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COVID-19 Epidemic: MSM deceptive fearmongering should be ignored, but the threat of recession is real


Version 2.40 (Apr 05, 2020)

Caution is advisable but panic is unacceptable.

News Health issues Recommended Links COVID-19 prevention measures The threat of "Coronavirus recession" COVID-19 epidemic handing in the USA COVID-19 as a bioengineered virus hypothesis
COVID-19 fearmongering COVID-19 epidemic as the second stage of the crisis of neoliberalism  COVID-19 hoarding epidemics  Diamond Princess epidemics of COVID-19 Absurdity of bureaucracies Medical workers problems  
Media as a weapon of mass deception  Stability is destabilizing: The idea of Minsky moment Manufactured consent Groupthink The importance of controlling the narrative Trumpcare scam Nation under attack meme
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Abstract

The US MSM Media Narrative is deceptive and amounts to a toxic mix of domestic hysteria and propaganda war against China. While it looks like the danger of the disease was exaggerated, even falsified, the crisis caused by it, internationally and locally is obviously real. The current lethality from SARC-CoV-2 is probably much lower then 2 to 3% which was registered in  China. It represents a serious danger mostly to the old (over 60) males, medical personnel, and/or people  with "sensitivized" lungs (the category which includes people in areas with very bad air quality, smokers, asthmatics, and a subset of people with hypertension who are taking ACE inhibitors). Only around 7% of infected develop virus pneumonia. After you get pneumonia other medical conditions such as coronary come into play and determine your prognosis.  In China already over 90% of its 81K Coronavirus patients have made a full recovery

Neoliberal MSM are creating artificial hysteria trying to use this issue to damage Trump. Worst-case predictions would not come true; but the  economy damage from hysteria, for which MSM are partly responsible for would be huge.  COVID-19 doesn't spread as easily as first thought. Most infected were infected in closed spaces populated by infected individuals (ships. military camps, hospitals, families, religious gatherings, conferences, etc). You need approximately 15 min contact with infected person to became infected. It is not instant: you need to get a critical viral load which differ one individual to another. At this point quantity turns into quality and you became sick.  Looks like you need to accumulate a critical dose like with radiation. That's why most infections acquired in family clusters (around 80%): the most vulnerable person catch it somewhere else and then he/she infects all the members of the family.

The Coronavirus hits mostly urban areas preferring metropolises with high density of population like NY metropolitan area.  Religious nuts can change this picture a little, but like happened with some obscure cult in Korea,  Jewish orthodox worshipers in NY and NJ, and evangelicals in LA. In a way, religious nuts along with military brass and reckless teenagers who partied during Spring brake and the brought infection to their communities proved to be a perfect Trojan Horses for the virus in the USA and made the epidemic  worse.  Perfumed princes of Pentagon also behave arrogantly and recklessly and engager the lives of troops: Esper’s decision to continue training camps for recruits  and dismissal of the captain of the aircraft carrier USS Theodore Roosevelt, on which the virus was reportedly spreading reflect a deeply ingrained Pentagon habit of protecting its parochial military interests at the expense of the health of American troops. To prioritize non-critical military objectives over public health. History repeats: they acted with even greater callousness toward the troops being called off to war in Europe during the devastating “Spanish flu” pandemic of 1918, which killed 50 million people worldwide. The real character of the US military brass running the WWI is clearly revealed by the fact that more American soldiers were killed and hospitalized by influenza (63,114) than in combat (53,402).

Bureaucratic incompetence of the US government also played role. The USA failed to distribute masks to population via pharmacies and enforce wearing of masks in public places for everybody. CDC blunder with the test for this virus added to the problem. As the result of this blunder the tests availability during critical period (Feb 26-March 26) in the USA was very low.  San Francisco ordered a shelter in place on only on 3/16, California on 3/19, and New York as late as 3/20.

While we can argue about actual mortality (probably in a range from 0.2 to 2%; with steep increase fro this level for older people to ~15% of people over 80), still, this new coronavirus is worse than seasonal flu, not because it produced more deaths or infections (it is not so far; then number of death is ten times less), but because it cause acute virus pneumonia for larger percentage of people then the seasonal flu.  An overloaded with COVID-19 patients hospitals are no joke, especially for people seeking help on unrelated matters.

But to understand the real level of the danger we need to know the facts. Facts do not cease to exits because they are ignored by MSM. 

Introduction

“Courage is not the absence of fear, but rather the assessment
that something else is more important than fear.”

Franklin D. Roosevelt

We need to know the enemy.  We need to know objective facts without usual MSM hype and fearmongering.  This way we can better protect ourselves and people who are communicating with us.  Don't take the information below uncritically. Check the facts.  Now it is responsibility for all citizens to think.  But if you do not find errors then you need to agree that the situation with this epidemics is quite different from the situation depicted by MSM.

Neoliberal MSM concentrates on total number of positive tests. But COVID-19 results in a spectrum of illnesses, with pneumonia as the most severe one. That means the hospitalization is more important metric as in any large scale epidemic there is a danger the patient intake overflow available beds. So far with around 30K hospitalization in the USA COVID-19 is very far from this state. And cries about possible lack of ventilators is most fake attempt to hoard more "just in case".   And that the exponential growth of new "tested positive" cases is typical for any early stages of virus epidemics and is not the most important part of the story (the speed of increase in the USA already slowed down from ~32% a day to 22% a day) . Like other coronaviruses new coronavirus probably has period of positive growth (starting with several weeks of exponential growth), peak and the period  of negative growth (recovery). More important is whether the USA repeats China curve  starting with the day with 100 new cases (March 7). If this is true then the lag is approximately 9 weeks and the peak can be expected somewhere in late April, early May:  In China the period to peak was around 6 weeks: from Jan to mid February.  Here the chart from J.P. Morgan created  on March 24, 2020.

And here is an updated curve from the same source as of Apr 4 (funny they remove Iran, which also probably entered recovery phaze):

First of all, nothing is new under the sun. Epidemics, like financial crises, have been a recurrent occurrence for all written history of human civilization. They go though several well defined phases (or figures above it is "Early development", "Acceleration", "Late Accumulation", "Recovery") and eventually phase out. Hundreds of epidemics have killed countless millions of people during middle ages (Black Death, cholera, etc)  and even quite recently Spanish Flu (1918) which caused virus pneumonia somewhat similar to virus pneumonia observed now with COVID-19.  Each lasted a certain time.

But this is not Spanish Flu II. Far from it. And we are much better equipped to fight it than in 1918. For one thing we now have is Internet. Another is genomic sequencing and the modern bioscience (which might contribute to the emergence of this virus if it was accidently leaked from one of biolabs). 

In any case, contrarily to the opinion of governor Cuomo and some neoliberal MSM,  it looks like the USA now entered at the stage of deceleration of daily infections speed - JPM called it "late accumulation phase" in pictures above (we are  down from 34% increase per day in mid March to less then 20% as of Apr. 4, 2020). The evidence suggests that this virus so far it failed to rose to the level of danger of several common infection, which do not make any headlines. I will name just three:

Nobody is insured against getting the infection. And some people unfortunately will die of it. But in case of coronaviruses,  which infects humans  for 3500 years (or more) even minimal hygienic measures as outlined in popular materials drop chances to get infection by an order of magnitude. The most infections occurs in closes spaces, home, office, conference room, church, etc  so you need to wear a mask to diminish changes of getting a virus doze that will provoke infection. You also have a moral responsibility to protect other people and that means wearing a mask in public places. So even in the absence of vaccine and proved treatment for this infection we are not powerless. As most coronaviruses are seasonal spending more time on sun and fresh air to boost your immune system might also help a little bit.  In 1918 this method was also used for sick patients during epidemic of Spanish flu (which, paradoxically was more deadly for young then for old people) with very good results. 

The current MSM mantra is that COVID-19 will spread evenly across the USA  like wild fire so that each major city eventually will become like New York is deeply wrong.  The percentage of deaths by Covid19 in the USA is 17.8 per million citizens, which corresponds to the usual percentage of seasonal influenza.

COVID-19 hospitalizations and deaths  rates per 1,000 inhabitants reveals important clustered patterns: COVID-19 does not spread uniformly in any country or region, but rather clusters in few hot spots according to principles of communicability. In the USA infections with coronavirus  are clustered in single interconnected  region of two states NY, NJ (New York metro area). This region with around 16 million people accounts for ~ 50% of all tested positively. Similarly, 60% of Italian deaths occurred in the Milan metro area, and this trend continues. Where to allocate resources is always a tough choice. But the  military axiom is that "he who defends everywhere defends nothing" [ COVID-19 is occurring in clusters, making good data and resource allocation crucial TheHill ]

All that means that we should resist unsubstantiated attempts by neoliberal MSM to create panic and promote false narrative. As Craig Murray  stated "The coverage is prurient, intrusive, unbalanced and designed to cause hysteria." (see also Dr. Wolfgang Wodarg Confirms this is an Insane Panic video). They have their own agenda (probably two: money and the desire to depose Trump)  that does not correlate with the interests of American people.  Think about the fact that they report total number of tested positively (which is large number which contain probably around 30% of false positives), but not the number of hospital admissions, cases requiring mechanical ventilation,  or other relevant metrics outlined by WHO:

You will never find this data in neoliberal MSM.  Weekly statistics comparing number of deaths in February and March 2020 in the USA with the corresponding number from previous years (or, better,  the average for ten previous years) is absent.  That is another clear sign of the bias of neoliberal MSM, and the sign that they are trying to inflate the threat.

Weekly statistics comparing number of death in February and March 2020 in the USA with the corresponding number from previous years (or, better,  the average for ten previous years) is absent.  That is another clear sign of the bias of neoliberal MSM, and the sign that they are trying to inflate the threat.

