wuhan - coronavirus

[Pen]

4 minutes ago, Carrie12345 said:

@Pen That’s exactly what we’re doing at our house, but it’s also exactly what I figure will get us sick one day. 
People are sharing influenza like it’s their job. Even given our reduction in outings and good hygiene, the few places we go are chock full of the usual germs. Nothing to stop one more!

It isn’t going to get worse unless it gets worse. And, by then, it’s worse. 

 

I have to frequently wear a mask because of health problems from various chemicals such as fragrance products. I have noticed that when I do, people tend to keep more distance from me probably assuming I am contagious. Maybe if you made masks for your family the flu people would stay farther away.

I know it is quite shocking how much our society thinks that going out and sharing sickness is fine.  I guess we had a historic period of quite good medicine which made people think they could rely on pharmaceutical intervention...  

[Arcadia]

38 minutes ago, Pen said:

 

If the government won’t take action, what can individuals, local schools, businesses etc do?  How top down and centrally controlled is it? 

Nothing 😞 Majority of the schools are public schools and as long as the govt (Ministry of Education) do not give the order, students who stay away would be marked as truant. Individuals still have to work because they won’t be paid and might be fired if they don’t show up. Most jobs don’t have unpaid leave and there is no protection for employees. Businesses are just hoping for the best and some would be making losses these few months. While businesses can close or reduce hours, they still have to pay full rental. 
Singapore has a new fake news law so many people have fake Facebook accounts as a precaution. Singapore’s parliament has a very heavy PAP majority so it’s very one sided. 
From CNN Oct 2nd, 2019 https://www.cnn.com/2019/10/02/asia/singapore-fake-news-internet-censorship-intl-hnk/index.html

“(CNN) Singapore's sweeping anti-fake news law, which critics warn could be used to suppress free speech in the already tightly controlled Asian city state, came into force Wednesday. 

Under the Protection from Online Falsehoods and Manipulation Bill, it is now illegal to spread "false statements of fact" under circumstances in which that information is deemed "prejudicial" to Singapore's security, public safety, "public tranquility," or to the "friendly relations of Singapore with other countries," among numerous other topics.

Government ministers can decide whether to order something deemed fake news to be taken down, or for a correction to be put up alongside it. They can also order technology companies such as Facebook and Google -- both of which opposed the bill during its fast-tracked process through parliament -- to block accounts or sites spreading false information. 

The act also provides for prosecutions of individuals, who can face fines of up to 50,000 SGD (over $36,000), and, or, up to five years in prison. If the alleged falsehood is posted using "an inauthentic online account or controlled by a bot," the total potential fine rises to 100,000 SGD (around $73,000), and, or, up to 10 years in prison. 

Companies found guilty of spreading "fake news" can face fines of up to 1 million SGD (around $735,000).”

[Arcadia]

@Pen @Carrie12345 @Acadie @BeachGal

The incubation period can be as long as 24 days.

From LianheZaobao (Singapore’s main Chinese daily) https://www.zaobao.com.sg/realtime/china/story20200210-1027772

Google translated and I edited obvious errors (ETA: new coronary pneumonia is referring to the Wuhan coronavirus)

“The study on "Clinical Features of New Type Coronavirus Infections in China 2019", led by Zhong Nanshan, a high-level expert group leader of the Chinese National Health Commission and the Chinese Academy of Engineering, was published on the preprinted website medRxiv on February 9. Studies have shown that the latency of the new coronavirus can be as long as three weeks.

According to the Science Network report, Zhong Nanshan et al. Conducted a retrospective study of the clinical characteristics of 1099 patients (as of January 29) confirmed by New Coronavirus. The study found that the median incubation period for neocoronary pneumonia is three days, with a maximum of 24 days. At the same time, only about 1% of the patients have had direct contact with wild animals, and more than 75% of the patients were Wuhan residents or had contact with people from Wuhan. This provides further evidence for human-to-human transmission of new coronary pneumonia.

In addition to droplet transmission and direct contact, the researchers also detected neocoronavirus in stool samples from some patients, as well as in the gastrointestinal tract, saliva or urine, and esophageal erosion and bleeding. Therefore, health protection should be considered through the gastrointestinal transmission of tract secretions.

The latest paper was completed by Zhong Nanshan in collaboration with 37 authors from the front line of the national epidemic. Authors include Guangzhou Institute of Respiratory Health, Wuhan Jinyintan Hospital, Huanggang Central Hospital and so on. The First Affiliated Hospital of Zhejiang University School of Medicine, where Academician Li Lanjuan of the Chinese Academy of Engineering is located is also among them. Zhong Nanshan is the corresponding author of this paper.

The paper proposes that although the new coronavirus is still spreading rapidly worldwide, the clinical characteristics of acute respiratory disease (ARD) caused by the new coronavirus remain unclear.

To this end, Zhong Nanshan et al. Conducted a retrospective study of the clinical characteristics of 1099 patients with new coronary pneumonia diagnosed in China. These cases came from 552 hospitals in 31 provinces / municipalities across the country.

These patients were confirmed by high-throughput sequencing or real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests on nasal and throat swab samples.

Details of the latest research conclusions are as follows:

1. Patient contact history

Of the 1099 patients with new coronary pneumonia, 483 (43.95%) were local residents of Wuhan. Outside Wuhan, 26.0% of patients have not recently traveled to Wuhan or have no contact history with people from Wuhan.

At the same time, only 1.18% of the patients had direct contact with wild animals, 31.30% of the patients had visited Wuhan, and 71.80% of the patients had contact with people from Wuhan.

These results corroborate recent reports, such as familial clustering, transmission of asymptomatic infections, and 3-stage outbreak patterns. At the same time, the existence of "super communicators" is not excluded.

2. Patient age

The median age of the patients was 47.0 years, and women accounted for 41.90%. Neocoronary pneumonia can occur throughout the age group, with 0.9% of patients under 15 years of age.

3. Symptoms and latency

Fever (87.9%) and cough (67.7%) were the most common symptoms, but fewer than half (43.8%) had fever symptoms at the time of consultation. Diarrhea (3.7%) and vomiting (5.0%) are rare.

