San Francisco Mayor Declares State of Emergency, Europe Prepares for Pandemic

Mish

Despite no cases, the Mayor of SF declares an emergency. New infections outside China now outpace those inside China.

SF Mayor London Breed Declares Local Emergency Amid Coronavirus Outbreak

The city of San Francisco declared on Tuesday a state of emergency even if at the moment there are no confirmed cases of Covid-19 in the area.

"Although there are still zero confirmed cases in San Francisco residents, the global picture is changing rapidly, and we need to step-up preparedness," Breed said in a statement. "We see the virus spreading in new parts of the world every day, and we are taking the necessary steps to protect San Franciscans from harm."

President Trump will hold a news conference on Covid-19 today at 6:00 PM ET.

The global pandemic is spreading: Europe Prepares for Pandemic as Illness Spreads From Italy

New cases of the coronavirus popping up across Europe. Dozens of infections in Iran stoking fears about an uncontrolled spread in the Middle East. Global market jitters continuing after a steep slide. American health authorities warning that it was a matter of when, not if, the epidemic would reach the United States. A toxic political climate in Washington complicating the public health challenge.

For the first time, more new cases were reported outside China than inside, according to the World Health Organization. Chinese officials on Tuesday reported 411 new infections; in the rest of the world, the number was 427. The total number of cases globally has now reached 80,980 and nearly 3,000 have died.

In the European Union, which prides itself on open borders, new cases were recorded in Austria, Croatia, France, Germany, Greece and Spain. Most were tied to Italy, where the authorities have been struggling to contain an outbreak that has infected at least 325 people, most of them in the north near Milan.

Hotels in Austria, France and the Canary Islands of Spain were locked down this week after guests tested positive for the virus or were suspected of having it. The steps to limit contagion differed from place to place, but large group gatherings were often the first things to be canceled where the virus had been detected.

Coronavirus Cases by Country

News Updates

The U.S. CDC yesterday suggested that the risk of a coronavirus pandemic is likely and is alerting the public to begin preparing for community spread in the United States.

Dr. Anne Schuchat, the CDC's principal deputy director declared: "It's not a question of if. It's a question of when and how many people will be infected."

Chart and updates from Worldometers.

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Mike "Mish" Shedlock

Comments (53)
njbr
njbr

FIFY...Despite no KNOWN cases, the Mayor of SF declares an emergency...

17 Replies

Anda
Anda

Via ZH and why testing isn't being done maybe.

"Wang explained that although nucleic acid testing is currently the only official test method that Chinese medical staff use to diagnose coronavirus, the result is not accurate.

“Only 30 to 50 percent of the patients present positive,” according to Wang.

He explained that all patients who test positive are infected with the coronavirus, but another 50 to 70 percent of patients are actually infected but cannot be detected by nucleic acid testing."

Though South Korea announced plans to test thousands.

Another figure from China, forget where, 14% at least are still infected /reinfect after being declared virus free.

Stuki
Stuki

Any indication of how many of those who are infected, but who cannot be detected by nucleic acid testing, go on to become critically ill or die?

Complete detection of absolutely all infected may be some ultimate goal. But is pretty unrealistic during a widespread outbreak. Second best is detection of those at risk of getting critically ill, early enough to possibly intervene.

Anda
Anda

Not in the article, but I expect same as anyone else who has the virus - it is the test, or point of test, that is variable, not the patients, I think.

I thought that also, but then if you are more or less telling people they don't have the virus, and they do, they may spread it more. It creates a lot of confusion, so not sure - I suppose if the endeavour/meaning was properly understood by people then not such a problem. Actually the insecurity it creates is that we know we cannot track the spread properly, on the other hand not testing is also a false sense that no-one has the virus yet.

Case in point. In Spain about eight new cases in the last day, all via Italy... except for one in Seville, who has been hospitalised with pneumonia for six days already, hasn't travelled... so now they suspect there might be an undetected outbreak from an unknown source in the city. So far everyone had assumed not because they weren't doing tests except for those with travel or contact, so no other cases detected.

Latkes
Latkes

>so now they suspect there might be an undetected outbreak from an unknown source in the city.

Pretty much what I have been telling you yesterday. The virus is a lot more spread out than the numbers suggest. I suspect it means that the total mortality rate is much lower than the numbers suggest too.

