COVID COVID-19 Coronavirus Containment Efforts

[homeylova223]

According to

 

[atyy]

A John Hopkins doctor say there might be up to 500,000 infected in the USA.No this can't be true.
This is the news article https://news.yahoo.com/marty-makary-on-coronavirus-in-the-us-183558545.html. The doctor name is Makaray here is website https://www.jhsph.edu/faculty/directory/profile/1565/martin-a-makary

A quick estimate by Trevor Bedford is between 10,000 to 40,000.

 

[DennisN]

Ok, please post if you get it. Good job.

Since I am wannabe internet spy*, I have managed to find the home address of the family anyway.
(I haven't yet got an email from the journalist).

* Which anyone could have done, but it takes some time, luck and a bit of brains.

EDIT: And I have now also located the mother of the family on facebook, so I will send her a message now.

 

[bhobba]

If one goes out in public, one may wish to wear a mask, because one does not know who one may encounter.

It only protects others if the wearer has it. Its value depends entirely on how many people are not symptomatic or have symptoms so mild you do not even notice it. So far the consensus has been that its not worth it - but our knowledge is changing fast.

Thanks
Bill

 

[phinds]

If you have a few months' supply - great. If you have 10 years worth and people like this cannot access any, then in emergencies like COVID19, that is practically criminal.

Why is the word "practically" in that sentence?

 

[bhobba]

Maybe we could ask @Greg Bernhardt for advice regarding this too, that is, maybe ask members how to locate available hand sanitization, perhaps?

Just use soap. I don't get this hand sanitizer thing. Yes you can have it on your desk and its convenient from that point of view - but its just convenience - not a necessity.

It's becoming likely the real issue here is decision makers do not understand exponential growth and do not take decisions early enough, not the lack of non-essential items like hand sanitizes. Today I decided to stock up a bit more on meat and veg. Not much veg - but I did find some. Meat was funny. Hardly any - except for expensive cuts of which there was tons. I bought a few thick cut on the rib steaks. This is an emergency - penny pinching on meat cuts - beats me.

Thank
Bill

 

[chemisttree]

In memoriam for the lost and seriously afflicted everywhere.

 

[bhobba]

Georgia is the second state to postpone primary elections due to concerns over the virus, joining Louisiana.

We have local elections soon. The council announced Coronavirus will not be an excuse for not voting (here in Aus we have compulsory voting). Normally you have long lines at the polling booths. You think people will listen when the government has announced social distancing of at least three feet is now required. Talk about mixed messages. I will drive to the polling booth and see the line. If it is as I think it will be I will drive home and see what silliness they try on those who did not vote - if they dare.

Thanks
Bill

 

[DennisN]

Just use soap. I don't get this hand sanitizer thing. Yes you can have it on your desk and its convenient from that point of view - but its just convenience - not a necessity.

I can assure you I will give the mother advice regarding safety learned from WHO and this thread when I get in contact with her.

 

[morrobay]

Have there been any documented cases of infection from surfaces like rails at malls and public transportation? There can be exposures but not in high enough numbers to be infectious.

 

[Jarvis323]

Doesn't one just self-isolate until one is no longer symptomatic, maybe a day extra if one wants to be cautious?

The transmission of COVID-19 from asymptomatic individuals is generally thought to be negligible.

My understanding is no?

Recent evidence suggests that even someone who is non-symptomatic can spread COVID-19 with high efficiency, and conventional measures of protection, such as face masks, provide insufficient protection.

https://www.thelancet.com/journals/...Djw5x0wmu9XZaooHRlZmqQq8PBtm2UJ4mWzQ80sJa_JxU

A well 6-month-old infant with Coronavirus disease 2019 (COVID-19) had persistently positive nasopharyngeal swabs to day 16 of admission. This case highlights the difficulties in establishing the true incidence of COVID-19 as asymptomatic individuals can excrete the virus. These patients may play important roles in human-to-human transmission in the community.

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa201/5766416

"Asymptomatic and mildly symptomatic transmission are a major factor in transmission for Covid-19," said Dr. William Schaffner, a professor at Vanderbilt University School of Medicine and longtime adviser to the CDC. "They're going to be the drivers of spread in the community."

https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

I have trouble finding out how long one needs to self-quarantine if they have the virus. For a patient known to have it, they would stay until the test came up negative on consecutive days. I found one source:

Overall, viral load above detection limit was detected until 14 and 25 days after symptoms onset and for 13 and 11 days after the first detection, respectively.[7]

https://www.journalofhospitalinfection.com/article/S0195-6701(20)30102-X/pdf

 

[bhobba]

@bhobba , what do you mean by "taking a Biologic", I wonder?

