Virologist says measures must be implemented for one year to address coronavirus

[DrTuner]

44 minutes ago, TallGuyJohninBKK said:

From the NYT today:

 

https://www.nytimes.com/2020/02/05/world/asia/coronavirus-china.html

 

Yeah. The confirmed diagnoses in JHU's dashboard are rising at 3-4k/day. It should be more exponential. The rate seems to be limited and I'd give high probability it's because of what the article describes. 

[rabas]

18 minutes ago, SkyFax said:

And the next paragraph in that article is:

 

Still, the number of people in China recovering from the virus is rising, suggesting that the treatment plan may be working. On Tuesday, 262 people left hospitals nationwide. The number of suspected cases has dropped for two days in a row. Officials said they were tracking 3,971 suspected cases, compared with 5,173 cases the day before.

It may not be that clear. The increase in cured per day also relates to the lag time between admission and discharge. Today's cured rate will track the rapid increase in admissions roughly 2-3 weeks prior.  The detailed paper on forcasting referenced by WaveHunter gives a better picture of how the whole process is modelled, particularity the sharp peak in April/May. Hope so, Thai flu season starts in June.

 

[WaveHunter]

2 minutes ago, rabas said:

It may not be that clear. The increase in cured per day also relates to the lag time between admission and discharge. Today's cured rate will track the rapid increase in admissions roughly 2-3 weeks prior.  The detailed paper on forcasting referenced by WaveHunter gives a better picture of how the whole process is modelled, particularity the sharp peak in April/May. Hope so, Thai flu season starts in June.

 

The real question in my mind is what exactly is the definition of "cured"?  More specifically, is it a symptomatic assessment, or is it actually being confirmed that there is no viral load (i.e.: the virus is not in the body any longer).  That is not being made clear at all from any sources I've seen.  Does anyone else have any better information?

[WaveHunter]

17 minutes ago, rabas said:

It may not be that clear. The increase in cured per day also relates to the lag time between admission and discharge. Today's cured rate will track the rapid increase in admissions roughly 2-3 weeks prior.  The detailed paper on forcasting referenced by WaveHunter gives a better picture of how the whole process is modelled, particularity the sharp peak in April/May. Hope so, Thai flu season starts in June.

 

Just think, last year at this time our main concern here in Thailand as summer approached was the flu and and the dangers of mosquitos as rainy season neared.  Now we've got this to possibly look forward to ???? 

 

Still though, some viruses do not do well at all in warmer more humid weather.  Remember that right now in China it is very cold.  SARS disappeared in the northern summer of 2003 and has not reappeared significantly since. The seasonality of influenza and other respiratory viruses in temperate countries is thought to be related to factors that affect infectiousness (person to person spread) such as the dryness of the air, ambient air temperature and possibly ultraviolet solar radiation.  The Thai weather may end up being our saving grace ????

 

 

 

Edited February 5, 2020 by WaveHunter

[SkyFax]

17 minutes ago, rabas said:

It may not be that clear. 

 

Thank you -- editor (at) NYtimes would love to hear from you.

[SkyFax]

40 minutes ago, WaveHunter said:

Firstly, China is member of the WHO, and has considerable influence over policy there.  They pour billions of dollars into the coffers of WHO, and

Key Facts

The World Health Organization (WHO), founded in 1948, is a specialized agency of the United Nations with a broad mandate to act as a coordinating authority on international health issues.

The U.S. government (U.S.) has long been actively engaged with WHO, providing financial and technical support as well as participating in its governance structure.

The U.S. is currently the largest contributor to WHO.

 

https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-the-world-health-organization/

[WaveHunter]

20 minutes ago, SkyFax said:

Key Facts

The World Health Organization (WHO), founded in 1948, is a specialized agency of the United Nations with a broad mandate to act as a coordinating authority on international health issues.

The U.S. government (U.S.) has long been actively engaged with WHO, providing financial and technical support as well as participating in its governance structure.

The U.S. is currently the largest contributor to WHO.

 

https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-the-world-health-organization/

...and ???  What point are you trying to make?

Edited February 5, 2020 by WaveHunter

[SkyFax]

23 minutes ago, WaveHunter said:

...and ???  What point are you trying to make?

