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*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (13 Viewers)

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Spike in South Korean cases - Super spreader possibly loose

  South Korea has reported a sudden spike of 20 new cases of coronavirus infection, raising concerns about a potential “super spreader” who has already infected 14 people in church.

This brings the total number of cases in the country to 51, sending alarm bells ringing as the government scrambled to strengthen quarantine measures to contain possible community spread.

Epidemiological investigations showed that 14 of the new cases revealed on Wednesday (Feb 19) attended the same church as the 31st patient - a 61-year-old Korean woman who developed sore throat on Feb 8 and was diagnosed on Tuesday.

It is not clear how she could have contracted the virus as she did not travel overseas recently and had no contact with the confirmed cases before her.

The woman, a native of the south-eastern city Daegu, is known to have come into contact with 166 people, all of whom have been quarantined. This includes her husband and two children.

The Korea Centres for Disease Control and Prevention (KCDC) said the woman was warded for 10 days from Feb 7 at Saeronan Oriental Hospital in Daegu. She was hospitalised after a car accident on Feb 6.

As her injuries were minor, she left the hospital to attend a two-hour religious service at Shincheonji Church of Jesus on Feb 9, and again on Feb 16. She also had lunch with an acquaintance at a hotel buffet restaurant on Feb 15.
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adonis said:
The thing that concerns me is how many of the younger doctors treating the patients have died.  These guys are likely to be in good health, and get the best care possible, yet several high profile folks have died.

I don't trust any of the numbers out of China.
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In general, risk for infection is based on the virulence of the pathogen, the inoculum (amount you’re exposed to) and host immune system.

Healthcare workers are at high risk of exposure, often without any warning to don appropriate PPE. I can’t tell you how many patients have coughed in my face when the presenting complaint was something like toe pain, for example.

Additionally, there appears to be an immunologic component to the severe cases. For some infections, the bug itself doesn’t kill you, but your own immune system overdoes the inflammatory response. I saw “cytokine storm” mentioned somewhere; this is an example of your immune system causing more harm than good. A younger, otherwise healthy person will typically have a more brisk immune response, and thus greater risk for such phenomena.

In summary, healthcare workers have a higher than average exposure risk and greater chance of immunologic sequelae of infection if they are otherwise healthy.

 
One other thing to consider: many infections have differential rates of infectivity/severity based on genetic factors. So some of the heightened mortality in China may be inherent to Chinese people, in addition to a severely overwhelmed health care system.

As an aside, US hospitals are typically operating at max capacity in the winter, so it’s not impossible to imagine our system being overwhelmed if this takes off locally.

 
culdeus said:
Reports are they are seeing good results from a malaria drug.  It's also super cheap. 
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This is interesting because malaria is caused by a specific genus of protozoa.

I'll look for a citation, but meanwhile ... do you have a link to this?
 

EDIT: Never mind, found some links quickly.

To Fight Coronavirus Outbreak, Doctors Deploy Drugs Targeting HIV, Malaria and Ebola (Scientific American, 2/6/2020)

Coronavirus: Chloroquine yields positive data in Covid-19 trial (Clinical Trials Arena, 2/18/2020)

EDIT: I really want to get some traditional-media corroboration for the chloroquine studies link. Clinicaltrialsarena.com appears to be a legit pharma news site, but the article itself lacks citations to data ... just quotes. The only other sites I can find running with "chloroquine seems to work!" are iffy news sites.

 
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Doug B said:
This is interesting because malaria is caused by a specific genus of protozoa.

I'll look for a citation, but meanwhile ... do you have a link to this?
 

EDIT: Never mind, found some links quickly.

To Fight Coronavirus Outbreak, Doctors Deploy Drugs Targeting HIV, Malaria and Ebola (Scientific American, 2/6/2020)

Coronavirus: Chloroquine yields positive data in Covid-19 trial (Clinical Trials Arena, 2/18/2020)

EDIT: I really want to get some traditional-media corroboration for the chloroquine studies link. Clinicaltrialsarena.com appears to be a legit pharma news site, but the article itself lacks citations to data ... just quotes. The only other sites I can find running with "chloroquine seems to work!" are iffy news sites.
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That does it. I am prescribing myself six gin & tonics a day

 
Terminalxylem said:
In general, risk for infection is based on the virulence of the pathogen, the inoculum (amount you’re exposed to) and host immune system.

