SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

[SirAF]

I think the best we can do is be healthy. I've added vitamins to my diet, i eat plenty of fruit, drink more water. I've recommended the same to friends and family. Whether I get it or not, I'd prefer to be strong and prepared.

I imagine most people who have contracted it weren't the least bit prepared.

Absolutely true. Get enough sleep, excercise and lay off alcohol as well and it will stand you in good stead I’d imagine.

 

[UnrelatedPsuedo]

I think it is.

No evidence for that bud. I’m sure that I’m right. Always happy to be proven wrong.

 

[oates]

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Nothing like that in our region.

 

[Paxi]

Nothing like that in our region.

I'm not sure even if the video legit or not. It's just that the first thing he mentioned is pasta.

 

[Paxi]

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[Adamsk7]

One positive for the UK in this - we’ve done more tests (over 7,000) than any European Country other than Italy, who have only done a couple of thousand more. America has laughably done about 500.
whilst there’s probably no keeping a lid on it here, it does seem like we are more on the ball than most, which is a refreshing change!

 

[oates]

I'm not sure even if the video legit or not. It's just that the first thing he mentioned is pasta.

Pasta is always packed dry, keeps for months, years and I'd be awfully surprised if all our neighbours don't already have at least two years worth in their pantries. It just doesn't ring quite right. More likely to empty the shelves of jars of toppings I would guess.

 

[Di Maria's angel]

No evidence for that bud. I’m sure that I’m right. Always happy to be proven wrong.

Fair enough. Better you're right than myself.

 

[GDaly95]

They've knocked up a few hand sanitizers in my office in Dublin.

We are ready.

 

[Redplane]

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Any excuse to not go to work and eat instead for those Italians. Gotta love em.

 

[Adamsk7]

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This got retracted because apparently it wasn’t a first hand account, which originally they said it was.
Some people say that’s the government trying to cover it up but either way it shows why we can’t believe a word of any of these reports.

 

[UnrelatedPsuedo]

One positive for the UK in this - we’ve done more tests (over 7,000) than any European Country other than Italy, who have only done a couple of thousand more. America has laughably done about 500.
whilst there’s probably no keeping a lid on it here, it does seem like we are more on the ball than most, which is a refreshing change!

I was amazed that I didn’t get checked flying into the country this week.

 

[Simbo]

Was it? I don't remember swine flu being that huge in the UK. Could be wrong though.

And I sort of agree with you regarding the first part. Although its a little worrying when younger people are dying.

Youger doesn't neccessarily mean healthier, you never know what is going on under the hood, how much they smoke,etc.

Based on the confirmed cases data the fatality rate for the under 40 is 0.2%. So likely even ower considering the assumed amount of unconfirmed mild cases. You'll see people talk about that one 23 year old that has died as if it is somehow comparable with how much the elderly are at risk, it is nowhere near in reality.

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

Regarging the death rate though, I was listening to a Doc who made a good point about how these stats may be actually understating the danger of this virus. Most of the confirm case data is coming out of China, a country which is actually better equpped to deal with it than anywhere else in the world, moreso than the UK even. There is specific equipment needed to treat those who that end up with a severe case of the virus, and nobody else has enough of it. I.e. the death rate outside of China is likely to be higher... In places completely unequpeed it really could be devastating.

 

[Redplane]

In case anyone cares- still sick and doc confirmed Influenza-A... Yep that same strain that animals have like swine flu and bird flu like H1N1. So that lovely stuff is still out there too. I'd say we blow this motherfecking planet up and start fresh somewhere.

 

[massi83]

I'm not sure even if the video legit or not. It's just that the first thing he mentioned is pasta.

Then why post it? You post plenty of good stuff. Thanks for that. But cut out the ones that are fearmongering/fake news

 

[Paxi]

Then why post it? You post plenty of good stuff. Thanks for that. But cut out the ones that are fearmongering/fake news

Fair enough.

 

[Adamsk7]

I was amazed that I didn’t get checked flying into the country this week.

