Life and Death in a Wuhan Coronavirus ICU - <AUTHOR> https://www.straitstimes.com/asia/east-asia/reporters-notebook-life-and-death-in-a-wuhan-coronavirus-icu <comment><USER3> > Doctors there were running "naked" as they knew they were set to be infected > given the shortage of protective gear. They still worked there nonetheless.

That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died.

[https://www.straitstimes.com/asia/east-asia/chinese- doctor-w...](https://www.straitstimes.com/asia/east-asia/chinese-doctor-who- tried-to-warn-colleagues-in-wuhan-about-coronavirus-dies)

<comment><USER4> Last thing the CCP needs is martyrs against the state

<comment><USER5> Easily solved by turning him into a state hero.

<comment><USER6> A state hero that the state arrested and silence just weeks earlier? That would be transparent.

</comment></comment></comment></comment><comment><USER7> My wife is mainland Chinese, and she has been saying that it a worse than what the government is saying. Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP.

Anyway, I feel like it'll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China.

Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don't know if she'll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ).

I live in Taiwan and they've been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.

<comment><USER8> I don't understand what it is that the Chinese authorities are supposedly misreporting?

The mortality rate of 2% is consistent with the number of cases and deaths reported by other countries.

Is it that there are a large number of undiagnosed cases? That is kind of a given and is probably also the case in other countries.

The timespan between first case and until it gets reported to who and quarantines start is less than a month. To me that seems very fast (but I am just a layperson).

<comment><USER9> Chinese authorities at some level -- it's not clear that this was CCP or local Wuhan decisionmakers -- clearly tried to shut down initial reports of the outbreak, as evidenced by Dr. Li Wenliang's detention and citation.

As a new disease, with the first cases possibly being acquired as early as late November 2019, it wasn't until mid to late January 2020 that city and national authorities appeared to start taking the outbreak seriously.

I'm not aware of other novel outbreaks outside of China and how quickly those have attracted notice, though there's the case of the 1976 initial outbreak of Legionaire's Disease, reported within a week of first outbreak (though the disease was both fast-acting and rapidly lethal for many victims). However epidemiologists _also_ realised that there had been previous, unrecognised outbreaks, dating to the 1950s. See:

[https://en.wikipedia.org/wiki/1976_Philadelphia_Legionnaires...](https://en.wikipedia.org/wiki/1976_Philadelphia_Legionnaires%27_disease_outbreak)

The case of HIV/AIDS in the US and elsehwere would be a case of a disease with ascribed social and moral assocations, for which early responses were very much delayed, on of several examples of stigma associated with the disease: [https://en.wikipedia.org/wiki/Discrimination_against_people_...](https://en.wikipedia.org/wiki/Discrimination_against_people_with_HIV/AIDS)

Reponse to the 2012 MERS outbreak appears to have been swift -- in November of 2012: [https://en.wikipedia.org/wiki/2012_Middle_East_respiratory_s...](https://en.wikipedia.org/wiki/2012_Middle_East_respiratory_syndrome_coronavirus_outbreak)

The 2003 SARS epidemic, also emerging in China, _also_ first emerged in November, but was not internationally reported until the following March:

[https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome)

(The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.)

Point being:

\- China are slow to detect, report, and respond to new contagious epidemics. Notably so in the case of SARS, and less so, but still, with 2019-nCoV.

\- Other countries, including the US, have had similar failures.

\- Early unofficial public disclosure of 2019-nCoV was prosecuted by Chinese authorities, though at what direction is unclear.

\- Trust between the people and the government is somewhat frayed.

\- There are also numerous actors with incentives to make the most of any missteps of the government, or to inflate distrust.

Several of those groups have legitimate gripes against the Chinese government, and I've seen reports associated with Falun Gong, Hong Kong, and Taiwan specifically. I've _not_ seen any associated with Tibet or Uygher populations. And there are various rabble-rousing actors elsewhere, doomers, and conspiracists (generally of the nutcake variety).

This ... clouds information. Many of the criticisms are legimate, some are not, and sorting fact from fiction (both between and _within_ reports) is challenging. China are in the position where _both_ locked-down _and_ unfettered communications are potentially harmful -- the first for preventing accurate information from being available to _both_ public _and_ government, the latter for allowing _agents provacateurs_ to rumourmonger, exaggerate bad news, and spread active disinforation. This is strong shades of attacks the West has seen over the past several years (within the US, UK, EU, and elsewhere), some of it from China itself.

How China responds will be interesting.

<comment><USER10> > The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during > November may be significant.

From [1]: The "seasonal" reflects the fact that viruses can't tolerate high heat and humidity, preferring the cool and dry conditions of winter and spring, Webby said. That's why flu, as well as the four coronaviruses, are less prevalent in warm, humid months.

1: [https://www.statnews.com/2020/02/04/two-scenarios-if-new- cor...](https://www.statnews.com/2020/02/04/two-scenarios-if-new-coronavirus- isnt-contained/)

<comment><USER9> Right.

Also less prevalent in warm and humid regions (though spread in Singapore and Thailand is ... interesting).

This is among the reasons my concerns' been on a breakout in North Korea, which has both a meterological and political/epidemiological climate that seems highly favourable to outbreak of a disease such as 2019-nCoV.

Though it's politically viable to order a near-complete shutdown of transportation and travel, the likelihood of this being effective (particularly against high-level party members breaking quarantine), or pragmatically possible to sustain (what exists of the PRK economy likely requires people in close contact), limiting epidemiological effectiveness.