Healthcare workers are at high risk of exposure, often without any warning to don appropriate PPE. I can’t tell you how many patients have coughed in my face when the presenting complaint was something like toe pain, for example.

Additionally, there appears to be an immunologic component to the severe cases. For some infections, the bug itself doesn’t kill you, but your own immune system overdoes the inflammatory response. I saw “cytokine storm” mentioned somewhere; this is an example of your immune system causing more harm than good. A younger, otherwise healthy person will typically have a more brisk immune response, and thus greater risk for such phenomena.

In summary, healthcare workers have a higher than average exposure risk and greater chance of immunologic sequelae of infection if they are otherwise healthy.
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Can you talk more about the "inoculum"?  I find that this isn't something I"ve thought much about.  I realize I've been operating under an assumption that you're either sick with a virus or you're not...and not thinking about it in terms of virus load.

 
Doug B said:
Aside from China and the cruise ship Diamond Princess docked off of Yokohoma, here are the rest-of-the-world totals to date:

(15 new cases today)
457 total cases Feb 18, 2020
(minus 160 patients recovered to date)
297 total active cases Feb 18, 2020

20 seriously/critically ill patients
5 deaths

...

To derive these numbers, I turned the chart here into an Excel sheet, then excluded the first two rows.

...

Same data with all of East Asia removed (Nepal's one recovered case left in):

(0 new cases today)
100 total cases Feb 18, 2020
(minus 52 patients recovered to date)
48 total active cases Feb 18, 2020

3 seriously/critically ill patients
1 death

That one death was a Chinese vacationer in France who contracted the virus at home before traveling.
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Thought I'd update the numbers above. IMHO, the picture is a lot clearer with China and the Diamond Princess cruise ship removed.

Rest-of-the-world totals to date (excluding China and the cruise ship Diamond Princess docked off of Yokohoma):

(37 new cases today)
494 total cases Feb 19, 2020
(minus 183 patients recovered to date)
311 total active cases Feb 19, 2020

19 seriously/critically ill patients
8 deaths (+2 Iran, +1 Hong Kong)

Same data with all of East Asia removed (Nepal's one recovered case left in):

(2 new cases today [reported by Iran, both dead])
102 total cases Feb 19, 2020
(minus 52 patients recovered to date)
(minus 2 deaths [Iran's two 'new' cases])
48 total active cases Feb 19, 2020

3 seriously/critically ill patients
3 deaths (Iran's two 'new' cases)

 
Mr. Ham said:
Sounds like everything related to Diamond Princess was a goat rodeo, with 500 people sent into the wild to potentially spread the virus. Apparently, a taxi driver who had contact with passengers when the ship was docked in Okinawa February 1 has it and is seriously ill. Appears to be on the longer end of the incubation spectrum.

As an Austinite, I’m not particularly thrilled that sxsw is coming up March 13-23. Looked at last year’s economic report. 49% of the 100k attendees come in from other states. 26% are international. It’s one of the world’s biggest Internet festivals, and the music and film tracks draw attendees from everywhere.

Will see how things progress over next couple weeks, but if you’ve ever been in town for one of these, it’s all about big crowds in tight spaces, small venues, lots of Ubering about. I’d prefer we don’t invite that level of international co-mingling just yet.  
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ugh. My plans to move 3/13-14 just took on a few magnitudes of difficulty

 
culdeus said:
Remind me where cruise ship patient zero got it. 
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BBC, 2/7/2020

Some 3,700 people are on board the Diamond Princess, which is quarantined in Yokohama for at least two weeks.

The [COVID-19] checks began after an 80-year-old Hong Kong man who had been on the ship last month fell ill with the virus.

He boarded the [Diamond Princess] in Yokohama on 20 January and disembarked in Hong Kong on 25 January.
Click to expand...