As of March 27, 2020, statistically this virus epidemic is a non-event and its effects so far are far less then the effects on the world population of seasonal flu ( 5 Million Cases Worldwide, 650,000 Deaths Annually ). In GB actually average mortality per week dropped in recent weeks. 

Only Italy recently showed a statistically significant excess number of deaths. At the same time 85% of those who died in Italy are over 70 and they died from other medical problem aggravated by coronavirus infection : ~88% of patients who have died have at least one pre-morbidity - many had two or three. Also Italy has an older population, the largest in Europe and second only to Japan.

European total mortality continues to decline since Feb. 10. This might be the rare pandemic that saves lives, since mortality has declined throughout the crisis.

European total mortality continues to decline since   Feb. 10. This might be the rare pandemic that saves lives, since mortality in EU has declined throughout the crisis.

Let’s put it straight: as for the capacity to kill people SARS-CoV-2 is a weak, inferior to Spanish flu, virus.

Let’s put it straight: as for the capacity to kill people SARS-CoV-2 is a weak, inferior to Spanish flu, virus. As of March 25, 2020 the total number of deaths from coronavirus worldwide ( around 22K for approx. three months period ) is comparable with the number of births in three hours ( ~10-16K per hour )

As of March 25, 2020 the total number of deaths from coronavirus worldwide ( around 22K for approx. three months period ) is comparable with the number of births in three hours ( ~10-16K per hour )   (Sic Semper Tyrannis):

In one hour there are 16,000 new births around the world. And how many have died from the Corona virus since the first of January? 15,328 (from John Hopkins as of 10:40 am). That works out to roughly 8 deaths per hour globally. Catch my drift? If someone you love and care for dies of Corona virus it is a sad, tragic loss. I get it. But the reality of Mother Nature is that life is far more potent than death.

...Please also consider that as a percentage of the global population, the number who have tested positive is .00004 % (in other words, 4/10,000 of a percent). That number barely registers.

...More perspective - literally thousands of people around the world die every day due to Hep B and C. Literally thousands die every day due to TB. AIDS kills thousands a day. These are all contagious diseases that fester in the third world. Yet those almost incredible death rates don't even register in the US and up to a couple of weeks ago, the Democrats were calling for open borders; which would have allowed those contagious diseases into the country unmonitored. Why no hysteria over any of those (all of which have been increasing prevalence in the US in recent years)?

The danger of fearmongering and overhyping the threat: the damage to the economy caused by overreaction might far exceed the damage to human health caused by the virus

Some public health professionals have been pleading with authorities to consider the implications of the unreasonable, disproportional response (Could the Covid19 Response be More Deadly than the Virus – OffGuardian) including total quarantine instead of obligatory wearing of masks in public places.

Many experts have spoken out publicly, criticizing the overreaction to COVID-19. A professor of medical microbiology, for example, has written an open letter to German Chancellor Merkel in an attempt to draw attention to the concerns.

The real problem we face today is not a virus. The greater problem is that people have failed to engage in critical thinking due to the fear promoted by some media and government officials. Ultimately, the fear of COVID-19 and the lack of critical thinking that has arisen from it are likely to cause far more deaths than the virus itself.

The level of fearmongering in US MSM does not correlate with the known facts about the virus and suggests the neoliberal elite (aka bankers and the Deep State)) decided to use this tragic event as a cover-up for organizing "soft landing" of the USA economy, which was on the brink of economic recession since September 2019.

Is MSM fearmongering a yet another attempt to depose Trump and/or the neoliberal elite decided to use this tragic event as a cover-up for organizing "soft landing" of the USA economy, and first of all its overextended and overleveraged via derivatives banking sector (financial oligarchy rules this country.) As Senator Durbin aptly said: " The banks — hard to believe in a time when we're facing a banking crisis — that many of the banks created — are still the most powerful lobby on Capitol Hill. And they frankly own the place." Interview by Bill Moyers, Bill Moyers Journal, PBS, May 8, 2009.
 

While the virus might be natural,  despite widespread rumors that it was bioengineered and escaped from the lab accidentally, corona panic is definitely not a natural phenomenon. It is artificially created (Wake Up! Your Fears Are Being Manipulated The American Conservative):

There are many reasons to take prudent action. There are no good reasons for fear and panic. The fear being promoted has no rational basis compared to regular influenza and the swine flu of 2009. We have a terrifying example in 9/11 of how easily manipulated fearful people are. Remaining calm and helping others do so is a big part of what your contribution to the disaster relief could be.

... ... ..

robt -> Ossian the Bard 11 hours ago

From the UK Government: Status of COVID-19

As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK....They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.
https://www.gov.uk/guidance...

Yes, virus pneumonia caused  COVID-19 by is a very dangerous, often life threatening disease, with possibly long term negative health effects for some of the affected individuals (fibrosis of the lungs).  But it hits a very small percentage of all infected (serious cases in the USA are around 2% of all tested positively), mostly (but not exclusively) people over 60.  Most deaths occur in an "over 70" age group and it is difficult to say whether they die "from the coronavirus", or "with the coronavirus" as most have other serious medical conditions.  In the letter case COVID-19 infection was just the last straw that broke the camel back, and they would die if infected with regular seasonal flu too. 

It looks like R0 (number of people that an infected person will infect) for this virus is unusually high, which makes this virus the most infectious among its predecessors and seasonal flu. And that guarantees the initial exponential curve of cases.  But this is not the whole story.  What MSM do not tell us is that the percentage of population that is susceptible to the virus. Among Wuhan medics only 60% became infected. Among Diamond Princess cruse ship population only 20%. It is logical to assume the for the USA population the figure is closer to 20% then to 60% of the  total population.  Please note that the USA population is much younger then the population of Diamond Princess which improves prognosis.

Also while the US government fell flat on its face as for testing,  many European countries are testing all contacts and family of confirmed cases in addition to wider “random” testing (starting with medical personnel, supermarket staff etc.). In addition only essential services are working. In such circumstances , the R0 is probably less than one, and might be as low as 0.1.

The mortality of the virus is probably overhyped ( based on cruise ship epidemics data it is probably around 0.2%, not 2-3% figure propagated by MSM) as most of the deaths of older people tested positive for the virus are attributed to the virus.  The question is why ?  This is not the first virus pneumonia that hit the USA. Why this time the reaction is completely different?  Is this because the virus provides justification for drastic measures and as such help to ensure "soft-landing" for the USA economy which was about to enter the recession? I  do not know. Speculations are rampant.  See The threat of "Coronavirus recession"

In the current situation, when neoliberal MSM are engaged in fearmongering,  humor greatly helps, serving as a powerful antidote.  One outstanding example of COVID-19 related humor is  Torn - Natalie Imbruglia (#Coronavirus Parody)   Another great parody is Covid-19 Global Lockdown  by CJ Hopkins. Softpanorama political humor section contains some related items too.

Concentration on fearmongering ("K infected and N dead for a day in country XXX.  Horror!") leaves the public with a new health concern to worry about, but no useful knowledge of the actual factors involved in this epidemics.  I wonder if anyone has data about the number of deaths this year and the number of deaths in the same period in previous years? I suspect such data might well show no excess deaths. For example, coronavirus actually reduced mortality in GB:

Steve Hayes ,

According to the Office of National Statistics, in the week ending the 6th of March 10 895 deaths were registered in England and Wales. The average number of deaths registered for the corresponding week over the previous five years was 11 498. So the coronavirus appears to be reducing mortality. https://www.ons.gov.uk

Over 90% of infected individuals have only mild symptoms and almost none in case of the infected are children and teenagers. If so, what was the criteria of closing schools (children usually are not infected in school settings or public places; China data suggest that they are infected mostly in family settings). Former Presidential candidate Andrew Yang  made the following apt observation (https://www.politico.com/news/magazine/2020/03/17/coronavirus-universal-basic-income-andrew-yang-134922):

YANG: That’s what freaks me out about the whole thing. What we’re doing is saying things like, “Keep your social distance,” and trying to stop the spread that way, which is fine. But we have shit for data. Like, we don’t know what the infection rate is. And so, there’s no reason we would ever be able to give the ‘all-clear.’ If you don’t have any data, this whole thing is a nightmare that doesn’t end.

When you close schools, what gives you the all-clear to say, “OK, open them again”? Nothing. There’s no data to compare it to. This whole thing is a fear-based approach with no end in sight. There’s no catalyst to ever sound the all-clear. This whole thing is so fucked up.

... ... ...

We need to know now what the future can look like under different scenarios and then be presented with what scenario we’re in when that time comes. We’ve been on lockdown for half a week. Right now, the American people don’t have any visibility into whether it’s going to be four more weeks or four more months, and we don’t know how those judgments are going to determined. As president, I would say, “Look, here’s the information, here’s the dashboard, here’s what we’re lining up, here’s what we’re hoping for, here’s how circumstances could change, and thank you for doing your part — if you proceed with like the rest of the country in flattening the curve and keeping things under this level, then we can look forward to this.” You know, so we could actually have a sense of accomplishment and purpose.

It is impossible to make informed judgments without definitive data about lethality of the this virus. Which probably is considerably less in Western countries than the current inflated number of 2-3%.  The latter is the result of counting "deaths with the virus" instead of "deaths from the virus".

Pft says: March 25, 2020 at 4:51 am GMT • 100 Words

...Report shows up to 88% of Italy’s alleged Covid19 deaths could be misattributed

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,”

– Professor Walter Ricciardi, scientific adviser to Italy’s minister of health
Report in English:

https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf 

Regular seasonal flu is also the "great eliminator" of old people with serious medical conditions, who are at the end of their life span and nobody closes schools and businesses because of that.

From formal standpoint corona viruses are classified as common colds rather than influenza. According to the CDC, symptoms of this new coronavirus include fever, dry cough, and shortness of breath, which can appear anywhere between two days and two weeks after the exposure. Nausea is also occurring, but is not the leading symptom.  The most distinctive pair of symptoms is dry cough, and later shortness of breath.

