Comments 1 to 13:

1. nigelj at 07:07 AM on 12 April, 2020

   Thank's for the  covid 19 article. It  is very detailed and one of the best I've read on the issue. However this company reckons they could have a vaccine on the market by September.

   One reason Germany has a reasonably low mortality rate could be because it has a high number of hospital beds and also ventilators per 1000 people. In comparison Italy has the opposite. America is  somewhere in the middle. I did some googling on this and didn't keep a record of the data and sources on ventilators, but you can find numbers of hospital beds per 1000 people here.   

   It appears there is a philosophy in some countries of minimising numbers of hospital beds to save costs and treat as many people at home as possible. I recall this from our media some years ago. Unfortunately this has problems when you get huge surges of patients with natural disasters and pandemics.

   That said, numbers of beds would be one factor of many. It appears that even ventilators arent saving some people.

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2. JWRebel at 08:43 AM on 12 April, 2020

   @Nigelj Couldn't disagree more. Nothing particularly new in this interview.

   [1] Zoonotic origin. No direct evidence given for zoonotic origin. There are a host of obstacles to the zoonotic claim. Not mentioning these and not offering direct evidence means it's not scientific. Any scientific approach should not fail to mention strengths and weaknesses of competing hypotheses. That's the trouble with most slanted information/propaganda — failure to take into account contrary evidence and hypotheses, which are almost always present.

   [2] I have not seen anybody make a cost benefit case for social distancing. What will be the costs in human life years of the global depression we are now headed into? How many millions of families in the informal economy are already having to tell their children there is no food? How many people will have no health care access at all in the future? How many lives have we actually saved? Don't forget, a 12% save rate with people on ventilators is the highest claim I've seen; it was 5% in Wuhan. If we take a one year survivor horizon, it will be even slimmer. Most of the people that didn't go to ICU would survive without hospital care (oxygen can be administered at home), so it isn't at all clear what the lives saved margin really is. There is plenty of evidence that the R₀ (reproduction rates) rolled over before NPI's (non-pharmaceutical interventions) could have had an impact.

   [3] China adopted HCQ + Zinc + Azithromycin +Remdesavir in their standard treatment guidelines after published clinical studies on Feb19. So did S. Korea, which had far lower mortality numbers. Yes, there are a lot more angles to this, but we seem incapable of learning from the Chinese. Do we actually know if the oral-fecal route is not important? Do we know whether health care itself is not a primary vector? Do we know how minor the aerosol vector is? The Chinese and Koreans (index patient 31, super spreader) warned about asymptomatic carriers in January (later studies show 79% of infections caused by asymptomatic carriers), but many Western countries denied it. Singapore warned about the extreme transmissability via various routes. China immediately started building/dedicating facilities b/c hospitals were transmission nodes, and a third of the health care workers in Wuhan were out of commission. Interview does not mention any of this.

   [4] Vaccines. This is happy talk. Is there a vaccine for HIV or SARS? No. Vaccine formulations for SARS led to ADE in cats (antigen dependant enhancement, making subsequent infection progress more catastrophically instead of less). Are there any virus diseases which we have been able to eradicate, barring small pox? Are there any vaccines against Corona viruses human or veterinarian which give more than an ephemeral protection? Do people have long-lasting antibodies to protect them against colds (Corona viruses)? No. Does everybody show strong antigen protection after recovery from Covid? No, au contraire.

   [5] Did we do a good job protecting our health care and the most vulnerable? No. Having schools shut does not significantly impact ICU demand. The entire spike in ICU demand would have to come from the risk groups. But we have shut down the economy without taking appropriate steps to quarantine the most important vector (the vulnerable), which represent virtually the entire pool (>98%) of ICU demand. 40% of deaths have come from nursing homes, globally! Not counting all those who die at home (too frail to go to ICU). These places/people should have been locked down in February, with zero people entering or exiting. Pay the staff triple overtime for staying on premise (way cheaper than Tr$6 to save all the banks and hedge funds).

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3. michael sweet at 10:19 AM on 12 April, 2020

   JWRebel,

   Please provide references for all your claims.  The zoonotic orgin has been demonstrated by DNA analysis.  Likewise the rest of your claims are not what has been widely reported in newspapers (I read the Guardian, BBC, Politico, CNN, LA Times and NY Times.).

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4. nigelj at 11:50 AM on 12 April, 2020

   JWRebel @2

   There are far too many points and questions for me to respond to, so Ive just picked out a few that relate to things I have some knowledge of form our media.

   "Nothing particularly new in this interview."

   Ok maybe so, but you seem to be judging it as something meant to inform experts. It was intended more for the general public that may know virtually nothing about the issues.

   "[1] Zoonotic origin. No direct evidence given for zoonotic origin"

   Sounds a bit like your unsubstantiated opinion. And its an article directed at the general public not a 20 page thesis on the subject!