25.2% of patients had at least one underlying disease (eg hypertension, chronic obstructive pulmonary disease).

The median incubation period for new coronary pneumonia is 3.0 days (ranging from 0 to 24 days), with a maximum of 24 days.

4. Clinical characteristics

Of the 840 patients who underwent a CT scan of the lungs at admission, 76.4% showed pneumonia. Typical features are ground glass-like shadows (50.00%) and bilateral patchy shadows (46.0%).

At the same time, 82.1% of patients had lymphopenia, and 36.2% had thrombocytopenia. Overall, leukocytopenia was observed in 33.7% of patients.

Severe cases have prominent laboratory abnormalities, ie, leukopenia, lymphopenia, thrombocytopenia, and elevated C-reactive protein levels.

5. Treatment

Overall, 38.0%, 6.1%, 57.5%, and 35.8% of patients received oxygen therapy, mechanical ventilation, intravenous antibiotics, and oseltamivir, respectively.

In addition, extracorporeal membrane oxygenation ECMO was used in 5 severe cases.

6. Complications during hospitalization

During hospitalization, the most common complication was pneumonia (79.1%), followed by acute respiratory diseases (3.37%) and shock (1.00%).

7. Clinical Prognosis

The percentage of patients who entered the ICU, required invasive ventilation, and died were 5.00%, 2.185, and 1.365, respectively.

Zhong Nanshan and others stated in the paper that compared with the two previous studies published in The Lancet, the mortality rate of new coronavirus in the latest study has changed significantly based on a larger sample size and cases recruited across the country Low (1.4%). When including the pilot data from Guangdong Province, the case fatality rate was even lower (0.88%).

This is because Guangdong has taken effective preventive measures. Early isolation, early diagnosis, and early treatment may have contributed to a significant reduction in the mortality rate of new coronary pneumonia in Guangdong.

According to Nanfang Daily, from February 1st, the cumulative cure rate of Guangdong New Coronary Pneumonia increased significantly, and 128 cases are currently cured (as of February 9th). In addition, the rate of increase in confirmed cases has slowed.

Zhong Nanshan said that according to the current observations, the mortality rate of new coronary pneumonia is about 2.7%, and the patients are mostly middle-aged and elderly. Although the case fatality rate is stronger than that of ordinary influenza, it is much lower than SARS coronavirus, Ebola virus or H7N9 influenza virus”

Edited February 10, 2020 by Arcadia

[Pen]

@Arcadia

1 hour ago, Arcadia said:

 @Carrie12345 @Acadie @BeachGal

The incubation period can be as long as 24 days.

From LianheZaobao (Singapore’s main Chinese daily) https://www.zaobao.com.sg/realtime/china/story20200210-1027772

Google translated and I edited obvious errors

 

Thank you.

Much to be concerned about there, for example:

•  the longer incubation period would mean that quarantines have not been long enough

 

1 hour ago, Arcadia said:

fewer than half (43.8%) had fever symptoms at the time of consultation.

 

•. relatively few people showing fever when examined can mean that the forehead temperature meters being used to triage suspected cases at train stations, airports, etc probably will have missed a lot

And more too.

 

[Excelsior! Academy]

4 hours ago, Pen said:

 

I have to frequently wear a mask because of health problems from various chemicals such as fragrance products. I have noticed that when I do, people tend to keep more distance from me probably assuming I am contagious. Maybe if you made masks for your family the flu people would stay farther away.

I know it is quite shocking how much our society thinks that going out and sharing sickness is fine.  I guess we had a historic period of quite good medicine which made people think they could rely on pharmaceutical intervention...  

 

I agree with your statement and want to add...

Many people risk losing their jobs if they take all necessary sick days and some are just plain uninformed.  A few years ago we had a lady at our congregation who's child was frequently sick. She would comment about said child having a fever that morning and how she gave her Tylenol to bring down her fever "so now she's fine."  Um, no!  Take that sick baby home!!

[mathnerd]

6 hours ago, Pen said:

 

https://www.ccn.com/billionaire-whistleblower-wuhan-coronavirus-death-toll-is-over-50000/

English.  I don’t know what CCN is or reliability...

 

Behavior of authorities and traffic shut down  seems more consistent with order of magnitude of thousands or tens of thousands dead than several hundred

Yes, this is consistent with what my chinese friend was saying, including the high numbers of death. Not sure about the reliability there but I have heard this same story from Chinese language links that my friend was showing me. She even says that it is very naive to take China's official numbers seriously because they are never open about any internal issues that they have.

Edited February 10, 2020 by mathnerd

[Ausmumof3]

Health officials in Hong Kong are conducting a partial evacuation of residents from an apartment block following possibility that the coronavirus may have been transmitted via the building piping system, Professor KY Yuen said during an impromptu midnight press conference held on Tuesday morning local time.

Health officials have traced at least two confirmed cases of the coronavirus to the specific residential building called Hong Mei House in the Tsing Yi area of Hong Kong.

"As the pipeline that transfers feces is connected to the air pipe, it is very likely for the virus in the feces to be transmitted through the air fan into the toilet," Professor Yuen said. 

 

From CNN 

[Arcadia]

@Ausmumof3 the SCMP article has more information https://www.scmp.com/news/hong-kong/health-environment/article/3049921/tsing-yi-residents-evacuated-hong-kong-health

“More than 100 residents in 35 households at a public estate in Hong Kong were evacuated in the early hours of Tuesday after two people in the block were confirmed to have contracted the coronavirus.

The precautionary move was sparked by the case of a 62-year-old woman in Room 307 on the third floor of Hong Mei House at Cheung Hong Estate. She was Hong Kong’s 42nd and latest case as of 1.30am on Tuesday.
She was found to have lived directly below a man in Room 1307 on the 13th floor, who was confirmed earlier to be Hong Kong’s 12th case. While comparisons were quickly drawn with Amoy Gardens in Ngau Tau Kok – the scene of a rapid infection during the severe acute respiratory syndrome outbreak in 2003 – University of Hong Kong microbiologist Professor Yuen Kwok-yung said this was not the case in Tsing Yi.

Yuen said a vent pipe, which connected to a discharge pipe in a bathroom was not properly sealed and could have carried the virus – present in faeces – into other toilets by extraction fans.

