COVID-19 Coronavirus Containment Efforts

[kadiot]

Somewhere there should be data about the time the dead patients were registered as infections, that would give the true time lag distribution between infection and deaths (for people who died).

Are you referring to the large increase last February 13 in Covid-19 cases in China due to a CHANGE in the DEFINITION of the cases? If I understand it correctly, previously, they were only counting LABORATORY CONFIRMED cases. But now they are counting CLINICALLY DIAGNOSED cases. This means anyone IN CHINA ONLY who comes with symptoms and findings CONSISTENT with Covid-19 CAN BE considered a case. This is to help people ACCESS care and to include those who DIED before testing. If anything, this move INCREASES transparency and gives us a better UNDERSTANDING of the IMPACT of the virus.

 

[kadiot]

In my simulation, nearly 10,000 people were infected by the time the first person died. I find that difficult to believe.

I invite you to read this article. I think it answers why in your simulation nearly 100,000 people were infected by the time the first person died.

One reason the Wuhan mayor failed to take health experts’ advice, as explained by a Beijing adviser to the Financial Times, was his concern “that an escalation in disease prevention may hurt the local economy and social stability”. This decision would have two escalatory effects.

First, it accelerated the spread of the virus, given that members of some 40,000 families prepared the food for the banquet, many of whom showed up to eat it.

Second, it facilitated the spread of the virus around the world. The banquet was followed by an exodus of about five million people from the city, which helped transport the virus beyond Hubei province and China.

Even if not actually complicit, the WHO at the very least must share some of the blame for the slowness of the response. As the virus spread through Wuhan in January, the WHO’s director general, Tedros Adhanom Ghebreyesus, praised the “transparency” of the Chinese response. As The Washington Post put it, this gave the impression that “China has got this.” The Communist Party has a vice-like grip on what is seen and heard in the country; after all, controlling the narrative is the sine qua non of the success of Beijing’s leadership. Contagious diseases are, however, indifferent to ideologies. Sometimes, a message is simply too critical to ignore or cover up.

Now that the cover-up has failed, China is slowly and begrudgingly admitting the inadequacy of its response to the crisis. An advance team from the World Health Organisation was only able to enter China on February 10, and it is still unclear how much latitude it will have to investigate the origins of the epidemic.

The US Centres for Disease Control and Prevention – one of the world’s most respected organisations – has not even been invited to assist in the investigation. With this degree of restriction and censorship, not to mention the threat to public health outside China, there has been a massive outcry over not only the silencing of Dr Li, but also the Chinese government’s mishandling of the entire crisis.

https://www.scmp.com/comment/opinio...s-chinese-government-has-made-its-mishandling

 

[mfb]

And I have yet to see or hear more Caucasians contracting the COVID-19.

I'm not sure if that's a well-defined group, but anyway, you can consider the infections in Germany for example. Various other European countries have a few domestic transmissions with no connections to China.

Excerpts from the book published in 1981.

Errie prediction or the chinese read the book and made it real?

The description of the book doesn't fit in several aspects, so clearly no one made it real. And so far all I have seen is this exact image. Did no one else find the book to check? This could be a simple hoax.

I believe mfb said they can test around 5000 people a day.

There was a source that could be interpreted as 6000 tests per day, it's unclear if it was accurate at that time and it's outdated now.
Anyway, take Chinese numbers with a grain of salt, especially but not limited to numbers from Hubei.

Are you referring to the large increase last February 13 in Covid-19 cases in China due to a CHANGE in the DEFINITION of the cases?

No. I mean: Look at the people who died and find out when they were diagnosed to have the virus. For how many of them did that happen at the day of death (or even later)? 1 day before? 2 days before? Normalize by the number of confirmed cases and you get a pretty good idea how much deaths are behind recorded infection numbers.

 

[kadiot]

I'm not sure if that's a well-defined group, but anyway, you can consider the infections in Germany for example. Various other European countries have a few domestic transmissions with no connections to China.

Ok, thanks. I was simply wondering if this is a bespoke virus that mainly affects Asians or Caucasians, largely, have a natural immunity against it. There is no substatial genetic differences among the races. But there are differences.

