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I want to offer my thoughts and opinions as someone who was born and raised in Taiwan, lived in China for 7 years and the U.S. for 5 years. I have lots of close friends from Mainland China, and we often try to discuss these political issues as logically and open-minded as we can.Let me start by sharing one of my experiences as a “fob" college freshmen in the states, meeting people who just came from Mainland China. We started out conversing in English because we’re not sure where each other is from. Then, at a certain point in the conversation, the person asked “are you from China as well?”, to which I responded: “nah I’m from Taiwan actually”.He looked at me with a slightly frustrated face: “that means you came from China.”To be honest, I was quite confused to hear that. Having grown up in Taiwan, I’ve always considered the island as a country. I still distinctively remember drawing out the taiwanese flag during art class in Kindergarten and singing our national anthem in elementary school. I have a dark green Taiwanese passport, and when I traveled to other countries, I write “citizen of Taiwan” on the immigration forms. Taiwan has its own independent government, and the Chinese Communist Government has never had anything influence or control over Taiwan. Ever since I was born, whenever I meet people from other countries, I’ve always introduced myself as someone from Taiwan.So this begs the question: why does the person from Mainland China think differently? This is the question that has been on the back of my mind for several years. I begin looking through forums and discussions online, and chatting with my Chinese friends about these topics. More recently, especially with the protests in Hong Kong, I start to get a better understanding of the underlying issues that contributes to the disagreements between Mainland Chinese people and people from Hong Kong or Taiwan.What I’ve realized is that we are all the same. By this, I mean that we have all been instilled with certain assumptions and believes about one another. We are all patriotic to some extent, and we are all proud of where we are from. None of us represents the government of our home country, none of us are deeply affiliated with politics, and yet lots of us are tearing our brains out insulting each other or belittling each other on issues that we have no control over.This leads me to my second realization, there’s too much generalization and misunderstanding. I’ve heard things like “Mainland Chinese people can’t afford tea eggs” from a TV show in Taiwan. False. The person who was speaking on the show does not represent all Taiwanese people and I sincerely apologize to offended Mainlanders for these narrow-minded comments. By the same token, I’ve heard Mainland Chinese people saying “Taiwanese people are stupidly arrogant, they don’t want to be associated with Chinese people because they think they are better than us.” Mostly false. There are always going to be people who think they are superior no matter where you come from, but they don’t represent the general Taiwanese population. Most of us know that China is a rising super power in the world, and we respect that Mainland Chinese people, especially students, are highly driven and hardworking.As someone who grew up in Taiwan, I know I’m ethnically Chinese. I speak Mandarin and my culture is deeply influenced by Ancient Chinese teachings. However, there is a difference between ethnicity and nationality. I am Chinese the same way a Singaporean is Chinese, or a Malaysian is Chinese. An American of Chinese descent could say that he is Chinese, but his background and experiences might greatly differ from a Chinese who was born and raised in China. Therefore, if someone asks an Asian-American where he is from, most likely, he would say he’s American because it most accurately defines his character. So why do most Taiwanese people avoid acknowledging their Chinese ethnicity? The reason is simple. We are losing our main identity. The Chinese Government is doing everything it can to make sure that Taiwan loses its place in the international community. Taiwan was booted from the UN after China rose to power. We are banned from using “Taiwan” as our country name and use our national flag when we compete in the Olympics and several other international meetings and competitions. And to be honest, that’s really depressing. I remember celebrating International Day at an International school I was attending in China. We saw all the other students singing their national anthem and waving their flags, but the school administration prohibited all Taiwanese students from doing anything to show where they are from. How would you feel if you were in our position?So are Taiwanese people avoiding to acknowledge their ethnicity because they are arrogant? No. We are the minority and we are losing our nationality. The Chinese government literally has missiles directed at our home right now. The Chinese government is using its economy to force all other countries to stop acknowledging Taiwan as a country, and sadly, they are succeeding. That’s why we are doing everything we can to emphasize our identify as a Taiwanese citizen. It doesn’t matter if it was the Chinese government or the American government, or any government in the world for that sake, trying to rob us of our identity. It’s nothing personal, we just want everyone to know that we are still here in this world, and we will always be here. We are fighting to preserve what we know as home, and I believe that if you were in our place, regardless of who you are and what you believe in, you would do the same.My third realization is that we are all heavily influenced by the community we grew up in. Why do so many people from Mainland China want Taiwan to be taken over by the Chinese Communist Government? Is it for the money? the land? the people? My personal opinion is it’s none of the above, China has all the resources it needs. I think the biggest reason Mainland Chinese people have strong feelings about Taiwan is because they’ve been taught Taiwan is a part of China ever since they are born. The same applies to Taiwan, we were all raised to believe that Taiwan is its own independent country. Anything that goes against our believes is almost immediately rejected. But the truth is, most of us know very little about each other. Lots of Mainland Chinese people I’ve spoken to have not been to Taiwan, and lots of Taiwanese people have never been to Mainland China. This ties back to my first point about us being the same. We have all been instilled certain believes and assumptions with little underlying understanding and knowledge about each other. This is something we had truly no control over. If I was born in China, I would probably think differently then I do now. If someone from China was born in Taiwan, she might think differently than she does now as well.Therefore, I believe that when discussing sensitive issues like this, the most logical approach is to try and forget everything you know for a second and analyze the issue neutrally. I can’t ask you to think like me, and I respect everyone’s personal opinion on the issue. All I can suggest is for you to put behind any preconceived believes you have and ask yourselves these two questions:How much does Taiwan’s status as a nation and its abilities to govern its own affairs affect your daily life?How would you feel if you were in my position, where all of a sudden, you are banned from celebrating your nationality in the international community, and how would you feel toward the government responsible for that?Lastly, I want to emphasize that a government’s views do not necessarily reflect its citizen’s views. I believe that people are not responsible for its government’s actions and that everyone is entitled to their own opinions and believes. Too many people in Taiwan redirect their anger towards the Chinese Communist Government towards Mainland Chinese people. I think this is absolutely wrong. Most Mainland Chinese people are not affiliated with the Communist Government’s actions, and yet, they are often the victims of belittling insults and derogatory comments. All that does is worsen the misunderstanding and disagreement between the two parties. At the same time, I want both Mainland Chinese people and Taiwanese people to know that we can fix this. We are both Chinese, and we share a lot of common traits and culture heritage. We all desire to live a free and happy life. We both know how it feels to be the minority in certain situations, and we all understand the urge to fight back when someone insults our country or our ethnicity. So why are we doing it to each other? To quote a Chinese idiom, 退一步海闊天空 (Take a step back, and the sea is broad and the sky open).Looking at FeiFei Wang’s comment, I agree with the statement that compared to China, Taiwan is really really small. It’s landmass is only 2% of what China has. But to the 23 million people living on that small island, it’s 100% of what we have. For me, I just want to keep Taiwan the same. I want the Taiwanese Government to continue to govern Taiwan independent of outside influences. Taiwan will always be my home, and I want to be able to proudly say that I'm from Taiwan in the international community. All the rest is just politics.Hope this sheds some light on the topic. Please feel free to send me a message or leave a comment. I’d love to hear your opinions as well.

