COVID COVID-19 Coronavirus Containment Efforts

[OmCheeto]

Is it true that Covid-19 update shows mortality rate up to 3% the past 3 days? Anyone please share your stats?

I've decided to go with the "mainland China w/o Hubei" stats, as the newbies are throwing off the "world w/o mainland China" numbers.

[ref: confirmed]
[ref: dead]

 

[Rive]

Any one have a clue why there are no deaths aged nine or younger? Interesting...

It just hit me yesterday that we have very little knowledge about the statistics what a 'common cold' would produce in a population without previous immunological experience - with other words: without that specific age group (without much mortality in this case) having contracted every possible germ in circulation.
Interesting. Maybe this one will become just another 'cold' on the long run?

 

[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.”

This is an interesting quote (albeit wordy for me non-virologist/biologist) on rt-PCR. I have read a news article saying that 14% of recovered Covid-19 Patients in Guangdong Tested Positive Again. In layman's term, once a patient cured of the disease is unlikely to get reinfected. His body develops immunity against that virus.

That's how vaccine works. Vaccine is just a less toxic form of the virus that doctors introduce into us to induce the body to recognize the virus and learn to identify it quickly and kill it. Once the body recognize the virus it has resistance to it, and we call that "immunity".

So a cured patient is reinfected wasn't really reinfected, but possibly human errors in testing infections.

I think the true test of whether someone is "reinfected" or is a real virus carrier is through the use of rt-PCR and viral culture, which is way harder for me to understand. Can anyone explain rt-PCR and viral culture a bit further?

 

[bhobba]

Do you have sources for these timetables? A recent press release from the university suggests that they don't expect the vaccine to be ready for clinical testing until after the middle of the year:

I do not remember the source, but I recall reading after initial, not as rigorous testing, they hope to have a vaccine first responders can use by April and one for everyone, tested to accepted CDC standards, by June-July. When it reaches that stage the issue is producing enough. I think UQ said they could do about 200,000 doses in the following 6 months. That will of course be prioritized for Australians. So producing a world wide supply, and even a supply for just Australians, is an issue. But UQ is not the only facility that could be called upon to produce the vaccine. That IMHO is the real issue - how are we going to ramp up production for everyone. I think its solvable, but the details need to be elucidated.

Thanks
Bill

 

[bhobba]

For example, Science reports that the UQ team would need 6 months to produce 200,000 doses of the vaccine (far fewer than would be needed to contain a worldwide pandemic).

That's likely correct - I seem to recall UQ itself saying it. It's a problem for sure. Fingers crossed its solvable - I think it is - but my opinion is only as good as anyone else's. Anyone fancy a holiday in St Lucia Brisbane where the UQ is - I can tell you where the lesser known tourist hot spots (eg Mt Tambourine etc) are and the best Aussi wines to keep your spirits up (pun intended) eg (in typical wine critic over the top prose - 99 points btw - if it matters):

'The colour is an astounding density. A myriad of dried fruit panettone, lapsang, five-spice, hoisin and roasted walnut doused in espresso and bitter chocolate, reel from a core of thoroughbred intensity. An immense wine that dichotomously, despite its sheer weight, almost evaporates from the tip of the tongue and surfaces of the cheeks, while lingering endlessly.'

I have imbibed far too much of that wine over the years - its amazing.

Thanks
Bill

 

[russ_watters]

Although that’s true in COVID-19, it isn’t always the case. Swine flu 2009 had this mortality distribution:

https://www.cdc.gov/H1N1FLU/images/graphs/qa_graphC.gif

In old/weak people it is obvious that being sick usually carries more risk than in young, otherwise healthy adults. Why that sometimes reverses is less obvious:

My understanding is that what typically kills you with these sorts of diseases isn't the disease itself, it's the immune system response; fever, congestion, etc. Sometimes a disease triggers a stronger immune system response, and otherwise healthy peopl have strong immune systems, capable of more extreme responses. Therein lies the danger.

 

[jim mcnamara]

@russ_watters - what you are describing is called a cytokine storm. Ebola, a haemorrhagic infection, is an extreme example.

Somewhat technical link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294426/
Less jargon: https://www.sciencedaily.com/releases/2014/02/140227142250.htm

 

[kadiot]

This is one of the BEST articles of the COVID19 illness. Many points are raised here, some of which I have been thinking of but didn’t feel like I was qualified to discuss.

https://www.uml.edu/news/stories/2020/coronavirus-ethics-evans.aspx?fbclid=IwAR2ykc_UDOLjbc2tHzO5YtKSLbFofqwC9yOC6DWywvjCFk7KyZ7V1Yf3Aco

 

[Rive]

This is one of the BEST articles of the COVID19 illness. Many points are raised here, some of which I have been thinking of but didn’t feel like I was qualified to discuss.

