COVID COVID-19 Coronavirus Containment Efforts

[kadiot]

China has listed their cases broken down by age, by previous medical condition and a bit more:
http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51

Out of all patients with data, 74% had no "comorbid tension" - but only 33% of the patients who died were in that group. Cardiovascular disease came with a factor ~5 higher death rate, diabetes with a factor ~4, hypertension with a factor ~3. Note that these are all highly correlated with age, so it's not a comparison of a patient with/without that condition at the same age!

Is there data outside China (aside from Singapre) to know the mortality rate for high risk patients? (Elderly/ immunocompromised etc?)

I don't know how or if data like that is tracked.

Example, normal flu mortality is 0.1% for general pop. For immunocompromised individuals its closer to 1%.

If that holds true for covid, a 1% mortality rate in gen pop is 10% for immunocompromised individuals.

 

[atyy]

Singapore is going to attempt taking swab samples for PCR at the airport from some people who have minor flu-like symptoms, and have results in 3-6 hours.

https://www.channelnewsasia.com/new...ce-wong-iran-korea-italy-checkpoints-12494744

"Also starting on Wednesday, travellers entering Singapore who exhibit fever and other symptoms of respiratory illness but do not meet the clinical suspect case definition may be required to undergo a COVID-19 swab test at the checkpoint.

"We know that temperature standards alone are not sufficient," Mr Wong said.

They may continue their journey immediately after undergoing the test, but while awaiting results - which may take between three and six hours - they are advised to minimise contact with others, said MOH.

They will be contacted when the results are released and those with positive results will be taken to the hospital in a dedicated ambulance."

 

[chirhone]

Huh? You do realize, I hope, that alcohol would just evaporate off (after possibly killing the germs). It certainly won't cause rust. I would just wipe it down with hand sanitizer.

How many alcohol wipes of any surfaces before the viruses are killed?

Why do alcohol kill viruses? Arent there any viruses resistant to alcohol?

Lastly. A small bottle of alcohol is cheap. If i soak the item in a pan or cup of alcohol. It still won't rust?

 

[Vanadium 50]

We'll need (age,condition,outcome) data for that. (age,outcome) and (condition,outcome) is better than nothing, but with the strong correlation between age and condition we can't conclude how important each one in isolation is.

Agreed. Also, compounding this, when the extremely ill die, it is not always easy to separate dying with Coronavirus from dying from coronavirus.

 

[Bandersnatch]

Later today I'll receive the item and package from china (although travel from and to china in my country is restricted, but they can ship any package at will):

Is it safe to receive a letter or a package from China?

 

[kadiot]

Singapore is going to attempt taking swab samples for PCR at the airport from some people who have minor flu-like symptoms, and have results in 3-6 hours.

This is too technical for me. I've read some articles about Real Time PCR. Please let me know if I understand it correctly.

• rt-PCR stands for real-time polymerase chain reaction which uses tiny pieces of DNA (primers) to detect and amplify (think photocopy machine on steroids) some genetic material (viral, bacterial, human etc.) of interest.
• rt-PCR is incredibly sensitive, in some cases being able to pick up a single copy of target DNA in a sample.
• The extreme sensitivity of rt-PCR is a double edged sword. It is great for detecting organisms that are difficult to culture and are present in tiny amounts. However, this also makes it prone to contamination, resulting in false positives (aka fake news that somebody is infected).

Please correct me if I am wrong. Thanks.

 

[StatGuy2000]

By the way, it's not death I'm worried about. :) It's more like hospitalization for a few weeks and massive bills.

My trip was with family to Atlantic City/Borgata. Not just me involved. We had multiple family members (some older wanting to cancel). But, it's also big city territory and in a place where lots of people would be associating.

Even Google, Facebook, Microsoft, etc. are canceling conferences, I'm seeing. They are worried about the virus!

I do know some people who've been avoiding Chinatown too. While there is some logic to that, I also think if thee virus were spreading from there, it'd likely be in so many other surrounding areas too.

It is obviously up to you and your family to make the call on what decision you are most comfortable with in terms of travel.

That being said, in my personal opinion, you and your family are overreacting. I say this because there is still not widespread person-to-person transmission of COVID-19 within the US, and Atlantic City is certainly not a major source of transmission.

As for cancelling conferences, businesses tend to be overcautious when it comes to situations like this, to avoid potential liability (not to mention saving money on travel and conference costs). That being said, business conferences involve participants from all over the world, so limiting unnecessary travel can be potentially prudent. Personal travel like yours is a different matter (at least within the US -- obviously there are areas of the world which are riskier in terms of travel).

