Corona virus general questions mega thread

[CharonY]

2 hours ago, Sensei said:

Coronavirus has 100% hospitalised rate.

Ok that is clearly wrong. You may be confused by some studies who studied the characteristics of those hospitalized in the first place. Current data suggest that ca. 20% of patients have severe symptoms and are likely in need to be hospitalized. There are potentially more if they have added risk (e.g. other pulmonary issues). While the number are higher than for influenza it is way below 100%. 

Edit: perhaps I should add that the Chinese government implemented a strict quarantine system, where all infected people (I believe) are isolated either in hospitals and/or quarantine systems. In other words, even mild cases would be isolated, whereas the numbers for influenza are only looking at severe cases that need to be hospitalized.

From there, we also see that the rate is similar when it comes to death rates- COVID-2019 is associated with a ~10-20 fold increase of severe cases and death. As shown by the data, the current outcome is still way below the annual effects of influenza, even if only looking at US numbers. It does not mean that it cannot reach or even surpass those numbers eventually, but we are certainly not there yet. As an interesting side note, the CDC numbers also clearly show how undervaccinated folks are when it comes to influenza. Up to half of the population are estimated to contract it with an estimated vaccination coverage of 40-odd percent. 

It should also be noted that there is often an inverse correlation between severity of a disease and its spread. The coronavirus is far more effective in spreading compared to MERS, for example, because its symptoms as a whole are mild for most folks. I.e. similar to flu there is a significant time period where folks can spread the disease without being aware of it. 

[zapatos]

Quote

The Harvard epidemiology professor Marc Lipsitch is exacting in his diction, even for an epidemiologist. Twice in our conversation he started to say something, then paused and said, “Actually, let me start again.” So it’s striking when one of the points he wanted to get exactly right was this: “I think the likely outcome is that it will ultimately not be containable.”...

Lipsitch predicts that, within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, he clarifies emphatically, this does not mean that all will have severe illnesses. “It’s likely that many will have mild disease, or may be asymptomatic,” he said. As with influenza, which is often life threatening to people with chronic health conditions and of older age, most cases pass without medical care. (Overall, around 14 percent of people with influenza have no symptoms.)

https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/?utm_medium=offsite&utm_source=yahoo&utm_campaign=yahoo-non-hosted&yptr=yahoo

[CharonY]

As a side note, from an co-evolutionary standpoint, diseases that have stuck around for a longer time in a population tend to become less virulent over time, due to an ongoing interplay between host and pathogen.

[Sensei]

6 hours ago, CharonY said:

Ok that is clearly wrong. You may be confused by some studies who studied the characteristics of those hospitalized in the first place. Current data suggest that ca. 20% of patients have severe symptoms and are likely in need to be hospitalized. 

From papers that I saw, 26% to 29% of the all infected are admitted to intensive care unit (ICU). Are you making mental shortcut "hospitalized" = "intensive care unit"? 

6 hours ago, CharonY said:

Edit: perhaps I should add that the Chinese government implemented a strict quarantine system, where all infected people (I believe) are isolated either in hospitals and/or quarantine systems. In other words, even mild cases would be isolated,

Yes. This is what I meant. Patient in isolation outside of his or her house, around medical staff monitoring and taking care of somebody = hospitalized. Obviously with increasing number of the cases hospital buildings are running out of space for new patients..

ICU is for unlucky ones in critical conditions..

If a mildly ill patient is not isolated,  it is straight forward route to further infection and spread of viruses to friends, family, coworkers, random people in shops and public transport vehicles, etc.

Edited February 25, 2020 by Sensei

[Externet]

Is it known if this virus is also disseminated by pets, clothing, utensils ?

[CharonY]

16 hours ago, Sensei said:

Yes. This is what I meant. Patient in isolation outside of his or her house, around medical staff monitoring and taking care of somebody = hospitalized.

Well that is then not something you can compare with the influenza data then. There hospitalization is only indicated in severe cases, which roughly corresponds to the ~20% of the case of covid-2019. It is not that they need to be taken care of, it is more that they are monitored to limit spread, which is not the case with influenza. As such it is not an apple to apple comparison. Or was your point not regarding the severity of the disease but regarding the personnel and medical effort put in place in order to contain them? In that case yes, folks are putting more effort into containing the disease than for flu.

[iNow]

2 hours ago, Externet said:

Is it known if this virus is also disseminated by pets, clothing, utensils ?

