Wuhan Coronavirus, also known as 2019 nCoV, has a current death rate of 2-3%. This isn't as high as SARS, but similar to 1918 Spanish influenza. In Wuhan the number of infected is doubling every 6 days. Containment is complicated by the fact that patients can transmit infection before they know they're sick, before any symptoms. Mild infections resemble the flu. Patients can recover from symptoms, feel well, and still be highly contagious. Not all patients have symptoms, and asymptomatic people are potentially contagious. How infectious the dead bodies are is unknown.
Each patient infects 2.2 to 2.5 others. It's about as transmissible as Spanish flu. Ebola infects 2, but it's more lethal. It will not be controlled until each patient infects less than 1 other.
It appears to be out of control in China. Concerns are that countries with "fragile" public health sectors could become secondary sources for global infection. It might become endemic in some areas. The earliest any vaccine might be available is this Summer.
So far the youngest patient to die was 39. It mostly kills older people with health conditions such as high blood pressure or diabetes.
As a vulnerable person by age and health, I consider Wuhan coronavirus a personal threat.
"this video explains what a cytokine storm is, how that actually is the cause of harm, and additional troubling information that nCoV (now "covid-19") spreads through the air."
Feb 11th news:
1. By mid-January there were 500 confirmed COVID-19 cases among Wuhan medical workers and 600 more suspected cases.
2. Hong Kong's leading public health epidemiologist says that two-thirds of Earth's population could get COVID-19, if it can't be contained.
3. Hong Kong's PolyU invented a machine that can diagnose 40 pathogens for respiratory disease with one sample in an hour.
4. A few details roughly transcribed from Coronavirus: The New Pandemic? - Public Health Grand Rounds at the Aspen Institute:
If the disease can be transmitted by people who are asymptomatic or even mildly symptomatic, it makes it really clear we won’t be able to stop it spreading in the US.
In the short term, this year, we don’t have mitigation strategies. No vaccine for a year, We don’t have a specific countermeasure. So when we talk about mitigation, what we’ll be talking about is things like social distancing, stay home if you’re sick, “cover your cough”, wash your hands.
[The US has] a federal health care system that isn’t really a federal health care system. [We have a hodgepodge of private, public, state level, etc.]
[Coping with the pandemic is] going to require funding… from congress … an emergency package.
Getting the hospitals ready… the system moves super slowly.
5. About that one report of a 24 day incubation period. Dr. Roger Seheult, MD of Medcram suggests this outlier is an instance of (immediate) reinfection. [At 10:13]
I knew that immunity from recovery wasn't perfect, but immediate reinfection is scary, even if rare.
Feb 12th news:
1. The CDC is preparing for community spread, for COVID-19 to "take a foothold". Meanwhile the test kits sent to states are giving "indeterminate" results.
According to Dr. Robert Redfield, the CDC will conclude that containment has failed in the US ...
“Once we get greater than three — so four or more is our view — [generations of] human-to-human transmission in the community … and we see that in multiple areas of the country that are not contiguous, then basically the value of all of the containment strategies that we’ve done now then really become not effective,” he said. “That’s when we’re in full mitigation.”
2. Scott Gottlieb told a Senate committee,
Models suggest that from the time of first introduction of the virus into China — which we now suspect occurred sometime in November — to the time of epidemic spread in China, was about 10 weeks.
... if cases were imported into the U.S. in early January and remain undetected, then we could still be early in our own evolution toward broader outbreaks. Right now, we’re depending largely on clinical surveillance as our primary tool for identifying potential outbreaks since we’re just now deploying diagnostic tools to the Laboratory Response Network. Moreover, we still haven’t broadened our screening criteria to include patients who don’t have a connection to recent travel to China. This limits our ability to identify secondary spread.
3. Among hospitalized patients getting anti-viral meds and antibiotics, 26% ended up in ICU and 16% had respiratory failure. 8 days was the mean from first symptoms to acute respiratory distress syndrome (ARDS).
4. A study of 59 COVID-19 patients found that all has abnormal kidney X-rays, and most had renal impairment symptoms.
5. A US preprint, not peer reviewed, concluded that in the early epidemic, the number of infected doubled every 2.4 days, suggesting an R0 value from 4.7 to 6.6.
6. Here's a short video on how to remove contaminated gloves.
News from 13th & 14th
1. COVID-19 severly attacks the heart.
Reinfection can hasten fatal heart attack.
2. Using a lung CAT scan for rapid diagnosis, as China is now doing along with virus tests, makes sense to me because there is "radiological evidence of lower respiratory tract lesions in patients who do not present with clinical pneumonia."
Infected individuals produce a large quantity of virus in the upper respiratory tract during a prodrome period, are mobile, and carry on usual activities, contributing to the spread of infection.
There seem to be three major patterns of the clinical course of infection: mild illness with upper respiratory tract presenting symptoms; non-life-threatening pneumonia; and severe pneumonia with acute respiratory distress syndrome (ARDS) that begins with mild symptoms for 7–8 days and then progresses to rapid deterioration and ARDS requiring advanced life support...
3. "Hand washing reduces the risk of respiratory infections by 16%."
4. US Military says the number of Chinese COVID-19 cases is probably several orders of magnitude higher than their new numbers.
5. "A toilet flush can release up to 80,000 polluted droplets and leave them suspended a metre in the air for hours if the lid is left up, a new study has found."
The current estimated R0 for the novel coronavirus varies from two to three…
a potential crisis simmers in the shadows: The global dependence on China for the production of pharmaceuticals and medical equipment.
China is also the largest supplier of medical devices in the U.S. These include things like MRI equipment, surgical gowns, and equipment that measures oxygen levels in the blood.
It could take years to develop the necessary infrastructure to reestablish U.S. manufacturing capacities...
Wuhan is a significant player in the biotechnology and pharmaceutical industry, with multiple pharmaceutical companies located in the city.
Here's what we recommend you focus on now
by Chris Martenson
Friday, February 14, 2020,
How to remove a face mask.