COVID-19 Coronavirus Containment Efforts

[PeroK]

A news report broadcast briefly explained that they are more physically fit and so recover better from the infection. This also meant/means, fewer die.

That seems to me a highly implausible answer.

 

[mattt]

I notice there is still a major discrepancy in the death rate for the USA and Germany, as compared with other western countries that are suffering from a large number of cases. Italy and Spain are already very bad and I can't see any hope for the UK not to suffer to the same extent. It's only a matter of time.

What's the prognosis for the USA and Germany? Is it expected that the death rate can be kept relatively low? How are the health services coping?

A current hypothesis:

 

[mfb]

I did some google research and found out these patent applications.

That means even less. Not even a granted patent means anything.
You can get a patent to cure all types of cancer with a mixture of 30% rice and 70% carrots. Seriously. Just apply in the US and it will fulfill all three required criteria:
- it is new
- it claims to do something
- it is not trivial
Note the absence of a point where you would have to show that it actually works. Some more discussion here
Be careful with sources here, please, especially with medical claims.

------

Not so good news from other places:

Coronavirus cluster emerges at another South Korean church, as others press ahead with Sunday services
Was the big outbreak caused by the other church not bad enough? Or the new cluster started by this church? Is there really a need to start yet another outbreak by yet another church?Tokyo's official numbers rise quickly after Olympics are officially postponed

[Prime Minister Abe] said a state of emergency is not needed just yet, but that Japan could at any time face a situation as bad as in the United States or Europe.

That's the same mistake that lead to the situation in Europe and the US. Do nothing and wait for a miracle to happen. There won't be a miracle. Waiting just spreads the disease more.

 

[Astronuc]

https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak
LA Times, March 29, 2020 - In Skagit County, Washington, 60 people went to choir practice on March 10. Members were offered hand sanitizer at the door, and people refrained from handshakes and hugs (but not known if this was 100%). The practice lasted 2.5 hours.

First illnesses appear three days later on March 13. Three of four of two couples began to show symptoms of infection; the fourth first felt ill two days later. In the following days, more choir members became ill, as did some of their contacts.

Three weeks later, 45 choir members have tested positive for COVID-19 or are ill with symptoms (implies some not tested yet?), three are hospitalized and two are dead. According to the LA Times, eight people present at the choir practice maintain that no one was coughing or sneezing, which would imply 'respiratory droplets'. However, it appears that normal singing, or perhaps normal chorale singing with 'voice projection' is enough to release the virus.

This event indicates that the virus is highly transmissible through the air, and it does not require an infected person to be sneezing or coughing.

Edit - this story had me thinking about the attorney in New Rochelle, NY, who commuted from New Rochelle to New York City where he passed through Grand Central Station on the way to his office near GCS. I've done that many times myself for meetings in NY City, and people walk briskly from the train through the station and out to parts of the city, and some head to the subways for further parts. Breathing heavily would push out the virus to those one is passing, who are also rushing and breathing deeply. Many people who are infected apparently don't know they are. This also points to the importance of wearing a mask (preferably N95) in public to avoid expressing the virus and to mitigate inhaling the virus.

Edit/update - On March 26, Mike Baker (NY Times) reported about the Skagit Valley Chorale. Ruth Backlund, a co-president at the Skagit Valley Chorale, said “Nobody was sick. Nobody touched anybody. Nobody shook hands. Nobody hugged everybody like you might do in a group. There was none of that.”
The story would seem to confirm airborne transmission without coughing or sneezing, and whoever brought the infection along did not realize they were infected.
https://www.nytimes.com/live/2020/c...0-people-show-up-for-practice-now-45-are-sick

 

[DennisN]

Bad and good news from Spain:

Spain has now passed China in number of cases, and is now third on the list of countries with most infections ( which is 1. USA, 2. Italy, 3. Spain, 4. China).

I checked the "daily increase" tab for Spain on the COVID-19 dashboard and it seems the number of daily increases are going down; the number has steadily gone down from 9'600 to 6'900 (ca) during the last five days.

