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COVID-19 outbreak (caused by SARS-CoV-2)


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On 2/20/2020 at 9:39 PM, Casio said:

Not having any understanding of this problem, which seems to be spreading according to the TV news (UK) my main concern (obviously) being me is to ask what is the likely chances of not being infected given that I work with three other UK individuals in a small business. We all live local and we deal with the public in reception each day but most are regular local customers. I've always had a salad lunch and a cooked meal for evening meal. I don't travel much anyway and most of the time stay local to where I live. Is there anything specific to watch out for?

Are you or your family member or friend smoking? If you, your family member, or your friend, answer positively, you can get indirectly infected the way that I described in this post:

Washing hands will just decrease chance. But who is washing hands prior each cigarette? I don't know such person..

Touch money after washing hands, and it is invalidated.. Illusion of having clean hands..

 

Thinking "I am not traveling, so I am safe" is "unwise".. Majority of the all infected people nowhere traveled. They get infected from somebody who returned from travel. Does not have to be foreigner. He or she could be just a tourist or businessman/businesswoman. That person has no idea about being infected. There can be no symptoms.

Somebody traveling to other country can inadvertently spreading virus to new regions which were not infected yet. Airplane is one huge can with bacteria and viruses coming from the all passengers and mixing them together.

Travel to country where are confirmed cases is also not necessary. People get in and out of airplane during long travel with a couple transfers..

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3 hours ago, Sensei said:

Washing hands will just decrease chance. But who is washing hands prior each cigarette? I don't know such person..

As a whole, washing hands has been shown to be one of the most effective measures of disease prevention. In addition, I do not thing that focusing on cigarettes is the most relevant metric (aside from preventing all the health effects of smoking itself). More commonly, everyone touches ones own face. Oberservational studies have shown that folks touch their faces roughly every 3-4 minutes, which can result in direct transmissions from their hands. 

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Nobody I socialize with daily smokes, but handling money is something else. To me something about this vivod 19 or whatever its proper name is seems odd. Some weeks ago I first heard about it and it all started in China as far as the TV news was concerned. Quarantines were talked about and restricting peoples movements within a short period of time, then a few days later (or it appeared that way to me) the news was showing this virus in numerous countries all around the world, infecting thousands of people at that time. It seemed a little too quick for me for the virus to have spread so fast in so many countries and then so many people affected so quickly. It looked to me that the virus had been around much longer than the news presenters had advised the world population. 

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24 minutes ago, Casio said:

Nobody I socialize with daily smokes, but handling money is something else. To me something about this vivod 19 or whatever its proper name is seems odd. Some weeks ago I first heard about it and it all started in China as far as the TV news was concerned. Quarantines were talked about and restricting peoples movements within a short period of time, then a few days later (or it appeared that way to me) the news was showing this virus in numerous countries all around the world, infecting thousands of people at that time. It seemed a little too quick for me for the virus to have spread so fast in so many countries and then so many people affected so quickly. It looked to me that the virus had been around much longer than the news presenters had advised the world population. 

Essentially the moment it was reported there was also some spread due to movement of infected people. At the beginning they seemed to be fairly contained outside of China, but the issue is that not all contacts were known or followed up, allowing further latent spread. This has most likely happened in Italy, when the wider distribution was only known after serious cases popped up. I am not sure where you base your assumption that it is too fast- modern travel can distribute diseases at an incredible rate, especially those that do not have rather obvious or strong symptoms. COVID-19 is such an example as in most folks the symptoms are pretty much the same as any cold and can therefore circulate a while before folks get tested for it. 

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9 hours ago, zapatos said:

I went out to Amazon to see what hand sanitizer was selling for. While all prices are ridiculously elevated, the worst was 36 1-oz bottles for $499.

Must be due to the elevated shipping costs for sending to isolated tribes out there.

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14 hours ago, CharonY said:

Essentially the moment it was reported there was also some spread due to movement of infected people. At the beginning they seemed to be fairly contained outside of China, but the issue is that not all contacts were known or followed up, allowing further latent spread. This has most likely happened in Italy, when the wider distribution was only known after serious cases popped up. I am not sure where you base your assumption that it is too fast- modern travel can distribute diseases at an incredible rate, especially those that do not have rather obvious or strong symptoms. COVID-19 is such an example as in most folks the symptoms are pretty much the same as any cold and can therefore circulate a while before folks get tested for it. 

Indeed, so at what point does the world wide reaction become disproportionate? Not only futile, but so costly that it kills more people than could have been saved by doing nothing; not even informing the people.

For instance, they could've ran a public information film about the dangers of flu, and it's mutations, and the methods of mitigating the chances of infection. So no panic in the stockmarkets, that may lead to an increase in deaths due to poverty, or the supermarkets.

 

 

Not to mention the reduction of deaths due to flu et al.

Today I met a guy that wore gloves, all day, so he could avoid washing his hands more than twice a day; yesterday he washed his hands twice.

Edited by dimreepr
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On 2/24/2020 at 1:58 PM, CharonY said:

I just came across a paper modeling infection numbers in Wuhan under a number of assumption regarding the effectiveness of control measures. They predict that assuming effective intervention, the peak could be reached by late February (with up to 84k cases). Or conversely, if a peak is not observed at that point it could indicate insufficient control to reduce the effective reproductive number.

