CharonY

While elderly are hospitalized at a higher frequency, it is a wrong assumption to think that younger ones don't. The US is heavily undersampled, so likely the actual values are lower, but recent reports show that as much as 20% of hospitalizations in the US are 20-44 year olds. It is likely that most of them have some pre-existing conditions, but we cannot be sure just yet. Also Germany has infection numbers close to Spain, (though Spain is probably more undersampled than Germany), but the deaths are weird. But yes, for now the plan is to keep the number of active cases in a manageable format. Flu, despite the relative high number of fatalities and hospitalization as a whole is manageable as the season is spread out over a longer time. Ideally the infection will reach mostly young and healthy folks, with more preventative measures for the elderly and those with pre-existing conditions. But since folks cannot behave I am not entirely sure what outside a shutdown will actually work. Sure, some countries did make it work but judging from the behaviour of folks (such as the spring breakers, but also apparently death-defying old folks) I am not entirely how else it can be managed. Some countries implemented measures early on which appeared to be mostly well accepted, but much of the rest of the world apparently are unable to learn from others.

Worse, it is less effective at higher concentrations.

Antibacterial and antiviral activity are lower if no water is present. Depending on microbe or virus, maximum effectivity were observed between 60-80%. Standard disinfection in lab is usually carried out with 70%.

The issue is that they started up late, most of the tests started up sometime around the second week of March. The response as a whole was not different from Italy. As such the outcome so far is more unexpected and could be a considered a lucky break rather than the outcome of some specific measures. The age distribution as well as the fact that in Italy there is more intergenerational contact has been speculated to play a role. However, the other issue is that it has circulated for quite a while untracked and that the testing is still way behind the actual rate. Depending on which metrics you use, Germany is about as old or a smidge older (depending on what age brackets you make).

Studies, including those in the link show an exponential decline within hours (with longer time on plastic surface). While you can recover active particles after a day or so, the number is greatly reduced (and will also depend on humidity temperature and other factors). You are also diluting the amount if you touch it and then touch your face, as each time there is less transfer. But as a whole it does not mean much more than wash your hands after touching stuff.

Death rate is a bad measure until towards the end. The most important measure is the increase and coverage of testing. Germany is not doing too well on either of them. The reason being that there are only mitigating measures in severe cases. I.e. once overwhelmed due to high infections, the system crumbles and deaths increases.

Germany is uncertain. They seemed to have a lucky start but were lagging in tracing and testing at the start. They have ramped up now and the next two weeks or so will provide more info. The current growth is still logarithmic.

Hope you dilute it down to 60-80 % first. There is an antibody based test (several actually) but not sure how well it works and whether they are put to test yet. So far all reinfections are suspected to be failure in tests. There is no strong evidence that folks get sick again (for now).

Phones can be cleaned with isopropanol, for example.

I think it is still the old nationalist thinking- things far away don't affect me. And if it starts I just close the borders and am safe. I am only worried if those close or similar to me are affected. Very human and thus very stupid.

I would exclude Japan from the list for now. They have a very low testing rate and it is unclear whether it is well contained or not. With regard to 5) a key element is that many (if not all) of these countries had a task force established in the wake of SARS. Those have become a central coordination centers for tracking, stockpiling of supplies and so on. What really annoys me is the fact is that while the epidemic raged in China, folks just looked on. It appears that folks still do not understand the concept of globalization. Just because their country dodged the bullet so far, does not make them immune. There were three months during which preparations could have been done, but apparently folks just started to realize it could hit them after Italy.

The trial is not "just" to satisfy regulations-they are to figure out whether they work in the first place. At this point we do not know if any of these work. It does not make sense to mass produce something if you do not know whether it at least elicits a significant immune response. And even then it is not clear whether that response will create immunity, but in an accelerated scheme hundreds to thousands would be tested within phase III (so it is not really waiting - it is data gathering). Again, this is the big thing, the a bit promising is about creating an immune response, and that will be ascertained primarily in Phase II and secondarily in Phase I with a relative handful of folks. The big problem is of course is if after committing to one particular vaccine if folks in PhaseIII still get sick- which could take a while to figure out, depending on exposure in a given test population. Therefore it is important to have several options in the pipeline.

Sounds like the 90 days fast track is for Phase I, similar to the other one. Rather obviously it will (not "potentially") take longer to test efficacy and there is a further timeline before first applications (which would be in the III).

Quarantine is generally applied to infected or potentially infected folks. If tested positive, it can be extended until certain indicators are met.