COVID-19 infects men more frequently then women (around 66% of infected persons are men). Which might suggest that smoking greatly increase susceptibility to the virus.  

Like for a typical flu epidemics,  pneumonia  is the most common cause of death from COVID-19. But unlike bacterial pneumonia caused by the flu, this one is far more serious and more difficult to treat. With this type pneumonia there is a possibility of developing ARDS -- Acute respiratory distress syndrome which occurs when fluid builds up in lung alveoli. Around 40% of patients who develop ARDS die.

For survivors ARDS often also has long term health consequences -- fibrosis of lungs. 

Again the virus hits mostly the elderly. Statistically the elderly with severe pneumonia from flu requiring a hospital stay have a ~ 20% fatality rate. COVID-19 has probably higher percentages due to ARDS.

Like all such viruses this virus causes an infection in the respiratory tract, or nose, throat and lungs (in mild cases mostly upper part  -- brouchs (acute bronchitis), but is several case lower part -- alveoli causing pneumonia). The virus is iether inhaled with infected aerosol or transmitted, usually via your fingers, to the mucous membranes of the mouth, nose or eyes.

When someone with the disease coughs, sneezes or talks, infected droplets spray into the air where they can stay for some time (hours?) and get into air conditioning system which reticulates air mixing flex air with "used".  The infected droplets may also land on a surface, where they remain active and contagious for several hours or days, depending of the type of the surface (more of steel, less on   paper surfaces, a very short time on copper). As one Chinese researcher stated:

"The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper."

In other words there are two main paths of infection:

Theoretically this category of viruses is very interesting and represents the borderline between live organisms and organic substances. This parasitic creatures are also very small (a couple of hundred nanometers), they "travel" in droplets which make regular surgical masks effective. N95 masks do not filter exhausted air and an infected person in N95 mask will spread the virus too although nor as actively as a person without such a mask: droplets will travel long distance as in case of cough of sneezing. .

The virus consists only of RNA in a coat of lipid molecules. RNA isn’t very stable. It instantly die when heated above 56°C, soap,  or disinfectants such as alcohol.  That’s one of the reasons why those viruses outside the host survive mostly within the buildings and  just a couple of days at best. They also do not survive drying of a saliva drop in aerosol. The body also has various mechanisms to quickly eliminate it. Human skin, for example, produces enzymes that quickly degrade RNA samples. Soap kills them instantly.  Direct sun kills them in an hour or several minutes.

It looks like hot and humid areas of the USA (and tropical countries) are less susceptible to this epidemics as hot and humid air for some reason make it for virus more difficult to propagate.  To examples population of Texas in the USA is much less susceptible than population of NY or Illinois.

Traveling internationally to the countries known to be affected dramatically increases the risk. In general, it’s safest to avoid nonessential travel to countries and areas with a sustained COVID-19 presence. Especially for seniors. Current estimates suggest that mortality starts with 0.1% for teenagers, less then 1% for people younger then 40. It dramatically picks up for people over 50,  reaching 15% for patients over 80 (who usually have other serious medical conditions; there are very few healthy 80+ year old). California recently made the right step requiring that  they self-isolate. Again, it looks like smokers are  more commonly affected and this is a strong reason to immediately stop smoking. 

The virus can be transmitted by infected individuals before the symptoms develop (incubation period). And first of all that means by children, students and young adults among which this virus of often looks like a light flu.  They are kind of Trojan horses in this situation. As incubation period can be quite long from 2 to 14 days with five days as the average.  That makes wearing masks in public places an important safety measure designed to protect those who are not infected from those who are already infected, but do not know about it:

"A new analysis by a team of Canadian and international researchers suggests that the novel coronavirus can be transmitted by infected individuals before symptoms develop – a possibility that could explain why the spread of the epidemic has proved so difficult to contain after it first appears in a new location. “It means we would not be able to stop all the transmission events by focusing on cases who have already developed symptoms.”  -GlobeandMail.ca

While for ordinary people inhaling infected air droplets is the most common infection path, "hands into eyes or nose" is an important path of infection with this virus for people suffering from dry nose or dry eyes. For this category of people it is important not to touch your nose and eyes, before they washed your hands.  And generally avoid touching face with hands.  Those who regularly touch their nose or eyes (people suffering from dry nose or dry eyes problem) now belong to the most vulnerable subset of the population independent of their age.  They should now carry saline spay or gel  and/or eye moisturizer with them. They can also try to wear a mask (any mask will suit) in shops and public transportation to prevent touching their nose or eyes instinctively, without any conscious control. Wearing gloves might also help. 

Proper hand washing with regular soup kills or disable the virus and as such is an important safety measure  (COVID-19-09). In the case of viruses, the soap basically dissolves or penetrates the outside boundary of the virus and it collapses.

Those who often touch their nose (people with dry nose problem),  or eyes (dry eyes)  are extremely susceptible to the disease.  Smokers and seniors are two the most vulnerable general categories.

Travel history is strong predictor of chances of being infected. Hong Kong has made it a criminal offence to lie to a health care provider about one’s travel or exposure history; the US should do the same.

Spending more time on sun improves resistance for the virus for healthy people and improves prognosis for those who are sick. In the USA this method was widely use to fight Spanish Flu epidemic and it still has great value today.  

Spending more time on sun improves resistance for the virus for healthy people and improves prognosis for those who are sick. In the USA this method was widely use to fight Spanish Flu epidemic and it still has great value today. 

Transmission: COVID 19 does not spread easily; mostly in confined spaces with infected people

We seem to have a terminology issue here. The term “aerosol” is generally taken to mean small water droplets dispersed in air carrying virus – and WHO has emphasized from the very beginning that this is the primary means of transfer. By contrast, the term “airborne” is used to describe free virus particles floating in the air at sufficient levels to cause infection.

Transmission  of coronaviruses is usually via droplets to the nasal mucosa or saliva of the affected person.  So it is transmitted via aerosol. 

According to the WHO, the primary mode of transmission is via respiratory droplets that people cough or exhale.[257] According to the CDC, it is thought to spread when people are in close contact, via these droplets, often during coughing or sneezing.[258][259]

The European Centre for Disease Prevention and Control (ECDC) concurs that it seems to spread via these droplets, during coughing, sneezing or exhaling, but "[t]here is not enough epidemiological information at this time [21 March] to determine how easily and sustainably this virus spreads between people."[260]

But the virus is not airborne -- there is no evidence that you can became infected via viruses in dry state spreading over the air. The working assumption is that when the drop of water dries the viruses in it became less active or inactive.  If droplet landed on some surface it might take some time for the virus to disintegrate.

The World Health Organization released a study on how China responded to COVID-19.  The results of their research show that COVID-19 doesn't spread as easily as first thought. The majority of viral infections come from prolonged exposures in confined spaces with other infected individuals. That's why most infections acquired in family clusters (around 80%.)  From the WHO report, https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

"When a cluster of several infected people occurred in China, it was most often (78-85%) caused by an infection within the family by droplets and other carriers of infection in close contact with an infected person.

Routes of transmission

COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. Airborne spread has not been reported for COVID-19 and it is not believed to be a major driver of transmission based on available evidence; however, it can be envisaged if certain aerosol-generating procedures are conducted in health care facilities.

Household transmission

In China, human-to-human transmission of the COVID-19 virus is largely occurring in families. The Joint Mission received detailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces. Among 344 clusters involving 1308 cases (out of a total 1836 cases reported) in Guangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families. Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong estimate the secondary attack rate in households ranges from 3-10%.

It looks like the virus can spread with the aerosol exhaled by asymptomatic person (without any coughing and sneezing), but this is unproven and in any cases such infection constitute a very small percentage of all infection. But if true, this make virus very dangerous indeed (Marc Wathelet, a virologist and specialist in coronaviruses and respiratory diseases )

I worked in an institute dedicated to respiratory diseases and there the work on aerosols, chemical or infectious, is done every day, it is perhaps 10% of their activities; I have absolutely no doubt that this virus is transmitted by aerosol, if I can leave my reserve as a scientist who must doubt everything. In an emergency situation, we follow the preponderance of evidence.

The stability of the SARS-CoV-2 virus in the air and on various surfaces is believed to be comparable to that of other coronaviruses.[261][262][263]

In any case the primary mode of transmission is via respiratory water droplets that infected people cough or exhale. And they are quite large, much larger than the viruses. In no way to  filter the viruses you need a special N95 mask. So regular surgical masks are very effective and essentially block infection lowering you risk at least five time as they do not allow for the virus to acquire "a critical mass":  

The virus starts to replicate in significant numbers (billions per mililiter) on day 2 after the infection. The virus first replicates in the upper throat and the infected person starts to spread it to others simply by breathing, talking or coughing.

Only on day 5 the infected person starts to develop first symptoms. The virus migrates into the lower lung and replicates there. The virus load in the upper throat will then start to decline. The immune system intervenes and defeats the virus but also causes additional lung damage which can kill people who have already other preexisting conditions. (Interestingly smokers seem not to develop a cytokine storms during a Covid infection and are thereby less prone to end up in the ICU.)

On day 10 only few viruses will be found in the upper throat and the person will generally no longer be infectious.

The typical hospitalization point in China was only on day 9 to 12 after the onset of symptoms. At that point a test by swabs is nearly useless as the infected person will normally no longer have significant numbers of the virus in the upper throat. Reports of "defective tests from China" were likely caused by a lack of knowledge about this phenomenon. The diagnose in these later cases should be done by a CT scan which will show the lung damage.

That's why 100%  wearing regular surgical masks in confined spaces is of paramount importance. It is not important and even harmful to wear masks in open spaces: you are fighting nonexistent threat, unless you are standing in line or other high concentration of people. 