VERY LONG answer [32+ pages].HCoV-19 (SARS-CoV-2) is very infectious (Each person infects 1.4–6.77 others), but rarely fatal for healthy people age 0–59 (maybe <1%).Recovered people may have 20-30% (or more) lung damage. One patient needed a double lung transplant. Even if you don’t die, COVID-19 scares many doctors.Flu doesn’t usually cause so much life-long lung damage.Main danger for people under 60 is pre-existing conditions - high blood pressure, diabetes, hypertension, heart disease, and cerebrovascular disease (maybe 6–23% fatality for people age 60+ or with pre-existing conditions).Most infected people show no symptoms (possibly 40–70%, but we need better studies). Diamond Princess cruise ship: 62% of infected people leaving the ship showed no symptoms. In Italy, 44% of laboratory-confirmed cases have been asymptomatic.Of people with symptoms, fever is more common at age 20–59 (85–91%) than at age 0–19 and 60+ (70–81%). Roughly 9–30% have no fever.Healthy children and teens can be infected. One study (N=2,141) shows3.0–10.6% severe/critical cases. Possible lung damage after recovery.94.2% (2,016/2,141) asymptomatic, mild, or moderate cases.It’s rare for them to be hospitalized, but if they are, it’s just as bad as for old people.Young adults ages 20-44 rarely have fatal cases, but ~20% of symptomatic cases require hospitalization, and ~2-4% require ICU.Kills more men (64%) than women (36%).Mask usage: Chinese advice is “Wear masks in public”.Coronavirus can travel twice as far as official ‘safe distance’ (4.5 meters) and stay in air for 30 minutes. (3/9/20) May stay in air for 3 hrs (3/17/20).HCoV-19 half-life on Cardboard is 3.5 (2–5) hrs. Be careful receiving packages. If package has been touched within 24-48 hrs, maybe use a disinfectant wipe (or wet soapy cloth). (3/9/20–3/17/20)Some pets can catch HCoV-19 (cats, dogs, tigers). Hong Kong is placing pets in veterinary surveillance or quarantine for 14 days if someone has HCoV-19. (3/4/20)How long does immunity last? UNKNOWN.Common cold coronaviruses usually confer weak immunity, which often fades within a year. MERS & SARS immunity lasts many years.Impact of HCoV-19 is similar to OC43 (one of four other mild “common cold” coronaviruses, 15% severe, 0.2% death), but more fatal for older people.HCoV-19 is the virus name (formerly known as SARS-CoV-2, 2019-nCoV, or “novel coronavirus”).COVID-19 is the name for the disease if you have symptoms.It’s very confusing. I don’t like the HIV/AIDS naming approach where the virus and the disease have different names.Other good sources to read:(1–2) Tomas Pueyo has amazing diagrams in his two Medium posts. Best analysis I’ve seen. Warning: Some historical dates and numbers in his diagrams and text are incorrect/out-of-date, but the essence of his concepts is good.(a) Coronavirus: Why You Must Act Now (3/11/20)(b) Coronavirus: The Hammer and the Dance (3/19/20)(3) Best introductory COVID-19 video I’ve seen (3/21/20).Takes you step by step through an illness - mild, moderate, severe, and critical. Some information is out-of-date/incorrect, but it’s a great start.This is what having the novel coronavirus looks like pic.twitter.com/mu7Sj1pq28— Tech Insider (@techinsider) March 22, 2020For people with a strong scientific background, read #4, 5, & 6:(4) Unlike #1–3 which were produced by non-experts…and have many minor errors and out-of-date information, this is 99–99.9%+ accurate (as far as I can tell).---Novel 2019 Coronavirus SARS-CoV-2 (COVID-19): An Updated Overview for Emergency Clinicians---I made three short collections of excerpts at:(4a) Some cool tables & diagrams (Easy to read for everyone)https://www.quora.com/q/coronavirus/Novel-2019-Coronavirus-SARS-CoV-2-COVID-19-An-Updated-Overview-for-Emergency-Clinicians-03-23-20-EB-Medicine/comment/1471753(4b) When to Test, Lung Ultrasound instead of CT, Drugs, Vaccineshttps://www.quora.com/q/coronavirus/Novel-2019-Coronavirus-SARS-CoV-2-COVID-19-An-Updated-Overview-for-Emergency-Clinicians-03-23-20-EB-Medicine/comment/1471880(4c) Interesting tidbitshttps://www.quora.com/q/coronavirus/Novel-2019-Coronavirus-SARS-CoV-2-COVID-19-An-Updated-Overview-for-Emergency-Clinicians-03-23-20-EB-Medicine/comment/1471927(5) Tirumalai Kamala's answer to What is the big deal about the new coronavirus, COVID-19? is good to read about top unanswered issues.(6) Dr. Muge Cevik has curated a collection of favorite papers (78) in a multi-thread tweet (Jan 28, Feb 28, Mar 22) from 1,250+ HCoV-19 papers. Mitchell Tsai's share in COVID-19: Top 25 - MTPeople age 20–54 have low fatality (0.1–0.8%), but many are hospitalized (14.3–28.3%) or need an ICU (2.0–10.4%).- Yes, Young People Are Falling Seriously Ill From Covid-19 (Bloomberg, 3/18/20)- ATAndyBiotech on twitter- Ed Taboada's answer to As a medical professional, what is your biggest concern about COVID-19?How bad is COVID-19 if you have a severe case?Read A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients — ProPublica (3/21/20). Many more details than I’ve posted here. Scary. Chinese doctors were reporting similar scary experiences in January. It’s why people put Wuhan under quarantine on Jan 23. Often stories from doctors were censored so that people wouldn’t panic.“I spoke to a respiratory therapist there [New Orleans], whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit…Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit.”‘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.’“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.“With our coronavirus patients, once they’re on ventilators, most need about the highest settings that we can do. About 90% oxygen, and 16 of PEEP, positive end-expiratory pressure, which keeps the lung inflated. This is nearly as high as I’ve ever seen. The level we’re at means we are running out of options.“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mindstate of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you, but you are drowning.”- A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients — ProPublica (3/21/20).The US news cycle is slowly discovering the stuff which encouraged people to put Wuhan under quarantine on Jan 23. COVID-19 can be MUCH worse than most flus and colds. We’re lucky it doesn’t affect kids very much.Just because you don't feel sick, doesn’t mean you are safe to other people.“March 10 estimate by a group of scientists, published in the Annals of Internal Medicine, of the incubation period of the virus.As Vox’s Brian Resnick explains, “you can see that nearly everyone who develops symptoms of Covid-19 shows them around 10 to 15 days after the infection, and the majority get symptoms by around five days.”- 11 coronavirus charts everyone should see (Vox, 3/17/20)How to make your own masks.Do-It-Yourself (DIY) hand sanitizer not recommended.Laboratory tests by City University showed 80-90% of the function of regular surgical masks for filtering aerosol and droplets.- Make your own mask: Hong Kong scientists reveal temporary solution to shortage (2/14/20)“Mixing it at home, you can't control how the alcohol gets diluted in the final product. If you don't use enough aloe gel, it will dry out the skin on your hands, which can cause it to crack or bleed (the same is true if you just pour rubbing alcohol on your skin).But if you don't use enough alcohol, the final product won't be as effective at killing germs as store-bought hand sanitizer -- rendering it basically useless according to some experts.You can also contaminate your batch with bacteria by not using clean tools to mix it together.”- No, you shouldn't make your own hand sanitizer (CNET, 3/5/20)Update 3/24/20: HCoV-19 may be active on surfaces for 17 days or longer.Please watch the news for further updates."SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted"- CDC says coronavirus survived in Princess Cruise ship cabins for up to 17 days after passengers left (CNBC, 3/24/20)- Public Health Responses to COVID-19 Outbreaks on Cruise Ships... (CDC)What should I do when receiving packages or shopping?Mitchell Tsai's answer to Hello I'm not trying to panic but my question is I ordered a package from China before the outbreak is this package safe for me to open once it gets here I know a lot of people are wondering the same thing? in Coronavirus WatchWhat happens to kids?New American Academy of Pediatrics study (3/18/20)3.0–10.6% severe/critical cases. Possible lung damage after recovery.94.2% (2,016/2,141) asymptomatic, mild, or moderate cases.WHO-China Joint Mission report:~49% critical patients die~15–20% severe patients become critical- https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (2/24/20)- New analysis of coronavirus risk: Young adults are not invincible - STAT- Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China (American Academy of Pediatrics, 3/18/20)Also posted as Mitchell Tsai's answer to What scientific studies have been done on kids with COVID-19?Soap works better than hand sanitizer.Why Soap Works (New York Times - 3/13/20)Update 3/13/20: History of HCoV-19.New info shows cases back to Nov 17 - a Hubei resident age 55 (first seafood market case was Dec 8), and they are still tracking backward to “person zero” - maybe infected Nov 14 (or earlier).- China’s first confirmed Covid-19 case traced back to November 17 (3/13/20)Genetic studies by four research groups estimate HCoV-19 infected “patient zero” in Aug-Nov 2019.----Conclusion: Wuhan seafood market transmission was probably caused by people who were already sick with COVID-19. Not from food eaten there.“Patient zero" could have caught it at the Wuhan seafood market Aug 1 - Nov 7, 2019, and then they (or other people) could have come back in December.Note: Longer history and genetic information towards the end of this answer.How does HCoV-19 (SARS-CoV-2) compare to 1918 Spanish Flu and Seasonal Flu?- graph is based on older 2/11/20 data (N=44,672)- mitchelltsai on Twitter (mitchelltsai on Twitter) (picture is from a Tweet by Seb Allaman - @AllamanSeb)- Newer 2/22/20 data (N=55,924) has CFR 3.8% (was 2.3%), and Age 80+ 21.9% (was 14.8%)- 11 coronavirus charts everyone should see (Vox, 3/17/20)At peak shedding, people with HCoV-19 emit over 1,000X more virus than SARS, which explains the rapid spread of HCoV-19.Infected people develop antibodies quickly (6-12 days), which may be why 80% of people infected do not develop severe disease.- People 'shed' coronavirus early, but most likely not infectious after recovery (3/9/20)A mathematical model suggests maybe 26% (0–32%) of people catch HCoV-19 from others who haven't had any symptoms yet (in a model with R = 2.5).Update 3/16/20: European CDC says other models suggest 48–62% asymptomatic transmission.In Italy, 44% of laboratory-confirmed cases have been asymptomatic.- Disease background of COVID-19 (ECDC)Analysis of serial intervals in 425 cases. Data from a cluster of cases in Germany suggest the proportion might be higher than 26%.- The Contribution of Pre-symptomatic Transmission to the COVID-19 Outbreak (3/2/20)In Singapore and Tianjin, infection was transmitted 2.55 and 2.89 days before symptom onset (on average).Estimated serial intervals are shorter than incubation periods, suggesting pre-symptomatic transmission.“The mean incubation period was 7.1 (6.13, 8.25) days for Singapore and 9 (7.92, 10.2) days for Tianjin. Both datasets had shorter incubation periods for earlier-occurring cases.The mean serial interval was 4.56 (2.69, 6.42) days for Singapore and 4.22 (3.43, 5.01) for Tianjin.We inferred that early in the outbreaks, infection was transmitted on average 2.55 and 2.89 days before symptom onset (Singapore, Tianjin).The estimated basic reproduction number for Singapore was 1.97 (1.45, 2.48) secondary cases per infective; for Tianjin it was 1.87 (1.65, 2.09) secondary cases per infective.”