Re: Guest Post - Legitimacy Deficits

1

"Foreseeable future"? It's 14 days. In a luxury hotel.
https://www.reuters.com/article/us-china-health-wuhan-food/chinese-farmers-supermarkets-race-to-supply-food-to-locked-down-wuhan-idUSKBN1ZS1XL
Scary, tedious, and stupid.
https://www.bloomberg.com/news/articles/2020-01-31/asia-s-governments-struggle-to-crack-down-on-virus-rumors
https://graphics.reuters.com/CHINA-HEALTH-VIRUS-SCIENCE/0100B59Z39Q/index.html
That one has a cool virus family tree.
https://www.reuters.com/article/us-china-health-facebook/as-coronavirus-misinformation-spreads-on-social-media-facebook-removes-posts-idUSKBN1ZV388
http://who.maps.arcgis.com/apps/opsdashboard/index.html#/c88e37cfc43b4ed3baf977d77e4a0667
https://www.reuters.com/article/us-china-health-deaths/data-suggests-virus-infections-under-reported-exaggerating-fatality-rate-idUSKBN1ZZ1AH
Possibly good news? Depends on the rate of infection which we don't yet?


Posted by: Mossy Character | Link to this comment | 02- 7-20 7:11 AM
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I haven't felt really good since September. Maybe it's the virus?


Posted by: Moby Hick | Link to this comment | 02- 7-20 7:30 AM
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Did you eat a Beluga whale that had been to China in the past month?


Posted by: Mossy Character | Link to this comment | 02- 7-20 7:36 AM
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We shared a soda from the same glass.


Posted by: Moby Hick | Link to this comment | 02- 7-20 7:48 AM
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Maybe I can get a free flight to Omaha?


Posted by: Moby Hick | Link to this comment | 02- 7-20 7:50 AM
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6

Sure. Via Wuhan.


Posted by: Mossy Character | Link to this comment | 02- 7-20 7:52 AM
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We're supposed to be flying to Japan via Beijing in the middle of next month. The tickets are changeable (for a steepish fee) but not refundable. Not sure whether to go ahead and book new flights by a different route now, while they're still relatively affordable, and use the original tickets later, or wait and hope that neither the UK nor Japan imposes a travel ban on China before then.


Posted by: Ume | Link to this comment | 02- 7-20 8:08 AM
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@1

It would seem that if only the severe cases are reported then basic reproduction number is likely underestimated (even though the case fatality rate is overestimated). Also, it is difficult to estimate the case fatality rate while the number of infected patients is rapidly increasing. The patients dying now were part of the smaller cohort of infected some number of days ago.

Lancet published a study on January 30 documenting all cases of confirmed 2019-nCoV at a Wuhan hospital. The study is not pay-walled. The investigators recruited 99 patients from January 1 to January 20 and followed them till January 25. As of January 25, 11 of the patients had died, 31 had been discharged, and 57 remained hospitalized.

Thirteen patients used non-invasive ventilator mechanical ventilation for 4-22 days (median 9 days [IQR 7-19]) and four used an invasive ventilator to assist ventilation for 3-20 days (median 17 [12-19]). As of January 25, these four patients were still using the invasive ventilator (i.e. sooner or later they are probably going to die).

Should 2019-nCoV spread like H1N1 did in 2009-2010 (estimated 59 million american contacted it - 12,000 died), would we even have enough respirators for them?

When you look at the dead versus recovered numbers (currently 638 to 1778), they seem to be maintaining this approximate 1:3 ratio.


Posted by: nope@nope.com | Link to this comment | 02- 7-20 8:08 AM
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Thing is, though, that's all cases at the hospital. It doesn't include people who recovered at home. Note that the patients were mean age 55 and half of them had comorbidities - ie older and sicker than the population.

Here's all the Lancet coverage. (Free). https://www.thelancet.com/coronavirus?dgcid=kr_pop-up_tlcoronavirus20

It would seem that if only the severe cases are reported then basic reproduction number is likely underestimated

Not necessarily. You miss the mild cases that give rise to severe cases, as well as the mild cases that are the result of severe cases.


Posted by: ajay | Link to this comment | 02- 7-20 8:16 AM
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Easy there. Chinese hospitals (up until effective administrative response to this virus kicked in) require payment before admission as far as I know, so most infected people are not going to seek treatment until they're pretty ill. Current statistics reflect that administrative regime (ie many go completely untreated, rare to seek treatment in early stages), so overestimate transmission with basic sanitation and treatment in place.