 

[Klystron]

This Washington Post report includes latest fatality data and updated information apropos to several posts in this thread: https://www.washingtonpost.com/worl...59df72-535c-11ea-b119-4faabac6674f_story.html

WaPo allows reading several free articles a month. As a digital subscriber I can access specific data.

Many international experts say the disease will continue to spread globally even as the Chinese government seeks to present the image that it is coming to grips with the epidemic. New cases inside China dropped again Wednesday, officials reported Thursday, after national authorities changed for the second time in a week the criteria for how cases are diagnosed and counted.

 

[BWV]

Ok, thanks. I was simply wondering if this is a bespoke virus that mainly affects Asians or Caucasians, largely, have a natural immunity against it. There is no substatial genetic differences among the races. But there are differences.

Are there other viruses that affect one 'race' more than another (excluding that one population may have a higher susceptibility due to a lack of previous exposure such as the native American population in the 1500s) ?

 

[OmCheeto]

Are there other viruses that affect one 'race' more than another (excluding that one population may have a higher susceptibility due to a lack of previous exposure such as the native American population in the 1500s) ?

I had the same question about the Zika virus.
As I recall, it seemed to be innocuous as long as it stayed in the old world.
But once it hit Brazil, all manner of newsroom panic ensued.
And then, just like that, nobody talked about the Zika virus, anymore.

 

[Klystron]

There are many books and reports on different reactions to alcohol based on geographical human distributions, often mislabeled as 'race', linked to blood type and, if memory serves, mitochondrial DNA. One recent text described alcohol absorption in the body and measured amounts and timing of related enzymes that metabolize alcohol and ethyl alcohol byproducts in blood and other internal organs among cohorts distinguished by age, gender and geography.

Relevance to illness may be a supposition although medical authorities recognize alcoholism and alcohol dependency as a disease; linked to heredity and culture. In other words given a marked difference in alcohol metabolism among 'Asians', 'Africans' and 'Caucasians'; different reactions to viral diseases would be a valid topic of further research.

 

[Ygggdrasil]

One example of "racial" differences in disease susceptibility is the presence of HIV resistance mutations in a small proportion of Europeans. It is thought that this mutation was selected for during the black plague that killed many Europeans during the middle ages. Of course, this is not the case that all Europeans are resistant to HIV as it only applies to a small proportion, and the mutation can be present in people of other races.

Nature recently had a news piece reporting that over 80 new clinical trials are ongoing in China to test new treatments for Covid-19, including chloroquinine (since @chemisttree mentioned he was waiting to see that tested).

The yesterday's situation report from the WHO on the Covid-19 outbreak also has a nice discussion of epidemiological models of the disease to better determine the infection fatality ratio:

Modeling is a helpful tool to try to account for missed cases, such as those that are mild cases potentially missed in current surveillance activities, and the time lag between onset and death. Using an estimated number of total infections, the Infection Fatality Ratio can be calculated. This represents the fraction of all infections (both diagnosed and undiagnosed) that result in death. Based on these available analyses, current IFR estimates10,11,12 range from 0.3% to 1%. Without population-based serologic studies, it is not yet possible to know what proportion of the population has been infected with COVID-19.

https://www.who.int/docs/default-so...0219-sitrep-30-covid-19.pdf?sfvrsn=3346b04f_2

 

[kadiot]

There are many books and reports on different reactions to alcohol based on geographical human distributions, often mislabeled as 'race', linked to blood type and, if memory serves, mitochondrial DNA. One recent text described alcohol absorption in the body and measured amounts and timing of related enzymes that metabolize alcohol and ethyl alcohol byproducts in blood and other internal organs among cohorts distinguished by age, gender and geography.

Relevance to illness may be a supposition although medical authorities recognize alcoholism and alcohol dependency as a disease; linked to heredity and culture. In other words given a marked difference in alcohol metabolism among 'Asians', 'Africans' and 'Caucasians'; different reactions to viral diseases would be a valid topic of further research.

I wonder if the virologists will be looking at that. This is scary. It can be used by terrorists to solely attack certain race. If memory serves me right, there was a Guy in the US that sprayed a buffet with fecal material that caused a salmonella outbreak. Also, some people are of the opinion that WW3 will be fought on a biological level.