Most of the places that do a “check” are checking your temperature. If I had a high temp, I’d take paracetamol to keep it down anyway. Also most of the time you have no or few symptoms so it’s largely a waste of resource.

what I mean by test is the full test to confirm the virus. 7000+ is very good comparatively

 

[UnrelatedPsuedo]

Most of the places that do a “check” are checking your temperature. If I had a high temp, I’d take paracetamol to keep it down anyway. Also most of the time you have no or few symptoms so it’s largely a waste of resource.

what I mean by test is the full test to confirm the virus. 7000+ is very good comparatively

Fair go, I agree for the most part.

But chucking a laser thermometer in the bag scanning guys hand seems low-cost and sensibly efficient.

I got scanned when entering Switzerland, as a point of comparison.

 

[Adisa]

Iran has 250 cases and 26 deaths. Damn thats high.

10% mortality. Sounds like bullshit to me.
They have far more cases than that. Tourists coming from Iran are testing positive ffs.

 

[11101]

It’s not airborne.

I don’t think.

Experts still saying it's not airborne but passed in water droplets, which can be suspended in the air for a few seconds.

It seems to spread incredibly easily from close contact though. Its going to be at least another week before it gets under control in Italy, as the restrictions start to outlast the incubation period. God knows how many cases there will be by then.

 

[UnrelatedPsuedo]

Experts still saying it's not airborne but passed in water droplets, which can be suspended in the air for a few seconds.

It seems to spread incredibly easily from close contact though.

The interesting one will be the fallout from the Flight Attendant that’s just tested positive. Confined space. Lots of interaction.

 

[diarm]

We met my wife's cousin who lives there and she said it was like that a couple of weeks ago but had calmed down since.
We took her some masks and hand sanitiser, cos they've sold out there.
I was surprised how few people had masks on.

Aren't a lot of the professionals saying that there isn't much point in wearing a mask unless you are a doctor/nurse in prolonged close proximity to the infected, or are in fact infected yourself?

Knowing Singaporeans, I'd imagine that once that advice went out, people were afraid that wearing a mask would come with the stigma of people thinking they were sick.

 

[Abizzz]

In case anyone cares- still sick and doc confirmed Influenza-A... Yep that same strain that animals have like swine flu and bird flu like H1N1. So that lovely stuff is still out there too. I'd say we blow this motherfecking planet up and start fresh somewhere.

Influenza is horrible to go through , but at least it's a known enemy. Hope you get well soon!

 

[Pogue Mahone]

Here's a good/interesting blog from a microbiologist (i.e. someone who actually understands this shit) which I'm sure he wouldn't mind me sharing. Had to copy and paste as is hosted on a site accessed only by doctors.

tl;dr Major concern is economic impact. Measures to contain intended to mitigate this impact. Virus will inevitably become endemic, all over the world, at which point the "hysteria" referred to by @africanspur will gradually die down.

(Obviously, I fecked up the graph, cos I don't do images, right @Samid ? )

What have we learned so far about Covid-19?

1. It spreads pretty well; each person infected and not isolated tends to infect another 2-3 people which can lead to an exponential growth in number of cases (currently over 80,000)
2. The incubation period is an average of about 5-6 days
3. The mortality outside of China is <1% (if you discount Iran which heavily skews the data with 15 deaths from only 95 cases)
4. If you put 3000 people in a closed environment with Covid-19 (Diamond Princess cruise ship) 695 people (23%) will get Covid-19
5. The World is putting a huge amount of effort into isolating areas with Covid-19 including Hubei province and yesterday Northern Italy

So how do we interpret what we have found out about Covid-19?

1. It spreads quickly and easily from person-to-person if we don’t employ the basic hygienic measure of strict hand hygiene, cough etiquette (use a tissue and wash your hands) and don’t mix with healthy people if you are unwell
2. The health impact of this infection on the majority of people is that it causes a mild infection a bit like the common cold or mild influenza; however if you are frail and already in poor health then the infection can be more severe (just as with influenza)
3. It is unlikely (and never was likely) that the measures taken by the global community will prevent the spread of Covid-19 around the World

What don’t we know about Covid-19?

