COVID-19 Coronavirus Containment Efforts

[BWV]

<mentor - moved to general discussion>

Wondering if the containment attempts are failing and this will be a world-wide pandemic. To put this in perspective, flu has something like a 0.5% mortality rate and this Coronavirus is 2-3% (far less than SARS or MERS) so in the US 80,000 people died of flu last season, if the Coronavirus became as prevelent as the flu, the deaths would be 4-6x higher, so 320,000 to 480,000 people in the US. Bad, but not Black Death II

https://www.statnews.com/2020/01/26/containing-new-coronavirus-may-not-be-feasible-experts-say/

Some infectious disease experts are warning that it may no longer be feasible to contain the new Coronavirus circulating in China. Failure to stop it there could see the virus spread in a sustained way around the world and even perhaps join the ranks of respiratory viruses that regularly infect people.

“The more we learn about it, the greater the possibility is that transmission will not be able to be controlled with public health measures,” said Dr. Allison McGeer, a Toronto-based infectious disease specialist who contracted SARS in 2003 and who helped Saudi Arabia control several hospital-based outbreaks of MERS.

If that’s the case, she said, “we’re living with a new human virus, and we’re going to find out if it will spread around the globe.” McGeer cautioned that because the true severity of the outbreak isn’t yet known, it’s impossible to predict what the impact of that spread would be, though she noted it would likely pose significant challenges to health care facilities.

Here is a real-time dashboard from John Hopkins

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

 

[jim mcnamara]

We have already had some members getting unduly upset. The flu never bothered them, just Wuhan.
If we had had 1918 epidemic in 1998, then things would have a different perspective for them. Flu would terrorize. - Credit for this idea belongs to the CDC staff.

Anyway, @BWV, good post. Per the dashboard as of 2020/01/27 16:47 MST we have ~6000 cases and with the death column almost all zeroes in places with good medical care. This is a very important point. Good quality healthcare == greatly reduced mortality.

I wish the internet news were not becoming Yellow Journalism Central. It is clickbait, not fact, all too often.
We have a flu pandemic every year. We also have a rhinovirus (colds) pandemic every year. Both of these carry some mortality, flu lots more.

People have gotten the wrong idea about what epidemic and pandemic mean.
Decent coverage:
https://www.webmd.com/cold-and-flu/what-are-epidemics-pandemics-outbreaks

 

[Bystander]

I wish the internet news were not becoming Yellow Journalism Central. It is clickbait,

Has it ever been otherwise?

 

An Australian lab has also recreated the virus (Chinese labs having sequenced it) and that's being flagged firstly as a way to create an antibody test, then hopefully a vaccine.

https://www.news-medical.net/news/20200128/Coronavirus-spreads-Australian-breakthrough.aspx

I wish the internet news were not becoming Yellow Journalism Central. It is clickbait, not fact, all too often.

Sign of relentless advertising being the bottom line of most sites, @jim mcnamara. They can't sell you - or too you - if they don't have your data.

 

[DaveE]

If you want to learn more about this virus and the current outbreak, this podcast is a great source of information targeted at people who can listen to more than a 30 second news story.
http://www.microbe.tv/twiv/twiv-584/

 

[Mary Conrads Sanburn]

Thank you dear BWV~

Centers for Disease Control and Preveniton
2019 Novel Coronavirus (2019-nCoV) in the U.S.
Updated January 29, 2020
CDC is closely monitoring an outbreak of respiratory illness caused by a novel (new) Coronavirus named 2019-nCoV. The outbreak first started in Wuhan, China, but cases have been identified in a growing number of other https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html#map, including the United States. CDC will update the following U.S. map daily. Information regarding the number of people under investigation will be updated regularly on Mondays, Wednesdays, and Fridays.

[. . .]

States with confirmed 2019-nCoV cases
Washington
California
Arizona
Illinois

[. . .]
###
https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

Again thank you dear BWV for sharing your kindness and thank you Physics Forums! I live in California. Deep breath for hopefully saving my life and all the people in my life. xxxooo

 

[Laroxe]

I think the problem at the moment is that we have very little information to go off and so there is a great deal of speculation and worry. Even the fact that this virus is new to humans means it might still undergo further changes. but it already looks as if its "transmissivity" is at a level that would make it self sustaining. I think the way in which China has responded will, if nothing else, significantly delay the spread of this virus and give the people working on a vaccine a chance to mount an effective response. So far it appears that deaths are concentrated in the same at risk populations that are susceptible to illnesses like the flu.
I'm actually impressed at how quickly a coordinated response has been put into place, it at least shows that we have learned some lessons from other outbreaks, but we will have to wait for more information before the potential risks become clear. There are some good links in other posts.

