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Discussion Thread I - 2019-nCov (new coronavirus)

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  • 615 cases, confirmation huanggang is quarantined


    • Vibrant62 this Feb 2018 BMJ paper looks at CAP in China which was running at 5/1000p.a


      • 3rd city on lockdown


        • Kudos to the health care workers....must be incredible amount of stress involved:



          Dialogue with frontline medical staff in Wuhan: All isolation wards are saturated and colleagues have been infected

          Interface News Dialogue A nurse at a hospital in Wuhan participated in the treatment of patients infected with the new coronavirus.
          Image source: Hero Creative. Image source: Hero Creative.

          Reporter | Chen Xin Ma Qiao Intern reporter Ou Yun Belek

          Wuhan became the focus of public opinion due to the epidemic.

          As of 24:00 on January 22, the National Health Commission had received a total of 571 confirmed cases of pneumonia of new coronavirus infection in 25 provinces (autonomous regions, municipalities) in China, including 95 severe cases and 17 deaths (both from Hubei Province). . A total of 393 suspected cases were reported in 13 provinces (autonomous regions and municipalities).

          武汉 After Wuhan announced the "closing of the city", the interface news dialogue with a well-known local hospital is on the front line to participate in the treatment of nurses infected with the new coronavirus.

          According to the medical staff, the number of patients began to increase sharply after the hospital discovered the first case of new coronavirus infection in Wuhan at the end of December 2019. "During this time, doctors and nurses are overloaded and work overtime every day."

          "All the isolation wards are already saturated." The medical staff said that if many patients have unclear symptoms, the doctor will prescribe some oral medications or infusions during the day. Because the beds are very tight, some of them need to be separated from home. Even some patients have reached the standard of hospitalization, but because they do not have a bed, they can only implement home isolation.

          Interface news: When did your hospital first have the first suspected case and confirmed case?

          Nurse :: It was discovered by our department around the end of December 2019. After knowing the news of the South China Seafood Wholesale Market, we started to screen our patients and asked them if they had a related contact history.

          Interface news: How did the hospital and the local health department judge when the pneumonia first appeared? How did you get nervous step by step after that?

          Nurse: Everyone is starting to be vigilant, we don't treat it as ordinary flu. On December 31, 2019, the hospital released documents on how to investigate, consult and identify suspected cases of pneumonia of unknown origin. After we reported to the CDC, the CDC did not take samples at that time. Sampling and diagnosis need to be notified, and sampling confirmation cannot be performed without notification.

          Hospital set up a special fever clinic on January 4, 2020 to prevent these patients from mixing with emergency patients.

          Interface news: It has been circulating on the Internet that some hospitals in Wuhan have refused admission.

          Nurse :: I think there may be a situation where the beds are full and it ca n’t be received. All the isolated wards in our hospital are already saturated.

          As far as I know, even the patients who have been hospitalized for observation in the fever clinic are sitting in the infusion. But I don't believe any hospital will refuse to accept it with a bed.

          Interface news: What doctors would recommend for home isolation?

          Nurse: If there are many patients with unclear symptoms, the doctor will prescribe some oral medications according to his condition, or he will receive hot fluids during the day. Because the beds are very tight now and there are no beds, some of them may be separated from their homes. Some patients have even reached the standard of hospitalization, but because they do not have a bed, they can only implement home isolation.

          There should still be a large number of people at home. At present, we recommend that patients at home be separated for a two-week observation period, mainly with oral medications. If you feel worse, you can go to the hospital at any time. As far as I know, there are cases where home isolation has turned into a confirmed diagnosis.

          Interface News: What treatment options are currently used for diagnosed or critically ill patients? For example, in the news report, the use of ECMO (External Membrane Oxygenation) to successfully cure patients.

          Nurse: At present, our mainstream treatment plan is mainly anti-virus and anti-infection, and then symptomatic treatment is performed according to other symptoms of patients. ECMO (Extracorporeal Pulmonary Oxygenation) is a first aid technique used primarily in emergency departments. ECMO technology can be used in severe cases, this technology is not a conventional treatment of this disease. What the news says should not cure the patient, but it may be that this patient successfully rescued the patient after using ECMO technology after the viral pneumonia became critical. It should be temporarily stabilized.