</comment></comment></comment></comment></comment><comment><USER11> If they screw up other measures, like hygiene for the sick and food delivery to 50 million people they can multiply the death rate.

Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition.

[1]: Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic - Implications for Future Pandemic Planning [https://www.nih.gov/news- events/news-releases/bacterial-pneu...](https://www.nih.gov/news-events/news- releases/bacterial-pneumonia-caused-most-deaths-1918-influenza-pandemic)

> However, it is possible that — as in 1918 — a similar pattern of viral > damage followed by bacterial invasion could unfold, say the authors. > Preparations for diagnosing, treating and preventing bacterial pneumonia > should be among highest priorities in influenza pandemic planning, they > write. "We are encouraged by the fact that pandemic planners are already > considering and implementing some of these actions," says Dr. Fauci.

<comment><USER12> Spanish flu killed very many people in regions that did not directly participate in WWI, so civilians (as opposed to recruits sent overseas) should not be affected by the war; e.g. India, Indonesia, etc.

The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.

<comment><USER11> In the US roughly half present of the population died. It killed roughly ~5% of the world's population.

btw. I did not say WWII was the single cause for high mortality. Hygiene, malnutrition etc. contributed. And the virus itself had higher mortality rate than usual, but not as much as previously thought.

<comment><USER12> Do you have a source for that 8-22% _of population_ died, which seems an extremely large, unrealistic number?

E.g. [https://www.quora.com/Which-country-was-most-affected-by- the...](https://www.quora.com/Which-country-was-most-affected-by-the-Spanish- Flu?share=1) cites some resource which shows an estimate of 2.3 M people dead in Europe, and [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634693/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634693/) shows an estimate of 2.6 M excess deaths in Europe i.e. 1.1% of population.

The vast majority of the worldwide deaths from Spanish flu were in Asia; the region with most deaths was India.

<comment><USER11> Sorry. Copied wrong numbers.

In europe 1.1%.

>Whatever is taken as estimation of the American pandemic death burden, it is well below the European estimations we provide and others have provided. A possible explanation is that, at the end of WW1, Europe was characterised by massive civilian and army movements, a health care system put at its minimum and frail populations. This has very likely heavily impacted the European death toll.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634693/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634693/)

</comment></comment></comment></comment></comment><comment><USER13> Honestly if there is truth to this article it is reassuring. I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted.

This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die.

Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.

<comment><USER14> > I've been scouring the darker corners of the internet obsessively for every > seemingly reputable bit of data under the assumption that virtually anything > official out of China could not be trusted.

I do the same. If you can read Chinese, I strongly recommend you read Sina Weibo, a micro-blogging social media in China, or Toutiao. Read them quickly before posts are inevitably deleted by the censors. There are some truly harrowing stories of ordinary people being refused treatment and left to die at home.

<comment><USER15> Can you grab and translate and share some of these please?

Also, do you have any opinion on this:

[https://i.redd.it/88osl54prjf41.png](https://i.redd.it/88osl54prjf41.png)

<comment><USER13> According to Wikipedia SO2 comes from fossil fuels so let's cross our fingers and pray they're just bringing a power plant online or something.

<comment><USER15> Huh:

[https://www.reddit.com/r/conspiracy/comments/f18ruz/more_evi...](https://www.reddit.com/r/conspiracy/comments/f18ruz/more_evidence_to_suggest_bodies_are_being_burnt/)

<comment><USER16> [https://www.reddit.com/r/China_Flu/comments/f19uc8/debunking...](https://www.reddit.com/r/China_Flu/comments/f19uc8/debunking_the_burning_bodies_sulphur_sulfur/)

</comment></comment></comment></comment></comment></comment><comment><USER17> I've learned more about the virus reading this article than anything else I've read over the past weeks.

<comment><USER18> I submitted this already, but this is worth reading also:

[https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere...](https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference- call-coronavirus-expert)

<comment><USER19> He's the expert, and I'm not. But I can do math. Influenza this year in the US: 19M infected and 10K fatalities. If you posit 1% mortality rate for coronavirus like he argues, that's 20 times more deadly. And it's twice that in China, it's unclear if that's a statistical anomaly or a structural feature of some difference in how things are tested/reported in China.

So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over.

I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?

<comment><USER20> You can only do the math right if you get counter and denominator right. The number of unreported cases is probably very high.

I found this in the article posted above:

 _"So the 20,000 cases in China is probably only the severe cases; the folks that actually went to the hospital and got tested. The Chinese healthcare system is very overwhelmed with all the tests going through. So my thinking is this is actually not as severe a disease as is being suggested. The fatality rate is probably only 0.8%-1%. There's a vast underreporting of cases in China. Compared to Sars and Mers we are talking about a coronavirus that has a mortality rate of 8 to 10 times less deadly to Sars to Mers. So a correct comparison is not Sars or Mers but a severe cold. Basically this is a severe form of the cold."_

<comment><USER21> Why are they building 12 hospitals at breakneck speed for a severe cold? Do you honestly believe that?

<comment><USER22> Wuhan's Healthcare system could not handle a widespread cold break out either.

Much of the rest of the world has sufficient capacity to hospitalize patients to prevent an outbreak. China being China is behind both due to recent industrialization and also an authoritarian state which lied about the dangers.

Take it how you want, but this is a severe flu which would not have survived in more industrialized nations.

