Jon Schultz

If would be nice if they'd mention the status of the other 50 or so people at LifeCare who were symptomatic and being tested. Parents in the area, especially, have to decide whether to send their children to school.

Thanks for your response. From looking at the CDC website - https://www.cdc.gov/sars/about/faq.html - I see what you're saying: "During November 2002 through July 2003, a total of 8,098 people worldwide became sick with severe acute respiratory syndrome that was accompanied by either pneumonia or respiratory distress syndrome (probable cases), according to the World Health Organization (WHO). Of these, 774 died." The WHO has a comprehensive document on the outbreak - https://www.who.int/csr/sars/en/WHOconsensus.pdf - but although it contains a section on "The presence and significance of subclinical infection" it doesn't even estimate how many people became infected with the SARS virus but were asymptomatic or only had mild illness. Perhaps there's more information somewhere else on the WHO website. As I think I said in an earlier post I think instead of just "case fatality rate" there should be three more specific metrics discussed about every pathogen - the infection fatality rate, the illness fatality rate, and the severe illness (warranting hospitalization) fatality rate - as all three are important to know and then you wouldn't have this kind of apples-to-oranges comparison.

He didn't mean January 1st, Stephen, only the first case in the U.S. which you are correct was on the 21st. If you remember that case got sicker and sicker by the day until they stopped all the things they were trying and used intravenous remdesivir, which seemed to miraculously make him better overnight. Hopefully they have a good supply of remdesivir on hand... Dr. Niman, you say that the stated 10% CFR for SARS was only of hospitalized people with pneumonia. That was something like 800 out of 8,000, which I believe is what they say was the total number of cases. So they're not aware of any people who had only mild symptoms or were asymptomatic with SARS and didn't need hospitalization? That sounds doubtful.

It might be a hacked page. Notice it's in the "Showbiz" section and the article isn't mentioned on the homepage of the site.

Thanks for the great Rense interview tonight, Dr. Niman. A few questions I hope you can find the time to comment on before too long: 1) Have any sequences of recently announced cases in Iran and Italy, especially been released? From the most recent sequences you have seen would you say that there are two strains or lineages now, the original one and the one with changes in the ORF8 gene? And is it known how their effects differ and how prevalent each is? 2) Why do you think the number of reported new cases in Chinese cities outside Hubei province has been markedly going down, rather than up? Do you think the Chinese government may be misreporting or purposely not testing because they think the damage caused by people not going to their jobs will be worse than the additional damage if they do? 3) Have you heard whether a cytokine storm and/or secondary bacterial infections are prevalent in Covid-19 pneumonia? If secondary bacterial infections are occurring in a fair number of cases, do you think it might be advisable for people to get a pneumovax vaccine? (I know you are not a medical doctor and cannot give medical advice, but hopefully you can safely share your thoughts.) 4) Any thoughts on the paper this story covers? https://www.scmp.com/news/china/society/article/3052495/coronavirus-far-more-likely-sars-bond-human-cells-scientists-say Thanks in advance!

As I'm sure you noticed, Dr. Niman, this is inconsistent with today's Hubei report which shows 116 new deaths, whereas this China report shows only 17 additional deaths since yesterday. The South China Morning Post is currently reporting 1383 deaths, an increase of 20 (the chart figures automatically update): https://www.scmp.com/news/china/society/article/3050570/coronavirus-hubei-province-reports-4823-new-cases-and-116-more

Thanks, Stephen, for the comprehensive response. The only thing I'll add is that Gilead's remdesivir seemed to work miraculously with the first U.S. patient in Washington and China is now starting trials. They are also looking at chloroquine, which is used to treat malaria. https://www.aljazeera.com/ajimpact/china-patent-experimental-anti-coronavirus-drug-200205054208307.html I'm wondering about BHT, which is relatively cheap and available: http://www.projectwellbeing.com/wp-content/uploads/2011/02/BHTbook-StevenWmFowkes-100903.pdf

Thanks, Stephen, for your learned response. I'm now wondering if a product like this might be good for people to start taking: https://www.lifeextension.com/vitamins-supplements/item01804/cytokine-suppress-with-egcg Also, do you know if secondary bacterial infections are playing a large part in the disease? If so, perhaps people should get a pneumovax vaccine.

Great Rense interview, Dr. Niman. One other factor which I think needs to be considered, with regard to the Diamond Princess and as a general principle, is that whether a person gets sick after becoming infected is not only dependent on the quantity of virus they absorbed and the general health of their immune system, but the amount of stress they are under after becoming infected, which affects the strength of their immune system. So not only are the people on the ship in a virus-laden environment where they can get easily infected, but being quarantined in small rooms and being worried about the possibility of infection there might cause some of them to succumb to sickness more readily than if they were infected and then quarantined in a less stressful environment. And then if they get sick they will tend to shed more virus than if they remained asymptomatic. Please comment if you don't think these are reasonable assumptions.

This doesn't make sense, they're reporting about 3,000 more "confirmed" cases and about 5,300 less "Suspected" cases than yesterday. Are they saying that 3,000 of the suspected cases were confirmed and 2,300 of the suspected cases tested negative on the second lab test? Can you provide a source, Dr. Niman, for the assertion that China's definition of a "suspected" case is one which has been lab-confirmed once but not twice? http://www.caixin.com/2020-02-05/101511886.html

I may have figured it out. I posted this at a site: https://www.scmp.com/news/china/science/article/3048772/striking-coronavirus-mutations-found-within-one-family-cluster Meanwhile, Sylvie Briand, Director of Global Infectious Hazard Preparedness at the World Health Organization (WHO) made what could be a scandalous statement, "It is quite a stable virus," in light of what the Chinese scientists quoted in the SCMP article above and Dr. Henry Niman, quoted below, are saying. If these scientists are correct, the WHO should be well aware of it. Of course the WHO may have to make concessions at times, i.e. by publicly praising a country in order to get its cooperation, so making a statement they know is false may in fact be in the public interest (or at least that may be their intention).

