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Discussion in 'The Watering Hole' started by Winston, Jan 26, 2020.
Here is a hobbyshop:
It came from Mars:
This was interesting:
It's still safe to go to P.F. Chang's
Yep, according to the study I linked to above:
We report here that pathogenic human coronavirus 229E remained infectious in a human lung cell culture model following at least 5 days of persistence on a range of common nonbiocidal surface materials, including polytetrafluoroethylene (Teflon; PTFE), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber, and stainless steel.
So, if you can manage to get something from an infected person in China to you in under that time, that might be a concern. However, this virus is going to have a huge economic impact in China because its killing business in general and a major Chinese holiday business boom specifically with many millions staying indoors... until they need to go out for food.
Patient zero was from Wuhan and had not visited the wet market, but neither the Vox.com summary nor the Lancet study say exactly WHERE in Wuhan he was from. From the Lancet study:
The symptom onset date of the first patient identified was Dec 1, 2019. None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases. The first fatal case, who had continuous exposure to the market, was admitted to hospital because of a 7-day history of fever, cough, and dyspnoea. 5 days after illness onset, his wife, a 53-year-old woman who had no known history of exposure to the market, also presented with pneumonia and was hospitalised in the isolation ward.
Great summary of Lancet study:
Did China downplay the coronavirus outbreak early on?
A new study shows the virus took off weeks earlier than Chinese officials have suggested.
27 Jan 2020
A new study, published on January 24 in The Lancet, helps explain why. The authors — Chinese researchers, and doctors working in Wuhan — paint a very different portrait of the first days of the outbreak. They suggest the virus, and its spread among humans, took off weeks earlier than Chinese officials said.
The researchers reviewed the clinical charts, nursing records, lab findings, and chest X-rays of the first 41 patients who had confirmed 2019-nCoV infections. Among other things, they reported that the first case of 2019-nCoV wasn’t even linked to the Huanan Wholesale Seafood Market at the center of the outbreak.
These discrepancies add new urgency to a question many are already asking: Did China downplay the outbreak early on? [Apparently - W] And if so, why? [Because it's a totalitarian regime and they can? Ya' think? - W]
There are a few key differences between China’s early reports of this outbreak and the findings in the new Lancet study focused on the first 41 patients. These are the most concerning:
1) More than a third of the earliest cases had no connection with the market.
As you can see from this Lancet chart, by the time China alerted the world about the outbreak, on December 31, there were already numerous cases detected with no connection to the Huanan market.
2) The outbreak’s first, or “index,” case also had no connection to the market.
Even more intriguing, the first known patient — represented in the blue bar on the left in this graph — also had no market exposure. And that person became ill on December 1, nearly two weeks earlier than Wuhan health authorities had suggested about the first case. The study also reports, “No epidemiological link was found between the first patient and later cases.” So not only did a sizable portion of the early cases have no market link, the first known patient didn’t either — and no one knows how that person became infected.
This indicates spread of the virus in Wuhan was likely happening months sooner, as early as October, Daniel Lucey, an infectious diseases physician and adjunct professor of infectious diseases at Georgetown University Medical Center, told Vox. It also indicates that there may have been multiple places in the food supply chain where people were exposed to animals with the virus, he added.
“There’s two possibilities if they did not get infected at the market: They got infected from an animal that had the virus in a different market or any place where there was an infected animal. Second, they got infected from another person — so there was already person-to-person spread.”
[for the rest, see it at the link]
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
TRF should be running ads for Purell.
Almost time for the Amber.
My local radio reported cases in Canada and the U.S. The Canadian case was confirmed to have travelled to China in the last two weeks.
Only if you can handle the fat and sodium load. Darn, that food is high in salt.
BINGO and there is a shot for that. People avoid the shot and it will give around 50% protection. Every year Pneumonia and Flu fill more but we ignore that.
A friend posted that on Facebook. My reply was that everyone in our household already got a shot for that. But, when I daily work with the elderly and regularly visit nursing homes, our daughter works in several healthcare facilities, my wife is immune suppressed, and we're both over 50, a new strain of "flu" that is particularly lethal to the elderly, people over 50, children, and anyone who is immune suppressed, certainly gets my attention.
CDC/NIH public briefing in progress which I'm listening to while posting this.
Containing new coronavirus may not be feasible, experts say, as they warn of possible sustained global spread
JANUARY 26, 2020
Some infectious disease experts are warning that it may no longer be feasible to contain the new coronavirus circulating in China. Failure to stop it there could see the virus spread in a sustained way around the world and even perhaps join the ranks of respiratory viruses that regularly infect people.
“The more we learn about it, the greater the possibility is that transmission will not be able to be controlled with public health measures,” said Dr. Allison McGeer, a Toronto-based infectious disease specialist who contracted SARS in 2003 and who helped Saudi Arabia control several hospital-based outbreaks of MERS.
