[pilowsky]

This may come as a surprise to you but nobody likes to die of preventable diseases such as Ebola, coronavirus and so forth. Please stop converting oxygen into carbon dioxide with arguments that make no scientific sense. The problem at hand has nothing to do with homosexuals Jews or left handed tennis players. Where do these red herrings come from?

[hrothgar]

pilowsky, on 2020-February-12, 05:54, said:

This may come as a surprise to you but nobody likes to die of preventable diseases such as Ebola, coronavirus and so forth. Please stop converting oxygen into carbon dioxide with arguments that make no scientific sense. The problem at hand has nothing to do with homosexuals Jews or left handed tennis players. Where do these red herrings come from?

Nigel directly stated that classes of people "Gays", "Haitians", etc should have targeted and locked up to prevent the spread of AIDs
(Note that said classes are ones that are already broadly discriminated against by society)

Thats where these "red herrings" are coming from

My assumption is that he is currently advocating locking up anyone from China or some such

[Winstonm]

How will quarantines help stop a virus that is passed for days when no symptoms are showing? Knowledge will help. Quarantines, not so much.

[barmar]

pilowsky, on 2020-February-12, 05:54, said:

This may come as a surprise to you but nobody likes to die of preventable diseases such as Ebola, coronavirus and so forth. Please stop converting oxygen into carbon dioxide with arguments that make no scientific sense. The problem at hand has nothing to do with homosexuals Jews or left handed tennis players. Where do these red herrings come from?

The difference is that HIV/AIDS is not transmitted through casual contact. There's no need to separate AIDS sufferers from society. You can shake hands with them, hug them, and even live with them for years and there's no danger. You have to exchange certain bodily fluids, which generally means having sex or sharing hypodermic needles.

There's no need to quarantine people infected with HIV, and even less justification for quarantining everyone in the most susceptible communities.

Coronavirus is completely different.

[y66]

Noah Smith @Noahpinion said:

Absolutely amazing thread. To put this thread in perspective, realize that China has now locked down 10% OF ALL THE HUMANS ON THE PLANET.

Paul Mozur @paulmozur Feb 15 said:

https://twitter.com/...751784111271936

To stop the spread of the coronavirus much of China has effectively shut down. What’s not been fully appreciated is how extensive the closures are. By our calculations 760 million are living under some kind of residential lockdown. https://nytimes.com/...tcore-ios-share

[Winstonm]

Quote

A study published in JAMA on Friday chronicled the case of a 20-year-old Wuhan woman, who infected five relatives, even though she never showed signs of illness.

“What we find is that this virus is going to be very difficult to contain,” said Jeffrey Shaman, an infectious disease researcher at Columbia University and co-author of the study posted Monday. “Personally, I don’t think we can do it.”

[y66]

From Peter Loftus at WSJ:

Quote

Drugmaker Moderna Inc. has shipped the first batch of its rapidly developed coronavirus vaccine to U.S. government researchers, who will launch the first human tests of whether the experimental shot could help suppress the epidemic originating in China.

Moderna on Monday sent vaccine vials from its Norwood, Mass., manufacturing plant to the National Institute of Allergy and Infectious Diseases in Bethesda, Md., the company said. The institute expects by the end of April to start a clinical trial of about 20 to 25 healthy volunteers, testing whether two doses of the shot are safe and induce an immune response likely to protect against infection, NIAID Director Anthony Fauci said in an interview. Initial results could become available in July or August.

Moderna’s turnaround time in producing the first batch of the vaccine—co-designed with NIAID, after learning the new virus’s genetic sequence in January—is a stunningly fast response to an emerging outbreak.

If a trial starts as planned in April, it would be about three months from vaccine design to human testing. In comparison, after an outbreak of an older coronavirus, severe acute respiratory syndrome, in China in 2002, it took about 20 months for NIAID to get a vaccine into the first stage of human testing, according to Dr. Fauci.

“Going into a Phase One trial within three months of getting the sequence is unquestionably the world indoor record. Nothing has ever gone that fast,” Dr. Fauci said.

Public-health authorities say advances in vaccine technology, aided by government and private investments, are shortening development timelines when outbreaks occur. In the past, researchers scrambled to develop vaccines in response to outbreaks such as SARS, Ebola and Zika with mixed results. Older types of vaccines are developed from viral proteins that must be grown in eggs or cell cultures, and together with animal testing it can take years before a vaccine can be used in humans.