 

[chemisttree]

Nature recently had a news piece reporting that over 80 new clinical trials are ongoing in China to test new treatments for Covid-19, including chloroquinine ...

Thanks for the link. The story links back to the clinical trial index. Searching “chloroquine” in the scientific title field yields 15 trials underway. Should have answers by May.

 

[Mary Conrads Sanburn]

HHS partners with drug makers on COVID-19 vaccine, drugs
Filed Under:
D-19

Stephanie Soucheray | News Reporter | CIDRAP News

Feb 18, 2020

The US Department of Health and Human Services (HHS) is partnering with Sanofi Pasteur and Johnson & Johnson to develop vaccines and therapeutics to use against COVID-19, according to press releases from the drug makers and HHS today.

Sanofi https://www.sanofi.com/-/media/Project/One-Sanofi-Web/Websites/Global/Sanofi-COM/Home/media-room/press-releases/2020/2020-02-18-16-00-00-1986380-en.pdf it will be revisiting previous development work for a SARS (severe acute respiratory syndrome) vaccine to examine a path for COVID-19 vaccine development. Both SARS and COVID-19 are coronaviruses that originated in China, with SARS appearing in 2002 and largely disappearing by 2004.

The work will be done through a collaboration with the Biomedical Advanced Research and Development Authority (BARDA).

Sanofi said its vaccine will use a recombinant DNA platform to produce an exact genetic match to proteins found on the surface of the virus. According to Sanofi, the previous work on a SARS vaccine gives them a head start, as that vaccine candidate performed well in non-clinical studies and animal challenge models.

Johnson & Johnson said it will also expand existing an partnership with BARDA via its Janssen Pharmaceutical Companies to develop therapeutics for COVID-19.

"This is the third Coronavirus to emerge and cause severe respiratory disease in humans within 18 years, and there are still no proven therapies to treat this disease," said BARDA Director Rick A. Bright, PhD, in an HHS press release. "In partnering with Janssen, BARDA is breaking this barrier to protect against this, as well as the next, Coronavirus outbreak. This partnership may accelerate discovery and development of a new potentially lifesaving medicines for people with Coronavirus infections."

[ . . . ]
###
http://www.cidrap.umn.edu/news-perspective/2020/02/hhs-partners-drug-makers-covid-19-vaccine-drugs

 

[morrobay]

South Korea has spike in cases now at 204. BBC news just reported cases have quadrupled in three days.

 

[kadiot]

South Korea has spike in cases now at 204. BBC news just reported cases have quadrupled in three days.

Yes,

1. SK: 204 cases
2. JP: 97 cases
3. SG: 85 cases

Total confirmed cases is 75,467

At this rate, 100k is reachable within 14 days.

 

[BWV]

Iran now, 18 confirmed cases and four deaths.

Iran confirmed 13 new Coronavirus cases, bringing the total in the country to 18, with four of the total having died.

“Based on existing reports, the spread of Coronavirus started in Qom and with attention to people’s travels has now reached several cities in the country including Tehran, Babol, Arak, Isfahan, Rasht and other cities,” health ministry official Minou Mohrez said, according to the official IRNA news agency.

“It’s possible that it exists in all cities in Iran,” she said.

The majority of Coronavirus cases in Iran have been in Qom, a Shi’ite Muslim holy city 120 km (75 miles) south of the capital Tehran.

https://www.reuters.com/article/us-...-deaths-mostly-in-qom-holy-city-idUSKBN20F1GU

 

[WWGD]

There are many books and reports on different reactions to alcohol based on geographical human distributions, often mislabeled as 'race', linked to blood type and, if memory serves, mitochondrial DNA. One recent text described alcohol absorption in the body and measured amounts and timing of related enzymes that metabolize alcohol and ethyl alcohol byproducts in blood and other internal organs among cohorts distinguished by age, gender and geography.

Relevance to illness may be a supposition although medical authorities recognize alcoholism and alcohol dependency as a disease; linked to heredity and culture. In other words given a marked difference in alcohol metabolism among 'Asians', 'Africans' and 'Caucasians'; different reactions to viral diseases would be a valid topic of further research.

Let's hope it doesn't become a PC issue and discussion becomes mired in accusations of racism as I have seen happen. Hope realization of the seriousness of the situation will outweigh any such reaction.