1. The true mortality; at the beginning of an outbreak mortality data is skewed to severe cases with a higher mortality as only the sickest present to healthcare settings and get tested, the true mortality will be less than this
2. What is going on in countries with poor surveillance systems such as Sub-Saharan Africa; if Covid-19 gets into areas of the World with poor healthcare infrastructures with populations who are malnourished the mortality in those countries will be much higher than for us in the developed World
3. How many people are dying FROM Covid-19 and how many are dying WITH Covid-19; some of the people dying with a positive test result may be dying for another reason e.g. heart attack, cancer, etc. in which Covid-19 didn’t kill them but their death skews the mortality data
4. What is the impact of all of the resource being put towards controlling Covid-19 on other areas of healthcare; could people be coming to harm because of the distraction and redirection of resource?

So let’s have a look at some of what we know about Covid-19 and see if we can use this to explain some of the public health measures being employed at the moment.
The current management of the Covid-19 outbreak is based upon:

1. Reduced exposure to potentially infected people by restricting movement of people to or within outbreak areas
2. Rapid detection of new cases based upon broad definitions for potential cases
3. Isolation of new cases to prevent further spread
4. Self-isolation of exposed people so that if they become infected they don’t infect others
5. Quarantining of people with high-risk exposure until they are outside of the incubation period

All of this is designed to try and limit and slow down the spread of Covid-19. I suspect that trying to contain Covid-19 is like trying to turn back the tide, however slowing its spread does have a value.
Okay, so what happens if we slow the spread down?
Not only will this move any potential outbreak into the spring and summer when there is supposedly less strain on the NHS (yeh, really! Does the NHS actually experience a time where there is “less strain”). However in spring and summer people are less likely to be inside spreading their viruses around. The main benefit of slowing down the spread of the infection is that the overall peak of infection is less, so the impact at any one time is also less.
Consider 1) that everybody with Covid-19 might infect 3 other people and 2) they become unwell in 5 days. In my graph below (based on very crude and basic maths!) I have assumed that every infected patient infects 3 people who become symptomatic on day 5. These original patients and the new cases then infect 3 more people each, who again become symptomatic five days late (I’ve assumed at this 10 day mark the original patients are better). If we start with 100 patients and then follow this graph out to 1 month you can see that by this stage you will have over 400,000 infected patients to deal with!
What happens if we manage to reduce the number of new infections to 2 new patients per patient with a 5 day incubation period (by isolating and using PPE)? At 1 month this will reduce the number of cases to 73,000 patients. But if we manage to increase the incubation period to 7 days rather than 5 days (by delaying transmission by 2 days e.g. isolation and PPE), at 1 month we only have about 26,000 cases. These precautions slow Covid-19 down and this is why we have control measures in place at present.

In fact the number of people infected by a patient is known as the Reproductive Rate (RR). An RR of 2 means each infected person infects 2 other people, an RR of 15 means each infected person infects 15 other people. This number is important in outbreaks because if you can bring the RR below 1 then the outbreak is unable to sustain itself and burns out.
So this is the crux of all of the public health measures being taken globally. They are trying to get the Reproductive Rate to less than 1, so the outbreak burns out, whilst reducing the speed of spread so that the overall impact at any one time is minimised.