   "[2] I have not seen anybody make a cost benefit case for social distancing. "

   I have in our local media. I can't find the article but they assumed about $2 million (NZ) per human life being average earnings potential and deduced from this the government could spend $150 billion on assistance to business during a lock down, thus giving a basis to put a time frame on a lock down (all other things being equal).

   "What will be the costs in human life years of the global depression we are now headed into? "

   We don't know that we are heading into a global depression. The data suggests a deep recession at this stage. But I take your point, an economic recession or depression can cost lives, and obviously reduce quality of life.

   My own view is that the scenario in Italy is very scary, and some level of border controls and social isolation seems very justified in my country at least (New Zealand), especially as we had a lot of tourism, but I'm not immune to the considerable economic problems lock downs bring, and their social and health implications. That is also very scary. For that reason I think lock downs have to be of limited duration, enough to buy time to strengthen health care systems, deveop a vaccine, and flatten the curve. Just so you know where I'm coming from. 

   "How many lives have we actually saved? "Don't forget, a 12% save rate with people on ventilators is the highest claim I've seen; it was 5% in Wuhan. If we take a one year survivor horizon, it will be even slimmer. Most of the people that didn't go to ICU would survive without hospital care (oxygen can be administered at home), so it isn't at all clear what the lives saved margin really is. "

   Where have you seen your claims about ventilators? Administering oxygen at home has various logistical complications and the patient is certainly going to be infecting the whole family. But I don't really know I'm not a health care expert.

   "[3] China adopted HCQ + Zinc + Azithromycin +Remdesavir in their standard treatment guidelines after published clinical studies on Feb19. So did S. Korea, which had far lower mortality numbers. Yes, there are a lot more angles to this, but we seem incapable of learning from the Chinese. "

   Who is we? New Zealand has copied China's lock down policy and social distancing and shortly after this rates of growth in infections started to slow and I doubt its a coincidence. Nothing much else explains it. We also used track and trace from very early on like Asian countries. Our infection rates and fatality rates are quite low comparitively speaking (easily googled).

   "Do we actually know if the oral-fecal route is not important?"

   This is a rather technical question for this climate website.

   " Do we know whether health care itself is not a primary vector? "

   I recall reading that hospitals are a major source of spread and its important to keep covid 19 patients in their own isolated wards and keep health care professionals divided into groups, and that some places are doing this.

   No doubt there are things we dont know. Im not sure what you real point is. Its a new virus, the experts are dealing with it as best they can.

   I have read several experts saying aerosols are a minor factor and why, and none saying they are a major factor.

   "China immediately started building/dedicating facilities b/c hospitals were transmission nodes, and a third of the health care workers in Wuhan were out of commission. Interview does not mention any of this."

   No it didn't. Maybe they should have, but no interview printed in the media is going to cover everything.

   "[4] Vaccines. This is happy talk. Is there a vaccine for HIV or SARS? No. "

   But my understanding is the Sars vaccine was cancelled because SARS fizzled out.

   "Are there any virus diseases which we have been able to eradicate, barring small pox? "

   Why are you asking me this? Vaccines keep measels and seasonal flu at very low levels (depending on public uptake). Dont make the perfect the enemy of the good.

   Are there any vaccines against Corona viruses human or veterinarian which give more than an ephemeral protection? Do people have long-lasting antibodies to protect them against colds (Corona viruses)? No."

   I read an article that although getting a corunavirus related cold does not give immunity, people who get reinfected dont have any symptoms or symptoms are at very low level as below, so its possible it may be the same with covid 19:

   https://play.stuff.co.nz/details/_6145112480001

   "[5] Did we do a good job protecting our health care and the most vulnerable? No. "

   Again who is we? New Zealand required elderly (over 70) and vulnerable to self isolate early in the growth curve. Personally I think that is the key to the whole issue.

   "Having schools shut does not significantly impact ICU demand. The entire spike in ICU demand would have to come from the risk groups. But we have shut down the economy without taking appropriate steps to quarantine the most important vector (the vulnerable), which represent virtually the entire pool (>98%) of ICU demand. 40% of deaths have come from nursing homes, globally! Not counting all those who die at home (too frail to go to ICU). These places/people should have been locked down in February, with zero people entering or exiting. Pay the staff triple overtime for staying on premise (way cheaper than Tr$6 to save all the banks and hedge funds)."

   Sounds like you mean America? Young people are carriers and often asymptomatic, so surely that ultimately means it spreads at school and from there to older people? That said, I admit closing schools is a big thing and can't last indefinitely for obvious reasons.

   Like I said we in NZ have isolated the elderly in home isolation early in the growth curve. However it leaves the rest home problem, although they have stopped allowing visitors from a couple of weeks ago. Most of our fatalities have been from a rest home cluster. I agree pay rest home (nursing home) staff triple the pay to stay on the premises.

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5. nigelj at 14:19 PM on 12 April, 2020

   Rebel @2, clarification. "[1] Zoonotic origin. No direct evidence given for zoonotic origin"...."Sounds a bit like your unsubstantiated opinion."

