Coronavirus COVID-19 - Global Health Emergency #5

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MJPeony said:
I’m way behind.... been traveling (not a fun experience all things CV considered!). Will hopefully catch up on the thread soon.

I was THE only person wearing a mask in the airport. Not one other soul. Lots of stares and several comments that I overheard. I was very self-conscience. Oh well.

I keep thinking maybe I’m way overreacting, but then I keep doing the research and I just can’t figure out why no one at the airports seemed to care. Meanwhile, hand sanitizer and face masks are sold out? I don’t know, it’s all kind of weird to me.

Off to catch up...
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So you're back home now, safe and sound?
 
Apple has warned that disruption in China from the coronavirus will mean revenues falling short of forecasts.

The tech giant said production and sales were affected, and that "worldwide iPhone supply will be temporarily constrained".

The iPhone maker is the first major US company to say that the epidemic will hit its finances.

Apple warns coronavirus will hurt iPhones supplies

I believe China is going to suffer long term consequences of this virus because companies like Apple are going to realise that being so reliant on one country for manufacturing is not a good idea. I imagine their iPhone manufacturing will increase in places like India.
 
Here's how long coronaviruses may linger on contaminated surfaces, according to science

Cleaning with common household products can make a difference, according to the research, which also found that human coronaviruses "can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite" or bleach within one minute.

The new research involved analyzing 22 previously published studies on coronaviruses, which researchers hope can help provide insight into the novel coronavirus.

"Based on the current available data, I would primarily rely on the data from SARS coronavirus, which is the closest relative to the novel coronavirus -- with 80% sequence similarity -- among the coronaviruses tested. For SARS coronavirus, the range of persistence on surfaces was less than five minutes to nine days," said Dr. Charles Chiu, an infectious disease professor at the University of California, San Francisco, and director of the USCF-Abbott Viral Diagnostics and Discovery Center, who was not involved in the new study.

Coronaviruses: How long they might linger on contaminated surfaces - CNN

I have started wiping shopping trolley handles with 99.9% antibacterial wipes. I’m wearing leather gloves when I go out and I disinfect them and also washing my hands as soon as I get home and disinfecting my front door handles.


 
Hatfield said:
Oh my. People in Hong Kong resorting to crime to get supplies.

"Police in Hong Kong said they have arrested two armed robbers who stole 600 rolls of toilet paper outside a supermarket—a sign of just how scarce the basic necessity has become amid panic buying due to the coronavirus outbreak."

Knife-Wielding Robbers in Hong Kong Steal 600 Rolls of Toilet Paper

Hong Kong gang steals hundreds of toilet rolls
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It is terrible that the situation is that bad that people are resorting to this.
 
I would think India would be another likely place of epidemic COVID-19. Huge population living in close conditions, poor national healthcare system, poor sanitation.

They have several cases in people who traveled from China, and most all have been kept in hospitals in the Kerala region.

It will be a miracle if they can keep the virus suppressed there.
 
Herat said:
I wonder how the US Ebola victims were evacuated?

They would be far more contagious and dangerous to the transport people and attendants than COVID-19.

So I looked:

They can be transported by Air Medical Transport aircraft, but they are required to be in an Isolation Unit or in a restricted space with a 6 foot "clean zone" for disposal of used protective equipment.

Designation of an “isolation area”
  • Use of a disposable, portable isolation unit is recommended to contain infectious waste (such as soiled absorbent pads, emesis [vomit] basins, portable toilet) and to prevent contamination of the aircraft cabin. After use, the unit should be discarded (see E. Waste Disposal below). If an isolation unit is not available, a perimeter should be established for designating “clean” and “dirty” areas that identifies where gowns and gloves should be put on and removed. The distance will depend on the area required for patient care support as well as designated space for safe removal of PPE. A minimum distance of 6 feet (2 meters) from the patient is recommended. Surfaces should be smooth, nonporous, and fluid-impermeable to allow appropriate cleaning and disinfection.
  • Materials required for patient care, including PPE, should be stored outside of the isolation area.
  • Containers for soiled linen, waste, and reusable equipment should be placed inside the isolation area. Supplies for cleaning spills should be kept in the area, including appropriate disinfectants (see F. Cleaning and Disinfection below).
  • A portable chemical toilet dedicated for patient use should be placed within the isolation area. The lid of the toilet should be kept closed.
Personnel who are within the isolation unit or designated isolation area should wear PPE as described in the CDC guidance: Guidance on Personal Protective Equipment to be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease (EVD) in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing). Outside of the isolation unit or designated isolation area, PPE is not needed
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I remember people panicking on news comment boards about the Ebola patients being transferred to the US. They were wondering how the pilots would manage to fly wearing full hazmat suits, they were sure that the virus would escape.

