Coronavirus

[KarenRei]

?? It IS meaningful when the individual is the director of a large scientific institution. Are you not familiar with NIH??

The article you linked is behind a paywall, but your summary talks about Dr. Nancy Messonier and says the director of the "National Center for Immunization and Respiratory Diseases", not the NIH. The director of the NIH is Dr. Francis Collins. In fact, I'd honestly never heard of NCIRD before this; apparently it's one of the many sub-branches of the CDC. Not even, from their descriptions, the one with the most applicability to this outbreak; that'd be the "National Center for Emerging and Zoonotic Infectious Diseases" (that's how specific the CDC's sub-branches get). More specifically, though, the CDC has a specific COVID-19 response team, headed by Dr. Daniel Jernigan; when it comes to speaking for the CDC, he would be the point person.

This is neither to dismiss Dr. Messonier's credentials or the seriousness of the threat (and I want to underscore this). I just wanted to point out that there are tens of thousands of people in the world with impressive credentials when it comes to infectious disease; a pick-and-choose strategy is not advised for this any more than it is for climate change. "But X doctor says...." should not be used to mean "the consensus view is...", unless said person is speaking officially on behalf of one of the primary organizations leading the fight against the disease. I don't like it when people do this when it comes to climate change, so obviously I don't like it here either.

Just my view. Yours may differ.

This paper estimates 18k cases in Iran. Very wide error band, but is still much more believable than the official number.

I could actually believe that, though I sincerely hope it's not that bad. And by all signs, it's still spreading there. :Þ They're letting themselves turn into a brand-new China. If they don't turn take serious action soon, they could become even worse.

The much more likely explanation is inadequate reporting and diagnosis of mild cases.

Indeed. As a general rule, diseases that rely on direct human-to-human transmission in-person usually evolve to become less virulent over time, not more virulent, as more virulent cases cause people to stay home and draw more attention from the medical community with respect to quarantines. There are lots of caveats, of course - diseases with intermediaries (such as biting insects), waterborne diseases, and the like can face opposite evolutionary pressures, people can unintentionally create opposite evolutionary pressures, etc. But usually the case is that when this sort of communicable disease jumps to humans for the first time, it's at its most deadly, but becomes less deadly with time in order that people keep going out and spreading it undetected. Which (alongside humans having a lack of defense against new diseases) is part of what makes them so dangerous.

Unrelated: Japan did ultimately report a batch yesterday: +10, bringing the total to 11. Still slightly down from the day before and well lower than the peak. Still encouraging there.

 

[bhtooefr]

From market politics:

The economic impact from this outbreak will probably last a year or more. China produces a large number of products in the world and most of the products that aren't made in China include components made in China. Just the economic disruption with China essentially shutting down so suddenly is setting off ripples throughout the world's economy.

I don't see the sort of death toll in the developed world (Europe, North America, Western Europe, Australia, New Zealand, Japan, and other countries with similarly advanced health systems) being staggeringly high. We're still at least six months from a vaccine for this virus, possibly longer, and there is no cure, but developed countries have the best secondary care in the world that allows the most people infected with a disease with a self cure rate the best chance to heal on their own and prevent secondary infections. Many of the people who died in the 1918 flu pandemic developed pneumonia. We can treat pneumonia and prevent it better than we did 100 years ago. As well as other secondary infections people weakened by disease tended to get 100 years ago.

China is a very crowded country and the sanitary standards in much of the country are not on par with many developed countries. Because it's the genesis country for the disease, it was widespread in that country before they knew it existed. The government has been lying about the figures, but they are claiming now that the epidemic there has peaked and the case numbers are dropping. That may or may not be true. We'll see in the next few weeks.

If the cases have peaked in China, the overall death toll has been relatively light for a country of over 1 billion people.

Trump's incompetence has drastically weakened the US's ability to respond to this outbreak. They have been thinking completely politically and not from a perspective of policy and that has resulted in the CDC's budget getting slashed, the government flying home 14 people from the cruise ship in Japan who tested positive with no containment (other people on that flight may have been infected and that could be the start of the US spread), and Trump has been more concerned about the stock market's reaction than any actual policy to deal with the problem.

The cruise ship issue is another example of politics over policy. When it started, the administration was content to let the Americans trapped on the ship to rot, until a passenger who personally knew a Republican congressman made a call, then it suddenly became a high priority to bring them all home, even with 14 infected. There was a long delay transferring the passengers from the ship to the airport after they discovered the infected passengers while loading them onto the bus. The CDC did not want to move the infected passengers, but the administration insisted. That decision may be the genesis of an uncontained outbreak in the US.

That was on Feb 17 and I've read the incubation period is about 14 days. We should know by next week.