- Transmission interval estimates suggest pre-symptomatic spread of COVID-19 (3/2/20)How can we control the spread of HCoV-19?This mathematical model estimates…"To achieve control of 90% of outbreaks, 80% of contacts needed to be traced and isolated for scenarios with a reproduction number of 2.5"- Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts (2/28/20)- Coronavirus: Why You Must Act Now (Tomas Pueyo, Medium)Can I catch HCoV-19 from breathing the air near a sick person? Yes.Coronavirus can travel twice as far as the official ‘safe distance’ (4.5 meters) and stay in the air for at least 30 minutes. A bus passenger was infected 30 min after a sick passenger left the bus.This paper has been officially retracted (see below), possibly for politcal reasons.The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres – further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.Their work was based on a local outbreak case on January 22 during the peak Lunar New Year travel season. A passenger, known as “A”, boarded a fully booked long-distance coach and settled down on the second row from the back.They said the study proves the importance of washing hands and wearing face masks in public places because the virus can linger in the air attached to fine droplet particles.“Our advice is to wear a face mask all the way [through the bus ride],” they added.- Coronavirus can travel twice as far as official ‘safe distance’, study says (South China Morning Post, 3/9/20)“A paper by Chinese researchers suggesting that the coronavirus could spread farther than previously assumed through fine droplets has been retracted.On March 10, the journal posted a “statement of retraction” signed by its editorial department, without offering any reasons.The researchers also found that none of those passengers who wore face masks were infected, a finding that they said supported China’s decision to ask people to wear a mask in public whether or not they show respiratory symptoms.Before the retraction, a doctor in Beijing involved in the diagnosis and treatment of coronavirus patients told the South China Morning Post the study had left some questions unanswered.For instance, the passengers sitting immediately next to the carriers were not infected, though they were most exposed to the disease-bearing droplets known as aerosols.“Our knowledge about this virus’s transmission is still limited,” he said.- Journal retracts study on how far coronavirus can spread through droplets (Inkstone, 3/10/20)What are COVID-19 symptoms?New York Times posted a great overview article.- What Does the Coronavirus Do to the Body? (New York Times, 3/11/20)Please read. It contains many details I don’t talk about in this answer.“Here’s what scientists have learned about how the new virus infects and attacks cells and how it can affect organs beyond the lungs.”What Does the Coronavirus Do to the Body? (New York Times, 3/11/20)Excerpts from Mitchell Tsai's answer to What are the symptoms of Coronavirus?Most people have fever (87.9%), dry cough (67.7%), and fatigue (38.1%).(a) Only 4.8% have nasal congestion. It’s rare.(b) Only 11.4% have chills, unlike flu.(c) Only 13.6% have headache.(d) Some people just have intestinal upset (5.0% nausea/vomiting, 3.7% diarrhea). No fever, cough, or fatigue. It’s not common, but it happens.- https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (WHO-China mission final report, 2/24/20)“Anosmia, the loss of sense of smell, and ageusia, an accompanying diminished sense of taste, have emerged as peculiar telltale signs of Covid-19, the disease caused by the coronavirus, and possible markers of infection.On Friday, British ear, nose and throat doctors, citing reports from colleagues around the world, called on adults who lose their senses of smell to isolate themselves for seven days, even if they have no other symptoms, to slow the disease’s spread.Dr. Clemens Wendtner, a professor of medicine at the Academic Teaching Hospital of Ludwig-Maximilians University of Munich, said that the patients regained their ability to smell after a few days or weeks, and that the loss occurred regardless of how sick they got or whether they were congested. Using nasal drops or sprays did not help, Dr. Wendtner said.Now, Mr. Berry said, he literally cannot smell the coffee.“Even with a clear nose, I just realized I couldn’t smell the food that I was cooking, and I couldn’t taste the food that I was making,” said Mr. Berry, a tattoo artist based in Orlando, Fla. He was cooking a plantain dish with onions and vinegar, yet he could not smell it.”- Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection (New York Times, 3/22/20)Fever seems more common in age 20–59 (85–91%, 77–97%) than in age 0–19 and 60+ (70–81%, 48–91%).Proportion of people without fever (N=1,286, Shenzen, China, 3/3/20):Age 0–9: 30% (15–52%) no feverAge 10–19: 25% (9–54%)Age 70+: 22% (9–45%)- Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts) (3/3/20)N=55,924 (cases in China until 2/22/20…from page 12):“typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%).”- https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (WHO-China mission final report, 2/24/20)Note: Many people in 2010s-2020s have body temperatures below 98.6° F (37° C).(a) 98.2° F (36.8° C) for young people(b) 97.7° F (36.4° C) for healthy older people (94–99.6° F).Know your own body temperature.“Normal body temperature is not a single number, but rather a range of temperatures. The average normal body temperature is most often said to be 98.6° F (37° C). This may have been correct when it was first determined 150 years ago. But our bodies have changed.More recent research suggests that the average adult body temperature is about one degree lower, 97.5° F (36.4° C). Older adults often have an even lower body temperature without it indicating any health problems.However, recent studies indicate that 98.2° F (36.8°C) is a more accurate average, and in older individuals it may be about 1°F lower. One small study even suggested that in healthy older patients, body temperature ranged from 94° F to 99.6° F, with an average of 97.7° F.”- When is body temperature too low? - Harvard Health (1/29/20)- Influenza kills more people than coronavirus so everyone is overreacting, right? Wrong — and here’s whyHow long before most people notice COVID-19 symptoms?Median times:Five days to be short of breath.Seven days to hospitalization.Eight days to severe breathing trouble.Perhaps 50–70% of infected people never show symptoms.Some people take 24, 26, 34, …, 94 days to show symptoms.This mathematical analysis estimates only 1% will display symptoms after a 14-day quarantine, but there is a chance.Incubation Period (from N=181 study)Median 5.1 (4.5-5.8) days to show symptoms97.5% in 11.5 (8.2-15.6) daysHypothetically:After a 14-day quarantine, 1% will display symptoms afterwardsAfter a 7-day quarantine, 21% will display symptoms- Coronavirus sufferers symptom-free for five days on average – study (Guardian, 3/9/20)- The Incubation Period of COVID-19 From Publicly Reported Confirmed Cases (Annals of Internal Medicine, 3/10/20)“The median time from their first symptoms to when they became short of breath was five days; to hospitalization, seven days; and to severe breathing trouble, eight days.”- Coronavirus Live Updates: Offers of Help Go Unanswered by China as Death Toll Grows Again (New York Times, 2/7/20)The Diamond Princess cruiseship is one of the rare examples where everyone was tested (all 3,711 people), regardless of whether they showed symptoms.- 62% (476/768) who tested positive showed no symptoms- 9% (80, 8 in Japan, 72 in other countries) later showed symptoms: US (46), Australia (10), Hong Kong (5), UK (4), Russia (3), Israel (3), Canada. 14 of the US people showed symptoms right off the boat.- so it’s down to 53% (410/768) asymptomatic (as of 3/9/20)Proportion of individuals infected by SARS-CoV-2 showing symptoms among passengers of the Diamond Princess ship (with 95% credible interval).- Adjusted age-specific case fatality ratio during the COVID-19 epidemic in Hubei, China, January and February 2020 (3/4/20)Age-group data from 4 countries:- ATAndyBiotech on twitter- Ed Taboada's answer to As a medical professional, what is your biggest concern about COVID-19?Korean age-group data from Wed 3/11/20 (N=7,755):Age 80+ 7.20% CFRAge 70–79 4.35%Age 60–69 1.46%Age 30–59 <1% (8/3,358)Age 0–29 0% (0/2,718)Overall 0.77%Male 1.19%Female 0.52%Average is heavily weighted(a) age 20–29 women(b) more females- Robin Daverman's answer to Why does Italy seem to be the most affected country by the Coronavirus?Italy age-group data from Sun 3/15/20 (N=13,323):- Coronavirus Disease 2019 (COVID-19) in Italy (JAMA, 3/17/20)- COVID-19 Case-Fatality Rate and Characteristics of Patients Dying in Italy (JAMA, 3/23/20)China age-groups - Old 2/11/20 data (N=44,672):- https://github.com/cmrivers/ncov... (2/16/20)China age-groups - Old 2/11/20 data (N=44,672):IFR (Infection Fatality Ratio) = deaths/all-infected-people-with-and-without-symptoms - includes asymptomatics, AND adjusted for underreporting.CFR (Case Fatality Rate) = deaths/symptomaticIFR for age 0–29 is lower than CFRIFR for age 30–59 is about the same as the CFRIFR for age 60–80+ is higher than CFROverall IFR 1.6% (1.4-1.8%) vs CFR 2.4% (2.1–2.8%)Age 0-9 .0094%10-19 .022% (0–0.082%) vs CFR 0.25% (0–1.3%)20-29 .091% (0.03–0.2%) vs CFR 0.22% (0.04–0.51%)30-39 .18%40-49 .4%50-59 1.3%60-69 4.6% (3.8-5.4%) vs CFR 3.8% (3.1–4.7%)70-79 9.8% (8.2-12%) vs CFR 8.5% (6.9–10%)80+ 18% (14-22%) vs CFR 15% (12–18%)- 11 coronavirus charts everyone should see (Vox, 3/17/20) - Adjusted age-specific case fatality ratio during the COVID-19 epidemic in Hubei, China, January and February 2020 (3/4/20)China age-groups - Old 2/11/20 data (N=44,672):Newer 2/22/20 data has Age 80+ 21.9% (was 14.8%) but China didn’t release age-group data for age 0–79, so this is still the best set of China age-group data.- Tirumalai Kamala's answer to What is the big deal about the new coronavirus, COVID-19? (2/17/20)- https://github.com/cmrivers/ncov/blob/master/COVID-19.pdf (2/17/20)China age-groups - Newer 2/22/20 data (N=55,924)WHO-China Mission report: CFR increased in 2/22/20 data (N=55,924) vs 2/11/20 data (N=44,672):CFR 3.8% (was 2.3%)Male 4.7% (was 2.8%)Female 2.8% (was 1.7%)No Co-morbidity 1.4% (was 0.9%)Age 80+ 21.9% (was 14.8%)CFR dropped over time from 17.3% (people admitted in 1/1-10) to 0.7% (people admitted after 1/31). Why?