Wuhan Coronavirus Resource Thread

[Amber G.]

Extremely concerned about lack of testing in USA.

While some countries are routinely testing 10,000+ tests everyday, situation in US is very dire and has been described by many doctors as disaster. These doctors can not order test, or if they do it takes very long time. Many are complaining about this loudly. Whole US has still conducted about 500 tests.

[g.sarkar]

https://www.nytimes.com/2020/03/04/worl ... -news.html
Coronavirus Live Updates: Global Mortality Rate Reaches 3.4 Percent
The World Health Organization confirmed that Covid-19 is deadlier than the seasonal flu, but does not transmit as easily.
RIGHT NOW Deaths outside China exceeded those in the country for the first time since the start of the outbreak.
The global death rate of the new coronavirus is 3.4 percent, the W.H.O. says.
The head of the World Health Organization said on Tuesday that the global mortality rate for Covid-19, the disease caused by the new coronavirus, was 3.4 percent. Tedros Adhanom Ghebreyesus, the organization’s director general, said in a news conference in Geneva that Covid-19 is deadlier than the seasonal flu, but does not transmit as easily. “Globally, about 3.4 percent of reported Covid-19 cases have died,” said Dr. Tedros. “By comparison, seasonal flu generally kills far fewer than 1 percent of those infected.”
The estimate most likely takes into account the growing number of infections being recorded outside China, mostly in South Korea, Iran and Italy.
“While many people globally have built up immunity to seasonal flu strains, Covid-19 is a new virus to which no one has immunity,” meaning more people can be infected and some will suffer severe illnesses, said Dr. Tedros. The coronavirus does not transmit as efficiently as the flu but “causes more severe disease,” he added. When the coronavirus crisis was concentrated in Wuhan, the Chinese city where the new virus was first found, the W.H.O. said that the mortality rate of the disease ranged from 0.7 percent outside of Wuhan to as high as 4 percent inside the city. The organization also said that the epidemic would affect different countries in different ways.
Data from the Chinese government shows that the mortality rate in that country is about 3.7 percent, with most deaths reported in Wuhan and the surrounding province of Hubei. Dr. Tedros added on Tuesday that the disease can be contained, but warned that “rising demand, hoarding and misuse” of medical supplies such as masks could compromise the world’s ability to fight the outbreak, and he recommended a 40 percent global increase in the production of such supplies.
Hospitals in South Korea struggle to find beds for thousands of infected patients.
The South Korean government scrambled on Wednesday to find hospital beds for thousands of people infected with the new coronavirus, as the country reported a higher number of new cases than China, the center of the outbreak.
South Korea reported 516 new cases on Wednesday, bringing the total number of infected patients to 5,328, including 32 deaths. By contrast, China, once the leading source of cases, recorded only 119 new cases.
Nearly 90 percent of the South Korean patients were residents of Daegu, a southeastern city, and nearby towns. In Daegu alone there were 4,006 patients, but more than half were still waiting for hospital beds. Most of the patients, the authorities said, showed only mild symptoms of Covid-19, the disease caused by the virus.
.....
Gautam

[Peregrine]

Iran says 92 dead amid 2,922 cases of coronavirus

Iran says the new coronavirus has killed 92 people amid 2,922 confirmed cases across the country, AP reported.

Health ministry spokesman Kianoush Jahanpour announced the new figures at a news conference in Tehran on Wednesday.

There are now over 3,140 cases of the new virus across the Mideast. Of those outside Iran in the region, most link back to the Islamic Republic.

Cheers

[UlanBatori]

Worldometer update. 51K+ recovered. 39K infected of whom 6.7K are serious/critical. Death rate is 6% of cases.

The Diamond Princess statistics: 700 out of 3000+ caught the disease. 100 recovered. 600 still sick. 6 dead.

Bad news is that # of Active Cases, though still decreasing, is not really dipping fast.

Good news is that 2-week-delayed death rate is now down to like 4.15%.

[nvishal]

8 confirmed cases of coronavirus so far, Union Minister for Health Dr Harsh Vardhan said Wednesday

These include the three Kerala patients who were discharged after recovery last month. All the remaining 25 cases were reported this week. These include:

- A 45-year-old man in Delhi who had returned from Europe

- A 24-year-old techie in Hyderabad who travelled to the city from Bengaluru after landing from Dubai

- Six people from Agra who got infected after coming in contact with the Delhi patient

- A group of 16 Italian tourists who travelled to Rajasthan and later Agra in Uttar Pradesh

- One Indian driver who accompanied the Italian tourists

All the patients who have tested positive for coronavirus are under isolation at various hospitals and facilities across the country.

