HN Theater @HNTheaterMonth

> I think when this all comes to an end, China will be one of the countries that dealt with the virus the best. Countries without authoritarian governments likely don't have the means to effectively quarantine major cities and shut down massive portions of their economy immediately without major problems arising.

China's authoritarian government is largely responsible for the severity of the initial outbreak. Their extreme quarantine efforts happened more than a month and a half after the first case was detected, well after it was too late to effectively contain, and only when covering up the situation proved impossible. The government sponsored a 100,000 person banquet with shared plates 3 miles from the epicenter with people who travelled to get there/would travel back while it was arresting doctors and media reporters for talking about the virus. If major sectors in freer countries weren't shut down until weeks after it spreads, it would be an improvement over China.

Here is a succinct summary of the timeline: https://youtu.be/hSIt496d82s?t=62

Last time I checked they were still barring members of the CDC from going into China to help asses the situation. Crucial information such as mortality rate and recovery rate are only being discovered now, as the numbers from China are not accurate.

This virus appears to be something any government would have difficulty containing due to the long incubation period, and some of the false statistics coming out of China are simply a result of a system that has become overwhelmed. Any system in a similar situation as the Chinese now find themselves in would have trouble dealing with this, and I think it may have reached currently levels even with a more transparent system that tried to contain it earlier, but I heavily disagree with your statement. They were extremely irresponsible about early containment during the crucial period when containment had the best chance of working.

⬐ yread

> Their extreme quarantine efforts happened more than a month and a half after the first case was detected

I do agree that China and especially Wuhan could have acted faster - perhaps by 2 weeks though not month and a half. 1st December there was a case of pneumonia admitted to a hospital - that happens probably more than millions times a year. After 3 days it was clear that it's a viral pneumonia. That's more severe but still not uncommon. Only by the middle of the month it became clear to doctors that there are more and more such cases - but still spread through different hospitals of the 11 million Wuhan.

Obviously it takes time for this information to get to the bureaucrats. They should have done something - but then again, what? There are perhaps ~50 cases of viral pneumonia in a city the size of small country during an influenza season. If China hasn't gone through SARS it would take months to act on this information.

⬐ tremon

They should have done something - but then again, what?

Well, arresting the doctors that were comparing cases in a group chat seems like a good start.

/s

⬐ toyg

That's actually the critical difference. Incompetence and carelessness are normal - public administration and epidemiological control are difficult activities in any country - but active repression of medical personnel is not.

⬐ oefrha

> Last time I checked they were still barring members of the CDC from going into China to help asses the situation.

I checked and the WHO team led by a Canadian epidemiologist has been working in China for more than two weeks, since Feb 10.

I fail to see why they are obligated to allow in a team from a nation that’s been openly hostile for a long time just because they asked and used the word “help”. Sounds like arrogance to me.

⬐ thinkingemote

Just to make it clear in case readers were unaware:

CDC: Center for Disease Control - a US Federal agency.

WHO: World Health Organisation - a United Nations organisation.

⬐ baq

the WHO has taken some not entirely transparent actions during handling of this epidemic and there are allegations that it's boss has a conflict of interest (his country apparently takes a lot of investments from China) and also that there are some pandemic-related financial instruments from which certain parties stand to benefit June 2020 if pandemic isn't declared. these are all hearsay but would explain trying to appease China and their choice of words in their press conferences. both are of course consistent with trying to not spread panic and make sure WHO has access to China, so I'm inclined to think that this is half politics, half good high level medicine work.

⬐ oefrha

I would hope that the WHO director’s personal politics doesn’t have a huge sway over WHO’s official stance.

⬐ netsharc

WHO politicking can be explained with other than an (IMO semi-bigoted) "China has a lot of investments in Ethiopia", it's got to do with trying to deal with an authoritarian country that doesn't like losing face. If WHO said something that can be taken as an insult, China can tell them to GTFO, and the WHO would lose first hand experience of what's going on there, which might make things more catastrophic..

⬐ allovernow

This is not an event for petty emotions. Also in high likelihood those who are there on behalf of the CDC are keeping quiet in order not to be kicked out. But you bet there's espionage going on. The Chinese government doesn't mess around.

And in this case it'd be justified. You're talking about the rest of the world at stake. This is no place for cover-ups and minimization. Transparency is critical.

⬐ Johnny555

If the outbreak started in the USA, would you expect the USA to welcome a team of Chinese Government epidemiologists?

⬐ grandmczeb

I expect they would be allowed. The US also allows international observers for its elections as well.

⬐ pbhjpbhj

The USA is objectively corrupt from the top, have recently removed themselves from non nuclear proliferation and climate treaties .. as a country the message seems clear that USA don't care two shits about the rest of the World.

