Wuhan Coronavirus Resource Thread

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shaun
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Re: Wuhan Coronavirus Resource Thread

Postby shaun » 26 Mar 2020 20:07

Krita wrote:
Rsatchi wrote:WION's Palki Sharma is a doing a great job of reporting and questioning the Chinese and the WHO for their mishandling of the Wuhan Coronavirus.


https://twitter.com/palkisu/status/1243054907554320385

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Re: Wuhan Coronavirus Resource Thread

Postby Bart S » 26 Mar 2020 20:09

Tomorrow will be the first major challenge, with the bious insisting on going out to pray in a large group. Also on the radar is Eid during the last week of April. Hope PAC and other forces are called out or put on standby.

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 26 Mar 2020 20:18

Mod Note

Several low signal one liner and whining posts have been deleted as cleanup . Please avoid treating this thread like a Nukkad . It’s not a place to post any random emotion or vent.

manju, you are on notice. Please don’t disrupt the thread.

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 26 Mar 2020 20:39

Minutes of Meeting at Collector office (Pune)

1) In today’s meeting, Collector has announced the new “COVID-19 hospital”. A 11 storeyed new building with 1100 beds at BJ medical college has been identified as the COVID-19 hospital, under the leadership of Dr Chandanwale with the help of various healthcare providers (private & Govt) in Pune district.

2) As per the announcement, after 31st March 2020, all positive cases would be admitted to this COVID-19 Hospital for further management by Dr Chandanwale’s team.

3) To make this hospital functional, they require trained manpower- intensivists, pulmonologists, doctors and nurses for critical and non critical care areas, class 4 staff and equipments. The private hospitals are required to volunteer and share the details/number of doctors, nurses, class 4 staff, PPE and ventilators that can be spared and sent to the new facility at COVID-19 hospital (Format issued). If hospitals do not volunteer, Collector would enforce regarding the manpower requirement/equipments.

3) Private hospitals are required to admit suspect cases in isolation and send for testing to NIV. Positive cases would be admitted at BJ COVID-19 hospital. Isolation facilities at private hospitals should be reworked to increase the number of beds considering present increasing trend of COVID-19 positive patients.

4) Stable COVID-19 patients not requiring admissions would be quarantined in specific bigger common facilities identified in the peripheral areas of Pune.

Basically they want to follow the China model of using common facility for treatment than treating at multiple hospitals and exposing all healthcare staff to the risk.

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Re: Wuhan Coronavirus Resource Thread

Postby dr.uday » 26 Mar 2020 20:43

Today some of my colleagues reported an increase in respiratory cases with fever and dry cough in some places. Almost all of them have mild symptoms. Should see if they are just panic cases or corona.. some of these were tested and results might take 2 days.
My advice is, do not go to hospital if u have mild symptoms. You might get infected at hospital if u didnt get it earlier.They are not going to test u anway, unless u have contact with traveller or u r really sick. Take just paracetamol and Keep away from old or people with chronic diseases. As soon as u develop breathlessness visit the hopital. This is the ICMR protocol right now. I will post here if there is any change in it.
Is there a way I can share any pdf document on this forum and how to share an image?
Last edited by dr.uday on 26 Mar 2020 20:52, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby Raveen » 26 Mar 2020 20:45

chola wrote:I don't think Cheen is lying about containing the virus. The princelings are paying $20K plus for a seat back to China.

Elite wouldn't send their kids back home to die. They will, though, be bringing the virus back to China for the second wave.

https://www.thestar.com.my/news/regional/2020/03/26/chinese-students-pay-us20000-for-seats-on-private-jets


Chinese students pay US$20,000 for seats on private jets

Thursday, 26 Mar 2020

BEIJING: As Covid-19 spreads across the United States, Chinese students from wealthy families are persuading their parents to pay tens of thousands of dollars for seats on private jets to get home.

The alternative, in a world of locked borders and grounded commercial planes, is 60-hour flights with multiple transit hops.

Jeff Gong, a lawyer in Shanghai, asked his daughter, a high school student in Wisconsin, if she wanted 180,000 yuan (RM112,753) as pocket money or a ticket on a private flight home.

“My daughter begged me to get her back home ... She said ‘No papa, I don’t want the money, I want to go home’,” he said.


US-based Chinese students are scrambling to get home as US infections top 50,000 while new cases in China have fallen to zero.

The sense of urgency is further heightened by the dramatic cutback in flight capacity. On Tuesday, 3,102 out of 3,800 planned commercial flights to and from China were cancelled, according to aviation data provider VariFlight.

But even the window for chartered flights is closing fast, further elevating prices. Beijing has banned all chartered flights from overseas and Shanghai is expected to follow suit soon. Hong Kong and Macau have blocked transit flights.

US-based Air Charter Service can fly passengers from Los Angeles to Shanghai on a 14-seat Bombardier 6000 for 2.3mil yuan (RM1.4mil), or about US$23,000 (RM101,896) for a spot.

“We have arranged a number of private jets travelling from the US to China repatriating Chinese nationals with routes including New York and Boston to Shanghai, San Jose to Hong Kong and Los Angeles to Guangzhou,” said Glenn Phillips, a PR and advertising manager at Air Charter Service.

“The prices range greatly depending on the positioning of the aircraft on the dates and time requested, and the exact route.” — Reuters




I am pretty sure they are falling for the same propaganda that the Hans expect the rest of the world to fall for. At the end of the day I will only trust any number from Cheen if a non-Chini counted it and it was double audited by non-Cheenis.

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Re: Wuhan Coronavirus Resource Thread

Postby shaun » 26 Mar 2020 20:52

Bart S wrote:Tomorrow will be the first major challenge, with the bious insisting on going out to pray in a large group. Also on the radar is Eid during the last week of April. Hope PAC and other forces are called out or put on standby.

