US cases have now hit 99, with 6 dead and at least 7 more in serious/critical condition. The deaths occurred in Washington state, 5 of them right here in King County. Washington State is currently treating 21 patients; Seattle and surrounds are a new epicentre of disease. Virus isolated from a recent US case, a person infected via unknown transmission, is genetically identical to the strain brought to the US by the first diagnosed case, right here. In other words, cryptic transmission has been occurring in the Puget Sound region for six weeks. A relatively conservative guess might mean over 1,000 people right here in Seattle already have the virus.

If you’re young and/or healthy, the odds are you’ll be fine; your risk of death is low—ten or twenty times higher than with seasonal flu, sure, but still low. I am a high-risk subject. I have now moved in abundance-of-caution mode.

Here’s how I’ll be managing, at least for the next couple of weeks and/or until we get a clearer understanding of the situation.

• No mass gatherings. I have just cancelled an appearance at the King County Library System’s Literary Lions Gala on Saturday because they expect at least 750 guests. Most of these people will be well-heeled, well-travelled folk; I would bet a reasonable sum several will have been exposed to the virus, and possibly infected—and therefore contagious. Also, I have a nagging cough—probably just allergies (it happens every year) but I can’t imagine guests at my table feeling comfortable in the presence of a hacking, spluttering person right now.
• If I do go out, it’ll be for unavoidable legal and/or medical appointments. I’ll wear gloves but not a mask. I will not touch doorknobs. I will wipe down hard surfaces such as table tops and chair arms with wipes containing bleach, hydrogen peroxide, or alcohol. I’ll sanitise my hands with gel containing at least 60% alcohol.
• Anytime I leave the house I’ll wear gloves, blue ones preferably, so I can’t help seeing them and being reminded not to touch my face. (We all do it, all the time, mostly without noticing.)
• No hugging, no kissing. Fist or elbow bumps, and lots of hand-washing and hand sanitising. And no leaning in too close to someone.
• Keep hand sanitiser on the table just inside the front door. Anyone who enters our house sanitises their hands immediately. No excuses, not, “Just let me put this down first,” or “I just washed my hands,” but immediately. No sanitisation, no visit. Actually, now I come to think of it, we need to get a table on the porch so people can sanitise their hands before they even ring the doorbell.
• No touching without gloves of hard smooth objects brought to the house: cans, bottles, Tupperware, shiny books, etc. Wearing gloves, wipe the container with bleach solution, hydrogen peroxide or alcohol. Wipe gloves. Throw away gloves. Wash hands.
• We already have masks, gloves, wipes, and gel in the house so next on the buying agenda is dry goods. It’s entirely possible there will be some kind of community isolation procedures to follow. This isn’t apocalypse prepping, it’s just sensible precautions: the less I have to venture out, the lower my exposure will be.
• Not order pizza, even when exhausted. Fast food workers have a terrible hygiene record, not because they’re bad people but because they’re poorly paid with zero job security. They can’t afford to go the doctor, and they can’t afford time off. A lot of them will get sick, and work while they’re sick.

And that’s just off the top of my head.

Do I really think these precautions are necessary? Yes, I do.

• Since my last update 10 days ago, the number of deaths outside China has jumped from 17 to 174 and the total number of case from under 2,000 to more than 10,000.
• The official number of cases here in Washington State is 21 but I suspect the true number approaches 1500.
• The virus has been isolated in urine and faeces; we don’t know for sure but it’s likely human waste can be a route of transmission.
• There been some discussion of the possibility of the virus being biphasic—like Ebola. You get infected, you get better, you test as negative and are released into the wild…and some time later you’re back, with new symptoms, and testing positive. At this stage, Ebola patients are infectious again. With COVID-19? Who knows.
• Beneficial immunity, if any, will, even in the most severe cases—and therefore strongest immune response—will be temporary because that’s how coronaviruses work. Best case scenario? Almost a year, like MERS. Pessimistically, less than 6 weeks, like a common cold.
• Governor Jay Inslee has declared a state of emergency. King County is buying a motel to isolate cases. And various individual schools and school districts here in Western Washington are closing.
• Right now, in Italy, a western European country whose doctors and equipment are as good as those here in the US, the case fatality rate is 2%, and 49% of their active cases are hospitalised. 9% of their cases are in the ICU. This is not flu.

These are not high drama precautions; they’re just sensible. We don’t expect to get T-boned every time we drive through an intersection, but we fasten our seatbelts and we look both ways. That’s all this is: common sense.

So, yes, I’m hunkering down. I expect I’ll get a lot of work done.