Thank you for the clarification. So when lay people talk about the case fatality rate of a virus, then, they could really be talking about one of three things: 1) the scientific definition you stated; 2) the percentage of people who die of all who have gotten at least somewhat ill; or 3) the percentage of people who die of all who will sooner or later test positive for antibodies. To avoid confusion I think maybe each of the three should have a different name, maybe something like case fatality rate, illness fatality rate, and infection fatality rate. I think it's important to know all three, as best possible. No?

WHO: World currently 'not in a pandemic' of coronavirus Sylvie Briand, director of global infectious hazard preparedness at the World Health Organization (WHO), said: "Currently we are not in a pandemic", we are at a phase where we have an epidemic of coronavirus with multiple foci and we try to extinguish each of these foci. She also said the WHO was working with different countries on repatriation of people from China, having "intense discussions to see how we can harmonise the practices". Briand said the WHO currently has no evidence of mutation of the virus, adding that "it is quite a stable virus". https://www.aljazeera.com/news/2020/02/china-admits-shortcomings-coronavirus-death-toll-hits-425-200203234036932.html Any guess as to why they are saying this about mutations, Dr. Niman? They must know about the ones you are seeing.

Yes, but in addition to calculating the CFR without regard for outcomes, some people are also saying that the real CFR is probably much less than 2% because there are probably many people who are infected but don't get sick. Is there any evidence for that or is it a likelihood in any viral outbreak? Thanks for responding and great interview.

https://www.cnbc.com/2020/02/03/nih-dr-anthony-fauci-25percent-of-china-coronavirus-cases-very-serious.html >>>Fauci credits “good public health measures” in the United States for helping to stop “sustained transmission” of the virus in America. “As the entry into the United States of potentially infected people is diminished because of the travel restrictions on both sides ... I think you are going to see a dampening down” of U.S. cases, he added.<<< But what's going to happen if the virus spreads widely in other countries and continents like Africa (not to mention the possible asymptomatic transmission which could be happening now)? Will all flights to the United States be halted? And ground and sea travel? Would that even work when it only takes one person with a highly infectious viral "lineage" to start an unstoppable chain reaction? I think it remains to be seen how responsible he was in saying that, which has probably led many people to believe there is no reason to stock up on supplies or make other preparations. Maybe it's wise to break the news that we may be in serious danger gradually, so there is time to prepare for riotous behavior, but you have to wonder to what extent, if any, private interests, as opposed to the public welfare, are a concern. Perhaps the government should impose a limit on the purchase of certain goods now, before some people have ten years worth of food in their basement and others can't buy anything - in the event this turns out to be a "Category 5" pandemic.

Dr. Niman, What do you think of the idea that the case fatality rate may not be very high because there are likely many people who are infected but haven't gotten sick or very sick? Arguing against that is the incidence of sick people 1) being turned away by the hospitals and not being tested; 2) not going to the hospitals for one reason or another, such as fear their family will be quarantined; and/or 3) dying at home or in the hospitals without being counted an nCov fatality (i.e. if their test wasn't double-confirmed or they had an underlying condition which was exacerbated by the virus). Actually 1) and 2) above don't directly affect the number of deaths outside of 3), but I'm not sure there's any evidence that there are a lot of people who are infected but haven't gotten sick or very sick. And then the CFR should go up, of course, in areas where hospital or medical care is no longer available.

Coronavirus infections predicted to grow exponentially; first death outside China; outbreak becomes political https://www.washingtonpost.com/world/asia_pacific/china-coronavirus-live-updates/2020/02/02/090d75d8-453d-11ea-99c7-1dfd4241a2fe_story.html

Great interview, Dr. Niman, thank you. The only thing I'll point out is that you sometimes said Hubei when you meant Wuhan.

Dr. Niman, why do you think SARS stopped spreading and, in your estimation, how likely is it that 2019-nCov will stop spreading in the next month or two - or before it becomes a severe global pandemic - as well? Thanks in advance.

Did you see the WHO press conference today? Dr. Michael Ryan completely avoided the question about whether the latest sequences show any significant changes by talking instead about how transparent and diligent China has been. It's at 14:50 in the video: https://www.pscp.tv/w/1OdJrqEvgaeGX The main thing he said which stood out in my mind is, "We have a chance."

Thank you for responding. I know your hard work is appreciated by a lot of people.

Based on what you are seeing and the paper at https://www.biorxiv.org/content/10.1101/2020.01.26.920249v1, is it possible that this is a new species of virus?

Please expand on your tweet which said, "Immediate resignations are in order." Also please comment on the comments Yi Guan made to Caixin: “My conservative estimate is that this epidemic could end up at least 10 times the scale of SARS.... I’ve never felt scared. This time I’m scared.” https://www.caixinglobal.com/2020-01-23/wuhan-virus-latest-china-reports-second-pneumonia-linked-death-101505300.html https://www.scmp.com/news/china/article/3047319/wuhan-coronavirus-full-blown-community-epidemic-chinese-health

Thanks, Dr. Niman, for your continued reporting on emerging pathogens.