</comment></comment></comment></comment></comment></comment><comment><USER23> Great article all around, worth reading as it's one of the only I've seen that are actually talking about disease progression and timeline. Some key info from the article:

\----

Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus?

Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus.

A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases.

I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting.

But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.

The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.

For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks.

\-----

Whole thing is worth reading.

<comment><USER24> Should add their discussion of cytokine storms in healthy people, which appears to have a more rapid timeline

> Some experts argue that the virus triggers a cytokine storm, which ravages > the stronger immune system of young adults

> Based on my observations, a third of patients exhibited inflammation in > their whole body. It was not necessarily limited to young adults. The > mechanism of a cytokine storm is about whole-body inflammation, which leads > to a failure of multiple organs and quickly evolves into the terminal stage. > In some fast-progressing cases, it took two to three days to progress from > whole-body inflammation to the life-threatening stage.

<comment><USER21> Look, you say inflammatory response science says steroids. But what about CBD? Maybe even THC? Let's experiment at least,

<comment><USER25> I always found a shot of straight whisky was good for a cold.

<comment><USER26> 60% of the time, it works every time.

</comment></comment></comment></comment></comment><comment><USER27> I'm curious, for most of the infected, is it obvious from the symptoms whether they have novel coronavirus, or just the regular flu?

That is, the tail end is clearly deadly -- but for the average case, are symptoms much worse than the yearly flu, or around the same?

<comment><USER28> There's a something like 20% hospitalisation rate. That seems kind of scary compared to the flu which is "you have a sniffle, get over it."

<comment><USER29> "the flu", i.e. influenza, is definitely _not_ "you have a sniffle, get over it"

more like feeling like you've been hit by a truck for 2 weeks while you shiver in bed with a fever, coughing your lungs out, unable to function

<comment><USER30> And you may not 'feel better again' for a month, or two, or more.

<comment><USER31> My anecdata from a few influenza events is that it is truly awful. A week of slowly worsening fever. I got close to admitting myself to hospital before my fever broke and I recovered. Symptoms dissapear very quickly once it's over, but it took me months to recover my fitness.

</comment></comment></comment></comment></comment><comment><USER32> This was the most valuable piece of info for me, which I shared among my social circle:

 _Doctor observed that three weeks seemed to determine the difference between life and death._

 _\- Patients with stronger immune systems would start to recover in a couple of weeks_

 _\- Second week, some cases would take a turn for the worse._

 _\- In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent._

</comment><comment><USER33> What can we do right now to increase our bio immunity for this?

<comment><USER9> Vector reduction.

That's the principle mechanism of public health to epidemiological outbreaks: reduce the likelyhood and rate of transmission between people.

This is why the appropriate response is to curtail transport, _especially_ long-distance modes which occur faster than onset of symptoms (e.g., air flights from known epidemic zones). It's why locking down cities within epidemic zones, restricting mobility _between_ cities where outbreaks have occurred, wearing barrier protection to prevent _both_ contracting _and_ transmitting particles, disinfecting infected surfaces, and limiting social and business contact, are all primary responses.

Get a flu shot, if you haven't already. Not because it'll keep you from getting 2019-nCoV, but because you _don 't_ want to be confusing having the flu with having nCoV, and you don't want to have to be out getting treated for flu whilst nCoV's circulating. And having all others treating you like Typhoid Mary to boot.

 _Wash your hands._

Carry (and use) alcohol-based hand sanitiser. (Antibiotic is useless against virus.)

Wash the doorknobs, light switches, taps, knobs/pulls, and bannisters in your home, regularly. Keep visitors and guests to a minimum. Don't touch your hands to your face, eyes, nose, or ears.

Look for indications of breakout in your area on news or online. Realise that _if_ there's a breakout, the disease has likely already been circulating for several weeks, e.g., _the risk is high_. Currently, outside of China, there are very few places at risk -- Singapore, Hong Kong, Japan, Korea, Japan, Thailand, and South Korea are the major additional locations.

Transmission seems to require several hours of fairly close contact.

Stocking up on cleaning supplies generally makes more sense than masks, which are of limited use or efficacy.

Some somewhat nonobvious practices (salt-infused masks, apparently, others may exist) seem to reduce transmission or viral capability profoundly.

For now, the containment trends are strongly positive, outbreaks outside China are quite limited, and it looks as if measures are effective. It'll be another few weeks before this is certain, things could still go quite badly, but signs are encouraging.

Most notably, the new cases _and_ deaths trends are dropping well below their initial exponential trajectory:

[https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou...](https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File%3ALog- linear_plot_of_coronovirus_cases_with_linear_regressions.png)

[https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou...](https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File:Semi- log_plot_daily_incidence_of_nCoV.png)

Comments I made yesterday on Diaspora regarding this, and pointer to a now 10-day-old post based on the then exponential growth, in which I'd suggested we should see containment working on new cases by early February, and deaths by mid-February (we're actually trending well ahead of that):

[https://joindiaspora.com/posts/17158824](https://joindiaspora.com/posts/17158824)

Disclaimers: lay views, not an expert.

<comment><USER34> One more data point.

[https://www.bbc.com/news/uk-51425702](https://www.bbc.com/news/uk-51425702)

Five Britons have tested positive for coronavirus in eastern France, the French health minister confirmed.

Four adults and a child were diagnosed with the virus after coming into contact with a British national who recently returned from Singapore.

