Coronavirus COVID-19 - Global Health Emergency #4

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BNO Newsroom on Twitter

CDC confirms 15th Case in Texas at Lackland from group that came in from Wuhan on February 7th.

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Here we go...... WHO briefing with ETAs.

  • Press briefing will be short today.
  • Dr. Tetras not there today, travelled to Congo for Ebola outbreak
  • Went over latest number, 46,550. In addition 13,332 clinically in Hubei. They are retrospective numbers... even back to the begining on the outbreak.
  • In Hubei ONLY, COVID 19 can dx on chest imaging which allows them to report quickly so pts get care quickly and contact tracing initiated faster. Backlogs were in testing. It was not a spike in one day.
  • Outside 447 dx from 24 countries and two deaths
  • We need to be cautious from daily reports.
  • Outside the cruise ship,we aren't seeing much spread
  • re 218 pts positive on ship, is largest cluster
  • Mike met at EU meeting this morning (it's on youtube for those that wanna view e.d.)
  • Advance team has done scope and design, and rest of team will arrive this weekend.
Q&A
  • Is it primarily elderly dying changing? No, we are not seeing shift. Severe in those over 40 and increases as getting older in severity. Most are 60,70, 80's.
  • Which research institutions are working on it? A. The group focused on what was most urgent, we listened to front line workers. Demands were better diagnostics for quicker decisions, expand clinical trials to Japan and Singapore and ones existing. We'll try MERS SARS drugs to see if working. Which drug works would be a miracle gift.
  • Ability to do serology tests will allow us to see how big this could get. Better point of care, better data for therapeutics, and identifying the animal source as if we end the epidemic we don't want it to reappear. Vaccines and new drugs will take longer and will take huge investments, hundreds of millions of dollars and we will need to decide and the state sector will need to support the private sector to drive the innovation. We need a vaccine against miscommunication. Social science is also very important.
  • re iceberg analysis, how big is the iceberg? A. In the absence of serology testing in ER's they have been testing thousands of samples and at the moment we are not seeing COVID in samples in Singapore and China. It's speculation, but therefore we think we are knowing of where cases are and it's not so more widespread. If we look outside China, over 400 cases and 4-5 weeks... only 22% evolved from local transmission. All of those cases, only 8 are not linked to our identified chains. Without serology test, we cannot say without absolute certainty how wide in communities.
  • re new counting system A. These are not new cases, they are reclassification of previous "suspect cases" so we don't anticipate the same rise again as yesterday. This is ONLY for Hubei for this definition.
  • SARS-CoV2 name question. A. WHO doesn't name, is a technical name not done by us. We relate the virus to the world, they name it for scientists and virologists.
  • Explain increase in deaths yesterday A. We believe some were related to the clinically dx change going back in Wuhan. We need disaggregated numbers and we'll come back to you on that.
  • How are you working for low capability countries A. We've based our matrix on weaknesses and shared with those countries. risk and vulnerability taken into account. e.g. we did with Ukraine and their measles outbreak. We ID gaps in PPE etc. ability their ability to manage first 100 and first 1,000 cases. We model the costs for each country and will roll out plans that are modeled to those countries. e.g. Western Somao for measles, all the ventilators were being used in the country so we need to support. We worked with EU on this also.
  • Who are members of your team going to China A. there has been agreement on the team, and there is a multinational team who will go to the field. and they will fly in over the weekend and I will not tell the names or nationalities. I will not preempt decisions made by their countries.
  • A. At this stage, almost all cruise ship issues have been resolved. Docked in Cambodia and drs on ship had mild respiratory conditions, all remain on board and is purely precautionary. We have looked at all ships to ensure they have a place to dock. In Japan, a large number in closed environment. Japan tests immediately and takes them local. Negotiations underway that elderly folks are removed from the ship as particularly hard for them to be isolated. Most needy will get off the ship and we are working with Japan. We are still working with them to take care of the welfare of the passengers.
THE END

ETA: I read this am that in Japan, they are testing ALL folks that are 80's, 70's... and now down to 60's and they are offered to get off if they want and quarantine in another place. The couple interviewed said they were in their 60's, but would probably stay on ship due to in the wards, there is a communication issue they have learned...so they are going to stay on ship if offered (and they have a balcony suite ;))
 
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Henry2326 said:
My read on the situation is communist countries don't play well with media outside their own sources. Because its occurring in China and there are less than 20 cases in the U.S., not much to work with. Once it begins to escalate elsewhere, we will see more sensationalism.
Click to expand...

