OT: Corona virus

[GetAssista]

ORIGINAL: Sardaukar
I was detained for 3 days for suspected COV-19...our legistlation is bit rude when it comes to that [:D]

Were you tested, or just detained?
3 day detention is far too short for the incubation period of COV-19

I have friends who maintain a voluntary stay-at-home quarantine after a recent trip to northern Italy. Apparently Netherlands Google is more than ok with that.

[Canoerebel]

3/4/20

Number of new cases worldwide up about 2,500 yesterday, which was the same on March 1.

Number of cases in China up less than 200 yesterday, and basically level there for the past several weeks. The chart at lower right, showing total cases in Mainland China, leveled off and has remained level. (It can't ever "drop," because it shows total cases reported.

In the USA yesterday, the total rose from about 91 to about 123. That's 33%, so enough to get attention. It'll be important to see the new cases reported today.

But, overall, if China is reporting true, then the virus has shot its wad there.

And, if the reports are true, the virus doesn't seem to be mushrooming in the west. It's increasing, and its spreading, so it's out there. But its not yet acting like its rampaging through the population unchecked.

Or am I misreading? Or is it too early to know for certain?

[MakeeLearn]

Face masks, hand sanitizer, toilet paper: Coronavirus panic shopping hits American stores


https://www.msn.com/en-us/money/markets ... li=BBnb7Kz


"Americans across the country are stocking up on hand sanitizer, cleaning wipes, toilet paper and other products to prepare for the spread of Coronavirus."

[MakeeLearn]

Why The Death Rate From Coronavirus Is Plunging In China

https://www.npr.org/sections/goatsandso ... g-in-china

"According to the China CDC study, among patients whose symptoms started between Jan. 1 and Jan. 10 the death rate was 15.6 percent. But it was just 0.8 percent among those who didn't get sick until Feb. 1 to Feb. 11.

That pattern of progressively dropping death rates is one we're likely to see in other countries.

In other words, there's a good chance the fatality rate in nations with good health systems will end up being a lot lower than what was first seen in China.

Still, it's worth noting that even after China got the death rate down to 0.7 percent, or even 0.4 percent, that's still about four to seven times greater than the death rate for seasonal flu. (The rate for the flu is about 0.1 percent – or 1 in 1,000 patients.)"

[GetAssista]

ORIGINAL: MakeeLearn
That pattern of progressively dropping death rates is one we're likely to see in other countries.

In other words, there's a good chance the fatality rate in nations with good health systems will end up being a lot lower than what was first seen in China.

This is exactly why you would want to follow the prevention measures list. The aim is not to avoid being infected, this is pretty hard given the nature of the decease. The aim is to be among the later infected people, so you would come for treatment when there is experience and facilities already in place.

[MakeeLearn]

US fears drug shortages after India restricts exports due to coronavirus disruption

https://theprint.in/world/us-fears-drug ... on/375080/


"“India has restricted the export of 26 active pharmaceutical ingredients for export, which represents about 10% of their export capacity,” U.S. Food and Drug Administration Commissioner Stephen Hahn told Congress at a hearing Tuesday in Washington."


"Though India is the source of about 20% of the world’s generic-drug supply, the country is dependent on China for about 66% of the chemical components needed to make them. A recent analysis by the Indian government found that as many as 450 drug ingredients could be affected by China’s efforts to contain the Coronavirus, which include a complete lockdown of Hubei province, a center of the country’s drug industry."

[RangerJoe]

It sounds like a new source or sources of those drug precursors need to be found or built . . .

[Kull]

ORIGINAL: Kursk1943

I'm a bit sceptical about the validity of theses numbers, because people on such ships really don't represent the average. I once was on such a cruise ship with my mother and I was one of the youngest there being 50...[X(] I think the infection rate and the mortality rate is a lot higher with very old people.
In the news yesterday our secretary of health stated that they found out that a lot of people never know they have the virus because they don't develop any symptoms at all. Therefore the mortality rate is suspected to be much lower if you included all these cases, too. The actual mortality rate is calculated in relation to people showing symptoms.

The point was to look at a controlled environment where you have:
- a known starting point
- a known period in which it was able to spread unhindered
- tests performed on 100% of the "subjects of the experiment" (so we aren't guessing as to how many "might have it")

Of the entire analysis, the most interesting part (to me) was the low infection rate (19%), despite the fertile breeding ground. Especially given all the fear-mongering about how this thing spreads so easily.

Also, you contradicted yourself by saying the infection rate in my analysis was too low since it would be "a lot higher with very old people" and then telling us that your anecdotal experience shows that cruise ships populations are composed of older people.

[Chickenboy]

ORIGINAL: MakeeLearn

"According to the China CDC study, among patients whose symptoms started between Jan. 1 and Jan. 10 the death rate was 15.6 percent. But it was just 0.8 percent among those who didn't get sick until Feb. 1 to Feb. 11.

