Merged 2019-nCoV / Corona virus

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The Atheist said:
I've been saying for the past two weeks that the virus causing an economic recession seems certain to me and I'm not sure why the sharemarkets aren't seeing it - they're normally the first place to panic.
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Markets have been trained to buy on the dips for the last 10 years and it has proven profitable.

I expect things will change shortly. Also, shortages will cause price increases and this isn't easily remedied by QE or liquidity injection. Interesting to see what effect this has on bond prices and interest rates generally. I think this is a fairly obvious black swan event. Market algos have never been good at tail risk.
 
This is why all the speculation about case fatality rate is a fool's errand.
https://www.worldometers.info/coronavirus/coronavirus-death-rate/
At present, it is tempting to estimate the case fatality rate by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude [...]

A precise estimate of the case fatality rate is therefore impossible at present.
2019-Novel Coronavirus (2019-nCoV): estimating the case fatality rate – a word of caution - Battegay Manue et al., Swiss Med Wkly, February 7, 2020
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It's from the favorite Worldometer site.
 
rjh01 said:
Snap. Same link and only one day apart.
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You're just looking at a different part of the link. The paragraph I quoted essentially says these (links at the link) calculations are nothing but unreliable speculation.
Presented on this page:

How to calculate the mortality rate during an outbreak
Mortality Rate (2.1% Nationwide, 4.9% Wuhan, 3.1% Hubei, and 0.16% other provinces) reported by the NHC of China
Mortality Rate comments by the WHO (2% estimate, but too early to tell)
Study providing a tentative mortality rate of 3%
Death rate among patients admitted to hospital (HFR): 15%
Days from first symptom to death: 14 days
Comparison with other viruses
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We know for a fact that the cases we see are biased toward the sicker patients. And look at the range in those cited links.

That the data is biased toward sicker patients was reinforced in the last couple days when more and more cases have turned out to have been spread by asymptomatic patients. There are many hidden cases.
 
The Atheist said:
Interesting take from a couple of profs from U of Queensland: https://theconversation.com/theres-...through-the-air-but-its-still-possible-131653
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I find it very odd that there have not been many cases where a person has caught the virus despite not being on a cruise ship or been in China. Maybe those that are likely to travel from China are also the ones least likely to have the virus. Like students are generally young and healthy so they may be able to get rid of the virus easily if they get it. And they are the ones who want to come to Australia (and elsewhere), rather than retirees.
 
Skeptic Ginger said:
Yes they do.

H5-specific RNA was detected in the lung, spleen, and small and large intestines by RT-PCR (Figure 2A).... virus replication was confined to the lung and intestine.

The eyes have it: influenza virus infection beyond the respiratory tract.
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Yes, there are a number of similar papers around. You have to understand that these papers exist because the claims are extraordinary. It is a bit like finding a paper that claims to have observed cold fusion and then saying cold fusion exists. Such observations would overthrow decades of research and thousands of papers studying the replication of flu.

Flu viruses have to bind to a specific cell receptor to infect cells. That receptor is found on cells in the human respiratory tract, but not elsewhere. Flu vaccines are designed on the basis that this is how flu viruses work. For flu viruses to infect cells outside of the respiratory tract that do not express these receptors then one of several explanations would have to be true. 1) This is a novel flu virus (that would be highly virulent) that shows pantropism. This does occur in some non-human flu viruses. This has never been observed. 2) This is a new variant human that expresses respiratory cell receptors on non respiratory cells. This has never been observed. 3) There was contamination of tissue samples when they were collected (likely). 4) There was in laboratory contamination when doing the tests (possible).

Yes for some flu viruses particularly avian ones there is a theoretical possibility of eye infections. Not surprising because via the tear duct the eye is in continuity with the respiratory tract. This is why wearing eye protection is part of PPE. I should have been more precise in saying respiratory and conjunctiva.