“When a person turns on the exhaust fan inside the toilet, the air inside the drainage system can enter via the ventilation pipe,” he said.

As a precaution, Yuen said all flats numbered seven on every floor had to be vacated so their piping could be inspected.

“We have reasons to worry that airborne transmission is a possibility,” Yuen said, adding that authorities were not ruling out other routes, such as contact.

Residents whose flats had the same piping issue would be quarantined for 14 days, even if they showed no symptoms, he added.

In the 2003 case, it was reported that a U-shaped plumbing design in the drainage system of flats allowed the Sars virus in, with transmission throughout the block mainly through this channel. Amoy Gardens recorded 321 infections with 42 deaths.

In Tsing Yi, residents living in 35 flats linked to the drainage system were evacuated overnight and put on medical surveillance, as building inspectors moved in.

Dr Wong Ka-hing, controller of the Centre for Health Protection, said the evacuation was a “safety precaution”.

“We are not sure what was the exact route of transmission … It could still be through the usual method of droplets or contact,” Wong said.

He added that residents could move back soon if inspectors found the piping in their flats to be in order, adding he did not know the exact number of people evacuated. Police put an initial estimate at 110.

Microbiologist Yuen said it was not possible to evacuate more than 1,000 residents in the building over two confirmed cases, and that the priority was to ensure the safety of the affected flats.

According to health authorities, the woman at the centre of the incident developed a cough on February 3 and consulted a private doctor three times between then and February 7. She then sought treatment at Princess Margaret Hospital on February 9 where she was isolated after she tested positive for the coronavirus. She is in stable condition.

The woman’s records showed she visited Macau from January 18 to 19. Her son and daughter-in-law who lived with her also displayed symptoms and were sent to hospital. Her husband and grandson, who are asymptomatic, will be quarantined.

Quarantine list  

The taxi driver who drove the patient from her home to the hospital at around 2pm on February 9 is urged to call the Centre for Health Protection’s hotline.

Residents from the Tsing Yi block will be sent to one of four quarantine centres operated by the government. Those showing symptoms will be sent to hospital and tested for the virus.

The late-night revelation raised concerns that Hong Kong was facing a community outbreak of the pneumonia-like illness that originated in the mainland city of Wuhan.”

[Pen]

1 hour ago, Excelsior! Academy said:

 

I agree with your statement and want to add...

Many people risk losing their jobs if they take all necessary sick days and some are just plain uninformed.  A few years ago we had a lady at our congregation who's child was frequently sick. She would comment about said child having a fever that morning and how she gave her Tylenol to bring down her fever "so now she's fine."  Um, no!  Take that sick baby home!!

 

I understand the job risk issue (though I think it should change as a standard of practice whenever feasible).

But yeah, the thing like where kids are taken to church or similar when sick — major problem.  And Tylenol to reduce symptoms certainly doesn’t = well.  

our local public schools shut down entirely a few years ago because of a cycle of sickness so as to let people get better and disinfect the classrooms...     otherwise people just kept going sort of sick, or siblings sick , passing infection, on and on.  It fixed remarkably quickly by a complete shut down for a week? 10 days? I don’t recall now.  It wasn’t longer than some years happens from ice storms. 

 

[Pen]

20 minutes ago, Arcadia said:

@Ausmumof3 the SCMP article has more information https://www.scmp.com/news/hong-kong/health-environment/article/3049921/tsing-yi-residents-evacuated-hong-kong-health

“More than 100 residents in 35 households at a public estate in Hong Kong were evacuated in the early hours of Tuesday after two people in the block were confirmed to have contracted the coronavirus.

The precautionary move was sparked by the case of a 62-year-old woman in Room 307 on the third floor of Hong Mei House at Cheung Hong Estate. She was Hong Kong’s 42nd and latest case as of 1.30am on Tuesday.
She was found to have lived directly below a man in Room 1307 on the 13th floor, who was confirmed earlier to be Hong Kong’s 12th case. While comparisons were quickly drawn with Amoy Gardens in Ngau Tau Kok – the scene of a rapid infection during the severe acute respiratory syndrome outbreak in 2003 – University of Hong Kong microbiologist Professor Yuen Kwok-yung said this was not the case in Tsing Yi.

Yuen said a vent pipe, which connected to a discharge pipe in a bathroom was not properly sealed and could have carried the virus – present in faeces – into other toilets by extraction fans.

“When a person turns on the exhaust fan inside the toilet, the air inside the drainage system can enter via the ventilation pipe,” he said.

As a precaution, Yuen said all flats numbered seven on every floor had to be vacated so their piping could be inspected.

“We have reasons to worry that airborne transmission is a possibility,” Yuen said, adding that authorities were not ruling out other routes, such as contact.

Residents whose flats had the same piping issue would be quarantined for 14 days, even if they showed no symptoms, he added.

In the 2003 case, it was reported that a U-shaped plumbing design in the drainage system of flats allowed the Sars virus in, with transmission throughout the block mainly through this channel. Amoy Gardens recorded 321 infections with 42 deaths.

In Tsing Yi, residents living in 35 flats linked to the drainage system were evacuated overnight and put on medical surveillance, as building inspectors moved in.

Dr Wong Ka-hing, controller of the Centre for Health Protection, said the evacuation was a “safety precaution”.

“We are not sure what was the exact route of transmission … It could still be through the usual method of droplets or contact,” Wong said.

He added that residents could move back soon if inspectors found the piping in their flats to be in order, adding he did not know the exact number of people evacuated. Police put an initial estimate at 110.

Microbiologist Yuen said it was not possible to evacuate more than 1,000 residents in the building over two confirmed cases, and that the priority was to ensure the safety of the affected flats.

According to health authorities, the woman at the centre of the incident developed a cough on February 3 and consulted a private doctor three times between then and February 7. She then sought treatment at Princess Margaret Hospital on February 9 where she was isolated after she tested positive for the coronavirus. She is in stable condition.

The woman’s records showed she visited Macau from January 18 to 19. Her son and daughter-in-law who lived with her also displayed symptoms and were sent to hospital. Her husband and grandson, who are asymptomatic, will be quarantined.