Ok - a little information about treating Auto immune diseases of which the most common are Rheumatoid Arthritis, Psoriasis including Psoriatic Arthritis, Lupus etc. I have heard about 10% of the population have them. Its caused by a malfunctioning immune system. The treatment is to suppress your immune system. For years the Folic Acid antagonist Methotrexate has been used for that. I have been taking it for nearly 20 years. But about 15 years ago a new drug appeared - Enbrel - the first of a new type of drug called Biologics. A mediator for your immune system is called Tumor necrosis factor or TNF. Enbrel is a bio-engineered drug to render TNF inert. It really suppresses your immune system - as my Rheumatologist said its like putting a superhighway through it - especially when combined with Methotrexate. Your incidences of cold and flu rise dramatically - I forget what it is but the one I currently take is 5 times the incidence and it's supposed to be much less than Enbrel. I refused to take it for that reason even though my Rheumatologist pushed me. But new Biologics with less side effects started to appear and my Rheumatologist finally convinced me to take a new one called Cosentex specifically designed for Psoriasis which has only a .1% infection rate and you only get 5 times more colds and flu. That's why you must get the flu vaccine with it - if I get the flu I am in deep do-do. I get colds more frequently than normal but they are usually, but not always, quite mild. Now since my immune system has never seen this new coronovirus before and I now have a superhighway through it the chances of me fighting it off is severely reduced. As I said 10% have autoimmune diseases and hence compromised or suppressed immune systems, so take that into account when hearing 80% come through the new coronovirus just fine. That's of no consolation to them at all.

Thanks
Bill

 

[TeethWhitener]

https://jamanetwork.com/journals/jama/fullarticle/2762688

Take a look at Figure 2 in the above article, a quick glance at the PCR Ct values seems to support @Ygggdrasil's guess - in a given patient one can have ND (non-detectable) values even with previous and subsequent days above detectability.

BTW, I don't think the statement from @Vanadium 50's doc can be generally right, because if a full sequence is done, I would expect essentially 100% accuracy with no false negatives for any patient (but with false negative for particular samples from a patient). The only thing is of course that a full sequence is not a sort of test you run on massive numbers of people (@Ygggdrasil please correct if wrong)

Based on what little info I’ve found about available tests, they’re not doing full sequences. This test from Applied Biosystems:
https://www.fda.gov/media/136112/download
uses three primers from different regions of the viral genome to reduce cross-reactivity (IOW, to reduce the false positive rate).

 

[phinds]

Have there been any documented cases of infection from surfaces like rails at malls and public transportation? There can be exposures but not in high enough numbers to be infectious.

One of the CDC people said on TV that the virus can last several days on hard, polished surfaces, particularly metal.

 

[StoneTemplePython]

Ok - a little information about treating Auto immune diseases of which the most common are Rheumatoid Arthritis, Psoriasis including Psoriatic Arthritis, Lupus etc. I have heard about 10% of the population have them. ...
As I said 10% have autoimmune diseases and hence compromised or suppressed immune systems, so take that into account when hearing 80% come through the new coronovirus just fine. That's of no consolation to them at all.

Just a couple other thoughts. (Possibly duplicating earlier posts in this thread -- where I've read things on covid19... blurs together)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527069/

Autoimmune diseases are overwhelmingly concentrated with women -- 78% of the cases (and estimated 8% of global population has some autoimmune disease). At a crude level my understanding is autoimmune disease translates to overactive immune system that results in a lot of 'friendly fire' to your body.

Covid19 deaths I think skew towards men which contrasts markedly with nearly 80% of autoimmune diseases being with women. Now diabetes, high blood pressure and many other things are also risk factors. The open question for your doctor of course is whether the biologic dosing should come down during this.

 

[DennisN]

Now since my immune system has never seen this new coronovirus before and I now have a superhighway through it the chances of me fighting it off is severely reduced.

I'm very sorry to hear that. Take care and stay safe!

 

[chirhone]

Hospitals worldwide have now more shortages of blood because not many people donate blood.