Newer approaches rely on what are known as platform technologies—building blocks that can be tweaked quickly with the genetic information from a newly emerged pathogen.

The fast production of a vaccine and plans to test it soon don’t guarantee its success. “You’re never sure until you’re at the end what you have,” said Bruce Gellin, president of global immunization at the Sabin Vaccine Institute. Saying there are other coronavirus vaccines in the works, he added: “The sequence of testing is designed to sort out what works from what doesn’t. That’s why it’s important to try as many things as possible that seem feasible, because not all horses will finish the race.”

It is uncertain whether Moderna’s vaccine will work because its gene-based technology hasn’t yet yielded an approved human vaccine. And even if the first study is positive, the coronavirus vaccine might not become widely available until next year because further studies and regulatory clearances will be needed, Dr. Fauci said.

But health authorities say it is worth placing bets on these new technologies in the face of fast-moving outbreaks. Since early January, when only a few dozen cases were confirmed in central China, the virus has spread to more than 78,000 people, including more than 2,400 who have died. The vast majority of the cases are in China, according to the World Health Organization.

Dr. Fauci said it is possible the spread of coronavirus could lessen during warmer months, but then return next winter and become a seasonal virus like the flu, making a vaccine useful even if it isn’t ready for widespread distribution until next year.

“The only way you can completely suppress an emerging infectious disease is with a vaccine,” Dr. Fauci said in his office in Bethesda. “If you want to really get it quickly, you’re using technologies that are not as time-honored as the standard, what I call antiquated, way of doing it.”

Moderna, which has more than 800 employees, was founded in 2010 to develop drugs and vaccines based on what is known as messenger RNA, the genetic molecules that carry instructions from DNA to the body’s cells to make certain proteins. The company is targeting cancer, heart disease and infectious diseases. It hasn’t brought any drugs or vaccines to market.

Moderna Chief Executive Stephane Bancel said he got in touch with NIAID after hearing about the new China virus while vacationing with his family in France in early January, to discuss collaborating on a vaccine.

Chinese scientists found the genetic sequence of the new virus and published it online around Jan. 10. Researchers at NIAID and Moderna analyzed the sequence and homed in on a section they believed was most likely to induce the desired immune response if incorporated into a vaccine. NIAID agreed to run a clinical trial if Moderna could supply a vaccine.

Moderna didn’t need actual samples of the virus or its proteins. The company’s vaccines instead contain nucleic acids with genetic codes that instruct the body’s own cells to make certain proteins from the virus that don’t infect a person, but trigger an immune response.

Moderna in 2018 opened a manufacturing site in the shell of a former Polaroid plant in Norwood, near the company’s Cambridge, Mass., headquarters. In the plant, employees wearing white lab gowns, hair nets and safety goggles work amid lab hoods, robotic machinery and steel tanks to produce drugs and vaccines for clinical trials. Meeting rooms are named after famous scientists such as Curie and Pasteur.

To make the coronavirus vaccine, Moderna repurposed some of the robotic equipment that was making cancer vaccines tailored to the genetic mutations of patients’ tumors.

As many as 100 manufacturing and quality-control employees were involved in the effort, many working nights and weekends. As manufacturing ramped up, the company’s leaders had frequent meetings, calls and WhatsApp messaging chains to monitor progress, and stayed in close contact with NIAID.

After Moderna’s effort became public in January, friends and family members became interested.

Juan Andres, Moderna’s head of technical operations, said, “I wasn’t used to my kid thinking I did anything cool,” but his 15-year-old son began asking questions about the project at dinner.

Moderna finished manufacturing about 500 vials on Feb. 7, a Friday. Normally, the company would have waited until Monday to start quality-control tests, but about 10 to 15 workers spent the weekend testing samples for potency and other features. The batch cleared most tests that weekend, but it took about two weeks to complete sterility testing. Moderna stored the supply in freezers set to minus-70 degrees Celsius.

One risk of moving so fast is that Moderna and NIAID won’t know for sure they picked the best fragment of the virus’s genetic sequence to target until the human study is completed.

