Mutating Corona Virus

[tobyjugg2]

I thought hightail made a couple of excellent points there:

 

Not least that there are far more people dying every year from 'ordinary' flu strains but we aren't panicking about it

 

Edited January 27, 2020 by tobyjugg2

[BazzaS]

Up to people to decide if they want to put trust in what I post, HB, not based on me claiming to be a virologist (I’m not claiming to be one btw!). I could claim to be John Oxford, or Nick Phin (I’m not either of them), but how would I prove it?. So, I’ll TRY to persuade people by using the resources I have access to, what I’ve posted here, and what I’ve posted about ‘flu in the past.

 

I had difficulty persuading someone back then, too.

 

I posted then about the likelihood of the change in UK vaccine schedule (again, based on a resource I had access to). 3 months later : that change became public policy. Perhaps that track record might persuade some.

[BazzaS]

10 minutes ago, BazzaS said:

No need for panic mode (for flu) (and I explained why ......

 

10 minutes ago, BazzaS said:

1 minute ago, tobyjugg2 said:

I thought hightail made a couple of excellent points there:

 

Not least that there are far more people dying every year from 'ordinary' flu strains but we aren't panicking about it

 

 

We have a vaccine.

 

We have a widely available testing system to differentiate FluA and B from the other respiratory viruses with similar presentations.
 

We have treatments (oseltamivir, and zanamivit) and the testing means to determine if the FluA is an H3 or H1 (helping predict when to use zanamivir because of the higher risk of oseltamivir resistance via the H275Y mutation that is seen more commonly with H1N1 over H3 strains)

 

More interventions / treatments : less panic.

 

Sadly my explanation hasn’t helped (or, at least hasn’t helped my main sceptic).

OK, I’m done here.

[tobyjugg2]

Warning

Describes modern day bubonic plague outbreaks - describes current 'real world' examples of the mechanism of transfer to humans in our current world.

 

https://www.acsh.org/news/2017/10/14/black-death-rages-madagascar-11961

 

 

 

Also (NOTE eradication term used) :

"Since the eradication of smallpox, there have been increases in poxvirus infections and the emergence of several novel poxviruses that can infect humans and domestic animals."

 

"Recently, several novel poxviruses have been discovered after infecting humans and/or domestic animals [22,23,24,25,26,27,28,29,30,31], including three newly proposed OPXV species: two isolated in Europe and one isolated in North America. Orthopoxvirus Abatino (OPVA) was isolated in Italy during an outbreak in captive macaques in 2015 and from a fatal infection in a cat in 2017 [28,29,31].

Another novel proposed OPXV, Ahkmeta virus (AKMV), was identified in three humans in the country of Georgia in 2010 and 2013 [22,27]. "

 

"In 2015, a novel poxvirus was isolated from a resident of Alaska [30]. Phylogenetic analysis of several highly conserved genes suggested that the Alaska isolate was a member of the OPXV genus but was highly diverged from known OPXV species [30]. "

 

https://www.mdpi.com/1999-4915/11/8/708/htm

 

[tobyjugg2]

28 minutes ago, BazzaS said:

 

 

Sadly my explanation hasn’t helped (or, at least hasn’t helped my main sceptic).

OK, I’m done here.

 

and you seem to have entirely missed hightails excellent point that more people ARE dying every year from those common strains of flu for which there are vaccines,

than die in the high profile new strain 'outbreaks' for which there is as yet no vaccine

 

[BazzaS]

Must resist, can’t resist.

 

It is about panic, and reasons to panic (or not).

 

I wasn’t ignoring hightails point (& I’ve found them a reasoned and reasonable contributor)

 

But if one is looking for factors where people should be more or less worried: I’ve laid them out.

 

What will happen? Hopefully 2019-nCoV won’t kill more than ‘flu (SARS didn’t!). SARS did kill many healthcare professionals in Toronto though, including those who knew the risks, and still turned up to work.

 

What will happen? Hopefully 2019-nCoV won’t kill more than ‘flu (SARS didn’t!), but only time will tell.

 

Really done now. Bait all you want, I’m turning notifications off. 

[tobyjugg2]

1 hour ago, BazzaS said:

 

What will happen? Hopefully 2019-nCoV won’t kill more than ‘flu (SARS didn’t!), but only time will tell.

