COVID COVID-19 Coronavirus Containment Efforts

[Ygggdrasil]

Regarding the prospects for adaptive immunity from COVID-19:

In studies with monkeys, infection with COVID-19 provides immunity to the disease in the short term, suggesting that re-infection is unlikely or rare and that a vaccine should be able to produce immunity. A bigger concern may be that our body's immune response to the virus can wane over time. Our experience with the four other endemic coronaviruses suggests that infection provides short term immunity that wanes over time, and studies on people who were infected by the similar SARS virus from the 2003 outbreak also suggests that levels of antibodies against the virus wane over the course of a few years. A non-peer-reviewed pre-print looking for the presence of antibodies in the blood of those with confirmed COVID-19 infections found that up to ~1/3 had low or no detectable antibodies (mostly from people who had mild cases), which could be a concern for the possibility of re-infection. However, as @atyy mentioned, it is not clear whether these antibody tests truly reflect immunity, and it is possible that some of the people with low/no detectable antibodies still have immunity, but the particular test is not able to detect the antibodies.

Current evidence suggests that the mutation rate of the virus is slow enough that we should not expect that the virus will mutate to avoid immunity. Of course, mutations can be unpredictable, so mutation to avoid immunity is always a possibility, though something that can be monitored.

Here's a good summary of what we know regarding immunity to COVID-19 from STAT news: https://www.statnews.com/2020/04/20...nity-and-antibodies-and-plenty-we-still-dont/

 

[Astronuc]

Article about Christian Drosten, a German virologist

The Coronavirus czar
By Kai Kupferschmidt
https://science.sciencemag.org/content/368/6490/462

From the article:

Drosten concedes it has surprised him, despite his 17 years of work on coronaviruses and his knowledge of the threat they pose. “I didn't think that SARS would come back like this,” he says—as a virus that is both deadly and much more transmissible. It is adept at infecting cells of the upper respiratory tract, from which a cough can expel it, and unlike SARS—but like the flu—it can spread before symptoms emerge. “That's pretty astonishing,” Drosten says.

Drosten says a key reason for SARS-CoV-2's success may be a tiny part of the “spike,” the protein that sits on the virus' surface and makes it look like a crown when seen through a microscope. The spike protein attaches to a receptor on human cells called angiotensin-converting enzyme 2. Before the virus can enter the cell, however, a part of the protein has to be cleaved. The SARS-CoV-2 spike protein cleaves more readily than equivalent proteins in other coronaviruses, because it has evolved something called a polybasic cleavage site, which Drosten likens to the perforations on a notepad that make it easier to rip off a page. That feature may explain the virus' rapid spread from cell to cell, he says.

Drosten started to warn of the new virus' potential in TV interviews in January, but quickly grew exasperated. After long interviews, journalists often used one short quote that failed to convey the immense threat, he says.

 

[Astronuc]

Regarding immunity, perhaps like susceptibility, some (perhaps many) will obtain immunity and others will not.

 

[DennisN]

Dennis - how have you been?

Quite fine, thanks for asking!

Have you had any "lingering" symptoms of possible COVID-19 we had previously talked about?

No, nothing that has been significant. I've had a bit of a sore throat a couple of times, but it has been really minor. And I suspect that I am on a heightened level of awareness of bodily symptoms due to the pandemic, so I can't really tell if the sore throat was really particularly sore at those times, or if it was an effect of my heightened awareness. So, if there was any symptom, it was very minor, barely noticeable.

Three days ago, I could barely breathe.
(etc)
[...]

I'm sorry to hear that. The symptoms you describe match - as far as I know - some of the symptoms of people that have had Covid-19 (difficulty breathing, fatigue, coughing). Another symptom is fever. Do you have a thermometer at home? If not, if I were you I would get one, just in case. And maybe you should have a talk with healthcare about your symptoms? Maybe you could get a test?

And about experiencing "waves" of symptoms... I have definitely heard about that. Earlier in March I watched an interview with a British man who had Covid-19 in Wuhan, in which he described the waves of symptoms. In his case, they got worse with each "wave". Also please note that symptoms may vary between different persons, of course! Here's the interview:

Coronavirus survivor reveals what it's like to have Covid-19 (Channel 4 News, Mar 10, 2020)
Take care, and stay safe!