But I should add that I am not aware of the testing policies in Spain. One big, or more correctly, giant difficulty with all numbers of cases is of course that they are so dependent on the level of testing that is done in each country (or each region etc). If let's say, the testing for some reason is decreased it would be natural to see a decrease in the number of confirmed cases, which may not reflect the number of actual cases.

Sources:

• Spanish Coronavirus cases overtake China (Reuters, March 30, 2020)
• COVID-19 dasboard by CSSE

Good news from Europe, though most likely temporary:

• Coronavirus lockdowns give Europe's cities cleaner air (Reuters, March 30, 2020)

 

[russ_watters]

https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak
LA Times, March 29, 2020 - In Skagit County, Washington, 60 people went to choir practice on March 10. Members were offered hand sanitizer at the door, and people refrained from handshakes and hugs (but not known if this was 100%). The practice lasted 2.5 hours.

First illnesses appear three days later on March 13...

Three weeks later, 45 chioir members have tested positive for COVID-19 or are ill with symptoms (implies some not tested yet?), three are hospitalized and two are dead.

Wow. This has me nervous about even going to the grocery store!

 

[bhobba]

Wow. This has me nervous about even going to the grocery store!

I try to avoid it, but there is only so much you can do eg I buy subway salads in lots of 3 or 4 so you only go every few days - not every day. It can be reduced, but I see no way it can be eliminated.

Thanks
Bill

 

[phinds]

Wow. This has me nervous about even going to the grocery store!

Some stores have home delivery (in my area anyway) and some have "curbside pickup" where you don't have to go into the store. You should check in your area.

 

[PeroK]

Wow. This has me nervous about even going to the grocery store!

I suggest you can go to the store, but don't get involved in any supermarket singalongs! Seriously, going to the store must be a low risk activity with the measures in place and the few people you go anywhere near. Compared with say a typical day at work before lockdown, where you might be in close contact with hundreds of people per day.

The difference between lockdown and total isolation must be so small that it's a diminishing return to isolate yourself any further. Unless, of course, you think you've actually got the virus.

To extract ourselves from this we are all going to have to balance risk with rationality. We can't even stay in lockdown indefinitely, let alone total isolation.

 

[peanut]

What are the reasons why someone infected with Covid-19 produces a false-negative result?

 

[mfb]

Antibody tests are arriving:
Germany could issue thousands of people Coronavirus 'immunity certificates' so they can leave the lockdown early

researchers at the Helmholtz Centre for Infection Research in Braunschweig want to send out hundreds of thousands of antibody tests over the coming weeks that could allow people to break free of the lockdowns, Der Spiegel reported on Friday.
If the project is approved, the researchers will test 100,000 people at a time starting in early April, Der Spiegel said.

Antibodies -> good to go
It will also give a better estimate how many people had contact with the virus so far.

Germany's new case count had an odd pattern in the past, that made it hard to interpret, but it might have stabilized, too.

 

[collinsmark]

What are the reasons why someone infected with Covid-19 produces a false-negative result?

One reason, I'm lead to believe, is that the method of gathering the sample is a tad invasive and uncomfortable. You need to shove a swab pretty far up your nose, up into your sinus cavity. If you don't get it up there just right, it might produce a false negative.

Another possibility is testing too early, before incubation has taken effect.

There are probably some other reasons.

[Btw, this refers the antigen test, not the antibody test.]

 

[Astronuc]

https://www.weforum.org/agenda/2020...navirus-in-minutes-has-won-approval-in-the-us

Abbott Laboratories said on Friday it won U.S. marketing approval for a diagnostic test for the Coronavirus that can deliver results to patients within minutes and be used in physicians offices and urgent care clinics, as well as hospitals.

 

[OmCheeto]

That seems to me a highly implausible answer.

Someone posted a New York Times article earlier that asked your original question.

Germany Has Relatively Few Deaths From Coronavirus. Why?​

March 28, 2020​

I liked the answers I saw.
ie, they seemed very plausible.