Edited 13 minutes ago by WaveHunter

  1 hour ago, WaveHunter said:
Firstly, China is member of the WHO, and has considerable influence over policy there.  They pour billions of dollars into the coffers of WHO, and

The US pours a lot more billions of dollars into the WHO than does China. This is for the UN as a whole not WHO specifically:

https://qz.com/1396994/where-does-the-un-get-its-money-a-simple-explanation-of-a-complex-system/ (SEP 2019)

Edited February 5, 2020 by SkyFax

[zydeco]

8 minutes ago, SkyFax said:

The US pours a lot more billions of dollars into the WHO than does China. This is for the UN as a whole not WHO specifically:

https://qz.com/1396994/where-does-the-un-get-its-money-a-simple-explanation-of-a-complex-system/ (SEP 2019)

But China shovels money into Ethiopia. And the head of WHO is an Ethiopian politician who is Xi's puppet.

[WaveHunter]

1 hour ago, SkyFax said:

The US pours a lot more billions of dollars into the WHO than does China. This is for the UN as a whole not WHO specifically:

https://qz.com/1396994/where-does-the-un-get-its-money-a-simple-explanation-of-a-complex-system/ (SEP 2019)

That may be true but money is money, and China has a reputation for using money in this manner, and doing it in an extremely effective way.  It is simply an extension of their "Belts and Roads" initiative, which, though it may sound noble and good on the surface, is really a very well-conceived and very effective way that China is influencing foreign governments and institutions all around the world to bend to their will.

 

Irregardless of the monetary incentive, how can anyone rationally explain WHO's position of finally declaring this crisis as a global emergency, yet emphatically and specifically stating that travel and trade should not be restricted nor should any other actions be taken "against" China, and anyone who thinks it should is making a big mistake (The Director-General's words, not mine). 

 

Using the word "against" is intentionally implying that to do so would be to punish the Chinese (i.e.; to act in a racist manner towards China.) That statement by the Director-General has a highly charged political statement that had nothing whatsoever to do with health issues.

 

The WHO's current position makes absolutely no sense at all, given the severity of the current situation.  Their mission is to promote the safety and well being of the global community, NOT the economic well being of China, which right now, are diametrically opposed to one another.  Yet that is exactly what the WHO is doing; placing greater concern with the economic well being of China, than the health and safety of the global community!

 

Please explain, if you can, how my reasoning is incorrect.

Edited February 5, 2020 by WaveHunter

[SkyFax]

9 minutes ago, WaveHunter said:

That may be true

It is true.

[WaveHunter]

7 minutes ago, SkyFax said:

It is true.

So you are just going to ignore everything else I said?

Edited February 5, 2020 by WaveHunter

[Haecksler]

 

5 hours ago, rabas said:

As for to 41 cohort study, this was a closed study in that all 41 cases were either dead or recovered. Their outcome is known. You are correct about sampling issues,

 

4 hours ago, WaveHunter said:

A lot of misinformation is going around about "death rate" figures.  Again for those who keep harping on a specific death rate figure for nCoV, there is no valid number right now since it requires

Hey guys please allow me that comment

You did both a outstanding work on all of this forums trying to bring a important and right message to the people and I see that you are now discussing / (hope not arguing) about something which is relevant but not relevant in precise numbers.

This virus is dangerous and people should prepare accordingly. People should not compare it with the flu I think this is misleading the point entirely.

It would be a pitty to see you guys wasting your time instead of posting more important facts.

I just closed a chat with a Chinese man and definitely he could not answer my questions about the situations at the hospitals. But he said that they use methylprednisolone to treat the symptoms with subsequent bone problems. Can you comment that? 

[SkyFax]

8 minutes ago, WaveHunter said:

So you are just going to ignore everything else I said?

Yes.

[WaveHunter]

7 hours ago, TallGuyJohninBKK said:

 

WH, was their projection of the April peak just for China alone, or for the world?

 

If for China alone, then all the other places and countries, including Thailand, are going to have presumably sequentially longer times to peak and resolution, because they were later starters in the process, so to speak.

 

Just for Wuhan City; Other seeded cities in China (and all provinces) would lag by about two weeks.  The April date is assuming that containment efforts are not effective, and the peak is caused by "herd immunity effect". 

 

So far, it looks like containment efforts within China are not proving to be very effective considering that all provinces are now affected and there is a lot of city seeding in every major city.  The containment is not expected to be very effective so April is probably the date for peak in Wuhan and a few weeks later for the rest of China, but if it proves effective to some degree, the peak dates could occur earlier.  It is all in the reports at Lancet. 

 

As for international locations, there really are no uncontained outbreaks yet, but there are dozens of confirmed cases all over the world as we all know.  Most seems to be well contained, so theoretically there could be no spread (and thus no peak to be concerned with), but then there is the problem of infected but unconfirmed cases. 