Trump has been very, very lucky as president. He has not had to face any serious world problems in the three years he's been in office. GW Bush had 9/11 in his first year and Obama came into office under the largest economic meltdown since the Great Depression. This is looking like Trump's Katrina. He crippled the government department tasked with dealing with this sort of thing, and he's playing politics at a time that should be focused on policy.

The human cost of this virus in the developing world could be catastrophic, but the biggest impact in the developed world will likely be more economic both from unnecessary panic as well as real economic impact from supply chains being disrupted. Though even in the developed world there will be people who probably won't be here next year who will be lost to this disease.

Another case of putting politics ahead of policy that goes back a decade is the decision by Republican governors to not take the expansion of Medicaid as part of the ACA. It's resulting in a wave of rural hospital closures in red states:
72 Percent of All Rural Hospital Closures Are in States That Rejected the Medicaid Expansion

This could result in the impact on human life from the corona virus being felt more heavily in red states than blue, even though it's more likely there will be more cases in blue states (the Pacific Rim states have more direct contact with China than most of the rest of the country).

I had a feeling that the corona virus was going to have legs when I heard about it's incubation period. Ebola and SARS are only a few days, which makes them much easier to contain. A 14 day incubation period allows it to spread pretty far before anyone knows it exists. A disease that is easily transmitted, with a long incubation period, with a high mortality rate is the trifecta that keeps infectious disease specialists up at night. Corona isn't an ultra high mortality rate, but it's up there. But it meets the first two criteria.

And consider how many people in, say, the American service industry (and therefore are customer-facing to the general public, and are massive transmission vectors) are living paycheck to paycheck, and don't get paid sick leave (so taking time off means they miss bills).

And, even in states with ACA expansion, you have a lot of people that simply can't afford healthcare, or that wait for things to get severe before going in and just treat symptoms with OTC medication. And, even if they can afford it, finding the time is very hard for many Americans.

And, unlike China, there will not be prefab hospitals built for this. There will not be any kind of quarantine of whole regions, because that will be a political third rail (and even if it's tried, people will escape quarantine - if nothing else, lost wages will be enough reason for mass violation of quarantine, and you know wages won't be compensated by the government).

I would be unsurprised if this thing hits the US hardest out of any nation.

 

[elasalle]

ignorance, non-compliance and colder/milder weather are where the new hot spots seem to be.(Iran, Northern Italy)

(Singapore, Australia etc where things were detected a while back have not really surged as initially feared. )


...Spring's around the corner.

 

[NicoV]

Covid is twice as contagious as influenza, with 20 to 30 times the mortality rate
And it’s only in its infancy with relatively little known about it. It could end up being worse than swine flu

Assume it gets as bad as the Spanish flu in 1918. Since the mortality is very heavily skewed towards the older population, the short term and long term economic effects may be very different:
- short term: less economic growth, maybe even a recession, due to the effects of closing areas and factories. Higher health costs for treating people.
- long term: more economic growth, due to the wealth transfer from (older) people that died (and who don’t do a lot with their money) to the younger generations (who use he money to buy/build houses, cars, raise children etc). Lower health costs due to less older people.

Note to mods: please delete this post if it is to cynical for this forum.

 

[KarenRei]

ignorance, non-compliance and colder/milder weather are where the new hot spots seem to be.(Iran, Northern Italy)

(Singapore, Australia etc where things were detected a while back have not really surged as initially feared. )


...Spring's around the corner.

And an antiviral goes into testing in a couple weeks, and a vaccine in April. Time is very much a good thing. The question is how big of a headache we're going to end up with in terms of containment until then. :Þ

 

[Rashomon]

Assume it gets as bad as the Spanish flu in 1918. Since the mortality is very heavily skewed towards the older population, the short term and long term economic effects may be very different:
- short term: less economic growth, maybe even a recession, due to the effects of closing areas and factories. Higher health costs for treating people.
- long term: more economic growth, due to the wealth transfer from (older) people that died (and who don’t do a lot with their money) to the younger generations (who use he money to buy/build houses, cars, raise children etc). Lower health costs due to less older people.

Note to mods: please delete this post if it is to cynical for this forum.

I already have a tweet that Corona virus may do more for the Social Security trust fund than any politician /s

 

[UCF3]

Assume it gets as bad as the Spanish flu in 1918. Since the mortality is very heavily skewed towards the older population, the short term and long term economic effects may be very different:
- short term: less economic growth, maybe even a recession, due to the effects of closing areas and factories. Higher health costs for treating people.

Maybe a recession? Spanish Flu killed 40 million people. We’d be looking at a depression if this thing kills 40 million people

 

[SageBrush]

As a general rule

CoVid-19 is a zoonosis, as is influenza.

Next year's strain may be more or less virulent

 

[avoigt]

I have seriously a hard time to understand why anybody ever would compare CoroVid with the Spanish Flue? Do we have a worldwide war with many injured, ill and people starving or having less or bad care and medicine? Thats really not an applicable comparison.

