Merged 2019-nCoV / Corona virus

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I read that there's now a good handle on the incubation period (time from infection to showing symptoms): 1 to 14 days.

And I think I read that this new coronavirus is somewhat unusual in that an infected person is themselves infectious from the get go; for many viruses the infected becomes infectious only when symptoms show.

However, I haven't yet read that what I call the asymptomtic incidence has yet been nailed down. This is the proportion of people who are infected who develop no or only mild symptoms. This is particularly concerning because an infected person with mild symptoms is likely to/may consider this "just a cold" or "just the flu" (am not sure if trained medical professionals can do differential diagnoses with high confidence). Among other things this means how deadly the new coronavirus is is essentially unknown (other than a clear upper bound).

Also: apparently missing is serious work on contact tracing (i.e. checking up on all the people an infected person has had contact with since they became infected). Probably nigh on impossible in Wuhan right now and for the next month or three.
 
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We have Chinese people wearing masks in public in NZ right now, despite zero cases in the country.

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A friend who lives in an eastern US state with no reported cases, in a town/suburb with a high Asian immigrant population, told me that masks - of almost all kinds - are sold out, in pharmacies, supermarkets, even hardware stores (e.g. Home Depot). I suspect that the masks are not being purchased for themselves (not primarily), but rather to ship to friends and relatives in China (where, it seems, they are sold out everywhere).

Fear is powerful.
 
There is an immense infrastructure in place to try to mitigate the impact of 'flu. There are monitoring stations throughout the world looking for the strains of circulating 'flu virus. Because of continued mutation by the 'flu viruses, new vaccines need to be produced twice a year to match what are predicted to be the circulating strains. Millions of doses of the new vaccine have to be produced in a few months, and transported round the world. Governments have to put in place vaccine programs and persuade people to be vaccinated. Modelling siggests that if one could achieve high rates of vaccination with an effective vaccine in children 'flu epidemics could be halted. There are effective drugs for 'flu if you have it but there is a reluctance to use them because of the cost

Every year there is information put out about good hygiene practices to minimise transmission of respiratory viruses.

For some other viruses
Yeah, some of the preventative measures for flu would be useless for this new coronavirus (e.g. vaccines), but much of the reporting and treatment machinery should work for the new virus, right?

Outside China - and in many parts of China - detecting new cases should be fairly straight-forward with little change (and there will be lots of change anyway!); in Hubei etc I wonder just how overwhelmed the systems are. For example, how many of the people being quarantined are not, in fact, infected with the new coronavirus (yes, they may have appropriate symptoms, but how many "just" have a "bad case of the flu"?).
 
Latest numbers from China are 2000 confirmed cases and 56 deaths.

That's ostensibly 2.8% mortality rate, but I'm sticking with cases being 100 times more than the confirmed number and 0.03%.
Oh stop it. These numbers are meaningless.


I have a couple research articles that are very interesting.

https://promedmail.org/promed-post/?id=6915411

In this posting:
[1] Research: bats considered as primary reservoir of 2019-nCoV
[2] 2019-nCoV genome, origins and mutations discussed
[3] EcoHealth Alliance's president interviewed
[1] Research: bats considered as primary reservoir of 2019-nCoV
Date: Thu 23 Jan 2020
Source: bioRxiv preprint [edited]
https://www.biorxiv.org/content/10.1101/2020.01.22.914952v2.full.pdf


Citation: Zhou P, Yang X-L, Wang X-G, et al. Discovery of a novel coronavirus associated with the recent pneumonia outbreak in 2 humans and its potential bat origin. bioRxiv [23 Jan 2020]. https://doi.org/10.1101/2020.01.22.914952

Abstract
--------
Since the SARS outbreak 18 years ago, a large number of severe acute respiratory syndrome-related coronaviruses (SARSr-CoV) have been discovered in their natural reservoir host, bats. Previous studies indicated that some of those bat SARSr-CoVs have the potential to infect humans. Here we report the identification and characterization of a novel coronavirus (2019-nCoV) that caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, started from 12 Dec 2019, has caused 198 laboratory-confirmed infections with 3 fatal cases by 20 Jan 2020. Full-length genome sequences were obtained from 5 patients at the early stage of the outbreak. They are almost identical to each other and share 79.5% sequence identify to SARS-CoV. Furthermore, it was found that 2019-nCoV is 96% identical at the whole genome level to a bat coronavirus. The pairwise protein sequence analysis of 7 conserved non-structural proteins show that this virus belongs to the species of SARSr-CoV. The 2019-nCoV virus was then isolated from the bronchoalveolar lavage fluid of a critically ill patient, which can be neutralized by sera from several patients. Importantly, we have confirmed that this novel CoV uses the same cell entry receptor, ACE2, as SARS-CoV....