Wearing regular surgical masks in confined spaces is of paramount importance. It is not important and even harmful to wear masks in open spaces: you are fighting nonexistent threat, unless you are standing in line or other high concentration of people. 

Also if everybody is wearing mask infected people spread diseases much less, which is important for fighting this epidemic.  Quarantine alone does not solve this problem: For an infected person staying at home, R0 simply becomes the number of other people in their household. Which suggest the focus should be on critical classes of workers, like hospital employees, grocery store clerks, first responders, etc.  They (and not the office worker staying home) are the most vulnerable population that is spreading the virus and theoretically should wear masks at home to prevent infections of other members of the household.

The USA government make a blunder when it does not supply citizens with a couple of masks and enforce wearing of masks in public places they can be easily disinfected by putting them in over and setting 70F for half an hour). 

The USA government make a blunder when it did not supply citizens with a couple of masks via pharmacies and enforce wearing of masks in public places like China did.  They can be easily disinfected by putting them in oven and setting 70F for half an hour).  Fauci should be fired for incompetence.

They protect uninfected people from infected and also diminish that doze of the virus uninfected people inhale if you are in contact with the infected person. If infected person is wearing no mask and you are wearing the mask, the dose is probably five time less, then if both are without the mask.  If both are wearing the masks the dose is probably hundred times less and might not cause the disease at all.  Comment from Unz.com. March 31, 2020):

Enormous numbers of medical staff can still be seen wearing the simple type of face mask and, of course, this will be a pretty good first line of defense by catching those aerosol droplets. However, a droplet caught by the gauze will quickly evaporate leaving the virus behind and there is a reasonable chance this will then be inhaled.

Still, simple masks are surely better than none and these are likely to be the only type readily available at this time for most of us – WHO downplays their value except for people who are themselves infected.

I am shocked to see supermarket check-out clerks still without any sort of mask.

The inability of the USA government to supply masks for frontline personnel like supermarket clerks is really damning. They actually do not care one bit about the people. In view of the size of the USA military expenses that makes textbook case of bureaucratic incompetence: there should be a stockpile of masks that provide at least two masks per person in case of such emergences. They can be distributed based on driver license.  

The inability of the USA government to supply masks for frontline personnel like supermarket clerks is really damning. They actually do not care one bit about the people. In view of the size of the USA military budget that's a really inexcusable blunder

That main danger of the respiratory coronaviruses is that they can cause disease of the lower airways including virus pneumonia,  but it is unlikely that this is due to direct infection via droplets. Most probably this is Stage II of the disease after the virus replicates locally in cells of the ciliated epithelium, causing cell damage and inflammation and releasing a new generation of viruses, which propagates down into lungs. 

Some specialists suggest that there is a strong association between the intensity of exposure to virus (which is highest in family and hospital settings) and the severity of subsequent disease is seen in other infections like measles (How Does the Coronavirus Behave Inside a Patient- - The New Yorker). In other words there might be a "critical mass" of virus particles that you need to inhale to become really sick:  

“If you acquire measles through household contacts, where the density and dose of exposure is the highest—you might be sharing a bed with an infected child—then you typically have a higher risk of developing more severe illness,” he said. “If a child contracts the disease through playground or casual contact, the disease is usually less severe.”

That hypothesis explains why medical workers  are affected more severely than the rest of the population -- they have much more severe cases than that control group.

That also suggests that the person who bought the virus into particular family might have suffer from a lighter form of the disease while the other members of the same family who he/she infected will have more severe cases.  But this is not proven fact, just a speculation.

If we could identify pre-symptomatic patients who were likely exposed to the highest doses of viruses—someone cohabitating or socializing with multiple sick family members (as with the close-knit Fusco family of Freehold, New Jersey, which has had four deaths), or a nurse exposed to a set of patients shedding large amounts of the virus—we might predict a more severe experience of the disease, and give them priority when it came to limited medical resources, so that they could be treated faster, earlier, or more intensively.

There is still a controversy whether people who have no symptom (asymptomatic cases) can shed the virus into their surrounding and if yes, how (on their skin, breathing, via kisses, handshakes, fecal masses, etc). See, for example, Presumed Asymptomatic Carrier Transmission of COVID-19 Global Health JAMA JAMA Network (February 21, 2020) in which transmission to relatives in a family cluster is assumed.  If the findings in this report of presumed transmission by an asymptomatic carrier can be replicated, the prevention of COVID-19 infection would prove very challenging indeed.  But for now the working hypothesis is -- "no symptoms, no transmission." Respiratory droplets may be produced during breathing but right now the virus is not considered airborne.

Typical incubation period for older coronaviruses is three days. For Covid-19 it is longer with the average of 5 days ( and range 2 to 14 days.) On what day the infected person starts to produce viruses is unclear, but probably not before he/she develops at least minor symptoms like running nose or dry cough. The patient definitely spread the disease, if his are affected with pneumonia.  Approaching such a patient without protective clothing and face mask is dangerous. But that typically what is happening in family settings.

The most important current assumption about this new virus is: the virus does not spread with the breath of an infected person that has no symptoms. He/she needs to cough or sneeze and in this case droplets can travel long distance.

But sneeze and cough germs travel farther than you may think (Business Insider, November 2018)

How long the virus survive of various surfaces

SARS-CoV-2 behaves like a typical respiratory coronavirus in the basic mechanisms of infection and replication.  The virus can live of surfaces from a couple of hours to several days depending on the surface. https://hub.jhu.edu/2020/03/20/sars-cov-2-survive-on-surfaces/

According to a recent study published in the New England Journal of Medicine, SARS-CoV-2, the virus that causes COVID-19, can live in the air and on surfaces between several hours and several days. The study found that the virus is viable for up to 72 hours on plastics, 48 hours on stainless steel, 24 hours on cardboard, and 4 hours on copper. It is also detectable in the air for three hours.

... ... ...

Machamer: What's getting a lot of press and is presented out of context is that the virus can last on plastic for 72 hours—which sounds really scary. But what's more important is the amount of the virus that remains. It's less than 0.1% of the starting virus material. Infection is theoretically possible but unlikely at the levels remaining after a few days. People need to know this.

While the New England Journal of Medicine study found that the COVID virus can be detected in the air for 3 hours, in nature, respiratory droplets sink to the ground faster than the aerosols produced in this study. The experimental aerosols used in labs are smaller than what comes out of a cough or sneeze, so they remain in the air at face-level longer than heavier particles would in nature.

... ... ...

You are more likely to catch the infection through the air if you are next to someone infected than off of a surface. Cleaning surfaces with disinfectant or soap is very effective because once the oily surface coat of the virus is disabled, there is no way the virus can infect a host cell. However, there cannot be an overabundance of caution. Nothing like this has ever happened before.

Touching  infected surfaces on which droplets landed and you touched by hands  is believed to be an important secondary path of infection, at least for  people who regularly are touching their nose (dry nose) or eyes (dry eyes).  Such people also should wear  spectacles and mask which prevents touching nose

What is the time of virus to enter the human cell after it lands on infernal surface in the nose. Is this hours or minutes? If this is hours that washing of you nose after coming from public places might be a useful hygienic procedures. If it minutes, it is less useful, but still worthwhile as an elementary precaution. 

So disinfection of often used surfaces and personal items like cellphones is highly desirable and should be a daily ritual. Things that can transmit the virus include your cellphone and keyboard. Steam can be used to disinfect winter cloth, or any cotton clothing.  Ironing kill the virus instantly.

Soap also kill the virus instantly both on hands and clothing.

Alcohol  can be used for disinfection of plastic and metal surfaces (keyboards, phones, remote control, toilet seats, door knobs,  countertops, tables, etc).  See How Long Does Coronavirus Live on Surfaces  WebMD advices to keep surfaces clean, even if everyone in your house is healthy.

After you visit the drugstore or supermarket, or bring in takeout food or packages, wash your hands for at least 20 seconds with soap and warm water. Do the same thing after you pick up a delivered newspaper, especially it is wrapped into plastic bag. The virus lives on plash much longer then on paper.

Here is an old (Mar 13, 2020) but still useful article from Yahoo Sport You’re Most Likely To Contract Novel Coronavirus From An Infected Person’s Cough Or Sneeze (originally from Women's Health ):

Q: What about touching stuff? How long does novel coronavirus live on surfaces?

A: It's thought that the new coronavirus can live on surfaces, but the answer is still not totally clear. There are mixed reports about what types of surfaces it can live on (e.g., stainless steal, plastic, glass), as well as for how long on each type of surface. The World Health Organization (WHO) estimates that it can live on some surfaces for anywhere from a few hours to several days, but the reality is that “this is still an evolving science,” says Dr. Lin.

The CDC states: "It may be possible that a person can get COVID-19 by touching a surface or object ... but this is not thought to be the main way the virus spreads." Still, you want to be extra cautious about handling common-touch objects, like railings, elevator buttons, and door handles.

Q: Can you get COVID-19 from touching mail and packages?

A: The answer is similar to the one above—researchers still aren't sure if (and for how long) the virus can survive on and be picked up from mailing materials, like paper and cardboard. According to the CDC, "because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures." And yes, that includes packages coming from areas where there are novel coronavirus outbreaks.

It might well be that such cases are mainly limited to family settings. If they are small or insignificant then gigantic effort for disinfection surfaces in public places are wasted and can cause additional harm to humans as chemical used are not exactly benign. 