Quarantine list  

The taxi driver who drove the patient from her home to the hospital at around 2pm on February 9 is urged to call the Centre for Health Protection’s hotline.

Residents from the Tsing Yi block will be sent to one of four quarantine centres operated by the government. Those showing symptoms will be sent to hospital and tested for the virus.

The late-night revelation raised concerns that Hong Kong was facing a community outbreak of the pneumonia-like illness that originated in the mainland city of Wuhan.”

 

I think that transmission is probably a concern from lavatories in public places, especially toilets that don’t have lids, whether they are stand over or sit on or whatever type

And USA flush type toilets that aerosolize fecal matter (and urine if urine is involved too) probably result in contamination of air and all surfaces.  

 

[Arcadia]

My county https://www.kron4.com/health/coronavirus/coronavirus-outbreak-santa-clara-county-to-declare-local-health-emergency/

“Posted: / Updated: Feb 10, 2020 / 02:32 PM PST

SANTA CLARA COUNTY, Calif. (KRON) — County officials declared a local health emergency in Santa Clara County Monday due to the coronavirus outbreak. 

Officials stressed that this does not mean there is an increased risk to the public. 

The declaration helps ensure that the county is prepared to respond effectively to the outbreak and allows them to receive mutual aid resources from the state of California and other jurisdictions. 

Two people have tested positive for the coronavirus in Santa Clara County.”

[Renai]

1 hour ago, Pen said:

 

I think that transmission is probably a concern from lavatories in public places, especially toilets that don’t have lids, whether they are stand over or sit on or whatever type

And USA flush type toilets that aerosolize fecal matter (and urine if urine is involved too) probably result in contamination of air and all surfaces.  

 

And then the fecal matter is pulled from the air and conveniently delivered directly to one's hands via hand dryers...

[Pen]

14 minutes ago, Renai said:

And then the fecal matter is pulled from the air and conveniently delivered directly to one's hands via hand dryers...

 

🤢

[Ausmumof3]

Again this makes me wonder about the wisdom of quarantine large quantities of people on the cruise ship and in confined apartment buildings.  Presumably there is some kind of air circulation system on the cruise and what are the risks of spreading that way.  Seems like if it was possible it would be better to get people off the cruise and quarantine them where they could be further spread out.  On the qantas evacuation flights they changed the cabin air every 3-5 minutes, used medical grade air filters and they changed all air filters etc afterwards instead of the usual 8-10 months changeover period.

[Ausmumof3]

43,100 confirmed and 1,018 fatalities.

I keep seeing a number of cases in United Arab Emirates - is that driven by expat workers or what?

[Arcadia]

21 minutes ago, Ausmumof3 said:

 

I keep seeing a number of cases in United Arab Emirates - is that driven by expat workers or what?

https://wam.ae/en/details/1395302822895 “ABU DHABI, 10th February 2020 (WAM) - The Ministry of Health and Prevention announced today the eighth confirmed case of new coronavirus in the UAE, which is an Indian national who had interacted with a recently diagnosed person.

The Ministry announced Sunday the country’s first recovery of a new coronavirus case, a 73-year-old Chinese patient.”

https://wam.ae/en/details/1395302822125 “ABU DHABI, 8th February, 2020 (WAM) -- The UAE Ministry of Health and Prevention, MoHAP, announced today two new cases of coronavirus, bringing the total number of cases to seven in the country.

The patients were identified through the continuous periodic screening being conducted in accordance with the standards of the World Health Organisation, WHO, for people with symptoms of the new coronavirus.

In a statement, the Ministry said that the new cases, who are of Chinese and Filipino nationalities, are under observation and necessary medical care according to the highest health standards applicable in the country, stressing the effectiveness of the online reporting system.”

https://wam.ae/en/details/1395302820367 “ABU DHABI, 1st February, 2020 (WAM) -- The UAE Ministry of Health and Prevention announced a new case of Coronavirus infection in the country, and added that the patient was stable and under medical care. He arrived from the Chinese city of Wuhan. Since the outbreak of the disease in China, only five cases have so far been detected in the UAE, a fact that indicates the efficient system of surveillance in the country’s health sector.

The Ministry disclosed that the four cases detected earlier in a Chinese family were still under medical care. Their condition is stable. The Ministry is taking all necessary precautions in coordination with other relevant health authorities in the country in order to ensure the safety of the citizens and residents.”

[Pen]

31 minutes ago, Ausmumof3 said:

43,100 confirmed and 1,018 fatalities.

I keep seeing a number of cases in United Arab Emirates - is that driven by expat workers or what?

 

News said first group all one family who travelled to Wuhan.

Latest an Indian National who had had contact with someone who was infected. 

(Arcadia beat me to it! And with far more detail!)

Edited February 11, 2020 by Pen

[Pen]

30 minutes ago, Ausmumof3 said:

Again this makes me wonder about the wisdom of quarantine large quantities of people on the cruise ship and in confined apartment buildings.  Presumably there is some kind of air circulation system on the cruise and what are the risks of spreading that way.  Seems like if it was possible it would be better to get people off the cruise and quarantine them where they could be further spread out.  On the qantas evacuation flights they changed the cabin air every 3-5 minutes, used medical grade air filters and they changed all air filters etc afterwards instead of the usual 8-10 months changeover period.

 

I’m not sure if there are facilities ready to quarantine passengers off cruise ships of several thousand people at a time in a spread out way.  Are there? 

The info on the Hong Kong building indicated that it could not readily relocate 1000 people.  

 

[RootAnn]

I'm reading that there is a 13th case in the US from the first evacuation flight from China--from the people who are in quarantine but are getting ready to be released. I wonder if the group will be kept in quarantine longer if one of the group came down with the coronavirus & they have been interacting with each other?

https://www.10news.com/news/local-news/first-confirmed-case-of-coronavirus-in-san-diego

Edited February 11, 2020 by RootAnn
Included link

[Ausmumof3]

1 hour ago, Pen said:

 

I’m not sure if there are facilities ready to quarantine passengers off cruise ships of several thousand people at a time in a spread out way.  Are there? 

The info on the Hong Kong building indicated that it could not readily relocate 1000 people.  