Utensils, yes. Clothes, maybe, but probably not. Pets, not likely.

See here for more: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

 

Similarly, and given your level of concern, information is power: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Unfortunately, it is getting worse. 
 

https://abcnews.go.com/International/white-house-requesting-125b-part-25b-plan-fight/story?id=69190968

Quote

U.S. health officials issued a strong warning about novel coronavirus on Tuesday -- that it's no longer a matter of if, but when it will spread in the U.S., and that Americans should prepare for a "significant disruption."

<...>

Although the virus "absolutely" has the potential to become a pandemic, WHO director-general Tedros Adhanom Ghebreyesus said it's still too soon to classify it that way.

"For the moment, we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale severe disease or deaths," he told reporters at a press conference in Geneva on Monday. "Does this virus have pandemic potential? Absolutely it has. Are we there yet from our assessment? Not yet."

 

Edited February 25, 2020 by iNow

[Externet]

51 minutes ago, iNow said:

Utensils, yes. Clothes, maybe, but probably not. Pets, not likely.

Thanks, iNow.  Depending on the interpretation of 'utensils' , sneezed-upon products arrived imported from China could complicate the entire global commerce and health with unexplainable origin 😒

That was a good link from an authority voice we should respect away from speculations and social nets.

[CharonY]

8 minutes ago, Externet said:

Thanks, iNow.  Depending on the interpretation of 'utensils' , sneezed-upon products arrived imported from China could complicate the entire global commerce and health with unexplainable origin 😒

Nope, it is a typical droplet infection with similar risks. Utensils are only a higher risk if they have been relatively freshly sneezed upon. It is unclear how high the risk for indirect exposure is, but is not considered the main route. Shipped products have even lower risk. Based on what is known based on SARS-CoV there is no real indication that dried droplets shipped over days post any risk. In order to further minimize risks I probably would not recommend putting random things into your mouth, though.

[iNow]

Yeah, when he said utensils, I’d assumed he was speaking of ones that were just used to eat by an ill person. 

[CharonY]

1 hour ago, iNow said:

Yeah, when he said utensils, I’d assumed he was speaking of ones that were just used to eat by an ill person. 

Yeah I have seen various articles regarding safety of shipment from China. Evidently that has folks concerned. Meanwhile, I tell students not to lick door knobs.

[iNow]

2 hours ago, CharonY said:

Meanwhile, I tell students not to lick door knobs.

Which of course makes it taboo and paradoxically MORE likely they will. Humans are dumb 

[Sensei]

1 hour ago, iNow said:

3 hours ago, CharonY said:

Meanwhile, I tell students not to lick door knobs.

Which of course makes it taboo and paradoxically MORE likely they will. Humans are dumb

Any cigarette smoker "licks door knobs", just indirectly, and inadvertently.. People touch the knob.. and then take cigarette to their lips using the same hands. I am not smoker, but as far as I know, the filter which people put to their mouths is the first thing that you see after opening a new cigarette box, and it's almost impossible not to touch it, to get out the rest of cigarette from the box. You must touch the filter...

Yet another reason to quit smoking..

 

ps. The same with paper money, etc. etc., and smoking..

Edited February 26, 2020 by Sensei

[iNow]

It’s entirely possible to remove a cig from the pack with your teeth, but if you’re smoking then good health is likely not your primary concern or motivator 

Edited February 26, 2020 by iNow

[CharonY]

13 hours ago, iNow said:

It’s entirely possible to remove a cig from the pack with your teeth, but if you’re smoking then good health is likely not your primary concern or motivator 

And also connected to the thread, lung damages and other comorbidities seem to be strongly connected with poor COVID-19 infection outcomes.

[Sensei]

It would be much faster and easier to ask the tobacco industry to place cigarettes upside down. With a detailed explanation of how smokers can become infected with microbes and viruses by simply taking cigarettes out of the box.

[Sensei]

News from Italy about coronavirus. Data from 1 March 2020:

They claim to make over 9000 tests, and confirmed 1600 infected people, 41 people unfortunately died.

Tests were made not only on people with symptoms but the all who had any contact with suspected infected people (that should be obvious method of work).

They made a lot more tests than the rest of the Europe and USA. e.g. USA and France made 400-500 tests, only on people with symptoms.

Italian officials say "we have so many confirmed cases, because we performed the largest amount of tests, but you (i.e. the rest of western world countries) did not"..