 

Over 5 million people were able to leave Wuhan before the city was locked down.  Many were able to travel overseas before any sort of screening was in place, so they are the "wild card" right now in how the pandemic plays out over the next week I think.  It is a wait-and see type of thing right now of whether or not this thing blows up globally, I guess.  Hopefully it will not!

 

Edited February 5, 2020 by WaveHunter

[overherebc]

Mostly questions.

The other day I'm sure I heard, uk news, the virus has not mutated. Later samples been exactly the same as initial samples.

SARS and MERS, from memory did mutate and started to lose some of their impact.

As I started by saying, questions, not statements by me, could this new virus not 'need' to mutate to ensure its own survival, ie it doesn't so far have any obvious weak points that can be attacked.

I'm in no way a medical person, just someone asking questions.

Edited February 5, 2020 by overherebc

[ThaiBunny]

[ThaiBunny]

The above can be seen on the Al Jazeerah site - https://www.aljazeera.com/news/2020/02/dangerous-coronavirus-200205205234883.html

[WaveHunter]

17 hours ago, Haecksler said:

 

 

Hey guys please allow me that comment

You did both a outstanding work on all of this forums trying to bring a important and right message to the people and I see that you are now discussing / (hope not arguing) about something which is relevant but not relevant in precise numbers.

This virus is dangerous and people should prepare accordingly. People should not compare it with the flu I think this is misleading the point entirely.

It would be a pitty to see you guys wasting your time instead of posting more important facts.

I just closed a chat with a Chinese man and definitely he could not answer my questions about the situations at the hospitals. But he said that they use methylprednisolone to treat the symptoms with subsequent bone problems. Can you comment that? 

All I really know about methylprednisolone use for nCoV patients is from a Lancet article I read.  It is a corticosteroid that was given as part of a combined regimen if severe community-acquired pneumonia was diagnosed.  It was given in combination with antibiotic treatments. 

 

I may be wrong but I do not think the use of methylprednisolone or antibiotics is to address the virus directly but to address associated inflammation brought on by pneumonia.

 

However, I recently read an article in Nature that discusses two drugs that may be proving to be effective at dealing with nCoV and I'll do a post on them shortly.

[englishoak]

A Chinese newborn has been diagnosed with the new coronavirus just 30 hours after birth, the youngest case recorded so far, state media said. The baby's mother tested positive before she gave birth. It is unclear how the disease was transmitted. https://www.bbc.co.uk/news/world-asia-china-51395655

 

Medical experts say it could be a case of mother-to-child transmission - where the infection was contracted in the womb or it could have contracted it after birth in the usual close contact manner. This could be a BiG complication because babies cant contract the Flu virus from mother to child transmission, if it turns out the baby was born with it then we have just jumped the shark and in bigger doo doo than current assessments predict.

Edited February 6, 2020 by englishoak

[sometime]

Todays Daily Express

Coronavirus terror: Major panic erupts amid fears REAL death tally for virus is revealed

TERROR has erupted after a coronavirus tracker on one of China's top tech giants Tencent briefly listed the death toll as almost 25,000 on Saturday. The figure comes in at almost one hundred times the official tally that day of just 300.

[WaveHunter]

I read a fascinating letter to the editor on the Nature.com website published 04 February concerning two antiviral drugs that may prove to inhibit the novel coronavirus (2019-nCoV), so I thought I'd share here.

 

The link is https://www.nature.com/articles/s41422-020-0282-0

 

The drugs are Remdesivir and Chloroquine.  The findings reveal that remdesivir and chloroquine are highly effective in the control of 2019-nCoV infection in vitro (in a petri dish), and seem to have actually worked in-vivo (in human)...in the man in Washington State who has recovered.

 

Remdesivir was seriously looked at during the SARS, MERS, and Ebola outbreak, and while it worked in-vitro, it did not work in-vivo.  They now have tried it In-Vivo with the man in Washington State in critical condition with nCoV, and it appears that it may have worked since he felt better within a day, and seems to have fully recovered after a few more days (no viral load detected). 

 

Of course without controlled random trials that can't yet say it actually works so formal trials are now about to begin.

 

The way it works is that once the virus enters a healthy cell, Remdesivir prevents the virus from replicating itself. 

 

Science-Speak:  The way nCov works is that once the virus is able to enter a healthy cell, the virus tries to use the healthy cell's replication machinery to replicate itself by changing the RNA sequence of the healthy cell from ATGCTT to AUGCUU, let's say. 

