Coronavirus COVID-19 - Global Health Emergency #4

[tabitha111]

I noticed that no one on that plane was wearing googles or eye protection (except for some with glasses, which may help minimally.)

 

[Hatfield]

Are you kidding me? Allowed to infect other passengers and crew?

Diamond Princess: "After consultation with HHS officials, including experts from the HHS Office of the Assistant Secretary for Preparedness and Response, the State Department made the decision to allow the 14 individuals, who were in isolation, separated from other passengers, and continued to be asymptomatic, to remain on the aircraft to complete the evacuation process," the agencies said.

JMO
Wonder why they couldnt have gotten a separate plane for suspected infected people and keep them on a separate plane?

A plane is a fixed enclosed place and I dont think any amount of plastic sheeting could guarantee others on the plane will not breathe in the same air.

It seems common sense keeps going out the plane windows. We try to trust they are doing things right but then we keep hearing stories like this that dont make sense.

 

[Hatfield]

There was a paper in arxiv very early on that had 8 patients from around the world and said that the Asian male had more of the ACE2 receptors and maybe that was why it had taken off in China especially in males.

But other scientists said that the sample size of 8 individuals with only 1 Asian male wasn't enough to draw inferences from.

Another study has potentially linked smoking with increased ACE2 receptors in the parts of the lungs that this virus seems to target and suggested that smoking might be related to more severe cases.

Also, the study of 138 January patients, I believe that didn't show up any major difference between males and females as regards more serious cases.

Thank you. That is the kind of information I hope the WHO will be able to determine more accurately now that they are there.

It is vitally important to know these things so we can help combat it and to know what gives us a better chance of not catching it.

 

[Medstudies]

County Officials Declare Precautionary Public Health Emergency Amid Coronavirus Cases

Supervisor Nathan Fletcher announced the city declared a local emergency and a public health emergency to ensure readiness for the county after providing an update on the coronavirus cases in San Diego County Friday afternoon.

“We're doing this to best position our county to contain and confront the novel coronavirus,” Fletcher said.

Fletcher continued saying that this action does not signify an increase in the risk for the residents of San Diego County.”

 

[MommyStephV]

I’ve been following along but don’t have anything intelligent to add, I’m in Lincoln and I’ve been getting News Popups and seeing Facebook Live videos from an Omaha station, looks like some of the passengers from the ship were brought to Omaha this morning. Sounds like they took some directly to UNMC.

People in hazmat suits, facemasks working around planes at Eppley Airfield

 

[Herat]

I remember they did this with Ebola patients also...

China: Blood plasma effective for coronavirus | NHK WORLD-JAPAN News

The Chinese government says blood plasma from people who have recovered from the new coronavirus has helped infected patients to get better. The government says a state-owned drug maker has administered blood products developed from such plasma to over 10 seriously-ill patients since February 8. It says the patients' condition clearly improved in terms of inflammation, blood oxygen levels and virus counts in their body within 12 to 24 hours after plasma infusion. An expert was quoted as saying in the absence of a vaccine and specifically targeted drugs, the use of such plasma is the most effective way to treat the infection and can significantly reduce the death toll. The expert says infusion of blood plasma from recovered patients also caused improvements among SARS patients during the 2003 outbreak.

Forced donation of your plasma? I wonder if these recovered Chinese patients have any say as to whether they will be donors or not?

 

[Herat]

The R0 isn't a fixed number. It can be higher on the ship than in other conditions, and the location/environment is more likely to be the explanation for this massive R0 than the age of the persons on the ship.

I've heard it said that while R0 has a relation to the virus, but it also has a relation to human behavior and the environment in which the people are living.

The R0 of Ebola in the outbreak in West Africa was far higher than the R0 of Ebola in the UK or USA even though it was the same strain of the same virus.

Our responses to a virus outbreak can affect the local R0. Without contact tracing and isolation of those testing positive there would be a higher R0 in the UK, Canada, etc.