Well they might get the below treatment :twisted:
https://twitter.com/ANI/status/1243161110468890624

vijayk
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Re: Wuhan Coronavirus Resource Thread

Postby vijayk » 26 Mar 2020 20:53

https://www.u-tokyo.ac.jp/focus/en/arti ... 00083.html


Nafamostat mesylate (brand name: Fusan), which is the drug used to treat acute pancreatitis, may effectively block the requisite viral entry process the new coronavirus (SARS-CoV-2) uses to spread and cause disease (COVID-19). The University of Tokyo announced these new findings on March 18, 2020.
According to the new research, Nafamostat can prevent the fusion of the envelope of the virus with host cell surface membranes, the first step in infection with the causative virus SARS-CoV-2. Nafamostat can inhibit the membrane fusion at a concentration less than one-tenth that of Camostat mesylate (brand name: Foypan), which was recently identified by a German group as an inhibitor of SARS-CoV-2 infection (Reference 1).


“Considering that SARS-CoV-2 infection is already spreading worldwide, drug repurposing (*1), which searches for therapeutics among existing drugs with established safety records, seems to be extremely worthwhile,” Inoue said.
The genomic RNA of coronaviruses such as SARS-CoV-2 is surrounded by an envelope composed of a lipid bilayer and envelope proteins. SARS-CoV-2 initiates human cell entry after the Spike protein (S protein) present on the envelope binds to a cell membrane receptor ACE2 (*2). The S protein is cleaved into S1 and S2 by a human cell-derived protease (proteolytic enzyme) that is assumed to be Furin. S1 then binds to its receptor, ACE2. The other fragment, S2, is cleaved by TMPRSS2 (*3), a human cell surface serine protease, resulting in membrane fusion. According to Hoffmann et al., ACE2 and TMPRSS2 are essential in airway cells for SARS-CoV-2 infection (Reference 1).
The research group already reported in 2016 that Nafamostat effectively inhibits MERS-CoV S protein-initiated membrane fusion. The researchers did this using the Dual Split Protein (DSP) reporter fusion assay (*4) to screen a library consisting of 1,017 FDA-approved drugs. This screening result, together with experimental data from MERS-CoV infection of cultured airway epithelial cell-derived Calu-3 cells (*5), led them to propose that Nafamostat could be effective at inhibiting MERS-CoV infection (Reference 2).




Future potential of Nafamostat and Camostat

Nafamostat is administered clinically by intravenous infusion. The research group speculated that the blood concentration of Nafamostat after administration would exceed the concentration needed experimentally to inhibit membrane fusion via the SARS-CoV-2 S protein. Therefore, it is expected that Nafamostat will prevent SARS-CoV-2 from entering human cells. Camostat is an oral drug. Blood levels after oral administration may be inferior to Nafamostat.
“Both drugs could be used alone, or in combination with other antiviral drugs that target separate processes needed for virus production, such as RNA replication or viral protein processing,” said Inoue.
Last edited by vijayk on 26 Mar 2020 20:54, edited 1 time in total.

suryag
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Re: Wuhan Coronavirus Resource Thread

Postby suryag » 26 Mar 2020 20:54

Hoping Khatvanga sir updates his graph

getting little jittery about the numbers from India, quite perplexing, all those intelligent doctors on this forum, is the virus becoming a dummy piece in India(all fa** no sh**) or we are not reporting(my prayers are for the former)

India - trends
03/19 - 244
03/20 - 330
03/21 - 396
03/22 - 499
03/23 - 536
03/24 - 657
03/26 - 716

USA
03/05 - 262
03/06 - 402
03/07 - 518
03/08 - 583
03/09 - 959
03/10 - 1300
03/11 - 1700
03/12 - 2200
03/13 - 2700
03/14 - 3500
03/15 - 4600
03/16 - 6400
03/17 - 7800
03/18 - 13700
03/19 - 19100
03/20 - 25500
03/21 - 33300
03/22 - 43800
03/23 - 53700
03/24 - 65800
03/26 - 69210

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Re: Wuhan Coronavirus Resource Thread

Postby IndraD » 26 Mar 2020 21:05

anaesthetic machine ventilators (posted above) do not work like ITU ventilators which are more sophisticated with more ventilatory strategies,
they are also not supposed to keep firing like ITU ventilators , diff software and hardware , they are unsuitable for Covid19 patients for long run, at several centres failure of anaesthetic ventilators breakdown being reported when used for Covid19.

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 26 Mar 2020 21:08

dr.uday wrote:Today some of my colleagues reported an increase in respiratory cases with fever and dry cough in some places. Almost all of them have mild symptoms. Should see if they are just panic cases or corona.. some of these were tested and results might take 2 days.
My advice is, do not go to hospital if u have mild symptoms. You might get infected at hospital if u didnt get it earlier.They are not going to test u anway, unless u have contact with traveller or u r really sick. Take just paracetamol and Keep away from old or people with chronic diseases. As soon as u develop breathlessness visit the hopital. This is the ICMR protocol right now. I will post here if there is any change in it.
Is there a way I can share any pdf document on this forum and how to share an image?

If either of those are located at a place on the internet, then you can offer a link to them as :
[ url ] the_web_address [ / url ]
Remove all the spaces from the code above

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Re: Wuhan Coronavirus Resource Thread

Postby nvishal » 26 Mar 2020 21:10

19 new cases reported in Kerala
India total 719

Top 10 states
KERALA 137
MAHARASHTRA 125
KARNATAKA 55
TELANGANA 44
GUJARAT 43
UTTAR PRADSH 42
RAJASTHAN 40
DELHI 36
PUNJAB 33
HARYANA 32

Both Maharashtra and Kerala cases are community spreads(contact tracing failure). More cases might emerge in the coming days before effects of lockdown trickle in. We are currently clocking 100+ new cases daily.