</comment></comment></comment><comment><USER35> The sad story of the pregant woman described in the Strait Times article, is described in this link

[http://www.sixthtone.com/news/1005146/dispatches-from- hubei-...](http://www.sixthtone.com/news/1005146/dispatches-from-hubei-two- weeks-between-life-and-death)

</comment><comment><USER36> > That was why ICU medical staff were almost all sickened.

This is a brilliant strategy for spreading the virus to any patients who might've come in with regular cold or flu and hadn't been infected with coronavirus yet.

This is like a commercial for why we need to build medical telepresence robots.

<comment><USER37> If they were in the ICU in a severe or critical state, they already had the virus. ICU is not the same as the regular hospital admissions.

</comment></comment><comment><USER38> There's an understandably big focus on mortality/non-mortality. It seems that people are classified recovered and sent home after 3 to 14 days of tests are clear (depending on the hospital) but I haven't seen estimates for full recovery from symptoms and fatigue afterwards. Many companies run very lean... Is it likely 2 weeks off work per person after hospital discharge? 4?

</comment><comment><USER39> If you get sick with 2019-nCoV, and recover, do we know if You have developed immunity against it at that point?

<comment><USER40> I don't know, but if the answer is no, then a vaccine against it is not going to confer immunity either.

</comment></comment><comment><USER41> If you look at the graphs here:

[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)

And know that in 3 weeks everyone either dies or has recovered.

Doesn't that mean we will see a large amount of total deaths in a couple of weeks?

Those graphs are both exponential!

Remember that cases are subjectively selected, while deaths have a fixed statistical variance!

<comment><USER42> Those graphs depict Total Cases and Total Deaths. (This presentation of data is sometimes used by startups trying to show their amazing growth off to potential investors.)

If you look at the daily change in amounts of deaths from this data series, it is more of a wobbly straight line:

[https://i.imgur.com/gQajRT9.png](https://i.imgur.com/gQajRT9.png)

I did a linear projection of this data series to see how long it would take for a 1000 a day to be perishing if this trend and I came up with 8/8\. Can anyone else replicate this?

I would hope containment would slow these numbers, but it is possible it could go another way. If the data itself is underreported then it could also be worse.

<comment><USER41> Ah, ok... thx!

I guess the number of serious condition jumping from 5000 to 6000 since last I looked yesterday or the day before was what startled me...

</comment></comment></comment><comment><USER43> It was worth reading and by any measure the first great writeup on the virus and the bravery to fight it.

</comment><comment><USER43> The whole thing is worth reading. Hats off to all the bravery around to fight the virus and save lives.

</comment><comment><USER21> Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that's the worst irony I have ever heard.

This disease is virulent and unpredictable. A 34 year old doctor died. 12 hospitals are being built at breakneck speed. This will become endemic at this rate. Either we create a vaccine or we each roll the dice on acquired immunity and too many people die in the process. It is time to be concerned.

<comment><USER44> > Even in Communist China, people are turned away from hospitals due to > inability to pay for treatment...that's the worst irony I have ever heard.

If you had read the whole article you would have learnt that treatment is free for those affected.

> It is time to be concerned.

Concerned sure, alarmed no, like your post seems to tend towards.

<comment><USER45> It became free the day after the person already died for lack of funds for treatment. Very very sad case.

</comment></comment></comment><comment><USER46> "The most regretful thing to me was a pregnant woman from Huanggang. She was in very serious condition. Nearly 200,000 yuan (S$39,505) was spent after more than a week in the ICU. She was from the countryside, and the money for hospitalisation was borrowed from her relatives and friends. Her condition was improving after the use of Ecmo, and she was likely to survive. But her husband decided to give up. He cried for his decision. I wept too because I felt there was hope for her to be saved. The woman died after we gave up. And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients. I feel so sorry for that pregnant woman."

I had the unchecked belief that China claiming to be a communist country would be covering medical costs.

Above reminded me of this: "'He cannot speak or look after himself': A 17-year-old with cerebral palsy died after being left alone for 6 days while Chinese authorities quarantined his father over coronavirus fears" \- [https://www.businessinsider.com/teenager-cerebral-palsy- dies...](https://www.businessinsider.com/teenager-cerebral-palsy-dies-father- quarantined-suspected-coronavirus-china-2020-2)

Edit: I really can't understand why anyone would downvote this comment - <USER2> downvotes are making me laugh.

<comment><USER47> >>I had the unchecked belief that China claiming to be a communist country would be covering medical costs.

This is the problem with socialist, they believe the government is always the good guy, and entrust it to provide for everyone.

We capitalist know that government in all cases the worst solution to any problem

<comment><USER48> Yes, that's why capitalists drive on private roads only, and go to private courts when they get in trouble with private police forces. They also honk to honor their private armies and thank them for their service. The private fire service is of course a pillar of most capitalist communities as well.

<comment><USER36> ...And we're writing about this on an internet that was developed by privately funded defense researchers and private universities. You can use this internet to get driving directions via privately funded geolocation satellites.

<comment><USER48> No, the internet originally was funded almost exclusively by public money (US military and CERN being some of the biggest contributors), and there is basically no such thing as "privately funded defense researchers" \- almost by definition, defense research is funded by public money, or at least by private investors looking to get their money back by selling to the state. Universities also tend to do research funded by outside grants, which in the early days of computer technology were, again, almost exclusively public US military budgets.

GPS is a public utility, as are GLONASS and Galileo, so I'm not even sure what "privately funded geolocation satellites" you are talking about.

Regardless, your claim was a universal (the state is worse at providing ALL services) so showing some services which the state is much better at providing is enough to prove you were wrong.