If that’s the case, she said, “we’re living with a new human virus, and we’re going to find out if it will spread around the globe.” McGeer cautioned that because the true severity of the outbreak isn’t yet known, it’s impossible to predict what the impact of that spread would be, though she noted it would likely pose significant challenges to health care facilities.
The pessimistic assessment comes from both researchers studying the dynamics of the outbreak — the rate at which cases are rising in and emerging from China — and infectious diseases experts who are parsing the first published studies describing cases to see if public health tools such as isolation and quarantine could as effective in this outbreak as they were in the 2003 SARS epidemic.
“Despite the enormous and admirable efforts in China and around the world, we need to plan for the possibility containment of this epidemic isn’t possible,” said Neil Ferguson, an infectious diseases epidemiology at Imperial College London who has issued a series of modeling studies on the outbreak.
One of the luckiest breaks the world got with the SARS outbreak was the fact that the virus did not transmit before people developed symptoms. [not so with this virus; according to the Chinese its incubation period is 10 to 14 days, and it is contagious during that time. - W]
With some diseases, like influenza and measles, people who are infected but who are not yet feeling sick — people who are still going to work or school, taking public transit, shopping in malls, or going to movies — can pass the viruses to others.
“If it’s not contained shortly, I think we are looking at a pandemic,” Bedford said, though he cautioned that it’s impossible to know at this point how severe that type of event would be.
Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins School of Public Health, urged countries to start planning to deal with global spread of the new virus. Such plans need to include far more aggressive efforts to develop a vaccine than have already been announced, he suggested.
“I’m not making a prediction that it’s going to happen,” Inglesby said, though he noted the mathematical modeling, the statements from Chinese authorities, and the sharply rising infection numbers make a case for this possible outcome. “I think just based on those pieces of limited information, it’s important for us to begin some planning around the possibility that this won’t be contained.”
Stats for early 28 Jan 2020:
4,515 Cases confirmed worldwide
106 Dead worldwide
2714 Cases in Hubei (up 1291 overnight - a stunning 91% surge)
100 Dead in Hubei (up 24 overnight - a 24% surge)
North Korea closes Chinese border
Germany reports first case
US raises travel alert for China to Level 3 (2nd highest)
*If* the Chinese numbers are accurate. But, as the video I posted earlier pointed out, China's numbers are suspect. If there are only 2700 cases in Wuhan, a city the size of London with 14,000 hospital beds, then why are hospitals overwhelmed and running out of supplies, and why does China have a crash construction program to build two new hospitals with 3000 more beds? Something doesn't add up.
Then again, even with the numbers currently available, why are other nations, including ours, even allowing flights from hot zones to land, or at least to de-plane passengers? Especially true if, as reported, carriers can be asymtomatic *and* contagious for up to two weeks.
This looks like a job for Torchwood....
Exactly. In the pathologist video I posted, he found that there are over 20k hospital beds in Wuhan alone and yet there are images everywhere of people sitting in hallways, some with dead bodies. The huge problem with this virus is that it is contageous during it's apparently long gestation period. BTW, the CDC/NIH briefing I'm listening to indicates they are really taking this seriously. Screening at US airports has been increased to 20 airports, but with the long asymptomatic gestation period...
As usual, because of M-O-N-E-Y. If this doesn't turn out to be a pandemic, it's already predicted to have significant economic impacts, especially in China.
Interesting comment by CDC/NIH just heard in answer to a question- they have received no official stats/data from China about asymptomatic transmission. They also say that pandemics have always been primarily driven by symptomatic transmissions. They plan to send a tiger team as part of NHO to China.
The briefing this morning:
Health Secretary Alex Azar is joins Robert Redfield, the director for the Centers for Disease Control and Prevention, Nancy Messonnier, who directs the National Center for Immunization and Respiratory Diseases, and Anthony Fauci, director for the National Institute of Allergy and Infectious Diseases.
I'd like to throw out this post from Derek Lowe's "In the Pipeline" blog: https://blogs.sciencemag.org/pipeline/archives/2020/01/27/coronavirus
Derek is a thoughtful, experienced, medical research professional who is NOT prone to hyperbole. He provides a nice set of links within the post to legit scientific sources, and respected medical research/healthcare news sites.
I for one agree with the belief put out in the "Stat" article linked therein that we are likely past the point at which containment is a viable alternative, and that we now have another human virus that is and will remain in circulation going forward. Therefore, personal preventive behavior (wash your freakin' hands, and don't try to shake mine), treatment and vaccine development should be the points of focus. To be honest, I'm personally more worried about the impacts of mass human panic and the resultant behaviors than I am the actual pathogen. Admittedly, were I 80 years old with a history of pulmonary issues the pathogen would worry me far more.