28 confirmed coronavirus cases in India so far: Health minister Harsh Vardhan
https://www.indiatoday.in/india/story/c ... 2020-03-04

[vinod]

A week ago was half term holidays in UK. Most travelled to europe during those days. So, expect a big jump in numbers in UK in the next 2 weeks.

UK cases jump by 34 today to reach 85!

Getting there....

[Amber G.]

Meanwhile the land which gave SN Bose, JC Bose, Tagore, Vivekananda is reduced to this...
Coronavirus panic to divert attention from Delhi riots: Mamata Banerjee slams Modi Government

[sooraj]

Yeshiva University in New York says one of its students has tested positive for coronavirus -- the third reported case in the state.

NYGovCuomo says son, wife, daughter and neighbor of Westchester man hospitalized in serious condition with #coronavirus have all tested positive. Brings total number of confirmed cases in New York to six.

Officials say that the 1st #COVID19 case in #NorthCarolina is a person who visited the #Washington-state nursing home that has multiple #coronavirus cases and deaths.

Paytm employee in Gurgaon has tested positive for coronavirus: Company statement. It said the employee had recently returned from a vacation in Italy, one of the worst-hit countries from coronavirus.

@drharshvardhan said Italian govt declined to take #coronavirus positive Italian tourists from Jaipur / Delhi.

Italy to close all schools for two weeks as a precaution against the coronavirus.

Coronavirus fears cause halt at Japan, Italy F-35 facilities.

JNU suspends biometric attendance in view of Corona Virus threat.

Spain confirms its first coronavirus death. The 69-year-old man from Valencia had recently returned from Nepal. Over 150 cases of coronavirus have been detected in the country so far.

Coronavirus on phone screens. Disinfect with alcohol wipes twice a day.

Beard sanitiser gel sale went up recently in the UK after NHS encouraged employees to shave.

Health Minister Dr Harshvardhan says “We will now screen all international passengers...we will not limit our screening to just 12 countries as we did earlier”.

Delhi BJP spokesperson Tajinder Pal Singh Bagga asks police to suspend breath analyser tests to prevent further spread of disease.

[UlanBatori]

Delhi BJP spokesperson Tajinder Pal Singh Bagga asks police to suspend breath analyser tests to prevent further spread of disease.

Yippeee! (Hic!)

[Krita]

In Delhi local shops as well as on Amazon, N95 respiratory masks, Hand sanitizers, Paracetamol and Vitamin C tablets are sold out.

[Krita]

Now in Gurgaon.
https://www.financialexpress.com/lifest ... s/1889216/

[Zynda]

In Delhi local shops as well as on Amazon, N95 respiratory masks, Hand sanitizers, Paracetamol and Vitamin C tablets are sold out.

One pharmacist in BLR told me that even though GoI has banned sending and/or selling masks along with other critical items to China, it is still being continued to be sent illegally.

[yensoy]

Lots of fakes, poorly packaged and/or mislabeled masks in the market these days. Buyer beware. Forget the N-95, go for the basic blue/white surgical mask. When in doubt, use two. Or three.

[Amber G.]

Lots of fakes, poorly packaged and/or mislabeled masks in the market these days. Buyer beware. Forget the N-95, go for the basic blue/white surgical mask. When in doubt, use two. Or three.

To be clear basic surgical mask is effective if the wearer has a cold/coughs etc.. it protects others to prevent spread germs but for protection from the environment it is basically unhelpful. The virus will go right through the cloth (these viruses are much smaller in size than pores) when you breath in.

Washing hands, staying away from others (5-6 feet), not touching face/eyes, "Namste" instead of handshake in gatherings -- etc are *much* more important.

Here are some advice for doctors (and other health care providers)
- Educate/advice your patients -
- Tele-medicine / email (mychart kind) / hotlines - If the symptoms are mild, ask them to stay home and work over phone. (Many insurance companies are okay with that).. (Refer the patients to hot-lines etc)
- Ask your patients to call ahead if they are coming so you are ready.
- Know the places which are ready so you can send them there.
- Remember most/many places like Operating rooms etc are positive pressure - not suitable. Make sure you are negative pressure areas.
- There is little choice, if unprepared - all who come in contact will be quarantined so it *will* disturb your work,

[Amber G.]

I agree with Bibi's advice:

Israeli Prime Minister Benjamin Netanyahu on Wednesday encouraged his countrymen to adopt 'Namaste' - the Indian way of greeting - instead of the normal handshake

[Vadivel]

In Delhi local shops as well as on Amazon, N95 respiratory masks, Hand sanitizers, Paracetamol and Vitamin C tablets are sold out.

One pharmacist in BLR told me that even though GoI has banned sending and/or selling masks along with other critical items to China, it is still being continued to be sent illegally.

That was lifted on Feb 10 as per CBiC notice, Goi does allow export of masks to other countries now, it was only effective for around 10 days.

