Coronavirus COVID-19 - Global Health Emergency #4

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Who do you believe? I listened to a video from the British gentleman regarding why Britain had abandoned them. It was fairly recent, he was referring to the US and Canada sending planes to evacuate their countrymen, but nothing from Britain. In it he said there were military trucks that came to take the USA passengers away to planes. And yet I read the passengers departed on buses but undergoing no health tests (link below). David Abel from Britain who has been posting from his suite on the cruise ship is now critical of the way Britain has forgotten their people, and applied to Richard Branson to send a small plane to evacuate them. (He even said he didn't know how to pay for it, but he would find a way so that Branson wouldn't be out any money). I think there's a lot of problems with little or no information being given to the Diamond Princess passengers. Also, does anyone know for certain that the planes to the US have actually taken off. The flight aware (thank you posters) doesn't seem to be updated and I can't find any additional information.

US passengers evacuated from quarantined cruise ship off Japan

MOO


<modsnip>


They are perfectly safe where they are and the cost and the people they could then infect is not worth it. He is not in a 3rd world country here and is he going to pay the costs that are involved in bringing him back or is it down to the tax payers?

They have all been treated really well considering they are in quarantine and it’s not meant to be a jolly good time.


MOO
IMO
 
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Anger builds among passengers stuck on coronavirus-stricken cruise ship as they face long quarantine period even after they get off the vessel

The number of infected passengers continues to grow, with an additional 70 cases reported on Monday, taking the total to 356.

Another 70 people have been infected with coronavirus on Diamond Princess cruise ship | Daily Mail Online





What do these people expect?


Nobody wants to be infected by any of them if they are a carrier. This is to keep everybody safe and they should just be happy that unlike 2000+ they are not dead.


IMO
 
I’m wondering this morning just how soon the WHO will officially declare this to be a pandemic. IMO, it’s time!

With all of the cases that continue to be reported worldwide, to believe that infected individuals haven’t fallen through the cracks of the quarantines would be wishful thinking at best. I will be absolutely amazed if we don’t see localized outbreaks worldwide within the next few weeks (I’m guessing sooner rather than later).
Trying to chase down all individuals that an infected person has had contact with in the general public is difficult at best. All it takes is one infected person to attend a large sporting event or social gathering. Or to forget one detail of where they have been while infected.
I can’t help but think about the early precautions that were being taken as people were arriving on return flights from China. Their temperatures were being taken and anyone without a fever was considered safe. In hindsight, with what we know now, I think most of us on this thread would agree that it wasn’t nearly enough. This particular virus had found various ways to go undetected in the early stages, and for a greater period of time compared to its relatives. Unfortunately, the truth of the matter is, to contain something, you first have to know that it’s there.
Containment through quarantine methods still provides the best opportunity to slow the progression of the outbreak, but IMOO, total containment has failed. IMO, we’re in the midst of a pandemic that has yet to be officially recognized.

I’ve been one of the outspoken “alarmists” on this thread, but I’m really more of a realist. I will again suggest that everyone do at least a little to prepare. Panic, fear, and chaos will more than likely be worse than the virus itself. Take the precautions you can, but don’t be one of the panic stricken if a global breakout does occur. Take extra precautions if you have underlying health issues. But here is the reality for most of us based on what’s being reported thus far....

  • This virus spreads very rapidly, but if we look at the number of confirmed cases in China, the percentage is extremely low compared to the 60 million people currently under quarantine. Even with under reported numbers, this means that either only a relatively small percentage has been infected, OR the majority of the cases have produced mild symptoms.
  • If by chance you do get infected, it currently appears that you have a 95% - 98% chance of recovery. Those are VERY GOOD ODDS!
  • Science these days is absolutely amazing - the odds are in humanities favor that a vaccine will be discovered or that new drugs will be created to help fight the disease.
  • I’ve always believed that a viral pandemic could/would decimate the human population, but unless there are major mutations that make this virus more deadly - this is not the one that will have a huge impact on the world population.
  • The world as a whole will go through an “adjustment period”, and though this virus (again - in my opinion) is much worse than the flu, we have to keep in mind that the flu IS a very deadly virus, but we have learned to live with it and do what we can to minimize it.
Getting through the adjustment period is going to be the difficult part. A little preparedness and continued education on the subject are key. A little bit of fear will keep us alert and will ensure that we stay focused on our precautions. Panic and chaos will only make any situation more dire.

Ok - stepping off of my soap box!

I’m hoping this post will help calm the nerves and lessen the anxiety of some folks that are following along.
Even in the worst of situations, it’s best to look at the entire picture and keep things in perspective. Cool heads will prevail!