(Wang et al. Cell Discovery 6:10 2020)

Since we are in March now, I thought it might be interesting to revisit the paper again. Here, the authors created several models to estimate infections in Wuhan, assuming different levels of efficiency in containing the virus. Assuming the containment reduced the transmission of the virus, the infections were assumed to reach a peak between 55k and 84k by late February.

The actual numbers now indicate a maximum of about 50k active cases by February 18. Interestingly, the low estimate by the authors predicted a peak for February 19th with 55k cases, which is remarkably close. As such, it appears the actual scenario has slightly outperformed the most positive scenario.

 

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8 minutes ago, CharonY said:

Since we are in March now, I thought it might be interesting to revisit the paper again. Here, the authors created several models to estimate infections in Wuhan, assuming different levels of efficiency in containing the virus. Assuming the containment reduced the transmission of the virus, the infections were assumed to reach a peak between 55k and 84k by late February.

The actual numbers now indicate a maximum of about 50k active cases by February 18. Interesting, the low estimate by the authors predicted a peak for February 19th with 55k cases, which is remarkably close. As such, it appears the actual scenario has slightly outperformed the most positive scenario.

 

I bet the epidemiologists are all full steam at the moment. I find that side of it pretty interesting and that looks quite impressive to me.

Edited by StringJunky
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20 minutes ago, StringJunky said:

I bet the epidemiologists are all full steam at the moment. I find that side of it pretty interesting and that looks quite impressive to me.

There is a lot going one in various communities, including the medical side, but also the microbiology/virology area. Many manufacturers have also jumped in, and provide e.g. reduced rates or rush orders for research involving the new coronavirus.

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5 minutes ago, CharonY said:

There is a lot going one in various communities, including the medical side, but also the microbiology/virology area. Many manufacturers have also jumped in, and provide e.g. reduced rates or rush orders for research involving the new coronavirus.

I hope it's not just one pharma company getting a lead on a vaccine, as they'll fleece countries medical systems, like Gilead did with their HCV cure not too long ago when they got the first working treatment out.

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I think the development is closer with regard to developing potential therapeutics. Or at least we will see results sooner for them (positive or negative) Last time I checked there were something like a hundred clinical trials registered to look at treatment options, many of them in China, but also in the US. This does include options against coronaviruses associated with SARS and MERS.

On the vaccine front I think I have seen two (both in early stages). One is sponsored by the NIH with the Kaiser Permanente Washington Health Research institute another one by the Shenzhen Medical Institute in China. I have also heard rumors of some biotechs trying to develop e.g. nanoencapsulated vaccines, but as long as they are in preclinicals, it may amount to nothing.

It should be noted that often companies are not at the forefront of developing new  things. More commonly at least concepts are developed in Universities and research institutes, which sometimes develop start-ups which fully develop the therapeutics. Those are then bought out by the companies. The HCV treatment for example was developed in a company (Pharmasset) which were founded by then researchers at Emory University. Gilead acquired them and sold the drugs to presumably inflated prices. It is not unlikely that similar things can still happen with a vaccine, considering that often start-ups or researchers developing vaccines and therapeutics rarely have capacity to produce and distribute them.

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17 minutes ago, CharonY said:

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%).

 

Does that suggest that for every case reported there are likely another 2 out there?

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2 hours ago, J.C.MacSwell said:

Does that suggest that for every case reported there are likely another 2 out there?

Not necessarily (or at least only partially). For the most part it depends on parameters like spread and test capacities. Especially at the beginning tests are often limited to high risk patients. As such there are plenty of non (which are not considered in this estimate) or mildly symptomatic folks that are not tested. They may recover (or never know that they were sick) unless they were tested as part of contact tracing. But overall, chances are that actual transmissions are not well aligned with actual positive tests. This is where much of the Western world is right now. Age is also a consideration as more younger folks have only mild symptoms are are also often undersampled. The authors also took travel estimates into account.

Looking at the Wuhan data, especially toward the later time points, the crude death rate dropped dramatically, and was more in line with fatality rates reported outside of Hubei, indicating that there are parameters, such as overwhelmed health care system that drove up fatalities.

Accordingly, the authors found that the crude fatality rate outside Hubei was 0.85%, which is even lower than the estimated symptomatic case fatality risk as assessed by the authors for Wuhan.

So in that regard there is a strong underestimation of transmission especially at the earlier stages of testing, and depending on how many tests you roll out relative to transmission, it can at some point approximate the actual value. The authors here tried to model the true transmission rates in order to figure out what the effective risk of dying after developing symptoms is.

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Thanks CY.  I've looked at the numbers a fair bit, and done quick rough estimates based on simple assumptions (often not the same ones). 

I've noticed on the crude assumptions discussed by the media is that they often compare deaths to total cases, generally admitting that there could be many more cases out there unrealized (which would put the actual death rate lower)...but don't seem to factor that while pretty much every death has been counted, the living cases include some that won't recover (which would put the actual death rate higher). If you compared the death numbers to those that have been reported as recovered...currently those numbers would look particularly bad...but you can't go by that either.

So a fair bit would need to go into doing reasonable estimates.

Hopefully it gets better over time as the virus is better understood and preparations get better, and not worse as the hospitals are put on excessive strain.

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!

Moderator Note

I have merged several threads into another to cut down on the number of threads on COVD-19 that are asking more or less the same questions. I haven't merged this one as it would have made that thread a little confusing, but if you wish to respond to anything posted here, please feel free to quote the relevant posts in the one I have kept open. 

 
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