Both early testing and incubation of the virus among the young go part of the way in explaining why the country’s fatality rate is so comparatively low. “It’s how much and whom we test,” Martin Stürmer, a virologist who is the director of a lab that is running Coronavirus testing in Frankfurt, told me. In general, countries that test less and reserve it for those already very ill, like Italy, have higher fatality rates.​

In other words, Germany has a lower death rate because they've tested more people.

It’s quite possible that Germany is just behind the curve.​

This is, in my opinion, based on the following graph I plotted yesterday, is 100% accurate:

[source numbers are from github]

I've been trying, unsuccessfully, to mathematically hand model an epidemic to try and reconcile why the "case fatality rates" are so nonsensical. After seeing the following statement in the article, I've decided to give up.

On average, a severely ill Covid-19 patient dies 30 days after being infected.​

If the following graphs don't make sense, don't blame me, as I only plotted the numbers.

 

[PeroK]

Someone posted a New York Times article earlier that asked your original question.

Germany Has Relatively Few Deaths From Coronavirus. Why?​

March 28, 2020​

I liked the answers I saw.
ie, they seemed very plausible.

Both early testing and incubation of the virus among the young go part of the way in explaining why the country’s fatality rate is so comparatively low. “It’s how much and whom we test,” Martin Stürmer, a virologist who is the director of a lab that is running Coronavirus testing in Frankfurt, told me. In general, countries that test less and reserve it for those already very ill, like Italy, have higher fatality rates.​

In other words, Germany has a lower death rate because they've tested more people.

The numbers are quite stark now, if we believe them: 11,591 deaths in Italy against 560 in Germany. That said, Spain, France, the UK and Netherlands are all commensurate with Italy (if we believe the total case numbers by country).

The USA, which has relatively few deaths, may be behind the curve as their case numbers have exploded in the last week or so.

 

[kyphysics]

Some stores have home delivery (in my area anyway) and some have "curbside pickup" where you don't have to go into the store. You should check in your area.

Although, you'd still have to trust the person packing your order, no? I.e., are they COVID-19 positive? Did they wash/sanitize their hands?

 

[jbriggs444]

Although, you'd still have to trust the person packing your order, no? I.e., are they COVID-19 positive? Did they wash/sanitize their hands?

So you wash the perishables and put the non-perishables in the garage for three days to sanitize.

Then remove clothing in a designated area, wash hands and/or take a shower after unpacking. My sister works in a bio lab and clued me to some things.

 

[Astronuc]

More on the lack of containment and control - or how to spread a virus:
March 23 - https://www.nytimes.com/2020/03/23/us/coronavirus-westport-connecticut-party-zero.html

About 50 guests gathered on March 5 (Thursday) at a home in the stately suburb of Westport, Conn., to toast the hostess on her 40th birthday and greet old friends, including one visiting from South Africa. They shared reminiscences, a lavish buffet and, unknown to anyone, the coronavirus.

Someone brought the virus to the party, maybe one of those who became ill, or maybe one who hasn't shown symptoms.

After the party, the partygoers scattered.

The partygoers — more than half of whom are now infected — left that evening for Johannesburg, New York City and other parts of Connecticut and the United States, all seeding infections on the way.

Westport, a town of 28,000 on the Long Island Sound, did not have a single known case of the Coronavirus on the day of the party [March 5]. It had 85 on Monday (March 23), up more than 40-fold in 11 days.

the Westport soirée “may be an example of the kind of thing we call a super-spreading event,” said William Hanage, an associate professor of epidemiology at Harvard, especially since some of the partygoers later attended large social events in the New York metropolitan area.

“Some of the early cases in Northern Italy were associated with small towns, and people thought, ‘Oh, it’s just in the small towns.’ But then you suddenly find cases emerging from Milan Fashion Week and spreading internationally,” Dr. Hanage said. “Everywhere you think the virus is, it’s ahead of you."

The visitor from Johannesburg — a 43-year-old businessman, according to a report from South Africa — fell ill on his flight home, . . . That fact didn't get back to Westport, CT until March 11.

