COVID COVID-19 Coronavirus Containment Efforts

[bhobba]

So some people want schools to reopen because kids are "minimally affected" by coronavirus.

Here in Aus we have come up with a compromise position. Schools remain open so critical health care workers can still go to work - it is estimated at least 1/3 of health care workers would not be able to work if they were closed. But we are having a student free week next week so schools can gear up to deliver classes online. Some schools do it already:
https://www.acc.edu.au/marsdenpark/online/index.html

Then it will be the parents choice if to send them or not.

I said before virtually all commentators thought we would be in stage 4 lockdown by now, but we are still at late stage 2 or start of stage 3 because it is thought the increase we are seeing now is the backlog of people returning to Australia. TV footage showed, unfortunately, its still 'chaos' at airports - but reducing. Which is good because that chaos included almost total disregard for social distancing etc.

Thanks
Bill

 

[bhobba]

CSIRO in Aus latest information:
https://www.acc.edu.au/marsdenpark/online/index.html

Thanks
Bill

 

[peanut]

Yes. USA overtook China's lead in infection numbers. NY alone comprises half of the total. Looks like every major Western country will overtake China.

 

[peanut]

Here in Aus we have come up with a compromise position. Schools remain open so critical health care workers can still go to work - it is estimated at least 1/3 of health care workers would not be able to work if they were closed. But we are having a student free week next week so schools can gear up to deliver classes online. Some schools do it already:
https://www.acc.edu.au/marsdenpark/online/index.html

Then it will be the parents choice if to send them or not.

I said before virtually all commentators thought we would be in stage 4 lockdown by now, but we are still at late stage 2 or start of stage 3 because it is thought the increase we are seeing now is the backlog of people returning to Australia. TV footage showed, unfortunately, its still 'chaos' at airports - but reducing. Which is good because that chaos included almost total disregard for social distancing etc.

Thanks
Bill

Unfortunately, in the third world countries, where everyone is crammed into a tight space, some people seriously think the kids won't bring the virus home, or if they get it from their home, bring it to school? And who brings a lot of kids to school? Adults! Plus the teachers. And you know what? Grandma and grandpa live with these kids! If they contract the virus it may kill them. And I think the reason why testing of kids isn't done much: (two words) nasopharyngeal swab. Try sticking that baby down your 7-year old's nose. No. Schools should stay closed. .

 

[mfb]

Iceland tested 3% of their whole population (about 10,000 tests) and found that about half of the 218 positive cases don't show symptoms. This looks similar to South Korea.
The article doesn't say if they watched these patients for some time, or if this was at the time they tested positive, however.

Italy found more cases in the most recent update, largely driven by an increase in Lombardy. They are now reaching the total case numbers China reports.

 

[chemisttree]

How does a camera looking at a highway, where people are in their cars and not able to infect anyone else, have any relevance to whether or not NYC is in lockdown?

Because people get into and out of their cars. Infected people drive around and then get out of their car. Then they transmit at distant locations. Infected people drive into the city and get out of their cars and spread their infection. Are you really asking about how cars work?
If those drivers would self quarantine in their cars for 14 days it wouldn’t be a problem. I see lots of personal cars and few trucks. No checkpoints at all. There is traffic even at midnight across at the Lincoln Tunnel.
https://webcams.nyctmc.org/google_popup.php?cid=319

George Washington bridge facing west into Jersey. Really busy, even at 12:30am!

https://webcams.nyctmc.org/google_popup.php?cid=840

 

[PeterDonis]

Are you really asking about how cars work?

There's no need for attitude. This situation is tough enough for everyone without gratuitous snark.

If those drivers would self quarantine in their cars for 14 days it wouldn’t be a problem.

Plenty of essential workers have to drive to and from work, every day, even during lockdown, and many of them work all hours. In a city with the population of NYC there will be a lot of them. That's why you can't draw any reliable inferences just from cars on the highway. You need to look, as I said, at places like Times Square, where on a normal day (or night, for that matter), there would be lots of people crowding around. A few days ago I saw a camera view of Times Square in midafternoon and it was deserted. That tells me there are indeed a lot of people in NYC who are practicing social distancing.

 

[Rive]

Iceland ... half of the 218 positive cases don't show symptoms. This looks similar to South Korea.

