Coronavirus - worldwide spread and control

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Update from Berlin regarding closure of daycare centers

After criticism by corona specialist Drosten: Berlin Senate renounces central emergency daycare centres

The Senate will make amends: When regular daycare ends on Tuesday due to the Corona crisis, all daycare centers will be able to continue to offer emergency care. The obligation to provide centralised care in a few selected facilities will be eliminated. The Senate Department for Youth thus reacted on Saturday to reminders from Charité virologist Christian Drosten, who had described the centralization initially communicated as "counterproductive".

Drosten said that the infection would be "fired" if children were grouped into new groups. Thereupon, youth senator Sandra Scheeres (SPD) had again consulted with representatives of day-care institutions and revised the decisions made on Friday.

Scheeres emphasized that the new assessments by Professor Drosten had been taken into account and that "suggestions from the day-to-day practice of the day-care providers had been taken up". The care should now "in principle take place in the familiar Kita". However, only those parents who work in systemically important professions and are unable to organize any other form of childcare are entitled to it. Both criteria must apply.

The Senate Department of the Interior wants to determine which occupations are considered "systemically relevant" this weekend. The Senate assumes that the criterion applies to about 15 percent of parents.
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https://www.tagesspiegel.de/berlin/...erzichtet-auf-zentrale-not-kitas/25645052.htm

Translated with DeepLl
 
Update from Berlin regarding public transport

What will happen to Berlin's public transport system?

On Friday evening, Berlin's mayor Müller declared: "We have discussed that we will maintain public transport." However, this should be adapted "to public demand". Senate circles are already expecting a five to ten percent reduction in the number of passengers using public transport.

The ban on events, meetings and trade fairs, as well as the closure of educational facilities, would "automatically" lead to a "reduction in demand for public transport". There was no longer any talk of concentrating on railways at the expense of buses, as proposed by the governing mayor on Friday morning.
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https://www.tagesspiegel.de/politik...ch-berlin-in-quarantaene-begibt/25643520.html

Translated with DeepL
 
Simon M said:
See this graph of Spanish flu cases, showing how the second much bigger peak occurred when Restrictions were relaxed. This seems to be used as evidence that containment isn't possible.
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To me this has similarities to industrial process control. If you have a fast, high'ish-order system controlled to a point well away from where the system would naturally revert to, and then suddenly remove that control, the system will then rocket away to revert to that point, and potentially overshoot to a high value. The trick is to not remove the control instantly, as a step change, but to slowly and progressively modify the control so that the system control point changes much more slowly; you then retain much better control, and minimise or eliminate the overshoot. Completely removing the control as a step change, so the process is allowed to run riot, and then in a panic whacking the control back on again when you realise too late you need to, is not the way to go!

So if you have a contagious infection still active within a population but rigorously controlled to a low level, but if you have no choice but to relax that control in order for society to function, then you absolutely must back off the control progressively, to damp the rate at which the infection reestablishes itself, and thereby have some reasonable chance of control.

ETA: However I've just seen @Lucibee's post, so what I've said above may not apply to the Spanish flu example. But it is still valid as a general principle.
 
Simon M said:
do we have any evidence as to which is right
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Haven't been following things closely but from graphs I've seen on COVID-19 cases in Asian countries, it seems possible to stop the spread of the virus by taking draconian measures. So I see no need to assume that it will be impossible to stop the virus from infecting a large part of the population.

That's why I'm a bit confused by the popularity of the 'flatten the curve' graphs online and in the press. If I understand correctly these make the point that even if we can't prevent the virus from infecting a large part of the population, it's still important that we make sure it spreads slowly to not overburden the healthcare system. But in the case of SARS COV-2, it seems that preventing the viruses from infecting a large part of the population is still realistic. So rather than flattening the curve, we could try to make sure that there isn't a curve or only a tiny one.