 

[Ygggdrasil]

An Australian lab has also recreated the virus (Chinese labs having sequenced it) and that's being flagged firstly as a way to create an antibody test, then hopefully a vaccine.

In addition to the team at the University of Queensland, the Coalition for Epidemic Preparedness Innovations is funding two companies, Moderna Therapeutics and Inovio Pharmaceuticals, to develop vaccines against 2019-nCoV: https://cepi.net/news_cepi/cepi-to-...ines-against-the-novel-coronavirus-ncov-2019/

However, it is unlikely that a vaccine could be produced in time to help with the current outbreak. For example,

In 2015, as the Zika virus raged in South America, Weiner and Inovio went from zero to having a ready-for-testing vaccine in about seven months. “And that is still considered the fastest,” Weiner said.

But that work, later published in the New England Journal of Medicine, never resulted in an approved vaccine, through no fault of Inovio’s. The Zika outbreak dissipated in 2016, sapping the need for a vaccine and making it virtually impossible to run the large-scale trials necessary to prove one’s worth.

https://www.statnews.com/2020/01/24/how-fast-biotech-vaccine-coronavirus/

Of course, vaccine development would be of great help in containing potential future outbreaks (e.g. as in the case of more recent Ebola outbreaks where therapeutics developed for previous outbreaks have shown great success in more recent outbreaks, or how Inovio is using their knowledge from producing a vaccine for the MERS Coronavirus to jump start its program to develop a vaccine against 2019-CoV).

 

[Mary Conrads Sanburn]

30 JANUARY 2020

Coronavirus latest: WHO declares global emergency
Updates on the respiratory illness that has infected thousands of people.

https://www.nature.com/articles/d41586-020-00154-w

Please read the entire article. Thank you for your kindness.

 

[kadiot]

View attachment 256355
30 JANUARY 2020

Coronavirus latest: WHO declares global emergency
Updates on the respiratory illness that has infected thousands of people.

https://www.nature.com/articles/d41586-020-00154-w

Please read the entire article. Thank you for your kindness.

What does the WHO pronouncement mean? How does it translate to how countries should address the disease?

 

[kadiot]

SARS(2003) fatality rate:11%
MERS(2012):35%
2019nCov:2% at latest reckoning

 

[kadiot]

In addition to the team at the University of Queensland, the Coalition for Epidemic Preparedness Innovations is funding two companies, Moderna Therapeutics and Inovio Pharmaceuticals, to develop vaccines against 2019-nCoV: https://cepi.net/news_cepi/cepi-to-...ines-against-the-novel-coronavirus-ncov-2019/

However, it is unlikely that a vaccine could be produced in time to help with the current outbreak. For example,

https://www.statnews.com/2020/01/24/how-fast-biotech-vaccine-coronavirus/

Of course, vaccine development would be of great help in containing potential future outbreaks (e.g. as in the case of more recent Ebola outbreaks where therapeutics developed for previous outbreaks have shown great success in more recent outbreaks, or how Inovio is using their knowledge from producing a vaccine for the MERS Coronavirus to jump start its program to develop a vaccine against 2019-CoV).

Six months to one year. Fast tracked based on the US projection. They have genetic code now. Please read too on the Australian work on this

https://www.smh.com.au/national/csi...us-vaccines-within-weeks-20200130-p53w9j.html

 

[chemisttree]

SARS(2003) fatality rate:11%
MERS(2012):35%
2019nCov:2% at latest reckoning

There is no possible way to compare those two numbers to nCoV. Not a good idea to compare time series data to final counts.


China started building two special hospitals when the official case count was in the low thousands! If the infection rates were accurate, how come a city like Wuhan with available hospital bedspace of greater than 40,000 is swamped by the then number of around 2,000?

View the time series data here:
https://ncov.r6.no/

Looks to me like nCoV is much worse than SARS.

 

[chemisttree]

An Australian lab has also recreated the virus (Chinese labs having sequenced it) and that's being flagged firstly as a way to create an antibody test, then hopefully a vaccine.

I thought they already had an antibody test. If not, how are they “confirming” nCoV? By TEM/SEM? EDIT: I’ve seen that they are using PCR in Germany.
Is it unusual to have an antibody test so soon after an outbreak? I believe the first cases were in early December and they were testing by early to mid January? Is that fast or what!