Also, like Vo Euganeo

Awful high ratio. Of course, it is good that the mortality is actually 'just' around 1%, but with that many asymptomatic it will be a nightmare to stop this. Requires much more severe actions.

 

[chemisttree]

There's no need for attitude. This situation is tough enough for everyone without gratuitous snark.

Oh, my mistake. So you really think it’s OK for this level of travel as long as they are essential workers. You think no inferences are to be made seeing people in cars freely driving around the city along routes people use to get into and out of the city?

Plenty of essential workers have to drive to and from work, every day, even during lockdown, and many of them work all hours. In a city with the population of NYC there will be a lot of them. That's why you can't draw any reliable inferences just from cars on the highway. You need to look, as I said, at places like Times Square, where on a normal day (or night, for that matter), there would be lots of people crowding around. A few days ago I saw a camera view of Times Square in midafternoon and it was deserted. That tells me there are indeed a lot of people in NYC who are practicing social distancing.

No, they don’t have to. They’re allowed to. “Reliable inferences” will be drawn in 10 days as this disaster unfolds in both NYC and Jersey.
Before this is over, the Mayor will close the bridges and tunnels into and out of the city except for trucks bringing in supplies and those “essential” workers will be staying in the city in the now mostly empty hotels. That’s what a real lockdown is going to look like. What they are doing now is a joke.

 

[PeterDonis]

So you really think it’s OK for this level of travel as long as they are essential workers.

I don't know the specific circumstances that apply to all the cars shown in those webcams, so I can't possibly say. And neither can you.

Before this is over, the Mayor will close the bridges and tunnels into and out of the city except for trucks bringing in supplies and those “essential” workers will be staying in the city in the now mostly empty hotels.

Ok, you've made your prediction. We'll see.

 

[hmmm27]

Here (Toronto, Canada : pop.4M), I just drove to the other side of the city for a delivery, and back again, between 4:30 and 6:00pm ; something I wouldn't try normally given a choice, but there wasn't "rush hour" traffic.

 

[bhobba]

Unfortunately, in the third world countries, where everyone is crammed into a tight space, some people seriously think the kids won't bring the virus home, or if they get it from their home, bring it to school? And who brings a lot of kids to school? Adults! Plus the teachers. And you know what? Grandma and grandpa live with these kids! If they contract the virus it may kill them. And I think the reason why testing of kids isn't done much: (two words) nasopharyngeal swab. Try sticking that baby down your 7-year old's nose. No. Schools should stay closed. .

Its the same in Aus (except of course not as crammed) - but if they close schools necessary occupations will be impacted. If open - then the children will act as spreaders. The evidence so far is they are not as bad spreaders as say they are for the flu and with increased new 15 minute return time on testing (using a simple blood prick) the compromise in my post was thought the best balance. Like I said we all thought we would be in stage 4 lockdown by now - but still hovering stage 2 to 3.

Thanks
Bill

 

[chemisttree]

Ok, you've made your prediction. We'll see.

I’ll slightly amend my prediction. It won’t be the Mayor. It must be the Governor. The Mayor doesn’t have the authority. It might also come from the Jersey side.

 

[peanut]

INCREDIBLE. A humble sea worm from Brittany may bring hope to the sick who require respiratory assistance.
Initially tested for organ transplant, the hemoglobin of this worm may come to the aid of the sick who require respiratory assistance, says the report.

.../...

Translation of part of the report:

In a few days, doctors could start testing a hemoglobin extracted from the arenicola, a sea worm found on Breton beaches (photo). "The hemoglobin in this worm is capable of transporting 40 times more oxygen from the lungs to body tissues than human hemoglobin. In addition, it is a universal oxygen carrier compatible with all blood groups," explains Franck Zal, former researcher in marine biology at CNRS and founder of Hémarima, the biotech that developed this molecule.

https://www.lefigaro.fr/sciences/co...WHr6-UXT8kQwQEqtrbsHg9dDTl8r5viBxfi9yG1cXc3QQ

 

[gleem]

I surely hope that the world is taking this pandemic seriously and forming plans to take care of the next one.