That pattern of progressively dropping death rates is one we're likely to see in other countries.

The CDC is focusing on the CFR from Korea as a better starting point for understanding the disease process than assuming the Chinese numbers' verity. As such, the numbers I heard discussed yesterday were 0.2-0.4%, approximately 1/10th the ballyhooed 2-4% CFR from the early Chinese numbers. This needs to be emphasized: breathless knee-jerk assumptions about what the CFR is / will be for everyone ex-China were significantly inflated. If media is responsible, they need to dial down their 'we're all gonna die!" context for responsible discussion of this situation.

That being said, a 0.2% CFR would be approximately twice as high as a bad influenza year. So that's the context that I'm working from-this will be a really bad 'flu' year (CFR-wise) level of mortality globally. But it's in line with many other communicable diseases that have made a comeback on the world stage from time to time.

I'm also very interested to read about the viral mutation seen in the Chinese data. Again, not surprising-coronaviruses will be coronaviruses. But a less virulent human-adapted strain displacing the 'wild-type' COVID-19 would actually be good news from the disease impact perspective. This is what we see with coronaviruses in animal populations: initial exposure to big, bad nasty novel viruses will, in time, be displaced by either vaccine strains or less virulent host-adapted strains.

Of course, this opens up a can of worms on the diagnostic and prevention front.

[Chickenboy]

ORIGINAL: Canoerebel

And, if the reports are true, the virus doesn't seem to be mushrooming in the west. It's increasing, and its spreading, so it's out there. But its not yet acting like its rampaging through the population unchecked.

In general, I agree with this conclusion. Anything that can be implemented to reduce the frequency/ ease of spread with these novel viruses is a good thing. We've seen all manner of travel bans, bans on large congregations, reminders of the importance of personal hygeine, individual quarantines and trace-back contacts, etc. implemented on the world stage with this in mind. One can see a reduction in the rate of spread ("R0") directly correlating to fewer novel cases-or at least decreased velocity of new cases over time.

Domestically, I don't think there's an American that hasn't heard that this thing is running around globally. That's good! Awareness may actually filter through to change human behavior. Several studies that I've done regarding avian influenza control programs come back to this age-old saw: the most difficult thing to do is to change human behavior. It's harder than making vaccines. Harder than making or testing treatments. Harder than coming up with money to thrown at the problem. If you can change human behavior, you can impact the trajectory of these diseases.

[witpqs]

ORIGINAL: Chickenboy
If media is responsible, they need to dial down...

[Chickenboy]

ORIGINAL: PaxMondo
When a virus is in the general population, testing is kinda moot except for people are really ill to determine what (which virus/secondary infection) they have.

Exactly right.

From an interventional / treatment perspective, diagnostic tests are a tool that will help dictate the next course of action. Too many people think that testing for testing sake is worthwhile. Usually it's not. Unless one is trying to determine the next course of action for a choice of available treatments or gain in-depth understanding of disease incidence/prevalance, the information gathered by diagnostic testing is often overrated.

In the case of COVID-19, I have scientific curiosity about how many Americans have been exposed to the virus. But we wouldn't know that unless we had a broad profile of the population tested. So, how many of the 330 million Americans do we need to test for that? Is that the right thing to do now-test millions of people across the board-to assess the trajectory of this virus in the population? Can our laboratories handle that throughput and provide meaningful real-time information based on that study design. I think the answer is no.

We have to assume that the genie is out of the bottle on this thing. Assume that most everyone could have contact with someone that may have been shedding virus at some point or another. Eventually, I'd like to see a big study looking at seroconversion in the population, but that may take months or years to see how many people (or a representative sample) have been exposed. Assume 'lots' and go with that for the time being.

Diagnostics in the face of an outbreak-what we have here-are better suited for interventional strategies. Think flow chart or decision tree. If someone tests positive for X, we assign treatment/prevention Y. What happens if there IS NO treatment/prevention Y? The value of the test and the rationale for the test diminishes.

So with COVID-19, what would we do *differently* with the patient if they test positive with RT-PCR? Perhaps one could argue that there is greater scrutiny about self-quarantine or imposed quarantine procedures. Several health departments have been remitting positive cases or positive contact cases to self-quarantine. I guess I'm OK with that rationale. But would our instructions to 'wash hands, stay home, drink plenty of fluids, avoid social gatherings, etc.' be any different for someone with a high fever and respiratory disease (ala influenza) be so radically different between someone that tested positive versus someone that tested negative on that given diagnostic test? Probably not.

We've got this virus running around. Take heed. Take precautions to limit its spread. Prepare yourselves accordingly. In the absence of a specific treatment or preventive measure (e.g., vaccine), the panacea of widespread testing won't do much to inflect the epidemic curve.

[Chickenboy]

ORIGINAL: witpqs

ORIGINAL: Chickenboy
If media is responsible, they need to dial down...