 

Yeah logistically would be challenging.  It may be able to be arranged by country of origin of passengers but that’s a whole lot of moving people around.

[Ausmumof3]

1 hour ago, RootAnn said:

I'm reading that there is a 13th case in the US from the first evacuation flight from China--from the people who are in quarantine but are getting ready to be released. I wonder if the group will be kept in quarantine longer if one of the group came down with the coronavirus & they have been interacting with each other?

https://www.10news.com/news/local-news/first-confirmed-case-of-coronavirus-in-san-diego

The way it’s being done here is people are segregated into smaller groups.  So if one person comes down with it their small group will have an extended quarantine but not everyone in the facility.

i believe Christmas Island supposedly holds up to 1800 people and they only have about 200 there and the 2nd flight went to a different location.  I’m not sure what that says about the conditions detainees were kept in but that’s a bit political for the forum

[Pen]

https://www.sandiegouniontribune.com/news/health/story/2020-02-10/san-diego-county-has-firt

[Arcadia]

From NBC https://www.nbcnews.com/health/health-news/coronavirus-quarantine-some-americans-prepare-leave-workers-air-force-base-n1134336

“Feb. 10, 2020, 2:26 PM PST

As the first group of Americans evacuated from China prepares to leave quarantine at March Air Reserve Base, California, those who work on the base have faced public harassment stemming from unnecessary fear of the new coronavirus.

On Tuesday, the mandatory 14-day quarantine will be lifted for the 195 American citizens and their families, who were evacuated from Wuhan, China — the center of the outbreak — on Jan. 28.

The Centers for Disease Control and Prevention says 14 days is the maximum time period during which symptoms might develop after a person is exposed to the virus. None of the passengers has tested positive for the virus.

But those who work at March Air Reserve Base have been harassed both in person and online by Riverside County residents who fear that the coronavirus — most cases of which have been in China — might take hold in the United States.

Officials in Riverside County sent a letter to residents Monday, urging people to stop targeting base employees with "hurtful" statements online or in person.

A few base workers have been "accosted in uniform," the letter read. "This is not acceptable, and needs to stop."

According to the letter, those who work on the base have had no exposure to anyone who has been in quarantine.

"You do not need to exclude household or family members of [March Air Reserve Base] personnel, nor do you need to require them to obtain unnecessary 'clearance letters' from a physician or health authority," the letter read.

Since arriving at the base, two quarantined children developed fevers and were tested for the coronavirus. Both tests came back negative.

When the quarantine officially lifts Tuesday morning, all 195 evacuees will undergo a final health screening. It's anticipated that all will be healthy, and will be permitted to travel freely to their final destinations.”

[Ausmumof3]

15 hours ago, Ausmumof3 said:

The Westerdam cruise ship -- which has more than 2,000 people on board -- will dock this Thursday in the Thai city of Laem Chabang. It was previously denied entry to Japan, PH, and Taiwan as countries closed their ports to cruise ships over coronavirus fears | via

@CNN

 

looks like this might be good news for your friend hopefully.

Looks like they were refused entry yet again

https://uk.mobile.reuters.com/article/amp/idUKKBN205042?__twitter_impression=true

[mumto2]

16 minutes ago, Ausmumof3 said:

Looks like they were refused entry yet again

https://uk.mobile.reuters.com/article/amp/idUKKBN205042?__twitter_impression=true

Dh and I have been talking about this on and off all day and we thought they were going to be able to get off in Thailand.   Landing is just phase one......being allowed to board an airplane will not be easy.  What about transfers.....then the question is what about when they get home after being on a series of planes in Asia.  My friend is definitely an experienced traveler and if anyone can make it work out it’s that couple but just the logistics is a mess.  What if they get sick......I think friend has asthma.

[Pen]

https://www.theguardian.com/world/live/2020/feb/11/coronavirus-live-updates-deaths-infections-symptoms-transmission-wuhan-china-cruise-ship-quarantine-cases-hong-kong

has some interesting graphs ...

[Ausmumof3]

28 minutes ago, Pen said:

https://www.theguardian.com/world/live/2020/feb/11/coronavirus-live-updates-deaths-infections-symptoms-transmission-wuhan-china-cruise-ship-quarantine-cases-hong-kong

has some interesting graphs ...

One thing I saw was that China won’t be counting asymptomatic cases in official figures anymore.  Can’t find a more reliable source in English though 

https://mobile.twitter.com/BNODesk/status/1227043486089850880
 

this will skew the figures I guess 

[Pen]

2 minutes ago, Ausmumof3 said:

One thing I saw was that China won’t be counting asymptomatic cases in official figures anymore.  Can’t find a more reliable source in English though 

https://mobile.twitter.com/BNODesk/status/1227043486089850880
 

this will skew the figures I guess 

 

I didn’t realize they were testing anyone in China other than significant cases making it into hospitals in the first place—at least in hardest hit areas.

[Ausmumof3]

Just now, Pen said:

 

I didn’t realize they were testing anyone in China other than significant cases making it into hospitals in the first place—at least in hardest hit areas.

I would have thought that.  But with the round up and enforced quarantine happening in Wuhan it seems like they may be sending anyone’s whose been in contact to quarantine centres so maybe they are getting some that way.

they have been saying there is asymptomatic transmission so I have to assume they have tested at least some.

[Ausmumof3]

http://ib.adnxs.com/seg?add=1&redir=https%3A%2F%2Fwww.nine.com.au%2F
 

Australia are releasing close to 1,000,000 of the mask stockpile to health workers and border force

[Ausmumof3]

4 minutes ago, Pen said:

 

I didn’t realize they were testing anyone in China other than significant cases making it into hospitals in the first place—at least in hardest hit areas.

The BBC’s correspondent in China, Stephen McDonell, has tweeted about the China’s national health commission changing the way it counts confirmed cases of the virus.

I have seen a lot of this on social media today. 

The suggestion is that patients who test positive but have no coronavirus symptoms, are not counted in the daily update of confirmed cases ... and that this may account for the slowing growth rate of new cases. I’ll bring you more on this when I have it.
 

also this quote from further down in your link suggests the same

[Ausmumof3]

3rd person in my state tested a weak positive followed by a negative.  Apparently about 28 people still under observation.  