We got a message from SARS and MERS but ignored the warning. We could have been farther along on a vaccine or treatment if research on SARS was allowed to continue. That research lost financial support and was discontinued see https://www.cnbc.com/2020/03/05/scientists-were-close-to-a-sars-coronavirus-vaccine-years-ago.html.

 

[phinds]

I surely hope that the world is taking this pandemic seriously and forming plans to take care of the next one.

The only lesson that mankind learns from history is that mankind doesn't learn anything from history.

 

[peanut]

The only lesson that mankind learns from history is that mankind doesn't learn anything from history.

I agree. I just want to support your statement that mankind indeed doesn't learn from history.

Edited by mentor

 

[atyy]

Iceland tested 3% of their whole population (about 10,000 tests) and found that about half of the 218 positive cases don't show symptoms. This looks similar to South Korea.

https://nordiclifescience.org/covid-19-first-results-of-the-voluntary-screening-in-iceland/

In an earlier report. they got 0.86% positive.

If they are screening everyone, 0.86% seems absurdly high for Iceland, since that would be a higher percentage than the 0.6% confirmed cases for Wuhan. I would suspect that these are false positives as @Vanadium 50 pointed out in post #994.

If they are only testing symptomatics, 0.86% is high but at least reasonable. In Guangdong, when testing symptomatics (flu-like symptoms that may or may not be Covid-19), postive cases were about 1/200 to 1/1000.

My understanding is that South Korea does not screen asymptomatics. If they do test asymptomatics, they I suspect they only test the high risk subset, eg. those who are closed contacts of confirmed cases.

 

[Ygggdrasil]

The only lesson that mankind learns from history is that mankind doesn't learn anything from history.

Not all of humankind failed to learn from the past:

In the aftermath of a 2015 outbreak of the Middle East Respiratory Syndrome that killed 38 people and cratered the economy, South Korea took a hard look at what had gone wrong. Among the findings: A lack of tests had prompted people ill with the disease to traipse from hospital to hospital in search of confirmation that they had MERS, a Coronavirus far more virulent than the one that causes COVID-19. Nearly half the people who got the disease were exposed at hospitals.

Korean officials enacted a key reform, allowing the government to give near-instantaneous approval to testing systems in an emergency. Within weeks of the current outbreak in Wuhan, China, four Korean companies had manufactured tests from a World Health Organization recipe and, as a result, the country quickly had a system that could assess 10,000 people a day.

https://www.propublica.org/article/...-testing-while-the-us-fell-dangerously-behind

Ironically, South Korea was able to dismantle burdensome regulations to unleash the power of the private sector, while the American response involved relying on a centralized federal agency (the CDC) to distribute testing while preventing individual states and private companies from developing their own tests.

Various Asian nations (such as South Korea, Singapore, Taiwan and Hong Kong), despite their proximity to China, have been much more successful at containing the COVID-19 outbreak than other nations, and notably many of these were nations that had been hit hard by the SARS outbreak in 2003.

So, some nations were able to learn lessons from past outbreaks, in contrast to other nations that failed to learn or actively sought to dismantle and ignore lessons from past outbreaks.

 

[anorlunda]

Various Asian nations (such as South Korea, Singapore, Taiwan and Hong Kong), despite their proximity to China, have been much more successful at containing the COVID-19 outbreak than other nations, and notably many of these were nations that had been hit hard by the SARS outbreak in 2003.

That sound rational. I think you are correct.

 

[Astronuc]

At this point, we can confirm that the virus has not been contained in the US, and never was.
See world map animation of virus spreading (by cases) - https://www.nbcnewyork.com/news/nat...avirus-cases-spread-across-the-world/2303276/

New York reports 44,635 confirmed cases with 519 deaths (25,398 positive cases in NY City alone). Locally, there have been two deaths from COVID-19, where the individuals were not tested before they were hospitalized (by then they were severely ill). In New York City, doctors and nurses are catching the virus and dying, and in too many cases, they are lacking the proper personal protective equipment. One hospital is putting multiple patients on ventilators/respirators, because they do not have enough equipment.
https://www.nbcnewyork.com/news/cor...ospital-reports-13-deaths-in-one-day/2344831/
https://www.nytimes.com/2020/03/25/nyregion/nyc-coronavirus-hospitals.html
https://www.nbcnewyork.com/news/loc...-19-than-to-homicides-in-all-of-2019/2346703/

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm

 

[Astronuc]

March 20, 2020 - Young people appear to be at greater risk of serious illness from the Coronavirus than initially realized in the U.S. (A week ago) https://www.usnews.com/news/national-news/articles/2020-03-20/coronavirus-and-its-emerging-risk-to-the-young

preliminary data out this week shows that among a sample of 508 patients who were hospitalized for COVID-19 in the U.S., fully 38% were between 20 and 54 years old.