Western countries have given up containment and embraced herd immunity concept. Sacrificing the old to save economy. This means that 2nd/3rd wave infections are inevitable. This'll go on all through 2020; Indian monsoon will bring relief but will probably pickup soon.
Last edited by nvishal on 26 Mar 2020 21:21, edited 2 times in total.

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Re: Wuhan Coronavirus Resource Thread

Postby nam » 26 Mar 2020 21:14

5 deaths today. We might be at the door..

GoI would have got the ICU figures couple of days back and is probably expecting higher deaths. Might explain the sudden announcement of lockdown.

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Re: Wuhan Coronavirus Resource Thread

Postby Karan M » 26 Mar 2020 21:23

dr.uday wrote:Today some of my colleagues reported an increase in respiratory cases with fever and dry cough in some places. Almost all of them have mild symptoms. Should see if they are just panic cases or corona.. some of these were tested and results might take 2 days.
My advice is, do not go to hospital if u have mild symptoms. You might get infected at hospital if u didnt get it earlier.They are not going to test u anway, unless u have contact with traveller or u r really sick. Take just paracetamol and Keep away from old or people with chronic diseases. As soon as u develop breathlessness visit the hopital. This is the ICMR protocol right now. I will post here if there is any change in it.
Is there a way I can share any pdf document on this forum and how to share an image?


Panic is definitely a factor, your advice is spot on.

Regarding the document, please upload on google drive or some filesharing website like mediafire and link it.

Has any treatment protocol been released yet from GOI? X medicine etc?

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Re: Wuhan Coronavirus Resource Thread

Postby madhu » 26 Mar 2020 21:31

tandav wrote:
nam wrote:Apparently the Chinese virus has almost the same viral load in a asymptomatic person, compared to one with symptoms.

And nose has more load than mouth. So looks like most of the spread is done by people sneezing and thinking it is due to dust.


No one has reported sneezing as a major symptom. Top 3 symptoms are 1) High Temp 2) Coughing 3) Fatigue in fact sneezing has never been mentioned in any report I have seen so far

Loss of smell as one more factor.

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Re: Wuhan Coronavirus Resource Thread

Postby Mort Walker » 26 Mar 2020 21:35

nam wrote:5 deaths today. We might be at the door..

GoI would have got the ICU figures couple of days back and is probably expecting higher deaths. Might explain the sudden announcement of lockdown.


I've seen only 4 deaths today and +62 cases as of 9:00PM IST.

I think we will know definitively by March 28th as to how the lockdown is working. Enforcing the lockdown in districts which have been harder hit may be needed by giving police more authority.
Last edited by Mort Walker on 26 Mar 2020 21:38, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby Deans » 26 Mar 2020 21:38

chola wrote:
Sathish_A wrote:Just an insight on how Germany is managing to keep its fatality rate low. Detection and Isolation is the key.

https://www.thelocal.de/20200326/germany-ramps-up-coronavirus-tests-to-500000-a-week


On Wall Street, the Krauts are known as the most "Asian" of the Europeans. Their mercantile, export oriented economic policies are a big factor but they are a disciplined lot much like the chini-types. If told to self-quarantined they will do so unlike Italians and Spaniards. They are running a trajectory like South Korea's.


If someone admitted to hospital for a respiratory ailments like Pneumonia and dies, he is not checked for Corona (unlike Italy, Spain and India).
That might explain some of the disparity in figures between Germany (and Austria) and rest of Europe. Germany has also not compromised on medical infrastructure post 2008. They have tested more people than anyone else (from 120,000 per week end Feb, ramping up to 500,000 /week from next week). People with minor symptoms are being identified and treated early, reducing the fatality rate.

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Re: Wuhan Coronavirus Resource Thread

Postby Deans » 26 Mar 2020 21:54

neerajb wrote:Sirs, I have no data but there was a sudden death in our locality. All symptoms and past history medical/travel is suggestive of what was the reason. Local doctor and the one who declared the demise is saying the same thing. Government contacted, not a word on it and certainly the number didn't bump so it went under the radar. People at their level are doing their best to get family tested, but even after couple of days no test done on the family. So we don't know the status of that person and the family.

Just extrapolating that if this is the situation in the capital of India then what to expect in remote areas.


Neeraj, Your point, if correct, is a very serious one, which can undermine confidence in the system. Are u saying the Doctor knew he was (most likely) suffering from Coronavirus ? Who issued the death certificate and what was the cause listed. If the doctor felt it was Corona but listed otherwise, he can be prosecuted, as he's knowingly endangered the lives of others. If he did not think it was coronavirus, why is there is feeling that it was ? Whom did the family approach to get tested ? Have you contacted the helplines / state govt/ municipality ? Whoever has refused to test a suspected Coronavirus victim should be punished, so the details must be publicised, once they are believed to be correct.

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 26 Mar 2020 21:57


DrRatnadip
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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 26 Mar 2020 22:04

Dr. John Murray , great auther of book on respiratory medicine died due to COVID 19.. He coined the term ARDS.. RIP sir

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 26 Mar 2020 22:07

The article he is talking about:

Keeping the Coronavirus from Infecting Health-Care Workers | newyorker.com

What Singapore’s and Hong Kong’s success is teaching us about the pandemic.

By Atul Gawande

March 21, 2020

The message is getting out: #StayHome. In this early phase of the coronavirus pandemic, with undetected cases accelerating transmission even as testing ramps up, that is critical. But there are many people whom the country needs to keep going into work—grocery cashiers, first responders, factory workers for critical businesses. Most obviously, we need health-care workers to care for the sick, even though their jobs carry the greatest risk of exposure. How do we keep them seeing patients rather than becoming patients?

