H5N1

COVID-19 posts from January 1, 2020

On the morning of New Year's Day, I posted this item from Beijing News: China: Wuhan South China Seafood Market has been closed, unexplained pneumonia has a mature surveillance system.

I also posted an item from the South China Morning Post: World Health Organisation in touch with Beijing after mystery viral pneumonia outbreak. 

 

As usual, when some outbreak occurs, I started rummaging through whatever local media I could find, and posted a story from Wuhan's Yangtze Daily: China: No human-to-human transmission of pneumonia in Wuhan.

 

And this from Chutian Dushi Bao: China: 8 people spread false information about pneumonia and were processed.

 

That was it. My running stories at the time were the tenth Ebola outbreak and the Australian wildfires. But the "mystery viral pneumonia" had clearly grabbed the attention of the Chinese health system (and the Chinese cops), and it was precisely the kind of event that Flublogia evolved to cover. The response online was very much like those in the early days of H1N1, cholera in Haiti, Zika in Latin America, and Ebola in West Africa and DR Congo: something undiagnosed had emerged, people were getting very sick, and no one seemed to know what it was.

 

But as grim as those earlier outbreaks turned out to be, they didn't turn the world upside down. Six months after they started, they were still killing people, but (except for H1N1) they were relatively contained in parts of the world of little interest to the "advanced" nations. 

 

Not this time. After the past six months, we have no business calling ourselves "advanced." COVID-19 has shaken us all, exposing our every weakness and failure without giving us a moment's respite to remedy our political and structural flaws. This is a different world from New Year's Day 2020, and all we can say about New Year's Day 2021 is that it too will dawn on a world very different from today's. 

FluTrackers blogger Sharon Sanders spotted COVID-19 before American media

Thanks to @V2019N for alerting me to this report. Via The Washington Post: FluTrackers blogger Sharon Sanders spotted coronavirus before American media. I am happy for, and proud of, Sharon and the whole FluTrackers team. Excerpt:

The news seemed so intriguing — and so potentially alarming — that Sharon Sanders stayed up almost until dawn on Dec. 31 to keep track of it.  

From her home in Winter Haven, Fla., Sanders began compiling reports of public comments by health officials in China’s Hubei province. The officials, Sanders reported on her blog, FluTrackers, had announced an outbreak of an unusual cluster of pneumonia cases, caused by a mysterious virus. 

The disease apparently had spread among merchants in a seafood market in Wuhan, a city of 11 million people. “A number of people from hospitals in Wuhan said that the current cause is not clear,” read one of FluTrackers’ first, uncertain posts about the outbreak. 

Although few Americans saw the reports and even fewer reacted with urgency, Sanders’s blog began to track, in minute detail, what would soon explode into a pandemic. As eventually became clear, the illnesses chronicled by the blog were the first caused by a new strain of coronavirus.

Only a few mainstream news outlets, mostly in Asia, had picked up the story, echoed in brief reports that first went out on wire services like the Associated Press and Reuters on Dec. 31. Major American news outlets, however, were slower to grasp what Sanders watched unfold in those early morning hours. 

The New York Times on Jan. 6 took note of a “pneumonia-like illness” that had sickened 59 people in Wuhan; two days later, The Washington Post, the Times and AP published staff stories about the outbreak after Chinese researchers determined that the illnesses in Wuhan — later dubbed covid-19 by the World Health Organization (WHO) — were the result of a previously unknown coronavirus. 

Even so, the story wasn’t big news. That first Times story was published on page 13 of its print edition; the Post put its first story on A14.  

The story didn’t fully enter mainstream discussion in the United States until later in the month. Fox News anchor Neil Cavuto, for example, brought it up in an interview with an emergency-room physician on Jan. 20, noting the potential for rapid transmission. “So I’m beginning to wonder now whether the genie is out of the bottle here...” he said.  

The slow-building reaction suggests the Western media underplayed what was unfolding, certainly in the first weeks after the Chinese disclosed it. Even after SARS, swine flu and other outbreaks of recent vintage, a small but novel infection halfway around the world might not have seemed like a very compelling story, especially when other stories — including the impeachment trial of the president — were at the top of the agenda. 

When news outlets finally devoted more attention to the story in late January and early February, President Trump and his allies responded by criticizing the coverage as hype, branding it a Democratic conspiracy to undermine Trump‘s reelection chances.

To be sure, much of the early reporting about the virus was tentative and sometimes inaccurate, as is often the case with breaking news events. The authorities involved often don’t have a full understanding yet of what’s unfolding, leaving the journalists who are reporting on them equally in the dark.  

But the first reports and commentary about the outbreak were further complicated by questions about the credibility and candor of Chinese officials — the same questions that arose with the outbreak of Severe Acute Respiratory Syndrome (SARS) in China in 2003. During that contagion, WHO accused Chinese officials of covering up the number of cases. 