 

[BWV]

Lancet article projects the actual number of cases in Wuhan >75K and epidemics in other Chinese cities are 1-2 weeks behind

In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47–2·86) and that 75 815 individuals (95% CrI 37 304–130 330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8–7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227–805), 113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext

 

[chemisttree]

The PCR test described here:
https://www.who.int/docs/default-so...-assay-v1991527e5122341d99287a1b17c111902.pdf

And an R0 of 2.68? SARS is what? 2-5?

 

[chemisttree]

A new *non-peer reviewed study* modeling the nCoV virus has an R0 of 4.08(!) and a fatality rate similar to SARS. I don’t think we can stop a pathogen with an R0 of 4.08. Interesting scary if true.

https://www.medrxiv.org/content/10.1101/2020.01.27.20018952v1.full.pdf

 

[kadiot]

There is no possible way to compare those two numbers to nCoV. Not a good idea to compare time series data to final counts.

China started building two special hospitals when the official case count was in the low thousands! If the infection rates were accurate, how come a city like Wuhan with available hospital bedspace of greater than 40,000 is swamped by the then number of around 2,000?

View the time series data here:
https://ncov.r6.no/

I was simply putting it in perspective to address the fear-mongering grandstanding narrative. In my country (Philippines), critics of the administration have taking this as an opportunity to attack the President and push for another ridiculous ouster. Funny.

Looks to me like nCoV is much worse than SARS.

So far n-COV is less fatal than SARS and even comparable in severity to the common flu. Most patients have already recovered. Nearly all confirmed fatalities have been in elderly patients with preexisting conditions. However, the media frenzy and panic has caused more damage than the virus. Across the world, countries are panicking and forwarding unwarranted and race-based stances ungrounded in science.

 

[Ygggdrasil]

Here's a nice piece from the New York Times updating what we currently know about 2019-nCoV: https://www.nytimes.com/interactive/2020/world/asia/china-coronavirus-contain.html

It also has this graph (it does not cite sources for the figures in the graph, but the estimates for mortality and transmissibility of 2019-nCoV are in line with other sources I've seen):

(note that the y-axis is on a logarithmic scale)

Essentially, 2019-nCoV seems to be contagious as SARS and previous epidemic/pandemic flu outbreaks, though it is not as deadly as other Coronavirus outbreaks. Still, even if the mortality from 2019-nCoV is at the lower end of estimates near seasonal flu, there is reason to be concerned. Because it is a new virus, people lack pre-existing immunity and no vaccines are available, so we have very limited means to stop its spread.

While public health officials in China and elsewhere were able to contain the SARS outbreak in 2003 by tracking down and quarantining infected individuals, 2019-nCoV may present challenges to that strategy. For example, the New England Journal of Medicine published a case study from Germany reported evidence that asymptomatic individuals could spread the disease.

 

[chemisttree]

...For example, the New England Journal of Medicine published a case study from Germany reported evidence that asymptomatic individuals could spread the disease, which presents challenges to the quarantining strategy.

I think the takaway from this report is the following...

“The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum viral load in a convalescent patient (Patient 1) arouse concern about prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019-nCoV detected on qRT-PCR in this patient remains to be proved by means of viral culture.”

The fact that people have “recovered” might be unimportant from a standpoint of transmission. If someone indeed remains infective after the resolution of their flu symptoms, it’s unlikely any control is possible without testing the entire population and testing perhaps many times as was done with these patients in Germany.

 

[chemisttree]

There appears to be an inflection/deviation in the apparent log phase graph of cases! Perhaps the draconian measures China has in place are starting to show results!

https://ncov.r6.no

 

[Rive]

If someone indeed remains infective after the resolution of their flu symptoms, it’s unlikely any control is possible without testing the entire population and testing perhaps many times as was done with these patients in Germany.

In that case vaccination of some kind is more likely as some form of control: even as if just the way the different strains of flu makes population less vulnerable against variations of the same strain.

 

[chemisttree]

It would be great if the seasonal flu vaccine would impart some resistance to nCoV. Haven’t seen anyone make that claim yet.
Flu vaccination rate in China is ~10% and in the US its between 40%-50%.

 

[Rive]

Not likely to happen. But flu (sickness or vaccine) can make partial resistance against flu of other (closely) related strain.
So what I mean: if this thing will become endemic in the human population ( what seems more and more probable at this point) then similar mechanism might work later on, providing a limited control on long term.

 

[OmCheeto]

...
It also has this graph (it does not cite sources for the figures in the graph, but the estimates for mortality and transmissibility of 2019-nCoV are in line with other sources I've seen):
View attachment 256449
(note that the x- and y-axes are on logarithmic scales)

...

<nitpick>Actually, only the y-axis is logarithmic</nitpick>
I probably wouldn't have noticed it, but I've been generating tons of graphs for this outbreak. Not that it means anything at this stage, but it's good maths practice.