In the index outbreak in Wuhan, thirteen hundred health-care workers became infected; their likelihood of infection was more than three times as high as the general population. When they went back home to their families, they became prime vectors of transmission. The city began to run out of doctors and nurses. Forty-two thousand more had to be brought in from elsewhere to treat the sick. Luckily, methods were found that protected all the new health-care workers: none—zero—were infected.

But those methods were Draconian. As the city was locked down and cut off from outside visitors, health-care workers seeing at-risk patients were housed away from their families. They wore full-body protective gear, including goggles, complete head coverings, N95 particle-filtering masks, and hazmat-style suits. Could we do that here? Not a chance. Health-care facilities don’t remotely have the supplies that would allow staff members to see every patient with all that gear on. In Massachusetts, where I practice surgery, the virus is circulating in at least eleven of our fourteen counties, and cases are climbing rapidly. So what happens if you are exposed to a coronavirus patient and you don’t have the ability to go full Wuhan? My hospital system, Partners HealthCare, has already sent more than a hundred staff members home for fourteen days of self-quarantine because they were exposed to the coronavirus without complete protection. If we had to quarantine every health-care worker who might have come into contact with a COVID-19 patient, we’d soon have no health-care workers left.

Yet there are lessons to be learned from two places that saw the new coronavirus before we did and that have had success in controlling its spread. Hong Kong and Singapore—both the size of my state—detected their first cases in late January, and the number of cases escalated rapidly. Officials banned large gatherings, directed people to work from home, and encouraged social distancing. Testing was ramped up as quickly as possible. But even these measures were never going to be enough if the virus kept propagating among health-care workers and facilities. Primary-care clinics and hospitals in the two countries, like in the U.S., didn’t have enough gowns and N95 masks, and, at first, tests weren’t widely available. After six weeks, though, they had a handle on the outbreak. Hospitals weren’t overrun with patients. By now, businesses and government offices have even begun reopening, and focus has shifted to controlling the cases coming into the country.

Here are their key tactics, drawn from official documents and discussions I’ve had with health-care leaders in each place. All health-care workers are expected to wear regular surgical masks for all patient interactions, to use gloves and proper hand hygiene, and to disinfect all surfaces in between patient consults. Patients with suspicious symptoms (a low-grade fever coupled with a cough, respiratory complaints, fatigue, or muscle aches) or exposures (travel to places with viral spread or contact with someone who tested positive) are separated from the rest of the patient population, and treated—wherever possible—in separate respiratory wards and clinics, in separate locations, with separate teams. Social distancing is practiced within clinics and hospitals: waiting-room chairs are placed six feet apart; direct interactions among staff members are conducted at a distance; doctors and patients stay six feet apart except during examinations.

What’s equally interesting is what they don’t do. The use of N95 masks, face-protectors, goggles, and gowns are reserved for procedures where respiratory secretions can be aerosolized (for example, intubating a patient for anesthesia) and for known or suspected cases of COVID-19. Their quarantine policies are more nuanced, too. What happens when someone unexpectedly tests positive—say, a hospital co-worker or a patient in a primary-care office or an emergency room? In Hong Kong and Singapore, they don’t shut the place down or put everyone under home quarantine. They do their best to trace every contact and then quarantine only those who had close contact with the infected person. In Hong Kong, “close contact” means fifteen minutes at a distance of less than six feet and without the use of a surgical mask; in Singapore, thirty minutes. If the exposure is shorter than the prescribed limit but within six feet for more than two minutes, workers can stay on the job if they wear a surgical mask and have twice-daily temperature checks. People who have had brief, incidental contact are just asked to monitor themselves for symptoms.

The fact that these measures have succeeded in flattening the COVID-19 curve carries some hopeful implications. One is that this coronavirus, even though it appears to be more contagious than the flu, can still be managed by the standard public-health playbook: social distancing, basic hand hygiene and cleaning, targeted isolation and quarantine of the ill and those with high-risk exposure, a surge in health-care capacity (supplies, testing, personnel, wards), and coördinated, unified public communications with clear, transparent, up-to-date guidelines and data. Our government officials have been unforgivably slow to get these in place. We’ve been playing from behind. But we now seem to be moving in the right direction, and the experience in Asia suggests that extraordinary precautions don’t seem to be required to stop it. Those of us who must go out into the world and have contact with people don’t have to panic if we find out that someone with the coronavirus has been in the same room or stood closer than we wanted for a moment. Transmission seems to occur primarily through sustained exposure in the absence of basic protection or through the lack of hand hygiene after contact with secretions.


Consider a couple of data points. Singapore so far appears not to have had a single recorded health-care-related transmission of the coronavirus, despite the hundreds of cases that its medical system has had to deal with. That includes one case reported this week of a critically ill pneumonia patient who exposed forty-one health-care workers in the course of four days before being diagnosed with COVID-19. These were high-risk exposures, including exposures during intubation and hands-on intensive care. Eighty-five per cent of the workers used only surgical masks. Yet, owing to proper hand hygiene, none became infected.

Our early experiences in the U.S. have so far been similar. The Centers for Disease Control and Prevention, in the face of limited information, recommended stricter precautions than have been employed in Asia, putting health-care workers on fourteen-day self-quarantine if they are exposed to an infected person for even a few minutes without protection, including a mask and goggles. That policy was implemented at U.C. Davis Medical Center, where the first case of community transmission was diagnosed, in late February. Eighty-nine health-care workers involved in the patient’s care were put under self-quarantine. None, it turned out, had been infected.