If it begins to escalate elsewhere. SARS really didn’t. This could but I’m not going to expect the worst at this point.

The issue is people are positing that the media is part of a governmental conspiracy to hush this epidemic. As if tabloids can be controlled. Or the Washington Post,
and similar news sources around the nation. How would that even work? There are so many.

Plus we have social media. If there were vast numbers of people dropping like flies there is no way this could be kept secret outside of nations like North Korea. Or is Facebook being controlled too?

I’m nervous about this epidemic but I do think it’s unwarranted hysteria to believe there’s a large scale conspiracy that controls the media and social media worldwide.
 
Hatfield said:
JMO
Right. Besides the fact there is no actual preventative vaccine developed yet, the other important thing that I cringe about when I see a comparison saying the flu kills more each year is this new virus is.....well.....New. And still growing. We are nowhere near having it establish what its eventual overall worldwide impact will be.

The Flu has been around for years and there is much data available for it. With this new virus, we are nowhere near able to tell where this thing is headed. It may end up fizzling out (i hope) or after a few years, we may find the yearly deaths exceeding the flu deaths. We just have no idea yet because its, well, "New".
Click to expand...
I realize that it's a very dangerous virus and has already been catastrophic, especially in China. I was just hoping to put it in perspective at this particular point in time in order to perhaps ease some fears, even if just a little. Can it become worse and the deaths exceed influenza? Absolutely. Could a vaccine be developed to fight it? The answer is also absolutely.
 
sloane7777 said:
GREAT :( welcome to Texas ya'll , where it will spread like wildfire
Click to expand...

Why? These people are in quarantine. The person they’re talking about is under isolation in the hospital. I mean I think we’ve learned from Ebola which is super contagious. No one has both contracted and died from Ebola in the states.
 
LaborDayRN said:
I realize that it's a very dangerous virus and has already been catastrophic, especially in China. I was just hoping to put it in perspective at this particular point in time in order to perhaps ease some fears, even if just a little. Can it become worse and the deaths exceed influenza? Absolutely. Could a vaccine be developed to fight it? The answer is also absolutely.
Click to expand...

I understand and I really do appreciate that we have so many different opinions about this topic. Its what makes the world so great is we are all different.

It helps to have checks and balances here and it is much appreciated. :)
 
asyousay said:
I just love this

London Underground could be a hotbed for coronavirus, doctors say


So the Tube which I use daily could be a hotbed for the illness but “everybody just carry on as normal” :eek:
Click to expand...

If one cases of Covid-19 in the capital is reason to not carry on as normal for the time being, what are 10,000 cases of flu per year in London (I made up that number, I have no idea what the actual yearly flu figures are, but logically I know it's far more than 1).

I would think that after one gets off the tube, or a bus, is a good time to use hand sanitiser, especially if you've been holding the poles.
 
Wow. So she was spreading it around for WEEKS and only tested because she was in critical condition. So how many have mild flu and cold symptoms who never get tested? I have a feeling this is way way more widespread than recognized. Japanese taxi driver who can recall only driving one person who appeared to be Chinese?

dixiegirl1035 said:
Japan confirms 1st coronavirus death as more infections reported

Japan confirms 1st coronavirus death as more infections reported

A Japanese woman in her 80s infected with the new coronavirus died Thursday, becoming the country's first confirmed fatality, the health minister said, as more cases of infection were reported besides hundreds on a quarantined cruise ship near Tokyo. The woman from Kanagawa Prefecture near the Japanese capital, who had not traveled overseas recently, was found to be infected with the virus after she died, health minister Katsunobu Kato told a press conference. She had been diagnosed with pneumonia and hospitalized since Feb. 1, the health ministry said, adding her breathing deteriorated on Feb. 6.....