“It is possible it’s going to work, but we have to wait and see,” said Mr. Bancel, Moderna’s CEO.

The first trial will be conducted at NIAID’s clinical-trials unit in Bethesda. If the first one is successful, a second trial of hundreds or thousands of participants could begin, which could take six to eight months, Dr. Fauci said. This trial could be conducted partly in the U.S. but also in China or a region where the virus is spreading, so the testing could gauge whether the vaccine reduces infection rates.

If the second trial is positive, the vaccine could be ready for widespread use, he said. How widely the virus has spread by then will determine whether it is given to targeted groups such as health-care workers, or more broadly to the general population, Dr. Fauci said.

[barmar]

It's times like this I wish we were in Star Trek, where Dr McCoy (and his analogs in all the sequels) would routinely develop the cure to a completely new syndrome in the course of a single episode.

[Winstonm]

barmar, on 2020-February-25, 10:34, said:

It's times like this I wish we were in Star Trek, where Dr McCoy (and his analogs in all the sequels) would routinely develop the cure to a completely new syndrome in the course of a single episode.

Live long and prosper.

[kenberg]

A week ago experts were explaining how silly we were to be worried about this because obviously the flu is much more dangerous. Today PBS had someone explaining that we should think of it as just being like a really bad flu season, and that was presented as one of the milder estimates. of the danger. There is a lot to be said for phrases such as "We don't know" and "I'm not sure".

[y66]

From Farjad Manjoo channeling a forummate at NYT:

Quote

A few weeks ago, I told you not to panic about the coronavirus. No, that’s putting it too mildly. In the big, screaming urgency of a New York Times headline, I all but commanded you not to panic about the novel virus threatening to spread across the globe.

To be totally fair to myself, my reasoning in that column was mostly on point: At the time, the new coronavirus appeared to be a far less worrisome danger than the flu, which kills hundreds of thousands of people around the world annually. The illness, since named Covid-19, had then killed fewer than 200 people, and the Chinese government’s late but immense efforts to contain it looked as if they might work. The bigger worry, I argued, was the threat of mass overreaction and panic — and the restrictions on civil liberties, especially to those of immigrants and other vulnerable people, that a frightened world might accept to prevent the disease from spreading.

Events have not exactly been kind to my thesis. I still think mass panic is a grave threat, but now that the number of Covid-19 deaths has risen to thousands and the illness has appeared on several continents, I’m starting to get straightforwardly scared of the virus and its potential lethality, too. Am I panicking? Not really, not yet. But after watching the stock market plummet on Monday and governments struggling to get hold of the contagion, I’ve begun to smell doom. This weekend, idly, I found myself looking for N95 masks online, and my wife and I began reining in family vacation plans for the summer. It’s all a swift reversal from the insistent, don’t-worry tone of my last column.

Now, I’ve been a pundit for a long time, and I learned early on not to sweat being occasionally wrong about the future. I figure if I’m not wrong sometimes, I’m probably thinking too small. What I do regret about my virus column, though, is its dripping certainty. I wasn’t just pooh-poohing the virus’s threat; using the history of two other coronaviruses, SARS and MERS, as my guide, I all but guaranteed that this one, too, would more or less fizzle out.

In retrospect, my analytical mistake is obvious, and it’s a type of error that has become all too common across media, especially commentary on television and Twitter. My mistake was that I hadn’t properly accounted for what statisticians call tail risk, or the possibility of an unexpected “black swan” event that upends historical expectation.

A projection of certainty is often a crucial part of commentary; nobody wants to listen to a wishy-washy pundit. But I worry that unwarranted certainty, and an under-appreciation of the unknown, might be our collective downfall, because it blinds us to a new dynamic governing humanity: The world is getting more complicated, and therefore less predictable.

Yes, the future is always unknowable. But there’s reason to believe it’s becoming even more so, because when it comes to affairs involving masses of human beings — which is most things, from politics to markets to religion to art and entertainment — a range of forces is altering society in fundamental ways. These forces are easy to describe as Davos-type grand concepts: among others, the internet, smartphones, social networks, the globalization and interdependence of supply chains and manufacturing, the internationalization of culture, unprecedented levels of travel, urbanization and climate change. But their effects are not discrete. They overlap and intertwine in nonlinear ways, leaving chaos in their wake.