 

[Vanadium 50]

Yes, the media seems to have discovered "excess deaths". (Maybe they've been reading PF). The problem with excess deaths is that it is an upper bound: one can look at last year at this time in Europe and there were 100,000 excess deaths before there was Covid. Presumably this is flu.

The European numbers today are about 120,000 identified deaths and 160,000 excess deaths. Some of the difference is surely Covid and some (especially early on) is surely flu.

 

[kadiot]

Diagnostic laboratory testing is a cornerstone of the management of the COVID19 pandemic. There are now 26 reference laboratories with expertise in virology, diagnostics, sequencing, viral culture.

 

[kadiot]

Quite fine, thanks for asking!No, nothing that has been significant. I've had a bit of a sore throat a couple of times, but it has been really minor. And I suspect that I am on a heightened level of awareness of bodily symptoms due to the pandemic, so I can't really tell if the sore throat was really particularly sore at those times, or if it was an effect of my heightened awareness. So, if there was any symptom, it was very minor, barely noticeable.I'm sorry to hear that. The symptoms you describe match - as far as I know - some of the symptoms of people that have had Covid-19 (difficulty breating, fatigue, coughing). Another symptom is fever. Do you have a thermometer at home? If not, if I were you I would get one, just in case. And maybe you should have a talk with healthcare about your symptoms? Maybe you could get a test?

And about experiencing "waves" of symptoms... I have definitely heard about that. Earlier in March I watched an interview with a British man who had Covid-19 in Wuhan, in which he described the waves of symptoms. In his case, they got worse with each "wave". Also please note that symptoms may vary between different persons, of course! Here's the interview:

Coronavirus survivor reveals what it's like to have Covid-19 (Channel 4 News, Mar 10, 2020)
Take care, and stay safe!

I invite everyone to watch this vid. It appears that COVID-19 is not only causing ARDS (breathing prob syndrome) but blood clotting and fast...to die. That's why those who have diabetes and cardio issues are very high risks.

 

[DennisN]

Three days ago, I could barely breathe. I literally was struggling to breathe as if someone had closed my airways by 60% or so. It was odd. I wasn't even moving much and found it hard to breathe. Even drinking and eating were difficult. The moment I opened my mouth to try to drink something, I was gasping for air. I could barely eat. I felt like I had sprinted to the point of needing a lot of air whenever eating or just moving. I had to literally sit still to have air that felt relaxed. Otherwise, I was gasping.

I felt weak as well. Then a day and half later or so, everything felt great. It was an 180 turn-around. It was SO odd.

Really wondering if I had it, because I've had sudden days where I've had a non-stop cough. Then, it'd go away a few days later...and come back...and repeat the cycle. It's totally bizarre. There were two very scary moments when I considered going to the E.R. The first was back in March when I felt I literally could not raise my arms. I had massive fatigue, cough, and a burning sensation in my chest/throat/gut.

The second was just a few days ago when I had the breathing issue and felt very tired as well. It's just this sudden weakness that is bizarre and coupled with other stuff. Anyhow, hope you're doing well.

@kyphysics , I just happened to visit The Guardian (UK news site) and I saw this brand new article:

Lingering and painful: the long and unclear road to Coronavirus recovery (The Guardian, 1st May 2020)

I think maybe you ought to read it. When I read it I thought about your post above about your recent symptoms.

One quote from the article:

People tell of symptoms coming and going weeks after falling ill, even in mild cases

[...]

From 11 March, Alice experienced consistent severe fatigue, chest pain and tightness, and a cough – but no fever. Other symptoms came and went in waves, including chills, insomnia and heart palpitations. “Day eight, nine, 10 was just really horrible, you are just concentrating on breathing and hanging in there,” she said.

[...]

The symptoms continued to come and go, Alice said. “It is like a storm. One day you can have zero symptoms … then it will just go crazy and as quickly as it hits you it can go.”

[...]

(my bolding)
Please note again that the symptoms may be different from person to person.
If I were you I would really consider talking to a health care advisor/health care provider.

 

[kadiot]

USA Today: Coronavirus may last 2 years, study warns. And its second wave could be worse. This is seriously tedious...

 

[bhobba]

From the NYT piece.

Unfortunately true. To counter it though much of the work is being done by CEPI and financed by the Bill Gates foundation so I am not sure all are touting for money - still definitely worthwhile keeping in mind.