There are a few natural experiments on transmission- the quarantine zones of people who flew together, and a Japanese cruise liner. None of those show rapid spread.

Also, there are existing treatments that look promising if not 100% effective, antivirals and quinine.
https://www.nature.com/articles/s41422-020-0282-0.pdf


Posted by: lw | Link to this comment | 02- 7-20 8:25 AM
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Also Mossy's arcgis link shows cases, death, and recovery count in other provinces (and countries), where there were fewer early cases that went untreated until people got very sick, much less alarming there.


Posted by: lw | Link to this comment | 02- 7-20 8:29 AM
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1: Trapped in a room on a luxury liner! I would wither on the vine.


Posted by: heebie-geebie | Link to this comment | 02- 7-20 8:40 AM
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Only first class even has a vine.


Posted by: Moby Hick | Link to this comment | 02- 7-20 8:43 AM
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There are a few natural experiments on transmission- the quarantine zones of people who flew together, and a Japanese cruise liner. None of those show rapid spread.

There are now 61 confirmed cases aboard the Diamond Princess. That seems quite a lot. The index case was one Hong Kong man who was aboard ship from 20-25 January.


Posted by: ajay | Link to this comment | 02- 7-20 8:50 AM
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14: Also, that's 61 out of 271 people tested. There's another 3,400 or so people on the ship who haven't been tested yet.


Posted by: Ume | Link to this comment | 02- 7-20 8:52 AM
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So, given an incubation period of about five days, what figure does that give you? Two or three generations of spread to go from one case to 61? That looks like each case giving rise to about seven new ones. (Admittedly in the highly virus-friendly environment of a cruise ship.)


Posted by: ajay | Link to this comment | 02- 7-20 8:53 AM
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Good point Ume.


Posted by: ajay | Link to this comment | 02- 7-20 8:53 AM
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Though they seem not to be working their way through the ship testing everyone; they're waiting for people to go symptomatic (fever) and then testing them.


Posted by: ajay | Link to this comment | 02- 7-20 8:59 AM
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Have they accounted for the decline in average body temperature since the original 98.6 standard was created?


Posted by: Moby Hick | Link to this comment | 02- 7-20 9:09 AM
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20

In a luxury hotel.

Lucky Duck!!!


Posted by: Minivet | Link to this comment | 02- 7-20 9:21 AM
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I'm going to Japan next month, but fortunately by a direct flight. It seems Japan is somewhat at risk due to the volume of travel connections with China, but it's also rated one of the top (safest) countries in the world in institutional protections from infectious disease.


Posted by: Minivet | Link to this comment | 02- 7-20 9:24 AM
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21: On the bright side, the incidence of seasonal influenza in Tokyo is right down on previous years as people are actually washing their hands properly for once. (Scroll down in the link to see the graph: the bright red line is this year's cases, compared with the past few years in other colors).


Posted by: Ume | Link to this comment | 02- 7-20 9:33 AM
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7: Check with your airline. I'd expect that they are waiving change fees for flights through China. For example, if you scroll down at https://www.aa.com/i18n/travel-info/travel-alerts.jsp for flights to Beijing or Shanghai they're not only waiving change fees you can just change your destination to Seoul or Tokyo. Hong Kong its waived change fees or delays but you can't change final destination.


Posted by: Unfoggetarian: “Pause endlessly, then go in.” (9) | Link to this comment | 02- 7-20 9:53 AM
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IMHMHB I was listening to a well informed China person on Tuesday who was scathing about the figures. His line was that in Wuhan you can only get into hospital after testing positive for the virus; you can only get the test with a doctor's appointment. The appointments (well fancy) can only be booked in advance and are in limited supply. So the policy is in practice that people can die at home and stay off the spreadsheets, since no one is going round to check. That's what he said, and as he was recently deported from China for publicising uncomfortable truths I'm inclined to believe him.


Posted by: NW | Link to this comment | 02- 7-20 10:27 AM
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Hong Kong is out of rice and toilet paper. Says my son, and sends pictures of empty shelves.


Posted by: NW | Link to this comment | 02- 7-20 10:27 AM
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Are people pooping more because of the virus?


Posted by: Moby Hick | Link to this comment | 02- 7-20 10:31 AM
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I spent a week teaching a grad seminar in Wuhan two years ago, and I'm still in touch with a few students in the program. Only one is currently stuck in Wuhan, thankfully. The rest were gone for the holidays.