In the last couple of decades, the world has become unmoored, crazier, somehow messier. The black swans are circling; chaos monkeys have been unleashed. And whether we’re talking about the election, the economy, or most any other corner of humanity, we in the pundit class would do well more often to strike a note of humility in the face of the expanding unknown. We ought to add a disclaimer to everything we say: “I could be wrong! We all could be wrong!”

Since I don’t expect many of my commentating colleagues to do so, it’s best for you in the audience to remember this the next time you watch, say, veteran political pundits insisting that nominating Bernie Sanders would be insane: The world is strange! Odd things happen! And it’s possible, maybe even likely, that in 2020 nobody knows what they’re talking about. Like, at all.

I should note that there is some controversy about the thesis that black-swan events are increasing due to global complexity, and the claim is difficult to prove empirically. But there is theoretical backing to the idea that more-connected, complicated systems lead to more surprising, unexpected outcomes. And the claim makes sense intuitively, too. For instance, increased global connectivity is one of the reasons Covid-19 has been so hard to contain. (Authorities clearly weren’t prepared for the disease threat posed by the cruise industry, which has grown rapidly in China over the last decade.)

More than that, the growing unpredictability of human affairs is clear in the number of surprises we seem to be enduring lately. What was the 2008 financial crisis if not an out-of-the-blue event that stymied most prognosticators? Or, for that matter, the election of the first African-American president, America’s hyper-fast flip on gay rights, Brexit, Trump’s election, or the rise of Bernie Sanders?

And, sticking with politics, consider all the unknowns now clouding our picture of what might play out in 2020. Will Michael Bloomberg’s and Trump’s gargantuan levels of spending on digital ads substantially alter how elections work — or is it possible that we’re overhyping the role of ad spending? Will Americans really recoil from socialism, or do many of us not care so much about an outdated label? Will Sanders’s revolutionary army turn out, or stay home? Will our election survive malign interference or domestic ineptitude? How will the virus affect the economy and Americans’ sense of safety — and will that be good for Trump, or terrible for him?

I’ll lay my cards on the table: To me, Sanders is looking increasingly electable, the virus looks like it could reshape much of daily life at least in the short term, and the Trump administration’s response to it is bound to be bumbling and perhaps extremely scary.

Of course, I could be wrong. We all could be.

[kenberg]

y66, on 2020-February-26, 16:01, said:

From Farjad Manjoo channeling a forummate at NYT:

Thanks!


I did not expect such a mea culpa. He seems to be a very harsh critic of himself.

Of course we should all be cautious when we hear some conclusion stated with certainty. Even more, we should be cautious about our own certainties. Sometimes we have to act, and very often it comes down to making the best choice we can with incomplete information.

Anyway, this acknowledgment of error makes me trust him more, not less.

[y66]

Prabhat Jha, professor of global health at the University of Toronto @ft said:

The coronavirus outbreak is on the verge of becoming an official pandemic. Since December, the disease known as Covid-19 has spread from China to infect more than 81,000 people in more than 40 countries, killing more than 2,700 people.

No country alone can cope with rapidly spreading pandemics; we need to develop a global response. Timely access to data is vital. The local government in Wuhan probably missed a window to shut down this outbreak by failing to act in early December, after detecting a cluster of lung infections among workers from one market.

Singapore provides exemplary reporting on the transmission details of each case. However, similar data from China are not yet available. Canada fell short in initial reporting during the 2003 Sars epidemic but has substantially revamped its data systems.

To address this issue, the world should consider establishing a global surveillance facility, modelled after the hugely successful Gavi, the vaccine alliance. Such a facility, based in the World Health Organization but with independent accountability, would provide countries with funding and technical assistance during outbreaks. It would help to build resilient systems before epidemics strike. If the world’s largest economies collectively contributed $2bn a year, that would allow us not just to build the fire station and pay firefighters but also to prevent fires.

Countries are, in theory, supposed to report outbreaks to WHO through the International Health Regulations. While the IHR is a legal obligation, political incentives or fear of economic disruption means timely reporting doesn’t always occur.

Public health systems can learn lessons from the global financial sector, which has appropriated epidemiological terms such as contagion or surveillance. In the 1960s, the IMF made its lending contingent on national income accounts. It invested heavily in helping countries improve their data allowing it to track financial flows. Bank regulators now stress test banks, and a new epidemics body could use the IHR to test whether countries can provide complete, quick and transparent reporting.