Disclaimers and Disclosures:
- Derek is an organic chemist who does drug discovery research, and got his Ph.D. from Duke...all things we have in common, so maybe I'm biased to his point of view.
- My day job (and what I think about much of the rest of the time) is drug discovery, but I do not work in anti-virals or vaccine areas. Nor does the company I work for, so I have no financial irons in the fire here.
- Along the above line, my positions are my own (given on my lunch break), and not those of my employer.
Oops, this angle, if things in China get bad enough, should have crossed my mind, but didn't:
The Coronavirus Is a Threat to the Global Drug Supply
The world's pharmaceutical supply chain is in danger as the virus spreads across China and jeopardizes travel and trade.
28 Jan 2020
“This outbreak just underscores what can happen in a worst-case scenario,” says Amesh Adalja, an infectious disease physician at the Johns Hopkins Center for Health Security, who has warned about the national security implications of a heavy dependence on China and other countries for vital medicine and medical supplies. “Any kind of supply shock or instability would render the drug supply vulnerable,” he says. “With this outbreak, it is concerning whether or not the stability of our supply chain will remain intact.”
My post from 24 Oct 2019:
With text from this article:
U.S. officials worried about Chinese control of American drug supply
"Basically we've outsourced our entire industry to China," retired Brig. Gen. John Adams told NBC News. "That is a strategic vulnerability."
12 Sep 2019
One bit from it:
"If China shut the door on exports of medicines and their key ingredients and raw material, U.S. hospitals and military hospitals and clinics would cease to function within months, if not days," said Rosemary Gibson, author of a book on the subject, "China Rx."
Other generic drugs whose key ingredients are manufactured in China include medicines for blood pressure medicine, Alzheimer's, Parkinson's, epilepsy and depression, Gibson says.
"We can't make penicillin anymore," said Gibson. "The last penicillin plant in the United States closed in 2004."
From The New York Times:
Coronavirus Live Updates: Cases Up Nearly 60%, as Airports Expand Screenings
The number of known cases of the new virus rose by nearly 60 percent overnight. A shortage of test kits has led experts to warn that the real number may be higher.
After repeated offers of assistance, China will allow in international health experts to help with research and containment.
Update (1824ET): Adding additional pressure to American airlines, CNBC just reported that the White House warned airline executives that it's considering suspending all flights between China and the US.
This comes on the heels of United Airlines, the US carrier with the most exposure to China, which has about a dozen daily flights to Hong Kong and the mainland, said it was cancelling dozens of flights. The Chicago-based airline said it has experienced a "significant decline in demand for travel to China."
Several countries, including the US, have been expanding airport screenings for possible virus-carrying travelers. But a complete shutdown of passenger plane traffic would be even more draconian than Hong Kong's strict border controls implemented Tuesday.
In a sign that the Communist Party may have overplayed its hand, more videos depicting violent clashes between Chinese citizens and police have surfaced on [Chinese] social media.
One video, likely taken somewhere in Hubei Province (where the most strict travel bans are being enforced), shows a car ramming a roadblock.
Update (1750ET): Reuters just reported that Thailand has confirmed another six cases of the coronavirus, bringing the total to 14. All six are under observation in a hospital. Five of the six are members of the same CHinese family who traveled from Hubei provine to Thailand for the LNY holiday together. No. 6 is also a Chinese tourist.
Update (1710ET): Minutes ago, as dawn nears in China, state-controlled TV station CCTV reported 25 new deaths in Hubei, and another 840 new confirmed cases (and this time only 315 were in Wuhan). Of the dead, 19 died in Wuhan, 2 in Xiaogan, and 1 each in Jingmen, Ezhou, Huanggang, and Tianmen.
Per CCTV, 3349 patients have been hospitalized in the province. More than 20,000 are still under medical observation.
Across China, the tensions of the LNY cancellations, the holiday extension and the travel bans, and lockdowns, combined with a general sense of hysteria, are leading to civil unrest in some areas.
CDC/NIH briefing said that thanks to genetic technology much more advanced than during SARS and MERS, they've already developed a rapid test kit which they're using, but holding for general release until it proves as accurate as they want (I don't know what the Chinese are using), and Phase 1 vaccine testing will begin soon, lasting three months after which Phase 2 will last more months before release for human use.
Same here, with those issues by far the most likely in China.
24 Jan 2020 data:
Various analyses highlighting potential for sustained human-to-human transmission of #nCoV2019. Current 'estimates' of R0:
- @JulRiou & @C_Althaus: 2.2 (90% interval: 1.4-3.8)
- @JonRead et al.: 3.8 (95% interval: 3.6-4.0)
- @maiamajumder & @mandl: 2.0-3.3
- @nextstrain: 1.5-3.5
The Deceptively Simple Number Sparking Coronavirus Fears
Here’s what the oft-cited R0 number tells us about the new outbreak—and what it doesn’t.