All of the resources China has deployed to impose and maintain the mass quarantine would be better invested in increasing the capacity for testing, bringing in more health workers and setting up more isolation units to treat people confirmed with the disease.

Well, I think the only reason why the authorities could reallocate the necessary equipment/personnel and maintain this was because they could partially contain the pandemic - by the enforced quarantine.

And I have a bad feeling that Europa would/will not be able to repeat this trick at this point anymore.

 

[kadiot]

@russ_watters - what you are describing is called a cytokine storm. Ebola, a haemorrhagic infection, is an extreme example.

Somewhat technical link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294426/
Less jargon: https://www.sciencedaily.com/releases/2014/02/140227142250.htm

cytokine is a word that comes from cyto meaning "cell" and kinin meaning 'hormones'.

Cytokine is a term that is applied to protein or polypeptide mediators which is synthesized and released by cells of he immune system during the inflammation.

Cytokines are secreted by white blood cells as well as variety of other cells (fibroblasts, endothelial cells, epithelial cells, etc.) in the body in response to inducing stimuli.

There major functions are to mediate and regulate immune response and inflammatory reactions.

 

[kadiot]

Well, I think the only reason why the authorities could reallocate the necessary equipment/personnel and maintain this was because they could partially contain the pandemic - by the enforced quarantine.

And I have a bad feeling that Europa would/will not be able to repeat this trick at this point anymore.

Here are my thoughts on this:

1. Most likely, the majority of the world will get COVID19. With how fast it has been spreading, it will be a matter of time before most of the world’s population will be exposed.
2. COVID19 is seen to take its place among the other corona viruses, as in it’s “cold, flu, COVID19 season.” Meaning, unlike the very fatal H1N1, or the MERS / SARS viruses, it will be another mainstay corona virus the way the common cold and flu are.
3. Containment will not help, and will actually harm the world when we need rapid exchange of resources and information. Borders should not be closed.
4. A vaccine is being developed, but it’s in its earliest stages, and may take a year or two before it will be released.
5. Many patients in the Diamond Cruise showed they had COVID19 in their blood, but exhibited no symptoms, which is why unlike H1N1 and other deadly viruses that were quickly contained because patients were too ill to walk around, COVID19 infected patients will spread the virus without knowing as many of them are asymptomatic.
6. The world’s governments and the world’s foremost scientists are doing their best—seriously, cut them some slack.
7. This is not China’s problem—this is the world’s problem. The sooner we realize that, and quit blaming and isolating China, the sooner we can fix this.
8. Live your life. Be cautious but don’t stop living your life.

 

[bhobba]

Just watched an interview with Professor Nigel McMillen, Program Director, Infectious Diseases & Immunology, Griffith University on the Gold Coast. He confirmed UQ has given the CSIRO the vaccine so mass production can commence ASAP. His exact words were what the UQ did was literally a gold medal effort. We now just need to confirm safety and efficacy. Amazing - so maybe we will get it sooner than we think - fingers crossed.

Thanks
Bill

 

[StatGuy2000]

Here are my thoughts on this:

1. Most likely, the majority of the world will get COVID19. With how fast it has been spreading, it will be a matter of time before most of the world’s population will be exposed.
2. COVID19 is seen to take its place among the other corona viruses, as in it’s “cold, flu, COVID19 season.” Meaning, unlike the very fatal H1N1, or the MERS / SARS viruses, it will be another mainstay corona virus the way the common cold and flu are.
3. Containment will not help, and will actually harm the world when we need rapid exchange of resources and information. Borders should not be closed.
4. A vaccine is being developed, but it’s in its earliest stages, and may take a year or two before it will be released.
5. Many patients in the Diamond Cruise showed they had COVID19 in their blood, but exhibited no symptoms, which is why unlike H1N1 and other deadly viruses that were quickly contained because patients were too ill to walk around, COVID19 infected patients will spread the virus without knowing as many of them are asymptomatic.
6. The world’s governments and the world’s foremost scientists are doing their best—seriously, cut them some slack.
7. This is not China’s problem—this is the world’s problem. The sooner we realize that, and quit blaming and isolating China, the sooner we can fix this.
8. Live your life. Be cautious but don’t stop living your life.