I suggested that instead of the pilots wearing the full hazmat-type suit that instead the patient would be placed in a tent-like structure to contain their body/air/requirements. And when I saw the videos of the patients coming off the planes, that's what they were in. The same things can be used in isolation rooms in hospitals....the patients with Ebola who were treated in the UK were treated in those structures that look like a bed with a clear plastic tent over the top of them.

I think it look pretty awful to have to be in one of those things, but it has to be done with something that's highly communicable and very high risk if it's contracted.

To use that larger 'box' on the plane, could suggest that the CDC were prepared in case it was more than one person who either tested positive by the time they took off or came down with symptoms on the flight.
 
Hatfield said:
Im really worried for the residents getting enough food and basic supplies to survive.

I would think it would be almost impossible for their government to make daily supply runs to each and every high rise apartment complex that has hundreds, if not thousands, of residents in each one.

I watched that video that someone kindly shared of what it is like to live in a typical China high rise apartment and it was very interesting and a little depressing too.

They have huge high rise apartments for the masses and most had basic needs covered but to imagine being locked inside of one and having to rely on the government to bring them food and supplies , i just dont see that being able to be done. It would have to be a 24X7 herculean effort on a large scale and I dont see how they are going to handle it.

From what I have heard, its like they locked everyone up and the food deliveries was an after thought. Let alone, toilet paper, normal medicines that people may need, etc.

They cant inform the world how they are doing because their internet is being controlled so I guess we have to wait to see if anyone is able to get information out to the world about their conditions as this progresses.

Praying for the residents that are locked up.
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What I've read is that vehicles are banned from the streets except for official supply vehicles transporting goods to pharmacies/hospitals/supermarkets. And each person from a household is allowed out, wearing a mask, about every two or three days to go buy what they need.

I think in some ways, living in an authoritarian country helps them achieve these massive quarantines/lockdowns. People in the West are more likely to get frustrated and say "I'm not taking this!" And business owners are more likely to say, "I can't do this or I'll lose my business" and these are all voters whose views need to be considered while also having effective public health measures to limit the spread of the virus. It's not easy for decision-makers in non-authoritarian countries to balance out all these demands and risks.
 
Herat said:
I keep wondering what is happening to people that have the ordinary medical maladies happening in Wuhan?

Where are the appendectomies, ectopic pregnancies, testicular torsions, seizures, heart attacks, DVT's, asthma attacks, high-risk pregnancies, CRF dialysis patients, broken bones, dental abscesses, etc, etc, etc being cared for?

And where is their blood supply coming from? Is their blood donation program screening people for COVID-19 also?
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I think that's one reason why they needed extra 'hospital' space to separate out coronavirus patients from other patients, so that emergency operations could still be done without such high risk of cross-infection.

Good point about the blood supplies, I guess they'd be running on stocks at the moment? Though there are some provinces with fewer than 1000 confirmed cases, so if the stocks ran too low I guess they could get fresh blood from towns and villages that haven't had any reported cases?

Maybe ensuring blood supplies are high is something other countries should be thinking about now as a precaution in case blood donor sessions need to be canceled at some point?
 
Well, the Japanese are still saying that negative folks will start being released tomorrow through Friday unless they were in close contact with a positive person. I just can't fathom as it appears to my ignorant viewpoint that it's spreading after isolation within the ship. I'm hoping that someone in the media asks about this in tomorrows briefing as this is what the Director said today as these blue bars in the graph from Princess are scary to think tomorrow's release of so many yet to be positive folks could happen. Jeez, what would happen if Japan just flat out prohibited folks from getting off? They don't want another Westerdam situation do they?

https://www.who.int/docs/default-so...0217-sitrep-28-covid-19.pdf?sfvrsn=a19cf2ad_2

Tuesday.JPG

"Q. Reports of infected passengers on Diamond Princess, 100 more today, what can you do? A. What is clear is that the infection prevention and control measures are difficult to implement in a ship environment because there are a number of factors that are very difficult to put under control and we have seen this on many other occasions for other infections like norovirus. It’s not specific therefore for COVID-19. And that’s why we are working with Japanese folks and cruise ship doc to protect the passengers and STICK TO OUR PRIMARY OBJECTIVE WHICH IS CONTAINMENT OF THIS VIRUS. We need to focus on our primary health objective which is to contain the virus, and not the people. Making sure we have the right balance of protecting the population in not only Japan and other countries but also the health of the people on this boat. It’s very difficult as there are many unknowns for this virus. We learn more every day and every hour about this virus. Thanks to the owners of the Princess and the Westerdam for being so open"

It will be interesting to see if the numbers from the tests are released in perhaps 4 hours (at about 4:30 am eastern time?) are anywhere near the latest 99 in one day. I guess I'll have to eat crow and say I was wrong 100 times if they release all the negative folks and don't re isolate.