The reports flagged by FluTrackers, in fact, were based on government statements about patients who had already been sick for weeks. Efforts to sound the alarm earlier were suppressed; eight doctors in Wuhan who raised concerns before the official announcement on Dec. 31 were detained by police. One of the whistleblowers, Li Wenliang, became a national hero in China before he died of the virus. 

Sanders, however, recognized quickly that there was something unique about this outbreak — in part because it seemed highly unusual for Chinese officials to even be acknowledging a health crisis in the first place.

“Local officials and media in China need government approval before they can disclose negative information,” she said in an interview. “Any type of disease outbreak is considered negative [news] and may impact social order.”

When Chinese officials admit to a problem, she said, they tend to undersell it — a red flag that there’s far more to the story. This is what prompted her to stay up late on the night of Dec. 31. But Sanders said she had no idea where the story of the pneumonia outbreak in Wuhan would lead.

Her blog’s contributors — who include some medical professionals, though many merely “self-trained” disease-detection enthusiasts — routinely submit links to local news reports, medical journals and other data from around the world, with an eye toward unusual patterns. One of the tipoffs to the seriousness of the Wuhan situation was the absence of data: After the initial disclosures from officials on Dec. 31, the statements stopped.

“China always reports their good news,” she said. “When you don’t hear anything for five days, it warrants more investigation. . . . We knew something was unusual because we follow China and look for trends.”

The details pointed to a far more serious situation than Chinese officials had described. Sanders and her contributors soon started picking up “things we had never seen before” from a hodgepodge of sources, including doctors in Hong Kong, local media accounts and ordinary people in Wuhan. The bits and pieces were shocking: hospital wards with health-care workers dressed in full patient-protective suits, teams disinfecting entire streets, body bags stacked in vehicles outside hospitals.It quickly became clear that the problem wasn’t isolated or contained. “It appeared to be an infectious and dangerous agent, [an] ominous sign for the world,” she said.

Sanders, herself a self-trained disease-tracker after working in finance and real estate, co-founded the site in 2006 as a hobby — or, as she describes it, “a fun way to meet interesting and intelligent people online.”

Her timing was pretty sharp: Soon after the blog launched, a series of global disease shocks began to break, from the avian flu in 2006, the H1N1/swine flu pandemic in 2009, and the H7N9 bird flu outbreak in China in 2013. The blog aggregated research papers, local reports and obscure documents translated by contributors from multiple languages.

Soon, officials from WHO, the U.S. Centers for Disease Control, the National Institutes of Health and international agencies were logging on, sometimes several times a day.

Sanders doesn’t take advertising or sell anything on her site. She funds the whole enterprise out of her pocket; her overhead is just a few thousand dollars a year for server time. The rest, she says, is “a labor of love.”

These days, more than a few people seem interested. Since the outbreak in Wuhan, Sanders says, FluTrackers has attracted nearly 353,000 unique visitors who have clicked on the site 15.5 million times, far more than the 11.6 million recorded during all of 2019.

Personal note

On this date in 2005, I posted my first item on this blog: H5N1: Bird flu infects nurses. This site was a sideline, an attempt to educate myself about a little-known but threatening new disease. My real interests were in blogging about how to write fiction, how to write for the web, and answering questions about English usage. 

But as time passed, H5N1 and then other outbreaks took up more and more of my attention. I became part of a little group called Flublogia; many of the early bloggers are gone now, but a few like Mike Coston and FluTrackers are still very active indeed. 

 

And with every emerging disease, experts emerged to battle them, along with a growing group of superb health journalists and science writers. Flublogia made itself useful by digging up stuff from obscure corners of the internet and passing it along to people who could make sense of it (or dismiss it as a scare). I think of Flublogia as a kind of Baker Street Irregulars, kids doing rudimentary epidemic intelligence for the "grownups"—the scientists and public health experts. The grownups are often politically constrained from saying rude things about their political masters, a constraint we street urchins are free of.

 

Each outbreak has been scary at some point, and then faded out. Sometimes I thought Flublogia was like the odd group in the Beyond the Fringe sketch, waiting day after day for the end of the world: "Never mind lads, we must get a winner some day."

 

Well, we do seem to have a winner now. I saw a doctor in my clinic today (after an hour's wait), just to get some prescriptions renewed. He's Iranian, he was wearing a mask, and he told me he's never seen anything like this in his 20 years of practice. 

 

I think I caught a thousand-yard stare in his eyes, the kind I used to see in Canadian students who'd fought in Vietnam or Afghanistan, or an Italian doctor who'd worked in "the pandemic": H1N1 had been considered a joke by the public, but not by those who cared for the victims.