 
Up to 8 deaths outside of China.  Up 3 from yesterday. Easy to see why it’s a bit early to calculate mortality rates when so many of the new cases are very recent.  

 
shader said:
Up to 8 deaths outside of China.  Up 3 from yesterday. Easy to see why it’s a bit early to calculate mortality rates when so many of the new cases are very recent.  
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Especially considering Iran didn't report their two infections at all until hours before their deaths. Too many countries willing to play the denial game.

 
i'm punting on my tech conference in San Jose in two weeks.  too many people that travel back and forth to Asia regularly in too close of quarters.

 
Mr. Ham said:
Sounds like everything related to Diamond Princess was a goat rodeo, with 500 people sent into the wild to potentially spread the virus. Apparently, a taxi driver who had contact with passengers when the ship was docked in Okinawa February 1 has it and is seriously ill. Appears to be on the longer end of the incubation spectrum.

As an Austinite, I’m not particularly thrilled that sxsw is coming up March 13-23. Looked at last year’s economic report. 49% of the 100k attendees come in from other states. 26% are international. It’s one of the world’s biggest Internet festivals, and the music and film tracks draw attendees from everywhere.

Will see how things progress over next couple weeks, but if you’ve ever been in town for one of these, it’s all about big crowds in tight spaces, small venues, lots of Ubering about. I’d prefer we don’t invite that level of international co-mingling just yet.  
Click to expand...
A heavy dose of Franklin BBQ should burn the ends off that virus pretty quick. Brisket based vaccine hopefully available by then. 

 
I hope Iran had known about those two cases from early on versus finding out today after the two infected had been out in the public for weeks

 
TwinTurbo said:
A heavy dose of Franklin BBQ should burn the ends off that virus pretty quick. Brisket based vaccine hopefully available by then. 
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Yeah, but if he contracts the virus at the beginning of the line, he'd likely keel over before he got to eat that brisket.

 
Sooo.... 

You guys remember Me talking about the team member next to my desk who went to Asia (Malaysia, unsure of flight path) for lunar new year, then was directed to self quarantine for 14 days upon return? 
 

Roll into the office today and shes there. No mask. Nothing.

I start chatting with her "Suk-Lee, aren't you supposed to be in quarantine?!" 
 

"Yes but I had onsite meeting today. I had to come in early for call then two meeting." 

(blank stare from me from ~2M away)

"I know (director name) told me 14 day, but I had meeting. She told me to wear mask after but It's hard to talk with mask" 

then..... she ####### coughs. :eek:

Not right at me, but close enough.
 

I kinda roll back back a couple feet, grab my computer, and walk out of the office. I'm not going back till Monday. Frankly I ####### hope I offended the #### out of her. 

This same woman came in last fall with a brutal chest cold and got our entire team sick,

 
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bradyfan said:
If she goes down, she wants everyone she knows to go down with her!
Click to expand...
Seriously. 

Brings up the Old topic: if you're "I go to work sick to show how tough and dedicated I am" guy.... I hope you get in an accident on the way to work.

Not one bad enough to cause serious injury, but you deserve to have your car disabled because you're not a responsible adult. 

 
Non-China Reported Cases

2/7 - 277

2/10 - 394

2/11 - 430

2/12 - 490

2/14 - 525

2/15 - 684

2/16 - 695

2/17 - 893 reported cases - (454 on Diamond Princess) - 135 recovered - 36 serious/critical - 5 dead 

2/18 - 1,014 reported cases (542 on Diamond Princess) - 152 recovered - 39 serious/critical - 5 dead

2/19 - 1,149 reported cases (621 on Diamond Princess) - 169 recovered - 45 serious/critical - 10 dead

 
adonis said:
Can you talk more about the "inoculum"?  I find that this isn't something I"ve thought much about.  I realize I've been operating under an assumption that you're either sick with a virus or you're not...and not thinking about it in terms of virus load.
Click to expand...
It’s just a measure of how much virus (or more broadly, pathogen) to which you’re initially exposed - your body can often effectively control small exposures, though this varies for different types of infections. An intimate household contact of an infected individual or healthcare worker is far more likely to be exposed to high viral quantities than a casual contact, which may place them at risk for more severe illness.