JimmyScot
JimmyScot

Chevron sent its oil and gas traders home from the Canary Wharf, London, office today, as one of its staff had flu-like symptoms after visiting an unspecified country with an outbreak.

Uk Dept of Health advice to employers is not to send employees home while test results are awaited....and not to send employees home if another employee tests positive.

I am wondering what to make of that. It's almost as if they don't see the need to control it.

Canary Wharf is a pretty people-dense place. Lots of nice air conditioned buildings for viruses to spread around, lots of sandwich shops, coffee bars and pubs for patient zero to visit. I guess 10 days from now....

Anda
Anda

I was just waiting for you to say that...

Latkes
Latkes

It is the only way the patterns of spreading make sense. Unless you want to go deep into conspiracy territory.

Anda
Anda

In Spain they are saying expressly not to wear masks (based on WHO saying they were useless without further measures?) , no follow up of inbound passengers, no temperature checks at airports. I cannot believe they would dissuade people from wearing masks, herd mentality says that people need the excuse of a recommendation by authority before they start to, otherwise many won't. Hard to figure out the approach they are taking - shortage of masks for health workers is one reason cited, the rest seems like incompetence and no preparation, probably the idea of putting off tourists affects their presentation also.

JimmyScot
JimmyScot

Venturing far into supposition, but thinking about this a little more, something is off with all this advice.

  1. We know the NHS will stop testing after 100 positive cases
  2. We know that businesses are being told not to close even with positive cases
  3. We know the tests don't work all that efficiently

In short, it seems like the UK govt has decided not to take a strong stance on this.

The only reasons i can think of for this is that (1) control and quarantine measures have been shown not to work or (2) that there is something important about the virus that we do not know or that (3) governments are incompetent.

1 is clearly nonsense since they have worked in China, 3 is what we like to think, but is unlikely to be true.

In the discussion about pros and cons of quarantine this week, Carl pointed out that he expected that "letting it rip" would result in high death rates because hospital resources would be overrun. I'm just wondering if there is any statistic about progression from mild to severe to critical. If most patients with severe disease do not progress, then maybe the narrative from the NHS talking about patients being treated at home by GPs makes sense, and there will be no overwhelming NHS impact from patients who were never going to die. I know this sounds like nonsense but the Chinese authors of the paper, and commenters on here, have observed that no severe cases have died. On the one hand this is what you'd expect, because if they got worse, they'd be classed as critical, but this is so obvious that i wonder why it was even mentioned. Could it be that there is something that is specific to initial presentation that clearly leads to a worse outcome. For example, it was mentioned that some patients experience GI problems prior to flu symptoms coming on. Is it possible that those patients have worse outcomes? Or something else due to initial presentation.

If i knew i only had to hospitalise 5% of the sick, then that is a very different proposition to 20%. 15000 acute and 300 critical care NHS beds might be enough to deal with that 5%.

Anda
Anda

So far in Europe, except for one case in Spain and one in Italy, all infections I know of are traceable, and there is no heavy hidden background infection found either in any wider tests !!! So I think if there is conspiracy going on you are closer to it than myself !!!!!!!!!!!!! X 100653457

Latkes
Latkes

No idea what that number at the end of your post means...

There is a strong selection bias among the traceable cases.

Roadrunner12
Roadrunner12

Anda
Anda

I don't deny the selection bias. You have one severe case confirmed, as in Italy, and they then trace a hundred other cases from that, in this case across Europe. That will include eighty mild cases from that original infection that would not have been tested. That is understood. However, you also have other outbreaks going on NOW, unregistered. People who flew in from elsewhere with mild cases starting them, or contacts via Italy that were missed. Out of every ten of those, two will be severe enough to be tested, and from that they will then test and find a hundred more cases of mild infection. The bias is towards severe, but the registry of wider mild cases is not far behind, a week or two, shorter if they decide to do mass testing. In short, the main part of the bias is eliminated quite quickly. So I might say now there are five hundred people unregistered with nCov walking around, fifty times those registered, but case statistics will not appear for another couple weeks or a month maybe , and by that time the background infection rate will have been sampled as best as possible and its number will be close to accurate. So I just don't buy the idea that many are infected and only the severe are picked out, not now because most related mild are traced, and not in the greater sum eventually presented, though at specific cherry picked times it might look like that . This is why the lack of proper data from China is frustrating or wrong also.