28 Jan 2020
In the past week, at least six teams of researchers, along with the World Health Organization, have published estimates of R0 for the new coronavirus. All these groups used different methods, but their results have been mostly consistent, with estimates hovering between 2 and 3. WHO was a little more conservative than the others, with estimates of 1.4 to 2.5. One Chinese team is a clear outlier, with estimates of 3.3 to 5.5. And a British-led group initially published a high average value of 3.8 last week before revising it downward to 2.5 as new data emerged.
In the intervening time, however, some observers seized upon the 3.8 number, with one Harvard doctor describing it as “thermonuclear pandemic level bad” in a tweet that has since been retweeted more than 16,000 times. That’s a dubious interpretation, and here are six reasons why.
Here’s the latest on the novel coronavirus outbreak in Wuhan
Case counts are jumping quickly as the outbreak continues and testing increases.
28 Jan 2020
There have also been reports of asymptomatic cases in several places. For instance, in a second case report published in The Lancet, researchers identified an asymptomatic case in a 10-year-old boy. The case was discovered in a cluster of infections in a family. The boy’s asymptomatic case was only caught at his parent’s insistence that he be examined and tested. Both of the boy’s parents and three of his grandparents had contracted the virus after the family traveled to Wuhan and visited other sick relatives in a local hospital.
The discovery of asymptomatic cases has led to concerns that infected people with no symptoms may be unknowingly spreading the virus and thwarting outbreak control efforts, such as quarantines. However, it is unclear if this is happening, and experts suspect that, if it is, it may only be a limited source of new infections.
So far, experts suspect that 2019-nCoV mainly spreads through respiratory droplets — sprayed from things like coughs and sneezes — that can then enter the nose, mouth, or eyes of an uninfected individual to cause an infection. It’s still unclear when during an incubation period an infection a person is contagious, though.
The virus appears to mainly be spreading among people who have close contact with each other, such as between family members and from patients to medical staff, and not, say, strangers passing in an airport.
This is a positive sign in terms of outbreak control, as the NIH’s Anthony Fauci described:
"It does not seem to be as efficient in the persistent sustained transmission from human to human... without a doubt it can spread from one human to another. What it doesn’t seem yet to be doing as efficiently—certainly not like influenza, which spreads very efficiently in a sustained way—this does not do so. Which means that, just like SARS, we have the possibility—with good public health measures—of hopefully getting control of it."
British Airways suspends all flights from Chinese mainland after flights repatriating British citizens. Repatriated citizens were immediately put in quarantine.
Some hopeful news:
JANUARY 28, 2020
Coronavirus outbreak could peak in ten days: Chinese expert
Zhong Nanshan, a renowned scientist at China's National Health Commission, told the official Xinhua news agency that the outbreak "will not increase at a large scale."
"I believe it should reach a peak in a week or around ten days," Zhong said.
Zhong told Xinhua that the "fatality rate would certainly continue to fall" even though no cure had been found so far, thanks to life support technology and efforts of researchers and medical workers.
The virus spread quickly through Wuhan because "there could have been many mild cases that were similar to regular colds," Zeng Guang, a member of the health commission's senior expert panel, told state broadcaster CCTV.
But Ma Xiaowei, the head of China's National Health Commission, said Sunday that the virus was "contagious during the incubation period," prompting worries that asymptomatic people could be spreading the disease undetected.
"Compared to SARS, the new coronavirus is more 'cunning,'" said Zeng, who is also the chief epidemiologist of China's Center for Disease Control and Prevention.
Nevertheless, Zeng believed the situation would improve with the onset of warmer weather, which was "not conducive to the spread of infectious respiratory diseases."
Chinese health authorities said many of the people who have tested positive for the virus without showing any symptoms were known close contacts of existing cases, so they were more likely to deliberately avoid public spaces. [that missed the main point - it isn't so much about them avoiding public places - it is about the possibility that people without symptoms did not infect anyone and that, instead, THEY were infected by close contact with someone with symptoms while they simply haven't yet shown symptoms - W]
Since "patients with mild illness tend to show fewer cough symptoms... the transmission ability might not be that strong," said Li Xingwang, chief expert of the infectious diseases diagnosis and research center at Beijing Ditan Hospital. [that further makes the point that since people without symptoms aren't coughing and spewing virus laden droplets into the air or getting them on their hands, they aren't transmitting the virus effectively - in other words, just their breathing isn't infecting the air or their skin as it can with some extremely infectious diseases - W]
I wonder which "Category of life" they will be assigned?
Any idea which "Overflow camp" they will be sent to?
Hopefully they stay out of the modules.
Separate names with a comma.