A hundred and fifty years ago couples often had six to twelve children, so even if they all stayed home, they're living in close quarters, and back then they didn't understand as much about hygiene either but even if they had, they'd still have a high R0. Back in those days, boarding schools and orphanages would have similar issues with massive R0 in that particular population. Nursing homes have a similar issue today. Schools and colleges and universities are known as good environments for spreading diseases (high R0).

I think the comparison of children to adult to elderly is complex. Oftentimes children pick things up very easily due to the high R0 conditions in schools and children's behaviour. So it can be possible for them to bring a virus home with them, get a fairly light illness but spread it to the parents and grandparents who then go onto get more severe illness. Perhaps there's an aspect where those who have a more severe case will shed more virus and for longer (as it takes their immune system longer to 'beat' the virus), but outside of a cruise ship or nursing home I don't think they would normally spread a virus as easily as children do.

And think about a child's behaviour not just with each other at school, but then when they come home. Smaller children are cuddled, their faces and mouths are kissed, they're not as good at covering their coughs and sneezes, etc. But often if a child doesn't 'feel' ill they'll just keep moving around performing these close behaviours that can spread the virus to someone more vulnerable.

So it's a highly dependent number that can be reduced with both government-level and personal actions.

And social behaviour. The influenza season peaks are highly correlated with the socializing and travel that occurs in the west with the holidays; Thanksgiving, Christmas, New Years, even President's Day. As the first two are very prominently family get-togethers, there is the opportunity for children who have picked up respiratory illnesses from schools and daycares to interact with older or extended family at close range.

 

[Wicked Strong]

I’ve been following along but don’t have anything intelligent to add, I’m in Lincoln and I’ve been getting News Popups and seeing Facebook Live videos from an Omaha station, looks like some of the passengers from the ship were brought to Omaha this morning. Sounds like they took some directly to UNMC.

People in hazmat suits, facemasks working around planes at Eppley Airfield

Thank you, I also saw this in the local news just now
Americans possibly exposed to coronavirus on cruise ship taken to Nebraska Med Center campus

 

[Herat]

Are you kidding me? Allowed to infect other passengers and crew?

Diamond Princess: "After consultation with HHS officials, including experts from the HHS Office of the Assistant Secretary for Preparedness and Response, the State Department made the decision to allow the 14 individuals, who were in isolation, separated from other passengers, and continued to be asymptomatic, to remain on the aircraft to complete the evacuation process," the agencies said.

Yes, I did a double take on that, too.

I surmise the test results were issued fairly close to the departure time, and the six-hour departure delay was because of this issue. How to deal with the number of positive-testing passengers?

 

[MimosaMornings]

They can still be infectious. And who knows if all of them will even make it. The disease seems to starts off with mild symptoms similar to cold, but then in some it develops into viral pneumonia.

They tested positive - interested in seeing when the symptoms occur. And if infectious.....scary.

 

[MimosaMornings]

Yes, I did a double take on that, too.

I surmise the test results were issued fairly close to the departure time, and the six-hour departure delay was because of this issue. How to deal with the number of positive-testing passengers?

 

[galiuro1]

Lucky refers to getting off the boat and back to US for competent care.....

I don't think the Japanese are necessarily 'less competent' than our doctors...just saying.

 

[galiuro1]

All the attention is on the cruise ship in Japan...what about the one in Cambodia, was it? where everyone had been allowed off and then a passenger tested positive after the passengers had already dispersed to their respective countries? Hello, how many more are positive and already back in their communities?

Coronavirus Infection Found After Cruise Ship Passengers Disperse

Or how bout the Japanese tour boat where more people have already been out in the community before it was discovered?


11 infected on Tokyo tour boat, likely transmitted coronavirus to non-passengers - The Mainichi

Dang but I knew there was a reason I have always disliked boats, haha, besides growing up in a desert...

 

[Auntie Cipation]

JMO
Wonder why they couldnt have gotten a separate plane for suspected infected people and keep them on a separate plane?

A plane is a fixed enclosed place and I dont think any amount of plastic sheeting could guarantee others on the plane will not breathe in the same air.