For those needing surgery. If they have many friends or relatives with say type O plus. Can the people go to the hospitals at the time of the surgery and have their blood drawn and can this be used immediately on the patients? Or does it needs hours of centrifuge because it can be used?

 

[kyphysics]

QUICK QUESTION:

Does asymptomatic mean you are not exhibiting the symptoms and NEVER will (as in you do carry the virus, but for whatever reason, your body is handling it fine and you won't ever have any issues manifest physically) OR that they JUST HAVEN'T SHOWN UP YET?

thanks!

 

[phinds]

QUICK QUESTION:

Does asymptomatic mean you are not exhibiting the symptoms and NEVER will (as in you do carry the virus, but for whatever reason, your body is handling it fine and you won't ever have any issues manifest physically) OR that they JUST HAVEN'T SHOWN UP YET?

Both, I think.

 

[chirhone]

In the lockdown. The military, police, buildings are using hundreds of IR thermometers where they point it at the forehead and it's in shortage.

I understand an IR thermometer doesn't measure the core temperature but just the surface temperature of the skin. But at least it can segregate those with major rise in temperature.

Because of the shortages. I'm thinking whether to lend my thermal imager to a building or the military. The box in the middle (in the picture below where i tried it on a friend) can search for area with highest temperature. Is this as effective as the IR thermometer (considering both of their limitations in not able to get the core temperature which can work better by inserting the thermometer at the anuses. This is not advisable at the checkpoints because people can transfer feces).

 

[anorlunda]

It’s not simply the ability to detect the cases and explain why they happened that makes Singapore such a role model in this epidemic; nucleic acid testing kits were rapidly developed and deployed to ports of entry. Within three hours, while individuals are quarantined on-site, officials can confirm whether or not they are infected with the virus before allowing them to enter.

Three hours suggests some kind of on-site testing without shipments to a central laboratory.

What is nucleic acid testing?
Are there other types of testing with wide spread use?

 

[BillTre]

QUICK QUESTION:

Does asymptomatic mean you are not exhibiting the symptoms and NEVER will (as in you do carry the virus, but for whatever reason, your body is handling it fine and you won't ever have any issues manifest physically) OR that they JUST HAVEN'T SHOWN UP YET?

thanks!

It means that at some point in time a determination was they you (or whoever) showed no symptoms (by what ever method of discerning symptoms was used).

It does not mean you will not get symptoms later. It is only a reading at one point in time.
You could be very infected but show no symptoms for some reason.
You could also be infected and not show it on a test (a test result could be considered a symptom). This would be a false negative for the test and could be due to a variety of causes.
Another possibility would be that you already have an immunity, or for some reason the virus does not bother you.
The biggest problem is a carrier (infected person) who has no symptoms but is spewing out infectious virus particles, unknown to those around them.

In any case, you could still get infected later (unless you are already immune), and show symptoms then.

 

[chemisttree]

(considering both of their limitations in not able to get the core temperature which can work better by inserting the thermometer at the anuses. This is not advisable at the checkpoints because people can transfer feces).

Are you sure that’s the reason?

 

[TeethWhitener]

Hoarders at their worst:

https://www.nytimes.com/2020/03/14/technology/coronavirus-purell-wipes-amazon-sellers.html

An update:
https://www.usatoday.com/story/news...oarding-hand-sanitizer-urged-stop/5054155002/
I’m not a lawyer, so I’m not sure what kind of legal recourse the AG has.

 

[morrobay]

One of the CDC people said on TV that the virus can last several days on hard, polished surfaces, particularly metal.

Yes but surviving on some surface and then transferring in large enough numbers to cause an infection are two different things. From an infected person to the surface then to someone touching the surface then touching face. If there were surfaces infections it would seem infections would be orders of magnitude greater.
I also read there have been no documented cases.

 

[kadiot]

In Italy, given the crisis situation with more than 1,500 dead, the decision on who dies and who lives depends on the AGE, HEALTH condition and potential for RECOVERY of the patients...

https://www.telegraph.co.uk/news/20...ill-left-die-country-overwhelmed-coronavirus/

 

[kyphysics]

You could be very infected but show no symptoms for some reason.

Just to be sure I understand, this is not BAD for the patient him/herself, right? I agree with your point later that it would be horrible for everyone else, who the asymptomatic person is spreading the virus to. But, for the person without symptoms, they don't just suddenly die, right?

In other words, those who die, are those who have it manifested physically in things like trouble breathing, fever, fatigue, etc. There aren't people who don't show symptoms and just die of this thing never knowing they were in trouble, right?