From 2019–20 coronavirus pandemic - Wikipedia

A single study of how long SARS-CoV-2 (COVID-19) remains infectious on various surfaces, "show[s] that when the virus is carried by the droplets released when someone coughs or sneezes, it remains viable, or able to still infect people, in aerosols for at least three hours."[264]

They also tested SARS-CoV-2 on plastic, stainless steel, copper, and cardboard, and found that although SARS-CoV-2 decayed exponentially over time in all five environments they tested, the virus was viable for infection for up to three days on plastic and stainless steel, for one day on cardboard, and for up to four hours on copper.[265][266][267]

A survey of research on the inactivation of other coronaviruses using various biocidal agents suggests that disinfecting surfaces contaminated with SARS-CoV-2 may also be achieved using similar solutions (within one minute of exposure on a stainless steel surface), including 62–71% ethanol, 50–100% isopropanol, 0.1% sodium hypochlorite, 0.5% hydrogen peroxide, and 0.2–7.5% povidone-iodine; benzalkonium chloride and chlorhexidine gluconate are less effective.[261]

The WHO has stated that the risk of spread from someone without symptoms is "very low". However, if someone has early symptoms and a mild cough, there is a risk of transmission.[268] An analysis of infections in Singapore and Tianjin, China revealed that coronavirus infections may be spread by people who have recently caught the virus and have not yet begun to show symptoms, unlike other coronaviruses such as SARS.[269][270]

Estimates of the basic reproduction number (the average number of people an infected person is likely to infect) range from 2.13[271] to 4.82.[272][273] This is similar to the measure typical of severe acute respiratory syndrome-related coronavirus (SARS-CoV).[274]
 

Testing and the percentage of false positives in the tests

We need to distinguish between new cases of positive test for COVID-19 and actual disease. There are two types of test available for coronaviruses:

macilrae , says: Show Comment Next New Comment March 25, 2020 at 6:36 pm GMT

@Realist I have two family members in UK who have already recovered after testing positive and I, myself, suffered ten days with an unpleasant dry cough, malaise and low grade fever late in February – which has since cleared uneventfully. I was never tested and, following my GP, discounted being infected with COVID-19 at that time.

An antibody test for COVID-19 virus exposure is near to becoming commercially available and this is likely to be widely used in order to identify people who can safely volunteer to help with the pandemic – it may provide some interesting statistics and a different management perspective.

The most popular is  Reverse transcription polymerase chain reaction  test which can be taken in multiple ways:

1. Swab Test - Most common. Under this test, a sterile cotton swab will be used to collect a sample of the secretions produced in the back of your throat.
2. Nasal Aspirate - In this test, secretions from your nose will be collected by inserting a small tube into your nostrils. The tube will be attached to a suction device.
3. Tracheal Aspirate - This test involves collecting a sample from the inside of your lungs with the help of a thin, light-weight tube called a bronchoscope.
4. Sputum Test - The doctors will acquire a variation of mucus from your lungs which can either be found in your cough or in a sample from your nose.
5. Blood Test - A small sample of your blood will be collected and tested.

There are four possible outcomes of your COVID-19 test

  1. Positive: you are infected and diagnosed with coronavirus
  2. False positive: you are not infected but you are diagnosed with coronavirus
  3. False negative: you are infected and not diagnosed with coronavirus
  4. Negative: you are not infected and not diagnosed with coronavirus

As test need to be made quite sensitive to avoid many "false negatives", it necessary produced a lot of false positives. A positive test for coronavirus does not mean necessarily that this patient is infected (so called false positives).  CDC explicitly warns:

Results are for the identification of 2019-nCoV RNA. The 2019-nCoV RNA is generally detectable in upper and lower respiratory specimens during infection. Positive results are indicative of active infection with 2019-nCoV but do not rule out bacterial infection or co-infection with other viruses. The agent detected may not be the definite cause of disease.

Current screening tests for COVID19 (a PCR test, not an antibody test) have a high rate of false positives 

Japanese investigators estimated that around 30% of those infected (or, more correctly, those with positive test results)  do not develop disease. As the reliability of tests for the virus is unknown  (and might be only around 70%)  it is possible that most false positives are misclassified as "asymptomatic infected persons" inflating the counters (2019–20 coronavirus pandemic - Wikipedia )

Infection by the virus can be provisionally diagnosed on the basis of symptoms, though confirmation is ultimately by reverse transcription polymerase chain reaction (rRT-PCR) of infected secretions (71% sensitivity) and CT imaging (98% sensitivity

 It is quite possible that all or most of "asymptomatic " cases are the result of the deficiency of test used.

Very few papers so far were devoted to this important problem. One paper that I have found suggests a lower, 47% probability for the false-positive rate among asymptomatic individuals who are in close contact with infected patients  Potential False-Positive Rate Among the 'Asymptomatic Infected Individuals' in Close Contacts of COVID-19 Patients

Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention.

Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings.

Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%.

Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives.

The author conclusions are really important and are worth restating: In the close contacts of COVID-19 patients, nearly half or even more of the ‘asymptomatic infected individuals’ reported in the active nucleic acid test screening might be false positives.

We need to distinguish between new cases of positive test for COVID-19 and actual disease:

In infectiology – founded by Robert Koch himself – a traditional distinction is made between infection and disease. An illness requires a clinical manifestation. [1] Therefore, only patients with symptoms such as fever or cough should be included in the statistics as new cases.

In other words, a new infection – as measured by the COVID-19 test – does not necessarily mean that we are dealing with a newly ill patient who needs a hospital bed. However, it is currently assumed that five percent of all infected people become seriously ill and require ventilation. Projections based on this estimate suggest that the healthcare system could be overburdened.

My question: Did the projections make a distinction between symptom-free infected people and actual, sick patients – i.e. people who develop symptoms?

 

When the patient dies and the test was positive in no way this means that the virus is always primarily responsible for a patient’s demise (A Swiss Doctor on Covid-19, Mar 19, 2020) :

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 30% of the deceased are women.

But there are clues which will hint at a COVID-19 infection and which can increase the reliability of the test among them:

Is virus spreading exponentially ?

It is not outside a small initial period of approximately 30 days in a given country. After that initial period the daily rate of growth drops. They effect is due to both growing "herd immunity", countermeasures, and increased people awareness about the danger, which lead to lifestyle changes. Human societies are very adaptable.   In case of China peak was achieved somewhere between Feb 3 and Feb 15 or  approx in 45 days from the beginning of the epidemic.

Like in neoclassical economic we see "mathiness" flourishing: flawed assumptions, poor & flawed math, invalid statistical analysis, failing to account enough pertinent scientific considerations (and failing to discount the invalid pseudo-medical/pseudo-scientific crap emitted by medical stooges serving neoliberalism).

There is a saying "Models are as good as underling assumptions are, and assumptions are often wrong." That means that "naive" models are highly deceiving and represent "fearmongering via mathiness", especially if they assume that all population is susceptible to the infection. In reality probably only somewhere between 10 to 30% are susceptible.  Diamond Princess cruse ship cruel experiment (where all passengers and crew were tested)  gave us 20% which should probably be assumed as working assumption. Wuhan medics represent an extreme case and they have 60% susceptibility which should be the upper bound for adult population (not total population, but only adult) 

The “garbage in, garbage out” effect is fully applicable to all these mathematical models that are scaring the daylights out of the public.  I would refer readers to the following article by John Ioannidis - Wikipedia , a prominent epidemiologist:   In the coronavirus pandemic, we're making decisions without reliable data  Ioannidis’s 2005 paper “Why Most Published Research Findings Are False” has been the most downloaded technical paper from the journal PLoS Medicine and is considered foundational to the field

In other words number of people infected with this virus probably will stay lower then the number of people infected with seasonal flu.

Also human societies are highly adaptable and communications patterns of people are strongly group oriented.  Random communication does not happen outside of air travel, international travel and such. Which limits infection to a particular set of  groups to which the infected individual belongs. In other words there is no random propagation outside very early period of the spreading of the virus (say the first 30 days), when the virus is easily finds susceptible individuals. After approximately the first 30 days part of the people are already immunized or removed from contacts, and part is not susceptible so finding new victim became much more difficult and the speed of transmission slows down. Even in a bus traveling, say, to NYC from suburbs  passengers soon  start recognize each other. In the USA the speed of transmission slowed down from approximately March 24, 2020 when is dropped to 25% a say from the average of 32% a day. 

utu , says: Show Comment March 25, 2020 at 11:20 am GMT

@Agathoklis
"Italian deaths are not rising exponentially. "

I am pretty sure they were in the initial period but once the epidemic spreads into areas with different population densities where doubling periods are different and when new countermeasures are being implemented you will see departures from the exponential growth.

Even w/o countermeasures when more and more people get infected the reproduction number R0 will be getting smaller resulting in a steady decrease of the exponential coefficient.

Zhanwei Du et al. studied the exponential growth in Wuhan in the period before quarantine was imposed. See the Appendix in

https://wwwnc.cdc.gov/eid/article/26/5/20-0146_article
The COVID-19 epidemic was growing exponentially during December 1, 2019– January 22, 2020, as determined by the following: dI(t) = I0 × exp(λ × t) in which I0 denotes the number of initial cases on December 1, 2019, and λ denotes the epidemic growth rate during December 1, 2019–January 22, 2020.

What is important about Ron Unz approach is that by looking at daily death increments one can gage the number of new infections and as the epidemic progresses the changes in doubling period would be adjusted from daily death increments.

In times when very few tests are being done to asymptomatic patients and no serum tests are performed to determine who already went through infection and recovered this approach is very useful and simple method to estimate the extent of the epidemic.

Who is dying from it ?

It is a truism that old people tend to die more frequently. In 2017 people over 55 constitute 87% (2.4 million) of all US deaths (2.8 million)  (cdc.gov). Of them people over 75 are approx half (55%  or 1.5 million).  So in "normal" times 8K of Americans each day move to other world. Of them 4K are people over 70.

Like other coronaviruses, this virus predominantly affects "Over 50"  age category and might speed up death for some, it currently does not distort the statistics of death in the USA as the number of death from the virus is currently statistically insignificant .  So the question arise, why such drastic measures were taken. What the authorities know that a regular overseer of events don't?