So if Covid-19 isn’t that bad why all the fuss?
Okay, some people are going to come to harm from Covid-19. The frail and the immunosuppressed and others with lots of comorbidities are at risk of serious infection with Covid-19. But that’s the case from all respiratory viruses such as influenza, Respiratory Syncytial Virus, Adenovirus, etc., etc. all of which we see as many thousands of cases every year. Therefore Covid-19 is going to cause infection in some people, and will probably replace the cause of their mortality from one of the more common viruses.
I think the main issue around Covid-19, and the main reason for the current public health strategies around the World, is to reduce the impact on the economies of affected countries. I know that sounds very cynical (and I am a cynic!) but even if it’s not the major reason it is a very real issue.
Think about it. If 20% of the population get Covid-19 and either are off work sick themselves, or having to be off work to look after sick children, then the economic impact of that missing workforce will be enormous. Factor in the number of healthcare workers not able to work because they have acquired the infection (including outside of work as well as from patients) then you can start to see the scale of the problem with people being unable to work.
Just look at what is happening to industries dependent on Chinese manufacturing which has ground to a halt in the worst hit areas of China. The same thing will happen in any country with sustained and uncontrolled transmission of Covid-19… at least until a large proportion of the population has had it and become immune, at which time transmission will start to go down, the RR will drop below 1, and the outbreak will burn itself out…
The other big problem PHE are going to have is repositioning the message from “killer deadly virus” to “it’s just like any other common cold” when Covid-19 is widespread in the community; I think the PHE might need a marketing agency to change this message for them.
At the moment there is a huge amount of amazing work being done to try and contain the virus, which currently involves: wearing hazmat suits, face masks, repatriating infected Nationals, testing an enormous amount of foreign travellers and self-isolating school children who have been on half-term skiing trips!
Once the government are no longer trying to contain Covid-19 (their 4-part plan is – Contain, Delay, Research and Mitigate) people will come into contact with Covid-19, and most of the patients will be related to cases who aren’t even known about (e.g. can you remember who you actually caught your last sore throat from?). When we get to thousands of cases, and widespread transmission in the community, this is when there will be no value in using PPE to prevent transmission in the healthcare setting, infection will be happening outside the hospital, just like flu does. The PHE message is likely to be one of “treat like any other respiratory virus and don’t worry about all of the space suits!” However this is going to be hard for everyone (medical staff, patients and the general public) to grasp. It is not because the danger from the disease has changed; it is that there is no longer a purpose in wearing the PPE. This is different to a viral haemorrhagic fever like Ebola, where the PPE is there to protect the healthcare staff from dying because Ebola has such a high mortality even in fit and healthy individuals. Covid-19 is not really the media’s “killer deadly virus”; Covid-19 is and will be as bad as many of the other respiratory viruses, which do have an associated mortality rate, especially in vulnerable patient groups.
Currently for Covid-19 the actions are all about contain it or slow it down, however watch this space as the advice will change if/when “containment” fails, then it will be cope as best we can with the influx of respiratory illnesses using all our “spare capacity!”
… and then when this is over, we can all get back to our normal jobs… at least until the next big thing in the world of “woohoo it’s a new… virus, bacteria, parasite, fungus”.

 

[Raulduke]

They've knocked up a few hand sanitizers in my office in Dublin.

We are ready.

Irish Mammies all over the country adding big bottles of 7-up to the Friday night big shop

 

[sglowrider]

14% of discharged patients in Guangdong test positive again

 

[africanspur]

I am not a medical professional, however judging by the extreme measures in China - building hospitals in days, welding people in their buildings , locking down whole provinces- perhaps this coverage is not that much " over the top". I presume there are certain aspects of this virus that are deemed unique in comparison to previous outbreaks .

I'm not saying we shouldn't be taking things seriously, of course we should. I think the Chinese response was as a result of a few unique features of the time: Its population, density of population in certain urban centres, especially along the East and South Coasts and Chinese New year, when literally tens if not hundreds of millions of people are travelling around the country to go home/ visit their families/ take a trip abroad. It was a perfect time to spread the virus hugely far and wide, both within China and outside, at a time when the virus was even less well understood than it is now.

I think that's just your friend's view.

I still have a lot of friends in China, Hong Kong, Singapore and Tokyo from the time i lived there, and life is definitely not normal. Lots of restrictions in place, nobody is travelling, offices are closed all over the place.

Yep, people I know in China and HK have basically not left their homes for the past 4 weeks.

 

[africanspur]

Here's a good/interesting blog from a microbiologist (i.e. someone who actually understands this shit) which I'm sure he wouldn't mind me sharing. Had to copy and paste as is hosted on a site accessed only by doctors.

tl;dr Major concern is economic impact. Measures to contain intended to mitigate this impact. Virus will inevitably become endemic, all over the world, at which point the "hysteria" referred to by @africanspur will gradually die down.

(Obviously, I fecked up the graph, cos I don't do images, right @Samid ? )

Is that doctors.net?

Good read.

I did dabble in infectious diseases and public health (and did some qualifications in both) before settling on my specialty a while ago so, while this is obviously horrible, I do get a slight curiosity with this stuff. Especially the PH aspects and the outbreak control measures we take. Admittedly, the work I've done in this field recently has been more related to Ebola than to respiratory viruses like corona.

PHE and the media certainly need to try to reframe the discourse about this currently. Judging by this thread first of all, they're not doing a great job at the moment....

Edit: The thing that does worry me is if it starts spreading in poorer countries with no systems in place to deal with an extra threat.