I personally live in an area of Toronto with a large Chinese and other Asian populations (although not an officially designated Chinatown), and thus far there in my city there have only a relatively small number of COVID-19 cases. So I'm not avoiding going out.

And I certainly have no intention on curbing any potential personal travel any time this year, at least for now.

[Note: At least one reason I'm not as concerned is because I live in Canada, which has universal health care that is free at point of service (with the exception of prescription medication, but I have a great health insurance package from my employer that covers that). So I'm not worried about big medical bills.]

 

[TeethWhitener]

How many alcohol wipes of any surfaces before the viruses are killed?

If you're really concerned, fill a spray bottle with 70% ethanol in water and spray the whole thing down.

Why do alcohol kill viruses?

It denatures their proteins

Arent there any viruses resistant to alcohol?

A few. A quick google search reveals that coronaviruses are not among them.

Lastly. A small bottle of alcohol is cheap. If i soak the item in a pan or cup of alcohol. It still won't rust?

It shouldn't. Alcohol isn't ionically conductive enough to sustain rust formation (especially over the timescale of a short-term dip).

 

[kadiot]

I just don't know what to say:
https://www.msn.com/en-au/news/australia/anti-vaxxers-terrified-of-a-mandatory-coronavirus-vaccine-in-australia/ar-BB10xPeA

Sorry guys, while I believe in freedom and all that, the government has decided, in a really bad emergency situation, your irrational belief about vaccines does not allow you to put others lives in danger. And yes, generally most people in Australia don't have guns for self defense, but even if you had guns the government has enough resources so it will not make any difference.

Tanks
Bill

Sorry slighly off topic: Describe the sound of anti vaxxer heads exploding.

https://www.dw.com/en/germany-law-m...ut3JGlS-iEje6zd3E26FQLWGG9d6FVNBks9l9b7JwIa6c

 

[bhobba]

How many alcohol wipes of any surfaces before the viruses are killed? Why do alcohol kill viruses? Arent there any viruses resistant to alcohol?Lastly. A small bottle of alcohol is cheap. If i soak the item in a pan or cup of alcohol. It still won't rust?

I just use a general spray cleaner that is marked antiseptic and, is claimed anyway, to virtually kill all viruses and bacteria. Alcohol works against most bacteria and viruses by, I seem to recall, but could be wrong, literally bursting them.

Alcohol itself doesn't cause rust but it has a very strong attraction to water and will actually pull water vapor out of the air.

But personally I would not worry - I clean metal surfaces all the time with my general purpose antiseptic spray and never had any trouble.

Thanks
Bill

 

[kyphysics]

[Note: At least one reason I'm not as concerned is because I live in Canada, which has universal health care that is free at point of service (with the exception of prescription medication, but I have a great health insurance package from my employer that covers that). So I'm not worried about big medical bills.]

Yeah, that's a big reason here.

Although, honestly, I doubt I'm really protecting myself much. I work on a college campus, in addition to having two side hustles that involve contact with all sorts of people.

I feel like the next 2-weeks will be crucial to gauge the spread of this thing. Assuming we can trust the Trump administration to be honest? If we get stories of kids getting hospitalized, I could see some areas shutting down Wuhan-style (if just for liability issues).

Let's hope we don't see an explosive rise in hospitalizations! So many Americans don't even have health insurance!

 

[kyphysics]

https://www.cnbc.com/2020/03/03/cor...r-telemedicine-to-stop-hospital-crowding.html

Telemedicine could interestingly help in these situations.

Less need for people to go into see their doctor (in which an otherwise healthy person gets sick from someone with the virus). Video-ing your doctor from home and never having to leave sounds pretty nice.

 

[kyphysics]

View attachment 258040

Key word: "long"

If we had a more specific number, that'd be helpful too for general purposes.

 

[phinds]

Let's hope we don't see an explosive rise in hospitalizations! So many Americans don't even have health insurance!

Possibly even more important is that the health care system could be swamped if this turns into a pandemic. Even those of us with health care might not be able to get treatment if we need it.

 

[Bandersnatch]

Key word: "long"

If we had a more specific number, that'd be helpful too for general purposes.

Do you think, when the WHO made that infographic, they did not consider the time it takes for a package to arrive anywhere from China?
Or do you think them not trustworthy?