The World Bank has a specialised agency to sell political risk insurance to companies. A similar system could provide no-fault epidemic insurance to responsible countries with strong and open health data systems. That would provide incentives to report data, instead of hiding it. Increasing the size of the World Bank’s pandemic bonds and linking them to improved data gathering could play a role.

Tackling the dramatic means fixing the routine. Only 3 per cent of the world’s children who died in 2010 had a proper medical certificate of death. The new global surveillance facility could strengthen routine reporting, by replicating innovations such as India’s Million Death Study, which tracks a random sample of all homes to reliably document the causes of death. The facility could also help countries apply modern genomics to test samples and monitor antimicrobial resistance.

Flu shots are updated annually because more than 80 labs around the world share information on the preceding years’ strains. A system to study new infections in hunters or others exposed to animal viruses could provide early warning of emerging threats.

Investing in tracking and controlling diseases saves money. Smallpox eradication cost $300m, but generated more than $27bn in savings. An outbreak of the plague in India in 1994 cost up to $2bn. Quick action in 2001 averted a smaller plague outbreak in northern India by applying cheap, basic 19th-century public health practices to trace contacts and enforce quarantine.

Viruses do not respect borders. Science also needs to think beyond them to implement global solutions that will keep us safer, healthier and richer.

[y66]

Noah Smith @noahopinion at Bloomberg said:

Oh dear

Vincent Racaniello, Higgins Professor of Microbiology & Immunology, Mt. Sinai School of Medicine, CUNY @profvrr said:

Trump has appointed Mike Pence coronavirus czar. Pence doesn't believe in science, fueled the worst AIDS outbreak in Indiana's history while governor, denied that smoking kills, spread disinformation about condoms, and called global warming a "myth." Good luck everyone.

[Winstonm]

Concerning Mike Pence, it has been decreed that if you do fall victim to Covid-19 it will be your own fault for having insufficient faith in Trump.

Damn! There's always a catch.

[y66]

Via Tyler Cowen:

In 2006, CBO estimated the impact of a potential flu pandemic on gross domestic product as about 4.25% in the severe scenario and about 1% in the mild scenario.

[y66]

From David Pilling at FT:

Quote

Peter Piot, tall, with grey stubble and a determined gait, sticks out his hand. A microbiologist and one of the world’s most famous “virus hunters” — we later decide “virus detective” is more apt — he evidently deems it safe to shake hands at this moment of coronavirus panic.

At 71, Piot is a rock-star virologist, the Mick Jagger of microbes. The man who helped discover Ebola when he was 27 and who led the fight against HIV-Aids is a legend in global health. Charming, rebellious and with little patience for protocol or authority, he has spent a lifetime battling bureaucracy as well as disease.

Fortunately for me, the now director of the London School of Hygiene & Tropical Medicine and recipient of numerous awards — including the Order of the Leopard from the former Zaire — is also great company, a wine lover and a foodie.

On this blustery London afternoon, he plonks down an espresso-sized plastic cup on the restaurant’s marble dining counter. It contains a black truffle he has purchased from a nearby delicatessen with the intention of asking the chef to prepare something to go with it. This, I predict, is going to be an epic lunch.

“I’m in your hands, Peter,” I say, delegating the ordering to him. “That’s really very dangerous,” he replies, a playful look on this face, as we take up our position at his favourite corner spot at the counter of Bocca di Lupo, a superb Italian tapas bar in Soho. Although he is a regular, he scans the menu with the intensity of a doctor examining a medical chart, announcing various items in his Dutch-accented English.

“Braised artichokes and potatoes from Rome. Grilled langoustine — but they are so messy. Monk’s beard. I like that. This is the sage leaves that I want. And do you have sea bream carpaccio?” he asks the waiter, who is bouncing from foot to foot in anticipation of our order. “Vitello tonnato I like also,” Piot says. “Let’s see whether Phil is here, the sommelier.”

Phil appears to be absent, so Piot takes charge. The FT is paying and I’m happy to see his eyes shift to the bottom half of the wine list. “It’s between a Barolo or a Brunello di Montalcino from Tuscany,” he says, undecided, before settling on a 2011 Elio Grasso. “Barolo is like the Burgundy of Italy.”