(1) In Jan, people got to the hospital an average of 15 days after infection. By late Feb, they got to the hospital in only 2–3 days (on average).(2) China learned better ways to keep people alive. After 7 weeks, they were on their 6th version of national patient care guidelines.- Partial summary at https://www.quora.com/q/lktjmwgkoxgvdzpp/WATCH-World-Health-Organization-delivers-update-on-the-coronavirus-as-it-continues-to-spread/comment/1361305 - Mitchell Tsai's share of "WATCH: World Health Organization delivers update on the coronavirus as it continues to spread" in COVID-19 and SARS-CoV-2 (Tue 2/25/20 8 am PT)- https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (WHO-China report, 2/24/20)Can you be reinfected? Unknown. Probably yes.If HCoV-19 is like the four other mild coronaviruses (which are probably responsible for 1/4 of all “common colds”), you can be reinfected.HCoV-19 appears similar to OC43, the strongest of the four, but seems to be more fatal for older people.(1) 4 mild coronaviruses circulate in people: OC43, 229E, HKU1, and NL63.(2) Mostly OC43 and 229E(3) OC43 is the strongest, and requires intensive care for 15%.(4) Asymptomatic: 18% OC43, 35% 229E(5) Death rate: ~0.2% (US Flu is ~0.1%)(6) Can get reinfected.- Mitchell Tsai's share of "Experts envision two scenarios if new coronavirus isn't contained - STAT" in COVID-19 and SARS-CoV-2How long is HCoV-19 active on packages (cardboard), door knobs (steel, copper), and in the air?Short version:Air: 3 hoursCardboard: 1 day, 2 days to be undetectableSteel: 2–3 days, 4 days to be undetectablePlastic: 3 days, 4 days to be undetectable- How long can the novel coronavirus survive on surfaces and in the air?(Economist diagram, 3/19/20)Excerpts from Mitchell Tsai's answer to How long does CoV19 last on surfaces?Update 3/21/20: These half-lives have changed since the 3/9/20 preprint. They come from the NEJM 3/17/20 final version.Boldface numbers are visual estimates from small graphs.Regular numbers are from text in the paper.HCoV-19 half-lives:Copper 0.8 hrs (0.43–1.3 hrs)Aerosol 1.1–1.2 hrs (0.64–2.64 hrs)Cardboard 3.5 hrs (2–5 hrs)Steel 5.6 hrs (4.5–7 hrs)Plastic 6.8 hrs (5.5–8.5 hrs)- Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 | NEJM (NEJM final correspondence, 3/17/20)Mask Advice: Since there’s so much random mask advice…(1) Official WHO recommendations (1/29/20): https://www.thebeijinger.com/sites/default/files/advice-on-the-use-of-masks-2019-ncov.pdf(2) Other observationsMasks are NOT enough if around very sick people.In an early Chinese surgery case, all 14 people in the surgery area caught HCoV-19 even with masks & gowns. Masks are NOT enough, since the virus can infect the eye area. Goggles and full face shields are now used in hospitals around very sick people.How useful is a mask in public to help keep you healthy?Update 3/9/20: Coronavirus can travel twice as far as official ‘safe distance’ (4.5 meters) and stay in air for 30 minutes.Chinese advice is “Wear masks in public”:“…the study proves the importance of washing hands and wearing face masks in public places because the virus can linger in the air attached to fine droplet particles.”“Our advice is to wear a face mask all the way [through the bus ride],” they added.- Coronavirus can travel twice as far as official ‘safe distance’, study says (South China Morning Post, 3/9/20)US advice is “Save masks for health workers, because we didn’t make and stockpile enough masks after the WHO warning on Jan 1 (2.5+ months).”HCoV-19 is ~125 nm (0.1 μm, ~150–300 atoms) in diameter, which is smaller than the 300 nm (0.3 μm, ~400–900 atoms) size N95 masks protect against.But most virus arrives in liquid droplets.IQAir HyperHEPA room filters claim to remove 99.5% of particles down to 3 nm (0.003 μm, ~4–8 atoms) diameter. HEPA filters remove 99.95% (Europe) or 99.97% (US) of particles down to 300 nm (0.3 μm, ~400–900 atoms).If you are sick, a mask in public will help keep other people healthy.But if you have HCoV-19, you probably should be inside (self-quarantine) or in a hospital.If buying food/supplies or going to a hospital, use a mask (if you can…many infected people have trouble breathing).“Surgical masks are highly effective against large airborne droplets.These traditional masks are less effective with small droplets, as they can travel farther and in unpredictable paths affected by wind and other gusts. The droplets can be inhaled around the sides of the masks.”- Blisse Edgerton's answer to What should you know about the new strain of coronavirus in China?What treatments do people receive in hospitals?Mainly people need help breathing.About 1/4 of severe/critical people need mechanical ventilation.About 3/4 just need additional oxygen.If it gets really bad, there’s an advanced breathing machine called ECMO.Most people who get that bad don’t recover. One needed a lung transplant.Treatments given to 99 patients in Wuhan:- “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study” (1/25/20) https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S0140673620302117.pdfWhat is the status of drugs, vitamins, and alternative medicine for treating COVID-19?I’m writing a work-in-progress - 19 drugs, vitamins, and other things in clinical studies around the world. Mitchell Tsai's answer to Are there any effective natural or artificial treatments (antivirals, malaria drugs, human serum, and Traditional Chinese Medicine - TCM) against SARS-CoV-2 (COVID-19)?We don’t know 100% that anything works (e.g. confirmed in double-blinded trials against placebos). A few things seem to help, but it’s hard to tell when 75-99% of people recover anyways. So medical experts are waiting for trials with placebos.First four drugs are the most beneficial ones. #1 approved for use in China. #2–4 undergoing the most clinical trials (e.g. testing drugs against placebos).(1) Favilavir (nucleoside analog of Guanine (G), a DNA/RNA base)(2) Remdesivir (nucleotide analog of Adenosine (A), a DNA/RNA base)(3) Lopinavir / Ritonavir (protease inhibitors)(4) Chloroquine (anti-malaria - we don’t know how it works…on malaria or viruses)- T-705 (Favipiravir)- Guanine - WikipediaIf you want to try Vitamins…Vitamin A, B12, C, and D are pretty good immune boosters.WARNING: Some people have medical issues which make high doses dangerous (slight danger or even life-threatening). Please consult doctors first.There are websites which list counter-indications, but it’s DIFFICULT to find the best advice without a lot of searching and some health/medical experience.You probably want to test Vitamin D & B12 blood levels first before using them.WAY TOO MUCH LOW-QUALITY INFO out there.Vitamin C megadosing helps lighten symptoms in 85% of mild cases (N=252), but doesn’t help severe patients who have breathing issues (ARDS).WARNING: Vitamin C megadoses are DANGEROUS for some people (especially with KIDNEY and other issues, please consult doctors).“In a controlled but non-randomized trial, 85% of the 252 students treated experienced a reduction in symptoms in the high-dose vitamin C group (1g / h at the beginning of symptoms for 6h, followed by 3 * 1g / day).Among patients with sepsis and ARDS, patients in the high-dose vitamin group did not show a better prognosis and other clinical outcomes.There are still some confounding factors in the existing research, and the conclusions are different.”- Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia - Full Text View - ClinicalTrials.govWhat is the status of vaccines?Many vaccine candidates have been created, but they need to be tested (1 year, or 5–10 years). Some approaches are:(1) NIH & US biotech Moderna - RNA vaccine based on crown-like spikes(2) University of Queensland in Australia, CEPI - "molecular clamp"(3) Vir Biotechnology - Monoclonal antibodies (mAbs)- With Wuhan virus genetic code in hand, scientists begin work on a vaccine“Even if a vaccine were ready within a year, it would be too late to stem the current epidemic in China. But it could help other countries.Fears are growing that the Wuhan virus will spread more widely and become an established seasonal disease around the world, like the common flu.China’s extraordinary efforts to contain the virus, including quarantining over 50m people, may stave off epidemics in other countries until next winter.”“Once a vaccine has been developed in a laboratory, it is sent to a factory where it is turned into a sterile vaccine mix. This is then put into vials and tested to ensure it is not contaminated before clinical trials in humans can be carried out.She leads a group at Oxford University which is working on a vaccine against the Wuhan virus. Her group has developed a template for vaccines that can be adapted quickly for new pathogens. The researchers can make the first small quantities of a new vaccine in just six to eight weeks. In the past the process would have taken up to a year.There are not many factories that can mass-produce vaccines, so new vaccines often wait in a long queue. Aware of this problem, the American government has built dedicated manufacturing facilities that can produce vaccines rapidly for emergencies. Britain is doing something similar.On February 3rd it brought on board as a partner GSK, a big drug firm, which has agreed to lend its highly effective adjuvant to a new vaccine. An adjuvant is a special ingredient that makes vaccines more efficient by boosting the immune response—which means that fewer doses of the vaccine or a lower concentration of its core ingredient is needed for vaccination.”- The race to produce a vaccine for the latest coronavirus (Economist, 2/6/20)How long does a test take? 2–3 hrs in a lab.It only takes a few hours to test for the virus (using Real-Time PCR … RT-PCR).Why do tests sometimes take days? A backlog of other people’s tests, limited equipment, limited and tired staff, paperwork, and bureaucracy.“The CDC…can diagnose a sample in a few hours once a blood specimen reaches a designated lab.”- Op-ed: We need to prepare for US outbreak of Wuhan coronavirus (CNBC)- Real-Time RT-PCR Panel for Detection 2019-nCoV (CDC Instructions)Can pets be infected? Yes. A dog in Hong Kong has been infected.Can humans transmit HCoV-19 to pets? Yes.Can pets transmit HCoV-19 to humans? Unknown.Excerpts from Mitchell Tsai's answer to Can household pets catch SARS-CoV-2 without showing symptoms?