Meanwhile, on March 8, another guest became ill. At noon on March 8, town and county health officials convened a Coronavirus forum at the Westport Library. “It is not out in our community that we’re aware of yet,” said Mark A.R. Cooper, the director of the Westport Weston Health District. “Give it some thought, but again, your risk is low.” But the virus was already circulating in the community.

By March 23, Westport, with less than 1 percent of the state’s population, now then more than one-fifth of its Covid-19 infections, with 85 cases. Fairfield County, where Westport is, had 270 cases, 65 percent of the state’s total.

As of March 29, a total of 908 of those cases are in Fairfield County (59.5 percent of the 1,524 positive cases of the novel Coronavirus (COVID-19) in Connecticut).
https://dailyvoice.com/connecticut/...-town-rundown-of-cases-other-key-info/785760/

https://dailyvoice.com/connecticut/danbury/news/covid-19-danbury-now-has-218-cases/785829/

https://www.wfsb.com/news/the-latest-more-than-covid--cases-deaths/article_54edec52-67ad-11ea-8482-877cb5d00dcd.html
As of March 30, Monday, The number of confirmed cases stood at 2,571 on Monday afternoon (an increase of 1047 cases in one day), according to Gov. Ned Lamont. Thirty-six deaths were also reported.

 

[mathwonk]

I drove to the solid waste (garbage and recycle) disposal site today, but it was closed. Seems the county closed all such sites last week, even though the governor listed residential waste disposal as an "essential" function during the emergency. A little puzzling since at least recycle dropoff involves no human contact. One is apparently expected to arrange "curbside pickup" suddenly, but we live on a private road a ways off the county thoroughfare, (no curbs), and the one private pickup company for this rural area is overwhelmed with signup requests this week. Oops. How is this going in rural Georgia?

 

[lavinia]

 

[bhobba]

I suggest you can go to the store,

Yes it is low risk, but at least here in Aus they still ask you to try and minimise leaving the house, which I do.

Saw my doctor today for a Flu shot, and he was more worried about me seeing my physio since they are not wearing face masks (short supply - more needed by emergency doctors - even he is not wearing one). But then again my physio keeps his distance and just guides me through the exercises, but there are some moments he gets close, such as when he attaches weights. Still to be as safe as possible I am reducing my physio to once a fortnight instead of once a week. When the pandemic is under control/over will increase it again and can rebuild any muscle that atrophied. As my doctor said their are many things we can't or should not eliminate, but can reduce - in fact we are all required (and when I say require - I mean by law - they now have police enforcing it and handing out fines) to reduce leaving the house as much as possible. It's not total lockdown - yet - but may end up that way.

The bureaucracy is, how to put it nicely, still learning. Check this one out from a doctor who was with a croup of other doctors:
https://glenlo.wordpress.com/2020/03/29/we-were-allowed-to-leave/

Don't you love it how one doctor (she is what's called a PHO which simply means she works in a hospital), using the authority they have as a registered doctor, who has not seen or examined the other doctor, is satisfied, because of the way he behaves, he is a public health risk. I wonder if the doctor who the order was issued on, could return the favor, using his power as a registered doctor to do the same to the other doctor? To make matters worse, a number of other doctors this order was issued on were urgently needed respiratory specialists. The mind boggles.

BTW they were returning from the Antarctic - sure there is a lot of Covid down there. To be fair they did return via the Falklands, that while they have no cases yet, may have a possible case that could be confirmed in a week

Of course the obvious answer was for someone with a few brains to recognise these are all registered doctors, and will do the right thing, such as isolate for at least two weeks etc etc, and let them go to where their expertise will undoubtedly be needed. Like I said a few bureaucratic kinks need to be ironed out.

Thanks
Bill

 

[mfb]

Italy could approach the peak of active cases, making it the third country with a larger outbreak to do so (after China and South Korea):

 

[peanut]

Antibody tests are arriving:
Germany could issue thousands of people Coronavirus 'immunity certificates' so they can leave the lockdown earlyAntibodies -> good to go
It will also give a better estimate how many people had contact with the virus so far.