In any case, you could still get infected later (unless you are already immune), and show symptoms then.

Do you mean reinfected later and then show symptoms the second time around? I thought once you get infected and fight the virus off that your body is now immune to it and it won't harm you anymore?

 

[BillTre]

You could be very infected but show no symptoms for some reason.

Just to be sure I understand, this is not BAD for the patient him/herself, right?

If one is infected and does not show symptoms does not mean they would not show symptoms later. In any case, you could still get infected later (unless you are already immune), and show symptoms then.

Do you mean reinfected later and then show symptoms the second time around?

No. A person already infected should have immunity or they would not have gotten uninfected.
But, an uninfected person without symptoms could get infected and either have or not have symptoms.

 

[mfb]

Just to be sure I understand, this is not BAD for the patient him/herself, right?

Right, it is just bad for others who might get infected from that person. At least that person doesn't cough/sneeze the virus around (by definition - that would be a symptom).

I found an interesting talk. It's made for people working at a hospital, the parts about specific diagnosis tools and medication are very technical (too technical for me at least), but apart from that it gives a good overview.

 

[Mary Conrads Sanburn]

This figure shows how S230, an antibody known to have neutralizing activity against the Severe Acute Respiratory Syndrome coronavirus, is predicted to interact with an initial model of a surface protein on the novel coronavirus. This computational estimate can quickly provide researchers with structural insights without waiting for time-consuming X-ray crystallography images of the actual protein.
Lawrence Livermore researchers release 3D protein structure predictions for the novel coronavirus

[ . . . ]

As global concern continues to rise about a novel Coronavirus spreading from China, a team of Lawrence Livermore National Laboratory (LLNL) researchers has developed a preliminary set of predictive 3D protein structures of the virus to aid research efforts to combat the disease.

The team’s predicted 3D models, developed over the past week using a previously peer-reviewed modeling process, are based on the genomic sequence of the novel Coronavirus and the known structure of a protein found in the virus that causes Severe Acute Respiratory Syndrome (SARS), also a Coronavirus that closely resembles the new virus.

“A major part of the value of these new structural models is that they present the predicted protein in complex with SARS-neutralizing antibodies,” said Adam Zemla, an LLNL structural biologist and mathematician. “This can be thought of as the first step for the global research community to identify and model how therapeutic antibodies can be designed to fight the novel coronavirus.”

Lab researchers are designing a diversity of protein models because the new Coronavirus protein structure is not yet known, according to Daniel Faissol, a data scientist in the Lab’s Computational Engineering Division.

The gold standard for obtaining protein structures for viruses is X-ray crystallography, but the entire process to learn the 3D structure of proteins can require weeks to months.

“We are making our initial protein structures available to the broader research community in the hopes of accelerating the development of disease countermeasures globally, because we hope to see a rapid response and because the situation is evolving so quickly. As we obtain more information about the virus, our intention is to update our models and provide follow-up data releases,” Faissol said.

To date, the Lab researchers have developed seven 3D, predictive models of Coronavirus proteins where therapeutics could be targeted using three different antibodies.

The models were developed at LLNL using published methods on structure modeling and structure variability analysis systems and structure alignment software. The most current 3D models can be obtained by contacting the LLNL Biosecurity Center.

The team’s work in support of the novel Coronavirus research is part of an ongoing research effort with the Department of Defense and others working toward accelerating the design of vaccines and therapeutics for various diseases.

As a next step, the team plans to use the preliminary protein models as part of a novel approach for accelerating countermeasure design, using a new LLNL-developed system that combines machine learning, biological experiments and simulation on high performance computing. In this process, the starting point is the estimated protein structures that they recently released.

Ultimately, the system may help identify new and/or improved candidates for countermeasure development. “Being able to estimate these structures rapidly is a key enabler for rapid computational design,” said Thomas Desautels, an LLNL data scientist.

The Coronavirus work leverages science and technology capabilities developed under LLNL’s internal Laboratory Directed Research and Development program, which supports cutting-edge, high-risk research.

In addition to Zemla, Desautels and Faissol, other team members are Edmond Lau, a computational chemist, and Magdalena Franco, a biomedical researcher.
https://www.llnl.gov/news/lawrence-...otein-structure-predictions-novel-coronavirus

I live close to Livermore, California and my husband worked there. Now he is retired.