As your first paper concludes,
In contrast to disseminated infection documented in other mammals and birds, H5N1 viral replication in humans may be restricted to the lung and intestine, and the major site of H5N1 viral replication in the lung is the pneumocyte.
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The multiorgan dysfunction observed in human H5N1 disease, despite the apparent confinement of infection to the lungs, has remained an enigma. The hypothesis that cytokine dysregulation may contribute to the pathogenesis of severe H5N1 disease remains a possibility.
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In birds flu is primarily a GI infection, the shift to human infection occurs because the receptor in birds GI cells is similar to a receptor in human respiratory tract cells. There is a similar receptor in the human GI tract and in theory there could be binding in the GI tract but even this paper does not claim they have shown active infection in the GI tract.

The second quote above really makes the point I was trying to make despite the confinement of flu infection to the lungs multiorgan dysfunction occurs and this is thought to be due to 'cytokine dysregulation' - collateral damage from the immune system and NOT directly mediated viral damage.

Unfortunately one paragraph comments on the internet are never going to be a detailed and accurate thesis on viral pathogenesis. I was trying to make a broad observation about the importance of a balanced immune response and the idea of a strong or weak response was simplistic.

ETA
In retrospect the most accurate term for me to have used was to say flu viruses in humans are limited to mucosal membranes, and do not affect organs such as the heart or brain despite the occurrence of encephalitis and myocarditis.
 
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Planigale said:
Yes, there are a number of similar papers around. You have to understand that these papers exist because the claims are extraordinary. It is a bit like finding a paper that claims to have observed cold fusion and then saying cold fusion exists. Such observations would overthrow decades of research and thousands of papers studying the replication of flu.

Flu viruses have to bind to a specific cell receptor to infect cells. That receptor is found on cells in the human respiratory tract, but not elsewhere. Flu vaccines are designed on the basis that this is how flu viruses work. For flu viruses to infect cells outside of the respiratory tract that do not express these receptors then one of several explanations would have to be true. 1) This is a novel flu virus (that would be highly virulent) that shows pantropism. This does occur in some non-human flu viruses. This has never been observed. 2) This is a new variant human that expresses respiratory cell receptors on non respiratory cells. This has never been observed. 3) There was contamination of tissue samples when they were collected (likely). 4) There was in laboratory contamination when doing the tests (possible).

Yes for some flu viruses particularly avian ones there is a theoretical possibility of eye infections. Not surprising because via the tear duct the eye is in continuity with the respiratory tract. This is why wearing eye protection is part of PPE. I should have been more precise in saying respiratory and conjunctiva.

As your first paper concludes,

In birds flu is primarily a GI infection, the shift to human infection occurs because the receptor in birds GI cells is similar to a receptor in human respiratory tract cells. There is a similar receptor in the human GI tract and in theory there could be binding in the GI tract but even this paper does not claim they have shown active infection in the GI tract.

The second quote above really makes the point I was trying to make despite the confinement of flu infection to the lungs multiorgan dysfunction occurs and this is thought to be due to 'cytokine dysregulation' - collateral damage from the immune system and NOT directly mediated viral damage.

Unfortunately one paragraph comments on the internet are never going to be a detailed and accurate thesis on viral pathogenesis. I was trying to make a broad observation about the importance of a balanced immune response and the idea of a strong or weak response was simplistic.

ETA
In retrospect the most accurate term for me to have used was to say flu viruses in humans are limited to mucosal membranes, and do not affect organs such as the heart or brain despite the occurrence of encephalitis and myocarditis.
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What a pile of crap. Here you go again making unsupportable assertions. :rolleyes:

Are you unable to understand the research?

H5-specific RNA was detected in the lung, spleen, and small and large intestines by RT-PCR ...

The successful extractions of RNA from all organs were confirmed by the amplification of GAPDH mRNA (data not shown). We also tested whether the RNA was genomic RNA from virion or replicating RNA and mRNA from productively infected cells. To determine this, we conducted strand-specific RT-PCRs. Positive- and negative-stranded viral RNA was found in the lung, small intestines, and large intestines, but only negative-stranded RNA was detected in the spleen (Figure 2B). Because of the absence of positive-stranded RNA, which would serve as mRNA and the template for genome replication, we concluded that viral replication was absent or very low in the spleen and that the viral RNA detected in the spleen was probably nonreplicating virion RNA.
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Contamination was ruled out.