What we heard today is that the new cases in China that has been called from the world devastating before, continue to fall every day while admittedly in Italy they increase because some stupid Hospital Manager thought they can disregard rules like the Superhost in the religious group who likely hoped if they do many prayers together the virus will not be bad. All people in Italy identified could be traced back to the place and person where he or she got the virus. Thats really important because as long as you can track you have control to stop it spreading further.

While the new cases in China are now lower than international and falling since days we can be positive that China has learned the lesson and other countries will benefit from their experience. China is hopefully a place where we don't see numbers go up big again. Cross Fingers.

No doubt its not good what we have seen in Italy but we should see new cases to increase there the next days and weeks but it does not matter as this is just the effect of people spreading it for days and weeks and no one did know. Once authorities know and take measure the question is are they effective. We know now from China they are.

I would be worried if we would see a ton of new infection heard in China but we don't. Instead we see some new heards in other places in Asia, Middle East and Europe and likely soon in the Americas too but to isolate them put a proper quarantine around and kill the Virus is just business as usual. Sounds too easy? Well thats how its been proven hindered times and there is absolutely no reason for us to believe this will be different.

Authorities do that since decades and its just funny for me how anybody can panic. If you life near an infection heard are older generation and have other diseases than you should be carful buts lets face that although the fatality rates sound high for many its a defined group that could protect and should if they believe they could be exposed. For most the infection goes mild and the Virus gets usually weaker with ever time he jumps.

Will that have a negative impact on economies? Sure, in some areas but thats happening every year somewhere sometimes more severe, sometimes mild but no one reports about it. You can mitigate a lot by giving cheap or free money and thats happening already.

Get used to it, situation like that are happening from time to time.

 

[KarenRei]

CoVid-19 is a zoonosis, as is influenza.

Next year's strain may be more or less virulent

There's not an non-human -> human jump for each seasonal influenza strain, even though they are are zoonotic in origin. Normally seasonal influenza strains are residual in populations of humans at lower levels, particularly (but not exclusively) present in the tropics, particularly (in modern times) in Asia. During the summer season, they tend to adapt enough to partially bypass the previous year's host immunity in high-latitude populations.

Ex: Explaining the geographical origins of seasonal influenza A (H3N2)

 

[SageBrush]

There's not an non-human -> human jump for each seasonal influenza strain, even though they are are zoonotic in origin.

That is correct, but the severe pandemics like 1918 and 2009 influenza are due to genetic recombinations between between human and non-human strains, as is the first jump from animal to human.

Antigenic drift causes another season of infection; recombination events are seasons that we remember.

I mis-wrote in calling the recombination event a strain. It should be labelled a sub-type. MERS, SARS and CoVid-19 are CoronaVirus subtypes that arose from recombination events. I never say never, but I cannot think of an intra-seasonal recombination event which is why I view the possibility of CoVid-19 "mutation" into a super deadly strain this season as a very remote possibility.

 

[plumazul]

I have seriously a hard time to understand why anybody ever would compare CoroVid with the Spanish Flue? Do we have a worldwide war with many injured, ill and people starving or having less or bad care and medicine? Thats really not an applicable comparison.<snip>

The Spanish Flu Pandemic was very hard on young healthy people in their prime. Older people were more likely to be protected by previous exposure to a similar strain. That's not the case with SARS-CoV-2 since it is new and has characteristics that would make it more deadly for older people or others with weaker immune systems. There ARE comparisons to be made. They are both RNA viruses, and both are shed in infected persons BEFORE clinical manifestations appear. This feature makes both hard to contain.

I would be worried if we would see a ton of new infection heard in China but we don't. Instead we see some new heards in other places in Asia, Middle East and Europe and likely soon in the Americas too but to isolate them put a proper quarantine around and kill the Virus is just business as usual. Sounds too easy? Well thats how its been proven hindered times and there is absolutely no reason for us to believe this will be different.

It's different because with SARS-CoV-2 there are asymptomatic shedders with VERY high viral loads. This was not seen in SARS-1. Because of this, it's hard to know who to quarantine. There aren't enough resources in most places (including the USA) to do the necessary screening. Make no mistake, this is a problem.

Authorities do that since decades and its just funny for me how anybody can panic. If you life near an infection heard are older generation and have other diseases than you should be carful buts lets face that although the fatality rates sound high for many its a defined group that could protect and should if they believe they could be exposed. For most the infection goes mild and the Virus gets usually weaker with ever time he jumps.

People panic because people are DYING. Certainly you can understand that, right?

 

[SageBrush]

The Spanish Flu Pandemic was very hard on young healthy people in their prime. Older people were more likely to be protected by previous exposure to a similar strain

That is true in part; the other part of the story is the auto-destructive immune response, similar to that seen in the 2009 Swine flu season. CovID-19 does not share that characteristic.