Thanks
Bill

 

[bhobba]

Few infections, no deaths - 'And then, boom': Outbreak shows shaky ground as Texas opens

In Aus and NZ we are starting to slowly lift restrictions. NZ had a stage 4 lockdown and is now going to stage 3 - Australia is stage 2 to 3 and is moving more towards 2. Not much difference between Aus and NZ so it seems not much between stage 3 and 4 lockdown. But the above suggests you can reach a point in easing restrictions where it suddenly explodes. Boy we have to be carefull and do it slowly, very slowly.

Thanks
Bill

 

[nsaspook]

Good news!
http://www.koreaherald.com/view.php?ud=20200429000724

South Korea’s infectious disease experts said Thursday that dead virus fragments were the likely cause of over 260 people here testing positive again for the novel Coronavirus days and even weeks after marking full recoveries.

Oh Myoung-don, who leads the central clinical committee for emerging disease control, said the committee members found little reason to believe that those cases could be COVID-19 reinfections or reactivations, which would have made global efforts to contain the virus much more daunting.

“The tests detected the ribonucleic acid of the dead virus,” said Oh, a Seoul National University hospital doctor, at a press conference Thursday held at the National Medical Center.

 

[atyy]

Good news!
http://www.koreaherald.com/view.php?ud=20200429000724

Virus cell culture, that's pretty definitive for dead versus live virus - of course it has to be done competently, with positive and negative controls and appropriate amounts of potentially infectious material, but I expect that from the Koreans (and they're showing they continue to deserve that respect).

 

[atyy]

Dennis - how have you been?

Have you had any "lingering" symptoms of possible COVID-19 we had previously talked about?

Three days ago, I could barely breathe. I literally was struggling to breathe as if someone had closed my airways by 60% or so. It was odd. I wasn't even moving much and found it hard to breathe. Even drinking and eating were difficult. The moment I opened my mouth to try to drink something, I was gasping for air. I could barely eat. I felt like I had sprinted to the point of needing a lot of air whenever eating or just moving. I had to literally sit still to have air that felt relaxed. Otherwise, I was gasping.

Really wondering if I had it, because I've had sudden days where I've had a non-stop cough. Then, it'd go away a few days later...and come back...and repeat the cycle. It's totally bizarre. There were two very scary moments when I considered going to the E.R. The first was back in March when I felt I literally could not raise my arms. I had massive fatigue, cough, and a burning sensation in my chest/throat/gut.

The second was just a few days ago when I had the breathing issue and felt very tired as well. It's just this sudden weakness that is bizarre and coupled with other stuff. Anyhow, hope you're doing well.

Was just curious if you've experienced any recurring weird stuff is all.

@kphysics, I really suggest talk with your doctor (same as what @DennisN says). Apart from COVID-19, it would also be good to make sure it's not something else potentially serious (like PF addiction) that can benefit from early treatment.

 

[kyphysics]

Apart from COVID-19, it would also be good to make sure it's not something else potentially serious (like PF addiction) that can benefit from early treatment.

What is "PF addiction" atyy?

 

[kyphysics]

@ Dennis

Thanks for the article. I've seen similar ones. It's bizarre, if true, that people have these "start and stop" symptom patterns.

Usually with a cold, you get it and it ends. Or, with some other illness, you get symptoms, treat it (sometimes just rest and eating healthy) and it goes away. I've seen some stories like this re: COVID-19 having an unclear recovery period/date.

 

[bhobba]

What is "PF addiction" atyy?

Simply that posting here on the issue concentrates your mind on it and may make your symptoms feel worse than they really are. I will not give the details but a similar thing happened to me and nearly, as my doctor said, meant I was heading for the trash heap of life. It took me over a year to recover fully, but was able to return to work in a couple of months with treatment by a very good psychiatrist. Such things can also be the first sign of an underlying autoimmune disease (and that proved to be true in my case) - so my psychiatrist was alerted to ensure my ESR was regularly tested. It took a few years to show - but one day my ESR went haywire and my iron dropped - I had an autoimmune disease - psoriatic arthritis. Really these things need to be checked out by a doctor - it can be more subtle than first thought.

Thanks
Bill

 

[mfb]

South Korea is on the way to a country-wide extinction as well. Most regions didn't have cases the last 14 days and the country-wide new cases per day are down to <= 10 after a total of 10,000 cases.

