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Discussion thread II - Covid-19 (new coronavirus)

Scary thoughts - what do you all think...

Numbers are going down because people are afraid to report they are sick due to the recent forced quarantines and door blockades of entire buildings.

Or

Numbers are going down because China wants the world to open trade routes again - too much money lost.

It is imperative for the Chinese to get the economy going again. I read somewhere (one of the chinese translation reports) that Xi said that the measures were too draconian and hurting the economy too much and could not be sustained for too much longer - the knock on effects to the West are also starting to be felt in a big way; companies are having to slow production having run out of parts e.g. JCB, Jaguar Land Rover, not to mention clothing companies dependent on textile exports and many, many others whose supply chains have at least one part in China. The world was teetering on the brink of a global recession before this... it hasn't got the resilience to cope with a prolonged shutdown or one that continues for much longer IMHO.
 
[h=1]Autopsy on two COVID-19 patients finished in Wuhan[/h] Source: Xinhua| 2020-02-16 23:30:54|Editor: Mu Xuequan
WUHAN, Feb. 16 (Xinhua) -- Autopsy on the bodies of two patients who died from the novel coronavirus disease (COVID-19) were finished Sunday in Wuhan and the autopsy results have been sent for further examination, a local hospital said.

The autopsy work on the first body was finished at around 3 a.m. and the second at 6:45 p.m. Sunday, according to Wuhan Jinyintan Hospital, a major designated hospital to admit confirmed cases in Wuhan, as permitted by national laws and policies, and with the consent of the patients' family members
...:tiphat:http://www.xinhuanet.com/english/2020-02/16/c_138789322.htm

http://mychinanews.com/news/n/1/2419033
(Original Title: Zhong Nanshan: The autopsy of patients with deceased neocoronary pneumonia found that inflammation and mucus were particularly numerous)
This afternoon (February 18th), the Guangdong Provincial Government Information Office held a press conference to report on the relevant situation of the new crown pneumonia epidemic prevention and control in Guangdong Province, focusing on the current progress of scientific and technological research on epidemic prevention and control in Guangdong.



Provincial Epidemic Prevention and Control Command Office Scientific Research Team Leader, Provincial Department of Science and Technology Wang Ruijun, National Health and Medical Commission High-level Expert Team Leader, Chinese Academy of Engineering Academician Zhong Nanshan, Provincial Health and Health Commission Epidemic Prevention Leading Group Office Director, Provincial Health Zhou Zixiao, deputy director of the Health Committee, Wang Guilin, director of the Guangzhou Science and Technology Bureau, Jiang Shanping, director of the respiratory department at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, and Yang Zifeng, professor of the Guangzhou Institute of Respiratory Health, attended and answered questions from reporters.

Reporter: What is the anatomy result of patients with new coronary pneumonia? What effect does it have on clinical treatment?

Zhong Nanshan Answer: The anatomy of the remains is very important. SARS 17 years ago also had the anatomy of the remains. We found that in addition to the lungs, other organs were damaged. What about the anatomy now? The results have not been fully achieved, but I have obtained some valuable information. I found that the performance of the lungs is a little different from SARS. It is not severe fibrosis. Some alveoli are present, the inflammation is severe, and there is a lot of mucus.

These are consistent with our clinical visits. In clinically many critically ill patients, the big problem is that there is not much sputum, but it is sticky, so it is very difficult to use the ventilator. He breathes his, and the ventilator breathes himself. Therefore, further anatomy and pathology will help our clinical treatment, such as whether we need to adjust the ventilation, because some patients do not have much sputum but are sticky, which will hinder ventilation, so pay special attention to let the airway open.
 
Feb.17
> China is currently producing large quantities of Favipiravir

could be the reason why the deaths are not increasing as expected with the 22-day-delay ?!
 
https://www.bannedbook.org/bnews/cbnews/20200218/1279127.html snip...
The report said that Sun Yanrong, deputy director of the Biological Center of the Ministry of Science and Technology of China, said on the 17th that the antimalarial drug "chloroquine phosphate" has anti-neo coronavirus efficacy. In this regard, Zhong Nanshan believes that chloroquine phosphate is effective for coronavirus. If it is really used in humans, it is in this epidemic. "According to research from Guangdong and Beijing, a considerable number of patients can make the virus negative within 15 days. It is impossible now A rigorous clinical trial was performed, but compared with other drugs, the fever and virus disappeared about one day earlier. In addition, the side effects of chloroquine phosphate are not very large, such as patients with gastrointestinal symptoms such as diarrhea, tinnitus, etc. In general, Special effects are not enough, but will they help? Judging by the existing signs, it should be helpful. "
 
Perhaps it is several things. If they have 80+ trials running then, hopefully, some of them are successful. The more they know the better they will be able to treat symptoms. Have a look at this ladies description of her treatment - http://www.mychinanews.com/news/n/1/2418096
https://www.bannedbook.org/bnews/cbnews/20200218/1279126.html
Source: Law wide RFI Author: Hill, the article content does not imply any position and views.)

