Along the “why are there not more cases outside China from patients -before- the travel ban starting transmission chains that should now start being detectable” lines…

Rumors that Singapore has at least three cases with no known connection to Wuhan and apparently acquired within Singapore.

Also reports that the CDC has set up 5 labs across the country, with plans to add more, to start screening all flu negative samples for coronavirus.  As we have mentioned before, flu and coronavirus look a lot alike clinically and part of the reason it ran so far in China like it did was delayed recognition that cases with flu symptoms, but no flu, were this instead.  Not until the doctors started getting overrun by the severe attack rate in Wuhan. 

This is a double edged sword.  On the one hand, patients with symptoms and connection to possible exposure are still ~25 times more likely to have something else in the US right now.  On the other hand, this is a good idea to see if the “missing cases” really are there and this virus has been a significant contributor to this year’s flu and cold season.

I suspect it has.  Globally.

If we find more cases among the flu negatives, but NOT in patients with severe disease or death, that will confirm that the true severity of the disease is closer to the flu.  More widespread coronavirus (and your chances of catching it go way up) but probably less severe than advertised.  That would make the clinical disconnect with China, with a much higher severe disease and mortality rate, all the more mysterious.  Or, if the flu negative/corona positive cases turn out to be concentrated in more severe cases (just not enough in any one place yet to overwhelm the system), that means the wave is building and it would be a good time to pull the trigger on some masks and about a month’s worth of food and water.

We will have to see what they find.

Barring any major, -major- developments, no coronavirus/Ebola updates this week.

<Paladin>