[The above research has been performed by the Center of Emerging Infectious Diseases at the Wuhan Institute of Virology (WIV), Chinese Academy of Sciences (CAS). For some background on the Center and its previous research of coronavirus in China's bats, see commentary in 20200123.6909913. - Mod.AS]



[2] 2019-nCoV genome, origins and mutations discussed
Date: Fri 24 Jan 2020
Source: STAT News [abridged, edited]
https://www.statnews.com/2020/01/24...navirus-genome-tracing-origins-and-mutations/


Since the sequencing of the 1st 2019-nCoV sample, from an early patient, scientists have completed nearly 2 dozen more, said Andrew Rambaut of the University of Edinburgh, an expert on viral evolution. That pace is "unprecedented and completely unbelievable," said Andersen [molecular biologist Kristian Andersen of Scripps Research, an expert on viral genomes], who worked on sequencing the Ebola genome during the 2014 outbreak. "It's just insane."

The genome of the Wuhan virus is 29 903 bases long, one of many clues that have led scientists to believe it is very similar to SARS.

By comparing the 2 dozen genomes, scientists can address the "when did this start" question. The 24 available samples, including from Thailand and Shenzhen as well as Wuhan, show "very limited genetic variation," Rambaut concluded on an online discussion forum where virologists have been sharing data and analyses. "This is indicative of a relatively recent common ancestor for all these viruses."

Given what's known about the pace at which viral genomes mutate, if nCoV had been circulating in humans since significantly before the 1st case was reported on 8 Dec 2019, the 24 genomes would differ more. Applying ballpark rates of viral evolution, Rambaut estimates that the Adam (or Eve) virus from which all others are descended 1st appeared no earlier than 30 Oct 2019, and no later than 29 Nov 2019.

The progenitor virus itself was almost certainly one that circulates harmlessly in bats (as SARS does) but has an "intermediate reservoir" in one or more animals that come into contact with people, Andersen said. Presumably, that reservoir is one of the species of animals at the Wuhan market thought to be ground zero for the outbreak. The ancestor of 2019-nCoV existed in that species for some unknown time, never infecting people, until by chance a single virus acquired a mutation that made it capable of jumping into and infecting humans.

The genome sequences suggest that was a one-time-only jump. "The genomes [from the 24 samples] are very uniform," Andersen said. "If there had been multiple introductions," including from many different animals, "there would be more genomic diversity. This was a single introduction."

That means that what's sustaining the spread is human-to-human transmission (suggesting that closing Wuhan's animal market is very much an after-the-horse-has-fled-the-barn reaction).

Unfortunately, genetic analysis can't identify what animal species the coronavirus jumped from into humans. But an analysis by a team from the Wuhan Institute of Virology, posted to the preprint server bioRxiv [see item 1], determined that the genome of this coronavirus (the 7th known to infect humans) is 96% identical to that of a bat coronavirus, suggesting that species is the original source. (Writing in the New England Journal of Medicine on Friday [24 Jan 2020], another team of scientists in China reported that the new coronavirus is 86.9% identical to the bat SARS-like coronavirus.) [reference below]....

[NEJM citation: Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med [Epub 24 Jan 2020] https://www.nejm.org/doi/full/10.1056/NEJMoa2001017]

The last piece is an interview with an expert on the epidemiology of coronaviruses.

There is a very big diversity of these [corona]viruses in the wild. We've been looking at bats ever since the SARS outbreak because we're the group that found bats are the real reservoir for SARS, not civets, that was originally thought. And what we found is there's this big diversity: We've found over 50 SARS-related coronaviruses in bats.

The worrying thing is some of [the viruses] you can treat with vaccines and therapies that have been developed against SARS and it works, but [with] other viruses from bats, those therapeutics don't work. So we've been saying for a while now that there are groups of viruses in bats that could be a risk, and in fact, one of them, we developed an antibody test and we went to communities in Yunnan Province [in] rural southwest China, and [tested] people who live near bat colonies where we'd found these viruses. We found a 3% prevalence of exposure to bat viruses, suggesting that all the time across the region, bat viruses are getting into people and either infecting them with a mild infection [with] no clinical signs or causing respiratory illness that never gets diagnosed properly. So this outbreak is probably just one of a number of spillover events that have happened in south China.
This stuff fascinates me.

This was the mod comment:
[The animal-related aspects of 2019-nCoV are yet to be fully clarified. This has been conveniently summarised in the editorial of the recent NEJM issue:

"Given the close similarity [of 2019-nCoV] to bat coronaviruses, it is likely that bats are the primary reservoir for the virus. SARS-CoV was transmitted to humans from exotic animals in wet markets, whereas MERS-CoV is transmitted from camels to humans. In both cases, the ancestral hosts were probably bats. Whether 2019-nCoV is transmitted directly from bats or by means of intermediate hosts is important to understand and will help define zoonotic transmission patterns" (https://tinyurl.com/uurzljt).