Posted by: J, Robot | Link to this comment | 02- 7-20 10:54 AM
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28

It seems like the basic reproduction number can be estimated based on the exponential growth rate r (obtained from the incidence data) and the frequency of secondary transmissions relative to infection age.

See equation five in
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819789/

For the sake of intuition, assuming that frequency of secondary transmissions is constant w.r.t. infection age, R0 can be approximated by the empirical growth rate r. So it appears that undercounting cases decreases the growth rate r and therefore results in an underestimate of R0.


Posted by: nope@nope.com | Link to this comment | 02- 7-20 2:29 PM
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29

"Foreseeable future"? It's 14 days.

In the Trump era two weeks is an eternity.


Posted by: teofilo | Link to this comment | 02- 7-20 2:30 PM
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30

29 is not wrong.


Posted by: soup biscuit | Link to this comment | 02- 7-20 3:34 PM
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31

My hospital suspended all business travel to China. They are also furloughing for 14 days anybody who goes to China.

A week ago they would have paid you, now you are on notice not to go. We are screening all patients for travel to China, including airports, Hong Kong and Macao.


Posted by: Bostoniangirl | Link to this comment | 02- 8-20 1:21 PM
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32

Our local hospital has removed the "Please sneeze on the door handles" signs.


Posted by: Moby Hick | Link to this comment | 02- 8-20 1:40 PM
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Like when there was a rotavirus going around and they removed "To conserve water, only wash your hands if you've pooped" signs from the restrooms.


Posted by: Moby Hick | Link to this comment | 02- 8-20 4:34 PM
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Another study found that 41% of patients with the coronavirus at a hospital acquired the virus at that hospital. Many were medical personnel.

In other news, the ratio of dead to recovered remains 1:3.


Posted by: Nope@nope.com | Link to this comment | 02- 8-20 7:14 PM
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35

||

investors will no doubt remain wary given the nature of the fluids at Jethro and Joe
|>


Posted by: Mossy Character | Link to this comment | 02- 8-20 7:36 PM
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||
In the bed on the other side of Yossarian was a psychology professor from Texas. He had achieved fame by preaching the virtues of an all-beef diet and an attitude of sturdy self-reliance and then his diet had pushed him over the cliff edge of multiple organ failure. Now he was in an induced coma while his fanatical beef-fed daughter attempted to persuade the doctors to permit a Russian specialist in beef-related addiction to treat him.
|>

I mean, it does have a sort of Heller sound to it...


Posted by: ajay | Link to this comment | 02- 9-20 1:05 AM
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You omitted the benzos, which I think improves your case.


Posted by: Moby Hick | Link to this comment | 02- 9-20 6:17 AM
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38

Good point, well presented.


Posted by: ajay | Link to this comment | 02- 9-20 8:02 AM
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39

I'm making slides now. I usually don't make fun of other peoples' addictions, but applying rules too consistently isn't good.


Posted by: Moby Hick | Link to this comment | 02- 9-20 8:09 AM
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applying rules too consistently isn't good

This is a principle I always adhere to.


Posted by: Stanley | Link to this comment | 02- 9-20 9:05 AM
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41

I can report the world's smallest meetup has been successfully executed. There were three of us; we all shook hands: if I have understood the thread above that means only one of us will die.

Other things learned in Vienna.

Sermons delivered in German with an accent far from those I learned in 45 years ago* are magnificently incomprehensible, except for the world's greatest linking sentence.
"Eine andere eigenschaft vom Selz ist ..."
It turns out that salt has many characteristics in common with the followers of Jesus. I'm still unclear what they are, though**.
But all this was for the sake of the Haydn choral Mass, which was stupendous.

*45 years ago? WTAF?
** Ume points out that both give heart attacks to the rich.


Posted by: NW | Link to this comment | 02- 9-20 9:34 AM
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I don't like to make fun of addictions either, but he'd make fun of yours.


Posted by: Spike | Link to this comment | 02- 9-20 9:56 AM
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There's hope as long as he doesn't meet the personnel from Ukrainian Ambulance.


Posted by: lourdes kayak | Link to this comment | 02- 9-20 10:10 AM
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42: I drink only fermented beef.


Posted by: Moby Hick | Link to this comment | 02- 9-20 11:43 AM
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Ah yes, the national drink of Uruguay.