For US:
NBC New York reports 83836 confirmed cases of COVID-19 including 1209 deaths and 681 recovered.
Coronavirus Dashboard reports: 85,498 cases including 1,388 deaths, 252 recovered and 1381 serious cases. I do not know the criterion for serious, but I imagine it probably means ventilators and pneumonia.
CD Update (1645): 93105 confirmed cases - 1546 deaths, 2297 recovered, 1674 serious.
Covidtracking.com reports: 82,286 cases including 1199 deaths, 10465 hospitalized.

New Jersey (1700 EDT) reports: 8825 confirmed cases including 108 deaths, and 16547 negative tests.

 

[OmCheeto]

A visualization of US causes of death
COVID-19 overtook "influenza and pneumonia" on Tuesday, with the current trend it will overtake accidents during the weekend. These numbers are averages, of course. Stay at home orders should reduce the number of accidents at the moment.

That was really fascinating.
I was a bit disappointed that they didn't plot the rest of the curve, which is still pretty much a straight line, so I did it.

It appears that sometime today, it's going from the #5, to the #2 cause of death, here in the US.
In 5 days, it will be the #1 cause of death.
5 days after that, it will kill more people per day than everything else combined.

This disease never ceases to surprise me.

 

[nsaspook]

Some might ask why we are in lockdowns. This is why.

 

[Astronuc]

Michigan Department of Health and Human Services
https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html
Map and cumulative statistics

As of March 27, 2020, 1500 EDT.
3657 confirmed/positive cases
92 deaths
10524 negative tests

 

[chemisttree]

I surely hope that the world is taking this pandemic seriously and forming plans to take care of the next one.

We got a message from SARS and MERS but ignored the warning. We could have been farther along on a vaccine or treatment if research on SARS was allowed to continue. That research lost financial support and was discontinued see https://www.cnbc.com/2020/03/05/scientists-were-close-to-a-sars-coronavirus-vaccine-years-ago.html.

The researcher states:

““We could have had this ready to go and been testing the vaccine’s efficacy at the start of this new outbreak in China,” said Hotez, who believes the vaccine could provide cross-protection against the new coronavirus, which causes a respiratory disease known as COVID-19. “There is a problem with the ecosystem in vaccine development, and we’ve got to fix this.””

So, without testing it for efficacy in humans, this researcher now makes the bold claim that it would provide cross-protection! Interesting if true.

 

[kyphysics]

Question about immunity and two COVID-19 strains:

We've discussed immunity before on a broad level. -----> For those who contract the virus and survive, their bodies develop immunity from the virus' harms in the future.

With two strains - L and S - does anyone know if immunity is specific to just one strain? Thanks!

 

[dlgoff]

Apologies if this has been addressed in this thread. What I understand is that the COVID-19 virus has a fairly short lifetime when in an open environment? I also understand this virus may be seasonal? If those understands are correct, my question is, how does this virus stay potentially infectious after the "off-season"?

 

[Astronuc]

““We could have had this ready to go and been testing the vaccine’s efficacy at the start of this new outbreak in China,” said Hotez, who believes the vaccine could provide cross-protection against the new coronavirus, which causes a respiratory disease known as COVID-19. “There is a problem with the ecosystem in vaccine development, and we’ve got to fix this.””

Since they hadn't seen this virus before December, or possibly before November, I can't image that they would have a vaccine 'ready' now. It seems to take months to develop a vaccine. He could be referring to a general vaccine for coronaviruses, and I think that is the intent going forward - to develop a vaccine that protects against the group of coronviruses and particularly nCov.

BBC, March 17, 2020 - Coronavirus: US volunteers test first vaccine
https://www.bbc.com/news/health-51906604

Scientists around the world are fast-tracking research.