 

What Remdesivir does is puts an artificial "A" in the healthy cell so when the virus polymerization begins and hits the Remdesivir's "A", the virus' replication process can not go beyond the "A" and the replication process is halted.  

 

I'm grossly simplifying this just to make it clear (and probably doing a poor job of it) but I think you get the idea.

 

Remdesivir has already been tested on humans and its' safety is known.  Even though it is not FDA approved, scientist felt it was proper to use it anyway under the new "compassionate use" laws passed by the Trump Administration.

 

Even though it worked, it is still not "proven" to work in-vivo.  Effectiveness must be determined by randomized, placebo controlled trials which will now be conducted in China, and it should be known by April if it works.

 

Chloroquine has been around for years and used effectively in Malaria.  It has also been found to be promising in treating nCoV.  The way it works is in raising the pH of lysosomes thus preventing the virus from merging to the healthy cell.

 

There are many other drugs being tested as well.  In Thailand for instance, researchers are exploring the use of AIDS drugs (lopinavir and ritonavir) in human cases of nCoV with apparent success.

 

Of course all of these drugs, as promising as they sound, they must go through randomized, placebo controlled trials to determine true effectiveness, but that seems to be what is now about to happen in China, so this is incredibly encouraging!

Edited February 6, 2020 by WaveHunter

[WaveHunter]

11 hours ago, overherebc said:

Mostly questions.

The other day I'm sure I heard, uk news, the virus has not mutated. Later samples been exactly the same as initial samples.

SARS and MERS, from memory did mutate and started to lose some of their impact.

As I started by saying, questions, not statements by me, could this new virus not 'need' to mutate to ensure its own survival, ie it doesn't so far have any obvious weak points that can be attacked.

I'm in no way a medical person, just someone asking questions.

It would seem that mutations could be either a good or bad thing; which I guess goes without saying really.

 

As for 'weak" points, over time, as more and more people get the virus and recover, they will be more immune to a second infection so this "herd immunity" effect will naturally lower the infectiousness of nCoV.

 

It's estimated this will lower infectiousness by about 50%, giving it an R0 (R-naught) of 1.3, which means 1 index case will only infect one healthy person instead of what it is now which is 1 index case infecting 3 persons, each of which then goes on to infect three more people, and so on.

 

It is estimated that even if containment efforts have a minimal impact on the additional outbreaks within China right now (which appears to be the case since it has spread to all provinces and major cities), the herd-immunity effect will cause the outbreak to peak by April, in Wuhan, and a couple of weeks later in other parts of China.

 

Also, there are anti-viral drugs (I posted about this earliest this morning) that appear to be effective and are going to be in clinical trials in China shortly that do in fact exploit the "weak" points and curtail the virus's ability to replicate.

 

These are drugs that have already been developed, safe for use in humans, and proved successful in-vitro (in petri dishes) for SARS, MERS, and Ebola, though they did not work in-vivo (in humans), but in the case of n-CoV, they appear to work in humans.  

 

BTW, I'm not a doctor or scientist either but I read The Lancet (probably the most well respected peer-reviewed medical journal in the world) and Nature.com, another science-based and highly regarded source of information on this virus, and this is where all of what I am relaying comes from. 

 

These are very trustworthy sources, unlike a lot of garbage floating around in the mass media, on the internet, and in social media right now.

Edited February 6, 2020 by WaveHunter

[overherebc]

3 minutes ago, WaveHunter said:

It would seem that mutations could be either a good or bad thing; which I guess goes without saying really.

 

As for 'weak" points, over time, as more and more people get the virus and recover, they will be more immune to a second infection so this "herd immunity" effect will naturally lower the infectiousness.  It's estimated this will lower infectiousness by about 50%, or an R0 of 1.3.

 

It is estimated that even if containment efforts have a minimal impact on the additional outbreaks within China right now (which appears to be the case since it has spread to all provinces and major cities), the herd-immunity effect will cause the outbreak to peak by April.

 

Also, there are anti-viral drugs (I posted about this earliest this morning) that appear to be effective and are going to be in clinical trials in China shortly that do in fact exploit the "weak" points and curtail the virus's ability to replicate.

 

These are drugs that have already been developed, safe for use in humans, and proved successful in-vitro (in petri dishes) for SARS, MERS, and Ebola, though they did not work in-vivo (in humans), but in the case of n-CoV, they appear to work in humans.  

Thanks. Let's hope any mutation goes the 'right way'.