 

[chirhone]

I just use a general spray cleaner that is marked antiseptic and, is claimed anyway, to virtually kill all viruses and bacteria. Alcohol works against most bacteria and viruses by, I seem to recall, but could be wrong, literally bursting them.

Alcohol itself doesn't cause rust but it has a very strong attraction to water and will actually pull water vapor out of the air.

But personally I would not worry - I clean metal surfaces all the time with my general purpose antiseptic spray and never had any trouble.

Thanks
Bill

Does a general spray cover every microns of the surface? If even one micron is spared
The virus can live there. Do you always follow it by wiping the sprayed alcohol with tissue? My worry is it would destroy the paint.

This is part of containment efforts.

 

[kyphysics]

Possibly even more important is that the health care system could be swamped if this turns into a pandemic. Even those of us with health care might not be able to get treatment if we need it.

Not to get political too, but if the Trump administration cared about people's health, perhaps some time of temporary (10 days?) locking down of locales across the U.S. might be helpful? Yeah, it'd slow economic activity, but what if it saved lives and prevented such overcrowding health facility scenarios you mention.

What's that saying...an ounce of prevention is worth a lb. a cure or something?

Do you think, when the WHO made that infographic, they did not consider the time it takes for a package to arrive anywhere from China?
Or do you think them not trustworthy?

No, I meant for general purposes (as I stated in that post). As in, I do respect WHO's comments regarding packages. But, I was curious how long the c-virus lingers in general on various surfaces (outside of hosts) - non-package related and just general purpose spreading.

Sorry if my wording implied something different!

 

[anorlunda]

I have a question. I can't find it with a google search. What happens after a few months?

• Of course a vaccine would be nice, I accept that may or may not happen.
• Does the danger subside by itself without a vaccine?
• Or does everyone in the world get exposed, and 60% of us catch it? If so, then avoiding crowds has no point if we all get exposed eventually.

I'm thinking SARS went away on its own, but the common cold and some variant of flu stays with us forever.

 

[dRic2]

https://arxiv.org/abs/2003.00507

Some statistical fitting of the available data. A Very easy-to-read and very short article.

According to the above article and the current available data Italy should reach a plateau around 5500 infected people in a month (if I interpreted the graph correctly)... Seems strange giving the fact that we have already 2230 cases in about 10 days.

 

[Vanadium 50]

Not to get political too

Then why are you the one who keeps bringing Trump into this? Twice in less than two hours.

The President of the United States is head of the executive branch. That means he gets to execute laws, not create laws. The most relevant law is the Public Health Services Act, which allows the HHS secretary to declare an emergency, which was done on January 31st. (By Secretary Azar, not President Trump) It does not give anyone the authority to "lock down" the country, and it is not likely to do any good in slowing the spread of the disease anyway,

It would, however, save 100 lives a day from traffic accidents.

 

[mfb]

Do you think, when the WHO made that infographic, they did not consider the time it takes for a package to arrive anywhere from China?
Or do you think them not trustworthy?

I think the WHO hopes that this virus is similar enough to previous coronaviruses. They actually say that themselves in the image: It's based on other viruses.

https://www.medicalnewstoday.com/ar...n-surfaces#How-long-do-coronaviruses-persist?

Human coronaviruses can remain infectious on inanimate surfaces at room temperature for up to 9 days. At a temperature of 30°C [86°F] or more, the duration of persistence is shorter.

Sure, 9 days is the extreme outlier, but it's certainly longer than some shipping times.

----

CDC stopped listing cases by state, for whatever reason. Instead of a number you just get "yes" or "no" now in the map and table.

 

[Ygggdrasil]

I have a question. I can't find it with a google search. What happens after a few months?

• Of course a vaccine would be nice, I accept that may or may not happen.
• Does the danger subside by itself without a vaccine?
• Or does everyone in the world get exposed, and 60% of us catch it? If so, then avoiding crowds has no point if we all get exposed eventually.

I'm thinking SARS went away on its own, but the common cold and some variant of flu stays with us forever.

Regarding a vaccine: Despite what some people in the thread and some political figures have been saying, experts say that a vaccine for the Coronavirus is at least a year away from being available to the general public (https://www.newsweek.com/anthony-fauci-coronavirus-vaccine-year-away-public-availability-1489214). Fastest time from outbreak to approval of a vaccine is ~ 7 months (for the 2015 Zika virus outbreak in South America, https://www.statnews.com/2020/01/24/how-fast-biotech-vaccine-coronavirus/). While approval for a vaccine (which involves performing clinical trials to make sure that the vaccine is safe and effective) could come within a similar time frame, this does not account for the time needed to mass produce the doses required for use by the general public. Before then, access to the vaccine would likely be limited to those at the highest risk of contracting the virus (e.g. hospital workers).