And this first human trial, funded by the National Institutes of Health, sidesteps a check that would normally be conducted - making sure the vaccine can trigger an immune response in animals.

But the biotechnology company behind the work, Moderna Therapeutics, says the vaccine has been made using a tried and tested process.

So someone has already started on a vaccine for 2019-nCoV/SARS-CoV-2.

 

[Astronuc]

Apologies if this has been addressed in this thread. What I understand is that the COVID-19 virus has a fairly short lifetime when in an open environment? I also understand this virus may be seasonal? If those understands are correct, my question is, how does this virus stay potentially infectious after the "off-season"?

I don't think that is known at this point. Considering that the virus (and COVID-19) is affecting populations in 191 or 195 countries, it doesn't seem to mind warm or cold weather! It's effectively spring in the US, and fall/autumn in the southern hemisphere, and we've been watching 2019-nCoV spreading during the winter in the northern hemisphere and summer in the southern hemisphere. And remember, part of the population can host the virus without symptoms to minor symptoms.

The situation with contagious diseases like the flu is that many people are vaccinated, which helps mitigate the spread. Currently, we do not have a proven vaccine for 2019-nCoV, although one or more have been developed and are being tested.

Here's what some models are showing: http://covid19.healthdata.org/projections

Coronavirus COVID-19 (SARS-CoV-2)
https://www.hopkinsguides.com/hopki.../540747/all/Coronavirus_COVID_19__SARS_CoV_2_

• Transmission
  • By respiratory droplets and by fomite. Virus found in respiratory secretions and saliva.
  • Stool shedding also described, but uncertain what role, if any, that plays.
• Incubation period
  • Mean of 6.4 days, range 2-12. For people quarantined, 14d observation recommended to exclude infection, though 24d asymptomatic time from exposure described.
  • Viral shedding occurs following recovery, but unclear what role this plays in transmission.
  • Children and intrafamilial spread appear to be a growing means of transmission.

Fomite - http://www.cfsph.iastate.edu/Infection_Control/Routes/fomite.php
https://aem.asm.org/content/73/6/1687

 

[collinsmark]

Perhaps PF members better versed in microbiology and epidemiology will have a better answer than mine. But for what it's worth, here's my take on it from watching the news and reading as much science on it as I could easily find.

Apologies if this has been addressed in this thread. What I understand is that the COVID-19 virus has a fairly short lifetime when in an open environment? I also understand this virus may be seasonal? If those understands are correct, my question is, how does this virus stay potentially infectious after the "off-season"?

o "What I understand is that the COVID-19 virus has a fairly short lifetime when in an open environment?"

Not too much is known about this, but certainly there's evidence that if an infected person were to cough up a loogie and spit it into a laboratory petri dish, and that sample were to be kept in ideal conditions (precisely controlling temperature, humidity, etc.), then the virus could survive many days.

For more practical situations, the survival time is on the order of hours. More hours for materials like metal and plastic, and less than that for materials like clothing. Probably. Maybe.

If instead we go by other similar viruses (for which we have more data), the virus tends to break down in conditions with high humidity and high temperature. They'll live longer in cold, dry conditions.

o "I also understand this virus may be seasonal? If those understands are correct, my question is, how does this virus stay potentially infectious after the 'off-season.'"

I wish we had more data on that for this particular virus. Some viruses are more susceptible to seasonal changes than others. That fact is we don't have a lot of data how well this virus does in summertime conditions (it's peaking pretty close to an equinox). It has seemed to survived well enough in countries that are presently hot and humid.

 

[collinsmark]

New 3Blue1Brown video.

 

[Astronuc]

I wish we had more data on that for this particular virus. Some viruses are more susceptible to seasonal changes than others. That fact is we don't have a lot of data how well this virus does in summertime conditions (it's peaking pretty close to an equinox). It has seemed to survived well enough in countries that are presently hot and humid.

COVID-19 may have peaked in China, possibly in S. Korea and few other countries. It has yet to peak in the US and parts of Europe. In one of my previous posts, I linked to one model that peaks in mid-April in the US, but that makes assumptions about current cases and deaths, and takes into account various measures, e.g., stay-at-home and social/physical distancing/isolation. Only 21 of 50 states have adopted stay-at-home, and many only in the last week or so. Let's see where we are in 1 week (7 days).