“The World Organization for Animal Health (OIE) published a report of the emerging disease, listing this case as the first known in dogs.On Feb. 26, health officials in Hong Kong placed a dog under quarantine after hospitalizing its owner for COVID-19 coronavirus infection.Veterinarians confirmed that the coronavirus had infected the dog too after taking nasal, oral and rectal swabs, along with fecal samples.Follow-up oral and nasal samples taken on March 2 and 5 continues to test positive.Doctors and veterinarians don’t know if the COVID-19 virus has the potential to be zoonotic, or transmitted from dogs to people.Doctors believe the dog got the virus directly from its owner. However, doctors don’t know how the virus was transmitted to the dog, whether by airborne particles, direct contact or bodily fluids.In Hong Kong, health authorities quarantine mammalian pets from households with confirmed human cases of COVID-19 and place the animals under veterinary surveillance for 14 days, according to the report.”- Dog infected by coronavirus COVID-19 in Hong Kong (3/9/20)“The AFCD said experts from universities and the World Organisation for Animal Health have unanimously agreed that "it is likely to be a case of human-to-animal transmission".The pomeranian has not shown any novel coronavirus symptoms the AFCD said.All pets of people in Hong Kong infected with the coronavirus will be quarantined for 14 days, starting Friday. Two dogs are already in isolation.The other dog in quarantine belongs to a second coronavirus patient that tested negative for the virus once and will be tested again before its release.Authorities said it will continue to closely monitor the pomeranian and return it to its owner when it tests negative for the disease.”- Pet dog infected with COVID-19, Hong Kong authorities confirm - France 24 (3/4/20)How fast does the virus spread? Each person infects 1.4–6.77 othersSeven R0 estimates: 4.08 (3.37–6.77, China/HK), 1.9–3.2 (Harvard), 2.6 (1.5-3.5, London), 2.24–3.58 (1.96–4.39, Hong Kong), 3.11 (2.39–4.13, Lancaster), 2.2 (90% 1.4-3.8, Swiss) 2.92 (2.28–3.67, Guandong)4.08 (3.37–6.77, 12/31–1/5) Zhidong Cao, et al., China & Hong Kong (1/29/20)Estimating the effective reproduction number of the 2019-nCoV in China1.9 - 3.2 (1/26/20) Maximum Majumder, Kenneth D. Mandl, Harvard (1/27/20)1.4 - 3.3 (1/18/20)Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China2.6 (1.5–3.5, -1/24) Natsuko Imai, et al., Imperial College, London (1/26/20)https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-2019-nCoV-transmissibility.pdf2.24–3.58 (1.96–4.39, -1/21) Shi Zhao, et al., Chinese University of Hong Kong (1/23/20)Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak3.11 (2.39-4.13, -1/22) Jonathan Read, et al, Lancaster (1/23/20)Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions2.2 (90% NOT 95%, 1.4-3.8, based on 897 cases until 1/23/20) Julian Riou, Christian Althaus, Switzerland (1/24/20)jriou/wcov2.90–2.92 (2.28-3.67, based on 830 cases until 1/23/20) Tao Liu, et al., Guandong (1/26/20)https://biorxiv.org/content/10.1101/2020.01.25.919787v1.full.pdfWhen did HCoV-19 first appear in humans?Aug-Nov 2019 - Four genetic studiesStill looking through records for “Patient Zero”Nov 17, 2019 - 1st known case (originally thought to be 12/1/19, 12/8/19, or 12/12/19).1-5 new cases each day after Nov 17.Dec 15 (27 cases)Dec 20 (60 cases)Dec 27 (180 cases)Dec 31 (266 cases)Jan 1, 2020 (381 cases)“Government records suggest first person infected with new disease may have been a Hubei resident aged 55, but ‘patient zero’ has yet to be confirmed”- China’s first confirmed Covid-19 case traced back to November 17 (3/13/20)Estimated start dates from four genetic studies are:Sep 2019 - 26 genomes (91–214 days before 12/1/19)https://www.biorxiv.org/content/10.1101/2020.01.30.926477v1.full.pdf (Xiong et al, 1/30/20, bioRxiv)11/9/19 - 12 genomes (as early as 9/25/19, 95% credible interval)Potential of large “first generation” human‐to‐human transmission of 2019‐nCoV (Li et al., Journal of Medical Virology, 1/30/20)11/17/19 - 86 genomes (as early as 8/27/19, 95% credible interval)Phylodynamic Analysis | 176 genomes | 6 Mar 2020 (Andrew Rambaut, Edinburgh, UK, 3/6/20)12/5/19 - 53 genomes (as early as 11/6/19, 95% credible interval)https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College---COVID-19---genetic-analysis-FINAL.pdf (WHO, Imperial College, 2/14/20)- 5 of first six cases known then NOT from Huanan seafood market- Amy Yu's answer to How serious is the 2019–20 Coronavirus? (Chinese CDC paper, 1/29/20)- 3 of first four cases known then NOT from Huanan seafood market- https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30183-5.pdf (Lancet, 1/24/20, updated 1/30/20)- Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China (Harvard, 1/27/20)- Wuhan seafood market may not be source of novel virus spreading globally (1/26/20)- Wuhan seafood market may not be only source of novel coronavirus: expert (1/29/20)- Coronavirus: Why You Must Act Now (Tomas Pueyo, Medium)Note: JAMA Diagram is amazing, but has some history errors.First case: 11/17/19 (earlier it was believed to be 12/1/19, 12/8/19, or 1214/19)HCoV-19 (2019-nCoV) identified: 1/2/20, not 1/7/20.Sequence shared: 1/5–1/10/10, not 1/12/20.Test kits available: 1/13/20. Test was being used before 1/9/20, but “kits” might not have been sent anywhere else until later.——-11/17/19: First confirmed case. Still searching for “patient zero”.12/30/19: Dr. Ai got the results for the laboratory test she ordered. It said “SARS coronavirus”. Dr. Li told more than 100 of his medical-school classmates “7 SARS cases confirmed at Hua’nan Seafood Market”1/2/20: Wuhan Institute of Virology sequenced virus (but kept it secret)1/5/20: Shanghai medical center sequenced virus and uploaded it to GenBank - Severe acute respiratory syndrome coronavirus 2 isolate Wuhan-Hu-1, co 1/7/20: HCoV-19 (2019-nCoV) announced by Chinese authorities1/9/20: Test was used to detect HCoV-19 in 15 other patients.新型冠状病毒！武汉不明原因肺炎“元凶”初步判定_新闻_央视网(cctv.com)1/10/20: Virological announced the GenBank sequence Novel 2019 coronavirus genome1/12/20: Possible the GenBank sequence was not publicly available until this date (although deposited on 1/5/20).- How It All Started: China’s Early Coronavirus Missteps (Wall Street Journal, 3/6/20)“2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%).These data are consistent with a bat reservoir for coronaviruses in general and for 2019-nCoV in particular. However, despite the importance of bats, several facts suggest that another animal is acting as an intermediate host between bats and humans.First, the outbreak was first reported in late December, 2019, when most bat species in Wuhan are hibernating.Second, no bats were sold or found at the Huanan seafood market, whereas various non-aquatic animals (including mammals) were available for purchase.Third, the sequence identity between 2019-nCoV and its close relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21 was less than 90%, which is reflected in the relatively long branch between them.Hence, bat-SL-CoVZC45 and bat-SL-CoVZXC21 are not direct ancestors of 2019-nCoV.Fourth, in both SARS-CoV and MERS-CoV, bats acted as the natural reservoir, with another animal (masked palm civet for SARS-CoV and dromedary camels for MERS-CoV) acting as an intermediate host, with humans as terminal hosts.Therefore, on the basis of current data, it seems likely that the 2019-nCoV causing the Wuhan outbreak might also be initially hosted by bats, and might have been transmitted to humans via currently unknown wild animal(s) sold at the Huanan seafood market.”- Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding (Lancet, 1/30/20)- See discussion at Dr. Eric Feigl-Ding on Twitter- https://nextstrain.org/groups/blab/sars-like-cov (1/27/20)How is HCoV-19 changing now?I keep a daily update on HCoV-19 varieties in North America hereHCoV-19 varieties in North AmericaAs of 3/11/20, there are 47 US/Canadian genomes (44 US, 3 Canada) out of 333 genomes at NextStrain/GISAID auspice - live website that anyone can play with.Nextstrain (@nextstrain) | Twitter posts updates when they upload new genomes.- auspice (NextStrain/GISAID live website)Washington state cluster:- Second diagram is by “divergence” (not time). Viruses on the right have more mutations than the ones on the left.- auspice (NextStrain/GISAID live website)What may happen in the future?In a good scenario, HCoV-19 may become a 5th coronavirus which is a “common cold”.In a bad scenario, HCoV-19 becomes a repeat of the 1918 Spanish Flu.First wave (Jan 1918) was fairly mild and killed mostly old people 60+ and kids 0–14.Mutated into a stronger version in the second wave (Oct 1918) which(1) killed lots of 15–40 yr-olds.(2) Some people who got sick in the morning, died before dinner.(3) Not as many deaths in 40–65 yr-olds & 5–14 yr-olds.“In 1918, older adults may have had partial protection caused by exposure to the 1889–1890 flu pandemic, known as the "Russian flu"As more people are infected by SARS-CoV-2, there is a larger chance of a mutation to a more deadly strain.- Spanish flu - WikipediaMy favorite Live Update sites:(1) Coronavirus Update (Live): 126,053 Cases and 4,616 Deaths from COVID-19 Virus Outbreak (Worldometers) - Best worldwide site today. Slow on China numbers.(2) Coronavirus Dashboard - Conveniently shows continents separately (US states, Canadian provinces, Australian territories, Latin America - no Africa yet).Updates slower than Worldometers.(3) Tracking coronavirus: Map, data and timeline - BNO News - Sometimes better than Worldometers with severe/critical information, but not updated as often.(4) 2019–20 Wuhan coronavirus outbreak - Wikipedia - sometimes more up-to-date than Worldometers or BNO.(5) COVID19info.live (Great graphics, good color choices)(6) Johns Hopkins https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html?fbclid=IwAR2QBDnxetMDGn-txrIUenFwDHZnrOCnXQ1eCLNv1nkN4LZcevgB81gLVho#/bda7594740fd40299423467b48e9ecf6 - old classic(7) Baidu https://voice.baidu.com/act/newpneumonia/newpneumonia - usually most up-to-date for China(8) 全国新型肺炎疫情实时动态 - 丁香园·丁香医生 (DXY)(9) ʵʱ���£�ȫ�����ͷ����������¶�̬ (newsDOTqqDOTcom/zt2020/page/feiyan.htm) QQ