I agree largely with the above points. All of the information about COVID-19 that we have available indicates to me that this outbreak will more closely resemble the flu, as opposed to MERS and SARS, in terms of fatality rates and the severity of the disease (despite the fact that COVID-19 comes from the Coronavirus family like MERS and SARS).

It's also worth noting that the CFS rate (that is used to estimate fatality, and is currently estimated to be around 2-3%) is based on the number of deaths out of confirmed cases of COVID-19 infection. Since the evidence is strong that many people infected exhibit no symptoms or only very mild symptoms (and thus escape detection) the true infection fatality rate (IFS) is likely far lower - again, more in line with the common flu. And there does not seem to be any evidence indicating that the virus is mutating to become either more virulent or more severe in terms of illness.

The one area where I disagree is the value of containment. Containment at this stage is still useful to slow the spread of the illness (to reduce the possibility of a more virulent mutation that could emerge) and to give more time for researchers to develop vaccines or more effective antiviral treatments for those at greatest risk of developing severe illness, even if complete containment is not possible.

 

[russ_watters]

It's also worth noting that the CFS rate (that is used to estimate fatality, and is currently estimated to be around 2-3%) is based on the number of deaths out of confirmed cases of COVID-19 infection. Since the evidence is strong that many people infected exhibit no symptoms or only very mild symptoms (and thus escape detection) the true infection fatality rate (IFS) is likely far lower - again, more in line with the common flu.

I totally agree, and I think this point gets lost in the media hype over the issue. 2-3% overall mortality would be really scary, but 2-3% of people already hospitalized is not.

Google might be able to guess whether I've ever had the flu, but I'm pretty sure my doctor has no idea.
[edit] Er; google shares that with the CDC, and with time to digest the CDC probably has a better picture of the mortality rate of the flu vs coronavirus.

[edit 2]
The Diamond Princess may be a good self-contained test. As of today, 705 cases and 4 deaths, or 0.6%. I would assume everyone onboard was tested, so the number of cases is probably reasonably solid.

One caveat is the population is not a good cross section, it leans toward high risk, with an older than typical population, at least for the passengers.

 

[Rive]

1. Most likely, the majority of the world will get COVID19. With how fast it has been spreading, it will be a matter of time before most of the world’s population will be exposed.

I do agree that with that: based on the observed behavior this virus is able to, and most likely will do that.

However, to control the spreading and limit the amount of hospitalized people to manageable amount is a must, since based on the observed behavior without control the virus is perfectly able to drown all the existing hospitals and completely jam up healthcare.

 

[kyphysics]

Is anyone here AVOIDING public places and staying home more due to this virus?

My state's primaries are coming up - lots of people going to be there in a tightly packed place...

Wondering how this things will affect elections (NO, not tryiing to get into politics - but more of a practical question and just wondering if people will abstain from stuff is all)?

I'm avoiding public bathrooms (unless emergency) and hotels now. Cancelled a trip already!

 

[bhobba]

This is not the interview I saw but is the same professor saying pretty much the same thing:
https://www.2hd.com.au/2020/02/25/b...el-mcmillan-on-the-spread-of-the-coronavirus/

BTW, as he makes clear, do not buy face masks they are 100% useless, unless you are infected in which case you should be isolated for 14 days anyway.

Thanks
Bill

 

[bhobba]

Is anyone here AVOIDING public places and staying home more due to this virus?

I am not. I am doing exactly what Professor McMillen said - wash your hands frequently, try not to touch your face, and gross things like pick your nose. And for heavens sake forget face masks - they are useless.

Thanks
Bill

 

[Rive]

Is anyone here AVOIDING public places and staying home more due to this virus?

Well, something like that. More organized shopping, no movies/concerts, less crowded trains.

Regarding face masks: only, when/if I have to visit any medical/healthcare facility - regardless if I feel sick or not.
I do know that in general use I would just mess up the rules, so it would be useless - especially since I'm not in any of the high-risk groups.

 

[StatGuy2000]

Is anyone here AVOIDING public places and staying home more due to this virus?

My state's primaries are coming up - lots of people going to be there in a tightly packed place...

Wondering how this things will affect elections (NO, not tryiing to get into politics - but more of a practical question and just wondering if people will abstain from stuff is all)?

I'm avoiding public bathrooms (unless emergency) and hotels now. Cancelled a trip already!

Absolutely not. It's important to keep in mind that the risk of someone contracting COVID-19 in the US and Canada is very low. So @kyphysics , you are not at high risk. So long as you practice basic hygiene, such as washing your hands and avoid touching your face, you should be fine.