A One Health approach is necessary for the achievement of that goal. - Mod.AS
 
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Is there any information about how long 2019-nCoV can be virulent outside the hosts body?
 
I read that there's now a good handle on the incubation period (time from infection to showing symptoms): 1 to 14 days.

And I think I read that this new coronavirus is somewhat unusual in that an infected person is themselves infectious from the get go; for many viruses the infected becomes infectious only when symptoms show.

However, I haven't yet read that what I call the asymptomtic incidence has yet been nailed down. This is the proportion of people who are infected who develop no or only mild symptoms. This is particularly concerning because an infected person with mild symptoms is likely to/may consider this "just a cold" or "just the flu" (am not sure if trained medical professionals can do differential diagnoses with high confidence). Among other things this means how deadly the new coronavirus is is essentially unknown (other than a clear upper bound).

Also: apparently missing is serious work on contact tracing (i.e. checking up on all the people an infected person has had contact with since they became infected). Probably nigh on impossible in Wuhan right now and for the next month or three.

You must have read an article like this one https://www.theguardian.com/science...ng-three-cities-to-contain-coronavirus-spread which says what you have said.

The above article is very worrying.

There is a big difference between a cold and a flu. Though many people say they have the flu when they have a cold.
 
You must have read an article like this one https://www.theguardian.com/science...ng-three-cities-to-contain-coronavirus-spread which says what you have said.
It wasn't that source, but the contents are, as you say, similar. I don't remember where I read it (if I find it I'll write a post with a link).

The above article is very worrying.

There is a big difference between a cold and a flu. Though many people say they have the flu when they have a cold.
Yes. I'm trying to look at this from both a biologically/medically correct POV and that of "the ordinary citizen".

From the latter POV, it would be totally unsurprising to learn that the vast majority of people rushing to hospitals (etc) in China, with symptoms they fear may be due to a 2019-nCoV infection, turn out to have "the flu" or "a cold" (or are essentially symptomless; fear can have strange effects). Equally, many people with 2019-nCoV-like symptoms may NOT go to a hospital to get tested, even when they are are very sick, for many different reasons (peculiar to China, these may include a fear of being "deported" due to hukou irregularities; somewhat like being undocumented in the US). And then there will be cases of people with symptoms resembling those of 2019-nCoV who do get quarantined, only to later learn they don't have it (are the screeners in, say, Wuhan over-cautious? Or too overwhelmed, but those in Beijing not but are vastly over-cautious?).

I did read - WaPo? - a report of an elderly couple in Wuhan, in the early days of this outbreak, who got sick and died, and were immediately cremated. No testing was done to see if they had 2019-nCoV (a relative reported that they had symptoms consistent with it). This is kinda like what happened in the early days of SARS ...
 
CIDRAP article:

Sustained transmission fueling outbreak
The new analysis on 2019-nCoV transmissibility was released today by a group based at Imperial College London that made two earlier projections on the number of symptomatic illnesses in Wuhan.

The report focuses on transmissibility, and the scientists say sustained human-to-human transmission is the only explanation for the large-scale outbreak in Wuhan. They add that today's report is an extended version of what they shared with the World Health Organization, governments, and academic networks earlier this week.

They estimate that the reproduction number (R0), the average number of illnesses spread by one infected person, is 2.6 (range, 1.5 to 3.5). Also, the experts said transmission patterns are probably variable, with some people infecting several others, while some don't, a pattern seen with SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).

Control steps in China would need to block 60% of transmission to control the outbreak, the researchers projected. Without drugs or vaccine, shutting down the outbreak depends on quickly finding and isolating sick people.

This is useful:
official outbreak total to 1,287. So far, 237 people have severe infections
The numbers are still fluid of course.
Websites that tally newly reported cases throughout the day reflect as many 1,409 infections, 42 of them fatal.

China's current tracking website: http://3g.dxy.cn/newh5/view/pneumonia
Nationally confirmed 2081 cases suspected of 2692 deaths 56 cases cured 49 cases...

Incubation period: 1 to 14 days, average 10 days, contagious during incubation period
 
OMG Australia is keep all of its cases in the middle of the desert!

That's a little bit harsh.

:D

Good place to put them. Then they cannot physically get access to mobile phone coverage, doctors or lawyers. Then they can be treated like animals. If anyone does not like this idea, they want to endanger Australia by allowing the virus to spread. As a extra step demonise the people.

Edit. I can put more smilies on my post than you :D :D :D :D :D
 
Oh stop it. These numbers are meaningless.

