Coronavirus - worldwide spread and control

So either the test doesn't work, the virus is adaptive, or it has a life cycle that includes dying back in a 'seasonal' fashion - which seems a little unlikely

My money is on the testing being flawed, which is a fun and interesting possibility.

 

Yep, along with the fact that the 14% figure will probably change as more work is done. It could be far fewer people...or many more.

 

Quite a few of the viruses I've had over the last 10 years have hit me hard, seemingly recover and then hit with what feels like exactly the same virus for another few weeks - and I'm talking about all the respiratory symptoms, cough, runny nose, eye pus etc.

But you are right that tests necessarily have thresholds and associated sensitivity/specificity. All tests are at least slightly flawed.

 

I’m wondering about this myself. Some ppl with ME report being somewhat immune to colds/flu. While others report catching everything. I have often wondered if in some ME patients the immune system is left on in part, meaning invading viruses don’t get the usual foothold as they would when invading a resting immune system in a healthy host.

 

In some previous outbreak, probably H1N1, I started pushing open shop doors using only my foot, elbow or the outside of my forearm. Sometimes the door has to be pulled open, in which case I'll pull my sleeve over my fingers - or I'll just use the tip of my little finger to open the door. In rest rooms, it's often possible to use a paper towel to open the door to leave, which is yet another reason to hate it when they replace paper towels with air driven hand dryers. Some of those hand dryers just suck up air from within the bathroom (you can see their intake vents) which just seems like a highly efficient way to get a lot of germs on your hands.

Whether these strategies are all that effective, I don't know. It may seem obsessive, but I've yet to cross the Rubicon of actually carrying little tissues to avoid touching door handles.

 

I wonder what exactly the mean by "tested negative". Does that mean just by throat swab? Does it mean throat swab and fecal test?

 

My order was cancelled and refunded today. I'm thinking s/he isn't allowed to leave the house.

 

This is a summary of the current data about Covid 19

Report of the WHO-China Joint Mission
on Coronavirus Disease 2019 (COVID-19)

"People with COVID-19 generally develop signs and symptoms, including mild respiratory
symptoms and fever, on an average of 5-6 days after infection (mean incubation period 5-6
days, range 1-14 days).

Most people infected with COVID-19 virus have mild disease and recover. Approximately
80% of laboratory confirmed patients have had mild to moderate disease, which includes
non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory
frequency ≥30/minute, blood oxygen saturation ≤93%, PaO2/FiO2 ratio <300, and/or lung
infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory
failure, septic shock, and/or multiple organ dysfunction/failure).

Asymptomaticn infection
has been reported, but the majority of the relatively rare cases who are asymptomatic on
the date of identification/report went on to develop disease. The proportion of truly
asymptomatic infections is unclear but appears to be relatively rare and does not appear to
be a major driver of transmission.

Individuals at highest risk for severe disease and death include people aged over 60 years
and those with underlying conditions such as hypertension, diabetes, cardiovascular
disease, chronic respiratory disease and cancer. Disease in children appears to be relatively
rare and mild with approximately 2.4% of the total reported cases reported amongst
individuals aged under 19 years."

 

This is quite interesting. My guess is that reported cases are not only 97.6% from 20 upwards but very likely with an even bigger skew to older age groups. So being in the 61+ age range does not necessarily mean that fatality rates are four times higher than the average (if most deaths are in the last of 0-20, 21-40, 41-60, 61-80 quarters). Maybe people over 61 are a third or even half of cases reported. And if having a pre-existing condition is critical then maybe the rate is still only 1-2% for others.

 

This is quite an interesting take on COVID19 from The Grauniad - comparing the way things are in UK now with the village of Eyam.
https://www.theguardian.com/commentisfree/2020/feb/28/coronovirus-test-wellbeing-herd-vaccination

 

Today I was in the hospital again to retrieve some diagnostic test results. This time right after entering the building, there was a checkpoint with a table and what looked like a nurse and a man from security. On the table were a few boxes and some object I didn't get a good look at. I think in two of the boxes were latex gloves and face masks. It looked like a checkpoint where people would be examined for possible fever, and/or being given face masks. The counter for the test results was the only one accessible without passing the checkpoint, and there were no other people entering so I didn't get to see what they did. This was in Italy.

I'm writing for those curious about how different countries are approaching this outbreak.

 

Has anyone in the UK had any luck getting extra medications in case of med Shortages? Like have you been able to get an extra months meds? My GP only prescribes me meds at the end of each months supply. Worried as I take lots of medications and there are some I cannot function without them even for a day.

 

As far as I'm aware, no-one's saying that there's a problem at the moment – I might have missed something, though.

One of the difficulties with patient stockpiling is that, even if it's only done to a modest degree, it risks creating shortages that wouldn't otherwise have occurred. I'm guessing this is one of the reasons GPs tend to resist it?

 

There’s no problems at the moment. But I’m just aware that if there are shortages - I could become very ill if I end up missing a few days of meds. I would hope if there’s a chance of that happening though, the NHS / Govt would do something!

 

The American Heart Association estimates that nearly half of US adults have hypertension, though other sources say it's more like a 1/3. The difference seems to be due to stricter guidelines published in 2017.

Anyway, that's a lot of people, though I wonder if hypertension alone is much of a risk factor vis-à-vis poor outcome with COVID-19.

 

I think this is a really good article about how people with pre existing conditions (including asthma; and immune conditions), or looking after someone who is very ill, are hugely anxious about the Coronavirus. I thought I’d share as maybe it would help some people feel less alone. I’ve certainly been extremely anxious and struggling to cope with my mental health because of it, and more than anything; the uncertainty and fear.

https://www.theguardian.com/world/2...p-uk-coronavirus-plans-to-reassure-vulnerable

 

I'm wondering about that, too for my older relatives.

In this study table 1 they are going into more detail with every of the mentioned pre-existing conditions (and every decade of age groups).

Hypertension according to that has a case fatality rate of 6%.

Which means the likelihood of dying from COVID-19 having hypertension is 6% - not 6% of all the infected had hypertension, right?

I would think though this has to be put into context with other factors, too.

 

It was confirmed yesterday that we (NZ) have a patient sick in hospital with COVID-19, our first reported.

I was impressed with the way my local supermarket was handling the long queue outside the supermarket this morning. I've never seen anything like it before. They had disinfectant wet wipes at the door which we all used before we went in. I'm so glad I started preparing over a week ago. I only needed to get a few things this morning.

 

Based on that chart, I think it's hard to make the case that essential hypertension in conjunction with the virus increases mortality. More likely, hypertension is indirectly connected to poorer outcomes via conditions like obesity, heart disease and diabetes. Hypertension could also be an indication of smoking, which might not be a great history to have in a fight with a respiratory disease.

The chart is based on data from China, and more than half the men in China smoke (52.7%) - including 60% of male doctors.

[...and yet there's no mention of smoking as a risk factor on that chart.]