 

I heard that some hospitals do influenza test to confirm or reject somebody have influenza (and treat it as indicator of having no coronavirus). Is it wise? What if somebody have influenza and coronavirus, at the same moment.. ? Somebody get flu the first and then is infected with coronavirus from other source, will have influenza test positive, and person blood won't be tested against having coronavirus, so such person will continue spreading it around, unaware of being infected..

 

[dimreepr]

15 minutes ago, Sensei said:

I heard that some hospitals do influenza test to confirm or reject somebody have influenza (and treat it as indicator of having no coronavirus). Is it wise? What if somebody have influenza and coronavirus, at the same moment.. ? Somebody get flu the first and then is infected with coronavirus from other source, will have influenza test positive, and person blood won't be tested against having coronavirus, so such person will continue spreading it around, unaware of being infected..

It's that type of question that makes me wonder...

[CharonY]

On 3/2/2020 at 10:38 AM, Sensei said:

I heard that some hospitals do influenza test to confirm or reject somebody have influenza (and treat it as indicator of having no coronavirus).

Could you provide details in which contexts that happens? I am somewhat aware that in regular influenza seasons clinicians often do not test for viral co-infection, which can be problematic as they actually do occur. However, it is not (or should not be) used as an exclusionary criterion. If they do it right now, I could only imagine that it is due to lack of a reliable test for the detection of SARS-CoV-2 but not sure why else it would happen.

As a side note, several European countries have ramped up testing. So far over 7000 in UK, ~900 France. However, US is definitely lagging behind.

 

Edit: there is a joint report by the WHO, which I finally got to read (together with some interviews and other articles). There is little fundamentally new, mostly a validation of what has been reported earlier, but with better validation:

- Transmission are likely droplet based (little evidence of other means as potential drivers, but still under investigation) and most are family-driven (ca. 80%)

- So far there is no evidence that folks are immune against it

- Most infections of health care workers happened in the early stages, once defenses were deployed. In addition, many happened outside of the workplace (i.e. contracted at home from family members).

- Children are barely affected (2.4% of all cases)

-Conversely over 60 year-olds are at high risk with significant fatality risk, especially if comorbidities exist.

- Many symptoms as in cold are found, most commonly dry cough and fever; running nose is not a symptom, however

 

There is also a closer look at the responses and as a whole there is for example no evidence for internet-fueled speculation of mass-fudged numbers. Another, perhaps rather obvious observation was that the crude death rate was much higher at the beginning of the outbreak. This is mostly because mostly very sick folks were tested and tests had to be ramped up to get a better view on the actual ratio between infections and fatalities. We will see similar things pan out in countries with low test rates. This also contributes to the rather low fatality rates in South Korea (over 66k tested; 4,335 positive cases, 28 deaths).

Some accessory information appear to suggest that despite being heavily overworked in many areas, most folks received good care (there is not information, however, regarding folks that may not have received the needed care due to illnesses not related to coronavirus). Looking at crude fatality rates, early cases had a higher crude fatality rate which declined over time. This has been discussed both in terms of increased detection (which reduces fatality ratios) as well as better handling of care. Various reports indicate massive efforts to track contacts in China combined with high-efficiency testing and same-day reporting. These efforts are apparently less pronounced in other countries so far, which could (in theory) allow broader spread before containment.

[Externet]

Hi.

Is there a proper term for the kind of illnesses that can be contracted only once as the body creates the correct antibody defenses ?

[CharonY]

It is less a property of the pathogen but rather that of the immune response. Specifically, our ability to mount specific responses is called the adaptive immune response and it works against most pathogens. 

[Externet]

Thanks, Charon.

Another stupid question...  Assuming inventing the word "singlill" -or whatever you want- to refer to illnesses that are contracted only once;  can persons who are cured from,  or survive an "singlill" infection episode provide microbiologic basis or sample for a vaccine ?  Like replication of chosen/picked antibodies by another host ?

[PhilGeis]

Vaccine would derive from the infectious agent - not the now immune individual.  Another "host" is not going to replicate foreign antibodies.

[CharonY]

15 hours ago, Externet said:

singlill

Please don't do that. It hurts my eyes. For the rest, what Phil said. One can add that there are antibody therapies in development, but they generally require highly specific antibodies, whereas those antibodies produced by infected folks are very broad range (and not all will be effective).

[iNow]

Apologies if this has already been shared, but it's too good not to be sure. A dashboard with drill-down capability for infections and recoveries from Johns Hopkins:

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6