[nits]

Gov can run ads on TV or make it compulsory for all channels to run message which talks about Do's and don't and precautions which needs to be done and how India is prepared

This has to be done and will help

[Amber G.]

I don't know if there are many molecular biologists or interested nerds here in brf but I found the famous Next Strain site extremely fascinating. It has live tracking of genetic data of COVID-19 -(Has lot of data from Ebola to SARS too)..

Lot of details about different "generations" and "family trees" of the viruses - (By measuring mutation etc)..
(You can track the routes these viruses taking - so to speak -)

[UlanBatori]

The advice now (Official from WHO/CDC) is **NOT** to wear masks unless you are sick yourself. Apparently, risk of infecting yourself from adjusting mask on your face and thus touching near your nose outweighs any proteections.

[Amber G.]

I agree with Bibi's advice:

Israeli Prime Minister Benjamin Netanyahu on Wednesday encouraged his countrymen to adopt 'Namaste' - the Indian way of greeting - instead of the normal handshake

I liked the picture which went with the story! (Of not shaking hands and doing Namste)


Added later: The above photo, it seems is mischief done by Indiatoday ... this photo below is from other news sources..


****

BTW - This "namste" part is being adopted/recommended at the sign-of-peace time in a few churches I know of. IIRC a few years ago, Toronto's Archbishop said the same thing (around SARS scare)

[Gerard]

PM urges Israelis to trade handshakes for namaste gesture to counter Covid-19

[chola]

Interesting and, I think, important look at how Cheen is controlling the virus. They are on a war footing.

https://www.nytimes.com/2020/03/04/heal ... lward.html

Inside China’s All-Out War on the Coronavirus

Dr. Bruce Aylward, of the W.H.O., got a rare glimpse into Beijing’s campaign to stop the epidemic. Here’s what he saw.

By Donald G. McNeil Jr.
March 4, 2020
Updated 7:35 a.m. ET

As the leader of the World Health Organization team that visited China, Dr. Bruce Aylward feels he has been to the mountaintop — and has seen what’s possible.

During a two-week visit in early February, Dr. Aylward saw how China rapidly suppressed the coronavirus outbreak that had engulfed Wuhan, and was threatening the rest of the country.

New cases in China have dropped to about 200 a day, from more than 3,000 in early February. The numbers may rise again as China’s economy begins to revive. But for now, far more new cases are appearing elsewhere in the world.

China’s counterattack can be replicated, Dr. Aylward said, but it will require speed, money, imagination and political courage.

Dr. Aylward, who has 30 years experience in fighting polio, Ebola and other global health emergencies, detailed in an interview with The New York Times how he thinks the campaign against the virus should be run.

This conversation has been edited and condensed.

Do we know what this virus’s lethality is? We hear some estimates that it’s close to the 1918 Spanish flu, which killed 2.5 percent of its victims, and others that it’s a little worse than the seasonal flu, which kills only 0.1 percent. How many cases are missed affects that.

There’s this big panic in the West over asymptomatic cases. Many people are asymptomatic when tested, but develop symptoms within a day or two.
In Guangdong, they went back and retested 320,000 samples originally taken for influenza surveillance and other screening. Less than 0.5 percent came up positive, which is about the same number as the 1,500 known Covid cases in the province. (Covid-19 is the medical name of the illness caused by the coronavirus.)

There is no evidence that we’re seeing only the tip of a grand iceberg, with nine-tenths of it made up of hidden zombies shedding virus. What we’re seeing is a pyramid: most of it is aboveground.

...

What about children? We know they are rarely hospitalized. But do they get infected? Do they infect their families?

We don’t know. That Guangdong survey also turned up almost no one under 20. Kids got flu, but not this. We have to do more studies to see if they get it and aren’t affected, and if they pass it to family members. But I asked dozens of doctors: Have you seen a chain of transmission where a child was the index case? The answer was no.

...

Are the cases in China really going down?

I know there’s suspicion, but at every testing clinic we went to, people would say, “It’s not like it was three weeks ago.” It peaked at 46,000 people asking for tests a day; when we left, it was 13,000. Hospitals had empty beds.

I didn’t see anything that suggested manipulation of numbers. A rapidly escalating outbreak has plateaued, and come down faster than would have been expected. Back of the envelope, it’s hundreds of thousands of people in China that did not get Covid-19 because of this aggressive response.

...

How did the Chinese reorganize their medical response

First, they moved 50 percent of all medical care online so people didn’t come in. Have you ever tried to reach your doctor on Friday night? Instead, you contacted one online. If you needed prescriptions like insulin or heart medications, they could prescribe and deliver it.

...

But if you thought you had coronavirus?

