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Corona Virus update — can we stop the pandemic?

Posted By Jo Nova On In Health,Microbiology | Comments Disabled

The latest news coming out is mixed. The live map and latest count of 2019-nCoV shows 20,000 confirmed infections, 426 deaths, and most importantly, a spread to 28 countries. It’s slightly encouraging that there are no extra cases in Australia and good to hear 3 of the 12 have been sent home, declared “recovered”. However the incubation period since flights were closed is still only halfway to the average (of 5 – 6 days) so it’s too early to tell.

A South Korean has tested positive after visiting Thailand (not a good sign, but the statement didn’t “rule out China”). Japan has quarantined a whole cruise ship (like Italy did). One passenger came down with the virus in Hong Kong. The whole ship of 3700 is confined to rooms, awaiting test results. It’s reassuring that so many tests can be done.  (Yay, Japan). Meanwhile door handles can carry the virus. Soap and hand sanitizer could help a lot.

On the plus side, one team in Thailand say they have treated one patient successfully with anti-virals. It’s only one case, but a nice thought. How big are those stockpiles? The other plus, is that summer may slow it down. Best case is this might be “like a new flu”. We just don’t know.

Corona virus live map.

Statistics Feb 4th, 2020 Click to enlarge.

Worryingly there are reports of thirty year olds coming down with the severe form. Though again, this happens even with the normal flu. Another downer is that the latest Ro estimate appears to be around 4.0 much higher than the Flu. Meaning it may spread even faster. Though I’m skeptical as that’s calculated from Wuhan data, which is both “uncertain” and there is always the possibility that the Ro may be lower in different countries.  For comparison the Flu causes around 300,000 to 600,000 deaths every year. The fear here, justifiably, is the death rate might be quite a lot higher. The next few weeks are very important.

There are no recorded cases in Africa yet, though that seems hard to believe given the large Chinese workforce. It’s still possible perhaps for the rich western nations to curb the spread domestically, but if this spreads to Africa, India (3 cases) etc, and possibly to animal populations too, it’s difficult to imagine how it will not become endemic. Most African airlines have stopped flights to China, though not Ethiopia (perhaps something to do with the Belt and Road debt trap and the man running the WHO?).

If Coronavirus takes hold in other nations, then flights to those, and not just China will need to be stopped to contain it. At that point the question becomes “is it worth it” — which depends of course on the death and incapacitation rate — something we still really have no idea of. There are reports from China both of people who just got the flu and recovered, suggesting that for most people and the young and healthy, it isn’t a major threat. But there are also reports of quick and unrecorded cremations, and we know the Communist party has been suppressing the bad news. Photos on twitter imply the army is being brought in. This virus appears to cause the full spectrum from asymptomatic to “needing ICU”.

–-Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say —  NY Times

The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents… The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease. “But will it be catastrophic? I don’t know.”

Stopping the spread

For those wondering how the SARS and other potential pandemics were stopped — it takes laborious tracking of contacts, which is difficult with symptomless transmission. The response team must isolate high risk contacts, and sometimes even treat them with anti-virals or vaccinations (if we only had one) pre-emptively. Health workers need to wear Hazmat suits and also get the pre-emptive options. We have to ring fence every single outbreak — something we can do when there are very few cases, but quickly becomes impossible if enough infectious people walk through shopping malls and schools.

In this case, if the virus doesn’t cause a severe illness in all people, it will likely spread further and faster, as asymptomatic people don’t need to report to hospitals or even doctors, and may not realize they are spreading it. Only mass testing around a small caseload would solve that. On the other hand, if there is a significant pool of people who didn’t get sick, if we can figure out why, it may give us another treatment tool. And once many have recovered, there may be potential for antibodies against corona virus to be gathered. In the case of Ebola, the antibodies from recovered people seemed to be the only useful medicine at one point in the battle.

New hospital built in ten days: (*Works in Chrome, but not in Firefox)

FYI, The videos here don’t display in all forms of Firefox, but they do display in Chrome.

Is that a hospital or a prison?

There are photos on twitter showing the new hospital has bars on windows and patients cannot open doors from the inside.

 

Thai doctor says new drug combination treated coronavirus patient

CNN —Doctors in Thailand said they have successfully treated one Wuhan coronavirus patient with a combination of antiviral drugs, according to a briefing on Sunday from the Ministry of Health.

Dr. Kriangsak Atipornwanich, a doctor at Rajavithi Hospital in Bangkok, said he treated a 71-year-old female patient from China with a combination of drugs used in HIV and flu treatments. He said the patient had previously been treated with only anti-HIV drugs.

“I had treated a patient with severe condition, and the result has been very satisfactory. The patient’s condition has improved very quickly within 48 hours.

 

Coronavirus: scientists identify possible new mode of transmission in human faeces

  • Genetic traces of the new coronavirus have been found in the stool of patients being treated at a hospital in Shenzhen
  • The findings have prompted researchers to warn of possible faecel-oral spread of the disease, in addition to respiratory droplet transmission and contact

The doctors reading may correct me, but I think it is unusual for a virus to spread both ways — through both air and water easily. Anthrax can, but through spores (it’s not virus in any case, but a bacillus). Most viruses are armored up to survive one or the other. So people may be shedding this virus fecally but it is possible that it’s not a significant route of infection. It would  be good news if it were the predominant mechanism because the West is good at stopping waterborne infections. But I suspect this is not the case. If it is, there is a hope that the virus won’t spread as fast in the West as it is currently spreading in China. Wait and see.

h/t Thanks to William Astley, Derec Avery, Bill in Oz. Gee Aye.

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