<comment><USER49> I think GP was being sarcastic.

<comment><USER48> Oops, you may be right...

<comment><USER36> My bad, forgot the /s closing sarcasm tag

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER50> Did you see Eric Raymond having a completely normal one about novel Coronavirus?

[http://esr.ibiblio.org/?p=8587](http://esr.ibiblio.org/?p=8587)

<comment><USER51> An excellent example of how expertise and reasoning ability in one domain does not necessarily transfer to another.

That humility is hard for engineers is something I try to remind myself daily.

<comment><USER52> [https://xkcd.com/1570/](https://xkcd.com/1570/)

</comment></comment></comment><comment><USER53> The original article (chinese version)

[http://china.caixin.com/2020-02-05/101511802.html](http://china.caixin.com/2020-02-05/101511802.html)

</comment><comment><USER54> When the innocent pays for the mistakes of the regime.

</comment><comment><USER55> This whole thing has brought out my conspiratorial side...I don't know what to believe anymore but I feel like we're in a tip of the iceberg situation here. Hope I'm wrong.

<comment><USER56> The [https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere...](https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference- call-coronavirus-expert)

article linked by someone above is quite a good antidote to the worries

</comment></comment><comment><USER57> I think we are dealing with black swan event. It's new disease, higly contagious and with 200 more deathly rate than flu. Since we don't know much about that disease and how much that virus can mutate being extra cautious is best strategy.

<comment><USER58> > with 200 more deathly rate than flu.

Source? I've not seen any published number higher than 5%.

</comment></comment><comment><USER59> Does that lead image tell you something? They are in full gear treating this guy. Would Doctors be geared up like that treating someone for the flu?

<comment><USER60> Doctors get the flu vaccine.

</comment></comment><comment><USER61> Some say the mortality rate is 10-20% because the 1-2% numbers being passed around are comparing current deaths against current population who have the disease. Current deaths should be compared to the population that had the disease at the time they contracted it which was 1-2 weeks ago. The epidemic began only two weeks ago.

[https://qz.com/1798887/china-coronavirus-fatality-rate-is- to...](https://qz.com/1798887/china-coronavirus-fatality-rate-is-too-early-to- tell/)

<comment><USER62> How useful is comparing deaths to confirmed recoveries?

<comment><USER63> While the epidemic is still in an exponential growth phase, not very useful, because death and recovery may not take the same average time from initial symptoms. Even a small difference in time will result in a huge bias in the death/recovery ratio, which right now is about 1:3, using the official statistics.

</comment></comment></comment><comment><USER64> The number of people dying each day from this corona virus is increasing and these are official numbers so might be under reported. 29-30th Jan around 40 people were dying a day now it has reached 80-90. When you take into account the number of infected is still increasing and no real way to control the spread or treat the virus this is going to be way worse in the next few weeks. [https://voice.baidu.com/act/newpneumonia/newpneumonia](https://voice.baidu.com/act/newpneumonia/newpneumonia)

<comment><USER65> As the share of the population that is infected grows, the death rate for complications will increase dramatically. It is already extreme, and it is expected to grow exponentially into April (at least in Hubei).

Up to the limits of medical facilities, your odds will be good, but it takes a lot of resources to keep patients alive when they are experiencing complications, and those resources are inherently limited.</comment></comment>


Things I Learned Eating On $1 A Day For A Month - <AUTHOR> http://www.grocerycouponguide.com/articles/10-things-i-learned-eating-on-1-a-day-for-a-month/ <comment><USER2> This is the most frustrating post because the majority of the text is telling you something is possible without telling you how to do it.

It reads like a timeshare brochure or coupon book sales pitch.

It's easy enough to live off $2 a meal though.

            Breakfast: Oatmeal with Bananas/Raisins/Cinnamon (no sugar though
            - it will make you hungry sooner) and tea or coffee from whole beans
            bought at IKEA. Eggs.

            Lunch: Beans and Franks or Sandwiches with coldcuts from Costco or Pasta.

            Dinner: Pasta; Rice and Costco Dumplings; PG's Rice & Beans; or
            homemade Pizza (cut large loaf of bread in half, add oil, sauce, cheese,
            misc. meat toppings, bake appropriately.) Homemade fries or mashed potatoes
            make for a decent side. Frozen stir-fry veggies. IKEA sells woks for $9.

            Snacks: Ramen, Costco Granola Bars, Chips.

This should give you a bit of leeway in case you want to go out once a week or buy a case of beer.

PG's Rice and Beans recipe here: <http://www.paulgraham.com/ramenprofitable.html#f1n>

<comment><USER3> I'm not some anti-carb fanatic by any means, but the near complete lack of fruits and vegetables in this diet can't be healthy.

<comment><USER2> I forgot to mention loads of apples, clementines, oranges, PB&J sandwiches and the _occasional_ salad.

IANAD, but it did get me through a summer of bootstrapping. It certainly isn't the healthiest diet, but we were hard pressed to do any better without resorting to coupon scavanging or food co-ops.

Also if you don't exercise already, but decide to take it up - the health benefits will probably more then compensate for the poor diet... _probably_.

<comment><USER4> That doesn't make much sense. Exercising makes you need proper nutrition even more, it doesn't make up for poor nutrition. The only way exercising "makes up for a poor diet" is if you have tons of extra calories on top of a full set of nutrients.

