Coronavirus - worldwide spread and control

I wonder, in a year or two when the outcome of all this is known or can be better predicted, which countries will come out of it having weathered the economic storms the best. I bet the UK won't be in the group that does well.

 

There are loose ends but my suspicion is that after the inevitable lag of 10-20 days numbers will start coming down quite quickly. In the meantime I think the penny will drop with the sceptics who think self-isolating means climbing Snowden. The dreadful situation in Spain and Italy will continue to help people wake up.

I think it is interesting that when people brought the virus to the UK from China the spread petered out maybe completely in maybe all cases. It was when people came back from Italy at a time when the magnitude of the European problem was not understood that everything got out of hand. I suspect that spread actually depends on quite specific mechanisms that much of the time do not apply. Apparently only 15% of family will get infected by a case. That does not sound like most respiratory viruses where usually everyone in a household gets it once one has brought it home.

I think the thing is to feel calm.

 

That's very interesting. Do you have any thoughts about what sort of mechanisms?

 

Not just stores. All businesses and industries not tied to essential services. We're essentially closing everything not essential until early May.

Shortly the entire country is likely to follow by invoking emergency powers. Our biggest problem in the near future will be the deteriorating situation in the US, the economic impact will be devastating, as nearly half of Canada's GDP is from trade with the US and most of this comes from cross-border industries that need a constant back-and-forth.

 

Uh, looks like the U.S. is not quarantining or tracing. Very difficult Trump speech, one of the most unclear, but it sounds like we're actually going to relax restrictions in the coming week. Some states can continue on their restrictions, but interstate travel can continue freely.

 

Precisely.

 

Hopefully, there is going to be a growing number of people who will have recovered from Covid-19. If these people can be positively identified, then presumably they could volunteer in various roles where people are needed to work in close proximity to patients, given they should then be immune. Do we know if there are any plans to enable recovered patients to assist in such ways?

 

That seems to be the reasoning in Japan if I understand correctly (@strategist linked to an interesting Twitter thread on this a couple of posts earlier).

The Japanese seem to think that the virus particularly spreads in clusters, places where the following three conditions are met simultaneously: (1) closed space with poor ventilation, (2) crowded with many people and (3) conversations and vocalization in close proximity (within arm's reach of one another). This is explained in this expert opinion document that states: "overall, approximately 80% of the domestic confirmed carriers, regardless of the severity of their symptoms did not infect others"

One of the studies behind this reasoning is this preprint by Hiroshi Nishiura and colleagues. The authors looked at secondary transmission data for clusters. They found that "All clusters were associated with close contact in indoor 38 environments, including fitness gyms, a restaurant boat on a river, hospitals, and a snow 39 festival where there were eating spaces in tents with minimal ventilation rate." They calculated that "The odds 44 that a primary case transmitted COVID-19 in a closed environment was 18.7 times 45 greater compared to an open-air environment." They also note that "Closed environments are consistent with 54 large-scale COVID-19 transmission events such as that of the ski chalet-associated cluster in France and the church- and hospital-associated clusters in South Korea."

It would also be in line with the letter from Bergamo, where doctors warned that in their experience, hospitals are an important location for transmission of the virus.

 

Have I missed things or gave there been no " public information" type broadcasts/ social.medua messaging/ adverts.

It seems strange in a situation like this to have had no official info campaign.

Is it just me , or have I completely missed things?

Scottish government using twitter etc - see below for shopping, and has broadcast info by chief medical officer. Haven't t seen UK ones?

If you are trying to change behaviour a coordinated media campaign usually helps

https://twitter.com/user/status/1242182852768411649

 

No, not just you. The UK govt have, in my opinion, been absolutely rubbish in spreading vital messaging during this time. As far as I can tell they have left it to the media to pass things on.

 

I can't remember where, but I saw a list last week that listed 'Neutrophilia' as one of the risk factors along with cardiovascular disease, diabetes, etc.

 

The numbers are going to be small for the foreseeable future (maybe 1/250), but perhaps not insignificant. We have already had a medic saying they are ready to get to the front line once recovered. I agree that people who cannot do their own job would be useful drafted into healthcare, but other than as orderlies they will need quite a lot of training. Things go badly wrong very easily if people do not now what to do.

 

Exactly, this is pretty much what I had worked out - maybe these factors:

1. Lots of people together indoors milling about and talking.
2. Recirculating air maybe through air conditioning systems.
3. Lots of people touching surfaces while eating or drinking.

This would explain spread on cruise ships, airport lounges, aeroplanes. It may apply to supermarkets but without the talking maybe much less.

Another factor that might be even more crucial is a pattern of behaviour in which individuals are in this sort of environment at least once a week - maybe these people, who seem to be overrepresented.

1. Politicians, their advisors and spouses
2. Film and music stars
3. Religious worshippers (Korea)

The point here is that if you do this once a week you are likely to spread your virus to others during an initial asymptomatic phase a week after catching it.

Perhaps all that we really need to do is to stop everyone from being in a crowded space ONCE A WEEK or more often. That would mean banning tube travel, pubs and restaurant meals, conferences and airports. Everything else could carry on as normal.

 

I think the tweet might be 'fake news' (others in the thread have questioned it)
also see
Iceland Slows COVID-19 Testing Due to Shortage of Swabs
from yesterday
https://www.icelandreview.com/society/iceland-slows-covid-19-testing-due-to-shortage-of-swabs/

 

They had a dedicated project for an emergency information app a few years back and never bothered to put it into practice. Why they cannot just twitter goodness knows.

 

I am not sure about that. Neutrophilia is not an abnormal condition. It is a normal response to bacterial infection. It may mean that people who show a strong neutrophil response during the illness do badly?

 

Does anybody know what "secondary transmission" and "case"mean?

It seems as simple as one "primary" case infects another, "secondary" case. Or is there anything specific?

 

Official UK document on what businesses and premises are to close and which are exempt, https://assets.publishing.service.g.../230320_-_Revised_guidance_note_-_finalVF.pdf