You would be sent to a fever clinic. They would take your temperature, your symptoms, medical history, ask where you’d traveled, your contact with anyone infected. They’d whip you through a CT scan …

Wait — “whip you through a CT scan”?

Each machine did maybe 200 a day. Five, 10 minutes a scan. Maybe even partial scans. A typical hospital in the West does one or two an hour. And not X-rays; they could come up normal, but a CT would show the “ground-glass opacities” they were looking for.

(Dr. Aylward was referring to lung abnormalities seen in coronavirus patients.)

And then?

If you were still a suspect case, you’d get swabbed. But a lot would be told, “You’re not Covid.” People would come in with colds, flu, runny noses. That’s not Covid. If you look at the symptoms, 90 percent have fever, 70 percent have dry coughs, 30 percent have malaise, trouble breathing. Runny noses were only 4 percent.

....

How good were the severe and critical care?

China is really good at keeping people alive. Its hospitals looked better than some I see here in Switzerland. We’d ask, “How many ventilators do you have?” They’d say “50.” Wow! We’d say, “How many ECMOs?” They’d say “five.” The team member from the Robert Koch Institute said, “Five? In Germany, you get three, maybe. And just in Berlin.”

(ECMOs are extracorporeal membrane oxygenation machines, which oxygenate the blood when the lungs fail.)

Who paid for all of this?

The government made it clear: testing is free. And if it was Covid-19, when your insurance ended, the state picked up everything.

In the U.S., that’s a barrier to speed. People think: “If I see my doctor, it’s going to cost me $100. If I end up in the I.C.U., what’s it going to cost me?” That’ll kill you. That’s what could wreak havoc. This is where universal health care coverage and security intersect. The U.S. has to think this through.

What about the nonmedical response?

It was nationwide. There was this tremendous sense of, “We’ve got to help Wuhan,” not “Wuhan got us into this.” Other provinces sent 40,000 medical workers, many of whom volunteered.

In Wuhan, our special train pulled in at night, and it was the saddest thing — the big intercity trains roar right through, with the blinds down.

We got off, and another group did. I said, “Hang on a minute, I thought we were the only ones allowed to get off.” They had these little jackets and a flag — it was a medical team from Guangdong coming in to help.

...

How did people in Wuhan eat if they had to stay indoors?

Fifteen million people had to order food online. It was delivered. Yes, there were some screw-ups. But one woman said to me: “Every now and again there’s something missing from a package, but I haven’t lost any weight.”

Lots of government employees were reassigned?

From all over society. A highway worker might take temperatures, deliver food or become a contact tracer. In one hospital, I met the woman teaching people how to gown up. I asked, “You’re the infection control expert?” No, she was a receptionist. She’d learned.

How did technology play a role?

They’re managing massive amounts of data, because they’re trying to trace every contact of 70,000 cases. When they closed the schools, really, just the buildings closed. The schooling moved online.

...

Isn’t it possible only because China is an autocracy?

Journalists also say, “Well, they’re only acting out of fear of the government,” as if it’s some evil fire-breathing regime that eats babies. I talked to lots of people outside the system — in hotels, on trains, in the streets at night.
They’re mobilized, like in a war, and it’s fear of the virus that was driving them. They really saw themselves as on the front lines of protecting the rest of China. And the world.

[sanjaykumar]

Possibly. There is an inflection December to February/March in Wuhan of temperature, total about 6-8 C but the slope is highest for the year. There is a more marked increase in rainfall and some increase in sunshine. Relative humidity is about constant but total moisture may not be as temperature rises. UV index also increases. Atmospheric pollutants including reactive ozone and nitric oxides, VOC are also precursors of ozone etc etc.

Helps to reserve judgement, and consider, like the brilliant scientist/ professor/thinker (can't find the emoji for emesis) some of us think we are, confounding variables.

Also see https://www.mdpi.com/1660-4601/17/2/428 Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China And also https://www.ncbi.nlm.nih.gov/pubmed/26766354 Acute effects of air pollution on influenza-like illness in Nanjing, China: A population-based study. (I know, some of us are brilliant with google searches too).


Then finally one needs to consider the effects of all these variables, singly and in combination, on not just viral survival but also on host defences and susceptibility.

[komal]

Trade conference that I had planned to attend in Florida canceled.

I get registration fee refunded. But might have to eat hotel and airfare.

[UlanBatori]

Interesting and, I think, important look at how Cheen is controlling the virus. They are on a war footing.

https://www.nytimes.com/2020/03/04/heal ... lward.html

Wow! Either the author is Wong Wei in disguise, or that absolutely smashes all the naysayers and Chickens Little. A Crow banquet please.
It is a national pride thing, apparently. I would **NOT** have believed this from a nation of all iklaute bacche.
Kudus to the Chinese People. A true Super Power.