Germany's new case count had an odd pattern in the past, that made it hard to interpret, but it might have stabilized, too.

View attachment 259650

Can Covid-19 antibody test be used as a standalone test to definitively diagnose Covid-19? Are they being used for mass testing in other countries?

 

[utsavchopra]

For those who are interested and know something about drones can help humanity during COVID outbreak. As I see FlytNow giving away it's Pro version of the product for free to fight Coronavrius thing.

User can learn more about and register for free here https://flytnow.com/drones-for-coronavirus/

 

[utsavchopra]

Can Covid-19 antibody test be used as a standalone test to definitively diagnose Covid-19? Are they being used for mass testing in other countries?

There is some report of that in Japan. But not confirmed.

 

[kadiot]

The officially compiled data on the number of infections and deaths caused by COVID-19 in the Philippines is too little to establish any correlation of infections and mortality rates relative to the size of our population. Simulation or forecasting models at this point is a better reference point on what could happen next or estimate the duration of the crisis.

The national circumstances and cultural practices are all pointing to high transmission and mortality rates. Based on projections it's possible the number of casualties will reach catastrophic numbers. However, there are certain factors that seem to be working in our favor: immunity and warm weather.

Viruses are comprised of a protein shell and either a DNA or RNA core. How does heat destroy the virus? I say destroy, because viruses are non-living, and thus, cannot be killed. I would love an explanation on how the heat from a blow dryer degrades the peptide bonds in the proteins. Also, not all blow dryers produce the same level heat either, so i’m curious on how one would even know whether their’s was at the proper heat?

As of now the CDC and the WHO state that there are no scientific direct cures or treatments for this novel coronavirus.

Anyway, the Philippines is not recording deaths by the hundreds in the range of Italy, Spain and other countries. Whether this low numbers is caused by under reporting or influenced by our unique factors. Virologists are still unsure to what extent the warm weather could affect the virus life cycle. With qualified optimism.

Although our national circumstances and cultural practices certainly will cause high transmission rates. The observed social practices of close contact, poor hygiene and high population density. Amazingly we're in the time period where the surge should have started and yet it's not happening - at least not yet.

 

[peanut]

Los Angeles Times reported "singing may have spread virus through the air at a church in Washington state". According to the Washington Examiner "it was a group of approximately 60 people singing in close proximity to each other for over an hour". I’m sure you’ve all experienced singing in a choir. When you sing, you drop your jaw much more than you do in a normal everyday conversation, you open your mouth and throat much wider, so the sound does not get trapped inside the mouth. Dr. Melfred L. Hernandez (The Voice Doctor), please feel free to correct me. When you sing, you project your voice. You spread DROPLETS, a LOT of droplets. So, imagine a group of people with strong and powerful vocal cords in a CLOSED room for hours SPREADING DROPLETS. The droplets fall everywhere (the floor, tables, chairs, sheet music, notes etc). The choir members take a break, sit on the chairs, exchange sheets / notes – these objects then become “fomites” objects that serve as vehicles for the spread of pathogens (in this case SARSCoV2 #coronavirus that causes COVID19) through indirect contact.

https://www.washingtonexaminer.com/...airborne-disease-as-experts-raise-possibility

 

[anorlunda]

How about a light-hearted piece for contrast.

Astrophysicist gets magnets stuck up nose while inventing Coronavirus device

https://www.theguardian.com/austral...ck-up-nose-while-inventing-coronavirus-device

 

[mfb]

Can Covid-19 antibody test be used as a standalone test to definitively diagnose Covid-19? Are they being used for mass testing in other countries?

It can be used to see if you had contact to the virus at least two weeks ago or so. It can't help finding people who got infected recently.

In addition to the antibody tests (post 1936) Germany aims at 200,000 virus tests per day by the end of April. German source.
Ideally this will be enough to test contacts of infected people again.

We'll get so many publications in the future analyzing the strategies of different countries. Will be very interesting to see once this pandemic is over and people have more time to study everything in detail.