Sacramento, Seattle, and San Francisco became coronavirus hot spots; as of this writing, however, significant occupational transmission has not been found.Meanwhile, the strict policy has been threatening to close entire emergency departments. So, out of necessity and based on the early evidence, public-health authorities in San Francisco have loosened restrictions, letting exposed employees stay at work as long as they wear a surgical mask and don’t have symptoms. At least one hospital in Seattle is now following a similar policy, with the support of state public-health officials and the C.D.C. Other hospitals across the country will likely soon follow.

The factors that appear to be important in protecting health-care workers from the disease have been insuring meticulous hand hygiene and cleaning; restricting clinics and hospitals to necessary patient visits; shifting as much care as possible to virtual channels (such as phone and video); and applying standard droplet precautions (surgical mask, gloves, and gown) with respiratory patients.

For those who cannot stay home, the lesson is that it is feasible to work and stay coronavirus-free, despite the risks. Deborah Yokoe, the medical director of hospital epidemiology and infection prevention at U.C.S.F. Medical Center, told me that, given the safety practices in the hospital, she is seeing a greater likelihood of staff picking up infections at home than at work. Following this logic, San Francisco public-health officials are pushing medical facilities to have all health-care workers—not just those who have had patient exposures—report whether they have fever or flu symptoms prior to starting work each day.

In South Korea, the success of mass testing in containing the spread of the disease has raised the possibility that asymptomatic carriers were causing outbreaks. But another implication of the experience in Singapore and Hong Kong is that these essentially invisible cases of the coronavirus may not be driving as many serious infections as some scientists have projected. Health officials there did not conduct mass testing of the population to look for infected people without symptoms. They focussed on aggressively searching out and testing only those who developed suspicious symptoms or had high-risk exposures in the community. They accepted that the virus might circulate among people who notice nothing. Yet their strategy brought cases under control.

There are a number of possible explanations for this. One is that truly asymptomatic cases—people who never develop symptoms that would prompt evaluation—may be less common than feared. In Wuhan, where testing became widespread and more than seventy-two thousand coronavirus cases were identified, just one per cent never developed symptoms. Aboard the Diamond Princess cruise ship, where, following an outbreak, more than three thousand passengers and crew were quarantined and tested—allowing one of the most complete evaluations of any affected population—six hundred and thirty-four people proved to have the virus. Most had no symptoms at the time of testing, but they proved to be pre-symptomatic: over several days, they developed recognizable signs of the disease. Just eighteen per cent were persistently asymptomatic.We know that people are less contagious while they have no symptoms, but not how much less.

The success that Hong Kong and Singapore achieved by screening for people with fever- or flu-like symptoms suggests that the risk of asymptomatic contagion could be much lower than we thought. That experience gives some guidance for what to do not only in health care but wherever the coronavirus is circulating and people have to go physically into work. There’ll be more information as testing expands and we continue to adjust our strategies. Nonetheless, we are finding our way.

When you have no choice but to leave home and go in to work while the case counts rise around you, it is hard not to panic. But we can learn from the experiences of our colleagues across the planet. The pandemic is global; its lessons are, too.

A Guide to the Coronavirus


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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 26 Mar 2020 22:14

dr.uday wrote:Today some of my colleagues reported an increase in respiratory cases with fever and dry cough in some places. Almost all of them have mild symptoms. Should see if they are just panic cases or corona.. some of these were tested and results might take 2 days.
My advice is, do not go to hospital if u have mild symptoms. You might get infected at hospital if u didnt get it earlier.They are not going to test u anway, unless u have contact with traveller or u r really sick. Take just paracetamol and Keep away from old or people with chronic diseases. As soon as u develop breathlessness visit the hopital. This is the ICMR protocol right now. I will post here if there is any change in it.
Is there a way I can share any pdf document on this forum and how to share an image?


Valid point.. Govt should increase public awareness about not going to hospitals for trivial complaints.. Almost all patients coming to opd with fever/ cold want to be tested for COVID 19.. It takes too much effort to convince them.. on other hand I am extremely happy with whatever GOI is doing.. we have large pool of young medicos including residents and interns who are more than willing to volunteer.. I am sure we will do much better than most western nations..

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Re: Wuhan Coronavirus Resource Thread

Postby kvraghav » 26 Mar 2020 22:18

On march 10, number of cases in India was 62. Today, we have 61 cases with results with 25% deaths. So we have to keep building hospitalization/home isolation facilities for 15 days growth till it tapers down.
My fiend who is a govt doctor reported that lot of people who are reporting with allergic bronchitis are being sent back unless they have fever, cough and throat ache. He says protocol for testing is above with contact with a traveler or respiratory difficulty. Else they are simply being sent home. He also says unless they are really sic, they would do better to stay at home to prevent cross infection and also mental health at home is better which boosts immunity.

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 26 Mar 2020 22:40

Karan M wrote:Panic is definitely a factor, your advice is spot on.

Regarding the document, please upload on google drive or some filesharing website like mediafire and link it.

Has any treatment protocol been released yet from GOI? X medicine etc?

I think panic is a bad term in the context. Given the circumstances, a lot of hypochondria is expected. Anyone who ones dismissed their symptoms as the result of anything typical they deal with, suddenly wonder if they have The Disease.

It's important to get out the message of the standard symptoms. There's data that was posted dozens of pages ago indicating that 2 factors are seen in >99% of cases: fever and dry cough. Please repost that.

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 26 Mar 2020 22:48

Deans wrote:
neerajb wrote:Sirs, I have no data but there was a sudden death in our locality. All symptoms and past history medical/travel is suggestive of what was the reason. Local doctor and the one who declared the demise is saying the same thing. Government contacted, not a word on it and certainly the number didn't bump so it went under the radar. People at their level are doing their best to get family tested, but even after couple of days no test done on the family. So we don't know the status of that person and the family.

Just extrapolating that if this is the situation in the capital of India then what to expect in remote areas.