How did the Chinese reorganize their medical response
First, they moved 50 percent of all medical care online so people didn’t come in. Have you ever tried to reach your doctor on Friday night? Instead, you contacted one online. If you needed prescriptions like insulin or heart medications, they could prescribe and deliver it.

[chola]

^^^ Actually, I think the quotes below gives a lot of hope for them and the world.

They have 200 trials running and competing for a declining pool of severe patients.

Hopefully one or more of them pans out.

What’s going on with the treatment clinical trials?

They’re double-blind trials, so I don’t know the results. We should know more in a couple of weeks.

The biggest challenge was enrolling people. The number of severe patients is dropping, and there’s competition for them. And every ward is run by a team from another province, so you have to negotiate with each one, make sure they’re doing the protocols right.

And there are 200 trials registered — too many. I told them: “You’ve got to prioritize things that have promising antiviral properties.”

And they’re testing traditional medicines?

Yes, but it’s a few standard formulations. It’s not some guy sitting at the end of the bed cooking up herbs. They think they have some fever-reducing or anti-inflammatory properties. Not antivirals, but it makes people feel better because they’re used to it.

What did you do to protect yourself?

A heap of hand-sanitizer. We wore masks, because it was government policy. We didn’t meet patients or contacts of patients or go into hospital dirty zones.

And we were socially distant. We sat one per row on the bus. We ate meals in our hotel rooms or else one person per table. In conference rooms, we sat one per table and used microphones or shouted at each other.

That’s why I’m so hoarse. But I was tested, and I know I don’t have Covid.

[g.sarkar]

Trade conference that I had planned to attend in Florida canceled.
I get registration fee refunded. But might have to eat hotel and airfare.

Arre babua: जान बची सो लाखो पाये.
Gautam

[Peregrine]

Lessons from the coronavirus front lines: What doctors in Wuhan have learned about treating Covid-19 : Bloomberg

March 5, 2020 10:45 AM EST

As the new coronavirus epidemic spreads across the globe, experts are turning to findings from China, where it originated, to better understand the disease. Since January, doctors at the outbreak’s epicenter in Wuhan have been studying the virus whose effects are mostly mild but can occasionally turn deadly.

Medical professionals who have been treating and studying Covid-19 patients in Wuhan shared their insights with reporters in Beijing on Wednesday. Here are three observations from the doctors.

Incubation and Transmission

Anecdotal reports that the novel coronavirus may have a long incubation have stoked fears that carriers can go undetected and unknowingly infect others.

Local authorities in another city in Hubei -- the same province that Wuhan belongs to -- reported on Feb. 22 that a 70-year-old man was infected by the virus but only showed symptoms 27 days later.

“From most of the publications right now the median incubation period is five to seven days, with the longest incubation period as 14 days,” said Du Bin, a member of China’s team of experts overseeing coronavirus treatment. “There’s no data showing that an incubation period longer than 14 days ever existed.”

In some patients, the onset of the virus happened very slowly with only a mild fever before their conditions deteriorated rapidly 10 days later, according to Li Haichao, deputy director of the respiratory department at the First Hospital of Peking University.

There’s also no evidence so far that people who have recovered and later test positive again for the virus can pass it on to others, according to Du, who is also the director of intensive care unit for internal medicine at Peking Union Medical College Hospital.

On Thursday, Chinese media The Paper reported that a man in Wuhan who had recovered from Covid-19 and tested negative for the virus died less than a week later from the infection. The report was later removed from the internet.
Younger Deaths

The coronavirus has a relatively low fatality rate and has largely claimed the lives of older patients with weaker immune systems, or those with pre-exisiting conditions. The deaths of some younger patients have been more difficult to explain.

Underlying diseases like hypertension and diabetes, the prolonged used of non-invasive ventilation and high doses of corticosteroids over a long period of time were major factors in those deaths, according to Du. He did not specify the age range he was referring to when speaking of younger patients.

Methylprednisolone, an immune-suppressing corticosteroid drug that’s in common use in China for severe cases, has been linked to “prolonged viral shedding” in earlier studies of MERS, SARS and influenza, according to the World Health Organization.

Lessons Learned

Du said if he could do it all over again, he would have pushed health care authorities harder to have all ICU staff work together in designated hospitals to better establish best practices for critical care.

He also would have been more aggressive in using invasive mechanical ventilation in all patients who showed “clinical deterioration” in their respiratory failure or low blood oxygen levels -- known as hypoxemia.

Planning is the most important aspect of the virus response, according to Du, and countries need to know ahead of time how they are going to handle each patient entering a fever clinic, detect suspected cases, confirm if they have the virus in labs and isolate possible cases.

“You must have a plan to provide not only space but also supplies such as personal protective equipment for all the healthcare workers involved,” he said.