When comparing the Chinese and British approach, I think the former has shown some evidence of success while the latter makes some dramatic assumptions that we simply don't know are true (comparing to the Spanish flu is speculating too much IMHO - situation was very different). To state it briefly, if the Chinese measures of trying to contain the virus are right, they could avoid a disaster and if they are wrong the disaster would be pretty much inevitable anyway. If the British measures are wrong they could lead to a disaster that was preventable while if they are right they would simply steer us through a horrendous disaster a little more smoothly.

Perhaps the virus will be less virulent during summertime or perhaps a vaccine might come quicker than expected given that this is a pandemic and worldwide emergency. Trying to stop the virus from spreading by isolation measures seems like the most sensible thing to do now - even if it isn't a very elegant solution. Guess it will be important to see how well economies are able to function during the quarantine measures.
 
I may have missed this, but do we have a sense of how long a person remains sick once he/she has contracted the virus. What is the time range, until a person recovers? Are they very ill for many weeks? months?

(As an aside, here in Quebec, Premier Legault has asked folks over 70 to remain in their houses and to shop on line. The schools and universities are all closed for the next two weeks; folks are asked to work from home. However, public transport is still operative. Legault is giving daily press conferences and evaluating constantly. He stated that all the cases have been brought in by folks who were elsewhere or on cruises. March break is over and folks are all back, but Legault thinks that amongst these folks who went on holiday there are carriers. )
 
Jonathan Edwards said:
No I don't think that applies. SARS stands for severe acute respiratory syndrome if I remember rightly. Until Nov 2019 nobody much had a severe acute respiratory syndrome. Then a cluster of people did and some died. The illness seems to have a typical pattern in a lot of cases - acute fever and dry cough. That is quite unusual. Also there is pneumonia, which is unusual without a findable cause. So there was no SARS2/Covid-19 before Nov 2019, or at least vanishingly few cases.
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Are you sure of this with COVID-19?

Its seems the death rate is between 1 and 2% that means 98-99% or people get nowhere near having pneumonia or a severe acute respiratory syndrome.

Were being told over and over again that the people who are dying are elderly and have preexisting illnesses it seems including things like cancer, COPD etc etc. Wouldn't they always have been at risk of pneumonia and respiratory illnesses anyway?


Where can we find exact information on deaths, ages, underlying illnesses etc that have been linked to confirmed cases that tested positive for Covid-19?

There is a massive difference between saying Covid-19 caused a death and saying someone with late stage cancer or COPD for example tested positive for Covid-19 and died.

As agreed earlier prior to the end of 2019 we had never tested for COVID-19 as a test did not exist. One may say we had no reason to develop such a test but we cannot know therefore the potential historic count.

How different countries count such a death toll could have a massive effect on the exact figures of what is happening either way in terms of cause of death.

Lets not also forget that currently all of our information is coming from the news media and not published data.
 
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large donner said:
Its seems the death rate is between 1 and 2% that means 98-99% or people get nowhere near having pneumonia or a severe acute respiratory syndrome.
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A fair number of those 98-99% are still going to be very sick and require care, including hospitalisation, even a spell in the intensive care unit.

'Mild' for this disease doesn't necessarily mean not very sick. Might just mean not requiring hospitalisation. Could still knock the shit out of you for a month.

Another reason to do everything possible to avoid getting it is that we don't know the long term consequences for survivors. It could leave considerable permanent lung damage for some, which could increase morbidity and reduce lifespan for individuals.
 
Beijing



Chicago, Illinois

Illinois had a reported 32 cases Friday.



Dallas / Fort Worth, Texas

Texas had a reported 63 cases Saturday.



Washington DC area




The US still doesn't have anywhere near enough testing.
 