In Wakayama Prefecture, a surgeon in his 50s became the first doctor in Japan to be infected with the virus, the local government said. It was not known whether he had close contact with visitors from China, the epicenter of the outbreak.

Dead woman found infected with coronavirus | NHK WORLD-JAPAN News

The woman in her 80s, living in Kanagawa Prefecture, near Tokyo, visited a hospital on January 22 as she was suffering from fatigue. Her health conditions had been monitored until she was diagnosed with pneumonia and admitted to the hospital on February 1. Her respiratory condition deteriorated on February 6 and she was transported to another hospital. On Wednesday, her respiratory condition became worse and she underwent a test for the coronavirus. The test result that showed she was positive came out on Thursday after she died earlier in the day. She had no record of overseas travel.

OK, this begs a question. Did they not do scans on her to see the ground glass appearance etc before the test?
Click to expand...
 
Hatfield said:
Excellent summary and questions.

JMO
I know they try to determine an "average" R0 factor, but I especially like this description you gave about R0 which rings true to me because the spreading can be greater in places that have large concentrations of people in small places.....

"The R0 is really a variable - it will be different based on a multitude of factors. Density of population, quarantine procedures, access to healthcare and early diagnosis, etc"

One thing I have been wondering about that may explain a missing variable is if its possible that this Virus affects a certain gene pool more than others or not?

Would there be something unique about a certain group of people that would be more susceptible to the Virus. I am not sure they know enough about it to determine if all humans can catch it equally or are certain groups of genetics more prone to it.
Click to expand...

BBM

One of the Dr Seheult videos went over a study that suggested that once caught, smokers could be far more vulnerable to the effects of the virus. I think that is probably also the case for things like pneumonia?

I think in general it's not so much about the catching it, but about how the body reacts to a virus once the virus is acquired. I haven't seen anything to suggest that things like blood types might have an effect. I would imagine that being a respiratory virus that blood types wouldn't really have an effect. Someone brought up sickle cell anaemia earlier, and I believe that a person who has only 1 copy of the sickle cell gene doesn't suffer from sickle cell anaemia but they do have a better chance of survival against malaria (sorry I should know more about that and I don't). The difference is that that's an issue with blood as opposed to a respiratory virus.

With the swine flu pandemic it was said that people who'd had the Spanish Flu back in 1918/1919 had some immunity to the swine flu, as they both had the same H/N numbers.

Would someone who had SARS, during that outbreak, have some immunity to Covid-19?

I even wonder if someone who's had a coronavirus cold recently might have some immunity to it due to the corona shape of both viruses? I would expect that if this was possible that the main beneficiaries of it would be younger children as they tend to get most colds.

Another issue with viruses like flu and SARS is the potential for a "cytokine storm" which is very dangerous in a patient, and if the virus causes a cytokine storm, then younger people (people under about 50) can be more susceptible to the effects of a virus. Right now what we're seeing in the deaths from Covid-19 does not suggest a cytokine storm response as the majority of the severe/fatal cases do seem to be in older people with other existing conditions.
 
dixiegirl1035 said:
Japan confirms 1st coronavirus death as more infections reported

Japan confirms 1st coronavirus death as more infections reported

A Japanese woman in her 80s infected with the new coronavirus died Thursday, becoming the country's first confirmed fatality, the health minister said, as more cases of infection were reported besides hundreds on a quarantined cruise ship near Tokyo. The woman from Kanagawa Prefecture near the Japanese capital, who had not traveled overseas recently, was found to be infected with the virus after she died, health minister Katsunobu Kato told a press conference. She had been diagnosed with pneumonia and hospitalized since Feb. 1, the health ministry said, adding her breathing deteriorated on Feb. 6.....