Here are Italian data cited from Moon of Alabama blog:

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 25% of the deceased are women.

The mortality figures from the Italian health ministry certain are surprising to say the least, and not in a way that support the MSM hysteria on this.

That suggests that the data we are getting from MSM is incomplete, hyped (especially about R0 and mortality) and does not allow to objectively size the treat. Only very crude numbers of cases and deaths are available and very little information about testing rates,   pre-conditions for development of pneumonia (smoking and poor air quality are two factor suspected but  nothing definitive known), very limited information is provided about the average ages of people who is being hospitalized (probably over 70), and especially those in intensive care. The question is who is dying from it ?

One important finding from the China study  that is ignored by neoliberal MSM is the near absence of cases among children. The 10-19 age bracket comprised only one percent of all infections, and a single death. Children under 10 made up less than one percent, with no deaths reported

One important finding from the China study  that is ignored by neoliberal MSM is the near absence of cases among children. The 10-19 age bracket comprised only one percent of all infections, and a single death. Children under 10 made up less than one percent, with no deaths reported

Difficulties in estimating mortality

 

Oxford’s Centre for Evidence Based Medicine is providing regular updates of an estimate of the infection fatality rate for Covid-19. Their current estimate is 0.20% (95% CI, 0.17 to 0.25).
March 25, 2020

In no way the Coronavirus death statistics are reliable.  One of the big problems is the reliability of the data. To figure out a death toll you need to estimate how many people have the virus, and how many people died as a result. Both of those are very difficult problems, the first because testing is spotty and carries inherent systematic error. The second because of comorbidities and the possibility of attributing deaths from other viruses to this one. Accounting trick of assigning every death with a positive test to COVID-19 has, effectively, reassigned normal (cancer, diabetes, etc.) deaths to COVID-19.

The best way to estimate if a new disease is a significant danger  is to compare death rate with the previous year (or average of 10 previous years) for a week or month with the current. For GB and Italy based on this metric increase of mortality caused by COVID-19 is statistically insignificant:

glib March 25, 2020 at 3:38 pm GMT 

 This is the Euro mortality map for last week. I assume they highlight by standard deviations. Italy shows no excess. What is the weekly death rate in Italy?

On average about 6000/day, higher in late winter every year. the square root of 6000X7 is about 200.

If I read this table right, there have been less than 600 extra deaths in Italy this week. Compare with the winter 2014-2015, when there were 54,000 extra deaths for the whole winter, so some 3000/week.

http://www.euromomo.eu/slices/map_2017_2020.html

But it is clearly looks like the amount of hysteria and panic is utterly disproportionate to the number of deaths. For this amount of panic I would expect hundreds of thousands of dead in the USA alone. Note that over 200K Americans die each year of preventable medical error. Does anyone panic about that, even though many of those errors are far easier to eliminate than a virus?

First of all it looks like that are at least two stains of this virus with different morality: S and L.

Second, the fact that swab tests produce a lot of false positives complicates correct estimation of mortality ?  In any case what is measured is the mortality among tested patients, which is always higher then that mortality among infected patients, because outside cruise ships not all people are tested.

But the most important issue is that most countries include in COVID-19 death statistics all deaths "with the virus" along with all deaths  "from the virus" The best definition would be: novel coronavirus antibodies test positive (proof of recent infection) plus ARDS (radiologically, if not pathologically, confirmed).

This happens because the majority of diseased patients are old and have at least one life threatening medical condition and virus was just the last straw that broke the camel neck. "Real" deaths from virus are deaths from virus pneumonia. They are probably a small fraction of the total deaths, as deaths are heavily biased toward older (over 70) population.

It seems hard to get any hands on this. It’s like a greased pig.

Again, there are very strong reasons to suspect that neoliberal MSM are deceiving us and the mortality figure promoted by MSM are over inflated: Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125% (statnews.com): 

That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.

Could the Covid-19 case fatality rate be that low? No, some say, pointing to the high rate in elderly people. However, even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter.

... ... ...

Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction? How can we tell at what point such a curve might stop?

The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have.

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125% (statnews.com) 

That raises question what if majority whose who died,  died of the coronavirus have such serious medical conditions that the coronavirus just was the last straw that broke the camel back and flu would do for  them the same.  In other words the number of deaths can well be pure hype and the real mortality from this virus is close to mortality from a severe epidemic of the seasonal flu.

That raises question what if majority whose who died, died of the coronavirus have such serious medical conditions that the coronavirus just was the last straw that broke the camel back and flu would do for them the same. In other words the number of deaths can well be pure hype and the real mortality from this virus is close to mortality from a severe epidemic of the seasonal flu. 

The main categories of people who are in real danger

There is also no clarity about the groups of high risk. The current working hypothesis is elderly (which is an established fact), smokers (less established fact) and people with hypertension (even less established fact).

Among three major groups of risk for pneumonia are

  1. Older people as they have weaker immune system;  each ten year of age after 60 increase the risk and for people over 80 around 15% develop pneumonia and die. Both Chinese and Italian data suggest that men over 50 are at higher risk. For old people the risk is especially high and increase dramatically with each decade of lifespan (In Italy, Coronavirus Takes a Higher Toll on Men - NYT) For example,  China CDC Weekly published data that among a subset of 44,700 infections confirmed through lab tests as of mid-February, more than 80% were at least 60 years old, with half over 70. The role of smoking is especially interesting in view of the mysterious "vaping pneumonia" epidemics that hit the USA in August  of 2019 (see below). It is difficult to find this information on the Internet, and I suspect I know why.
  2. People living in areas with very bad air quality and, especially,  smokers (including smokers of electronic cigarettes) and people with chronic lung conditions such as asthma, emphysema, TB, etc ;  this is a little bit speculative but generally the weaker lungs you have them worse is your prognosis. Part of high fatality of virus in Iran might be bad air quality plus the fact that most people over60 were subjected to effects of poison gases used by Iraq in the war with Iran. Plus that smoking is still quite widespread among Iranian men. 
  3. People with hypertension especially those who use ACE inhibitors : nearly 40% of the Italian fatalities were using ACE inhibitors (and this may be an underestimation as pre-admission medication charts were lacking). The virus binds to the pulmonary ACE2 receptor. Conceivably the use of ACE-inhibitors (or the related AT-receptor antagonists) induces upregulation of this receptor, but this is purely conjecture on my part. Anecdotally, use of this medication class is lower in Germany, which has been proffered among reasons for its lower fatality rates.
For people over 50 being male is a risk factor which doubles the risk. Especially if you are a smoker. The gender gap disappears  only at 90, probably because there are much fewer men in this age group. In Italy, men represented over 60% of  coronavirus cases, and over 70% of the deaths.

Another question is air quality. It looks like places with  very bad air quality such as large cities (NYC, Los Angeles, etc) and industrial regions with high level of smog (Northern Italy, Wuhan) are more affected. The same is true about people who spend most of their day in badly ventilated spaces (most people in the USA). Spending 30 min or more on sun is an important prophylactic measure (Coronavirus and the Sun a Lesson from the 1918 Influenza Pandemic):

Patients treated outdoors were less likely to be exposed to the infectious germs that are often present in conventional hospital wards. They were breathing clean air in what must have been a largely sterile environment. We know this because, in the 1960s, Ministry of Defense scientists proved that fresh air is a natural disinfectant.[5] Something in it, which they called the Open Air Factor, is far more harmful to airborne bacteria — and the influenza virus — than indoor air. They couldn’t identify exactly what the Open Air Factor is. But they found it was effective both at night and during the daytime.

Their research also revealed that the Open Air Factor’s disinfecting powers can be preserved in enclosures — if ventilation rates are kept high enough. Significantly, the rates they identified are the same ones that cross-ventilated hospital wards, with high ceilings and big windows, were designed for.[6] But by the time the scientists made their discoveries, antibiotic therapy had replaced open-air treatment. Since then the germicidal effects of fresh air have not featured in infection control, or hospital design. Yet harmful bacteria have become increasingly resistant to antibiotics.

Sunlight and Influenza Infection

Putting infected patients out in the sun may have helped because it inactivates the influenza virus.[7] It also kills bacteria that cause lung and other infections in hospitals.[8] During the First World War, military surgeons routinely used sunlight to heal infected wounds.[9] They knew it was a disinfectant. What they didn’t know is that one advantage of placing patients outside in the sun is they can synthesise vitamin D in their skin if sunlight is strong enough. This was not discovered until the 1920s. Low vitamin D levels are now linked to respiratory infections and may increase susceptibility to influenza.[10] Also, our body’s biological rhythms appear to influence how we resist infections.[11] New research suggests they can alter our inflammatory response to the flu virus.[12] As with vitamin D, at the time of the 1918 pandemic, the important part played by sunlight in synchronizing these rhythms was not known.

  How big is the statistical difference between place with good air quality and places with bad air quality is unclear. Similar questions arise about different climatic zones. Are hot and humid places less susceptible to this virus epidemics?  The main categories of people who are in real danger:

Moreover, the majority of cases in China are mild (Data as of February 17 from https://www.worldometers.info/coronavirus/ ):

#COVID19 China CDC releases largest dataset to date with >55,000 confirmed cases as per @WHO press briefinghttps://t.co/gIrb3iCsKK

Case fatality rates with significant sex and age difference

Data confirm children appear less susceptible to infection pic.twitter.com/1DYi98H1Dr

— Andy Biotech (@AndyBiotech) February 17, 2020

Here’s an interesting breakdown of cases on the cursed cruise ship (passengers likely significantly older than the general population):

From this report on #diamondprincess

Leaves 254 symptomatic of them 19/254 (7.5%) critically ill Still not final outcomes but this will be an important cohort analysis on clinical spectrum of #COVID19 https://t.co/8yU9xgImrZ

— Matt Kuehnert MD (@drkuehnert) February 17, 2020

Those people who have "bystander" infections are probably in particular danger: “Bystander” infection is a medical term for having a preexisting infection, which, when one is exposed to a new pathogen, might reduce one’s ability to combat the new pathogen. I wonder whether regular cold increases corona susceptibility or severity.