Du said it’s true that there is a decreasing number of patients in Hubei and more empty hospital beds, although it’s impossible to rule out the possibility of another spike in cases.

Cheers

[Amber G.]

There are a few technical papers, and may be popular article (may be coming soon) around the study of viruses' genetic code of Washington COVID-19 cases and increasing the understanding of how that particular epidemic spread.

Refer to my earlier post and a link I am giving below for more details.

I don't know if there are many molecular biologists or interested nerds here in brf but I found the famous Next Strain site extremely fascinating. It has live tracking of genetic data of COVID-19 -(Has lot of data from Ebola to SARS too)..

Lot of details about different "generations" and "family trees" of the viruses - (By measuring mutation etc)..
(You can track the routes these viruses taking - so to speak -)
<some inline images removed from the original post see original post >

Again - for molecular biologist and other nerds ..
Related article using this kind of info regarding Washington state ... Fascinating way how one can trace the spread of viruses ..
Learned a lot about some interesting ways to use the online tool - (it is quite good -- if one has data - and there is vast exiting data for Flu, and other viruses genetic sequences so one can study the spread)

Cryptic transmission of novel coronavirus revealed by genomic epidemiology

The field of genomic epidemiology focuses on using the genetic sequences of pathogens to understand patterns of transmission and spread. Viruses mutate very quickly and accumulate changes during the process of transmission from one infected individual to another. The novel coronavirus which is responsible for the emerging COVID-19 pandemic mutates at an average of about two mutations per month. After someone is exposed they will generally incubate the virus for ~5 days before symptoms develop and transmission occurs. Other research has shown that the "serial interval" of SARS-CoV-2 is ~7 days. You can think of a transmission chain as looking ...

..

We know that Wuhan went from an index case in ~Nov-Dec 2019 to several thousand cases by mid-Jan 2020, thus going from initial seeding event to widespread local transmission in the span of ~9-10 weeks. We now believe that the Seattle area seeding event was ~Jan 15 and we're now ~7 weeks later. I expect Seattle now to look like Wuhan around ~1 Jan, when they were reporting the first clusters of patients with unexplained viral pneumonia. We are currently estimating ~600 infections in Seattle, this matches my phylodynamic estimate of the number of infections in Wuhan on Jan 1. Three weeks later, Wuhan had thousands of infections and was put on large-scale lock-down. However, these large-scale non-pharmaceutical interventions to create social distancing had a huge impact on the resulting epidemic. China averted many millions of infections through these intervention measures and cases there have declined substantially.

[Amber G.]

^^^ I have read about the above take on Washington case (that it will/can/likely) can go like Wuhan by a few people quite early. (There were some papers and were taken seriously). Even the old FDA director was talking about it.

Unless drastic measures are taken, there is a very real possibility that we may have a Wuhan type situation there. (600+ cases as the above article suggests).

Anyone here knows if the genetic sequencing data for Indian cases is available?

[UlanBatori]

Wow. Cholaj, I think u got through the granite skulls at GOTUS! Yesterday the WHO doc said that GOTUS needs to do some soul-searching on the cost of the COVID test. This came todin from Medicare:

You've likely heard about the Coronavirus (officially called "2019-Novel Coronavirus" or "COVID-19") in the news. While there isn't a vaccine yet and the immediate health risk remains low, Medicare is still here to help.

Your Medicare Part B (Medical Insurance) covers a test to see if you have Coronavirus. This test is covered when your doctor or a health care provider orders it, if you get the test on or after February 4, 2020. You usually pay nothing for Medicare-covered clinical diagnostic laboratory tests.
To prevent the spread of this illness or other illnesses, including the flu:
Wash your hands often with soap and water,
Cover your mouth and nose when you cough or sneeze,
Stay home when you're sick, and
See your doctor if you think you're ill.
And if they say yes you are: Observer standard WMD Response Procedure:
Put your head between your knees and kiss your ass goodbye
Visit The Centers for Disease Control website for information on the Coronavirus.

That is not nearly as good as Cheen govt promising to pick up any costs from the disease beyond what insurance covers, but it is an amazingly fast start, given the Brutal Regime's policies and attitudes.

[Amber G.]

^^^^ WoW!
I saw one of the first paper about genomic epidemiology related to Washington case a few weeks ago and some of the experts in the field thought that way for quite sometime. I shared some of this in my social media but mentioned about this in brf too.

Recently Scott Gotllieb's tweeted (and many retweeted that) about it. It is a *very* nice and worth reading thread of tweets - which summarizes the situation nicely.