   I meant to say I  recall reading there was direct evidence, and that you are making quite a few assertions without explaining yourself.

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6. Philippe Chantreau at 14:21 PM on 12 April, 2020

   " Are there any virus diseases which we have been able to eradicate, barring small pox?"

   I am surprised that JW Rebel is asking a question that is so easy to answer.

   -Rabies, effectively eradicated among humans and even animal populations with enough coverage.

   _Polio, wherever campaigns were completed as planned, effectively eradicated in the Western World.

   -Mumps, same as above.

   -Varicella, same again.

   -Rubella, same.

   Some vaccines have not been available for long enough but HPV caused cancers can potentially be eradicated. Same goes for Hepatitis A and B.

   There has been some pseudo-debate on the value of vaccinating against Measles, but the reality remains that Measles can potentially be quite serious, leading to penumonia or encephalitis, or even subacute sclerosing panencephalitis, possibly decades later. There is no honest debate to be had there.

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7. nigelj at 18:01 PM on 12 April, 2020

   J W Rebel @2.

   "Don't forget, a 12% save rate with people on ventilators is the highest claim I've seen; it was 5% in Wuhan."

   Correct about Wuhan. About 30% in the UK and Washington State survive as below. This appears to be the best outcome, with 55% being normal for other respiratory problems. So its not as bad as you say but still pretty bad.

   www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients

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8. sailrick at 01:04 AM on 13 April, 2020

   J W Rebel @2.
   "[1] Zoonotic origin. No direct evidence given for zoonotic origin"

   Yes there is.

   How China’s “Bat Woman” Hunted Down Viruses from SARS to the New Coronavirus

   https://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-the-new-coronavirus1/

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   Moderator Response:

   [JH] Activated url link.

9. Philippe Chantreau at 01:20 AM on 13 April, 2020

   JW Rebel's multiple points appear extremely ill informed, and have internal contradictions.

   Zoonotic origin has been firmly established.

   Hydroxychloroquine is no panacea and has significant side effects, including cardiac arrest, arrythmias requiring defibrillation, profound hypoglycemia etc. It is by no means a risk free drug. Overdose is extremely toxic, often lethal. When I was growing up in Africa, it was known to be a suicide risk for troubled teens who had to take malaria prophylaxis, like everybody else. There is no conclusive evidence that HCQ/AZT actually helps outcomes.

   Asian countries achieved control at the price of drastic social distancing and self quarantine measures, the very thing that JW Rebel complains about.

   The fact that the survival rate of critically ill patients is low makes a strong argument for limiting contagion, less we allow something similar to the 1918 pandemic to happen.

   The whole point of social distancing is to prevent overwhelming health care facilities. The alternative would be to not practice distancing and tell people to not bring their sick relative to the hospital. We're talking about people in their 50s and early 60s, here; they work, they have families and other responsibilities. How is that going to go down in the Western world where we find it normal to code, intubate and throw heroic measures at people in their 90s with multiple chronic conditions?

   The fact that most working families do not have savings to withstand a crisis on the horizon of a few months speaks volumes on how unhealthy the entire socio-economic system has become. The fact that corporations that pay dividends would not be able to have a financial safety cushion is just mind boggling.

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10. nigelj at 06:28 AM on 13 April, 2020

    Philippe Chantreau @9 says "Hydroxychloroquine is no panacea and has significant side effects"

    Correct and the clinical trials related to its usefulness for covid 19 were very small and somewhat inconclusive as below:

    www.vox.com/2020/4/7/21209539/coronavirus-hydroxychloroquine-covid-19-clinical-trial

    In addition there is quite strong evidence emerging that China have severely under reported numbers of fatalities, (easily enough googled) so their cocktail of drugs including Hydroxychloroquine doesn't appear to have been terribly effective.

    If it was up to me Hydroxychloroquine might be worth trying just for very high risk patients where the prognosis is very bleak.

    It looks more like Chinas lock down measures that actually worked to at least stop the growth in numbers.

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11. KR at 08:02 AM on 13 April, 2020

    Note to those involved in climate discussions: Dr. Fred Singer passed away April 6th at the age of 95.

    Singer spent much of his life engaged in climate science denial, tirelessly denigrating good science in favor of industry and idiological positions. 

    As Max Planck said, “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

    This is equally true when said opponent is motivated by something other than science.

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12. Philippe Chantreau at 08:18 AM on 13 April, 2020

    Nigelj, I believe that what little data is there actually supports using it early in the disease process. Waiting to use it as a rescue measure would then not be wise, especially because of the added risk of throwing cardiac side effects on top of a possible viral myocarditis. All hypothetical, of course. This is kinda uncharted territory really.

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13. Eclectic at 11:15 AM on 13 April, 2020

    KR , the WaPo  link is to paywall.   Likewise with NYT.

    Free access to a biography / hagiography via WUWT  or maybe ClimateDepot.

    Unfortunately, the Scythe of Time cuts down both the good and the bad.

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