Kofi Annan called me on a Sunday afternoon. He said, “Peter, you’re a brave man, but nobody has ever won against the People’s Republic of China”

The waiter is already planning a post-bottle glass of something bolder for us, to go with the suckling pig coming later. Before that, there’ll be borlotti beans prepared Neapolitan-style with winter tomatoes and basil. And, for the truffle, two pasta dishes: spinach and ricotta ravioli, and some simple spaghetti with oil and garlic.

“So, that’s already the most important decision of the day,” Piot says with a wink as the bottle arrives and we take a sip of the beautifully rounded wine. “Cheers. To Africa,” he says, a continent to which he has returned again and again throughout his career.

When what turned out to be a sample of the Ebola virus extracted from a Belgian nun arrived in two vials, one smashed, at the lab where he was working as young microbiologist in 1976, he couldn’t wait to get started. He was gripped by what he calls “the rush of adrenalin that comes with a mystery outbreak”. He was wearing no protective suit or mask.

“I could’ve died several times,” he says, recounting how, during that epidemic, he refused to board a helicopter after smelling alcohol on the pilot’s breath. It crashed, killing everyone on board, including the man who had taken his seat. “The absence of bad luck in life is the most important thing.”

I want to hear his views on the outbreak that is happening right now: coronavirus. I wonder if we are not overreacting. After all, so far it has killed a fraction of those who die from seasonal flu.

“I’m not the scaremongering type,” he says. “But I think this is serious in the sense that we can’t afford not to consider it as a serious threat.

“It could be that, indeed, it’s going to be over in a few months,” he continues, crunching into a tempura-covered sage leaf. “But just take the counterfactual. We say, ‘OK, it’s fine and we don’t do anything.’ I bet that we would already have had far more cases in Singapore, the UK, Germany. Let’s not forget, we are already well over 1,000 deaths. That’s not a detail.”

We are meeting on February 13, since when nearly 1,500 more people have died, and serious outbreaks have occurred in South Korea, Iran and Italy. Japan has announced the closure of all its schools and Saudi Arabia a halt on pilgrimages to Mecca. Stock markets have slumped in anticipation of a further spread of the virus and a disruption of the global economy.

“Now, let’s say, the mortality rate is 1 per cent. So, the big question is, how many people will get infected? Are we talking about hundreds of thousands or millions? Now 1 per cent of one million is 10,000; that’s 10,000 people who will die,” he says.

“It’s clearly not Sars,” he continues, referring to severe acute respiratory syndrome, which killed nearly one in 10 who contracted it 17 years ago. “That’s the good news. But the bad news is, it spreads much faster. The Sars virus sits deep in your lungs. With this virus, it seems that it’s in your throat and that’s why it’s far more contagious.

“Secondly, we have no vaccine. All we have is medieval ways of containment: isolation, quarantine, contact tracing.”

Piot remembers hearing about the first cases of a mysterious virus in Los Angeles in 1981. “The first report of HIV was six or seven gay men in California. Cumulatively, now we have, like, 75m people who have been infected. Who would have thought that then? Nobody. I’d rather be accused of overreacting than of not doing my job.”

We’re both busy with the food. I’m trying the vitello tonnato — thin slices of veal, something I don’t normally eat. But it’s incredibly tender, accompanied by a yellow tuna-based mayonnaise.

Piot is explaining how much he likes the food in Japan, where he collaborates on a PhD programme with Nagasaki University. “Life is too short for bad food and bad wine,” he says, swirling the Barolo around the ample glass.

What’s the worst-case scenario with coronavirus, I ask. “That we’ll have a pandemic,” he replies. “I think it will get much worse in China. And here we will see more and more transmission. That’s my gut feeling. But how big it’s going to be, I honestly don’t know.”

He praises the role of the World Health Organization, which he says is nimbler under Tedros Adhanom Ghebreyesus, an Ethiopian and its first African director. Dr Tedros has been criticised for going easy on China, which suppressed information in the early stages of the outbreak. “The dilemma is he could have his five minutes of fame by bashing China. But what happens afterwards? You need to work with them,” he says, scooping up some juicy borlotti beans.