The idea Trump would open his response to an epidemic up to international inspection is just laughable - and I say his, rather than USA government's because that's how things appear to work there.

⬐ pimmen

Trump has not even nearly as much power as you seem to think. We hear about his abuses of power because hearing ”California government implements reforms to reduce carbon emissions, in spite of Trump” doesn’t generate as much emotions as his corrupt practices.

Imagine a Chinese provincial government openly (key word openly) going against the CCP’s wishes. Or a judge, or a prosecutor.

⬐ jki275

Please don't use "objectively" as a replacement for "in my opinion". The two are not the same.

⬐ pbhjpbhj

You don't believe that Trump's manipulation of Ukraine, say, is a proven fact? He damn near admitted it himself.

Or do you think a president subverting the will of the legislature of their country for personal gain isn't corruption?

I wasn't expressing my opinion.

⬐ jki275

This isn't a political discussion forum.

You are expressing your political opinion about someone you dislike. You are not expressing fact. Just stop.

⬐ pimmen

And for its justice system. And its infrastructure.

The difference in transparency between China and the US is hard to overstate.

⬐ oefrha

> This is not an event for petty emotions.

If only “openly hostile” was limited to “petty emotions” that can be waved away.

⬐ fastball

If only "openly hostile" was true. "open hostilities" generally means outright war or pretty close to it. Clearly something that has not been very close to happening.

⬐ ng12

Welcome to international politics. The US and Russia were in the UN together throughout the cold war -- cooperating on some issues while being at odds over others.

⬐ tanilama

Looking at CDC's response so far:

1. Testing only 400 cases across the whole country.

2. Defective test kits which will only be fixed until Mid March

3. Hawaii now asking ask Japan(which by itself is doing a horrible job at handling the situation) for test kits because they have none, and test 0 people so far.

Doesn't seem first world to me honestly. Might have South Korea gives them some lessons as how to deal with the pandemic situation. Maybe they are transparent and honest, but I really don't want to understand much more about how little they can do.

I am watching the development almost hourly everyday and so far CDC is only giving me more reasons to panic.

⬐ Symmetry

We had been making due with Lab Developed Tests (LDTs). They work fine but they're only allowed to be used at the lab that developed them and we're going to need tests that can be run at hospitals.

The CDC can legally issue emergency tests that can be distributed the way we need to. But for these to be used the FDA had to issue an Emergency Use Authorization (EUA). And that couldn't happen until the Health and Human Services Department (HHS) declared this was an emergency. All of which happened.

But When the HHS declared an emergency the situation is legally considered to important for LDTs to be used, which would normally be fine. But the original CDC tests had a reagent that was incorrectly manufactured. That's being fixed but last I heard the working testing kits hadn't been distributed yet.

This is sort of a huge problem because testing for a particular viral RNA sequence isn't especially hard and it should be within the capability of even a large hospital to develop their own tests, though there is a chance they'd mess up the way the CDC did. Our whole bureaucratic structure in the US isn't set up to deal with a new disease emerging quickly and we really need to fix this.

⬐ tanilama

Thanks for the information. The slated bureaucracy is eye-opening.

⬐ jariel

"more than a month and a half after the first case was detected, "

The 'first case' of what exactly though? Nobody knew it's effects, transmissibility, etc. etc..

I actually believe that even if said doctors were not sanctioned, not much would have really changed.

I think the delay to the authoritarian clamp-down would have been roughly the same.

In the West, we have responsible actors but they're neither entirely knowledgable (nobody is) neither do they have the widespread authority to do what China is able to do.

But much worse are places like India, Malaysia, Indonesia, Philippines ... these to me are the scary spots with high concentrations of people, crude medical practices, not a ton of gear, and no legit central authority to really turn the wheels on the disease.

And since the cat is out of the bag ... it doesn't look good.

⬐ rorykoehler

Not sure I’d lump Malaysia in with this lot but otherwise I agree. No cases on Indonesia? No chance

⬐ TravelN0mad

No confirmed cases, that is. The thing is, that Indonesia mostly doesn't have the means to detect the disease, or only in specialized labs.

Also, if no "known" cases are present in a specific country, the awareness to check for specific symptoms is probably lower.

That's also the curious thing about why usually the detection rate in a country rises fast in the beginning - when the first infected patient has been found, as by then doctors start to specifically test for the virus.

⬐ infinity0

> China's authoritarian government is largely responsible for the severity of the initial outbreak.

The recent explosion in cases in South Korea & Italy, which are much less authoritarian than China, would seem to be quite a large counterexample against this overconfidently-asserted conjecture of yours.

⬐ hoseja

Thank you, feels like 50-cent army found this thread or something, it's disturbing.

⬐ yibg

China can be held responsible for the slow early response and attempt to cover things up as well as being praised for the decisive efforts at containment later on.