SARS went away on its own because it was able to successfully be contained. Containment of SARS was easier because the symptoms were much more severe, so it was easier to detect and isolate those with the disease. COVID-19, however, is associated with much milder symptoms and it appears that asymptomatic individuals can transmit the disease (e.g. see https://www.nejm.org/doi/full/10.1056/NEJMc2001468 and https://jamanetwork.com/journals/jama/fullarticle/2762028). These features of the disease has made it much more difficult to detect and isolate infected individuals, allowing the disease to spread undetected in some communities (like in the current outbreak in Washington State). It is looking increasingly likely that containment methods will not be able to completely eliminate the disease.

However, while containment methods may not be able to eliminate the disease, this is not to say we should give up on efforts to contain the disease. As many in the thread have said, a major danger of the outbreak is that it could overwhelm healthcare systems when a large number of people show up to hospitals, sick and in need of treatment. Taking measures to slow the spread of the disease and limit its spread can make a big difference. For example, there would be a big difference between 60% of the population getting the disease in one month versus 40% of the population getting the disease spread over the course of 3-4 months. In the first scenario, hospitals could run out of capacity to treat patients, leading to much higher death rates.

As for the long-term outlook for the disease, STAT News published a very nice piece discussing the issue: https://www.statnews.com/2020/02/04/two-scenarios-if-new-coronavirus-isnt-contained/

 

[kyphysics]

Dumb question:

So, let's say a surface has a virus. Does that virus move around on that surface and how much (if so)? I know bacteria move all over the place and need a food source.

Can a virus also move all over and do they need something to "fuel" them?

 

[kyphysics]

Regarding a vaccine: Despite what some people in the thread and some political figures have been saying, experts say that a vaccine for the Coronavirus is at least a year away from being available to the general public (https://www.newsweek.com/anthony-fauci-coronavirus-vaccine-year-away-public-availability-1489214). Fastest time from outbreak to approval of a vaccine is ~ 7 months (for the 2015 Zika virus outbreak in South America, https://www.statnews.com/2020/01/24/how-fast-biotech-vaccine-coronavirus/). While approval for a vaccine (which involves performing clinical trials to make sure that the vaccine is safe and effective) could come within a similar time frame, this does not account for the time needed to mass produce the doses required for use by the general public. Before then, access to the vaccine would likely be limited to those at the highest risk of contracting the virus (e.g. hospital workers).

SARS went away on its own because it was able to successfully be contained. Containment of SARS was easier because the symptoms were much more severe, so it was easier to detect and isolate those with the disease. COVID-19, however, is associated with much milder symptoms and it appears that asymptomatic individuals can transmit the disease (e.g. see https://www.nejm.org/doi/full/10.1056/NEJMc2001468 and https://jamanetwork.com/journals/jama/fullarticle/2762028). These features of the disease has made it much more difficult to detect and isolate infected individuals, allowing the disease to spread undetected in some communities (like in the current outbreak in Washington State). It is looking increasingly likely that containment methods will not be able to completely eliminate the disease.

However, while containment methods may not be able to eliminate the disease, this is not to say we should give up on efforts to contain the disease. As many in the thread have said, a major danger of the outbreak is that it could overwhelm healthcare systems when a large number of people show up to hospitals, sick and in need of treatment. Taking measures to slow the spread of the disease and limit its spread can make a big difference. For example, there would be a big difference between 60% of the population getting the disease in one month versus 40% of the population getting the disease spread over the course of 3-4 months. In the first scenario, hospitals could run out of capacity to treat patients, leading to much higher death rates.

As for the long-term outlook for the disease, STAT News published a very nice piece discussing the issue: https://www.statnews.com/2020/02/04/two-scenarios-if-new-coronavirus-isnt-contained/

This is a fantastic post! Thanks for the work.

 

[chirhone]

Is soap enough to kill the virus? In case you don't have enough alcohol?

For example. The china items from Lazada arrive in just 4 to 5 days to thousands of users (even if Coronavirus survives 9 days).

Let's say the receiver would wear PPE to receive the package and cut the shipping packaging with scissors straight to waste disposal unit. Can you use soap to clean the scissors or does it have to be full alcohol to clear the scissors?