          Interface news: What do you do in the process of contacting suspected or confirmed cases?

          Nurse: We mainly care for patients. The usual care should be the same as other patients, except that we have isolated them for observation. We must also protect ourselves.

          Interface news: Are there any upgrades in protection measures for medical staff?

          Nurse: The emergence of this infectious disease is regulated for protection standards. From the very beginning, our department has been standard prevention, and what kind of protection to take according to the degree of contact with your patients. For example, if the patient is in the isolation ward, he can only wear isolation clothing if he only enters the corridor of the isolation ward. If you are in close contact with the patient for operation, you need to wear protective clothing, goggles, or a face shield or helmet. What kind of protection you take depends on what kind of contact you have with the patient.

          Interface News: There are now reports that many protective supplies are out of stock. Is the hospital's material reserves adequate in this regard?

          Nurse :: Our hospital should have sufficient reserves. Protective equipment has been prepared in advance. Disposable protective equipment is applied for by each department or isolated ward according to its own demand. There is also a certain standard procedure for the disposal of used medical waste.

          Interface news: So far, are the medical staff in your hospital more infected?

          Nurse: Medical staff in the infection department have the most infections. The staff of our department went to check today that there were 3 suspected cases, and they are all being observed in isolation.

          Interface news: How strong is the work?

          Nurse: There are fewer medical staff than patients. The number of patients is increasing rapidly, doctors and nurses are overloaded, and they have to work overtime every day. Take our department as an example. Recently, all employees have been working overtime. Many doctors and nurses may work more than 10 hours a day, like today I work 13 hours faster. The head of our department is shifting from fever to fever. There is no time to eat, drink water or go to the toilet.

          Interface news: How long does it take for isolation to be confirmed?

          Nurse :: The incubation period for the median isolation of this disease is about 14 days. Our colleagues in the department had no fever symptoms at first, but CT detected that there was indeed a change in suspected viral pneumonia. Therefore, Isolation was performed at home. Because they have no related symptoms, they are still working normally today.

          Interface news: Do you worry about bringing some viruses or bacteria to your home after you return home every day?

          Nurse :: To be honest, I am very worried. As a mother, my children are all very young. I told my colleague that I was not even afraid of being infected, but I was afraid of bringing the virus home to the child. So most of the medical staff in the departments I know sent their children to other places and stayed in Wuhan alone.

          Interface news: Will you worry about the next infected person appearing next to you?

          Nurse :: There are already infected people around me, and each of us will worry about the next one to be identified, and we can only remind ourselves to take precautions at all times. I try not to go out after work now, soak and wash with disinfectant after going home for UV disinfection. I was afraid that I could spread the virus to others and endanger the health of others.

          As medical personnel, we are also ordinary people. We are also afraid of death due to old age, sickness of death, and fear of infection. But since we did this, that is our responsibility. In front of patients, we have to do our own thing. I don't think doctors can be said to be particularly great or noble, but at least they are brave occupations. In such a difficult time, as a medical staff, I must be on the front line, and it is also worthy of being respected.

          鑫 Chen Xin Stella / Interface Reporter
          Editor-in-Chief: Zhao Ming
          Keywords: medical staff


          • Anyone heard more about this???

            On Reports Of Indian Nurses Hit By Coronavirus In Saudi Arabia, Kerala Chief Minister Pinarayi Vijayan Writes To Centre
            Pinarayi Vijayan has requested the Foreign Ministry to communicate with Saudi Arabia to ensure proper treatment and protection for the Coronavirus patients.
            KeralaWritten by Sneha Mary KoshyUpdated: January 23, 2020 17:16 IST

            Kerala government has not yet officially confirmed the numbers of Coronavirus affected (Representational)

            Kerala Chief Minister Pinarayi Vijayan has written to Foreign Minister S Jaishankar after reports emerged of Indian nurses in Saudi Arabia suspected to be affected by a deadly strain of the Coronavirus that originated in China and has killed 17 people and infected at least 570, most of them in the central Chinese city of Wuhan.