The model was predicting 1542 (1462-1629) by today, but Coronavirus Dashboard reports 1701 deaths in the US as of today; Covidtracking.com (3/27 20:49 ET) reports 1530 deaths (numbers subject to change). I hope we don't see 7000 deaths.

 

[Astronuc]

Another dashboard - https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Looking at the US, in addition to concentrations in the regions associated with major international airports (SEA, SFO, LAX, EWR, JFK, ATL), concentrations show up in metropolitan areas with major airline hubs (e.g., Denver, CO (DEN, United), Salt Lake City, UT (SLC, Delta), Charlotte, NC (CLT, American), Dallas-Ft Worth, TX (DFW, American), Houston, TX (IAH, United)).

https://www.ncdhhs.gov/covid-19-case-count-nc
https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83Looking back to January 30, 2020, which seems like a long time ago,
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf

First confirmed cases of 2019-nCoV acute respiratory disease in Finland, India and Philippines; all had travel history to Wuhan City.

One of the first cases diagnosed in the US was a 35 year old man returning from Wuhan on January 14/15. He was diagnosed in hospital after 4 days of being ill, and confirmed on Jan 20/21. The virus was probably widespread at that point.

 

[atyy]

Question about immunity and two COVID-19 strains:

We've discussed immunity before on a broad level. -----> For those who contract the virus and survive, their bodies develop immunity from the virus' harms in the future.

With two strains - L and S - does anyone know if immunity is specific to just one strain? Thanks!

Whether the 2 strain idea is a useful concept remains to be seen.

 

[atyy]

BBC, March 17, 2020 - Coronavirus: US volunteers test first vaccine
https://www.bbc.com/news/health-51906604

So someone has already started on a vaccine for 2019-nCoV/SARS-CoV-2.

I think we discussed earlier in this thread that Moderna's nucleic acid based vaccine is not the traditional route, and there is no vaccine used in humans that has previously used this approach. Others have mentioned more traditional approaches by Chinese and by Australian groups, but I'm not sure what the status of those are. My personal favourite (not for any scientific reason) that I've seen mentioned earlier in the thread is the MIGAL attempt - they happened to be working on a vaccine for chicken Coronavirus bronchitis, which they will now try to modify for humans.

 

[Ygggdrasil]

Question about immunity and two COVID-19 strains:

We've discussed immunity before on a broad level. -----> For those who contract the virus and survive, their bodies develop immunity from the virus' harms in the future.

With two strains - L and S - does anyone know if immunity is specific to just one strain? Thanks!

As @atyy mentioned, the paper making the claim about two different strains of the virus has been criticized by other researchers in the field:

An analysis of genetic data from the ongoing COVID-19 outbreak was recently published in the journal National Science Review by Tang et al. (2020) 84. Two of the key claims made by this paper appear to have been reached by misunderstanding and over-interpretation of the SARS-CoV-2 data, with an additional analysis suffering from methodological limitations. [...] Given these flaws, we believe that Tang et al. should retract their paper, as the claims made in it are clearly unfounded and risk spreading dangerous misinformation at a crucial time in the outbreak.

http://virological.org/t/response-to-on-the-origin-and-continuing-evolution-of-sars-cov-2/418

According to the Tang paper, the S and L strains they identify are primarily differentiated by two mutations, one in the orf1ab gene and the other in the ORF8 gene. Neither of these genes are expressed on the surface of the virion, so the mutations will not affect immunity to the virus, and I would expect immunity to one "strain" to confer immunity to the other "strain." The spike protein is the main protein on the surface of the virus, so scientists should monitor mutations in the spike protein to find potential mutations that could affect immunity against the virus.

So someone has already started on a vaccine for 2019-nCoV/SARS-CoV-2.