Japan completes virus testing for quarantined ship

health minister Katsunobu Kato insisted again Tuesday that passengers who test negative will be allowed to leave the ship from Wednesday. Kato said the process would last two or three days. But those who had close contact with people who have tested positive will have their quarantine reset to the date of their last contact with an infected person.
 
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Amonet said:
I think that's one reason why they needed extra 'hospital' space to separate out coronavirus patients from other patients, so that emergency operations could still be done without such high risk of cross-infection.

Good point about the blood supplies, I guess they'd be running on stocks at the moment? Though there are some provinces with fewer than 1000 confirmed cases, so if the stocks ran too low I guess they could get fresh blood from towns and villages that haven't had any reported cases?

Maybe ensuring blood supplies are high is something other countries should be thinking about now as a precaution in case blood donor sessions need to be canceled at some point?
Click to expand...

http://www.aabb.org/advocacy/regula...-2019-Novel-Coronavirus-on-Blood-Donation.pdf

Key Points•The 2019-nCoV epidemic continues, with the number of cases growing rapidly in China and additional cases being reported outside China•No transmissions by blood or other substances of human origin have been documented or alleged for 2019-nCoV. This is true, as well, for the other two coronaviruses that have emerged over the past two decades (SARS, the Severe Acute Respiratory Syndrome Coronavirus and MERS-CoV, causing Mideast Respiratory Syndrome). •AABB, FDA, and CDC are not recommending any action by blood collection establishments at this time because there are no data or precedent suggesting risk of transfusion transmission •Voluntary implementation of donor deferral for travel to China may address public concerns about the safety of the blood supply •A range of options are available to blood collection establishments considering implementation of voluntary measures (see below)

Early reports have identified 2019-nCoV RNA in the blood of 15% of patients studied in a small Chinese series. The authors of that paper were careful to emphasize that RNA is not synonymous with infectious virus, which indicates there is no clear evidence for blood-borne transmission.
 
Trino said:
So, 14 evacuated cruise passengers flown back to the US have the virus. And, how many did they contaminate? And how many will they contaminate after the new mandatory 14 days - assuming those on the flight back are going to get it? It's here, Folks. No doubts.
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It's not these ones I would worry about but the cases that haven't been identified.

Those people came back inside the isolation 'room' on board the aircraft. The other people can get off the plane first, and then fully suited-up medical staff and properly prepared ambulances can transport those patients to a properly prepared medical facility (Omaha's infectious diseases hospital did very well treating Ebola patients).

The other people on the plane might have tested negative, but they still need to do their extra 14 days of quarantine to ensure that they don't test positive during this 14 days. They're not going to be going out in the general population.

On the other hand a number of virology/epidemiology doctors have said that it's very possible there are cases out there that haven't been identified and are right now creating small clusters (like the cluster in the ski chalet in France) .... those are the ones I am more concerned about than people being taken so carefully into such well-prepared areas for quarantine or treatment in isolation rooms.
 
Henry2326 said:
Not sure how effective this will be to slow it down......4 days with a fever before you call a number to be assigned a hospital??? Take a number??
_____________________

Japan issues coronavirus medical guidance as infections rise

logo_image_thumbnail.png
KYODO NEWS - 11 hours ago - 22:34 | All, World, Japan

Japan's health ministry issued guidance Monday for when people with symptoms consistent with the new coronavirus should consult medical institutions, as the country steps up efforts to contain its spread with more cases, even among medical staff, confirmed.

The ministry is now encouraging people who have had a temperature of 37.5 C or higher for four days, are feeling lethargic or are experiencing shortness of breath to contact by phone nationwide health-care centers in charge of responding to the outbreak.

The centers will then recommend medical institutions they should visit. The period is shorter at two days for the elderly and those with underlying conditions such as diabetes, as they are viewed as more vulnerable to the pneumonia-causing virus, the Ministry of Health, Labor and Welfare said.

Japan issues coronavirus medical guidance as infections rise
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I think this is a good idea as a way to get testing done in the general population and to encourage people to stay home while they're ill without overloading the testing facilities with people who have flu or other cause of pneumonia, or causing mass panic. Hopefully this move will catch any small outbreaks like the taxi driver and his mother before they get out of control and there's no hope for contact-checking.
 
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