Here is the link: https://twitter.com/ScottGottliebMD/sta ... 68640?s=20
(If I find time, I may quote some parts here but highly recommend to read the whole series of tweets- quite informative)

Also here is a story in Main stream media - today's paper: (worth reading to)

Washington State risks seeing explosion in coronavirus cases without dramatic action, new analysis says

The coronavirus outbreak in the Seattle area is at a critical juncture and could see explosive growth in cases much like Wuhan, China, if public officials don’t take immediate, forceful measures, according to a new analysis of genetic data.

The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at least 500 to 600 cases of Covid-19 in the greater Seattle area. He urged health authorities and the public to immediately begin adopting non-pharmaceutical interventions — imposing “social distancing” measures, telling the sick to isolate themselves, and limiting attendance at large gatherings.

“Now would be the time to act,” Bedford, who is at the Fred Hutchinson Cancer Research Center in Seattle, told
The genetic sequences of patients in the Seattle-King County region suggest the virus has been circulating there since about mid-January, when the first U.S. patient — a man who returned from Wuhan — was diagnosed, Bedford wrote in the analysis, published online

<snip> please read the whole article...

(BTW - quite some time ago, I talked about that person - first case in US - returning from Wuhan - and my fears then that person should have been correctly quarantined etc... Some people/doctors/scientists raised the alarm then - they should have been listened to seriously then - I find it disturbing that people - who should know better - are quick to jump and to make fun of serious science.)

[Amber G.]

^^^ Excerpts from the tweet link I gave above:

Scott Gottlieb, MD: THREAD: In our federal system, local leaders get lot of discretion in reacting to local public health crisis. But #coronavirus, which may start regionally, is national threat. So how do we get Seattle to shut down their economy for good of nation? No city wants to go first 1/n
9:11 AM · Mar 5, 2020·Twitter for iPhone
***
We’re losing valuable time. Longer we take to implement tough mitigation steps in areas of outbreak like Seattle, the larger, longer our epidemic curve will grow. Should we consider emergency economic aid for cities that implement tough measures to mitigate local outbreaks? 2/n
--
These outbreaks are local public health crises with direct national consequence. It’s a time for Congress to consider how we encourage states and cities to take tough local measures that sacrifice local economic activity for sake of nation. It’s time for collecting action. 3/n
---
The concern is driven by elegant modeling out of Hutch and other groups suggesting spread could be far more pervasive in Seattle area. With hundreds or maybe low thousands of undetected cases 4/n

<snip> Please see the whole thread - it does have nice graphics etc .. (some of it may be familiar )

[ramana]

AmberG, Doctors here or on your SM feed?

(BTW - quite some time ago, I talked about that person - first case in US - returning from Wuhan - and my fears then that person should have been correctly quarantined etc... Some people/doctors/scientists raised the alarm then - they should have been listened to seriously then - I find it disturbing that people - who should know better - are quick to jump and to make fun of serious science.)
Top

[g.sarkar]

https://www.washingtonpost.com/world/20 ... e-updates/
Live updates: Cruise ship held off California coast; coronavirus turmoil grows as U.S. death toll mounts
By Rick Noack, Miriam Berger, Alex Horton and Andrew Freedman, March 5, 2020.
With California under a state of emergency, countries in Asia and the Middle East further restricting travel and some 300 million children facing school closures around the world, the coronavirus outbreak is spurring an escalating economic cost and increasing disruptions to everyday life.
A cruise ship carrying some 2,500 passengers, en route from Hawaii to San Francisco, was held off the coast for coronavirus screening. Two U.S. coronavirus cases, including the first U.S. patient to die outside Washington state, have suspected links to the ship. At least 20 people had fallen ill and will be tested for the virus.
The Dow Jones industrial average dropped more than 700 points Thursday morning amid mounting signs of economic problems ahead.
.....
______________________________________________________________________________________________________________
https://www.rediff.com/news/report/coro ... 200305.htm
Coronavirus: 16k passengers holed up in ships at Indian ports
By Namita Tewari, March 06, 2020.
As many as 16,076 crew members and passengers onboard ships from China or having travelled to coronavirus-hit countries have been scanned and not allowed to disembark at Indian ports as a precautionary step, a shipping ministry official said on Thursday.
However, all possible assistance and help are being provided to them -- onboard 452 ships anchored at designated places -- as per World Health Organization guidelines in case of any fever or symptoms.
"As many as 452 ships with EXIM cargo and 16,076 crew and passengers have arrived at Indian ports so far from China or a travel history to countries affected from coronavirus. As a precautionary measure to prevent any outbreak, we have not allowed the passengers and crew to disembark but ships were allowed to anchor at designated places. The cargo was brought with all precautions.
"No shore pass is being issued to the crew/seafarers having travel history from the infected countries," the official said.
.....
Gautam

[Amber G.]

AmberG, Doctors here or on your SM feed?