Posted by: Spike | Link to this comment | 02- 9-20 11:54 AM
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AMATEURS


Posted by: OPINIONATED MONGOLS | Link to this comment | 02- 9-20 5:18 PM
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Anybody can ferment milk.


Posted by: Moby Hick | Link to this comment | 02- 9-20 6:24 PM
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48

Not just anybody, you lying, dog-faced pony soldier.


Posted by: Joe Biden | Link to this comment | 02- 9-20 7:25 PM
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So, somebody just started a business in my hometown making copper mugs. I guess I'll have to drink Moscow mules in support.


Posted by: Moby Hick | Link to this comment | 02- 9-20 7:46 PM
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I had a copper mug and it got all green and skanky, because oxidization.


Posted by: Spike | Link to this comment | 02- 9-20 8:01 PM
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all green and skanky
was the mug fucking a whole series of shot glasses or what?

I am extremely bored with the coronavirus. lots of stuff is cancelled: my daughter's trip to laos, all university classes over 50--not that husband x hates that really, but his tutor is in quarantine so he has extra sections. the stores are, indeed, out of toilet paper, and the grocery delivery service has no slots for delivery, fucking with my previously successful make dinner without going shopping plans. poor girl y is really scared, because she has serious asthma, which makes me unhappy but I can't convince her not to be, in part because narnia's 14th case came from IN OUR FUCKING CONDO. I'm not worried about this, it's not like we are likely to ever have done anything but stop at the gate with him, but still not fun. girl x is in the hospital with some thing they don't actually know what, but is clearly a stomach bug thing, no coughing, etc. BUT there are no beds since the 1st class wards are all being used for isolation SO she has spent the whole day on a stretcher in the hallway behind the ER where I am not allowed to go. she actually just messaged me they found a bed (non air-con six bed ward but eh) so I am rushing to take her clothes and DS chargers and such before visiting hours end at 8. there is more lame shit but on the whole, fuck this. laaaame.


Posted by: alameida | Link to this comment | 02-10-20 3:19 AM
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you lying, dog-faced pony soldier.

See, I am now just trying to work out what the insult was before it was dubbed over for broadcast, cf. "Fork you, melon farmer."


Posted by: ajay | Link to this comment | 02-10-20 3:45 AM
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14-18: now 130 confirmed cases aboard the liner as of this morning.


Posted by: | Link to this comment | 02-10-20 4:14 AM
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they are showing a documentary about the spanish flu of 1918 on tv in the ambulance bay waiting room; it strikes me as unnecessary.

52: I heard it was goose-fucking whey-faced hobgoblin.

ooh, contemporary paintings of the cyanotic victims whose blue lips meant that they were sure to perish! maybe I should use hand sanitizer.


Posted by: alameida | Link to this comment | 02-10-20 4:30 AM
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54.last to 54.1... it is somehow quite Narnian to use a Spanish flu documentary as a public health tool.


Posted by: ajay | Link to this comment | 02-10-20 4:34 AM
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Hope everyone feels better and stays well.


Posted by: Moby Hick | Link to this comment | 02-10-20 4:58 AM
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Hand sanitizer doesn't actually kill virus particles, right?


Posted by: Mossy Character | Link to this comment | 02-10-20 5:20 AM
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52. "The devil damn thee black, thou cream faced loon! Where gotst thou that goose look!?" Biden is an idiot of culture.


Posted by: chris y | Link to this comment | 02-10-20 5:26 AM
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I almost posted that no one should tell me that about hand sanitizer but naturally it was oriole. narnia's official advice is to wash your hands as frequently as possible and to refrain from touching your face. something reassuring about the alcohol smell though. poor girl x is actually still lying on a stretcher, lone person remaining in the hallway, with someone still in her assigned bed, and our hopes waning that she will ever make it up to the ward tonight. and they won't let me sit with her. FUCK.


Posted by: alameida | Link to this comment | 02-10-20 5:36 AM
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If you're the only patient in the hallway, it's kind of like you have your own room.


Posted by: Moby Hick | Link to this comment | 02-10-20 5:47 AM
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57: The rhinovirus, no. In fact it probably likes the alcohol. Many others, yes. So wash your hands thoroughly and use hand sanitizer when it's not available. If you know someone has c. Diff, don't expect hand sanitizer to work.


Posted by: Bostoniangirl | Link to this comment | 02-10-20 6:04 AM
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Used hand sanitizer when it's not available? Modern medicine is getting harder.