 

[bhobba]

South Korea is on the way to a country-wide extinction as well. Most regions didn't have cases the last 14 days and the country-wide new cases per day are down to <= 10 after a total of 10,000 cases.

Like Australia that means they can reduce restrictions - but as per the warning of Astronuc about Texas, slowly does it would be prudent.

Thanks
Bill

 

[atyy]

What is "PF addiction" atyy?

Physics Forums addiction (it was just a joke)

 

[atyy]

Texas and Belgian researchers playing with a llama

How a llama could hold the key to beating the Coronavirus

• An antibody engineered from the animal’s immune system was found to neutralise the virus that causes Covid-19
• American and Belgian researchers hope the discovery may help protect humans from the deadly illness

https://www.scmp.com/news/china/science/article/3082508/how-llama-could-hold-key-beating-coronavirus

Accepted manuscript in Cell available here: https://www.cell.com/pb-assets/products/coronavirus/CELL_CELL-D-20-00891.pdf

 

[kyphysics]

https://www.bloomberg.com/news/arti...us-survivors-who-fall-sick-again?srnd=premium

‘False Dawn’ Recovery Haunts Virus Survivors Who Fall Sick Again

It had been over a month since Mirabai Nicholson-McKellar was infected with the coronavirus, and the 35-year-old filmmaker thought she was on her way to recovery. Then the shortness of breath came back, followed by chest pains.

A visit to the emergency room and a second test for Covid-19 gave another positive result. Just three days earlier, she’d been cleared by health authorities in Australia’s New South Wales state, and was allowed to end her home quarantine after going 72 hours without symptoms.

“When is this going to end? I think about that constantly,” she said of the twists and turns in her health. “Am I still contagious? How do I know if I’m not contagious?”

A big remaining question is: Are people capable of getting infected again after recovering? Or, does the virus just last a lot longer than previously thought?

 

[collinsmark]

https://www.bloomberg.com/news/arti...us-survivors-who-fall-sick-again?srnd=premium

‘False Dawn’ Recovery Haunts Virus Survivors Who Fall Sick AgainA big remaining question is: Are people capable of getting infected again after recovering? Or, does the virus just last a lot longer than previously thought?

I'd give the re-infection hypotheses more credence if the timespan (time between when she was cleared until the positive test) was more like three weeks, not three days.

With a timespan of only three days (as presented in the article), it sounds likely it could be (I'm not saying it "is," but it "could be") the result of sampling noise.

 

[Ygggdrasil]

Update on the numbers from Sweden (likely of interest to @Vanadium 50). I compared the numbers I downloaded from the Swedish FOHM on Mon 4/27 (for post#2695) to numbers I downloaded today (Sat 5/2).

These numbers show that the Swedish FOHM is updating death numbers as far back as 3/25. For the data before 4/18, the difference in death counts between the two datasets is below 10%, suggesting most of the death reporting in Sweden can take up to 9 days. Based on this figure, FOHM statistics up to ~4/23 should be usable for analysis.

Here are plots comparing the deaths/day/million people for the Sweden, Denmark, Germany and the US (data from the other three countries were downloaded from the ECDC).

These data suggest that the deaths/day for Sweden do indeed begin leveling off around 4/9-4/13. Because deaths lag infections by ~24 days, this would correspond to reflecting interventions put into place around 3/16-3/20. By 3/20, Sweden had imposed the following recommendations (according to Wikipedia):

• Advising those with respiratory infections to refrain from social contact (3/11)
• Passage of a law to ban all gatherings > 500 people (3/11)
• Enacting policy measures to promote employees to take sick leave (3/11, 3/13)
• Issuing advisories against all international travel (3/14)
• Recommending that people over 70 should social distance (3/16)
• Recommeding that employers should recommend employees to work from home (3/16)
• Recommending secondary schools and universities to institute distance learning (3/17)
• Stopping travel from non-EU/EEA member states (3/17)
• Advising against unnecessary travel within Sweden (3/19)

The evidence would suggest that these lagrely voluntary measures were sufficient to slow the spread of the disease. These measures still resulted in significant social distancing as studies suggest that ~50% of Sweden's workforce is working from home, public transit systems saw a ~50% drop in usage, and travel over the Easter holiday fell 80-90%.