[Arcadia]

1 hour ago, Ausmumof3 said:

One thing I saw was that China won’t be counting asymptomatic cases in official figures anymore.  Can’t find a more reliable source in English though 

https://mobile.twitter.com/BNODesk/status/1227043486089850880
 

this will skew the figures I guess 

 

1 hour ago, Pen said:

 

I didn’t realize they were testing anyone in China other than significant cases making it into hospitals in the first place—at least in hardest hit areas.

The document he refers to is the 4th edition  http://www.gov.cn/zhengce/zhengceku/2020-02/07/5475813/files/9a774a4defee44daa05894138bd0509a.pdf and is 57 pages long. There are 41 occurrences of “无症状感染者” (asymptotic cases) in that document. I have only read the first few pages. The asymptotic cases were found from contact tracing. So if someone tested positive, all household members were tested. The incubation period is still listed as 14 days. I wish Alex Lam just give the links in his tweets instead of people having to ask for links for all the screenshots.

The xinhua article  http://hlj.xinhuanet.com/xhjj/2020-02/09/c_138768326.htm that was quoted in the tweet was not quoted in full. Had to google for the link.  Below quoted Chinese portion was after the Twitter portion 

“据黑龙江省卫生健康委员会医政医管处二级调研员赵昱辉介绍，8日，黑龙江省核减14例患者，根据国家卫健委2月7日发布的《 新型冠状病毒肺炎防控方案 （第四版）》，将核酸检测阳性病例分为确诊病例和无症状感染者，而不是统一称为确诊病例。黑龙江省过去没有任何症状但检测阳性的病例共有13例，8日被国家卫健委统计为无症状感染者，不再计入确诊病例。另有1例外省病例也是根据国家卫健委工作方案的调整，将病例所属地确定为患者首次发生症状的地区，绥化一例患者在海南期间即有发热症状，8日被国家卫健委核减为海南省病例。

　　赵昱辉介绍说，2月7日，黑龙江省发生2例死亡病例，2月8日发生1例死亡病例。三名死亡患者都是年纪较大，有其他慢性疾病的老年人，新冠肺炎在影响呼吸功能的同时，容易诱发其他慢性疾病加重发作，使病情变得凶险。目前黑龙江省疫情防控进入关键期，充分隔离仍是最有效的防控手段，希望不是必须出门的人，尤其老年人，尽量留在家中，配合做好疫情防控工作。”

Google translate with minor edit.

“According to Zhao Yuhui, a second-level investigator of the Heilongjiang Provincial Health and Health Committee's Medical Affairs and Medical Administration Division, on the 8th, 14 patients were deducted from Heilongjiang Province. ", the positive cases of nucleic acid testing are divided into confirmed cases and asymptomatic infection, rather than collectively referred to as confirmed cases. In Heilongjiang Province, there were 13 cases with no positive symptoms in the past, but the positive cases were counted as asymptomatic infection by the National Health and Medical Commission on the 8th, and no more confirmed cases were counted. Another case in the province was also adjusted according to the work plan of the National Health Commission. The case was identified as the area where the patient first developed symptoms. One patient in Suihua had fever symptoms while in Hainan. and is now counted as cases in Hainan Province.

 Zhao Yuhui said that on February 7, two deaths occurred in Heilongjiang Province, and one died on February 8. The three deaths were all older people with other chronic diseases. Neocoronary pneumonia, while affecting respiratory function, is likely to cause other chronic diseases to worsen, making the condition dangerous. At present, the epidemic prevention and control in Heilongjiang Province has entered a critical period. Full isolation is still the most effective means of prevention and control. It is hoped that those who do not have to go out, especially the elderly, stay at home as much as possible to cooperate with the epidemic prevention and control work.”

 

[Arcadia]

@Pen @Acadie The report for the 24 days incubation period 

Clinical characteristics of 2019 novel coronavirus infection in China https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1

Edited February 11, 2020 by Arcadia

[Acadie]

From the chair of public health at Hong Kong University, on his way to a WHO meeting:

"The coronavirus epidemic could spread to about two-thirds of the world’s population if it cannot be controlled, according to Hong Kong’s leading public health epidemiologist.

His warning came after the head of the World Health Organization (WHO) said recent cases of coronavirus patients who had never visited China could be the “tip of the iceberg”.

Prof Gabriel Leung, the chair of public health medicine at Hong Kong University, said the overriding question was to figure out the size and shape of the iceberg. Most experts thought that each person infected would go on to transmit the virus to about 2.5 other people. That gave an “attack rate” of 60-80%.

“Sixty per cent of the world’s population is an awfully big number,” Leung told the Guardian in London, en route to an expert meeting at the WHO in Geneva on Tuesday."

https://www.theguardian.com/world/2020/feb/11/coronavirus-expert-warns-infection-could-reach-60-of-worlds-population

Edited February 11, 2020 by Acadie

[Arcadia]

@Pen think you ask about Singapore recovery cases

From CNA https://www.channelnewsasia.com/news/singapore/coronavirus-singapore-fully-recovered-patients-list-12416232

“

Here is what we know about the patients who have been discharged:

CASE 7

Who: The first person discharged from hospital in Singapore is a 35-year-old man from Wuhan. 

Details: The man arrived in Singapore on Jan 23 and visited Raffles Hospital after developing symptoms a day later. He was transferred to the National Centre for Infectious Diseases (NCID) and tested positive for the coronavirus on Jan 27.

The Ministry of Health (MOH) announced that he had been discharged from the NCID on Feb 4, eight days later. This was after he "comprehensively tested negative" for the virus.

The ministry’s director of medical services Kenneth Mak said on Feb 4 that “all his symptoms had fully resolved" and that consecutive tests over three days had come back negative.

CASE 2

Who: A 53-year-old woman from Wuhan was the second patient to be discharged.

Details: The woman, who only wanted to be known as Ms Jiang, arrived in Singapore with her daughter on a Scoot flight at 5.30am on Jan 21.

While she reported being asymptomatic on during her flight, she developed a fever, cough and chills in the afternoon of her arrival.

She went to Raffles Hospital the following day, and was later taken to Tan Tock Seng Hospital’s emergency department and isolated.