And infection isn’t binary; it’s a continuum from asymptomatic to mild cold-like symptoms to fulminant illness, usually with pneumonia and respiratory failure.

Unlike HIV or hepatitis C, viral load isn’t typically measured in coronavirus infections. So it’s not entirely clear how it correlates with disease severity, but it’s reasonable to expect those with greater viral exposure are more likely to get sick and may possibly develop worse symptoms.

 
Mr. Ham said:
Sounds like everything related to Diamond Princess was a goat rodeo, with 500 people sent into the wild to potentially spread the virus. Apparently, a taxi driver who had contact with passengers when the ship was docked in Okinawa February 1 has it and is seriously ill. Appears to be on the longer end of the incubation spectrum.

As an Austinite, I’m not particularly thrilled that sxsw is coming up March 13-23. Looked at last year’s economic report. 49% of the 100k attendees come in from other states. 26% are international. It’s one of the world’s biggest Internet festivals, and the music and film tracks draw attendees from everywhere.

Will see how things progress over next couple weeks, but if you’ve ever been in town for one of these, it’s all about big crowds in tight spaces, small venues, lots of Ubering about. I’d prefer we don’t invite that level of international co-mingling just yet.  
Click to expand...
I’ll be in Austin that week. 
 

Meeting some folks who are coming in from Japan :thumbup:  

 
JbizzleMan said:
Ruh Roh. Looks like Iran is starting to explode with new cases.
Click to expand...
It would figure that Iran would be next.  The only country possibly less trustworthy than China.

I saw some stuff on twitter about this too.  Reports of 10-20 deaths.  Some doctor has apparently said 20 people have died from corona virus in his hospital.  But who is this doctor?  Is he trustworthy?  Who the heck knows.  

 
shader said:
It would figure that Iran would be next.  The only country possibly less trustworthy than China.

I saw some stuff on twitter about this too.  Reports of 10-20 deaths.  Some doctor has apparently said 20 people have died from corona virus in his hospital.  But who is this doctor?  Is he trustworthy?  Who the heck knows.  
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There are rumors of a quarantine beginning in Qom.

 
Mr. Ham said:
14 with virus flew back with negative passengers

Despite objections from CDC, the State Department decided to fly 14 Americans who tested positive with the 328 passengers who tested negative. 
 

“In the wee hours of a rainy Monday, more than a dozen buses sat on the tarmac at Tokyo’s Haneda Airport. Inside, 328 weary Americans wearing surgical masks and gloves waited anxiously to fly home after weeks in quarantine aboard the Diamond Princess, the luxury liner where the novel coronavirus had exploded into a ship-wide epidemic. But as the buses idled, U.S. officials wrestled with troubling news. New test results showed that 14 passengers were infected with the virus. The U.S. State Department had promised that no one with the infection would be allowed to board the planes. A decision had to be made. Let them all fly? Or leave them behind in Japanese hospitals?”
Click to expand...
So all 328 are in quarantine back home now... right?

 
Scoresman said:
So all 328 are in quarantine back home now... right?
Click to expand...
Yes.  This isn’t new news; these are the ones who flew home Sunday into Monday, and the information came out then about the positive tests.

ETA:  healthy ones are quarantined in CA and TX.  Positive ones I believe are in Nebraska.

 
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Non-China Reported Cases

2/7 - 277

2/10 - 394

2/12 - 490

2/14 - 525

2/16 - 695

2/17 - 893 reported cases - (454 on Diamond Princess) - 135 recovered - 36 serious/critical - 5 dead 

2/18 - 1,014 reported cases (542 on Diamond Princess) - 152 recovered - 39 serious/critical - 5 dead

2/19 - 1,149 reported cases (621 on Diamond Princess) - 169 recovered - 45 serious/critical - 10 dead

2/20 - 1,259 reported cases (634 on Diamond Princess) - 191 recovered - 45 serious/critical - 11 dead

 
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