 

[Ygggdrasil]

<nitpick>Actually, only the y-axis is logarithmic</nitpick>
I probably wouldn't have noticed it, but I've been generating tons of graphs for this outbreak. Not that it means anything at this stage, but it's good maths practice.

Good catch.

 

[kadiot]

BREAKING: Philippines reports second case of novel Coronavirus and first death of patient with the virus.


* It’s the first death in the world outside of China ( not a Filipino but a Chinese National ).

---
Sorry slighly off topic...

Chinese officials announced an outbreak of a highly pathogenic strain of H5N1 bird flu at a farm in Hunan. The virus was discovered on a farm with nearly 8,000 chickens. More than half of them have already died.

 

[BWV]

Chinese officials announced an outbreak of a highly pathogenic strain of H5N1 bird flu at a farm in Hunan. The virus was discovered on a farm with nearly 8,000 chickens. More than half of them have already died.

China lost about a quarter of its hog population last year due to another virus,

 

[kadiot]

China lost about a quarter of its hog population last year due to another virus,

So, other than the 2019 nCoV epidemic that is spreading quickly across China and beyond it's borders, the risen Asian superpower is now facing two other epidemics: bird flu and swine flu! China's Ministry of Agriculture has ordered the slaughter of thousands of chickens and pigs to contain the epidemic that affects fowls and animals. Last year's loss about a quarter of its hog population and the new developments brings to focus the food security of the nation with 1.4 billion people.

 

[kadiot]

I think the takaway from this report is the following...

“The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum viral load in a convalescent patient (Patient 1) arouse concern about prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019-nCoV detected on qRT-PCR in this patient remains to be proved by means of viral culture.”

The fact that people have “recovered” might be unimportant from a standpoint of transmission. If someone indeed remains infective after the resolution of their flu symptoms, it’s unlikely any control is possible without testing the entire population and testing perhaps many times as was done with these patients in Germany.

With most respiratory viruses, people are thought to be most contagious when they show the most symptoms — in other words, when they are the sickest, according to the U.S. Centers for Disease Control and Prevention.

But that's not always the case — for example, people can spread the flu and the common cold about one to two days before they show symptoms. Diseases that spread before symptoms start can be harder to contain, according to STAT.

 

[chemisttree]

There appears to be an inflection/deviation in the apparent log phase graph of cases! Perhaps the draconian measures China has in place are starting to show results!

https://ncov.r6.no

Well that was short lived. Back to log phase spreading and death rate as well. Latest data is 305 deaths and rapidly approaching half the number seen for SARS.

If the rate continues as it has been (reported!) it will overtake SARS in less than a week, 5 days perhaps.

https://ncov.r6.no/

For those still thinking in terms of the seasonal flu, in the US we’ve had 19,000,000 cases of flu so far this season and 10,000 deaths which is about one death in 1,900 cases. When China had ~2000 cases of nCoV we were looking at ~35 deaths. 35 vs 1.

 

[Mary Conrads Sanburn]

Locations with Confirmed 2019-nCoV Cases

• China
• Hong Kong
• Macau
• Taiwan
• Australia
• Cambodia
• Canada
• Finland
• France
• Germany
• India
• Italy
• Japan
• Spain
• Malaysia
• Nepal
• Philippines
• Russia
• Sri Lanka
• Singapore
• Spain
• Sweden
• Thailand
• The Republic of Korea
• United Arab Emirates
• United Kingdom
• United States
• Vietnam

https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html#map

 

[kadiot]

This is a possibility, and needs more studies and data but just the same, this stresses the importance of hygiene. Hand washing, food safety. Probably the need to wear a mask in public toilets.

https://www.scmp.com/news/china/pol...tists-identify-possible-new-mode-transmission

 

[chemisttree]

Locations with Confirmed 2019-nCoV Cases

• China
• Hong Kong
• Macau
• Taiwan
• Australia
• Cambodia
• Canada
• Finland
• France
• Germany
• India
• Italy
• Japan
• Spain
• Malaysia
• Nepal
• Philippines
• Russia
• Sri Lanka
• Singapore
• Spain
• Sweden
• Thailand
• The Republic of Korea
• United Arab Emirates
• United Kingdom
• United States
• Vietnam

• 
  Isn’t this a pandemic yet?

 

[Ygggdrasil]

Isn’t this a pandemic yet?

Yes, the WHO declared the outbreak a global health emergency on Jan 30: https://www.sciencemag.org/news/2020/01/outbreak-virus-china-declared-global-emergency