How is it you think this is some iffy research making extraordinary claims?

As for the eye, flu presenting as conjunctivitis has been known for years. Google it.

And BTW, avian flu infects more than just their GI tracts.

Survival of Highly Pathogenic Avian Influenza H5N1 Virus in Tissues Derived from Experimentally Infected Chickens.
The maximum periods for viral survival were observed in samples stored at +4°C in all tissue types and were 240 days in feather tissues, 160 days in muscle, and 20 days in liver. The viral infectivity at +20°C was maintained for a maximum of 30 days in the feather tissues, 20 days in muscle, and 3 days in liver.
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Skeptic Ginger said:
What a pile of crap. Here you go again making unsupportable assertions. :rolleyes:

Are you unable to understand the research?

Contamination was ruled out.

How is it you think this is some iffy research making extraordinary claims?

As for the eye, flu presenting as conjunctivitis has been known for years. Google it.
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I am sorry you seem to be missing the point I am making.

This stuff about flu replication in organs such as the spleen brain etc. is a long time issue in virology. There are very strong views on it. People post these papers because it is controversial.

As I said I was imprecise in saying respiratory tract, being slightly too simplistic for a lay audience, and a better term would be mucosa which would have covered all options even rare ones. I accept that the conjunctiva can be directly infected, and there may be rare cases when particularly avian viruses infect the human GI tract, but you are missing the point I was really making in trying to nitpick the details.
 
And in cats: Cat study shows the H5N1 virus attacking gut and other organs.
Avian flu ravages tissues throughout the body, confirms an autopsy of infected cats. ...

In a follow-up study, published in the American Journal of Pathology this month2, they carefully probed the tissues of eight infected animals.

The virus wreaks havoc in the brain, liver, kidney, heart and numerous other tissues, they find, killing cells and triggering inflammation....

Researchers already knew that the H5N1 virus, like other pathogenic avian flu viruses, spreads throughout the body of birds. But they are only beginning to identify the genetic tricks that allow H5N1 to march into so many tissues.
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Viremia and extra-respiratory complications appear to be more common for infections with avian H5N1 virus than with human influenza viruses.
However, human influenza virus infection also is associated with disease in other organs, albeit to a lesser extent. Given the recent reports of extra-respiratory disease from highly pathogenic avian influenza H5N1 virus infection (see below), it is important to revisit these complications of human influenza virus infection...

The advent of endomyocardial biopsies at the time of acute disease together with sensitive (in situ) RT-PCR techniques have made it possible to detect the presence of influenza viral RNA in inflamed myocardial tissue in some cases [41;58] but not in others [59;60;60]. It is not clear what the target cells of influenza virus in human heart tissue are: Cioc and Nuovo [41] detected influenza viral RNA in lymphocytes and macrophages within the myocardium of a person who died suddenly and unexpectedly with marked diffuse myocarditis and marked cardiomyocyte necrosis. Ray et al. [56] detected influenza viral antigen throughout the myocardium (cell types showing antigen expression not stated) of a patient with massive myocardial necrosis and associated lymphocytic and mononuclear infiltrates. The necrosis and inflammatory process in the myocardium could be explained by a combination of direct cytolytic effect of viral infection and the host immune response....

The isolation of the virus from the blood of two patients [85;86] and the detection of H5N1 viral RNA by RT-PCR in 9 of 16 patients [87] suggests that viremia can occur at reasonably high levels and for prolonged periods in people with symptomatic H5N1 virus infection [30]. Such viremia would allow H5N1 virus to spread to extra-respiratory tissues. Indeed, pathological investigations provide evidence for the presence of H5N1 virus in multiple extra-respiratory tissues by immunohistochemistry, in situ hybridisation, or both, often in association with lesions. The brain, where H5N1 virus has been found in neurons, is edematous without significant histologic lesions, or with demyelination, necrosis, and accumulation of reactive histiocytes....