“It’s a fine line. I learnt this the hard way,” he says, referring to 2002 when UNAids, the organisation he ran from 1995 to 2008, issued the so-called “Titanic Peril” report, which argued that China had many more cases of HIV than it was admitting. “It’s the only time that my then boss, Kofi Annan, called me on a Sunday afternoon. He said, ‘Peter, you’re a brave man, but nobody has ever won against the People’s Republic of China.’”

I think it will get much worse in China. And here we will see more and more transmission. That’s my gut feeling. But how big it’s going to be, I honestly don’t know

Piot gritted his teeth and publicly apologised. Still, he remembers a meeting a few years later with Wen Jiabao, then premier, in the Hall of the Purple Light in Zhongnanhai, the communist party’s inner sanctum.

“Wen asked me, ‘What’s the situation, what should we do?’ And I thought, you have 10 seconds to think. Am I going to be diplomatic or am I going to say the truth? He must have seen it. He said, ‘Forget who I am. Forget that we’re the Communist party. Tell me what you think and I’ll see what I can do.’ Piot advised Beijing to be more open about the problem and to work with people who were vulnerable, including drug addicts and sex workers, rather than jailing them. China’s policy changed decisively after that encounter.

Our pasta has arrived and the waiter grates generous slices of Piot’s truffle onto both dishes. It’s beautifully cooked, and the rapidly vanishing wine is smooth and lovely.

How did Piot get into all of this? Growing up in the flat countryside of Flanders — what he thought of then as “the most boring place on Earth” — he wanted to escape. “I wanted adventure and to see the world,” he says, adding that he devoured books from Tintin to Livingstone’s exploration of Africa. “I was dreaming of becoming a discoverer, but what could I discover when the whole world had already been discovered?”

At university in Ghent, he studied engineering, but switched to medicine. A few years later, when he was working in a junior position in a lab in Antwerp, those vials arrived from what is now the Democratic Republic of Congo, and he boarded a plane for Kinshasa. His passport had expired but, in those more innocent days, he somehow wangled his way on to the plane and through Congolese immigration.

Of Kinshasa, he says: “You love it or you hate it. I went straight from Antwerp. Boom. I fell in love within 24 hours. I dove into the water and I swam and I could survive. I embraced it fully.”

Yambuku, epicentre of the outbreak, was gripped with fear. He and a handful of more senior colleagues began their detective work, eventually discovering that the virus was being spread by the Belgian nuns who were injecting pregnant mothers with a vitamin shot using reusable needles. “I was the one who told them,” he says, though in his book — "No Time to Lose" — he recollects that the nuns didn’t fully absorb what he was saying.

I recall from the book other madcap incidents. When he was in Congo the first time, he flew in a tiny plane to another suspected outbreak. As I remember it, he looked out of the window to see one of the wings break off. “Not the wing,” he splutters, stabbing a succulent ravioli. “It was an engine. If it was the wing, I wouldn’t have been here for this meal. But I’m really not a risk-taker. I’m scared of skiing downhill and parachuting.”

He was initially embarrassed to receive the Order of the Leopard from Mobutu Sese Seko, the kleptocrat then running Congo. Subsequently he found it useful for getting out of scrapes with jittery soldiers. “I’ve lots of funny decorations. Not funny. I have to be very respectful here. The Order of the Lion from Senegal, the Order of the Rising Sun from Japan.”

What did he get the Japanese honour for? “I’ve no idea, they don’t tell you. It’s not like here you have this ridiculous, someone becomes ‘Sir so-and-so for services to the food industry’,” he says of Britain’s honours list. In Belgium, where he was made a baron, he had to come up with a crest design. He chose the red HIV ribbon and the motto “Ken uzelf”, or “Know thyself”.

Our crispy-tender slices of suckling pig have arrived, together with two glasses of Sagrantino, a more powerful wine from Umbria.

As head of UNAids, Piot championed the marginalised, from gay Cubans and Chinese methadone addicts to sex workers in Nepal. Prejudice was the main engine of the Aids epidemic. He has also hobnobbed with a procession of leaders, including Nelson Mandela — who radiated “natural wisdom and authority” — and Fidel Castro, who kept him up till 3am in heated argument and then sent him cigars every Christmas.