</comment></comment></comment></comment><comment><USER5> If you're willing to cook from mainly fairly simple ingredients, you can do it without much coupon clipping. Lentils, beans, and potatoes are dirt cheap, eggs are pretty cheap (a two-egg omelette is about $0.25 of ingredients), and, depending on where you live, there's usually some variety of fruit or vegetable in season and very cheap. Bread is also nearly free if you bake it yourself from flour instead of buying it. It'll still take some effort to keep it at $1/day, but if you're willing to do $2/day, it's easy.

</comment><comment><USER6> what these sorts of schemes ignore is how much time it takes to clip, sort and strategize. how much is an hour of your time worth? if it's more than what you'd save by doing the extra work then to me the savings aren't really worth it (shortened version: opportunity cost matters).

<comment><USER7> false dichotomy. it is not necessarily going to the be the case that you'll be busy making money if you weren't busy clipping coupons.

<comment><USER8> You don't have to be making money for your time to be worth something. I'm home from work right now. If an hour spent clipping coupons takes away from "recreational" time spent coding for fun or in my machine shop puttering around, it's not worth it. The leisure time is worth more to me than the money the coupons would save.

<comment><USER7> again, i feel this is a false dichotomy. it doesn't always come down to making the choice of spending an hour clipping coupons or doing something you enjoy.

sometimes you have idle time and have the choice between spending 10 minutes to clip some coupons while watching tv, or doing nothing.

</comment></comment></comment></comment><comment><USER9> _If you truly want to save money shopping, you need to learn how to create your meals from what you already have in your house and then buy the best deals each week to replenish what you have on hand. This allows you to purchase food at the best prices as opposed to what they happen to be when you go to get the ingredients for your menu. This simple change should instantly cut your grocery bill by 50% or more._

<comment><USER10> This is what I do. Go to the shop, see what is on special, make something out of that.

Although lately, I just cook up loads of brown rice (after soaking it in water for 24 horus), and mix it with something. Skipping breakfast and lunch helps cut down on the cost as well.

<comment><USER11> Why do you soak it in water first?

<comment><USER10> This is called the GABA method, "This process stimulates germination, which activates various enzymes in the rice."

It also makes it cook quicker, since brown rice usually takes longer than white rice to cook.

<http://en.wikipedia.org/wiki/Brown_rice>

</comment></comment></comment></comment><comment><USER12> I am curious what percentage of the food acquired in this manner was packaged, e.g. canned, jarred, or wrapped in plastic, and from major brands. Any preserved/processed food from major brands can usually be found at discount if you look hard enough, since it has a long shelf life (from the processing), and there's usually lots of it in stock (from the large brand).

The picture from the original lifehacker story shows lots of major corporate brands, e.g Kellogg, Mission, Skippy, Quaker Oats, Place, Wheat Thins, and Kraft. <http://lifehacker.com/5560305/eat-well-on-just-1-a-day>

While it's great the author was able to include some fresh produce in his diet, since accomplishing that on an ultra-low budget is quite admirable, it still looks like this feat was pulled off thanks to the quantity of waste typical to mass-produced, processed food.

</comment><comment><USER13> If you want a more thorough guide of how to eat for a dollar a day and a personal account, day by day, of two people who did so for a month check out <http://www.dollaradaybook.com/it-starts-today>

</comment><comment><USER14> cashing in coupons is not eating for 1$ per day.

<comment><USER15> Yup, and neither is buying $16 worth of non-food items so that you can get $4 worth of food items for 'free'.

<comment><USER16> Are you sure that he was doing that?

I didn't read through whole thing day by day but on day 1 he uses his food money to purchase non food items because they give him coupons worth more than what he had to pay for them in cash: [http://www.grocerycouponguide.com/articles/eating-well- on-1-...](http://www.grocerycouponguide.com/articles/eating-well-on-1-a-day- day-1-what-i-bought/)

<comment><USER15> Oops, sorry, I was misreading [http://www.grocerycouponguide.com/articles/eating-well- on-1-...](http://www.grocerycouponguide.com/articles/eating-well-on-1-a-day- day-15-tampons-pantiliners/)

One wonders if he should have included gas burnt driving to all the places which had stuff on sale, and I definitely support all of the opportunity cost comments.

<comment><USER16> On one hand it's not the most economical use of your time if you can sell the time you spend on doing this. On the other hand if you can save 5$ by sacrificing one minute you can get pretty decent hourly rate on your effort.

Also this guy seems to be having a lot of fun gaming 'the system' and blogging about it.

</comment></comment></comment></comment></comment><comment><USER17> Does he buy en masse, then claim that he ate for $1/day even though he has an inordinate amount of leftovers? I don't understand how he can possibly have 32 boxes of cereal (among other things) at the end. I've never seen a box for less than a dollar, and already that is over his budget.

</comment><comment><USER18> If your job pays you say $50/hour to work, but you have to spend one additional hour each month implementing this system (figuring out what to buy, where, when, managing coupons, gaming the system, etc.) that right there costs you $50 in opportunity time, cancelling out some of the supposed savings. The problem gets worse if it takes you multiple hours per month, or your wage is even higher.

In short, I think the whole extreme min-maxing effort makes the most sense if you have a very low income job and the most important thing to minimize is your dollar outgo rate. Most professional programmers should not have to do this.

<comment><USER19> Well, that assumes you are willing to work in that hour and had the work available, but chose not to do it because your were implementing the system.

If you do this instead of watching mindless TV, factoring in the opportunity cost is inaccurate.

<comment><USER18> Good point!

