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Discussion Thread I - 2019-nCov (new coronavirus)

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At this point I believe, that the disease has been going on for much longer, that the case of the market has been linked to some superspreader and that it is spreading thanks to a large number of asymptomatic people


Many cases have mild symptoms and have probably not been recognized and mistaken for seasonal influenza, considering the period



If this were the case, it would be the worst scenario, worse than SARS, not as the severity of the individual cases, but as a diffusion that is difficult to arrest


At this point I believe that the Chinese authorities should stop the Spring Festival which starts next week ...
 
I believe that's actually a bit of sarcasm, lost in multiple machine translations.

I translated the entire article using Google word-for-word. They are saying that bloggers are referring to the virus as "patriotic" because it only appears when people travel abroad (to Thailand and Japan) and not domestically within China. The people making this comment are actually criticizing Chinese media for not disclosing what they assume are unreported domestic cases, something that China has now reported several of.
 
I have been thinking along the same lines as tetano re. a superspreader. Firstly I am glad that the 'this is SARS' meme has been squashed but the SARS zoonotic is an example of the behaviour of a close relative and superspreads were a feature with one individual, in a Hong Kong hotel, who had a massive impact on its early expansion and there were others (see https://wwwnc.cdc.gov/eid/article/10/2/03-0732_article ). A second hint comes from the fish market environmental samples, a number tested positive but the surprise was they all came from the fish section of the market and none from the mammals and birds area. A beta CoV is not going to come from a marine source (bats or birds are the normal hosts) so a superspreader in the fish section best fits the location and symptom onset date data for that tight cluster. This leaves some questions unanswered firstly do we know on which day or days those who did visit the market went? If they did not all go on the same day then spreader probably worked there. If contract casing can give us confirmed H2H cases we should be able to narrow down the incubation period, the length of the infectious period and importantly if the host becomes infectious prior to symptom onset. SARS was not infectious pre onset which means that thermal scanners at transport hubs are a very useful tools (they would be of less use if this was a flu). If this CoV follows SARS in this trait it will make it much easier to contain. Another factor pointing to a spreader working in the fish market is anyone else is likely to have formed a cluster where he worked or lived (It should also be noted that the most famous example of a superspreader, 'Typhoid Mary', was asymptomatic). The next question is where did he/she get infected again this would fit well with tetano's slow burning mildly symptomatic preexisting outbreak and the fact the most serious cases tend to be in those with preexisting comorbidites. The virus must come from an animal host and I am slightly surprised it has not yet been found given that usual beta CoV hosts were extensively investigated in China while looking for the SARS reservoir.
I have not seen the epi-model used by Imperial to come up with the 1700 undiagnosed cases figure but immediately thought it was probably wrong and that the most likely reason was a superspreader with a fairly short infectious period. I have read a number of epi-modelling papers and as a general observation they are usually brilliant models with one major flaw namely they need input variables which make huge differences to the outputs. Input variables will be things like Ro (the reproductive number i.e. how many people you infect if you get it), the incubation and infectious period. At the start of a zoonotic epidemic none of these are likely to be know with any degree of certainty, if your guess is even a little out it can give wildly inaccurate outputs. For example in the H5N1 models to workout the number of expected deaths you needed a Case Fatality Rate (CFR) seasonal flu is less than one percent, H1N1(1918) 2-3% and H5N1/H7N9 could be 50% so what number would you input to your model as the estimated rate at the start of a pandemic and what do you think it will do to your pandemic plan?
 
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Merci, vu le travail fait sur cette fiche wiki, le terme 92 n'est plus exact. Le chinois est une vraie langue qui permet bien des qualifications.
https://www.huffpost.com/entry/benefits-of-sarcasm_n_565487f5e4b0879a5b0c7099?guccounter=1
https://www.huffingtonpost.fr/2015/12/10/comment-etre-drole-sarcasme_n_8738252.html
je n'ai pas trouv? celui en espagnol.

sarcasme ou humour

https://zh.wikipedia.org/wiki/幽默#/media/File:國立自然科學博物館-飛天豬.jpg
https://zh.wikipedia.org/wiki/幽默
ceci n'est pas accessible :
Dan Waters. Le rire ? travers la grande muraille: une comparaison de l'humour chinois et occidental (PDF) . Journal du chapitre de Hong Kong de la Royal Asia Society. 1998, 38 : 3.

C'est incroyable le travail fait ...
 
I know The Sun is not the most reliable news source but I'll post this just in case it is true.
The 38-year old british man has NOT been in Chine, so IF this turn out to be the new coronavirus then it sems like it might be able to infect human to human:

https://www.thesun.co.uk/news/10775551/brit-thailand-chinese-coronavirus/
VIRUS STRIKES [h=1]British tourist fighting for life in Thailand feared to be first western victim of mystery Chinese coronavirus[/h]
  • Andy Jehring
  • 20 Jan 2020, 0:48
  • Updated: 20 Jan 2020, 1:05
 
I'm not sure if this site is reliable.
Jan 20, 2020, 03.24 PM(IST)

The strain of pneumonia outbreak spreading in the Chinese cities of Wuhan and Shenzhen has added a new nationality to their list of infected individuals - a 45-year-old Indian school teacher, who is undergoing treatment for the mysterious SARS-like coronavirus.

Doctors on Monday confirmed that she was suffering from the virus and is being treated for the same. The patient - Preeti Maheshwari - is a teacher at an international school in Shenzhen.

https://www.wionews.com/india-news/i...e-virus-275467

Other site: https://citytoday.news/indian-schoo...t-foreigner-to-contract-coronavirus-in-china/
 
I'm not sure if this site is reliable.
Jan 20, 2020, 03.24 PM(IST)

The strain of pneumonia outbreak spreading in the Chinese cities of Wuhan and Shenzhen has added a new nationality to their list of infected individuals - a 45-year-old Indian school teacher, who is undergoing treatment for the mysterious SARS-like coronavirus.