 

[LordNinio]

Here's a good/interesting blog from a microbiologist (i.e. someone who actually understands this shit) which I'm sure he wouldn't mind me sharing. Had to copy and paste as is hosted on a site accessed only by doctors.

tl;dr Major concern is economic impact. Measures to contain intended to mitigate this impact. Virus will inevitably become endemic, all over the world, at which point the "hysteria" referred to by @africanspur will gradually die down.

(Obviously, I fecked up the graph, cos I don't do images, right @Samid ? )

Great read. Thanks

 

[diarm]

In case anyone cares- still sick and doc confirmed Influenza-A... Yep that same strain that animals have like swine flu and bird flu like H1N1. So that lovely stuff is still out there too. I'd say we blow this motherfecking planet up and start fresh somewhere.

Ah here, you hardly expect us to bring all you sick notes with us to our shiny new planet?

 

[Paxi]

 

[Smores]

Is that doctors.net?

Good read.

I did dabble in infectious diseases and public health (and did some qualifications in both) before settling on my specialty a while ago so, while this is obviously horrible, I do get a slight curiosity with this stuff. Especially the PH aspects and the outbreak control measures we take. Admittedly, the work I've done in this field recently has been more related to Ebola than to respiratory viruses like corona.

PHE and the media certainly need to try to reframe the discourse about this currently. Judging by this thread first of all, they're not doing a great job at the moment....

Edit: The thing that does worry me is if it starts spreading in poorer countries with no systems in place to deal with an extra threat.

So Is the message in that post of "well they probably would have just died from another virus anyway" actually accurate?

Obviously there's some level of overlap but surely the point is that it's an additional risk factor and significant in certain groups?

When it inevitably becomes an epidemic then yeah life has to carry on but it seems a cold clinical view to discount the risks to the vulnerable based on them already being vulnerable. Perhaps I'm misreading it.

 

[Di Maria's angel]

Here's a good/interesting blog from a microbiologist (i.e. someone who actually understands this shit) which I'm sure he wouldn't mind me sharing. Had to copy and paste as is hosted on a site accessed only by doctors.

tl;dr Major concern is economic impact. Measures to contain intended to mitigate this impact. Virus will inevitably become endemic, all over the world, at which point the "hysteria" referred to by @africanspur will gradually die down.

(Obviously, I fecked up the graph, cos I don't do images, right @Samid ? )

Seems very grounded and answers many questions. Thanks Pogue.

 

[Di Maria's angel]

Then why post it? You post plenty of good stuff. Thanks for that. But cut out the ones that are fearmongering/fake news

In fairness, its quite funny and adds a different tone to an otherwise depressing dilemma.

 

[UnrelatedPsuedo]

I am not a medical professional, however judging by the extreme measures in China - building hospitals in days, welding people in their buildings , locking down whole provinces- perhaps this coverage is not that much " over the top". I presume there are certain aspects of this virus that are deemed unique in comparison to previous outbreaks .

People are not being welded in buildings. The Twitter Video had nothing to do with the Virus.

 

[Paxi]

https://amp.theguardian.com/world/2...ests-positive-for-coronavirus-for-second-time

Forgot the medical terminology for this but looks like people can get reinfected.

 

[UnrelatedPsuedo]

https://amp.theguardian.com/world/2...ests-positive-for-coronavirus-for-second-time

Forgot the medical terminology for this but looks like people can get reinfected.

This is not a surprise. It’s possible to get the Flu mote than once. There’s no immunity system in place.

 

[The Firestarter]

People are not being welded in buildings. The Twitter Video had nothing to do with the Virus.

They are. It was reported on CNN as well as state provided information.

 

[Redplane]

Influenza is horrible to go through , but at least it's a known enemy. Hope you get well soon!

Ty Abizzz!

Ah here, you hardly expect us to bring all you sick notes with us to our shiny new planet?

I'll get better in time, you watch. If I know the planet is about to be vacated and destroyed with me on it I'll be healthy REAL fast.

 

[Di Maria's angel]

https://amp.theguardian.com/world/2...ests-positive-for-coronavirus-for-second-time

Forgot the medical terminology for this but looks like people can get reinfected.

Could it be she was never fully cured?