 

[kadiot]

Can this happen? I mean I suspect it is a sloopy report, isn't it?

 

[mfb]

Asymptomatic carriers are known for various diseases. In some cases they get visible symptoms later, in some cases they never get them.

Edit: Google don't find the article directly at reuters, but https://www.usnews.com/news/world/articles/2020-02-21/wuhan-woman-with-no-symptoms-infects-five-relatives-with-coronavirus-study.

Edit2: Found the original article: Presumed Asymptomatic Carrier Transmission of COVID-19

Patient 1 (presumed asymptomatic carrier)
[...]
The sequence of events suggests that the Coronavirus may have been transmitted by the asymptomatic carrier.

 

[kadiot]

The article from Reuters says, "The case study, published in the Journal of the American Medical Association, offered clues about how the Coronavirus is spreading, and suggested why it may be difficult to stop", but they didn't even bother linking to the actual JAMA article.

https://www.reuters.com/article/us-...elatives-with-coronavirus-study-idUSKBN20G00J

 

[bhobba]

My local university, UQ, has done it - they will be starting vaccine trials this week:
https://www.abc.net.au/news/2020-02...mal-testing-days-away-uq-researchers/11991456

Evidently a team of 20 have been working around the clock. I still can't believe we have technology this advanced - its almost like magic. People rightly talk about the heroes from firefighters during the terrible bush-fires we had, but these researches are also heroes.

Thanks
Bill

 

[Rive]

Iran now, 18 confirmed cases and four deaths.

That's bad news. If the numbers there keeps increase then I think very little chance remains that the change of weather will has significant effect, and also: with this the disease would get a solid foothold in a populated area without sufficient level of medical background.

 

[kadiot]

Iran now, 18 confirmed cases and four deaths.

Wonder, How they infected? Are there any Local, traveled to China or Chinese visited Iran?

 

[kadiot]

That's bad news. If the numbers there keeps increase then I think very little chance remains that the change of weather will has significant effect, and also: with this the disease would get a solid foothold in a populated area without sufficient level of medical background.

The virus does better in cold weather. The current temperature in Iran is 12 deg. C.

 

[chemisttree]

It has jumped from Iran into Lebanon and British Columbia via recent travel from Iran. What are the odds that two travelers had contact with these 18 cases? Iran probably has a much bigger problem than these numbers suggest.

The BC case traveled to Iran and returned home back in January! That’s a long time both for incubation and for the virus to be circulating in Iran.

 

[chemisttree]

Italy’s numbers are startling. 18 new cases bringing their total to 39 with 2 deaths and 16 critical cases. # of critical cases ratio to total cases approaching 40%! Something is not right there. CFR is ~5%. Not right at all.

 

[hagopbul]

Could there is multiple strains of Covid-19 ?

 

[chemisttree]

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

1. Isolate

• Place facemask on patient
• Isolate the patient in a private room or a separate area
• Wear appropriate personal protective equipment (PPE)

2. Assess clinical status.
EXAM

Is fever present?

Subjective?

Measured? _____°C/F

Is respiratory illness present?

Cough?

Shortness of breath?

3. Inform

• Contact health department to report at-risk patients and their clinical status
• Assess need to collect specimens to test for 2019-nCoV
• Decide disposition

If discharged to home

Instruct patient as needed depending on severity of illness and health department consultation

• Home care guidance
• Home isolation guidance

Advise patient if the patient develops new or worsening fever or respiratory illness

• Call clinic to determine if reevaluation is needed
• If reevaluation is needed call ahead and wear facemask

* Documentation of laboratory-confirmation of 2019-nCoV may not be possible for travelers or persons caring for patients in other countries. For more clarification on the definition for close contact see CDC’s https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html.”

 

[OmCheeto]

Italy’s numbers are startling. 18 new cases bringing their total to 39 with 2 deaths and 16 critical cases. # of critical cases ratio to total cases approaching 40%! Something is not right there. CFR is ~5%. Not right at all.

Two deaths, according to my synthetic model, indicates at least 10,000 people are infected.
That would yield a current "actual" CFR of 0.02%.
So, Italy's numbers are startling, to me anyways, in that they indicate their CFR is roughly 1/10 as lethal as the common seasonal flu. (0.14% [ref])

Of course, this doesn't jibe with my other data, that indicates the Covid-19 CFR is about 0.8%, and still rising, so I wouldn't take me too seriously.