The danger to the medical personnel and complete inaptness of the US government in this area

And one of the most affected and the most neglected subgroup of population in this regard is medical personnel.  One obvious measure is to try train medical personnel to use optimal defense measures (and providing all the necessary for that materials). What is unclear is what are optimal defense measures.

The pressure faced by medical staff in the centers of epidemic is enormous and Chinese social media was flooded with posts showing exhausted workers struggling to cope. Posts tell about doctors and nurses working without much food or rest for long hours while wearing poorly ventilated hazmat suits. The initial  chaos in cities under lockdown across Hubei has led to shortages of virus testing kits and face masks. In late January the situation improved  and drug stores started giving out five free masks to everyone. Paranoid people can buy N95 type masks but need to pay for them.

Among initial batch of medics in Wuhan around 60% became infected so this is serious threat, which should not be discounted. And it can lead to the depletion of the medical personal as recovery takes one month or so. More than 1,700 medical workers have been infected by the coronavirus, according to China’s National Health Commission, while 26 have died. Among them was  51-year-old Liu Zhiming, the director of Wuhan’s central hospital, a 29 year old doctor Peng Yinhua, who postponed his wedding to fight the epidemics, and ophthalmologist Dr Li Wenliang, 33 who raise one of the first alarm about the virus. Most victims are men, but one 29 female doctor Xia Sisi, a gastroenterology physician also died.  Most medical staff have been infected in Wuhan and the broader Hubei province, where the virus first emerged in December.

China has mobilized medical workers from across the country to help treat and care patients, as the virus spread and overwhelmed local hospitals. More than 25,000 medical workers, including top-line doctors and nurses from the country’s best hospitals in Beijing and Shanghai, have been dispatched to Hubei. The extra staff sent to Hubei included 450 military medics with experience of battling SARS and Ebola, state media said, who arrived in Wuhan on Jan 24, 2020.

Hazmat suits that were used by Chinese medics is probably an overkill as they cause quick exhaustion which make medical personnel more susceptible to the virus and also cause some unrelated deaths from pure exhaustion.  Wuhan medic used adult pumpers as even visiting bathroom became complicated task.

For married medical personnel who are tested positive it might make sense to organize special quarters in order not to infect family members and to speed up recovery. That's what China actually did -- all tested positively went to hospitals  not to self-isolation.

For married medical personnel who are tested positive it might make sense to organize special quarters in order not to infect family members and to speed up recovery. That's what China actually did -- all tested positively went to hospitals  not to self-isolation.

Like in case of war there should be some rotation of personnel in hot zones, so the medical personnel did not suffer infections of even death from exhaustion (China experience can help; they did infuse hot zone with medical personnel from less affected areas; I do not know whether they practiced rotation or not) 

Elderly as the most vulnerable group

As elderly dominate serious cases and deaths from this virus protective measures should be varied by age categories. California was the  first state which made the decisive step in this direction and recommended to all seniors to stay home. But there are moral problems here as was pointed by a commenter in off-guardian.org:

Indefinite rolling lockdowns for the elderly – who in many cases will be in imposed solitary confinement – is a virtual death sentence for many. With emergency powers to detain, restrain (with reasonable force), and contain absconders in ”appropriate” and ”secure” facilities …surely a short fever and a 14% chance of mortality are more humane?

If we will not get vaccine soon lockdown of elderly might gradually turn into torture. Where is the respect for the elderly? In a long term this might well be worse than the disease:  the imprisonment potentially far more deadly than the  virus.

Draconian countermeasures have been adopted in many countries. If the pandemic dissipates — either on its own or because of these measures — short-term extreme social distancing and lockdowns may be bearable. How long, though, should measures like these be continued if the pandemic churns across the globe unabated? How can policymakers tell if they are doing more good than harm?

Also typically such epidemics subside in summer although they do not disappear completely. 

Implemented properly those measure help to "flatten" the curve and avoid overcrowding of hospitals by elderly patients as well as give authorities some time to extend the number of necessary beds and ventilators within hospitals.  Including creating temporary hospitals in severely affected areas like Chinese did.  

Two prognoses for the disease: one for over 90% of lucky people and another for 7% not so lucky

Let's summarize what we know about the COVID-19 at this point. Good YouTube presentation that presents most available facts as of late February 2020 (as well as some historical background) is by Dr. Forest Arnold  COVID-19 (SARS-CoV-2) Epidemic with Dr. Forest Arnold - YouTube

There are two prognoses for the disease. Kind of two separate diseases under one roof, if you wish. And mangling them into one as done by the US MSM is a junk science.

Every year, from 5 to 20 percent of the people in the United States will become infected with influenza virus. An average of 200,000 of these people will require hospitalization and up to 50,000 will die. Older folks over the age of 65 are especially susceptible to virus infection, since the immune system becomes weaker with age. In addition, older folks are also more susceptible to long-term disability following virus infection, especially if they are hospitalized.

MSM hysteria about the total number of cases which is deceptive in a sense that they greatly overhype the treat.  The cases that really matter are

CDC blunder with the production and distribution of virus test really borders with criminal negligence

Virus pneumonia hits around  7% infected

Pneumonia is usually diagnosed by the presence of liquid in the lungs. 

The good news is that well over 90%  COVID-19 cases exhibit only mild to moderate symptoms (acute bronchitis with severe dry cough) that don’t require hospitalization. Doctors recommend that these patients self-isolate, stay hydrated, eat well, and manage their symptoms as best they can.

But not all infected are that lucky. In some case a new type of pneumonia ( atypical pneumonia  or virus pneumonia ) develops approximately a week after the disease started. Which is a serious disease that can have long term health consequences for survivors. But luckily this new disease affects only a small percentage of people, around 7% of all infected. And it disproportionally affects so called "risk groups"

For people younger then 70 men are trice more severely affected then woman (66% vs. 33%). This ratio gradually equalizes at 90 as there far fewer men in this category then women.

Here is write-up of the development of virus pneumonia from  the National Geographic Here’s what coronavirus does to the body

In the early days of an infection, the novel coronavirus rapidly invades human lung cells. Those lung cells come in two classes: ones that make mucus and ones with hair-like batons called cilia.

Mucus, though gross when outside the body, helps protect lung tissue from pathogens and make sure your breathing organ doesn’t dry out. The cilia cells beat around the mucus, clearing out debris like pollen or viruses.

Frieman explains that SARS loved to infect and kill cilia cells, which then sloughed off and filled patients’ airways with debris and fluids, and he hypothesizes that the same is happening with the novel coronavirus. That’s because the earliest studies on COVID-19 have shown that many patients develop pneumonia in both lungs, accompanied by symptoms like shortness of breath.

That’s when phase two and the immune system kicks in. Aroused by the presence of a viral invader, our bodies step up to fight the disease by flooding the lungs with immune cells to clear away the damage and repair the lung tissue.

When working properly, this inflammatory process is tightly regulated and confined only to infected areas. But sometimes your immune system goes haywire and those cells kill anything in their way, including your healthy tissue.

“So you get more damage instead of less from the immune response,” Frieman says. Even more debris clogs up the lungs, and pneumonia worsens. (Find out how the novel coronavirus compares to flu, Ebola, and other major outbreaks).

During the third phase, lung damage continues to build—which can result in respiratory failure. Even if death doesn’t occur, some patients survive with permanent lung damage. According to the WHO, SARS punched holes in the lungs, giving them “a honeycomb-like appearance”—and these lesions are present in those afflicted by novel coronavirus, too.

It’s not known how many people with COVID-19 develop pneumonia and 7% is just an educated guess, but of the ones who do, about 20% get severely ill and develop Acute respiratory distress syndrome (ARDS) which occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. This group has 40% death rate. This is the situation when people need to be put on ventilator. 

Medical personnel is also high risk group as they are exposed to the virus in quantities far exceeding the rest of the population. 

Once inside the cells, the virus hijacks the protein manufacturing machinery of the cell to generate its own viral proteins and create more viral particles which when released infect other cells. While this process causes some lung injury, most of the symptoms   are actually caused by the immune response to the virus (What the flu does to your body, and why it makes you feel so awful):

The initial immune response involves cells of the body’s innate immune system, such as macrophages and neutrophils. These cells express receptors that are able to sense the presence of the virus. They then sound the alarm by producing small hormone-like molecules called cytokines and chemokines. These alert the body that an infection has been established.

Cytokines orchestrate other components of the immune system to appropriately fight the invading virus, while chemokines direct these components to the location of infection. One of the types of cells called into action are T lymphocytes, a type of white blood cell that fights infection. Sometimes, they are even called “soldier” cells. When T cells specifically recognize influenza virus proteins, they then begin to proliferate in the lymph nodes around the lungs and throat. This causes swelling and pain in these lymph nodes.

After a few days, these T cells move to the lungs and begin to kill the virus-infected cells. This process creates a great deal of lung damage similar to bronchitis, which can worsen existing lung disease and make breathing difficult. In addition, the buildup of mucous in the lungs, as a result of this immune response to infection, induces coughing as a reflex to try to clear the airways. Normally, this damage triggered by arrival of T cells in the lungs is reversible in a healthy person, but when it advances, it is bad news and can lead to death.

The proper functioning of influenza-specific T cells is critical for efficient clearance of the virus from the lungs. When T cell function declines, such as with increasing age or during use of immunosuppressive drugs, viral clearance is delayed. This results in a prolonged infection and greater lung damage. This can also set the stage for complications including secondary bacterial pneumonia, which can often be deadly.