 

Sheltered though I am, I can imagine that stare in my own eyes by the time this is over. At 79 I'm very aware that I'm a target in a target-rich demographic: those over 60. This afternoon a West Vancouver retirement home announced two new COVID-19 cases, one in a staffer and one in a resident—a home where a loved family friend lives. As the cliché has it, it's getting up close and personal.

 

 

My personal trainer, an Aussie shepherd, makes sure I stop poisoning myself with screen time by taking me for regular walks in our local woods three or four times a day. You may find it helpful seek similar professional help. 

 

COVID-19 is in my opinion the biggest world event of my lifetime since V-J Day, which I recall as a four-year-old wondering why so many car horns were honking in the distance. The wars of 75 years, the missile crisis, the flu pandemic of 1957, 9/11—a virus we didn't even know existed last fall has called into question everything that we've built up since V-J day.

 

And like all those lesser events, those who learned from them were the survivors. I hope to be a survivor, and I hope you are too. 

 

Go walk the dog.

CIDRAP's Novel Coronavirus (COVID-19) Resource Center

After such a bad day, I'm happy to report that CIDRAP has started a Novel Coronavirus (COVID-19) Resource Center:

CIDRAP is tracking and analyzing the rapidly evolving worldwide outbreak of novel coronavirus (COVID-19) disease that originated in China. The CIDRAP COVID-19 Resource Center provides a deep well of information for public health experts, business preparedness leaders, government officials, and the public.

It's already on my COVID-19 Links, and I expect to be consulting it daily if not hourly.

Fake news goes coronaviral

I've expanded a recent blog post into an article, and The Tyee has published it: Fake News Goes Coronaviral. Excerpt:

After following global health issues for 15 years, I’m used to a sudden burst of information about each new disease outbreak — SARS, H5N1, H1N1, cholera, MERS, Ebola. But I’ve never seen such a geyser of information as that generated by the current novel coronavirus (2019nCoV) in China. 

Most of that information is solid, something to build on for future research and preparation. But some of it is dangerously fake news, created by cynical opportunists eager to push their agenda regardless of the harm they do to global health and the people it tries to care for. 

A couple of days ago, searching for coronavirus news, I found a story claiming that China’s coronavirus death toll as of Feb. 1 was somewhere around 25,000, out of 150,000 cases. The official figures at that point were 304 deaths out of 14,380 cases. The story was on a site called CCN.com, reporting mostly on digital currencies and sports with a dash of regular news. (CCN stories have appeared on the main page of the Google News aggregator, which says something about the credibility of either CCN or Google’s algorithms, as we shall see.) 

CCN based its report on one in the English-language newspaper Taiwan News. The Taiwanese story said that daily coronavirus updates on the Chinese social media site Tencent had several times posted high figures that suddenly disappeared, to be replaced by much lower ones. Unidentified “netizens” had not only noticed the changes but had had the presence of mind to do a screengrab of one on Feb. 1. 

Well, it was exciting and scary, but the report had some very dubious assumptions. I started thinking like a disaster novelist, pitching a thriller about a pandemic breaking out, to a serious editor who can see the holes in any plot.

The lessons of flu blogging

Infectious Diseases Hub has published my article The lessons of flu blogging. Excerpt:

In the spring of 2005, I started a blog about H5N1 avian influenza – not because I knew anything about it, but because I didn’t. Surfing the web for news about it would, I thought, teach me something. 

That it did – and much more. I soon realized that I’d stumbled into a worldwide online community that I learned to call Flublogia: a growing number of bystanders, journalists and health experts who were beginning to share information on outbreaks and a growing number of public health issues. We didn’t have to teach ourselves; we could teach one another. 

Since then Flublogia has evolved into a volunteer epidemic-intelligence service, which is sometimes useful to the professionals and sometimes a nuisance. We’re useful in part because we work for free, usually every day of the week. We get wind of public-health problems and relay them via blog posts, tweets and other social media. When the professionals come to work on Monday morning, they may find next week’s agenda waiting in their Twitter feed. 

And as outsiders, we’re not obliged to be politically tactful; we can blast this or that government or health agency or NGO without fear of reprisal. I suspect the professionals, sworn to silence, tolerate us as conveniently annoying to their political masters.

Links to nCoV2019 resources

Well, we have a situation here, with coronavirus news coming in faster than we can handle but still not fast enough. I've created a new list of Novel Coronavirus Links, over in the far right column: a mishmash of health agencies, media, and Twitter links, very likely to expand. Its purpose is mostly to save myself some time in finding news stories, but its yours as well. And if you find other reliable sources of coronavirus news, let me know and I'll add them to the list.