At first I didn’t, or was undecided, but now I do.If you are a PRC patriot, or are uncomfortable with speculation and insinuations, please stop reading now. It’s for your own good.Let’s examine the source in question. Who was this “ex-diplomat”?Bilahari Kausikan was former Permanent Secretary of our Ministry of Foreign AffairsHe has substantial experience in the foreign policy arena. I assume he might be privy to classified information which is withheld from our public.He is no longer a civil servant; he is a pensioner. As such, his views do NOT officially reflect those of the Singapore government.Despite this, his views hold substantial weight and are frequently published in the Straits Times (which, although not under direct govt control, toes the official line and operates under some form of para-state oversight)He has not been outright repudiated by other foreign policy elites (as was the case with Kishore Mahbubani). From this we may infer that his views resonate somewhat with the establishment, or our foreign policy orthodoxyThere are some things which our government cannot publicly/officially state, out of prudence…by which I mean, complicating our relationships with certain powersIt is possible that the government prefers to use “unofficial” means (such as retired civil servants) to clarify or rebut certain narrativesNow let’s examine the substance of his argument.That China exercises influence, pressure and coercion on Singapore, is not surprising. What should be disturbing is the MEANS or the CHANNELS through which it deploys its influence. There are LEGITIMATE channels for interstate intercourse. These include diplomacy, state media, international aid etc. etc. It is entirely natural (whether it is fair or acceptable is a different debate) for Great Powers to leverage their superior political/economic/military resources to make smaller states comply with their wishes, whether through persuasion or coercion.But Bilahari Kausikan’s concern is with the ILLEGITIMATE channels: covert influence operations. These are violations of Singapore’s sovereignty, albeit under the cover of plausible deniability. Influence operations fall under the purview of covert action, which is different from espionage - and far more insidious. Espionage seeks simply to steal information. Covert action is intended to influence events (for example, domestic politics or foreign policy) within a target nation-state to one’s own benefitNow let me be clear: All Great Powers conduct influence operations and espionage. China is no exception. Neither is the US. And Singapore is not exempted from their attempts. Our response has been very even-handed.Examples of foreign interference in the course of history and in SingaporeAn American diplomat once tried to influence the 1988 Singapore General ElectionSingapore Protests U.S. 'Interference' After Diplomat WithdrawnRussia spy claims: US nabs Singapore centre research fellowBut this is not a valid excuse. People who employ this excuse are essentially saying “So what? everyone does it”. To quote the Chinese Ambassador’s response “I would say firstly that every country hopes to gain recognition and support for its development philosophy and foreign policies. In this sense, China is no different.” This is equivalent to arguing that wife-beating is acceptable, because many husbands beat their wives! The issue here is not that China or the US wants our support. The issue is the means by which they seek to procure our support.American influence operations seek to impose a liberal-democratic ideology on Singapore. They are mostly ineffective because American notions of liberalism do not find much resonance among our public political consciousness. Nonetheless, these operations should be exterminated/neutralized whenever and wherever they are detected.But Chinese influence operations are more dangerous and insidious because they seek to impose a CHINESE identity on multiracial Singapore. This is something much harder for our population to resist, particularly because our national identity is so young and malleable. The appeals of ethnicity and culture are primordial and enduring.SPECULATION ON CHINA’S 2016-2017 INFLUENCE CAMPAIGNIn August, Huang Jing was exposed for giving “supposedly "privileged information" to a senior member of the LKY School, so it could be passed on to the Singapore Government. The information was duly conveyed by that senior member of the LKYSPP to very senior public officials who were in a position to direct Singapore's foreign policy”.About 3 months later, LKYSPP Dean Kishore Mahbubani, who previously was a senior MFA diplomat (and presumably has contact with “very senior public officials who were in a position to direct Singapore’s foreign policy”), stepped down from his position. If you go on Youtube and watch the speeches and interviews he has been giving, he has become something of a hype-man advertising China’s rise.I think we can put two and two together.I do deeply respect Kishore Mahbubani. I think he is an intellectual worth reading and worth listening to. I have no doubt that he earnestly, sincerely believes in the views that he propounds. I definitely agree with many of his ideas about the rise of Asia and China. In fact, I will be buying his new book “Has China Won?”. But I also think some of his ideas regarding China lack nuance. Reality is often complex.When Lin Xieyi speculated that Huang Jing was a US agent, this was Kausikan’s comment: “This is the sort of stuff we must expect, intended to confuse the issue. Some of it will come from the seemingly neutral or well-meaning or the naive or from those whom Lenin used to call 'useful idiots'”Ambassador-at-large, Bilahari Kausikan, scoffs at Quora user questioning who Huang Jing is working forKausikan shared more details on the Chinese influence campaign in this lecture, which I encourage all of you to watch:If you don’t have time, I’ll summarize:When Singapore stood firm on its right to state its position on an issue of undoubted importance to us and to the region (South China Sea), the Chinese activated their influence apparatus and went into high gear to pressure the government - our government - to change position…Not all influence operations pose the same degree of risk. The uniqueness of Beijing’s influence operations stems from China’s triple identities. And this prescribes three tracks on which China conducts its foreign policy and influence operations.First, the PRC is a state like any other state, operating within a still largely Westphalian international order… On this first track of state-to-state relations, there’s nothing particularly unusual about what Beijing does, except the unusually assertive assertive behaviour of some Chinese diplomats of late, in countries as far-ranging as Malaysia, the PNG and Sweden.Secondly, the PRC is not just any state, it’s also a Leninist state…and the characteristic modus operandi of a Leninist state is the United Front, which Mao Zedong called the CCP’s “magic weapon”… the main characteristic of a Leninist state is the total subordination of state and society to the interests of the Party, irrespective whether the Party’s interest is internal or external. And as such, the United Front represents a blurring of the distinction between domestic and foreign policies and a significant modification of the principle of non-interference that goes far beyond what is generally considered acceptable diplomatic practice.Thirdly, the PRC is also a civilizational state: the embodiment and exemplar of millennia of the Chinese nation’s history and culture, now rejuvenated…and this identity as a civilizational state finds expression in the work of the Overseas Chinese Affairs Office… In plain language, overseas Chinese should identify their interests with China’s interests and work to advance China’s interests. And this represents a deliberate blurring of the distinction made between the 华人 (ethnic Chinese) and the 华侨 (overseas PRC citizens)…Now these 3 identities prescribe 3 tracks on which China conducts relationships. And taken holistically, they create a sophisticated and flexible instrument of influence that is far more effective than the conventional operations conducted by other countries. China’s influence operations are effective because the 3 tracks on which it operates makes it difficult to deal with or even grasp - even understand - in entirety.On the first track of state-to-state relations, the usual tactics of persuasion, inducement or coercion may be deployed as appropriate, whether overtly through diplomacy or covertly through intelligence organizations. But the United Front may simultaneously operate to, for example, emphasize coercion or inducement even as the first track stresses persuasion. And the third civilizational track may conveniently wrap everything up in appeals to ethnic pride…Now the tendency of all governments and in particular foreign ministries is to focus on the first track of state-to-state relations and to want to keep them on an even keel…But this can all to easily lead to Chinese activities on the other two tracks being overlooked or downplayed.[the narrative of China’s absolute rise and America’s inevitable decline] and others were propagated by various means: WeChat with Chinese-speaking populations, social and mainstream media, whispering campaigns, business, clan and cultural associations, as well as conventional agents of influence reporting to Chinese intelligence organizations who cultivate what Lenin called “useful idiots”.It was difficult to pin down the precise origin of such narratives, but the messaging was to consistent, and too insistent, to be coincidental…many Singaporeans did not realize they were being fed oversimplifications and swallowed them whole or played along for other reasons. Businessmen, academics, and others with interests in China were given broad hints that their interests might suffer unless Singapore was more accommodating and passed the messages to the government…Appeals to ethnic pride were made to others. The aim was to instil a fatalistic acceptance of the inevitability and desirability of a Chinese identity for multiracial Singapore and get Singaporeans to pressure the government to align Singapore’s interests with China’s interest.In any case and for whatever reason, the 2016–2017 Chinese influence operation was effective. The pressures on the government were great. It was very difficult to explain the somewhat abstract importance of UNCLOS or the nuances of our position on the South China Sea or the complications of our relationship with China to the general public, to whom the Chinese narratives were more easily understood. And it cannot be denied that ethnic appeals resonated strongly with a probably not insignificant section of our public.It’s clear enough for whom Huang Jing worked. I told you he had dual US-PRC citizenship. In case you don’t know, holding dual citizenship is forbidden in China. Huang Jing today holds a senior academic position in China, apparently without sanction for holding American citizenship.As the only majority ethnic Chinese sovereign state in the region, Singapore is a special case. A majority Chinese Singapore that nevertheless conducts an independent foreign policy may be something of an anomaly in Chinese eyes.This is not the ravings of some conspiracy theorist. This is our former Permanent Secretary of Foreign Affairs speaking.STRATEGIC NARRATIVESWhat is a strategic narrative? A weaponized story.In its influence campaigns against Singapore, the PRC advances a number of strategic narratives, all of which are, at best, questionable in their truthfulness. Sadly, some of our Singaporean Chinese compatriots sometimes buy into these narratives and even confidently echo them. Now, most of our population is only cursorily interested in foreign affairs and may find such superficial narratives plausible. This must change if they are to be immunized against these narratives.This is a war of narratives. China cannot officially pressure us to choose sides. But they can paint a certain picture through unofficial channels and try to box us into a corner. They can try to tell us “See, this is what you are doing! Stop it!”