Doctors on Monday confirmed that she was suffering from the virus and is being treated for the same. The patient - Preeti Maheshwari - is a teacher at an international school in Shenzhen.

https://www.wionews.com/india-news/i...e-virus-275467

Other site: https://citytoday.news/indian-schoo...t-foreigner-to-contract-coronavirus-in-china/

The cause of this teacher's infection has been debated for a week. There is nothing on the Guangdong site about her.

Please see the original thread:

China - Teacher, 41, hospitalized with severe pneumonia, renal failure, liver damage - officials say not new coronavirus - Shenzhen, Guangdong province - January 12, 2020
 
Wuhan friends notice: Just received a meeting from a superior, Wuhan Pneumonia Prevention and Control Conference: First, the severity is more than we think. Second, the severe rate of infection was 14%, and the fatality rate was 4%. Third, there are similarities with SARS. 4. It has been clearly passed down from person to person. Fifth, clustering has occurred, that is, the entire family is infected. The video is the official Douyin of People's Daily. Just judge the true severity.:tiphat:https://twitter.com/shijianxingzou/status/1219124973094293505
 
At the outset of the H1N1(2009) pandemic I wrote a series of post aimed at helping new visitors to the site to understand the numbers appearing in the media. The extract below is taken from post #9 (thread link) which is explaining the difference between confirmed/probable/suspected/estimated cases.
A confirmed case is one in which a sample has been grown, or RT PCR tested, in a lab. Until a day or two ago in reality that meant at the CDC in Atlanta because there were no primers for the new strain at regional testing centres. The CDC has a budget many times bigger than the WHO and I noted in a recent release that they said they could ‘test about 100 samples over night’. It is also reported that there are 35,000 swabs from Mexico alone awaiting testing. Taking these two bits of information along with the graph in post #7 you should see that looking at confirmed cases is unlikely to give an accurate picture. It is more likely to reflect how good a country’s lab facilities are than the realities of disease spread.
.
Post #10 looks at the meaning of Ro, CAR, CFR etc. While the posts were discussing H1N1 they also apply here.

In post #28 of this thread I gave a very brief explanation of the testing regime and we are now at a similar point in the outbreak as H1N1 was in the extract above primers have been developed and distributed and a slew of new confirmed cases should be expected as new & retrospective CAP (community acquired pneumonia) get tested.

From today's BBC article
Wuhan reported 136 new cases of the respiratory illness. The capital Beijing reported two cases, while Shenzhen confirmed one.
. Numbers like this are meaningless without context. Wuhan has a population of about 10m, European data shows CAP running at about 5 cases per 1000p.a. from which we get (assuming China is similar) 50,000p.a. or 137 a day for Wuhan and this does not account for CAP's seasonal distribution which is skewed toward winter and spring. So if anything 136 cases would look a little low. (data from a Feb. 2018 BMJ paper looking at CAP in China full text link ).
 
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Is there any information being released about successful treatment protocols? The UK's NHS is already at a point where some hospitals are buying Care Home spaces due to insufficient capacity from the current flu season (in line with some of the pandemic plans). I am concerned that stockpiling of drugs, PPE and other resources have likely not happened in the UK. I dont know about the US?
 
[


Is there any information being released about successful treatment protocols? The UK's NHS is already at a point where some hospitals are buying Care Home spaces due to insufficient capacity from the current flu season (in line with some of the pandemic plans). I am concerned that stockpiling of drugs, PPE and other resources have likely not happened in the UK. I dont know about the US?

/QUOTE]

See: https://www.who.int/docs/default-so...management-of-novel-cov.pdf?sfvrsn=bc7da517_2 Don't know if it has been updated
 
Zhong Nanshan confirms human-to-human transmission of new coronavirus pneumonia


Zhong Nanshan: According to the current data, the new type of coronavirus pneumonia is definitely a human-to-human transmission. There were two cases in Guangdong. I have not been to Wuhan, but my family members have been infected with the new type of coronavirus pneumonia after going to Wuhan. Some people pass on the phenomenon.:tiphat:video
https://www.pneumonia.cn/2020/01/20/...rus-pneumonia/
[h=1]Zhong Nanshan: New coronavirus pneumonia is definitely present in humans[/h] Release time: January 20, 2020 22:15 Source: CCTV News Client

Zhong Nanshan confirms human-to-human transmission of new coronavirus pneumonia

Zhong Nanshan: According to the current data, the new type of coronavirus pneumonia is definitely a human-to-human transmission. There were two cases in Guangdong. I have not been to Wuhan, but my family members have been infected with the new type of coronavirus pneumonia after going to Wuhan. Some people pass on the phenomenon.

Regarding how to prevent the new coronavirus, Zhong Nanshan reminded:

1. Try to avoid going to Wuhan in the near future; 2. If you have fever or other discomfort, you should go to the hospital immediately; 3. Wear a mask at any time, but it is not necessarily a N95 mask.

Looking back on Zhong Nanshan: the whole nation's vigilance will not repeat the SARS epidemic 17 years ago

Academician Zhong Nanshan pointed out that it is necessary to increase vigilance now. The people, leaders, governments, medical staff, including the media, and the leaders of the territories must take responsibility. We are confident that we can control the new coronavirus. Zhong Nanshan said that the new coronavirus was located in two weeks, and we have a good surveillance and quarantine:tiphat:http://news.cnhubei.com/content/2020-01/20/content_12633939.html?spm=zm1033-001.0.0.1.r8RwhE
 
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