It is difficult to be certain. Incubation time is an estimate itself is skewed toward symptomatic cases. For example you take the time point of a known contact with an infectious person and look when the secondary infection results in symptoms. The issue of course is if the contact happened in asymptomatic cases the data becomes kind of invisible and in pre-symptomatic cases one need to backtrack the contact, which can be tricky. So essentially those cases can only be estimated. That being said, in the early phases of infection viral particle counts are still low, so there is unlikely a lot viral shedding going on. There have been a handful reports of asymptomatic transmission, so it is a possibility, but data is too scarce so far to be actually certain how likely it is. It does seem to be much rarer than symptomatic transmission, but at the same time, asymptomatic transmission are also somewhat easier missed. As a whole I think the data so far suggests that pre- or asymptomatic transmission is probably not a major driver, but there are a handful of studies (most not reviewed yet and based on secondary estimates) that suggest a bigger role. Unfortunately we do not have certainty either way yet, the disease is just too new.

I am just reading a new paper that tries to provide a better measure of COVID-19 associated symptomatic case fatality risk. The result was lower (1.4%) than crude case fatality calculations (4.5%).

I could find some data, but I am not sure what you ate interested in. So far there is no indication that certain age groups do not get sick. Rather the age distribution follows familial infection clusters. If a family with kids get sick, the kids will eventually be positive. They are more likely to only have mild symptoms and may be undersampled. So co-infection with influenza and sars-cov-2 has actually been reported. However one potential issue is that one test is based on isolating RNA and performing an RT-PCR. If you have a high Influenza titer they influence the detection of sars-cov-2 RNA (with the RT step usually being the limiting factor). Differential analysis can distinguish them but can be difficult for standard test labs.

That makes perfect sense, cheers.

I have not looked at the particular paper, but there have been quite a few over the last decade (especially on norovirus, I believe) that support antibacterial as well as antiviral effects. It is at least plausible that it also applies to coronaviruses (though probably more info is needed).

There are a few hypotheses and studies on the mechanisms, but no super obvious answers yet. Some studies suggest that radical development (as with many other metals) may be a feature, but the slow rate in the absence of active metabolism (and in dry systems) has made some question the likelihood for viral killing. One common observation is that the genetic material seems to degrade over time. Some suspect that released copper ions result in oxidizing reactions with proteins which ultimately also affect DNA stability and there are a couple of others around. But as a whole it has been pretty well established that contact killing by copper is a reproducible effect and that it is also typically dose-dependent. There are also studies showing viral reduction on steel, but the reduction is usually slower than on copper (with some bacteria results are similar).

But the good news is that with multiple directions to develop a vaccine we might have an better idea what works better.

Well, that depends. When it comes to vaccines much of the donkey work is done anyway. E.g. safety of certain adjuvants or delivery methods is pretty well established, though it is still generally required to provide data that in combination they still remain safe (but requirements at that point are fairly low). Assuming it was effective to begin with, the question with mutations is why it renders it ineffective. And it is possible that new antigens need to be targeted then. And then one has to check whether the new target is actually effective.

Nah, folks don't panic, they just stock up on essentials, like toilet paper.. oh. But in all seriousness, the turnaround for vaccines is usually quite a bit faster as desired reaction is (i.e. showing immune responses) is fairly easy to measure (at least in principle). According to Pharm folks quite a few assume that the vaccine is not going to be used recurrently so there is a focus on cheap and easy. With the accelerated stream efficacy can also be tested faster which basically can allow a fast rollout of phase III. Essentially first a few hundred than a few thousand folks will be treated and tracked. There it will show whether there is a likely acquisition of immunity (i.e. in essence it is already a low roll out of vaccination and at least theoretically this could could happen this year). Say May/June first safety results, if all is well on accelerated Phase II say two months to ensure that titers are there and high enough to indicate immune response. While results roll in start recruiting and one might have the first rollout for III maybe as early as August (say a few hundred patients). If efficacy and safety is still alright at this step a next wave could roll out a few months later with a few thousand patients. While the vaccine is not available for the population as such, I am pretty sure some would claim at that point that success at this point already. However, in principle we would need more time to gather sufficient info from Phase III to evaluate how much protection the vaccine actually delivers. That could be tricky as at that time it is possible if not likely that the number of infections are already declining. Actual full production and rollout normally proceeds after it is known to offer at least some level of protection. One should also not neglect the psychological value of the development itself. It provides folks with a sense of potential control over the situation and even if it does not come out in time, at least it feels like someone is doing something. Oh, and I should add that the accelerate trials are (AFAIK) all sponsored by the respective governments, so it is not like the involved companies are hurting from doing it.

As usual, I am going to guess what you might mean. If the question is whether it is profitable if it gets developed but too late, the answer is how likely the disease is to become either endemic or perhaps seasonal. In these cases a working vaccination could be quite profitable. In a broader sense, many of these trials do not make money. This is part of the inefficiency of the pipeline and this is why most companies only commit after at least very promising pre-clinicals. In that respect these approaches are not very different from other biomedical pipelines. SARS vaccines were in development for a long time, but some shut down because there were no major outbreaks and money dried up, for example. Other than that, having more things in pipelines is generally a good thing, especially novel ones.

Actually there are several concurrent bets on the market, assuming that is what you meant.