(BTW - quite some time ago, I talked about that person - first case in US - returning from Wuhan - and my fears then that person should have been correctly quarantined etc... Some people/doctors/scientists raised the alarm then - they should have been listened to seriously then - I find it disturbing that people - who should know better - are quick to jump and to make fun of serious science.)
Top

Hi Ramana,
I am/was not talking about doctors here (in brf) but people and scientists in general. We have Mamata didi (in a leadership position, no less) talking about "how the whole thing is NaMo's effort to divert attention from riots". Here in US , Trump/Pence are doing the same. Meanwhile the situation here in US is really a scandal. And I am not even counting fake cures etc..


Just to give an example: A doctor - who is working on the front-line was having trouble even getting people tested. According to him the total number of people tested in the whole NY state was (then) 33!

Contrast this to Korea - where they are routinely testing 10,000+ cases every day! (probably the same size at NY state)

In other countries the "average" time (this is calculated by # of cases done / day - including all the red tape etc) for CT scan diag/ machine is about 10 minutes.

In US at present it is more than an hour.

Doctors are calling it a scandal. Hope things change.
(Fortunately things are much better in India - It is nice to see real scientists who has NaMo's ear).
***
Brf and posters here, in the grand scheme of things, ought to be taken in perspective - and not too seriously. Brf has a large audience so I try to post things which are helpful. If a few people find it helpful, and I can find time I will keep posting here.

If Brf has a place where one can host pdf and/or jpg /LaTex we could put some graphs / documents etc I have some useful stuff to share.
***
About the Washington case - IIRC I posted a few days ago and may be some time ago too. Others might have posted about that too.

That was the first US case so it stood out in my mind. It seemed strange that all the details did not come out. (Except the name of the hospital where he was admitted)

I once had son working for Microsoft, and a nephew/niece (both doctors) working in the area so I have spent quite some time there and am familiar with the area..
When the news about 18 year old came out (who was in the same area as the hospital) and then the Nursing Home cases - many feared that there are many more cases..

I really hope that we in US do all we can do to manage this. Please call your senators/congressmen - the testing procedure and other essential items must be taken care as soon as possible.

[UlanBatori]

Right now (as of Monday morning), CDC has ordered that Testing Labs are not to test walk-in patients without direct order from a Doctor. I asked the nurse who was drawing my blood (routine anti-ice-cream conspiracy not related to any of this) about whether they were getting any training, and she said yes. But their training so far is to not test patients who exhibit COVID symptoms. Big notice posted next to counter (but in fine print so you have to go breathe on the person sitting there to read it).
Overall, "chickens wandering in moonlight" (Malloo saying) would be a fine descriptor.

[g.sarkar]

https://www.nbcnews.com/health/health-n ... d-n1150561
Live Blog / Coronavirus updates live: California declares emergency, governments race to stop spread
March 5, 2020
California has declared an emergency over the coronavirus outbreak, as tests continued Thursday on board a Princess cruise ship that has been linked to two cases of the virus in the state.
California's first death related to coronavirus was confirmed on Wednesday, while another fatality in Washington brought that state's death toll up to 10. Congressional leaders, meanwhile, have agreed on an $8 billion emergency funding package to help fight the coronavirus that is headed to the House.
......
Gautam

[Amber G.]

Some update on testing kits availability : (From news sources)
>>VP Pence: " I am pleased to report we have 2500 kits available that we will distribute. We approved a process that will allow testing at state and university laboratories."

From what I know each kit should allow a lab to run about 500 tests. That would work out to 1.25 million tests.
(Perspective : The U.S. = population of 331 million people.. I don't know (or people who ought to know are not very clear in telling how fast .. how many tests per day etc..will local doctors will be satisfied etc..)

(BTW They've had a few months to be ready for this virus. This is inexcusable IMO)

Meanwhile: using the latest data (some latest and new genomic data on the spread) I think - some models are predicting that as many as 1500 active cases may be the number we have to be prepared for Washington state. Scarry!

(The number, if my going over numbers are correct, median comes out to about 570 - but as anyone who knows statistics there is lot of uncertainty - with 90% confidence level the number is between 80 and 1500 - from this model) - Point is we have to be prepared for worse case - It looks like these alarm bells were ringing since late January..)
(You can read the whole Tweet/thread I mentioned in last post here: https://threadreaderapp.com/thread/1235 ... 68640.html.

[Amber G.]

meanwhile : I watched this news conference tamasha live ... for those who missed it, here it is..
(Please do watch - at least a first few seconds at 1:00 --:)
https://www.youtube.com/watch?v=nnz95Ss ... tu.be&t=60
Please watch how the instructions are given "to wash hands and keep the hands clean and not touch your face, nose and eyes"".. (Did not say anything about tongue! ... She literally did that a few times .. Saying "do not touch face .. while she used tongue to wet the finger and turn the page..quite a few times