The following measures were put in place after 3/20 and may or may not have contributed to slowing the spread of the disease:

• Restrictions on restaurants and bars to promote social distancing (3/24)
• Banning gatherings of >50 people (3/27)
• Outlawing visits to nursing homes (4/1, though many municipalities had already banned visits)

As noted by others in the thread, Sweden has not closed elementary schools or non-essential businesses, unlike many other countries.

Of course, in evaluating which policies measures are effective, please keep in mind that this is an observational study of n = 1, and correlation does not necessarily imply causation. Furthermore, there could be features specific to Sweden that may not allow for generalization of their experience to other locales (e.g. I read that there is a higher fraction of people living alone in Sweden vs other countries). However, these data would seem to suggest that countries can control the spread of the disease through voluntary social distancing measures that do not completely shutter all non-essential businesses.

 

[Vanadium 50]

The evidence would suggest that these largely voluntary measures were sufficient to slow the spread of the disease.

It certainly would. Yet as late as Monday we were hearing "sky-high death rates" and "life-threatening experiments" in Sweden.

The Singapore site https://ddi.sutd.edu.sg/ is kind of annoying - they think they invented curve fitting and possibly differential equations as well, but it does put 28 countries' curves in one place. They use "cases" which has all the problems we discussed, but at least half of them are after the peak. It's remarkable how similar the data look. My conclusion is that by the time governments acted, everything was ballistic.

 

[Vanadium 50]

There is an interesting case going through the federal courts on Tuesday. The enabling legislation for Illinois' governors' emergency powers specifies 30 days. The suit's claim is the governor needs to have the legislature reauthorize this every 30 days (or pass legislation with a different time span). The governors' position is he doesn't: the fact that the crisis has lasted 30 days is enough, It's also that, although he shouldn't have to, he has the authority to declare as many consecutive and overlapping emergencies as he needs to.

The outcome is likely to not only affect this emergency, but future ones as well.

 

[anorlunda]

There is an interesting case going through the federal courts on Tuesday.

There are numerous legal challenges to the guidelines and emergency powers. Some have been settled already. Most of them are discussed on the Volokh Conspiracy Blog. I expect that judges will not be eager to make a decision that could label them as killers of people or killers of the economy. They will dodge and weave, and call in sick, and find technicalities that avoid the need to decide the merits.

https://reason.com/volokh/

 

[DennisN]

I just read a long interview with Dr. Michael Osterholm (an infectious disease epidemiologist)

I just visited a page at the University of Minnesota site/CIDRAP (Center for Infectious Disease Research and Policy) which I wanted to share:

COVID-19 Podcasts and Webinars
Relevant webinars and audio podcasts by subject matter experts. Each focuses on a specific area of interest within the topic of COVID-19.

It has among other things six podcasts with Michael Osterholm on different Covid-19 topics (Osterholm Update: COVID-19). I haven't heard or seen any of them yet, I just wanted to share the page here.

 

[Vanadium 50]

I expect that judges will not be eager to make a decision that could label them as killers of people or killers of the economy.

I agree. This is the same reason the state legislature doesn't want to vote on extending the state of emergency. It means they are responsible for the decisions they make.

 

[atyy]

Of course, in evaluating which policies measures are effective, please keep in mind that this is an observational study of n = 1, and correlation does not necessarily imply causation. Furthermore, there could be features specific to Sweden that may not allow for generalization of their experience to other locales (e.g. I read that there is a higher fraction of people living alone in Sweden vs other countries). However, these data would seem to suggest that countries can control the spread of the disease through voluntary social distancing measures that do not completely shutter all non-essential businesses.

There are several other cases that support the general idea - Hong Kong, Taiwan, South Korea, and arguably Singapore.

One may argue that South Korea does not support the idea, as they recently temporarily closed non-essential businesses (they've since started to re-open). However, they had brought their huge spike in cases under control (at least comparably well managed as Sweden) before shutting down non-essential businesses. The shutting of non-essential businesses appears to have been to bring their management of the epidemic from "decent" to "exceptional".

Despite the recent spike in cases in Singapore, the early phase of the outbreak here may also support the idea as we had six or seven weeks of heightened social distancing without closing non-essential businesses. We have had to close non-essential businesses recently because of a huge spike in cases, but I think the reason for the spike does not readily generalize, as it is among workers living in dormitories where there are 10 or more people in a room, and social distancing is extremely difficult.