[WaveHunter]

41 minutes ago, WaveHunter said:

...It's estimated this will lower infectiousness by about 50%, giving it an R0 (R-naught) of 1.3, which means 1 index case will only infect one healthy person instead of what it is now which is 1 index case infecting 3 persons, each of which then goes on to infect three more people, and so on. ...

Before somebody jumps on me for inaccuracies, An R0 of 1.3 means the virus will still spread, but only by a factor of 1.3. 

 

I worded it wrong in my original post but it felt weird to refer to 1.3 people, as if there is such a thing.

 

It is an R0 of 1.0 when an index case will infect only one other person, and that person will then only infect one other person; in other words, there will no longer be an epidemic when R0 = 1.0

 

Sorry bout that ????

 

Edited February 6, 2020 by WaveHunter

[DrTuner]

5 minutes ago, WaveHunter said:

Before somebody jumps on me for inaccuracies, An R0 of 1.3 means the virus will still spread, but only by a factor of 1.3.  I worded it wrong in my original post  An R0 of 1.0 means an index case will infect one other person, and that person will only infect one other person; in other words, there will no longer be an epidemic

With 1.0 it'll still linger a while before it peters out. It's not a constant of course, herd immunity, vaccine availability etc change it and it also varies due to population density, etc. If you're stuck in an immigration office with 1500 people cramming into 25 sqm (Jomthien comes to mind), one coughing their lungs out will infect half of them, to give an example. The R0 quoted for SARS & co was some average taken at some point of time from the final tally.

Edited February 6, 2020 by DrTuner

[WaveHunter]

10 minutes ago, DrTuner said:

With 1.0 it'll still linger a while before it peters out. It's not a constant of course, herd immunity, vaccine availability etc change it and it also varies due to population density, etc. If you're stuck in an immigration office with 1500 people cramming into 25 sqm (Jomthien comes to mind), one coughing their lungs out will infect half of them, to give an example. The R0 quoted for SARS & co was some average taken at some point of time from the final tally.

Yes I agree you are right; it will linger but it will not be an epidemic.

 

LOL...your mention of the Jomtien Immigration Office brought a cringe to my face.  I lived in Jomtien until last November, and suffered a bout of Flu after being in that frightful environment for a few hours, renewing my visa.  I don't know if that had anything to do with getting the flu then, but if that had happened now instead of back then, I would certainly be freaking out big time right now! ????

Edited February 6, 2020 by WaveHunter

[rabas]

There will likely be many announcements of cures based on various mixtures of known drugs. This was also true during the SARS epidemic. These were later reviewed in the medical literature and while a few looked promising, none were found to be cures. HIV drugs came to light at that time.

 

Here are a couple more for the new nCoV2019.

 

Another thread was bashing Thailand for claiming a cocktail of anti virals cured the first Thai patient, a severely ill woman. Later the Chinese announced similar findings, but note the Thai used a live patient, the Chinese did it in a beaker. 

 

China, Reuters:Oil-jumps-3-on-reports-of-effective-coronavirus-drug

 

China’s Changjiang Daily newspaper reported on Tuesday (Feb 4) that a team of researchers led by Zhejiang University Professor Li Lanjuan had found that drugs Arbidol and Darunavir can inhibit the virus in vitro cell experiments.

 

What are these drugs?

1. Arbidol is a Russian anti-viral drug similar in use to Tamiflu (Oseltamivir) it can prevent the virus from entering cells,  Tamiflu stops it from exiting.

2. Darunavir is a well known HIV drug, often used in combo with others.

 

The Thai used a mixture of HIV drugs and Tamiflu to cure the lady. So these trials were both HIV drugs + flu antivirals.  Expect more but good luck buying anything announced as a cure.

Edited February 6, 2020 by rabas

[morrobay]

1 hour ago, WaveHunter said:

 

 

I worded it wrong in my original post but it felt weird to refer to 1.3 people, as if there is such a thing.

 

 

 

Most here probably know the RO is an exponent. If the average generation/infection period is 2 days then in one month with RO 1.3  the infections = 15^1.3 = 33. I f the RO is 3 then 15^3 = 3375 

[FarFlungFalang]

12 hours ago, ThaiBunny said:

Notice the fatality rate 2% with the infected number of 20,000 well they only have the number of confirmed cases and the put a little plus symbol after the number because they have no idea of the actual number of infections and if they have no idea what the number of infections is they don't "know" the actual fatality rate is.Nobody can prove what the fatality rate is because they can't prove the infection rate. 

Edited February 6, 2020 by FarFlungFalang