But for folks who already don't watch mindless TV, or who have other opportunity projects or investments that monetize better, the argument still holds. For example, instead of putting an extra hour into one's day job, you could put an hour into making some new product or service which will in turn make you back more money than you would have saved if you did his extreme food cost reduction scheme. Or learn a new skill.

But who are we kidding? The extra hour will surely be spent reading HN. :)

<comment><USER20> That assumes a new product I was able to make or new skill I was able to learn in the time this takes would make me back more money than I would have saved. Not sure this is a given. Time doesn't tend to slice up so neatly.

</comment></comment></comment></comment><comment><USER21> <http://www.thegrocerygame.com/> has a system designed to help you sort through the coupon 'game'. Apparently, grocery goods typically go through a 12 week cycle of being the most discounted to not being discounted at all (this involves tracking manufacturer coupons AND grocery store coupons and timing the overlaps).

My mom did this for a family of 8 which cut grocery expenses in half. I'm not sure if it will scale down to 1-3 people effectively though.

</comment><comment><USER22> If the multiple stores you have to visit to use all of your coupons are more than a few miles apart, you fail by adding the food savings to your fuel bill plus some.

</comment><comment><USER23> I'm quite sure that I could accomplish that. Bulk brown rice, lentils and beans are extremely economical. Combined with some greens and fruit/vegetables from my own garden plus the bounty of nature (you can walk outside and pick raspberries here, for instance).. well, that's how I eat anyway. I'd just have to give up the bags of chips and jars of salsa.

</comment><comment><USER24> What actually more interesting is that he is able to make money from coupons: [http://www.grocerycouponguide.com/articles/eating-well- on-1-...](http://www.grocerycouponguide.com/articles/eating-well-on-1-a-day- day-15-tampons-pantiliners/)

<comment><USER25> It's the same story. He worked for his groceries rather than working for money to spend on groceries.

<comment><USER24> yeah but in working for his groceries, it doesn't seem as though he created any value to anyone in the process.

I guess he was brand loyal, but it seems like the work didn't benifit anyone else in society, which is in contrast with actual work.

<comment><USER26> > _it doesn't seem as though he created any value to anyone in the process._

Sure he did. He created value for himself by working. After all, in a pure economic sense coupon cutting is as valid work as log cutting.

Perhaps you are confused by the fact that he was working for himself? Say my current food expenses are $15 a day, so I hire that guy to shop and cook for me for $10 a day. Clearly he would be creating value for me.

<comment><USER24> Sure, but generally money is given to people when they do some sort of service for other people.

If you have a cook, you pay them to cook you food, and you got the money from some other place cause you performed some other service for someone else.

If you paid him to go shopping, thats because he was creating value for you (in saving you time) and you were paying him for it.

But this is different. Sure he is benefiting himself, but he isn't creating value for anyone else. The whole point of society to a certain extent to create a system which encourages people to help one another. This man is essentially getting food in exchange for shuffling papers around. What I don't understand is who else in society is benefiting from his paper shuffling.</comment></comment></comment></comment></comment>


How My Brain Kept Me from Co-Founding YouTube - <AUTHOR> http://prog21.dadgum.com/39.html <comment><USER2> In the late 90s I had a similarly bizarre "limitation" in that I didn't "trust" drives that were over 10GB in size (because.. "how can it work? It's just too much to get into a drive!"), so I just had multiple smaller drives instead of one 20~40GB one.

Thankfully, like the writer, I eventually realized the stupidity of my ways, but I think many of us are susceptible to this bug at least once ;-)

<comment><USER3> What's funny is that I now have a similar fear of 1TB drives.. "If a lone drive fails, that is a _lot_ of data to go at once"

<comment><USER4> Both the fears seem pretty reasonable to me, probably because I usually don't buy a main harddrive with more than 200gb usually no more than 120.

<comment><USER5> I started coding on a ZX81 with 16K RAM.

In 2 years, that will be 30 years ago. If RAM doubles every 1.5 years, then in 2 years a new machine should have 16G RAM (x1,000,000). At the moment they have about 4GB, so it's not far off.

<comment><USER6> You can already buy MacPro's with 32GB of Ram. For about 8k$ unfortunately.

<comment><USER5> You could also buy 32KB RAM for a ZX81 - but it felt a little out of reach. It was expensive, unusual, non-standard.

The thing is, 16GB RAM will soon be ordinary. Every PC will have it. What things become possible that are unthinkable today? Maybe multiple virtualized OSes could become standard.

</comment></comment></comment></comment></comment></comment><comment><USER7> The point that the article makes is not a technical one.

It is a philosophical one instead. The ideas of tomorrow must look beyond what is possible today into anticipating what may be possible tomorrow.

The execution of such an idea would then hold the promise of innovation to break today's barriers.

</comment><comment><USER5> It's Moore's Law: you're unconsciously calibrated to the past, and it doesn't make sense to your hindbrain that you'll be out by orders of magnitude: x1000 in 15 years. I mean, that increase is completely unreasonable. Isn't it?

On the flip side, it also opens opportunities that people in the industry simply didn't entertain, because they were literally unthinkable and therefore unseeable just a few years ago (and I literally mean literally). I spoke to the inventor of a new method (a few decades ago) of hardware multiplication that became the standard for a while; he said it was made possible by an increase in silicon. It was theoretically possible before then, but no one looked.

</comment><comment><USER8> Was he given the opportunity to co-found YouTube? That isn't clear from the article.