            "Corona outbreak among nurses in Azir Aba Al Hayat hospital in Saudi Arabia should be considered seriously and necessary steps must be taken," Chief Minister Pinararyi Vijayan said.

            The chief minister has also requested the Foreign Ministry to communicate with Saudi Arabia to ensure proper treatment and protection for the patients.

            The Kerala government has not yet officially confirmed the numbers of Coronavirus affected or suspected to be affected patients and sources at Chief Minister's Office have said that the state is closely monitoring the situation and working around it...


            • Here's more:\

              30 Indian nurses quarantined in Saudi hospital over coronavirus scare: Reports

              india Updated: Jan 23, 2020 17:06 IST

              HT Correspondent Hindustan Times, Thiruvananthapuram

              [Click and drag to move] A thermal scanner checks on arriving passengers at Manila's international airport, Philippines on January 23. (AP Photo)
              At least 30 nurses from Kerala have been quarantined in a hospital in Saudi Arabia after one of them tested positive for deadly coronavirus that claimed many lives in China, reports emanating from the Gulf kingdom said.
              The incident came to light after some of them called their relatives and complained about their situation. “We have been herded in two rooms of the hospital for more than a day. No proper tests were done and we are not treated properly. We have also complained to Indian embassy officials,” one of them told a Malayalam channel over phone.
              As per details available, a 38-year-old nurse hailing from Ettumanoor in Kottayam contracted the virus while treating a Filipino who had tested positive for the virus. Later, all nurses who came in contact with their affected colleague, were isolated and put under observation. But quarantined nurses said it was a panic reaction and they were isolated without any tests or procedures. A senior official of the Non-Residents Keralites Association said they are in touch with Indian embassy officials in Riyadh...
              Last edited by Shiloh; January 23, 2020, 07:11 AM. Reason: removed photo


              • I'm wondering if the above two articles aren't actually referring to MERS, not 2019nCoV. Maybe the reporter got confused. There are (yet) no confirmed cases of 2019nCoV in either Saudi Arabia or Manila, so it's not clear how these cases would have been exposed.


                • Alert: I do remember reading something somewhere that Philippines had suspect cases. They may have asked WHO not to officially confirm or include data in official figures but have notified them (as they are obliged to), as is their right. Not every country will agree for cases to be made public for domestic reasons. This is worth remembering as things develop. Equally, if MERS or bird flu cases pop up we can expect a lot of confusion among reporters.


                  • In Wuhan, supermarket shelves were empty and local markets sold out of produce as residents hoarded supplies and isolated themselves at home. Petrol stations were overwhelmed



                    • Originally posted by sharon sanders View Post
                      hat tip Goju:

                      Wuhan Institute of Virology, CAS

                      "The CAS has thirteen regional branches, in Beijing, Shenyang, Changchun, Shanghai, Nanjing, Wuhan, Guangzhou, Chengdu, Kunming, Xi'an, Lanzhou, Hefei and Xinjiang." link

                      Only one lab in China can safely handle the new coronavirus

                      By Nicoletta Lanese - Staff Writer 10 hours ago

                      As an escalating viral outbreak unfolds in China, only one lab in the country meets the required biosafety standards needed to study the new disease.

                      The lab happens to sit in the center of Wuhan, the city where the newly identified coronavirus first appeared, according to the Hindustan Times, an Indian news outlet. The facility, known as the Wuhan National Biosafety Laboratory, is housed within the Chinese Academy of Sciences and was specifically designed to help Chinese scientists "prepare for and respond to future infectious disease outbreaks," according to a 2019 report published by the U.S. Centers for Disease Control and Prevention (CDC).


                      Designated at Biosafety Level 4 (BSL-4), the Wuhan lab can hold the world's most dangerous pathogens at maximum biocontainment levels.