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Perrier said:
As an aside, I just heard this evening on Radio Canada (the French CBC) an Anthropologist arguing that this is nature's way of dealing with the fact that the planet is overpopulated.
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I think it may be Nature's way of telling us to keep the animals we want to live with (or consume) away from bats.
 
hinterland said:
Dr Mark Guthridge tweeted this study:

Hickie et al, 2006 "Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study"



The infections they studied were EBV, Q-fever and the mosquito born infection Ross River Virus, all of which, I think, are known to have the potential for long-term sequelae. Of course, we don't yet know what health outcomes Sars-Cov-2 is going to have, but I would have to say I think a figure as high as 11% is unlikely.
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This study is famous, and misleading. Most patients recovered in a few years if I recall correctly. Post viral fatigue, meeting broad CFS but not ME criteria, can last up to five years, though I also have to wonder if some of this is ME in disguise. Indeed a lot of post pathogen fatigue might be ME, just not counted as ME. We don't have the proper epidemiology to be sure. Post-SARS has long been a thing, but I have not read any research on it lately.

Severity of infection is likely to be a good indicator though. Covid-19 is severe in older patients, and less severe in younger patients. I am guessing we will see some kind of post-Covid-19 syndrome, though whether or not its ME is another matter. Until we have a reliable test for ME we wont be sure one way or the other.
 
Sarah94 said:
If that happens with COVID-19 survivors then the world will be a mess.
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Well Dr Phil Hammond on Broadcasting House (BBC Radio4) this morning seemed to think it was a possibility, although his solution was not to be scared, because fear activates the immune system (mind-body connection, you know), which will just make it worse and make it more likely that you will get CFS. :facepalm:

Here is the transcript of that bit:
Paddy: Well I’m just thinking that there’s a perfect example of fear which we want to talk to you about. If you panic buy, you are clearly afraid or are trying to stop yourself feeling afraid?

Phil: Yes. And if you get in a big sweaty scrum in the aisle of Lidl fighting for toilet rolls, that’s the perfect way to spread the virus, so it may actually be counterproductive. It’s very hard not to panic. I remember when I was a young doctor in a hospice speaking to a wonderful old lady who told me that the fear of cancer was worse than cancer, and it just got me thinking with this particular pandemic – I work in the area of post-viral fatigue, so I’m expecting a spike in cases when this is all gone away – and we know that when you’re frightened and when you pick up a virus infection it can affect your immune system and make the infection symptoms worse and increase your risk of post-viral fatigue afterwards. So there’s clearly a delicate balance between appropriate concern and fear, and we have to make sure that we get that right, because otherwise the psychological consequences of all this – we know that mind and body and environment are inextricably linked –could end up doing a lot of harm in addition to the physical consequences.
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The British Immunology Society issues this statement a couple of days ago around herd immunity
https://www.immunology.org/news/bsi-response-herd-immunity-and-sars-cov-2

One issue that people seem to keep comming back to is whether immunity remains.

BSI response to herd immunity and SARS-CoV-2
13 March 2020

In light of current discussions in the media around how herd immunity might be generated and protect the population against the SARS-CoV-2 virus, the British Society for Immunology has released the following statement.

Professor Peter Openshaw, Past President of the British Society for Immunology and Professor of Experimental Medicine at Imperial College London, said:

“Herd immunity occurs when a large percentage of the population is protected against a particular disease, stopping the ability of that disease to spread within communities. This protection can either be gained through methods such as vaccination (which induces the body to produce antibodies which protect you against catching the disease) or through enough people in the population having been infected and generating antibodies by their body fighting the pathogen directly. Modelling studies show that, over time, we can expect 60-80% of the population to be infected with SARS-CoV-2. Generating herd immunity in the population, and particularly in younger individuals who are less likely to experience serious disease, is one way to stop the disease spreading and provide indirect protection to older, more vulnerable groups.

“SARS-CoV-2 is a novel virus in humans and there is still much that we need to learn about how it affects the human immune system. Because it is so new, we do not yet know how long any protection generated through infection will last. Some other viruses in the Coronavirus family, such as those that cause common colds, tend to induce immunity that is relatively short lived, at around three months. However, these viruses have co-evolved with the human immune system over thousands of years meaning they may well have developed methods to manipulate our immune responses. With the novel SARS-CoV-2, the situation may be very different but we urgently need more research looking at the immune responses of people who have recovered from infection to be sure.”
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