Neeraj, Your point, if correct, is a very serious one, which can undermine confidence in the system. Are u saying the Doctor knew he was (most likely) suffering from Coronavirus ? Who issued the death certificate and what was the cause listed. If the doctor felt it was Corona but listed otherwise, he can be prosecuted, as he's knowingly endangered the lives of others. If he did not think it was coronavirus, why is there is feeling that it was ? Whom did the family approach to get tested ? Have you contacted the helplines / state govt/ municipality ? Whoever has refused to test a suspected Coronavirus victim should be punished, so the details must be publicised, once they are believed to be correct.

It's also important not to drive panic and fear psychosis. People die, suddenly or otherwise, for various reasons.

Those with coronavirus don't just 'suddenly die'. They're asymptomatic for ~2 weeks, and then the fever and cough lasts between 5-15 days (please post patient data on this if already posted). Rapid mortality may be related to pre-existing conditions.

It's important to be vigilant, but also to be cautious about inducing panic.

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Re: Wuhan Coronavirus Resource Thread

Postby dr.uday » 26 Mar 2020 22:50

No specific treatment recommendations from GOI but advised doctors to use drugs according to their discretion with patient's consent.
From the limited trials, evidence from UK showed no benefit for lopinavir-ritonavir. Chloroquine has resulted in somewhat reduced viral load, but whether it resulted in better patient outcomes is not know yet. China used 500mg twice daily for 10 days in many patients.
Last edited by dr.uday on 26 Mar 2020 22:56, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby Srutayus » 26 Mar 2020 22:51

Please be very careful to substantiate & verify your information before sharing in these times.

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 26 Mar 2020 22:57

Two thirds of coronavirus victims may have died this year anyway, government adviser says | telegraph.co.uk

By Sarah Knapton,
SCIENCE EDITOR
25 March 2020 • 4:13pm

Professor Neil Ferguson said experts were now expecting around 20,000 deaths, although said it may turn out to be a lot less

Up to two thirds of people who die from coronavirus in the next nine months are likely to have died this year from other causes, a government advisor has said.

Professor Neil Ferguson, who is recovering at home from Covid-19, told the Science and Technology Committee that experts were now expecting around 20,000 deaths, although said it may turn out to be a lot less.

But he said that many of those deaths were likely to be old and seriously ill people who would have died from other conditions before the end of the year.

Appearing via videolink, and drinking from a Keep Calm and Carry On mug, Prof Ferguson said: “We don’t know what the level of excess deaths will be in the epidemic, in that, by the end of the year what proportion of people who died from covid would have died?

“It might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or have underlying conditions so these are considerations.

“Fatalities are probably unlikely to exceed 20,000 with social distancing strategies but it could be substantially lower than that and that’s where real time analysis will be needed.”Prof Ferguson, who sits on the government’s Scientific Advisory Group for Emergencies (Sage) said that the decision to lockdown Britain had been taken because the NHS simply could not have coped with the surge in demand, which would have had a huge knock-on effect for other health services, potentially having unintended consequences. He said that he expected the virus to peak within 2.5 to three weeks before tailing off and said that the warmer weather could also see transmision dip by up to 20 per cent. 

The government’s strategy is to keep people apart to flatten the peak so that the health service can cope with the cases until a vaccine or anti-viral is ready, which is unlikely before the end of the year.

Prof Ferguson said that the new social distancing measures announced by Boris Johnson earlier in the week meant the NHS would now be able to handle the incoming cases of coronavirus.

“The strategy being done now in some areas ICUs will get close to capacity but it won’t be reached at a national level,” he said.

“We are reasonably confident that at a national level we will be within capacity.”

The government has faced widespread criticism for failing to test people in the community and trace the people they have come into contact with, unlike other countries such as South Korea, which managed to contain the virus far more quickly. 

But Prof Ferguson said they were unable to adopt a similar strategy because Public Health England (PHE) had informed the Sage committee in January that there was not the capacity to test that number of people.

Instead, the current strategy aim is to suppress transmission indefinitely until other counter-measures are put in place, including a vaccine.

Prof Ferguson said it was clear that widespread testing was needed to help move the country from suppression measures and lockdown into something the country can manage longer-term.

He suggested that local areas may face lockdown if they have especially high rates of infection.

"There will be some resurgence of transmission but the hope is that by employing more focused policies to suppress those local outbreaks, we can maintain infection levels at low levels in the country as a whole indefinitely,” he said.

"It remains to be seen how we achieve this and how practical it proves to be. The long-term exit from this is clearly the hopes around a vaccine.”

However Sage was criticised for its slow response by the Editor of the medical journal the Lancet, who said experts had failed to appreciate just how serious the situation was in China by January, and the risk to Britain.

Richard Horton, said the group did not seem to have read important modelling papers that Chinese scientists had produced early in the epidemic.

There was a mismatch between the urgent warning that was coming from the frontline in China and the pedestrian evaluation of what the likely severity of the outbreak would be,” he told MPs.

“That suggests to me that we didn’t understand fully what was taking place. I think the perspective was largely on the UK but I haven’t seen an outreach to the scientists in China, 

“China has top scientists who are doing cutting edge work and have responded in the most unbelievably rapid way so if I had been chair of sage I would have wanted to go to those scientists on the frontline to find out what is coming for us in the UK.”

