus continuing on a daily basis. However, medical experts believe that the worst of the outbreak might be over: Only 69 new cases of the virus were reported on March 9, amounting to the lowest rate of increase in 10 days.

    “I’m still extremely cautious, but there’s hope we can reach a turning point in the near future,” Prime Minister Chung Sye-kyun told reporters. As of March 9, more than 196,000 people have been tested for COVID-19 in South Korea since the beginning of the outbreak, while 166 people have fully recovered.

    Hwang Seung-sik, a professor and spatio-temporal epidemiologist at Seoul National University, said that South Korea’s gameplan has largely shifted from attempting to contain the virus to treating those who are at most risk of dying from it. Since the majority of South Koreans who tested positive suffer only mild symptoms, many have been directed to treat themselves at smaller clinics while major hospitals focus on the most severe cases.

    “Hospital doctors will put their efforts more on severe patients, and mild patients will be treated in local health centers,” Hwang said. For the rest of the world, he offered one piece of advice:

    “It is up to other countries whether or not they will test patients, but it is impossible to contain the virus by locking down certain cities or isolating people, given the experience in Korea,” he said. “We tried hard to prevent the entry of COVID-19 from outside of Korea, but we found out that, in reality, people can be infected asymptomatically and still spread it.”

    Notice, the implication of asymptomatic spreading. That suggests that to stop spreading, a general lockdown including of travel and of community interaction is needed for over one latency period, with further isolation of cases. That sort of lockdown will do serious economic damage.

    Another article notes:

    https://www.irishtimes.com/news/world/asia-pacific/what-strategies-did-asia-use-to-slow-down-coronavirus-1.4199768

    From Singapore to South Korea, countries across Asia have been mobilising for weeks in an attempt to contain the spread of the coronavirus. Some have had successes, combining mass-testing, technology and social distancing to stem the tide of infections. But uncertainty over the virus’s future course means the region is not out of the woods yet . . .

    Singapore poses particular food for thought:

    Singapore: financial support, clear messaging, big fines
    In the early stages of the outbreak Singapore appeared particularly hard hit. By mid-February it had recorded 58 infections, one of the highest numbers confirmed by any country outside China.

    Though the outbreak is far from over, the number of new cases emerging has appeared to slow over recent weeks, and 78 of 160 patients who tested positive have since recovered.

    “We don’t do anything different, we just do it well,” said Dale Fisher, professor at the National University of Singapore and chair of the Global Outbreak Alert and Response Network at the World Health Organisation.
    A staff takes the temperature of a visitor at the entrance of a library in Singapore. Photograph: How Hwee Young/EPA A staff takes the temperature of a visitor at the entrance of a library in Singapore. Photograph: How Hwee Young/EPA

    Singpore, a major business hub with large numbers of international visitors, has a strictly enforced home quarantine system and an exhaustive contact-tracing programme. This is underpinned by clear messaging from officials, who have repeatedly emphasised the need for collective social responsibility, said Fisher. Authorities have also warned of harsh penalties for those who break guidelines.

    Since the start of the outbreak thousands of people in Singapore have isolated themselves. Anyone required to do so can be called multiple times a day and asked to click an online link sharing their phone’s location. Officials also carry out spot checks in person to ensure compliance. Those who do not stay home can expect a fine of up to $10,000 or up to six months in prison.

    There is some financial support for people who are isolated: self-employed workers have been offered $100 per day, and people who are not able to remain isolated at home can stay in a government facility.

    For this quarantining system to be effective, officials must track down affected people as quickly as possible. Contacts are being traced by the Singapore police force, who use CCTV as well as interviews with patients to draw up lists of people who may have been exposed. Though Singapore has introduced charges for visitors who require treatment, tests are free for all.

    Officials have stressed that the number of cases is still likely to rise. The health minister Gan Kim Yong said many locally transmitted cases “were the result of the socially irresponsible actions of a few individuals” who continued to go out and mix with others despite having symptoms.

    Some argue that other countries – especially those with large populations that were less willing to accept sweeping restrictions – would struggle to adopt the same approach as Singapore, which has a high quality health system. Officials have a tight grip on the media and have been accused by rights groups of using fake news laws to clamp down on critical opinions online.

    “I don’t accept that it wouldn’t work [elsewhere],” said Mr Fisher, but he adds that officials elsewhere need to give clear and consistent public health messages. “If the community is not engaged then they won’t take the response seriously.”

    We need to think again.

    KF

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