                      China's First bio-safety Level 4 Lab Put into Operation

                      By CHEN Na | Jan 05, 2018

                      China has opened its first bio-safety level four laboratory, capable of conducting experiments with highly pathogenic microorganisms, according to the national health authority on Thursday.

                      Wuhan national bio-safety level four lab of the Chinese Academy of Sciences (Wuhan P4 lab) is part of Sino-French cooperation in prevention and control of emerging infectious diseases, said the Department of Health Science, Technology and Education with the National Health and Family Planning Commission.

                      Level four is the highest bio-safety level, used for diagnostic work and research on easily transmitted pathogens which can cause fatal disease, including Ebola virus.

                      The Wuhan P4 lab will conduct research in anti-virus drugs and vaccines. (Xinhua)



                      • I don't see why BSL4 is required for this pathogen, China had 43 BSL3 labs in 2013 and 3 mobile BSL3 labs which seem more than adequate.


                        • Originally posted by JJackson View Post
                          I don't see why BSL4 is required for this pathogen, China had 43 BSL3 labs in 2013 and 3 mobile BSL3 labs which seem more than adequate.
                          I think it is because there is no effective treatment or cure at this time. That may automatically make it a level 4.


                          • re: Saudi Arabia - report from BBC

                            Lockdown measures are increasing across China's Hubei province to try to control the spread of a new virus that has left 17 people dead.

                            Wuhan, Hubei's capital of 11 million people where the virus first emerged, has no trains or planes in or out.

                            At least four other provincial cities are seeing clampdowns on transport.

                            There are more than 500 confirmed cases of the virus, which has spread abroad, with Singapore, Saudi Arabia and Vietnam the latest affected.

                            Also in Hubei province:
                            • Huanggang. The city east of Wuhan announced a suspension of bus and rail systems and encouraged people not to leave the city. Cafes, cinemas, theatres and exhibitions are being shut
                            • Ezhou, just south of Huanggang, has shut its train stations
                            • Xiantao has cancelled gatherings, suspended transport and set up temperature detection stations, while Chibi is suspending transport



                              Published on Wednesday, January 22, 2020

                              Reynosa man who flew to China possible victim of coronavirus

                              The university professor flew to Wuhan in December

                              A professor at the National Polytechnic Institute (IPN) campus in Reynosa, Tamaulipas, may be the first case of the coronavirus in Mexico, according to state Health Secretary Gloria Molina.

                              After a recent trip to China, the 57-year-old molecular biologist was hospitalized after showing symptoms of a cough and runny nose.

                              “This doctor went to China on December 25 and was in the city of Wuhan, where the outbreak occurred, and returned to Mexico on January 10. He spent a day at the National Polytechnic Institute in Mexico City and later traveled to Reynosa,” Molina said.

                              more at link
                              May your days be steeped in love, and warmed with joy.



                                Brazil Reports Suspected Case of Coronavirus

                                January 22, 2020 Updated: January 22, 2020

                                Brazilian officials said on Wednesday that a woman who recently traveled from China likely has coronavirus, the first case of the virus in the South American country.

                                As Chinese officials announced they were quarantining Wuhan, the epicenter of the novel coronavirus, Brazilian officials said the 35-year-old woman arrived in the city of Belo Horizonte on Jan. 18 with respiratory symptoms.

                                The case was flagged as a suspected coronavirus case in view of the woman traveling from China, the Department of Health in the state of Minas Gerais said in a statement.

                                “The case was notified as a suspect. Considering the current epidemiological context of the country where the patient was, the hypothesis of illness caused by the new Coronavirus, which is a microorganism of international health alert, was considered, considering the potential pandemic with high risk to life and impact on care,” it stated. “Despite not showing any sign of clinical severity, the patient was quickly taken to the [the hospital] for careful observation in a hospital setting.”

                                The woman told authorities that she wasn’t in the Wuhan area and that she didn’t think she had contact with anyone who had coronavirus.

                                Test results haven’t come back yet confirming a coronavirus diagnosis or clearing the patient, who was described as clinically stable.

                                more at link
                                May your days be steeped in love, and warmed with joy.