Again, as @atyy mentioned, neither Moderna nor any other company has been able to make a successful vaccine based on their new technology. Their technology leads to very rapid and flexible vaccine development (their main advantage over conventional techniques and why they have been first to start clinical trials), but their approach to vaccine development remains unproven. Here's a good article describing Moderna's technology as well as discussing where it has failed in past attempts to develop a vaccine: https://www.nature.com/articles/d41586-019-03072-8 [edit: original version had the wrong link]

Here's a good article updating progress towards development of COVID-19 therapies: https://www.statnews.com/2020/03/19...oronavirus-drugs-and-vaccines-in-development/

In addition to Moderna, CanSino Biologics (a Chinese company) has begun Phase I Clinical Trials to examine the safety of their vaccine candidate. Various other companies are developing vaccine candidates (based on both new technologies and traditional technologies), but these other efforts remain in the preclinical testing and development phases.

 

[Astronuc]

Just how bad is it?
New Jersey Department of Health - Volunteers with qualified medical training and experience needed. !
https://covid19.nj.gov/volunteer

 

[mfb]

Italy's new cases have been stable for a week now.

As expected, Italy prepares for a lockdown extension beyond April 3, but the situation could already improve by that time.

----

It's a reddit comment, so no way to check claimed credentials ("I am a physician"), but here is a discussion of mutation rate. In summary, it's expected that vaccines will work and re-infection is unlikely.

----

The state of New York has 1/3 the population of Italy, but already 1/2 the reported cases. I scaled Italy's numbers by the population ratio. Italy reached 149 adjusted deaths by March 8, New York reached 157 by March 23. I shifted Italy's numbers by 15 days and then plotted everything on a logarithmic scale. Too early to tell how the deaths evolve, especially as New York might have missed some earlier deaths. New York is accumulating confirmed cases quicker than Italy.

 

[atyy]

https://www.sciencemag.org/news/202...avirus-big-mistake-top-chinese-scientist-says
Not everyone will agree with the comments on masks, and probably the WHO messaging is somewhat inaccurate on this point (ie. the truth is probbaly quite nuanced and context dependent between both positions). But I am posting this link not so much for the mask comment (let's avoid revisiting that controversy), but for the rest of the interview which is well worth a read.

 

[wukunlin]

https://www.sciencemag.org/news/202...avirus-big-mistake-top-chinese-scientist-says
Not everyone will agree with the comments on masks, and probably the WHO messaging is somewhat inaccurate on this point (ie. the truth is probbaly quite nuanced and context dependent between both positions). But I am posting this link not so much for the mask comment (let's avoid revisiting that controversy), but for the rest of the interview which is well worth a read.

That link is behind a proxy in NUS

 

[Ygggdrasil]

It's a reddit comment, so no way to check claimed credentials ("I am a physician"), but here is a discussion of mutation rate. In summary, it's expected that vaccines will work and re-infection is unlikely.

I agree that most of the available data points to relatively few mutations accumulating in the virus, so viral mutation to avoid immunity is not a huge concern. In studies with monkeys, infection with COVID-19 provides immunity to the disease in the short term, so re-infection is unlikely and a vaccine should be able to produce immunity. Still, viral mutation can be unpredictable (especially if the disease becomes very widespread, providing more opportunities for mutation), so this is something that scientists are monitoring by sequencing the virus and looking for mutations in the spike protein.

However, 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 immunity to these viruses wanes over time and studies on people who were infected by the similar SARS virus also suggests that levels of antibodies against the virus wane over the course of a few years. Of course, no data is available for COVID-19, but this is definitely a concern that scientists will need to monitor in the years to come.

 

[atyy]

That link is behind a proxy in NUS

Sorry, have edited the link.

 

[atyy]

It's a reddit comment, so no way to check claimed credentials ("I am a physician"), but here is a discussion of mutation rate. In summary, it's expected that vaccines will work and re-infection is unlikely.

Similar comments are made by Trevor Bedford in this Twitter thread.
"A thread on #SARSCoV2 mutations and what they might mean for the #COVID19 vaccination and immunity, in which I predict it will take the virus a few years to mutate enough to significantly hinder a vaccine."

 

[mfb]

I hope we have a good eradication campaign before that.

 

[bhobba]

My understanding is that South Korea does not screen asymptomatics. If they do test asymptomatics, they I suspect they only test the high risk subset, eg. those who are closed contacts of confirmed cases.