 

 

 

but that of course is the issue

 

If China ignored the issue, and it did turn into an epidemic, it still almost certainly wouldn't be as bad as say the 1918 Spanish flu pandemic.

Neither would a bubonic Plague outbreak, even if it turned pneumonic

It could be terrible, but not utterly catastrophic generally

We are generally well prepared and well informed, even given the sorry state of our NHS.

 

But if smallpox or a mutated version of one of the nasty variants jumped (as is shown happening in my links) which was sufficiently different that none of the original smallpox vaccine variants, or vaccinia (yes I did know what you were alluding too) or cowpox or monkeypox vaccine variants worked, especially that NOW we have little resistance due to the (good reasoned) lack of inoculation

that might be a MUCH bigger issue - although undoubtedly a vaccine would be developed quite quickly - the models I've seen would still result in a LOT of horrible deaths and panic.

 

 

Bacteria's growing resistance to anti-biotics is the real issue (although some hope is on the horizon there). Imagine a Bubonic plague developing with that resistance.

 

Edited January 27, 2020 by tobyjugg2

[hightail]

11 hours ago, honeybee13 said:

I apologise for mentioning this, but people are dying or afraid of dying

My point was that the fear being generated is disproportionate to the current threat. Initial under reporting of cases gave an inflated picture of the percentage death rate and images of cities in lockdown do look like a disaster movie so I understand why.

This article is worth a read for some perspective.

https://www.theguardian.com/science/2020/jan/27/what-is-coronavirus-symptoms-sars-china-wuhan

 

 

 

 

 

[London1971]

Look at some respected Viral epidemiologists working on this new virus on Twitter versus the crazy unverified reports of people 'dropping like flies'. Plenty of conspiracy theories from people trying to sell books too.

 

It's widely thought that some of the increase in cases is due to not having tests available at the beginning, and that there are large numbers of people who had mild symptoms, that never got detected.  Therefore it's likely that the mortality is much lower than thought. Also think about how many people are lining up in hospitals who might only have a cold but are terrified from all the panic.

 

However all are urging caution, that much more will be revealed over the coming weeks as the infections accelerate.

 

It is terrifying to see a city on lockdown, but also worth understanding even a 0.5% fatality rate in China is 10's of millions of people. That's why they are acting like it's a Hollywood disaster movie.

 

 

[BazzaS]

In case this hasn’t been posted (Lets just say I may not be seeing some contributors messages, nor their posts even if I dip back into this thread):

 

For the benefit of those who want info “from the horses mouth”

 

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf

 

“Current estimates of the incubation period of the virus range from 2-10 days, and these estimates will be refined as more data become available. Understanding the time when infected patients may transmit the virus to others is critical for control efforts. Detailed epidemiological information from more people infected is needed to determine the infectious period of 2019- nCoV, in particular whether transmission can occur from asymptomatic individuals or during the incubation period.“

Sitrep 8 has been issued by WHO, but doesn’t update on the epidemiological info of incubation and transmissibility periods, but does update on the case /country numbers.

 

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200128-sitrep-8-ncov-cleared.pdf?sfvrsn=8b671ce5_2

 

As ever, they are careful to state that this is “current best knowledge”, and subject to change as more knowledge / data becomes available.

 

[tobyjugg2]

2 hours ago, BazzaS said:

As ever, they are careful to state that this is “current best knowledge”, and subject to change as more knowledge / data becomes available.

 

 

You can bet you life on that ...

[tobyjugg2]

Britons evacuated due to coronavirus to be quarantined for 14 days

 

https://www.theguardian.com/world/2020/jan/29/evacuation-of-britons-in-coronavirus-hit-hubei-could-begin-thursday

 

Mmmmmm ....

 

 

[London1971]

Experts in Epidemiology, Virology and Microbiology are aplenty on Twitter. Consensus at the moment is that it's a lot milder than thought initially for most people, and doesn't spread as easily. There are even charts comparing it with other common disease like Flu.. Oh and there is still no concrete proof of it spreading in the incubation period.

 

Nutty conspiracy theorists, unfortunately are even more prominent on Twitter, to them 'It's the end of the world' blah blah blah. Bioweapons Laboratory  Yawn.