As for the effect on elections -- that depends on how COVID-19 will play out, but I don't see much of an impact at all in the US.

And for goodness sake, there is no reason to avoid hotels or public bathrooms or cancelling your trip! That's an overreaction.

Speaking of myself, I'm living my life in exactly the same way as I've done before. No change.

 

[StatGuy2000]

Well, something like that. More organized shopping, no movies/concerts, less crowded trains.

Regarding face masks: only, when/if I have to visit any medical/healthcare facility - regardless if I feel sick or not.
I do know that in general use I would just mess up the rules, so it would be useless - especially since I'm not in any of the high-risk groups.

If you live in the US, there is no need for you to avoid movies or concerts or otherwise change your daily routine. The prospect as of this moment of you being infected with COVID-19 is low.

 

[Rive]

If you live in the US...

It's within the EU. We have one busy internal (workforce) migration route across us. I expect this thing to develop really fast and really bad here.

 

[StatGuy2000]

I should also note that I used to work at a major research hospital in Toronto from 2002-2004, right during the middle of the SARS outbreak. And I've lived through the 2009 H1N1 flu pandemic (often inaccurately referred to as the "swine flu").

Much of the same fears and anxieties about COVID-19 were also expressed during both of these, and (for the most part) people around the world survived through these. I don't see the current situation as being all that different.

 

[russ_watters]

Is anyone here AVOIDING public places and staying home more due to this virus?

I won't be. I wouldn't go on a cruise to China anytime soon, but once the virus gets here, I'm not going to self-quarantine to avoid it.

 

[hagopbul]

I won't be. I wouldn't go on a cruise to China anytime soon, but once the virus gets here, I'm not going to self-quarantine to avoid it.

why quarantine your self ?

 

[russ_watters]

why quarantine your self ?

That's basically what @kyphysics was suggesting. It would substantially reduce risk, but also substantially reduce quality of life.

 

[Ygggdrasil]

The CDC really needs to update https://www.cdc.gov/coronavirus/2019-ncov/hcp/identify-assess-flowchart.htmlto be used by healthcare professionals for identifying potential COVID-19 cases. The bolded part should be “...tests negative for flu...”“For the evaluation of patients who may be ill with or who may have been exposed to 2019 Novel Coronavirus (2019-nCoV)

1. Identify if in the past 14 days since first onset of symptoms a history of either travel to china or close contact with a person known to have 2019-nCoV illness*
2. AND the person has fever or symptoms of lower respiratory illness (e.g., cough or shortness of breath)

if both exposure and illness are present

Very prescient post.

The first suspected U.S. case of a patient getting the new Coronavirus through "community spread" — with no history of travel to affected areas or exposure to someone known to have the COVID-19 illness — was left undiagnosed for days because a request for testing wasn't initially granted, according to officials at UC Davis Medical Center in Sacramento, Calif.
[...]
UC Davis included more details about the case in its own statement, drawing on an email sent to staff at its medical center. It said the CDC initially ruled out a test for the Coronavirus because the patient's case didn't match its criteria.

https://www.npr.org/sections/health...us-patient-in-california-was-delayed-for-days

 

[chemisttree]

BTW, as he makes clear, do not buy face masks they are 100% useless, unless you are infected in which case you should be isolated for 14 days anyway.

I doubt most people even know how to use them. They need to be fitted to the individual and one size does not fit all. Different brands fit differently too.
Home Depot has one size, one manufacturer. Good luck with that!
I saw a couple of corona princess passengers returning to Australia wearing them upside down! you would think that they would have received the most basic of training. Running around trapping viral particles on an N-95 and then taking it off bare-handed, reaching under one to scratch a nose with and without gloves. Ugh! Why not just donate the money you would spend on them to charity?

On the left- didn’t squeeze the nosepiece tightly against the face. That metal strip is there for a reason!
On the right - upside down!

 

[chemisttree]

Very prescient post.
https://www.npr.org/sections/health...us-patient-in-california-was-delayed-for-days

From UCDavis email about the case.

Upon admission, our team asked public health officials if this case could be COVID-19. We requested COVID-19 testing by the CDC, since neither Sacramento County nor CDPH is doing testing for Coronavirus at this time. Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process.

CDC was still using its outdated selection criteria referencing recent travel to China! When will they update it?

God help us all...

 

[chemisttree]

I should also note that I used to work at a major research hospital in Toronto from 2002-2004, right during the middle of the SARS outbreak. And I've lived through the 2009 H1N1 flu pandemic (often inaccurately referred to as the "swine flu").

Were it otherwise that would really be necroposting!