Here in Aus they have only recently started testing asymptomatics as part of better tracing protocols - if you have been in contact with a known case you are now tested regardless. As I mentioned in a post a politician was found asymptomatic, and even in quarantine feels perfectly well. But it has to be said saying you are feeling fine, and simple things like asking you to open your mouth and seeing your throat is hardly a thorough physical. So far the asymptomatics they have found are a small number - but that may change in time.

Thanks
Bill

 

[kyphysics]

As @atyy mentioned, the paper making the claim about two different strains of the virus has been criticized by other researchers in the field:

http://virological.org/t/response-to-on-the-origin-and-continuing-evolution-of-sars-cov-2/418

According to the Tang paper, the S and L strains they identify are primarily differentiated by two mutations, one in the orf1ab gene and the other in the ORF8 gene. Neither of these genes are expressed on the surface of the virion, so the mutations will not affect immunity to the virus, and I would expect immunity to one "strain" to confer immunity to the other "strain." The spike protein is the main protein on the surface of the virus, so scientists should monitor mutations in the spike protein to find potential mutations that could affect immunity against the virus.

Again, as @atyy mentioned, neither Moderna nor any other company has been able to make a successful vaccine based on their new technology. Their technology leads to very rapid and flexible vaccine development (their main advantage over conventional techniques and why they have been first to start clinical trials), but their approach to vaccine development remains unproven. Here's a good article describing Moderna's technology as well as discussing where it has failed in past attempts to develop a vaccine: https://www.nature.com/articles/d41586-019-03072-8 [edit: original version had the wrong link]

Here's a good article updating progress towards development of COVID-19 therapies: https://www.statnews.com/2020/03/19...oronavirus-drugs-and-vaccines-in-development/

In addition to Moderna, CanSino Biologics (a Chinese company) has begun Phase I Clinical Trials to examine the safety of their vaccine candidate. Various other companies are developing vaccine candidates (based on both new technologies and traditional technologies), but these other efforts remain in the preclinical testing and development phases.

I appreciate your answer and thoughts even if I do not understand the science behind it. I do, however, understand the broad gist of what you were saying. Thank you.

A follow-up for you or anyone else is whether we can still, in theory, get a mutated new strain in the future that would make survivors with immunity to the current strain once again susceptible to getting sick from that new strain?

If I'm not mistaken, the Spanish flu had a second wave that involved a mutated new strain, which was much more virulent than the first strain, no? What I am not sure of is whether those immune to the Spanish flu's first strain were still immune to the next wave.

 

[bhobba]

I hope we have a good eradication campaign before that.

Well at least in Aus everything looks like its on track - we are still in level 2-3 measures, not a total level 4 lockdown everyone thought we would be in by now. It seems the rate of infection is slowing. But I still believe they have not handled this as well as they could have - look at Taiwan. If we did what they did we would be in much better shape, not necessarily much health wise, but certainly economically. Still Taiwan had the SARS experience to draw on - we didn't. The good news here is they are, finally, isolating in Hotels every single arrival from overseas and police, instead of just warning people that violate social distancing rules etc, are now fining them. But some are still ignoring rules eg a large group of people have been spotted ignoring social distancing outside a restaurant at Canungra. Nice place - the sort of not well known outside Aus tourist attraction those visiting should go to - but we all must follow the rules - takeaway only for restaurants:
https://www.mustdobrisbane.com/features/day-tripping-canungra

Thanks
Bill

 

[wukunlin]

But I still believe they have not handled this as well as they could have - look at Taiwan. If we did what they did we would be in much better shape, not necessarily much health wise, but certainly economically. Still Taiwan had the SARS experience to draw on - we didn't.

Not wanting to take anything away from the excellent job done by Taiwanese health workers, but if any country wants to look for a gold standard, they might want to know that citizens of PRC were not allowed to apply for individual travel visa to Taiwan since Augest last year (reasons being political shenanigans), so they could only travel to Taiwan in tour groups, and all tour groups in China were canceled on the 24th of Jan. After that the only people who could go to Taiwan from China, were Taiwanese returning. And all the Taiwanese in Wuhan were trapped there, because more political shenanigans.

 

[mfb]

Do we have some data what happens to asymptomatic cases over time? People who get sick seem to be infectious as long as they have symptoms and then a little bit beyond that. But that approach is meaningless for people who never develop symptoms.