Very well said, What if. I concur!
 
This is a very very good article about the sensitivity of the CORVID-19 testing and the predictive positive and predictive negative results and their impact.

It's quite pithy, but ends up with these conclusions:

"Either way, it is clear that low sensitivity diagnostic tests are a major problem in this COVID-19 outbreak."

The sensitivity of the current CORVID-19 test ( done on a thoat swab) is currently only about 40%.

Contrast that with the current rapid molecular testing for Influenza A or B done in most US hospitals which is about 90-95% sensitive.

This is a huge problem right now for epidemiologists. With a low-sensitivity test in a high-prevalence area, this paper explains you would have to test the same person 8 different times to get a statistically valid negative result. There is just no way any country can do this. Right now the best lab can only process 6,000 specimens a day. If the practice was to re-test negative results up to 8 times to assure they were negative, that would mean they would only test something like 1500 people a day, not 6000

Statistics, Decision Making, And Containing COVID-19 With Unreliable Diagnostic Tests

I think it might be possible that instead of doing nasal and mouth swabs, that they really need to get samples from deep in the lungs. I think maybe the virus could proliferate deeper in the lungs and could be harder to detect during that period? Maybe?

But if it is hiding out deeper in the lungs and not detectable on the other swabs, surely that means it's not going to be so communicable before it's detectable/a person is symptomatic?
 
I think it might be possible that instead of doing nasal and mouth swabs, that they really need to get samples from deep in the lungs. I think maybe the virus could proliferate deeper in the lungs and could be harder to detect during that period? Maybe?

But if it is hiding out deeper in the lungs and not detectable on the other swabs, surely that means it's not going to be so communicable before it's detectable/a person is symptomatic?
Here’s what I know about swabs in animals. Nasal swabs can be worthless. What you want to get is a pharyngeal swab from deeper in the throat. My 2 cents.
 
Here’s the thing. When people are literally locked up, they get cabin fever. They get cranky. And little things start to bother them.

If you’ve never gotten to the point of frustration with a situation where little things begin to bother you, you must be super special. It actually happens to me quite often due to pain levels. So I understand. And I have compassion for all of them.
 
Have seen it about on the internet...Dr Li Wenliang should be awarded a Nobel Peace Prize...I don't know what the qualifications actually are for such but he is certainly deserving of all the accolades that come his way for his courage and humanity.
 
South Korea tracks coronavirus patients' locations using phone data and CCTV footage - then publishes it online

Using mobile phone data, credit card records, CCTV footage and public transport cards, authorities pinpoint the activities of the 29 patients.

These travel logs are then uploaded onto the Ministry of Health and Welfare website so other citizens know if they could have come in to contact with an infected person.

South Korea tracks coronavirus patients' locations using phone data and publishes it online | Daily Mail Online


 
Young couple's wedding on board a cruise is cancelled because of the coronavirus crisis - and now they have nine days to plan their dream day

Kiara Titan and her fiance Ryan Robertson planned to say their vows on the Princess Cruises ship from Fremantle, Western Australia, to Singapore on February 22.

But their wedding dreams were shattered on Saturday when they received an early-morning email from the cruise company to say the trip had been cancelled.

Young couple's wedding on board a CRUISE is cancelled nine days out because of coronavirus | Daily Mail Online


Princess Cruises should be giving more notice of cancellation than nine days. It’s not like this crisis just started a few days ago.

 
Wow....had no idea....
___________________________

A Coronavirus Quarantine in America Could Be a Giant Legal Mess

America’s defense against epidemics is divided among more than 2,000 individual public-health departments, which makes implementing a national strategy very difficult.

7:00 AM ET

If a fast-spreading, deadly epidemic should threaten the United States, could the U.S. government do the same? The answer is yes: American government officials do have extensive authority to implement public-health measures to stop an epidemic, as the Americans on the Diamond Cruise ship in Yokohama, Japan, are now learning.
But the average American may be surprised to learn who holds the authority to order such public-health measures. Except at the nation’s borders, the federal government, with the expertise of the Centers for Disease Control and Prevention, is not in charge. America’s defense against epidemics is divided among 2,684 state, local, and tribal public-health departments. Each one is responsible for monitoring people within its jurisdiction, imposing isolation or quarantine as needed. CDC officials are “preparing as if [the new coronavirus] is the next pandemic,” but in reality, the laboring oar falls to state and local health departments......

A Coronavirus Quarantine in America Could Be a Giant Legal Mess
 
Well. That would certainly drag politics into this. What a colossal mess that would be. Hopefully, it never happens.