She was subsequently warded in an isolation room in the NCID and discharged on Feb 7, 16 days after she developed symptoms.

Her daughter has tested negative for the virus. 

READ: All the confirmed cases of coronavirus in Singapore

CASE 10

Who: A 56-year-old man from Wuhan.

Details: The man arrived in Singapore on Jan 20. He was asymptomatic on his flight, but developed symptoms on Jan 21. 

He was admitted to the NCID on Jan 28 after a health screening station at Marina South Pier identified him as a suspect case. He tested positive for the virus the next day.

He was discharged from the hospital on Sunday along with three others, said MOH, 11 days after testing positive for the virus.

CASE 13

Who: A 73-year-old woman from Wuhan.

Details: The woman arrived with her family on Jan 21 and tested positive for the virus at 2pm on Jan 30.

She was a close contact of Ms Jiang, the second confirmed case, and multiple attempts were made to contact her before she was located on Jan 28, said MOH.

She reported having developed symptoms on the same day she was located.

She was warded in an isolation room in the NCID and was one of the four patients discharged on Sunday, 10 days after testing positive for the virus.

CASE 22

Who: A 41-year-old Singaporean man evacuated from Wuhan.

Details: The man was among 92 people evacuated from Wuhan on Jan 30.

He did not have any symptoms on the flight and was put under quarantine upon landing in Singapore.

He tested positive for the virus on Feb 3 despite continuing to show no symptoms and was later placed in an isolation room at NCID.

He was also discharged on Sunday, six days after testing positive for the virus.

CASE 26

Who: A 42-year-old woman from Wuhan.

Details: The woman is the daughter of case 13. They arrived in Singapore from Wuhan on Jan 21.

She was taken to NCID on Jan 28 after developing symptoms and tested positive for the virus on Feb 4.

She was discharged on Sunday, five days after testing positive for the virus.

CASE 11

Who: A 31-year-old woman from Wuhan.

Details: The woman is a travelling companion of the fourth confirmed case. They arrived in Singapore from Wuhan on Jan 22.

She did not have symptoms during the flight to Singapore. 

The woman was quarantined from Jan 26 after she was identified as a close contact of the fourth case. She developed symptoms the next day and was admitted to NCID. She tested positive for the virus on Jan 29.

She was discharged on Monday, 12 days after testing positive for the virus.

CASE 17

Who: A 47-year-old Singaporean woman.

The woman was among the Singaporeans evacuated from Wuhan on Jan 30. 

She was asymptomatic when she boarded the flight. According to MOH, she was found to have a fever during medical screening upon arrival at Changi Airport, and was taken to NCID.

The woman then tested positive for the coronavirus infection on Jan 31.

CASE 36

Who: A 38-year-old Singapore PR.

The Singapore permanent resident had attended a business meeting at Grand Hyatt Singapore, which has been linked to several cases overseas. 

She had not travelled to China recently but had been in Johor Bahru from Jan 25 to Jan 28. 

The woman, who lives at Bukit Batok St 31, had also visited a family member at Ng Teng Fong General Hospital before being hospitalised.

On Jan 24, she reported onset of symptoms and visited a GP clinic on Feb 1. 

She was admitted to KK Women’s and Children’s Hospital on Feb 4. Test results confirmed the coronavirus infection on Feb 7. ”

[Acadie]

Also from the Guardian article I linked above, the ideal in terms of public health would be to test in quarantine every couple days, and reset quarantine periods as needed:

"For now, containment measures are essential. Leung said the period of time when people were infected but showed no symptoms remained a huge problem. Quarantine was necessary, but to ensure people were not still carrying the virus when they left, everybody should ideally be tested every couple of days. If anyone within a quarantine camp or on a stricken cruise ship tested positive, the clock should be reset to 14 days more for all the others."

[catz]

On 2/5/2020 at 8:38 AM, Pen said:

 

 

Edited February 11, 2020 by FuzzyCatz
Oops forget it got behind in thread, don't want to go back that far

[mommyoffive]

10 hours ago, mumto2 said:

Dh and I have been talking about this on and off all day and we thought they were going to be able to get off in Thailand.   Landing is just phase one......being allowed to board an airplane will not be easy.  What about transfers.....then the question is what about when they get home after being on a series of planes in Asia.  My friend is definitely an experienced traveler and if anyone can make it work out it’s that couple but just the logistics is a mess.  What if they get sick......I think friend has asthma.

 

I must have missed that you have a friend on the ship.  What a nightmare.  

[Arcadia]

From WHO twitter https://mobile.twitter.com/WHO

“17m

BREAKING "We now have a name for the #2019nCoV disease: COVID-19. I’ll spell it: C-O-V-I-D hyphen one nine – COVID-19" -

@DrTedros

#COVID19”

“Replying to @WHO @DrTedros and 8 others

"Under agreed guidelines between WHO, the @OIEAnimalHealth & @FAO, we had to find a name that did not refer to a geographical location, an animal, an individual or group of people, and which is also pronounceable and related to the disease"-

@DrTedros

#COVID19

7:10 AM · Feb 11, 2020·Twitter Web App”

·“18m

Replying to

@WHO @DrTedros and 10 others

"Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing. It also gives us a standard format to use for any future coronavirus outbreaks"-

@DrTedros

#COVID19”

“18m

"As of 6am Geneva time this morning, there were 42,708 confirmed #COVID19 cases reported in #China & tragically we have now surpassed 1000 deaths - 1017 people in have lost their lives to this virus. Outside , there are 393 cases in 24 countries, with 1 death"-

@DrTedros”

[Pen]

https://www.nature.com/articles/d41586-020-00364-2

On pangolins and coronavirus 

[gardenmom5]

On 2/10/2020 at 7:06 AM, Pen said:

 

https://www.ccn.com/billionaire-whistleblower-wuhan-coronavirus-death-toll-is-over-50000/

English.  I don’t know what CCN is or reliability...