Holy crap, I am getting really sick of your dishonest posting.

You comment on the half of one sentence, but it needs the other half to make sense.

That half you ignored said that I suspected the real number of cases had been understated by a factor of ~100, giving a mortality rate of 0.03%.

And funnily enough, that's exactly what Imperial College is now saying: https://www.theguardian.com/science...rus-could-infect-100000-globally-experts-warn

Prof Neil Ferguson, a public health expert at Imperial College, said his “best guess” was that there were 100,000 affected by the virus even though there are only 2,000 confirmed cases so far

I will also note you still haven't walked back on the idiotic statement that "Influenza is thousands of times worse".

This virus would seem to have a similar mortality rate to influenza, but whatever it turns out to be, it's blindingly obvious it won't be a factor of hundreds less than 'flu, let alone thousands.

Is there any information about how long 2019-nCoV can be virulent outside the hosts body?

A few hours, same as any other coronavirus.
 
Holy crap, I am getting really sick of your dishonest posting.

You comment on the half of one sentence, but it needs the other half to make sense.
....
The other half doesn't make your claim any more valid.

You are picking numbers out of a hat and then asserting meaning from them.

None of us has much clue to the actual denominator here. Look at the numbers I posted on recognized mild cases.
1,287. So far, 237 people have severe infections
That means there have been ~1,000 mild cases that have been identified.

How many people with cases so mild they went under the radar do you think that represents? Unless people are fairly ill, they aren't going to go stand in line to be seen at an overcrowded hospital.

Uncounted cases is likely to be very large and we won't know that number until population antibody tests are done.

Here's from another link above:
We found a 3% prevalence of exposure to bat viruses, suggesting that all the time across the region, bat viruses are getting into people and either infecting them with a mild infection [with] no clinical signs or causing respiratory illness that never gets diagnosed properly. So this outbreak is probably just one of a number of spillover events that have happened in south China.

What is the population in Wuhan again? 20 million if you count the outlying areas? Do your math with 3% of 20 million as the denominator for total cases.

What are the demographics of most of the fatalities so far? They're elderly!

I keep waiting to see a better accounting of the demographics but haven't yet seen one.


I'm not trying to piss you off or insult you. I am challenging some of the more blatant misinformation in this thread.
 
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You are picking numbers out of a hat and then asserting meaning from them.

Again, total dishonesty - the numbers I quoted were from the leading world authority on viral diseases and I even gave the link to the statement from Professor Neil Ferguson of Imperial College, London.

I'd be prepared to accept his version of events over yours.
 
Again, total dishonesty - the numbers I quoted were from the leading world authority on viral diseases and I even gave the link to the statement from Professor Neil Ferguson of Imperial College, London.

I'd be prepared to accept his version of events over yours.

One word: denominator. Where are you getting a reliable denominator?
 
Fear of the unknown, or reasonable fear?

If, in 2020, the flu kills faaaaaar more people than this new coronavirus does, what will the vast fortune spent of face masks, the locking down of a major city, etc have been for?

Maybe the widespread wearing of face masks (etc) will reduce the incidence of colds, the flu, ... and the new coronavirus?

I've wondered the same thing. However, there's two possible meanings to your hypothetical:

The first is that we overreacted.
The second is that we successfully minimized the damage compared to a scenario where we didn't react at all, or didn't react enough or in a timely manner.

There's a bit of an ironic trade-off that way, like with vaccines. The more successful vaccinations are, the less important some people end up thinking they are. I've heard people argue to the effect "why do we need measles vaccines anymore? Hardly anyone gets measles these days". :rolleyes:
 
I've wondered the same thing. However, there's two possible meanings to your hypothetical:

The first is that we overreacted.
The second is that we successfully minimized the damage compared to a scenario where we didn't react at all, or didn't react enough or in a timely manner.

There's a bit of an ironic trade-off that way, like with vaccines. The more successful vaccinations are, the less important some people end up thinking they are. I've heard people argue to the effect "why do we need measles vaccines anymore? Hardly anyone gets measles these days". :rolleyes:

The third possibility is that the measures taken did not work. That is, the results would be the same if people did nothing. Wearing face masks, for example, do little to protect you against a virus. All what they will do is protect others if you have a virus. And that assumes that the main method is transmission via the air. And then a person takes a mask off to wash, eat or drink and they can start spreading the virus. Or should that only be done alone? And that room sterilised between uses?

Edit. Here is a reference on wearing masks that cover similar issues to what I have mentioned. It does so in the context of flu, but either the virus is spread in a similar way to flu or masks are worthless to protect yourself

https://newoldage.blogs.nytimes.com/2013/01/16/in-flu-seasonuse-a-mask-but-which-one/
 
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