In cases when virus pneumonia  develops, this coronavirus is very similar to SARC    But  in comparison with SARC we can feel upbeat in some ways:

COVID-19 and SARS do share some common features: they belong to the same family of viruses,  they both seem to have jumped from animals to humans, they both originated in China and both can cause severe pneumonia.

But there are some important differences. SARS was more lethal than COVID-19, but less easily transmitted. It went straight for the lungs, and caused severe pneumonia which became transmissible only when patients were quite severely ill and usually by then in hospital. About 10% died.

COVID-19, on the other hand, seems to be more likely to replicate in the upper respiratory tract and it seems like individuals might produce a lot of virus when they are only mildly symptomatic. It’s not known how many people with COVID-19 develop pneumonia, but of the ones who do, about 20% get severely ill and fewer than 2% die. Overall death rates are still not known for sure, but are probably less than 1%.

So COVID-19 is a lot less lethal than SARS, but harder to control because it spreads more easily and by people with milder symptoms. That’s why, despite being considerably less likely to kill you than SARS was, COVID-19 has still in total killed more people in 6 weeks than SARS did in eight months.

For people who develop pneumonia preexisting conditions come into play. Some of them such as cardiovascular disease, diabetes and hypertension make prognosis much worse: 

PRE-EXISTING CONDITION DEATH RATE confirmed cases  DEATH RATE all cases
Cardiovascular disease 13.2% 10.5%
Diabetes 9.2% 7.3%
Chronic respiratory disease 8.0% 6.3%
Hypertension 8.4% 6.0%
Cancer 7.6% 5.6%
no pre-existing conditions   0.9%

The current estimate of mortality for people younger then 50 and with no pre-exiting conditions  is less then 1%.

Who among infected will get pneumonia?

Pneumonia affects approximately 450 million people globally (7% of the population) and results in about 4 million deaths per yea or around 2% of total death. "Who will get virus pneumonia?" after being infected with COVID-19 is a very important question as currently there is no medicines that treats it directly. Because "regular" pneumonia vaccines target bacteria, they would not prevent pneumonia caused by a virus. Antibiotics also would not be effective.

So far the working hypothesis is that two factors are important: your age and status of your lungs tissue. For younger people with healthy lungs typically immune system usually jump into action and kill the virus in lungs, or virus is not able to bind with lung cells receptors. Again, only 7% of infected and mostly older males are unlucky. Looks like older men, explicitly smokers and those who live in highly polluted areas  are the main risk group. In general males are twice more susceptible to the virus then women of the same age bracket. Data are based on Italian and China samples and it may well be because there are more smokers among them in those two countries.

Other part of the answer are difference in lifestyle between people. Overweight people with almost zero physical activities are another important risk group. The same, for lesser extent, is true for "coach potato". Especially, if they are living in area with highly polluted air, such as many large cities (traffic) and industrial regions, lungs receptors are more "inclined" to bind with virus (much like for smokers)  and that  makes this category of people more vulnerable. Several areas heavily affected by the virus are areas with a very bad quality of air (Northern Italy, Iran, Wuhan, NYC )

Spending on fresh air under direct sun 30 or more min a day improves you immune system and as such helps to became less susceptible to the virus, and if you got it improves prognoses. During Spanish flu epidemic sick people were moved in beds on flesh air and spend several hour under sun radiation. Results were encouraging. 

Some medical conditions like high arterial pressure also probably increase chances of virus binding with lung receptors.  But this is all speculation. Not reliable data are available.  But there is strong indirect evidence that smoking makes you more susceptible to the development of this type of virus pneumonia

Looks like smoking or living in the area with bad air quality makes people more  susceptible to COVID-19 pneumonia. That means that one of the first thing to do to protect yourself is to stop smoking

Old people generally have higher chances to get pneumonia as they have weaker immune system. After you got it other medical conditions come into play, especially cardiovascular diseases, diabetes and suppressed immune system  (A Swiss Doctor on Covid-19, Mar 19, 2020) :

According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 30% of the deceased are women.

It looks like COVID-19 pneumonia is similar to SARC pneumonia. SARS (atypical pneumonia) is characterized by a cyclic course, pronounced intoxication,  destruction of alveolus and in fatal cases the development of acute respiratory failure:

Coronaviruses affect the epithelium of the upper respiratory tract. The main target cells for the SARS virus are the cells of the alveolar epithelium, in the cytoplasm of which the virus replicates. After the assembly of the virions, they pass into the cytoplasmic vesicles, which migrate to the cell membrane and exocytose out into the extracellular space, and before that the virus antigens are not expressed on the cell surface, therefore, antibody formation and interferon synthesis are stimulated relatively late. Sorbing on the surface of cells, the virus contributes to their fusion and the formation of syncytium. In this way, the virus spreads rapidly into tissues. The effect of the virus causes an increase in the permeability of cell membranes and enhanced transport of a fluid rich in protein into the interstitial lung tissue and lumen of the alveoli. At the same time, the surfactant is destroyed, which leads to the collapse of the alveoli, as a result of which the gas exchange is severely affected. ...

Atypical pneumonia has an acute onset, the first symptoms of SARS are chills, headache, muscle pain, general weakness, dizziness, fever of 38°C or more. This febrile (febrile) phase lasts 3-7 days.

...Most patients have a mild form of the disease, and they recover after 1-2 weeks. Depressing patients after 1 week develops acute respiratory distress, which includes dyspnea, hypoxemia and rarely ARDS. Death occurs as a result of the progression of respiratory failure.

... ... ...

Thus, atypical pneumonia is a cyclically developing viral infection, in the development of which three phases can be distinguished.

In developing countries, and also among the very old pneumonia often shortens suffering among those who are already close to death and has thus been called "the old man's friend."  For people with serious medical conditions, pneumonia always was  the leading cause of death.

For people with serious medical conditions, pneumonia always was  the leading cause of death.

The severe cases predominantly happen to people over 60 and constitute approx 7 to 12% of all COVID-19 infections.   See  https://www.worldometers.info/coronavirus/

Approximately 88-93% of cases of infection are mild and do not require medical attention. Only 7-12% of cases are severe. The Diamond Princess death rate is 0.19% with 7 deaths in a population of 3700 which has was much older then average. Outside of Hubei, Italy and Iran, mortality rate based on confirmed cased is under 1%. For those under 50 its less than 0.2%. 

That fact does not correlate with media hype and many people noticed this discrepancy and reacted accordingly:

Stevie Boy, March 7, 2020 at 15:21

With all the (politically motivated ?) hype, I had a look at the official mortality figures for our annual common flu. Over the last five years the average death rate is 17,000 per year in England, with a high of 28,000 and low of 1,600 !!!

Apparently, we happily live with these large death rates without the “The worlds going to end” hyperbole. People go about their business, going to work, travelling and all the normal trappings of daily life.

What is it with this Corona virus tosh ? What’s going on, who’s benefiting ? Is it part of the [anti] China propaganda ? Utter madness.

Changes to get pneumonia dramatically increase after 80. So there is nothing surprising that large percentage people killed by COVID-19 are people over 80 ( Pneumonia - Wikipedia )

Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke and a weak immune s Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired, such as community- or hospital-acquired or health care-associated pneumonia.

Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include hand washing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.

Pneumonia affects approximately 450 million people globally (7% of the population) and results in about 4 million deaths per year. Pneumonia was regarded by Canadian pathologist William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival greatly improved.

Nevertheless, in developing countries, and also among the very old, the very young and the chronically ill, pneumonia remains a leading cause of death.

Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's

If someone gets pneumonia early in the course of COVID-19 disease (during the first 14 days or so), that’s likely a sign the virus is to blame. If a patient gets pneumonia after he/she seems to recover a bit, the culprit is more likely bacteria.

Bacterial infections sometimes spread to the blood making patients critically ill. In such cases pneumonia can lead to lung or kidney failure. The virus itself, or the inflammatory response it instigates, can also attack heart muscle. That makes people more vulnerable to heart attacks and strokes for three to six weeks after they appear to have recovered

The worst case scenario of virus pneumonia is development of ARDS

The worst case scenario is ARDS -- Acute respiratory distress syndrome (mayoclinic.org ):

Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.

ARDS typically occurs in people who are already critically ill or who have significant injuries. Severe shortness of breath — the main symptom of ARDS — usually develops within a few hours to a few days after the precipitating injury or infection.

Many people who develop ARDS don't survive. The risk of death increases with age and severity of illness. Of the people who do survive ARDS, some recover completely while others experience lasting damage to their lungs.

Holy Shit, This Is Not The Flu Medical Worker Describes Terrifying Lung Failure From COVID-19... Even In Young Patients

I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people.

Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.

They suddenly become unresponsive or go into respiratory failure.

“We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive — these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive.

That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.

The lung is filled with so much fluid, displacing where the air would normally be.

“It’s called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And it’s notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream.

“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you’re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body.

“Typically with ARDS, the lungs become inflamed. It’s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what’s called ‘ground glass opacity,’ like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.

Mysterious epidemic of "vaping pneumonia"  in the August of 2019 in the USA

Pneumonia caused by the virus is somewhat similar to "vaping pneumonia" epidemic in the USA in summer of 2019 which was attributed to e-cigarette use: 

As of Friday, there have been more than 450 possible cases of lung illness associated with using e-cigarettes reported to the CDC across 33 states and the US Virgin Islands. The numbers have been changing frequently.

Before the death in Kansas, five deaths were reported in California, Illinois, Indiana, Minnesota and Oregon.

Symptoms were remarkably similar to COVID-19 and while e-cigarettes were around for years epidemic happened in summer of 2019 (What You Need to Know About Vaping-Related Lung Illness - NYT,