My car gets 40 rods to the hogshead and that's the way I likes it! [:D]

[Chickenboy]

ORIGINAL: obvert

ORIGINAL: RangerJoe

ORIGINAL: JohnDillworth

The statistics are not giving a good picture of what may be going on. So the U.S. does not look so bad with 100 cases. The problem is is that only 500 people in the U.S. have been tested! 500! So, 20% of all people tested have test positive. I suspect there is a lot more than 100 cases. https://www.theatlantic.com/technology/ ... us/607348/

But who needs to be tested? As far as I know, I've had no contact with anyone who has or had it. I have not traveled. That is the problem, it takes a lot of money to test and without a good reason to do so it will not be done.

One big difference between the US and Europe (and many other places in the world) is the profit oriented healthcare industry in the States.

If containment is improved by testing and self-or-imposed quarantines of known cases, then a profit oriented medical system ends up being very ineffective. It will end up costing more in the long run of course not to splash out on the early stage efforts to test and contain (through increased hospital stays, more missed work time and general panic if numbers go way up, etc).

The large segment of the populace who don't have health insurance will also end up spreading the disease through their reluctance or inability to go in to a doctor and incur fees to be tested. It will also likely hit the poor and uninsured harder due to a higher prevalence of pre-existing conditions.

Meh.

The merits of a profit-oriented healthcare system versus that of a state-run healthcare system are too broad to start a thread about here. There is a role in a public health system / policy system that cannot be filled well by profit-oriented healthcare systems-outbreak disease investigations being a prominent difference in favor of the former.

But you can't look past the 'one size fits all' approach associated with the single-payer systems. These are more prone to rationing of care, decreased expenditures for R&D, decreased expenditures for novel treatment/interventional strategies and overstepping of state rights into individual rights than a more tailored individualistic 'for profit' healthcare system provides.

[MakeeLearn]

Chinese scientists identify two strains of the Coronavirus, indicating it’s already mutated at least once
Published Wed, Mar 4 20207:35 AM ESTUpdated 3 hours ago
https://www.cnbc.com/2020/03/04/coronav ... id-19.html


"The more aggressive type of virus was found to be prevalent in the early stages of the outbreak in Wuhan — the Chinese city where COVID-19 was first detected late last year. "




Structural basis for human coronavirus attachment to sialic acid receptors

https://www.nature.com/articles/s41594-019-0233-y
Published: 03 June 2019

"Coronaviruses cause respiratory tract infections in humans and outbreaks of deadly pneumonia worldwide. Infections are initiated by the transmembrane spike (S) glycoprotein, which binds to host receptors and fuses the viral and cellular membranes."

"Currently, no specific antiviral treatments or vaccines are available to combat any human coronavirus. Furthermore, future cross-species transmission events of coronaviruses seem likely, given the large reservoir found in bats. Studying coronaviruses will therefore help in understanding the principles governing cross-species transmission and adaptation to humans and in preparing for putative future zoonotic outbreaks."

[MakeeLearn]

Schematic representation of a coronavirus particle.
https://www.futuremedicine.com/doi/10.2 ... -2018-0144

[MakeeLearn]

The coronavirus replication cycle highlighting areas where membrane interaction occurs.
https://www.futuremedicine.com/doi/10.2 ... -2018-0144







1) Most Coronaviruseses enter by receptor mediated endocytosis. The positive sense genomic RNA is released into the cytoplasm and translated into the initial virus polyproteins which encode the nsp.

(2) The nsp stimulate the production of DMVs and establish the replication transcription complexes (RTC), which produce the -ve strand replicative intermediate from which more +ve strand genomes and mRNAs are produced. Translation of the N mRNA produces the N protein in the cytoplasm which combines with the new genomes to form RNPs while translation of the remaining structural proteins, M, E and S occurs in the ER where they accumulate in the ERGIC and cis-Golgi.

(3) Virus assembly begins and completes as the protein cargos migrate through the Golgi stacks resulting in new virus particles in vesicles
(4), which eventually fuse with the plasma membrane.

[Canoerebel]

That's what happened on the few occasions I was invited to a high school party. All the guys would be talking about cars or sports, and I'd try to change the topic to the Civil War or butterflies or Olivia DeHaviland.

Conversations stoppers, circa 1978.

MakeeLearn, circa 2020. [:'(]

[warspite1]

ORIGINAL: Canoerebel

That's what happened on the few occasions I was invited to a high school party. All the guys would be talking about cars or sports, and I'd try to change the topic to the Civil War or butterflies or Olivia DeHaviland.

Conversations stoppers, circa 1978.

warspite1

.. ohh I say, is that the time? I've just remembered I've got to go... whoaaah, hold on, did you say Olivia de Haviland... I've just remembered, I don't have to leave after all....


Hubba bubba!!

[Scott_USN]

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is. [&:]