Posted by: Moby Hick | Link to this comment | 02-10-20 6:05 AM
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61: CDC recommends hand sanitiser for coronavirus, if you can't get soap and water. Rhinoviruses, which causes colds and a few other diseases, are completely different from coronavirus. Viruses in general vary widely in robustness; some can remain viable for days outside a host, some only for minutes.

Washing hands (properly) is always the best bet.


Posted by: ajay | Link to this comment | 02-10-20 6:25 AM
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That takes so long. Why can't they make a way to UV-sanitize my hands or something?


Posted by: Moby Hick | Link to this comment | 02-10-20 6:33 AM
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cool. I'm glad the whole island ran out for a reason. at this point we are waiting for girl x's room to be cleaned. and I have reached the conclusion that the hospital is officially fucking with us in that a documentary on the lives of the workers at CPS is now showing adjacent to children's emergency. I'm going to go see if I can wheedle my way back into the actual sick people area, though I imagine they have protocols they can't bend at the moment. the poor girl is regretting having turned 18, even though it was so much preferable to the alternative. (if she were under 18 I could have been with her the whole time obviously, and I did send her back 10 hours ago.)


Posted by: alameida | Link to this comment | 02-10-20 6:41 AM
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Why the fuck is Narnia running out of toilet paper?


Posted by: Mossy Character | Link to this comment | 02-10-20 6:48 AM
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They have butts, but not in a way we can understand.


Posted by: Moby Hick | Link to this comment | 02-10-20 6:53 AM
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Best wishes to you and yours alameida


Posted by: Barry Freed | Link to this comment | 02-10-20 7:05 AM
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66: people are preparing for self-quarantine and are stockpiling. Since toilet paper is bulky, shops tend not to hold very large stocks of it, and so they run out pretty quickly. And once rumours start that the shops are running short, you get panic buying.


Posted by: ajay | Link to this comment | 02-10-20 7:13 AM
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Meanwhile, I am trying to believe that we're seriously going to have a Mobile World Congress.


Posted by: Alex | Link to this comment | 02-10-20 7:15 AM
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Mobile World Congress is the sort where the earth moves for everyone.


Posted by: ajay | Link to this comment | 02-10-20 7:21 AM
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It's the Narnia part of the question I'm confused about.


Posted by: Mossy Character | Link to this comment | 02-10-20 7:42 AM
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Do fauns poop little pebble-things like deer or man-style poops.


Posted by: Moby Hick | Link to this comment | 02-10-20 7:51 AM
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man-style poops

My poops are just as big and fluffy as yours, sexist.


Posted by: Tia | Link to this comment | 02-10-20 9:30 AM
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The secret is beans.


Posted by: Moby Hick | Link to this comment | 02-10-20 9:31 AM
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||

Meanwhile, in enlightened topless Japan...

|>


Posted by: Minivet | Link to this comment | 02-10-20 9:56 AM
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62: You know I meant water and a sink.


Posted by: Bostoniangirl | Link to this comment | 02-10-20 4:00 PM
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There's no way to be sure what I know.


Posted by: Moby Hick | Link to this comment | 02-10-20 4:03 PM
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Not even a process of pure reason?


Posted by: teofilo | Link to this comment | 02-10-20 4:12 PM
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I just found a copy of a book by David Hume.


Posted by: Moby Hick | Link to this comment | 02-10-20 4:14 PM
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Happiness is discovering that you have a jar of olives you had forgotten about.


Posted by: Mossy Character | Link to this comment | 02-10-20 4:20 PM
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76 I was promised tiddies.


Posted by: Barry Freed | Link to this comment | 02-11-20 9:51 AM
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Your surgeon ran away?


Posted by: Moby Hick | Link to this comment | 02-11-20 10:30 AM
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Ran out of masks.


Posted by: Mossy Character | Link to this comment | 02-11-20 10:33 AM
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https://www.bloomberg.com/news/articles/2020-02-13/china-coronavirus-cases-jump-after-counting-method-revision


Posted by: Mossy Character | Link to this comment | 02-13-20 10:42 AM
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Hello I read your article I like it very much your blog is very informative I know a person whose article page is also really good I like it very much you see the page I hope you like it too windirstat


Posted by: Grace | Link to this comment | 07-16-22 12:46 AM
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Posted by: Emma | Link to this comment | 10-14-22 3:09 AM
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