 

[TeethWhitener]

Does a general spray cover every microns of the surface? If even one micron is spared
The virus can live there. Do you always follow it by wiping the sprayed alcohol with tissue? My worry is it would destroy the paint.

This is part of containment efforts.

Spraying down surfaces with 70% ethanol is standard sterilization practice in a bio lab.

Also, if spraying a part like that with ethanol takes off the paint or rusts the part, you’ve paid too much for the part. This is true regardless of what you paid for it.

 

[StatGuy2000]

Regarding a vaccine: Despite what some people in the thread and some political figures have been saying, experts say that a vaccine for the Coronavirus is at least a year away from being available to the general public (https://www.newsweek.com/anthony-fauci-coronavirus-vaccine-year-away-public-availability-1489214). Fastest time from outbreak to approval of a vaccine is ~ 7 months (for the 2015 Zika virus outbreak in South America, https://www.statnews.com/2020/01/24/how-fast-biotech-vaccine-coronavirus/). While approval for a vaccine (which involves performing clinical trials to make sure that the vaccine is safe and effective) could come within a similar time frame, this does not account for the time needed to mass produce the doses required for use by the general public. Before then, access to the vaccine would likely be limited to those at the highest risk of contracting the virus (e.g. hospital workers).

SARS went away on its own because it was able to successfully be contained. Containment of SARS was easier because the symptoms were much more severe, so it was easier to detect and isolate those with the disease. COVID-19, however, is associated with much milder symptoms and it appears that asymptomatic individuals can transmit the disease (e.g. see https://www.nejm.org/doi/full/10.1056/NEJMc2001468 and https://jamanetwork.com/journals/jama/fullarticle/2762028). These features of the disease has made it much more difficult to detect and isolate infected individuals, allowing the disease to spread undetected in some communities (like in the current outbreak in Washington State). It is looking increasingly likely that containment methods will not be able to completely eliminate the disease.

However, while containment methods may not be able to eliminate the disease, this is not to say we should give up on efforts to contain the disease. As many in the thread have said, a major danger of the outbreak is that it could overwhelm healthcare systems when a large number of people show up to hospitals, sick and in need of treatment. Taking measures to slow the spread of the disease and limit its spread can make a big difference. For example, there would be a big difference between 60% of the population getting the disease in one month versus 40% of the population getting the disease spread over the course of 3-4 months. In the first scenario, hospitals could run out of capacity to treat patients, leading to much higher death rates.

As for the long-term outlook for the disease, STAT News published a very nice piece discussing the issue: https://www.statnews.com/2020/02/04/two-scenarios-if-new-coronavirus-isnt-contained/

An excellent post - thanks for updating us!

I would like to add that as someone who had worked at a major vaccine manufacturer, I can indeed attest to the time frame required for a vaccine to become available (at least a year away, even if taking into account the approval period for the new vaccine).

It is also worth noting that there has also been research into whether existing approved antiviral medication could be effective in treating and controlling COVID-19. There are clinical trials in progress for a number of such antivirals, including favipiravir, ribavirin, remdesivir, and galidesivir.

https://en.wikipedia.org/wiki/2019–20_coronavirus_outbreak#Management

https://www.nature.com/articles/d41573-020-00016-0

 

[hmmm27]

OT thread-related question :
Why is everybody saying "70%" isopropanol ? 99% is readily available where I am, for pennies more. Useful stuff (either dilution) : antiseptic, aftershave, parts cleaner, general and specific solvent.

 

[Ygggdrasil]

OT thread-related question :
Why is everybody saying "70%" isopropanol ? 99% is readily available where I am, for pennies more. Useful stuff (either dilution) : antiseptic, aftershave, parts cleaner, general and specific solvent.

At concentrations higher than 70%, alcohol evaporates too quickly to efficiently disinfect a surface. The presence of water in the solution also aids in disrupting the cell membranes of germs:
https://blog.gotopac.com/2017/05/15...than-99-isopropanol-and-what-is-ipa-used-for/
https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html

 

[kyphysics]

I would like to add that as someone who had worked at a major vaccine manufacturer, I can indeed attest to the time frame required for a vaccine to become available (at least a year away, even if taking into account the approval period for the new vaccine).

Does a "capitalistic incentive" speed that up at all?

I.e., If it were announced that a large cash prize would be offered for those able to come up with a vaccine by x amount of time, can we speed things up.