<comment><USER9> I don't think so. I believe he had similar thoughts (streaming video online would be great) but immediately dismissed them as requiring too much bandwidth.

Had he had the foresight to avoid those limiting beliefs, he could have invented something like YouTube.

<comment><USER10> Thing is, a lot of people could have invented something like YouTube, and a lot of people tried. But the YouTube people had the skills to grow and scale their site in a phenomenal way, which is why they're the ones that are remembered. YouTube exemplifies the notion that ideas are worthless, execution is everything.

<comment><USER11> Right, but the article isn't really about creating youtube, it is about realizing when you've mentally added an artificial constraint and not letting it stop you.

<comment><USER12> Yeah, but in reality the ideas in the article are really more boring then the headline suggests.

He wasn't in a position to co-found youtube, not to mention there were already plenty of video sites around before and during youtube's rise to prominence.

It's a classic case of "well I had that idea I could of done it" - doing it is 99.9999% of the exercise, having the idea is 0.0001%.

</comment></comment></comment></comment></comment><comment><USER13> The author's argument is a total non-sequitur. The whole "mental block" about sites like YouTube and Flickr was that DEVELOPERS couldn't imagine having to pay for such outrageous bandwidth usage (or that they'd even be able to find a place to host the site, for that matter).

He then goes on to equate this to developers not wanting to have their users download 64MB runtimes or 2GB IDEs. These two things are entirely different.

A developer knows that, while Joe User may have no problem waiting for a 500MB video of some chick topless to download, the same user isn't going to want to wait to download a 50MB installer for a program that makes Bingo cards.

<comment><USER14> _the same user isn't going to want to wait to download a 50MB installer for a program that makes Bingo cards._

As something of the resident expert on this topic, let me tell you: users are certainly willing to wait for a 12MB installer for a program that makes bingo cards. It actually converts (very marginally) better than the 500kb installer which needs Java as a pre-req.

<comment><USER13> Hehe, I actually had you in mind when I wrote that :)

</comment></comment></comment><comment><USER15> I created a deployment of a production Smalltalk application recently. (It's been around well over a decade.) 24 MB. I use the image compression utility. 8MB.

The default VisualWorks image is 12MB. And I also worked on one production app that was 110MB deployed. Most of that was data. We pre-cached all of the queries required to populate all of the drop-downs, so that after it got done loading, users found it to be "fast."

I thought of something like YouTube. "Flash video? No self-respecting techie would use _Flash_!"

</comment><comment><USER16> Hmm, maybe I'm too retro for this guy, but 16 bytes for an element in a linked list does sound excessive. :)

<comment><USER17> It's only two words! You need two 64 bit pointers on a 64-bit machine.

A fuckton of people have come up with the idea that "hey, since a 4gb address space is really plenty, why don't we try using an n/2 address space and have a whole cons fit in one word?" I'm sure the same thing has come up plenty of times before.

It turns out to be not so hot to avoid directly using the OS' VM and the hardware's MMU.

</comment></comment><comment><USER18> _Flickr blew my mind when it appeared back in 2004._

A mind easily blown. Stand back anytime this guy is near a website that is anything more than an aggregate of img tags.

<comment><USER17> Did you ever notice how flickr prevents you from seeing multiple high-res images at once? You can't even see links to other photos when viewing a higher res! The highest resolution you can see on a navigable page is 500px on a side.

Flickr is fucking atrocious for actually viewing someone's photos. It's about as shitty as they could possibly get away with.

On the other hand, it has absolutely terrific support for communities, with all sorts of little touches to encourage their formation. It also manages to simultaneously appeal to US Grandmas, Arab twentysomethings, and the requisite "self facilitating media nodes" that fuel _WEB 2.0_ hype.</comment></comment>


Radioactive boars on the rise in Germany - <AUTHOR> http://news.yahoo.com/s/ap/20100819/ap_on_re_eu/eu_germany_radioactive_boars

<comment><USER2> IIRC, in the months after the Chernobyl accident, mushrooms in affected areas were concentrating the fallout up to 400 times.</comment>


Ask HN: What are some high-impact books on leadership you've read? - <AUTHOR>

<comment><USER2> 5 Dysfunctions of a Team (a leadership fable) as well as the related leaders field guide to help you run a strategic weekend offsite are both amazing.

[http://www.betterworldbooks.com/Five-dysfunctions-of-a- team-...](http://www.betterworldbooks.com/Five-dysfunctions-of-a- team-H0.aspx?SearchTerm=Five+dysfunctions+of+a+team) [non affiliate link]

</comment><comment><USER3> _21 Laws of Leadership_ has some good nuggets.

</comment><comment><USER4> Tribal Leadership by Dave Logan.</comment>


Boeing's Bean-Counters Courted the 737 Max Disaster - <AUTHOR> https://www.thedailybeast.com/how-boeing-bean-counters-courted-the-737-max-disaster <comment><USER2> MBA's gone wild.

</comment><comment><USER3> That is what free-market capitalism does.</comment>


The Emails That Got My Unsexy Start-Up Covered By TechCrunch - <AUTHOR> http://jamesdeer.com/2012/10/10/techcrunch-emails

<comment><USER2> Find this type of post so useful to other startups, thanks for sharing James.

</comment><comment><USER3> Great post and congratulations on the coverage. Great to see a Scottish start up getting a look in.

<comment><AUTHOR> Thanks! :)

</comment></comment><comment><USER4> Saw this in net magazine also, great work!</comment>