The liver, where H5N1 virus has been found in Kupffer cells, shows hepatic necrosis, hepatic lipidosis, cholestasis, and Kupffer cell activation. Lymph nodes, where H5N1 virus has been found in lymphocytes, have reactive histiocytes with hemophagocytotic activity. Such evidence of hemophagocytosis also is present in spleen, bone marrow, lungs, and liver.
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Planigale said:
I am sorry you seem to be missing the point I am making.

This stuff about flu replication in organs such as the spleen brain etc. is a long time issue in virology. There are very strong views on it. People post these papers because it is controversial.

As I said I was imprecise in saying respiratory tract, being slightly too simplistic for a lay audience, and a better term would be mucosa which would have covered all options even rare ones. I accept that the conjunctiva can be directly infected, and there may be rare cases when particularly avian viruses infect the human GI tract, but you are missing the point I was really making in trying to nitpick the details.
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So you take it back. Got it.

This is what you said:
You have to understand that these papers exist because the claims are extraordinary
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No, I don't have to understand, because you're wrong.
 
The Atheist said:
I think there's no doubt at all we're going to see a wave break in the next few days, with hundreds or more cases around the world. The long lead time on infection, plus the potential that 90% or more of infections probably aren't serious enough for people to take action seems to mean there's a bit of a critical mass to achieve for it to start being noticed in wider quantities.
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I'm working in Windsor at the moment and Windsor is a big tourist draw for tourists, especially Chinese tourists. About 2 weeks ago I had what I think was a bad cold, bit feverish, etc. About a week before that I had gone to McDonalds for a drink (strawberry milkshake, nothing beats it) I used the touch screen system. I didn't wipe the screen before I ordered or washed my hands and those giving out your orders don't wear gloves etc. Now I don't think I've had it but if there was someone infected I can see how easily it could be spread very quickly, I am slightly surprised we haven't seen more outbreaks around tourist attractions.

Chinese tourists have now pretty much disappeared from Windsor, tourist based business are suffering economically, another knock on that people on the whole haven't thought about.
 
portlandatheist said:
The NYT has a new article today
One thing mentioned is that a Fiat factory in Serbia shut down because they do not have the parts they need from China. I'm surprised there haven't been more market jitters as this thing could definitely cause an economic slowdown. The potential of this being pandemic seems more and more likely with each passing day.
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JCB plant in UK has reduced hours.
 
Darat said:
I'm working in Windsor at the moment and Windsor is a big tourist draw for tourists, especially Chinese tourists. About 2 weeks ago I had what I think was a bad cold, bit feverish, etc. About a week before that I had gone to McDonalds for a drink (strawberry milkshake, nothing beats it) I used the touch screen system. I didn't wipe the screen before I ordered or washed my hands and those giving out your orders don't wear gloves etc. Now I don't think I've had it but if there was someone infected I can see how easily it could be spread very quickly, I am slightly surprised we haven't seen more outbreaks around tourist attractions.

Chinese tourists have now pretty much disappeared from Windsor, tourist based business are suffering economically, another knock on that people on the whole haven't thought about.
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SARS Covid-19 doesn't present as a cold, with runny nose and sneezing. All you get is a high fever, aches and pains and a dry cough.

Secondly, I am pretty sure McDonalds workers wear latex gloves.

However, you are right to be wary of public places. I joined a gym just before this time last year in London. It was very popular and within two weeks I went down with a horrible cold/flu, which I know was due to unclean gym equipment (=lots of people having gripped the treadmills and bikes, etc). You just know. After that, I transferred to a brand new gym and all was well.
 
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Thank you to the beautiful country of Cambodia for accepting the @CarnivalCruise ship Westerdam into your port. The United States will remember your courtesy!
 
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