. When they do that, we MUST push back by painting our own narratives and showing them that “no, actually we’re not doing that. We’re doing THIS”.MYTH 1. Surely as a “Chinese country”, Singapore should “explain” China’s position (on the South China Sea and other issues) to the rest of Southeast AsiaMYTH 2. China is rising and US is declining; therefore we should bandwagon with China. You should get on the right side of history!MYTH 3. If you are not with China, then you are against China! You are an American puppet/proxy, or, if you are ethnic Chinese, even worse - a race traitor!MYTH 4. Singapore has no claims in the South China Sea, and purports to be a neutral/non-aligned country so why is it “taking sides” with the US against China by agreeing with the PCA ruling and hosting US naval assets?MYTH 5. Unlike Lee Kuan Yew, the current PAP leadership under Lee Hsien Loong doesn’t know how to deal with China. Relations were sooooo much better under LKY.Let me proceed to puncture each of these myths in turn, with great pleasure.MYTH 1: We are NOT a “Chinese country”. We are a country that happens to have a majority ethnic-Chinese population that organizes itself on the basis of multiracialism/multiculturalism. This has been fundamental to Singapore’s identity since the days of Lee Kuan Yew, and this is something we must always remember, no matter how many times we are accused of being “race traitors” by our mainland friends. When the PRC tries to impose a “Chinese” identity on multiracial Singapore, we MUST resist.Yes, we share ties with mainland Chinese on the basis of blood and culture. This ethnocultural kinship should be celebrated, not denied (as in the case of some HKers). Our similar cultural programming allows us to understand the Chinese mindset in some respects, to “empathize” with it.But it does not mean we should unreservedly parrot China’s claims to the rest of Southeast Asia. As country coordinator for ASEAN-China relations, our job is to uphold ASEAN centrality; to represent the interests of ASEAN, of our REGION, in dealing with China. It is not to represent China’s interests in dealings with ASEAN. We have no obligation, moral or otherwise, to advocate or support China’s interests. Understanding them is one matter. Supporting them is another. The two are not mutually irreconcilable, but they must be distinguished.MYTH 2: This myth, like many other myths, has a grain of truth to it. It is very ably represented by the speeches and works of Professor Kishore Mahbubani, our former ambassador and an intellectual whom I admire very much. Unfortunately, it is also extremely oversimplified and ignores many problematic nuances.Indeed, China is rising and has been for quite a while. You would have to be blind to deny that. But China’s rise is not going to be linear; it is going to be a long, winding, and fluctuating road. China has many internal structural problems of its own to deal with. From the way some people talk about China in juxtaposition to the West, it makes it sound like the Chinese are strategic masterminds while the Westerners are a bunch of bumbling idiots. Like I said, grain of truth, but grossly oversimplistic. It ignores many of the US’ intrinsic strengths and some of China’s structural challenges.China is rising, but America is NOT in decline, except in relative terms. Militarily it is still pre-eminent in the Asia-Pacific. Its military dominance is receding and will continue to recede in time, as the PLA Navy becomes stronger. China is becoming more and more economically central to our region and the world; depending on which index of measurement you use (GDP PPP, GDP per capita, absolute GDP) it may have already eclipsed the US economy. China is pushing the frontiers of cutting-edge technology like 5G. This process is inevitable.But what is not inevitable is the outcome of China displacing the US as regional or global superpower. This is an outcome that is FAR from certain. It is still too early to tell. The only thing we can say for now is that the regional strategic equation will become more and more symmetrical over time. As with buying new stocks/shares on the financial market, it is too early to count our chickens before they are hatched. Some views on China’s rise (Mahbubani’s included) tend to take the Whig view of history - “up and up and on and on”The Chinese never tire of reminding us that China’s presence in Asia is a permanent geographic fact, while America’s presence is the product of a political calculation. This implies both enhanced threat and opportunity for the rest of East Asia (be nice to us, because you have to live with us for the rest of eternity). And that is true - what is our Plan B if America withdraws from the region? Without America, the balance of power in Asia cannot be maintained. But again, this myth is too simplistic. America’s presence in Asia is not as fragile as the Chinese would like us to think.Asia is burgeoning with growth. In the next few decades the economic center of gravity is going to shift toward the Asia-Pacific. America has an interest in retaining access to this region, in economic and military terms. I do agree that China cannot be contained - it is so interdependent with America that America might as well try to contain itself as to contain China. But we should not underestimate the degree to which America has integrated and committed itself to the Asia-Pacific.MYTH 3: This one I find the most ludicrous and at the same time the most hilarious. Just because I disagree with China’s stance on a SPECIFIC, SINGLE issue means that I must have been brainwashed by western media into being an anti-China dog? Hahahaha.This is what is known as a false dichotomy. It is powerful because these dichotomies do exist, but they are a spectrum rather than a binary choice of A or B. China posits an illusory binary between itself and the West, and forces you to choose between them. If you are not A, then you must be B and ONLY B and nothing else. Substitute A and B with pro-China and pro-US, pro-CCP and pro-democracy, blah blah blah. You get the idea. This ignores all the nuances in between.This myth is also the most insidious and dangerous one because it denies the existence of AGENCY on the part of small states. It denies that small states can ever act autonomously -that anything that we do must be driven by the hidden hand of Great Power competition.Singapore’s policy can be characterized as strategic hedging. I will admit we lean slightly toward low-intensity “soft” balancing against China, but it is still more nuanced than “hard” balancing against China and “hard” bandwagoning with the US.By the way, Singapore is not the only country practicing a hedging strategy. Duterte has recently taken to flirting with China; I don’t blame him, I think it’s a smart move. But he has also increased cooperation with Japan, and he has not abolished the alliance Treaty which formally commits the US to defend the Philippines in wartime. Thailand has grown closer toward China as well, buying Chinese tanks, but it is still a US ally. Even Myanmar: when Myanmar realized in the 2000s and early 2010s that it was growing more and more dependent on Chinese investment, infrastructure etc., what did it do? It initiated a rapprochement with the Obama Administration. Malaysia under Mahathir began to reassess a number of Chinese infrastructure projects in light of its indebtedness to China. The American 7th Fleet still calls at Malaysian ports. Vietnam is probably leaning even further toward the Balancing end of the spectrum than Singapore - the very existence of Vietnam as an independent entity is predicated on thousands of years of resisting subordination to China.So, fellow Singaporeans, do not believe that we are alone in playing this delicate game of power-balancing. That is what China wants you to believe: that we are acting alone and inadvertently as a US proxy, when in reality we are making calculated choices to minimize risk and maximize gain.MYTH 4: Yes, Singapore is a non-claimant state. We have no territorial claims in the South China Sea and we take no position on the claims of Vietnam, Philippines, Malaysia, China etc. But what we do have is an interest in FREEDOM OF NAVIGATION in the South China Sea (enshrined in international law, namely UNCLOS). We want our merchant ships carrying our imports and exports to be able to transition the South China Sea freely. Trade is the lifeblood of our free and open economy.Now, some mainland Chinese might argue that China has not explicitly threatened the right of freedom of navigation in the area. They are right. China has not demanded we pay a toll or tariff for passing through the area, not yet anyway. Hopefully it never does. But China’s behavior of creating and militarizing artificial islands in the South China Sea has not exactly inspired confidence on the part of Southeast Asian states regarding its future behavior.And in case you think our statement on the PCA’s verdict was somehow “extreme” or “new”, let me read out the statement to you:Singapore has taken note of the Award made by the Arbitral Tribunal convened under Annex VII to the 1982 United Nations Convention on the Law of the Sea (Unclos) on 12 July 2016 on the case between the Republic of the Philippines and the People’s Republic of China. We are studying the Award and its implications on Singapore and the wider region.Singapore is not a claimant state and we do not take sides on the competing territorial claims. However, we support the peaceful resolution of disputes among claimants in accordance with universally recognised principles of international law, including Unclos, without resorting to the threat or use of force. As a small state, we strongly support the maintenance of a rules-based order that upholds and protects the rights and privileges of all states.Singapore values our long-standing and friendly relations with all parties, bilaterally and in the context of Asean. We urge all parties to fully respect legal and diplomatic processes, exercise self-restraint and avoid conducting any activities that may raise tensions in the region.Singapore supports the full and effective implementation of the Declaration on the Conduct of Parties in the South China Sea and the expeditious conclusion of a legally binding Code of Conduct in the South China SeaIn other words, we did NOT even explicitly SUPPORT the ruling of the PCA in favor of the Philippines. We simply positively acknowledged the ruling and said that international law is important and we should all respect it. Can that be any less provocative? How could this be construed in any way as “taking sides”? Are the Chinese really so thin-skinned that they object to us even SPEAKING about the SCS issue?Let me remind you that the PCA was the same court that ruled in favor of our dispute with Malaysia over Pedra Branca. So what would the implication be if we supported the PCA ruling for ourselves, but turned a blind eye to its ruling over the SCS? International law for me, but not for thee?Note also that Singapore was not alone: Vietnam, Myanmar, and Malaysia also positively acknowledged or outright supported the ruling of the PCA. Why did we deserve to be singled out for coercion?Non-alignment/neutrality is a PREFERENCE. It is not a solution. Singapore cannot prosper and be secure simply by pursuing a “hiding” strategy of laying low and hoping not to be noticed. I will be happy to elaborate if you disagree. We host the US military because we consider it productive to our security interests (and that of regional security) for America to maintain a regional presence. This is to provide a counterweight to China and give us strategic space to maneuver. It is NOT to contain China or obstruct its rise.And while we are on the subject, we should note that the US military only maintains a purely rotational presence in Singapore. There are NO permanent US military bases or assets stationed here. The naval base which their aircraft carrier uses belongs to us. We should also further note that Singapore has NO formal treaty of alliance with America. In fact it is rumored that in 2003 America offered us the status of a major non-NATO ally - a formal security commitment from the US to defend Singapore…and we rejected them. Now, is that how we would behave if we were really American proxies?“I am non-aligned in the sense that I do not want to be involved in power blocs…but when my security, Singapore’s survival, Singapore’s prosperity is threatened, I cannot be neutral” - Lee Kuan Yew“Singapore has to take the world as it is, it is too small to change it. But we can try to maximise the space we have to maneuver among the big ‘trees’ in the region” - Lee Kuan Yew, One Man’s View of the World, 2013MYTH 5: Kishore claimed that “now that LKY is no longer with us, we should change our behaviour significantly…we should be very restrained in commenting on matters involving Great Powers”. I agree with him that we should be circumspect, pragmatic, even cold-blooded, when it comes to dealing with Great Powers. We must tread carefully.But has there been any fundamental change in Singapore’s policy toward China post-LKY? No. Our relationship with the US goes back to the 1990s. Likewise with China we have always (and I emphasize, we CONTINUE to) promote the engagement of China with the region and the world. China must come to terms with the world order, just as the world order must accommodate China.The Chinese like to grumble about the good old days of LKY and how well he got along with them. Again, they are not wrong. But this is a form of historical cherry-picking, of selective memory. Remember that LKY was one of the only Asian leaders to go up against a CCP-backed communist united front and win. Remember also that Mao’s China issued frequent propaganda proclamations labelling him a “running dog” of the West.Lee Kuan Yew’s views on China were not one-dimensional. They were complex and nuanced. They were tactful, yes, but honest and direct. He did not shy away from political incorrectness.“The Chinese may make a miscalculation…they may become assertive and pushy, which is contrary to their long-term interest, which is to win over the smaller countries in the south to their side” - Lee Kuan Yew, 2011“[My uncle-in-law] had this romantic idea that, you know, [China] is a land of my forefathers. I have no doubts that the land of my forefathers would have brought me down in the world…They (the Chinese) wanted me to contribute [to my uncle-in-law’s manor house which the Chinese refurbished and made into a historic tourist site]. I said no, no, I’m not Chinese, I’m Singaporean, I’m not going to visit the place…I have no romantic view about where I sprang from. I’m very grateful that my great grandmother who was born here decided she’s not going to go back (to China) with her husband because she doesn’t know China…I’m a lucky fellow. Yes, we are all lucky fellows. But the older generation has this romantic idea…I discovered when I was a student in England, that I had more in common with the Singaporeans and Malaysians of other races than with the Chinese from China because they are completely different. Their dress, their manners, their language. They are a different lot, that’s all. They come from a different society. Of course, at the end of the day they are Chinese.” -Lee Kuan Yew, Hard Truths, 2011“That romantic idea of going back to the bosom of your motherland is a delusion. We have become different, that’s all. You can go back to China, you’re still different…If you go to China, I don’t think you will belong. They’ll say okay, we’ll accept you. But look at even the Malayan communist cadres who sent their families and children there…- nevertheless, they were treated differently…You think you’re Chinese , and that you will blend in, but you will not. You are already different. We are already different. Just like the American and the British people, or for that matter, the South African whites, Australians, New Zealanders and the British. The Taiwanese mainlanders and Chinese mainlanders, who have not stayed in Taiwan, yes, they are same stock, same heritage, but had different exposure, different standpoints, different views of the world. Are we Chinese? Yes, ethnically. Can we sit down with the Chinese and really feel part of them? Not possible. Because you speak Chinese? No. Your major premises are in your mind” - Lee Kuan Yew, Hard Truths, 2011“[The Chinese] expect us to be more respectful - you must respect me. They tell us countries big or small are equal, we’re not a hegemon, 不称霸. But when we do something they don’t like, they say you have made 1.3 billion people unhappy … So please know your place” - Lee Kuan Yew, Hard Truths, 2011“I do not see Singapore surviving on the Chinese economy. If we spoke only Chinese, we would not be today’s Singapore. What is the difference if China is ten times stronger? It will make us ten times stronger? No. Our prosperity comes from linkages with the world…the future is the same. We are not Hainan Island. We are not Hong Kong, where they have no choice. We are in the centre of an archipelago of great diversity, with rich natural resources, and the world will come here” - Lee Kuan Yew, One Man’s View of the World, 2013“How can [the Chinese object to the American logistics hub here]? That is crude. If they ask us to stop the logistics base, our answer would be: you can use the logistics base and store your equipment here (so we would host both the Chinese and Americans” - Lee Kuan Yew, One Man’s View of the World, 2013“Singapore is quite comfortable with the Americans being present. We do not know how brash or assertive China will become. When I said in 2009 that we must balance China, they translated the word in Chinese into ‘conscribe’, and there was a big uproar among their netizens, who asked how dare I say that when I am Chinese. They are hypersensistive” - Lee Kuan Yew, One Man’s View of the World, 2013“You have to accept the fact that they (China) are the biggest boy in the neighbourhood. They will not be the biggest in the Pacific because the US will always be there to counterbalance them. But increasingly, they would be able to keep the US away from the coastal regions. That’s a development we have to accept. No more [uncomfortable for Singapore] than for the other countries…It’s even more tricky for Vietnam. We have no conflict of interest with China…we have no such overlapping claims with them.” - Lee Kuan Yew, One Man’s View of the World, 2013CONCLUSIONLet me emphasize again: I see the rise of China as a good thing in the long-term. It is not an ABSOLUTE good, but it is good. China is a FRIEND, even if friends can be pushy at times and we do not always agree with our friends about everything all the time. Singapore and China have no fundamental clash of core interests. Indeed, I think it is possible for our core interests to align with China. Not only with China, but also with the US, India, Japan, etc. Whether or not it aligns with China to a greater degree than with other powers is to be seen, and in large part decided, by China’s own behaviour.But in any case if there is alignment, our lodestar must always be our NATIONAL INTEREST - Singapore’s own national interest - determined by Singaporeans’ own choices ALONE and no one else’s, undiluted by the manipulation of ANY foreign entity. And in case you think I’m only referring to China, go look at our handling of the 1988 Hendrickson Affair.Huang Jing was only one manifestation of this. Foreign powers will continue to attempt to influence our policy. When they stick their fingers into our sovereign discursive space, we must continue to quietly, tactfully, but ruthlessly slice those fingers off.防人之心 不可无