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Re: Wuhan Coronavirus Resource Thread

Postby rsingh » 26 Mar 2020 23:14

Belgium has messed-up big time. Consider
-They destroyed masks last year (old stock).
-The ordered new masks from a turkey that does't exist.
-They refused to order masks from China ( we are TAFTA) and Chinese masks are contaminated.
-Now it seems Chinese masks are OK. Belgium is on knees asking China to give more masks.
India is doing far better.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 26 Mar 2020 23:17

meanwhile back at the ranch :mrgreen:


What VIPs in Chandigarh want: Curfew passes for barbers, salon women to visit them at their homes


Most of the VIPs in Chandigarh, which is under curfew, have still not been able to realise that at this moment it is not a privilege anymore to get access to luxuries out in the open when the coronavirus has hit the city. Many VIPs have been bombarding the UT officers for curfew exemption for reasons like allowing a pass to vendor making fresh fruit juice, taking dogs out for a stroll, allowing their barber to come to their residence or passes for saloon women to come home and evening walks at the Sukhna Lake.

The Chandigarh Administration had imposed a curfew in the Union Territory starting midnight of March 24. It was imposed keeping in view the spread of the virus as many had been infected and the number of cases shot to seven. It was stated that curfew passes would be given only to those performing emergency duty or in extreme urgency. But many VIPs took it otherwise.

Officers said that people are not understanding the gravity of the situation. “I am getting requests that mother takes only fresh fruit juice from one vendor and for that curfew pass be allowed. Then there are many who are seeking a pass for morning and evening walk at Sukhna Lake,” a senior officer of the administration said.

UT Adviser Manoj Parida stated that there could be nothing worse in a time of crisis than seeking pass for a barber to have a hair cut at home. “Also, they want passes to take their dogs out for a stroll and allow saloon women to come. It is height of everything. They don’t know what the situation is. If we are home for 21 days, we will be able to save not only our life but others’ as well,” the officer added.

Finding too many requests for trivial reasons, Parida had to tweet, “Please don’t make undue requests for passes to me. Test of efficiency of Chandigarh Administration is not how much convenience we have provided to people during curfew but how many deaths or new cases we prevented. Now citizens may be angry with us. Later, they will thank us for strictness.”

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 26 Mar 2020 23:24

Coronavirus: Chinese-backed company's mission to source Australian medical supplies

By Kate McClymont
March 26, 2020 — 5.00am


As the coronavirus took hold in Wuhan earlier this year, staff from the Chinese government-backed global property giant Greenland Group were instructed to put their normal work on hold and source bulk supplies of essential medical items to ship back to China.A whistleblower from the company has told the Herald it was a worldwide Greenland effort - and the Sydney office was no different, sourcing bulk supplies of surgical masks, thermometers, antibacterial wipes, hand sanitisers, gloves and Panadol for shipping.

The company even posted its efforts of packing pallets in the company’s Sydney headquarters on social media.

Image

"Basically all employees, the majority of whom are Chinese, were asked to source whatever medical supplies they could," one company insider told the Herald. This exercise went on for weeks through January and February, he said.

The entire accounts department, contract managers, the human resources team and even receptionists were sent on a mission to find bulk supplies of surgical masks, thermometers, antibacterial wipes, hand sanitisers, gloves and Panadol.

"There were numerous requests from the HR manager and even our direct reporting line [which] prioritised the assisting of the company in gathering these supplies over other work activities," said the source. The entire accounts department were absent for days as they were out purchasing supplies, he said.In a statement to the Herald, the Greenland Group confirmed the shipment of medical supplies in January and February saying it "felt compelled ... to assist in efforts to mitigate the spread of the virus, which had caused a shortage of crucial medical supplies in China."

Greenland Australia supported the group's initiative "by arranging for medical supplies to be dispatched to China, which at that time, was the epicentre of the outbreak," the statement said.

The boardroom and meeting rooms of Greenland’s headquarters in Market Street were used to repack the medical items into boxes stamped with the company’s logo. Pallet-loads of the medical supplies were then sent to China.

Sherwood Luo, the managing director of Greenland Australia, posted photographs of this occurring on social media.

For instance on February 13 he posted on WeChat "#CombatCoronavirus, Greenland Australia is Taking Action. The second batch of non-contact forehead thermometers will soon take off to China! Coronavirus situation is serious, Chinese people, local and overseas, are trying their best, fighting together to combat the virus."

At this time China was battling the COVID-19 epidemic. As of February 14 Australia had only 15 known cases. It now has more than 2,300.

According to a company newsletter, the Greenland Group sourced 3 million protective masks, 700,000 hazmat suits and 500,000 pairs of protective gloves from "Australia, Canada, Turkey and other countries."

The newsletter also said, "Greenland Group Australia also organised the manpower and material resources to urgently purchase medical supplies such as masks, protective clothing and goggles in major Australian cities."Image[..]

Second Chinese developer flew 82 tonnes of medical supplies to China

By Kate McClymont
March 26, 2020 — 6.47pm

A second Chinese property company based in Sydney flew more than 80 tonnes of medical supplies on a corporate jet to Wuhan in late February, at the time coronavirus was devastating the regional city.

"The chartered plane with 90 tons (82 tonnes) of medical supplies, including 100,000 most needed protective coveralls and 900,000 pairs of medical gloves, has successfully departed from Sydney and arrived in Wuhan on 24 Feb," Risland Australia posted on its LinkedIn page.

Risland, formerly known in Australia as Country Garden, is a totally owned subsidiary of Country Garden Holdings, one of China’s largest property developers.

Its major shareholder is 38-year-old Yang Huiyan, the richest woman in China.

The Herald has previously reported another major Chinese developer was doing the same thing. Employees of Greenland Australia, a subsidiary of the Chinese government-backed global property giant Greenland Group, were instructed to put their normal work on hold and source bulk supplies of essential medical items to ship back to China.

A whistleblower from the company has told the Herald it was a worldwide Greenland effort - and the Sydney office was no different, sourcing bulk supplies of surgical masks, thermometers, antibacterial wipes, hand sanitisers, gloves and Panadol for shipping.

"Basically all employees, the majority of whom are Chinese, were asked to source whatever medical supplies they could," one company insider told the Herald. This went on for weeks through January and February, he said.