 

Question is do you trust the expert teams who have already modeled the Virus and are working on a Vaccine, or some inane random nutter screeching deluded tweets.

 

 

[tobyjugg2]

Some reputable resources are stating that the number of cases has outstripped 'SARs already

 

 

https://hub.jhu.edu/2020/01/23/coronavirus-outbreak-mapping-tool-649-em1-art1-dtd-health/

Edited January 29, 2020 by tobyjugg2

[London1971]

They are right, it’s far outstripped SARS. Probably hundreds of thousands of unreported mild cases, many who recovered without even realising they had it.
 

SARS fatality rate was far higher though.  10%!

[tobyjugg2]

Makes you wonder if the immunity/resistance level in China is higher?

and worse is to come?

 

Which also does beggar the question:

are we storing up a huge problem for the later mutated one that 'gets away'

[tobyjugg2]

China's coronavirus hospital built in 10 days welcomes patients

 

 

https://www.euronews.com/2020/02/03/china-s-coronavirus-hospital-built-10-days-opens-its-doors-n1128531

 

Holy heck Batman

 

 

Edited February 3, 2020 by tobyjugg2

[BazzaS]

Trying to persuade people I know what I'm talking about, will just have to be my pet project, but not my Priority. 10 (or more) useful cites might help establish my bona fides - but I suspect still won't persuade all.

 

Latest WHO Sitrep: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200204-sitrep-15-ncov.pdf?sfvrsn=88fe8ad6_2

1 death outside China (in the Philippines). That page summarizes the cases by region, including Europe, and confirms the UK's 2 cases.

 

There is now a candidate treatment : remdesivir.

 

South Korea is now derogating from the case finding definition of 

a) travel to China in the preceeding 14 days, or

b) contact with a confirmed case

South Korea is now aiming to test anyone with compatible symptoms regardless of travel / exposure history.

 

Expect hospitals to have a room (ideally NOT in A&E!) to redirect possible cases into (to phone 111, to have them screened for the case definition).

 

I'll try to update (to reach my 10 or so useful cites), but this is for people to make their own minds up : I'm unlikely to enter into protracted debate - as I said, it isn't my priority.

 

 

 

[tobyjugg2]

Bazzas

How does any of that change:

The standard range of a fast mutating and highly variable coronavirus being up to 14 days and safety measures using that?

 

It might end up that the original/early version had a mean incubation period of 10 minutes unlikely as that is,

but that wont change squat about how it should have been approached,

and very unlikely to change the standard recommendations for DEALING WITH ANY FURTHER OUTBREAK,

and certainly doesn't mean that the latest mutations are doing the same and people should consider themselves OK after 10 minutes.

 

It would just be added to the info and considered a bullet dodged.

 

I entirely fail to see what point you are trying to make. The whole point is that these virus' mutate rapidly.

Edited February 5, 2020 by tobyjugg2

[tobyjugg2]

A nice non technical presentation

 

https://www.worldometers.info/coronavirus/coronavirus-incubation-period/

 

 

Part:

 

 

Last updated: February 5, 2020, 11:45 GMT

Coronavirus Incubation Period:

2-14 days

Summary of findings:

• 2-14 days represents the estimated range at the moment for the novel coronavirus (2019-nCoV).
• Period can vary greatly among patients.
• Average incubation period observed in a study was 5.2 days.
• Asymptomatic transmission of the novel coronavirus has been confirmed in a German study.^[5] The WHO maintains, however, that asymptomatic infection "may be rare" and that transmission from asymptomatic cases with other coronaviruses (as seen with MERS) "is very rare."^[8]

Wuhan Novel Coronavirus (2019-nCoV) Incubation Period

The incubation period (time from exposure to the development of symptoms) of the virus is estimated to be between 2 and 14 days based on the following sources:

• The World Health Organization (WHO) reported an incubation period for 2019-nCoV between 2 and 10 days. ^[1]
• China’s National Health Commission (NHC) had initally estimated an incubation period from 10 to 14 days ^[2].
• The United States' CDC estimates the incubation period for 2019-nCoV to be between 2 and 14 days ^[3].
• DXY.cn, a leading Chinese online community for physicians and health care professionals, is reporting an incubation period of "3 to 7 days, up to 14 days".

The estimated range will be most likely narrowed down as more data becomes available.