In recent years, he has been increasingly drawn to Asia, particularly Japan, a country he first visited in 1981. “I left after two days. I thought this was not for me. The taxi driver with white gloves who holds the door open and all that. It was an acquired taste as far as I was concerned.” About a decade ago, he changed his mind. “I decided there’s absolutely no way I will ever understand what the hell is going on. I can’t read, I can’t speak, I don’t understand. It was so liberating.”

I ask for an Americano with vanilla ice cream. Piot says no to coffee. “Gives me tachycardia,” he explains, ordering an almond granita.

Piot is near the end of a second five-year term as director of the London School of Hygiene & Tropical Medicine, more than half of whose staff is now based in Africa. He’s thinking of prolonging his tenure a few more years, prompting me to tease him that he’s been hanging out with too many dictators for whom two terms is just not enough. No, he says, he is already planning what comes next: mentoring young health workers, and possibly something in biotech. London, where he lives with his second wife, Heidi Larson, a renowned anthropologist, is likely to remain home.

Why, incidentally, does he dislike the term “virus hunter”? “Well, it’s not that I’m actively hunting. Things happen. Sh#t happens. It’s more understanding what’s going on,” he says, comparing what he does to solving a mystery. “So, maybe detective is a better word.”

I remind him of Laurie Garrett’s book "The Coming Plague". In our arms race with microorganisms, are humans destined to lose? Piot quotes Louis Pasteur: “‘Messieurs’ — because they were all men in those days — ‘microbes will always have the last word.’”

Piot thinks differently. “If we do nothing, then that’s the case,” he says, particularly since new viruses — as coronavirus appears to have done — can always jump from animal to human. But these days far more people die of non-communicable diseases than of infectious ones, he says.

“Collectively, we’ve done quite a good job. That’s why we need, how to say it, a fire brigade,” he says, of a stronger and better-prepared global health system. “You don’t set up a fire brigade when your house is already on fire.”

[Zelandakh]

Just to mention that the coronavirus has arrived in the next town so I imagine it is going to get crazy around here soon. I am debating whether to go into the office (using public transport) on Monday or go for a Home Office day. So far no guidance from the employer other than concerning Italy and China.

[y66]

From SwissInfo.ch:

Quote

The Swiss government took an unprecedented measure on Friday to take over powers from the cantonal authorities to ban large gatherings in order to contain the spread of the virus.

The decision was made shortly before the Geneva-based World Health Organisationexternal link raised its impact risk alert for the coronavirus worldwide to “very high” – its highest level.

Some local governments, including Canton Bern and the city of Chur in eastern Switzerland, have announced even stricter measures. Bern authorities say they will cancel events with fewer than 1,000 participants, if organisers cannot prove that none of the participants were in a region affected by the virus in the past 14 days. Chur is banning all events with more than 50 participants, with some exceptions.

By Saturday evening, the Swiss authorities had confirmed 18 cases of infections, which have been tested positive in two tests. In at least the first 12 cases, the patients had recently been to Italy. Four additional patients have tested positive in one test and are awaiting results from the reference laboratory in Geneva.

The Swiss authorities expect the number of infections of the novel coronavirus to rise in the country but plan to keep schools and the border with Italy open.

[kenberg]

Zelandakh, on 2020-February-28, 08:57, said:

Just to mention that the coronavirus has arrived in the next town so I imagine it is going to get crazy around here soon. I am debating whether to go into the office (using public transport) on Monday or go for a Home Office day. So far no guidance from the employer other than concerning Italy and China.

First, I wish you the best. It is becoming pretty clear that there will be many ,amy people with similar decisions. Good luck to us all.


My wife's son and his family live near Portland OR. A school fairly near them has an employee who came tested positive. Their daughter goes to pre-school, so far so good.

I was at the Y Friday There were fewer people than usual, perhaps a coincidence. They have sanitizing wipes to be applied after we use the equipment. I used them also before using the equipment.


People are going to be making decisions, and often I think they will be of this sort: Some things I must, or probably must, do. How should I go about it? Other things I really don't need to do. Some of those I will skip. We plan to fly out to Oregon sometime, but I we will wait to see how this all plays out before we buy tickets.


The word is not to panic. I do not believe I am panicking, But I, and a lot of other people, will be exercising some caution. .


But again, good luck to you and good luck to us all.