It seems common sense keeps going out the plane windows. We try to trust they are doing things right but then we keep hearing stories like this that dont make sense.

I thought they were fully isolated on the plane, like shown in Coronavirus COVID-19 - Global Health Emergency #4

(that's post 967 of this thread, in case it doesn't link properly)

 

[Henry2326]

I don't think the Japanese are necessarily 'less competent' than our doctors...just saying.

Not saying that........considering they have been left on a boat for almost 2 weeks infecting each other, another option has got to be better. They will be quarantined adequately in the US and isolated in infectious disease controlled hospitals if needed in the US.

 

[mickey2942]

About 40 years ago, I needed cash, and volunteered for a cold medicine test. They tested every volunteer, half were infected with a rhinovirus, the other half were "receptors", and given meds to not catch the cold.

We were paid be in a room with everyone for two days, 16 hours, to play games, like Yahtzee, for a whole weekend. 4 people at a table, half infected, half not infected.

Fed lots of food. It was not worth the money to me, I was given the cold, and was sick as a dog.

Not sure how they decided who was a "receptor", we had blood tests, all sorts of tests. And I was paid $500, cash, which paid for a full semester of college tuition back then.

But some people never caught the virus. Not sure what they found out from the tests. They called me for more tests, I told them to forget it.

 

[LaborDayRN]

Someone posted a link to a DailyMail story suggesting that the virus didn't come direct from the wild (seafood market) but from an infectious diseases research centre in Wuhan.

Ticks on bats were suggested. But ticks don't really match with a respiratory virus.

I think it's important to bear in mind that these things crop up sometimes, they cross from one animal to another and/or into humans. I think one reason I feel suspicious of these 'theories' that it escaped from a lab are how often that theory comes up, like with the poisoning in Salisbury/Amesbury. I don't believe that substance came from Porton Down, I believe it came from out of the UK in a vial.

Scientists have said that they see no sign of genetic engineering in the virus. It makes little sense to purposely release such a virus. It would probably make a lot more sense to study known coronaviruses/influenzas in a lab than to be attempting to find new ones and get lucky enough to find this one, successfully transfer it into another animal, and then into humans, and then accidentally release it.

It seems a lot simpler to me (Occam's Razor) for this virus to have got into humans in the conventional way...its genome suggests it has been in a bat reservoir for a long time, just like its cousin SARS. SARS jumped into civet cats, and then into humans. They believe this one jumped into another species before jumping to humans. My guess would be that species is some kind of live animal that was on sale in that market... a chicken, a pig, something I've never heard of? This sort of thing has been happening for thousands of years. It happened less than 20 years ago with SARS. It happened with MERS. Is it really an outlandish concept that it happened again? There are four coronaviruses that cause symptoms we call 'a cold', and once upon a time they lived in an animal before a mutation happened that meant they could thrive in humans.

Yes, viruses have escaped from labs before..smallpox got out from a British lab and caused the last deaths from Smallpox in the UK, I believe. But smallpox was already in existence, nature had already made it. If SARS got out from a lab, same thing, nature already made it. I believe the most likely explanation is that this one also developed naturally. Viruses jumping species is not unusual. What would be unusual is a virus with a history like covid-19s, that doesn't appear to scientists to have been genetically engineered, there wouldn't appear to be any reason to make such a thing...it's not like an unknown variant of smallpox that shows obvious signs of genetic engineering for a purpose.

Agreed. Thank you so much for this thoughtful, well written post.

 

[Wicked Strong]

I thought they were fully isolated on the plane, like shown in Coronavirus COVID-19 - Global Health Emergency #4

(that's post 967 of this thread, in case it doesn't link properly)

I'm also wondering why both of the planes planes landed at Eppley in Omaha this morning but apparently only 7 passengers got off the second plane to be taken to UNMC. The planes landed in the US at different locations, did they both take off from Japan with infected passengers?

ETA this article shows the interior of one of the planes. I believe the white box might be the isolation?