It's different because with SARS-CoV-2 there are asymptomatic shedders with VERY high viral loads.

Proof ?
I suspect you are confusing asymptomatic shedders with shedders who have cormorbidities that mask the CV infection or elderly who provide poor history information. You should learn to be circumspect in your conclusions from the cruise ship experiment.

And yes, the distinction matters greatly when the question is R naught value

 

[jfabula]

overblown out of proportions from data....Older folks are suseptibles to this kind of virus. In China where the pollutions are bad, contacting this virus probably is fatal due low immunity. Just my guesses and no data to prove it otherwise....hmmmm

 

[SageBrush]

Older folks are suseptibles to this kind of virus. In China where the pollutions are bad, contacting this virus probably is fatal due low immunity.

Not immunity, but respiratory and cardiovascular co-morbidities. Think tobacco

 

[jfabula]

Not immunity, but respiratory and cardiovascular co-morbidities. Think tobacco

ADD that is destructive proportions

 

[plumazul]

That is true in part; the other part of the story is the auto-destructive immune response, similar to that seen in the 2009 Swine flu season. CovID-19 does not share that characteristic.

auto-destructive immune response?? Be specific. What are you talking about? Cytokine storm was documented in SARS and again in patients with SARS-CoV-2 infections.

Proof ?
I suspect you are confusing asymptomatic shedders with shedders who have cormorbidities that mask the CV infection or elderly who provide poor history information. You should learn to be circumspect in your conclusions from the cruise ship experiment.

And yes, the distinction matters greatly when the question is R naught value

I suppose you are unaware of so many things because you are busy and don't have time to read the literature. I'm retired so I have plenty of time to read published and preprint papers. If you have any questions about the latest research, feel free to send me a private message and I will try to help you understand.

 

[plumazul]

CoVid-19 is a zoonosis, as is influenza.

Next year's strain may be more or less virulent

COVID-19 is the name of the syndrome in humans infected with SARS-CoV-2. Let's try to get the terminology correct if nothing else.

 

[KarenRei]

The article you linked is behind a paywall, but your summary talks about Dr. Nancy Messonier and says the director of the "National Center for Immunization and Respiratory Diseases", not the NIH. The director of the NIH is Dr. Francis Collins. In fact, I'd honestly never heard of NCIRD before this; apparently it's one of the many sub-branches of the CDC. Not even, from their descriptions, the one with the most applicability to this outbreak; that'd be the "National Center for Emerging and Zoonotic Infectious Diseases" (that's how specific the CDC's sub-branches get). More specifically, though, the CDC has a specific COVID-19 response team, headed by Dr. Daniel Jernigan; when it comes to speaking for the CDC, he would be the point person.

This is neither to dismiss Dr. Messonier's credentials or the seriousness of the threat (and I want to underscore this). I just wanted to point out that there are tens of thousands of people in the world with impressive credentials when it comes to infectious disease; a pick-and-choose strategy is not advised for this any more than it is for climate change. "But X doctor says...." should not be used to mean "the consensus view is...", unless said person is speaking officially on behalf of one of the primary organizations leading the fight against the disease. I don't like it when people do this when it comes to climate change, so obviously I don't like it here either.

Just my view. Yours may differ.



I could actually believe that, though I sincerely hope it's not that bad. And by all signs, it's still spreading there. :Þ They're letting themselves turn into a brand-new China. If they don't turn take serious action soon, they could become even worse.



Indeed. As a general rule, diseases that rely on direct human-to-human transmission in-person usually evolve to become less virulent over time, not more virulent, as more virulent cases cause people to stay home and draw more attention from the medical community with respect to quarantines. There are lots of caveats, of course - diseases with intermediaries (such as biting insects), waterborne diseases, and the like can face opposite evolutionary pressures, people can unintentionally create opposite evolutionary pressures, etc. But usually the case is that when this sort of communicable disease jumps to humans for the first time, it's at its most deadly, but becomes less deadly with time in order that people keep going out and spreading it undetected. Which (alongside humans having a lack of defense against new diseases) is part of what makes them so dangerous.

Unrelated: Japan did ultimately report a batch yesterday: +10, bringing the total to 11. Still slightly down from the day before and well lower than the peak. Still encouraging there.

Correction to the above: it appears that Messonier has been doing the press briefings for the COVID-19 response team at the CDC, so her statements should be considered representative of the CDC's views. While that's different from the last statements of WHO, it gives them credence.

 

[JRP3]

A team of scientists at the Hong Kong University of Science and Technology (HKUST) has recently made an important discovery in identifying a set of potential vaccine targets for the SARS-CoV-2 coronavirus, providing crucial leads for guiding experimental efforts towards the vaccine development against the novel pneumonia (COVID-19) caused by the virus.

Scientists shed light on COVID-19 vaccine development