Wow....had no idea....
___________________________

A Coronavirus Quarantine in America Could Be a Giant Legal Mess

America’s defense against epidemics is divided among more than 2,000 individual public-health departments, which makes implementing a national strategy very difficult.

7:00 AM ET

If a fast-spreading, deadly epidemic should threaten the United States, could the U.S. government do the same? The answer is yes: American government officials do have extensive authority to implement public-health measures to stop an epidemic, as the Americans on the Diamond Cruise ship in Yokohama, Japan, are now learning.
But the average American may be surprised to learn who holds the authority to order such public-health measures. Except at the nation’s borders, the federal government, with the expertise of the Centers for Disease Control and Prevention, is not in charge. America’s defense against epidemics is divided among 2,684 state, local, and tribal public-health departments. Each one is responsible for monitoring people within its jurisdiction, imposing isolation or quarantine as needed. CDC officials are “preparing as if [the new coronavirus] is the next pandemic,” but in reality, the laboring oar falls to state and local health departments......

A Coronavirus Quarantine in America Could Be a Giant Legal Mess
 
CDC Situation Summary as of Feb 16, 2020:

_______________________

The United States reported the first confirmed instance of person-to-person spread with this virus on January 30, 2020.

The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan, but at this time, this virus is NOT currently spreading in the community in the United States.

The potential public health threat posed by COVID-19 is high, both globally and to the United States. The fact that this disease has caused illness, including illness resulting in death, and sustained person-to-person spread in China is concerning. These factors meet two of the criteria of a pandemic. It’s unclear how the situation will unfold, but risk is dependent on exposure.

For the general American public, who are unlikely to be exposed to this virus, the immediate health risk from COVID-19 is considered low at this time.

More cases are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in the United States.

The public health response is multi-layered, with the goal of detecting and minimizing introductions of this virus in the United States so as to reduce the spread and the impact of this virus.

CDC has deployed multidisciplinary teams to support state health departments with clinical management, contact tracing, and communications.

CDC has been uploading the entire genome of the viruses from reported cases in the United States to GenBank as sequencing was completed.
CDC has grown the COVID-19 virus in cell culture, which is necessary for further studies, including for additional genetic characterization. The cell-grown virus was sent to NIH’s BEI Resources Repositoryexternal icon for use by the broad scientific community.

2019 Novel Coronavirus (2019-nCoV)
 
Knowing what we know now about false negatives....wondering.....this is much larger group than I had hoped.
_________________________


The CDC report said that, by Jan. 31, the CDC had received clinical inquiries from public health officials and health care providers regarding 650 people suspected of being infected with the coronavirus.

The CDC team winnowed those inquiries down to 256 people with symptoms who needed further testing, of whom 210 were actually tested, the report said.

Among those tested, 178 were found through health care settings, 26 through contact tracing of confirmed infected people, and six through airport screening, the report said.

All those tested had some symptoms associated with coronavirus, including 143 with a fever and 189 with a cough or shortness of breath. There were 42 people who required hospitalization, and four were admitted to an intensive care unit.

No one in the United States has died from coronavirus infection, the CDC said. The agency received one inquiry regarding a person who'd died, but they were found to not have been infected with coronavirus.

Travel-related risks were identified for 148 of the people, while 42 had close contact with infected persons, 18 had both travel- and contact-related risks, and two were tested for possible contact.

The report was published in the CDC journal Morbidity and Mortality Weekly Report.

https://www.usnews.com/news/health-...irmed-how-cdc-identified-us-coronavirus-cases
 
Hoping no one's go to guy is Elton John. (pneumonia)

Ill Elton John halts concert saying he can't sing

And also, tonight, the BBC news report on outbreak focused on
how containment doesn't make sense at this point as virus has likely been seeded in communities since November, among other cold and flu cases.

ETA, Correction
 
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I think it might be possible that instead of doing nasal and mouth swabs, that they really need to get samples from deep in the lungs. I think maybe the virus could proliferate deeper in the lungs and could be harder to detect during that period? Maybe?

But if it is hiding out deeper in the lungs and not detectable on the other swabs, surely that means it's not going to be so communicable before it's detectable/a person is symptomatic?

Throat swabs are better sampling sources, but are more difficult to do correctly.

Getting deeper specimens from the lungs is an invasive procedure requiring anesthesia, some risk to the patient, and specialized equipment by a pulmonologist or intensivist. Most likely it would be a bronchoscopy. Expensive, some risk. Certainly not a screeing procedure.
 
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