 

Behavior of authorities and traffic shut down  seems more consistent with order of magnitude of thousands or tens of thousands dead than several hundred

I saw this on another site yesterday - extremely high levels of sulfur dioxide in the air indicate a very high level of burning bodies or medical waste.   it also fits in previous reports I've seen from crematorium workers of how much they are working overtime, and the number of bodies they're burning that aren't on the official record.

https://www.ccn.com/coronavirus-death-smog-is-china-burning-thousands-of-infected-bodies/

 

eta: someone elsewhere pointed out how ussr had repeatedly denied anything at Chernobyl - but the radiation that was detectable by other countries proved their lies.

 

 

Edited February 11, 2020 by gardenmom5

[Pen]

23 minutes ago, gardenmom5 said:

I saw this on another site yesterday - extremely high levels of sulfur dioxide in the air indicate a very high level of burning bodies or medical waste.   it also fits in previous reports I've seen from crematorium workers of how much they are working overtime, and the number of bodies they're burning that aren't on the official record.

https://www.ccn.com/coronavirus-death-smog-is-china-burning-thousands-of-infected-bodies/

 

Sounds increasingly likely to be the situation.

 

That might be yet another reason to be having people stay indoors.  

 

Maybe the smog smog thing will be confirmed by monitors in a neighboring country or satellite pictures 

23 minutes ago, gardenmom5 said:

eta: someone elsewhere pointed out how ussr had repeatedly denied anything at Chernobyl - but the radiation that was detectable by other countries proved their lies.

 

 

 

That was me too, I think.  I was in Kiev .   

[gardenmom5]

45 minutes ago, Pen said:

 

Sounds increasingly likely to be the situation.

 

That might be yet another reason to be having people stay indoors.  

 

Maybe the smog smog thing will be confirmed by monitors in a neighboring country or satellite pictures 

 

That was me too, I think.  I was in Kiev .   

it has been - via satellite.  the one I saw - didn't link because I didn't go searching for it again - had sulfur dioxide particulates at nearly 1,400 in central Wuhan.  also fairly high in a neighboring city.  and higher than is considered safe in several more cities.  

[alewife]

Nevermind I will wait for more official info before freaking out.

Edited February 11, 2020 by alewife

[Arcadia]

From CNBC https://www.cnbc.com/2020/02/11/cdc-says-mix-up-led-to-early-release-of-coronavirus-patient-in-california.html

“A mistake in the lab led U.S. health officials to release an infected coronavirus patient from a San Diego hospital, the Centers for Disease Control and Prevention confirmed Tuesday.

The patient was evacuated from Wuhan, the epicenter of the new coronavirus outbreak, on a government-chartered flight last week. Two such evacuation flights carrying over 200 Americans in total arrived last week at Marine Corps Air Station Miramar in San Diego.

...

However, CDC officials later told UC San Diego Health that further testing Monday morning revealed that one patient in fact tested positive for the virus.

CDC Principal Deputy Director Anne Schuchat was asked at a news briefing Tuesday whether the incident calls into question the effectiveness of the diagnostic test.

“With other cases around the country that we’re evaluating, we have been doing serial tests to understand whether they’re still infectious,” she said. “In this circumstance, that’s not what happened. It turns out there was probably a mix up and the original test wasn’t negative.”

When the patient was released on Sunday, they re-joined the more than 200 quarantined Americans at the Marine Corps base, UC San Diego Health said. The patient has now returned to the UC San Diego Health facility “for observation and isolation until cleared by the CDC for release.”

The CDC is now investigating how many individuals the patient may have been in contact with, CDC’s Schuchat said. It is unclear how long the patient spent back at the Miramar facility.

“The preliminary information I had is that there was very limited contact,” she said. “But i think that’s being reassessed at this point.””

[Katy]

It's legally okay to test vaccines on prisoners?  That doesn't seem right.

[prairiewindmomma]

It appears that some states are not disclosing information on COVID19.  In this case, Florida officials are saying that they will not disclose future cases: https://www.850wftl.com/reports-broward-hospital-patient-was-tested-for-coronavirus/

[prairiewindmomma]

I think this has been posted already: https://www.theguardian.com/world/2020/feb/11/coronavirus-expert-warns-infection-could-reach-60-of-worlds-population  but I get the sense that there is some discussion happening behind doors about what happens when we have to move from containment to mitigation.  Shutting down schools and businesses for any real length of time has very serious consequence economically and socially. 

[BeachGal]

On 2/10/2020 at 12:14 PM, Arcadia said:

@Pen @Carrie12345 @Acadie @BeachGal

The incubation period can be as long as 24 days.

The median period in that study is 3 days. An earlier study of 425 patients in China found 5.2 days.

The 24-day period could also be explained by

• reinfection
• an outlier
• contact with an unknown infected person
• contact with an infected fomite (object carrying the virus)
• dementia patients who don’t remember well
• bad data (personnel were possibly not overly concerned with accurate record-keeping when they began seeing cases similar to SARS)

We will have to wait to see what other countries are discovering to know if it's accurate. It could be true -- but who knows?

 

In addition to droplet transmission and direct contact, the researchers also detected neocoronavirus in stool samples from some patients, as well as in the gastrointestinal tract, saliva or urine, and esophageal erosion and bleeding. Therefore, health protection should be considered through the gastrointestinal transmission of tract secretions.

They tested 62 patients' stool samples and found 4 cases with the virus. It could be more or less but according to their paper, they didn't find a lot. Diarrhea was also uncommon. These were patients who were definitely positive and showing serious symptoms as well. 

 

Details of the latest research conclusions are as follows:

1. Patient contact history

Of the 1099 patients with new coronary pneumonia, 483 (43.95%) were local residents of Wuhan. Outside Wuhan, 26.0% of patients have not recently traveled to Wuhan or have no contact history with people from Wuhan.

My guess is that most of these individuals caught the virus from fomites, objects that the virus can survive on -- handles, countertops, etc.

 

3. Symptoms and latency

Fever (87.9%) and cough (67.7%) were the most common symptoms, but fewer than half (43.8%) had fever symptoms at the time of consultation. Diarrhea (3.7%) and vomiting (5.0%) are rare.

25.2% of patients had at least one (known) underlying disease (eg hypertension, chronic obstructive pulmonary disease). Patients may have had undiagnosed diseases, too.

 

@Arcadia I've snipped out some of the information because I only wanted to comment on a few points.

I read the paper put out by China. It will be interesting to see what other countries discover.