Adding in from Worldometer

" UK: 7,132 concluded tests, of which 13 positive (0.2% positivity rate). [source]
Italy: 9,462 tests, of which 470 positive (5.0% positivity rate), awaiting results: unknown. [source]
France: 762 tests, of which 17 positive (2.2% positivity rate), 179 awaiting results. [source]
Austria: 321 tests, of which 2 positive (0.6% positivity rate), awaiting results: unknown. [source] "

Even with just that many tests aimed at related cases, they would likely have picked up if there was also a widespread mild infection going around, so far none, as the symptoms of those in Italy tally with being infected by the original route.

What is a disconcerting possibility however is of a very long incubation, or where the virus never clears after infection, where the level of virus is too low to detect, with seemingly random outbreaks as it activates for whatever reason - this is completely speculative also if that is the way we will discuss. Better is to demand figures and details and then work out what the reality is, because for now we are left with too much guesswork for lack of them.

Btw, the number at the end is the secret code we discussed not long ago, regarding accessing the security registry of a certain country ;) ;) ;)

tokidoki
tokidoki

I was out and about in SF yesterday afternoon and I saw plenty of girl scouts out and about selling their cookies. Declaring a State of Emergency without "real" numbers is stupid. Next time, when s*** hits the fan, no one would listen.

Stuki
Stuki

"....it is the test, or point of test, that is variable, not the patients, I think."

Nucleic acid testing for a mutating, hence genetically variant, virus is not entirely straight forward. How sensitive the test is, is dependent on how closely the pathogen dna (rna in this case) matches the probe molecule used to bind to it and detect it. For a novel virus, those probe molecules, hence tests based on them, is not unlikely to have been "rushed out" to the clinic based on a less complete picture of the virus in all its variants, than is the case for something like HIV, which has been around "forever."

IOW, it could be, that differences in detection is not just due to differences between patients, nor how a specific test was administered, nor random; but also due to patients being infected by slightly different viral genomes. And neither is it impossible that different viral genomes, result in different distributions of symptoms and outcomes.

Anda
Anda

Best answer I found to that is

"Meanwhile, a group at Hong Kong University have developed two one-step quantitative RT reverse transcription PCR tests targeting both the open reading frame 1b (ORF1b) and the N regions of the viral genome based on the first sequence deposited at GenBank; these two test have been validated using two clinical specimens obtained from patients infected with SARS-CoV-2. The tests are explicitly designed to identify multiple viruses in the sarbecovirus subgenus to which SARS-CoV-2 belongs, given a lack of data on the genetic diversity of SARS-CoV-2 in humans and animals. As no other sarbecoviruses are known to be circulating in humans, a positive test can be considered as confirmation that a subject is infected with SARS-CoV-2 or a related animal virus. The N gene assay is recommended as a screening test and the ORF1b test is recommended as a confirmatory test. "

So if this is still procedure then it depends if the N essay possibly misses certain strains for any reason, because ORF1b seems to be more certain.

Rereading the article and

" The lab of Christian Drosten, of the Institute of Virology, Charité University Hospital, Berlin, along with academic collaborators in Europe and Hong Kong, published details of a real-time PCR (RT-PCR) diagnostic test and workflow on 23 January, which detects SARS-CoV-2 and distinguishes it from SARS-CoV. The group verified the test in the absence of SARS-CoV-2 isolates or patient samples but confirmed its specificity against 297 clinical samples from patients with various other respiratory infections. This formed the basis of shipments of 250,000 kits, which the World Health Organization (WHO) dispatched to 159 laboratories across the globe in recent weeks."

Is more pertinent in fact, and I don't know how accurate those would be. You would think they would cross check results with the more comprehensive ORF1b tests to see if they were missing certain strains for example, but who knows....and I don't know what test each country is using either.

Anda
Anda

From how new information on the working of the virus is being released, I think various authorities are in the dark. They will have good stats that will give them a numbers game to plan with, but they are taking the median approach of business as usual and stepping in if visibly nescessary, they are waiting behind the curve and trying to keep public perception channeled. In short they are not prepared to make moves that will disorder. My view, and I note it in different ways in different countries according to their manner. Noticed UK "leak" of reasonable worse outcome of 80% infected half a million fatalities.