 

 

 

Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases.

The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0),

with the 95th percentile of the distribution at 12.5 days.

Edited February 5, 2020 by tobyjugg2

[tobyjugg2]

1 hour ago, tobyjugg2 said:

with the 95th percentile of the distribution at 12.5 days.

 

 

Perhaps Bazza can explain in simple terms what that bit means .... and the line before;

 

 

 

So, How many people think that '95% sure that people are NOT infected' is good enough?

Let alone 'its quite likely 5% still could be' ....

 

 

 

 

Heres some quite non technical and HIGHLY relevant reading on

* Incubation periods

* Transmission during the 'incubation period' or while asymptomatic, or not.

 

.. note the bit about the asymptomatic child (lancet), what it means about being infected over periods without being visibly symptomatic and that it highlights that people react differently to exactly the same virus, let alone versions of a rapidly mutating one.

 

Edited February 5, 2020 by tobyjugg2

[BazzaS]

19 hours ago, BazzaS said:

Expect hospitals to have a room (ideally NOT in A&E!) to redirect possible cases into (to phone 111, to have them screened for the case definition).

posted 2 am 5/2/20 or thereabouts. Then, some 17 hours later......

 

Coronavirus: NHS orders 'assessment pods' in England hospitals https://www.bbc.co.uk/news/uk-51392607

from BBC News, 19.20 5/2/20

 

lucky guess by me, eh?

 

Incidentally, that BBC News page uses a “stock photo” of a healthcare worker using a surgical mask. Shame then that the picture used doesn’t show the correct PPE for 2019-nCoV..........

[tobyjugg2]

An example of the real risks:

 

One man's lies leave thousands in quarantine, (Chinese) state media claims

 

A man who lied about returning from Wuhan amid the coronavirus outbreak has led to thousands of people being quarantined, China's state CCTV reported Wednesday.

The man, who was only named as Zhang, came to a village in China's Fujian province in late January from Wuhan. CCTV reported that he lied to the villagers and told them he returned from the Philippines.

He then attended a number of events in the community, including a 3,000-people folk-custom banquet and a wedding banquet attended by nearly 1,000 people.He showed symptoms in late January and was isolated for treatment.

On Feb. 1 he tested positive for coronavirus.

 

A local police statement released Wednesday said when the man returned from Wuhan, the local county government and hospital staff requested that he be quarantined at home and not go out, but he didn't follow the order.

 

The statement said "compulsory measures" were taken against Zhang, who was suspected of endangering public safety.

Xinjing newspaper quoted a local official as saying more than 4,000 people are currently under medical observation as the result of the man's actions.

Edited February 6, 2020 by tobyjugg2

[BazzaS]

Case definition updated (change in symptoms) but also a much larger change in geographical areas

 

The initial advice had only covered mainland China, but now also includes:  
■   Thailand
■   Japan
■   Republic of Korea 
■   Taiwan 
■   Singapore
■   Malaysia
■   Hong Kong
■   Macau 

 

presumably because:

Coronavirus: Third UK patient 'caught coronavirus in Singapore' https://www.bbc.co.uk/news/uk-51398039

 

 

 

[BazzaS]

On 27/01/2020 at 14:39, BazzaS said:

 

Do you agree:

a) “superspreaders may widen the Ro range seen” (there are suggestion one hospitalised case generated 14 secondary cases), and

b) the outbreak can be controlled by measures to bring Ro (targeting both standard spreaders and accepting the challenge of “superspreaders”) down to below 1?

reports of a 4th UK case (and both that person and the UK-nationals in France confirmed with  Coronavirus) having acquired it from the “3rd UK case” (who was a returnee from Singapore).

 

Suggestions that that 3rd Uk case may be a “super-spreader) (as was seen with SARS)

 

BBC News has just reported that the government has just announced:

Coronavirus 'imminent threat' to public health https://www.bbc.co.uk/news/uk-51442314

Expect that to mean that quarantine can be enforced (it takes a change in the law, probably by Statutory Instrument) to add 2019-nCoV to the list of diseases a “proper officer” can detain a person against their will.

It has benefits for those affected to.

Expect that where someone doesn’t have friends or family to go shopping for them, or would suffer financially from being isolated / ‘self-isolated’, that there is a more formal mechanism for them to receive support.