The humanitarian efforts of Chinese companies to help their desperate compatriots back home may have contributed to shortages of products in Australia.By late January medical experts were worried about the lack of available masks. "The thing we need most as GPs is some masks," said Dr Harry Nespolon, president of the Royal Australian College of GPs. "They are not readily available."

[..]

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 26 Mar 2020 23:45

Deleted
Last edited by Suraj on 26 Mar 2020 23:58, edited 1 time in total.
Reason: Please don't derail this thread debating the names to call the virus.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 26 Mar 2020 23:50

TIMES NOW@TimesNow · 5h
#Breaking | Srinagar: Cops stamp 'lockdown violators' on their foreheads. The stamp reads 'I am a Corona lockdown violator'.

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 27 Mar 2020 00:10

1. The study from China:
High Temperature and High Humidity Reduce the Transmission of COVID-19
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767
Direct link to the paper

2. The study from Europe:
Spread of SARS-CoV-2 Coronavirus likely to be constrained by climate
https://www.medrxiv.org/content/10.1101/2020.03.12.20034728v1
Direct link to the paper


3. MIT study:
Will Coronavirus Pandemic Diminish by Summer?
15 Pages Posted: 19 Mar 2020 Last revised: 26 Mar 2020
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556998
Direct link to the paper


According to MIT scientists, total number of cases in countries with mean temperature greater than 18 degree Celsius and absolute humidity more than 9 g/m3 in January-February-early March is less than 6 per cent

Last Updated: March 26, 2020  | 13:57 IST

Asian countries experiencing monsoon may see a slowdown in transmission as absolute humidity is generally above 10g/m3 during monsoon

A warm and humid weather is linked to slower spread of the novel coronavirus, according to a study which suggests that Asian countries experiencing monsoon may experience lesser transmission of the virus. The scientists, including Qasim Bukhari from the Massachusetts Institute of Technology (MIT) in the US, assessed data on the number of COVID-19 infections in different parts of the world and compared it with two parameters of weather from all the regions -- temperature and humidity.

The findings, described in SSRN repository, show that 90 per cent of the novel coronavirus, SARS-CoV-2, transmissions until March 22, 2020 have occurred in regions with temperature between 3 and 17 degrees Celsius. They added that these regions also had between 4 to 9 gram per cubic metre (g/m3) of absolute humidity -- a measure of the amount of water vapour per cubic metre of atmosphere.

According to the MIT scientists, the total number of cases in countries with mean temperature greater than 18 degree Celsius and absolute humidity more than 9 g/m3 in January-February-early March is less than 6 per cent. Based on their analysis, the scientists noted that Asian countries experiencing monsoon may see a slowdown in transmission as absolute humidity is generally above 10g/m3 during monsoon.


[..]

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Re: Wuhan Coronavirus Resource Thread

Postby nam » 27 Mar 2020 01:03

Today's infection rate is 65. This is less than yesterday's and less than day before yesterday's 66.

We might see increased death rate.

If we can control the infection numbers, we can flatten the curve. The lockdown hopefully helps, specially the foreign returns, who created this mess in the first place are firmly inside their home.

If rioters can be financially penalized, these chaps should be as well.

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Re: Wuhan Coronavirus Resource Thread

Postby nam » 27 Mar 2020 01:05

One thing I really want is the PM come on TV and tell me, what exactly to do if they feel they have the Chinese virus.

Do not go to the hospital directly. Stay at home, specially for people below 60 and no underlying conditions. Call the helpline and hopefully they can arrange for a ambulance with the right suit.

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Re: Wuhan Coronavirus Resource Thread

Postby disha » 27 Mar 2020 01:11

^All the studies above concentrate on the virus. Not many studies concentrates on the human in summer.

For example., In Summer, humans have a better Vitamin D profile. And Vitamin D is proven to directly influence our immune system. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/

Moreover, in hot & humid climate the secretions both internally and externally influence the immune response as well. In cold & dry winters, it is speculated that the nostrils and the throat go dry and hence the nasal/throat cells are more susceptible to infection. Flu seasonality is well known.

At the same time, India's population density is high. And there are states like Rajasthan & MP which have hot and dry summer creating a reverse situation on human physiology (make them susceptible to flu type of viruses).

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Re: Wuhan Coronavirus Resource Thread

Postby Uttam » 27 Mar 2020 01:28

This is from Spain


Rapid tests for coronaviruses purchased in China do not work well

Microbiology laboratories report that the tests acquired by the Government have a sensitivity of 30% when they should exceed 80%

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 27 Mar 2020 01:57

nam wrote:One thing I really want is the PM come on TV and tell me, what exactly to do if they feel they have the Chinese virus.

Do not go to the hospital directly. Stay at home, specially for people below 60 and no underlying conditions. Call the helpline and hopefully they can arrange for a ambulance with the right suit.

Ever try to memorize a shopping list ? Specific medical / care instructions are not something humans remember exactly at a time of crisis. They will encounter the 'what exactly did Modi say' mental block, or malicious folks may misuse such a message claiming someone died because of supposed PMO level quackery.

What best helps people when it comes to precise and succinct instructions is something in a form where they can quickly read it. Therefore, this information needs to be widely disseminated on SM as FB or WA forwards as a succinct message in several languages.

Anyone up to create and start seeding such messages as simple images ?

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Re: Wuhan Coronavirus Resource Thread

Postby Bart S » 27 Mar 2020 02:00

^Govt already has offical WA and Telegram channel and is disseminating such messages. There are enough fake WA forwards floating around (actually a deluge of inane rubbish that people keep forwarding that drowns out other useful messages) so it would probably best for the Govt to do it rather than add to the private fwds that nobody can verify.


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