Housekeeping note: New measles list

I've (finally) added a list of measles links; you'll find it in the right-hand column, just below the Ebola list. If you're aware of any reliable, frequently updates measles resources, please let me know and I'll add them.

The infographic just below got me going on this. I was disappointed but somehow not surprised to find that the health ministries of Madagascar and Ukraine have essentially to say about the outbreaks they're contending with. But I'll keep looking on their sites, and if some obscure page turns up on either site, I'll link to it on the list.

Samoa measles: Police charge anti-vaccine blogger

Via Talamua On-line News: Police charge Anti-Vaccine blogger.

APIA, SAMOA – 6 DECEMBER 2019:  Police have arrested the 50 year old man who publicly stated on social media with reference to the current vaccination drive that “I’ll be here to mop up your mess. Enjoy your killing spree.” 

The comment drew angry responses with one saying the man, Edwin Tamasese had a “God complex.” 

A press statement from the Attorney General and Police today confirm that an alleged anti-vaxxer has been charged with incitement against the government vaccination order.  

The Deputy Police Commissioner, Papalii Monalisa Tiai Keti confirmed with Talamua that Edwin Tamasese was arrested by police in Savaii yesterday morning.  

The statement said a formal complaint was received by the AG from a concerned member of the public and duly referred to the police. 

The allegation is that the individual publicly stated with reference to the current vaccination drive “I’ll be here to mop up your mess. Enjoy your killing spree.” 

The AG confirmed that “this person who had previously been warned by the Police, has been charged and his bail is opposed for risk of reoffending. He is therefore in custody until the first available Court date.”  

This week, police confiscated Vitamin A & C supplements from patients at the Poutasi Hospital. There have been reports of parents of young patients brought in for measles treatment, bringing Vitamin tablets into the National Hospital at Moto’otua.  

A young mother whose 5 month old baby is being treated at the Poutasi hospital told Talamua that another patient gave her the tablets.  

Last week, Tamasese posted photos of the supplements he had received from the United States. He is in police custody in Savai’i to await his court appearance.

Thoughts on trolls, bots, and anti-vaxxers

This afternoon I found myself embroiled in a good old 1990s-style flame war on Twitter, in which Jason Kindrachuk and I contended with an anti-vaxxer. Its nostalgia value was limited, and I soon realized that the anti-vaxxer's intent was not to persuade us, or even discredit us, but to waste our time and the time of anyone else following the exchange.

So I pulled out and blocked the anti-vaxxer. Considering the length of time I've been blogging and tweeting about the politics of public health, it's remarkable how rarely I've run into this kind of nuisance. But as Jason observed, the public-health twittersphere is increasingly infested with annoying tweets. Dr. Peter Hotez has been a major target of the anti-vaxxers, but they're attacking plenty of other folks these days.

The attacks put us at an immediate disadvantage, because we were educated to provide evidence for our assertions and actions. But 75 years ago, Jean-Paul Sartre explained in his essay Anti-Semite and Jew that our adversaries are under no such constraint:

Never believe that anti‐Semites are completely unaware of the absurdity of their replies. They know that their remarks are frivolous, open to challenge. But they are amusing themselves, for it is their adversary who is obliged to use words responsibly, since he believes in words. The anti‐Semites have the right to play. They even like to play with discourse for, by giving ridiculous reasons, they discredit the seriousness of their interlocutors. They delight in acting in bad faith, since they seek not to persuade by sound argument but to intimidate and disconcert. If you press them too closely, they will abruptly fall silent, loftily indicating by some phrase that the time for argument is past. It is not that they are afraid of being convinced. They fear only to appear ridiculous or to prejudice by their embarrassment their hope of winning over some third person to their side.

That third person is presumably someone as ignorant and bigoted as themselves, and as resentful of know-it-all experts. If we engage with the trolls and bots and anti-vaxxers in hopes of winning that third person over to our side, we're probably deceiving ourselves and wasting our time.

Better to reach those third persons on our own initiative, with good-news stories about the successes of public health: vaccination, sanitation, good nutrition. If we must deal with bad news (and we must), let it be accounts of murderous half-wits like the Mai-Mai and ADF—not the dime-a-dozen bots running on Russian algorithms. 

If those trolls and bots show up in our timelines, follow the sage advice of my esteemed colleague Harry Turtledove and block them. Don't answer them—you might as well try to debate with a mosquito about whether malaria is a real disease.

But don't forget to take the initiative: get into the hashtags like #SamoaMeasles and #Measles with positive good-news tweets, not counter-attacks on the trolls. When your tweets attract mosquitos, block them and get more good news into the hashtags. Don't forget that a key goal of the trolls and bots is to make people uncertain of the truth, or even whether something like truth exists.

But don't answer the trolls directly. Just block them, block the clones that follow them, and use the time you save to do some good.