In Wakayama Prefecture, a surgeon in his 50s became the first doctor in Japan to be infected with the virus, the local government said. It was not known whether he had close contact with visitors from China, the epicenter of the outbreak.

Dead woman found infected with coronavirus | NHK WORLD-JAPAN News

The woman in her 80s, living in Kanagawa Prefecture, near Tokyo, visited a hospital on January 22 as she was suffering from fatigue. Her health conditions had been monitored until she was diagnosed with pneumonia and admitted to the hospital on February 1. Her respiratory condition deteriorated on February 6 and she was transported to another hospital. On Wednesday, her respiratory condition became worse and she underwent a test for the coronavirus. The test result that showed she was positive came out on Thursday after she died earlier in the day. She had no record of overseas travel.

OK, this begs a question. Did they not do scans on her to see the ground glass appearance etc before the test?
Click to expand...

As I'm only learning about pneumonia symptoms from the Dr Seheult videos I would think that when her pneumonia deteriorated she would have had the scan for the ground glass opacities, but still that wouldn't necessarily mean Covid-19 as opposed to another cause. Perhaps they did check her for other causes and those tests came back negative, so they did the Covid-19 tests as a last resort testing and it unexpectedly came back positive?

What concerns me with this case is the initial date the lady presented to the hospital with fatigue. The longer people have from exposure to fatality means the higher the death rate.
 
sloane7777 said:
I cant find any interviews from recovered victims etc , 6800 in China supposedly recovered per CNN but why aren't we hearing from any and I know this is DM but its scary

Does this satellite image show the scale of China's coronavirus cremations? | Daily Mail Online
Click to expand...

I can't say about China, maybe people are too scared to talk to media about their experiences over there?

But there have been interviews with people outside China. The 'superspreader' guy in Brighton has been released from hospital and is fine. The newlywed man from the cruise ship was getting messages out even while he was in hospital in Japan with Covid-19.

I am sure we will be hearing more from people in countries like the UK and US who survive.
 
Amonet said:
BBM

One of the Dr Seheult videos went over a study that suggested that once caught, smokers could be far more vulnerable to the effects of the virus. I think that is probably also the case for things like pneumonia?

I think in general it's not so much about the catching it, but about how the body reacts to a virus once the virus is acquired. I haven't seen anything to suggest that things like blood types might have an effect. I would imagine that being a respiratory virus that blood types wouldn't really have an effect. Someone brought up sickle cell anaemia earlier, and I believe that a person who has only 1 copy of the sickle cell gene doesn't suffer from sickle cell anaemia but they do have a better chance of survival against malaria (sorry I should know more about that and I don't). The difference is that that's an issue with blood as opposed to a respiratory virus.

With the swine flu pandemic it was said that people who'd had the Spanish Flu back in 1918/1919 had some immunity to the swine flu, as they both had the same H/N numbers.

Would someone who had SARS, during that outbreak, have some immunity to Covid-19?

I even wonder if someone who's had a coronavirus cold recently might have some immunity to it due to the corona shape of both viruses? I would expect that if this was possible that the main beneficiaries of it would be younger children as they tend to get most colds.

Another issue with viruses like flu and SARS is the potential for a "cytokine storm" which is very dangerous in a patient, and if the virus causes a cytokine storm, then younger people (people under about 50) can be more susceptible to the effects of a virus. Right now what we're seeing in the deaths from Covid-19 does not suggest a cytokine storm response as the majority of the severe/fatal cases do seem to be in older people with other existing conditions.
Click to expand...

He speaks to smoking at about 6:00 minutes in. As in China, 48% men smoke 1.9% of women smoke.:eek::eek: We'll see later more info of those outside China I would expect. I've done a google scholar alert for any journal articles speaking to the Princess cruise ship as that info will be very enlightening MOO, and I'll do another general one to see what comes across.

 
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