Btw, has anyone seen a model like I posted on Thursday?

 

[Ygggdrasil]

Italy’s numbers are startling. 18 new cases bringing their total to 39 with 2 deaths and 16 critical cases. # of critical cases ratio to total cases approaching 40%! Something is not right there. CFR is ~5%. Not right at all.

Mortality from respiratory disease is not uniform across the population. Younger people will have much less mortality than elderly people or people with complications (e.g. people who smoke, people with pre-existing health issues). An outbreak in a university dormitory would have much lower mortality rate than an outbreak in a retirement home. With such small numbers, it's hard to extrapolate information about mortality without more knowledge about the infected population.

 

[Ygggdrasil]

Btw, has anyone seen a model like I posted on Thursday?

Here are some studies cited by the WHO in my previous post that study the issue:
https://www.medrxiv.org/content/10.1101/2020.01.29.20019547v2.full.pdf
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf
https://institutefordiseasemodeling...ality_rates_and_pandemic_risk_assessment.html

 

[mfb]

Italy put 11 villages with a total population of 50,000 under quarantine.
The two deaths that tested positive were both old people (76 and 77). The second victim went to the emergency room for other reasons earlier, so she was probably not in good health anyway.

Edit: Quickly rising confirmed infection numbers in Singapore (discussed+plotted before) and in Japan (33->66 in 4 days, 66->134 in 5 days), and exploding numbers in South Korea (51->556 in 3.5 days). Some of that will come from increased awareness and more tests, but that can't be all.

 

[atyy]

File under, “No Good Deed.” China has filed a patent against Gilead’s patented Remdesivir anti-viral medication for use in treating nCoV. The Wuhan Institute claims to have made the application out of “national interest” and won’t exercise their patent rights if foreign pharmaceutical firms work with China to curb the contagion. In other words, “let us make it in China license-free or we’re just going to steal it from you!”

What an outrage!
https://time.com/5778216/china-patent-coronavirus-drug/

Hmmm, what is the status on this?
http://www.koreabiomed.com/news/articleView.html?idxno=7405
"It is not true that the Wuhan Institute of Virology registered the patent of remdesivir in China. The institute on Jan. 21 sought the China Patent Office’s approval for an urgent use of the remdesivir patent to fight the new coronavirus.

The system allows an administrative order on a third party to use a patent, regardless of the opinion of the patent holder, for a special public need and compensates the patent holder later."

A remdesivir trial is registered here:
https://clinicaltrials.gov/ct2/show/NCT04257656

 

[atyy]

The BC case traveled to Iran and returned home back in January! That’s a long time both for incubation and for the virus to be circulating in Iran.

Which BC case? This one arrived in BC in February:
https://bc.ctvnews.ca/b-c-s-6th-cov...igation-as-new-cases-add-up-in-iran-1.4822454
https://vancouversun.com/news/local...-provide-update-on-novel-coronavirus-thursday

 

[kadiot]

Italy put 11 villages with a total population of 50,000 under quarantine.

Quarantine, a medical term (from Italian: quaranta giorni, forty days) is the act of keeping people or animals separated for a period of time before, for instance, allowing them to enter another country. By doing this, it is possible to limit the risk of spreading disease.

Now the word is being used again in Italy, applied to the government’s draconian reaction as the Coronavirus and the disease known as COVID-19 appear to be hitting the country with a vengeance. More than 50,000 Italians living in 10 communities are literally locked down, facing jail sentences and fines if they leave their homes.

 

[bhobba]

Just listening to a debate on this at the moment. What seems the main concern is bans etc will only slow it down. The only real answer is the vaccine. But what got me and left me gobsmacked is the government only gave $2m to developing the vaccine, but gave, just as an example and in no way addressing the issue if it should be celebrated, $6m to celebrate Captain Cook discovering Australia. That's bonkers - the money allocated to a vaccine should be virtually carte blanche. Containment will fail, the only real answer is the vaccine. Richard Feynman was right - we do not live in a scientific age - god help us.

Thanks
Bill