I don’t want to let them off the hook for down playing this thing early on but I’m not sure how much more effective containment would’ve been if this happened in another dense country. Say Japan, India or somewhere in Europe.

⬐ iCarrot

Or say the US. In 2009 pandemic, the influenza A H1N1 pdm-09 originated from Mexico, spread to the US, and then to the world.

⬐ Retric

By comparison pdm-09 would have killed somewhere between 8 and 60 people with ~78,064 infections not 2,715 and counting. Thus reasonably getting a vastly lower response.

Deaths are easy to count if they are counted. Local doctors have photos of more dead in the hospital than were reported by China.

Numbers don’t line up based on a basic statistical analysis.

Checkout these videos for reference. https://www.youtube.com/watch?v=hSIt496d82s

https://www.youtube.com/watch?v=nkF4qYdNU9Y

For those interested in knowing more about this, from people that have lived in China for a long time, had families there, and have daily contact with others that still live there, I recommend these videos:

“Coronavirus: the lies and the truths” (29th of January) “Let’s look at a timeline of what’s happened to see how slowly it has been dealt with, and how the information was actively suppressed.” https://www.youtube.com/watch?v=hSIt496d82s&t=1m2s

“Coronavirus - Doctors arrested for revealing the truth” (31st of January) “So by now you’ve undoubtedly heard that, right in the beginning, a number of people were arrested for spreading rumors when they first tried to discuss the fact that there was a new virus going around in China. Turns out these people were all doctors.” https://www.youtube.com/watch?v=HE7Iz7HLpYg&t=0m12s

Winston, the author of the second video, is in fact married to a Chinese doctor, and they keep in touch with their doctor friends in China. He also worked for years organizing training sessions for doctors all around China, so they both have direct knowledge about how those things work there and direct communication with people currently dealing with the situation on the ground.

They have more recent videos, but those two are the first ones I recommend watching. Their channels are: - laowhy86: https://www.youtube.com/channel/UChvithwOECK5g_19TjldMKw - serpentza: https://www.youtube.com/channel/UCl7mAGnY4jh4Ps8rhhh8XZg - ADVChina (their joint channel): https://www.youtube.com/channel/UCwNPa8fSXzzAZuT9859GVhg

Edit: a brief take on this from the BBC (4th of February): “... well, we know that some warnings were ignored or silenced. Let’s focus on this doctor, he was working at Wuhan central hospital and noticed seven cases that he thought looked like SARS (that’s a virus that led to a global epidemic in 2003) and in December he posted a warning about a potential outbreak in a chat group with fellow medics. Shortly afterwards he was summoned by Police and accused of making false statements, and being told he’d severely disturbed the social order. He was then given this document to sign. [...] «We solemny warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice - is that understood?” https://www.youtube.com/watch?v=dRggIb5Je_w&t=4m0s

⬐ BiasRegularizer

Here's the actual news from Jan 1 reporting on the 8 "rumor spreaders". They kept emphasizing that there was no evidence of human-to-human transmission. It's pathetic to look at now. (sorry the article is in Chinese)

https://www.guancha.cn/politics/2020_01_01_530191.shtml?s=zw...

⬐ tim333

Todays FT also has a good article "Coronavirus: the cost of China’s public health cover-up" https://www.ft.com/content/fa83463a-4737-11ea-aeb3-955839e06...

⬐ AlbertoGP

This just in: that doctor that raised the first alarm and was silenced back in December has died from it:

https://www.globaltimes.cn/content/1178792.shtml

https://twitter.com/WHO/status/1225440373880782848

⬐ c0restraint

Neither of those links are working for me right now... first one is “not found” and second one is “doesn’t exist”

⬐ AlbertoGP

Yes, both GlobalTimes and WHO just pulled those links, instead of posting a correction, after the authorities decided to plug him to an ECMO (https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygen...) machine to defuse the massive uproar in China about his death, then had to declare him dead again.

Others like The Guardian updated their articles, keeping the URL, as the situation changed. After the announcement that he was being kept alive, they added a paragraph at the top of the article explaining that, and later when he was finally confirmed dead updated that note to simply say “Early reports of death of Li Wenliang were retracted, only for doctor to succumb to disease later in day”: https://www.theguardian.com/world/2020/feb/06/whistleblower-...

⬐ AlbertoGP

Seems he’s not dead yet. Both GlobalTimes and WHO have just deleted their posts, instead of a proper correction like The Guardian: https://www.theguardian.com/world/2020/feb/06/whistleblower-...

«A post on the official Weibo account of the Wuhan hospital where Li was being treated also said the doctor was in critical condition. “We are doing our best to resuscitate him,” the Wuhan City central hospital added.»

Another source reported that he’s being kept alive after heart failure by an ECMO (https://duckduckgo.com/?q=ECMO+oxygenation) machine.