 

[kyphysics]

Anyone here been tracking the development/availability of COVID-19 immunity tests?

We've mostly (or 100%?) talked about testing for the virus, but what about testing for immunity?

Are those supposed to be available widely anytime soon? And, if you got tested for having immunity, would that drastically change how you treated going out and your social activities? Would you do "favors" for others or volunteer, etc.?

 

[peanut]

It can be used to see if you had contact to the virus at least two weeks ago or so. It can't help finding people who got infected recently.

In addition to the antibody tests (post 1936) Germany aims at 200,000 virus tests per day by the end of April. German source.
Ideally this will be enough to test contacts of infected people again.

We'll get so many publications in the future analyzing the strategies of different countries. Will be very interesting to see once this pandemic is over and people have more time to study everything in detail.

So the rapid antibody test kits can only be used in people who had onset of symptoms for at least two weeks. For people who got infected recently would probably be tested with an RT-PCR.

Are antibody-based test kits available over the counter or ONLY medical doctors can prescribe and interpret the use of it?

 

[jbriggs444]

I take it as an article of faith that no test is currently available over the counter at your corner drug store.

If they cannot keep toilet paper in stock, there is no way on this Earth that they can stock a test kit for COVID-19.

 

[peanut]

Anyone here been tracking the development/availability of COVID-19 immunity tests?

We've mostly (or 100%?) talked about testing for the virus, but what about testing for immunity?

Are those supposed to be available widely anytime soon? And, if you got tested for having immunity, would that drastically change how you treated going out and your social activities? Would you do "favors" for others or volunteer, etc.?

How about the IgG/IgM tests? We need it for our frontliners to know if they've been infected then recovered and whether they have developed some sort of immunity.

 

[atyy]

Anyone here been tracking the development/availability of COVID-19 immunity tests?

We've mostly (or 100%?) talked about testing for the virus, but what about testing for immunity?

Are those supposed to be available widely anytime soon? And, if you got tested for having immunity, would that drastically change how you treated going out and your social activities? Would you do "favors" for others or volunteer, etc.?

@kadiot (post #319) and @BillTre (post #406) mentiomed immunity tests early in this thread, and they've been mentioned several times since then.

Indonesia is doing rapid tests, which are antibody tests. I am not sure, but I believe the accuracy of these tests is low (relatively speaking), so they are used to rapidly identify people who need to take a confirmatory test.
https://www.thejakartapost.com/news...se-tb-test-kits-for-covid-19-doctor-says.html
https://www.channelnewsasia.com/new...avirus-cases-deaths-jakarta-measures-12585684

Antibody tests to allow people who are immune to continue or resume working have been mentioned by Trevor Bedford in this Twitter thread (posts 17 & 18), and it seems Germany is preparing to use them https://www.dailymail.co.uk/news/ar...00-000-people-coronavirus-antibody-tests.html

The antibody tests used by Indonesia and Germany are probably different, so they may have different false positive and false negative rates. A couple of interesting false positives occurred in Singapore, where a patient was thought to have dengue on the basis of an antibody test. Later these patients turned out to be Covid-19 positive by PCR tests. With the first case it was thought to be a probably extremely rare case of dengue and Covid-19 double infection. However, there was more than one case, and it turned out that Covid-19 antibodies cause the dengue test to be positive, even though patients are dengue negative. So these patients did not have two diseases, they had only Covid-19, which caused false positives on the dengue test.
https://www.thailandmedical.news/ne...to-false-positive-in-dengue-serological-tests
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30158-4/fulltext

 

[chemisttree]

In both tests, Delos Reyes said conclusions showed inhibition in viral replication, significant reduction of virus quantity, even the ability to selectively kill infected cells. Both drugs are approved by the Food and Drug Administration (FDA) in the Philippines and in the U.S.

This work builds on the thesis of Dr. Elbourakadi. Interesting read.

http://images-a.chemnet.com/suppliers/chembase/cas10/cas59-46-1.gif

PROCAINE
- also known as Novocain

DEXAMETHASONE