Isolation chambers are installed on planes bringing 340 Americans back from Diamond Princess | Daily Mail Online

MOO

 

[Herat]

County Officials Declare Precautionary Public Health Emergency Amid Coronavirus Cases

Supervisor Nathan Fletcher announced the city declared a local emergency and a public health emergency to ensure readiness for the county after providing an update on the coronavirus cases in San Diego County Friday afternoon.

“We're doing this to best position our county to contain and confront the novel coronavirus,” Fletcher said.

Fletcher continued saying that this action does not signify an increase in the risk for the residents of San Diego County.”

I understand the intent, but this could easily turn San Diego into the county that cried "wolf".

 

[dixiegirl1035]

Fast notes from todays' WHO presser who prefer to read vs. listening, this is part 1 of 2...

Presser notes:



Dr. Tedras is back. He begins…



70,630 inf. 1,792 deaths to date (missed it, think he said in China)

94% continue to come from Hubei

We are starting to get a clearer picture, and where it is headed

Today China has published paper on 44,000 COVID-19 infections. This gives us better information of age range of people infected, the severity of the disease, and the mortality rate. As such, enabling WHO to give good advice to countries. The data appeared to show a decline in new cases. This trend must be evaluated very cautiously. This can change as new populations are infected. It’s too early to know if this reported decline will continue. Every scenario is still on the table. It appears that this virus is not as deadly as MERS and SARS. More than 80% have mild disease. In 14% causes pneumonia and shortness of breath. 5% have critical issues such as respiratory failure, septic shock and multi-organ failure. 2% the virus is fatal, and risk of death increases the older you are. We see few cases among children. More research is needed to understand why. Our team is working to close information gaps. We are working night and day to prepare other countries. Test kits and PPE’s we are sending out to them, working with manufacturers, training health care workers, providing advice to countries on how to do screening, testing, contact tracing and treatment. And calling out for $675 million to help countries with resources to ensure they are prepared. We don’t know how long this window of opportunity will remain open. Let’s not squander it.



Q&As



Q. On WHO risk assessment, should we still call it endemic? A. Yes, we need to be extremely cautious in calling it a pandemic. We had a lot of conversation with H1N1 of when it was/was not pandemic and I think we need to be careful. The real issue is if we’re seeing efficient community transmission outside of China, and at the present time, we are not observing that, and as such, we’re not in a position to have that discussion as what we are seeing is that most cases have a direct link back to China and of those outside of China, we can trace back to existing transmission chains.

Q. Any updates on the WHO team meeting with China A. Have had series of meetings with Chinese and emanate experts working side by side. In last 72 hours laying out what are outstanding questions, what we know, what we don’t know and what is the best way as to how to access what we don’t know. The team will then go to provinces to see on the ground that work together. This is a collaboration.

Q. It was reported estimate that this virus could infect 2/3 of the world population. A. Many people can express views of unlikely scenarios and many estimates of R0 and all of that is important for looking at possible scenarios. All predictions are important, most predictions are wrong, and I think we need to be careful.

Q. Re China calling on previous infected patients for using plasma from recovered folks, is this good option? A. The use of convalescent plasma or hyperimmune globulin has been part of treatment of the severe infectious diseases going back almost to the beginning of when we understood viral infections. We have seen it in rabies, we have seen it in other infections. And it has been proven to be life saving in a number of diseases, diphtheria being most recent where we use a similar approach. It is a very important area to pursue, and we will need to look at how it’s used, which patients are most likely to benefit from it’s use, when during the course of the illness it would be beneficial because what hyper immune globulin does is it is concentrates the antibodies in a recovered patient and what you are doing is essentially giving the victims immune system a boost of antibodies to get them through a very difficult phase so it must be given at the right time because it mops up the virus in the system and it just gives this the patients’ immune system this vital push at the time it needs it but it has to be carefully timed and not always successful. It’s a very valid way of experimental therapeutics especially when we don’t have therapeutics or antivirals. The protocol is very important as you could transfer other diseases and well as scaling up how much is used as it’s very difficult to produce so needs to be carefully assessed before we use it widely.