Today Buxton had first school closure in UK, I know Buxton and around well. Here in south western Europe I'm very aware that the virus will be establishing itself now. It is not ground zero obviously, but might end up looking like that. People are more subdued now, there is uncertainty around, one that people don't know how to place because usually they have an opponent to challenge or blame, but a virus doesn't react much to what they think. Authorities are getting criticised here as well.

No. 1-14
MiTurn
MiTurn

I'm a retired high school and community college history teacher and I can't help but be reminded of the Spanish Flu pandemic. Except this is faster, in that we're now dealing with intercontinental jet travel rather than steam ship.

History unfolding before us.

Sechel
Sechel

By declaring the emergency she probably gets access to resources she would not otherwise have. I think its an abuse but Presidents , this one included have declared fake national emergencies to get stuff accomplished. Once one person mis-uses the term why shouldn't everyone

Roadrunner12
Roadrunner12

Ive stated this before, China is between a rock and a hard place. Not getting the economy going will itself turn into a disaster and getting the economy going from my 2 cents will result in the whole country's hospitals being overwhelmed.

Pick your poison. I have seen some statements of its a balancing act to somehow have a controlled pandemic. Using that analogy, its like having 500 lb weights at the very ends and one small misstep results in one weight falling off.

Don't really know what the CFR Case Fatality Ratio is but it will definitely be higher with an overrun medical system.

Im wondering how other governments react? quarantines, let it runs its course?

And again will summer have any impact on the rate of infection?

Latkes
Latkes

Over the long run, if the virus becomes endemic, quarantines are not viable. Not in China, nor anywhere else.

SMF
SMF

No cases in San Francisco, but the first case in the US was discovered just south in Santa Clara, better known as the Silicon Valley.

Plus with the large Asian population in the city, the chances of someone having it already is pretty high.

Klagorio
Klagorio

Corona Virus is mostly a fecal virus.

White man sanitation good, as stated by Mr. Karl Denninger. Might be racist, but good! 57 cases less 19 from the cruise ship incubator total real cases 38! Nobody has died yet! Percentage of deaths higher than regular flu!  Not good! Deaths will drop as we acclimate and develop resistance to it! It is pretty virulent not over the top like the media wants you to believe! However overall death rate much lower than SARS, Zika and Ebola! So far so good in the USA, keep your fingers crossed! Homeless escapements could be another problem, SF, New York, LA, Etc. and other large cities. EDUCATE THESE PEOPLE AND GIVE THEM PORTABLE TOILETS, HAND WASHING STATIONS, GARBAGE BINS, ETC. The might use them since it has become a life and death situation.

Where sanitation is not good the virus is flourishing, that is most of the world unfortunately!

Wash you hands and practice good sanitation!

It is good Trump started moving the supply chain home! we will adapt quickly, you mark my word.

Mish has done an excellent job on covering this viral attack!

klausmkl
klausmkl

Media sensationalism at it's finest. Why don't they add in the 25% of the population of adults in the USA have non-alcoholic fatty liver disease going up to 33% soon.

thimk
thimk

well the prez will speak shortly , rather than emphasize the proactive measures he could/has taken he will downplay the severity of this bug and maybe jawbone the markets upward. Rush L today also joined in the "its not so bad" chorus. Has stock market valuations preempted public safety? I want to see a proactive action plan . F wall street.

MiTurn
MiTurn

The single case in Romania reported today was in Italy THREE WEEKS ago! Which suggests the virus was present and being shared in Italy the early part of February. Food for thought...

Sechel
Sechel

i was thinking about the wall and appropriating funds intended by congress for other uses.

Carl_R
Carl_R

The die is cast, now. Trump and the Republicans made a massive bet that then can contain this, and prevent it from spreading in the US. If it does spread, expect a Democrat in the White House, with a 2/3 majority in both houses for at least a dozen years. I just don't know why they wouldn't act like they care, even if they don't. It makes no sense to make such a huge stake on such a risky bet.

Sechel
Sechel

This is the problem. A response to pandemic just doesn't happen. It's something the CDC, DHS and others draw up plans and revise on a continuous basis. It must be routinely rehearsed to make sure everyone knows the routine , what to do and if anything needs to be updated. Trump has decimated staffing. Sure he's accepting money from Congress, put Pence in charge and there are still some good people at the CDC but Trump has ensured that our response will not be optimal.

lol
lol

With the US soaring poverty an homeless rate,just need one person to catch the virus, could literally infirm an entire city ,maybe the whole state!


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