China ’s State Council ’s joint prevention and control mechanism announced yesterday that theinjection of rehabilitated patients ’plasma for severe pneumonia patients inWuhanhas a significant effect, and there have been calls for donations of plasma. Chongqing Hongshi Zi will be more today proposed to provide each donor assistance payment of 1,300 yuan. However, the tide of new blood cases has caused concerns about blood infections, and experts have beencontroversial about the antibodies contained in theblood of patients with new coronary pneumonia . Earlier in the country, the rush to buy Shuanghuang medicine has just stopped. Officials and experts have promoted this traditional Chinese medicine,...
 
"Diamond Princess is COVID-19 mill. How I got in the ship and was removed from it within one day.

Diamond Princess has completely inadequate infection control, and there is no professional ID person in charge. Passengeres, crews, health care professionals working inside are at risk of infection, and the practice is even worse than what I saw in Africa. Immediate action is needed to save people inside."


https://www.youtube.com/watch?time_c...ture=emb_title
 
"tinnitus", Lost in translation? As a ringing in the ear this is not exactly a gastrointestinal problem.
 
Oh dear JJackson - absolutely right. I grabbed the original text and have alternate translations for the original word - noun
tinnitus
耳鸣
tingle
耳鸣, 哆嗦
drumming in the ears
耳鸣
Maybe they meant tingle???

It might be shorthand for 耳鸣, 哆嗦 which google explains means tinnitus shiver??? There are a lot of 哆嗦 posts about shivering and shaking with sweating when ill????
 
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Scary thoughts - what do you all think...

Numbers are going down because people are afraid to report they are sick due to the recent forced quarantines and door blockades of entire buildings.

Or

Numbers are going down because China wants the world to open trade routes again - too much money lost.

I think the numbers are going down due to a host of factors, but not those that you mentioned. My guess, in order of effect, would be
1. The unprecedented shutdown
2. They are beginning to get a better handle on what works, or doesn't, in patient treatment.
3. A better understanding of symptom progression, and viral shedding/infectivity curve overtime.
4. Knowing that negatives in PCR tests, particularly early in the disease, do not signal the all clear.
5. Mild infectious cases and a possible extended incubation period in some cases.

All of these are recent and will change the outbreak containment measures, which in turn will effect all epidemiological metrics. Twas ever thus.

China's shutdown has been very expensive for China, while very beneficial to the rest of us, but how long can they maintain it? As a short term measure to stop an outbreak it is a good idea but if it is just slowing things down then it is not a viable long term solution and will have to be relaxed at some point. Then we will see an epidemic go pandemic and we will all have to wrestle with China's dilemmas.
For those following the economic impact the BDI (Baltic Dry Index) is a good barometer. At the beginning of Dec it was 1600 now it is 450. I wrote about it, and why it matters, in 2008 which can be found here https://flutrackers.com/forum/forum/...ndemic-and-bdi

Chart from https://www.bloomberg.com/quote/BDIY:IND
Click image for larger version  Name:	image_29409.jpg Views:	6 Size:	16.5 KB ID:	830419
 
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Hi Everyone!

A couple of things.

Thank you to all of our participants! We are reaching many. So far in February we have 3,962,985 page views and 4,925,322 hits (not including search engine traffic).

We don't know what is going to happen with COVID-19 but it appears to be spreading world wide. The US CDC officials have used the pandemic word a few times. They have stated that their aim is to slow down the progress in the United States. I think that is a similar aim throughout many international health departments.

As such - please - pay attention to what governments do - not necessarily their words. If you see heightened actions like border controls, emergency evacuation flights, government people in hazmat suits, federal quarantines - these are big indicators.

For your part you can be prepared in any event. Get some things as per ready.gov that you would need if your apartment building or street is quarantined for a couple of weeks. This could happen. Sure - no one will let you starve - but do you really want to depend on the government to feed you? Their choices and timetable? Yuck.

We are volunteering here so that you are aware of what is going on. Use this knowledge to protect your loved ones, co-workers, neighbors.

If you get two weeks of "preps" and it is all for nothing and COVID-19 goes away....you can have a big laugh with your friends and neighbors about that time you bought a jumbo box of pop tarts back in 2020. Let's hope that is the case.

Watch our threads and you will see it coming - if it does. Do not wait until the last minute the way most people do here in Florida during hurricane season. What happens? All of the plywood, water, batteries, ice, etc. are sold out.

So give your family and friends a laugh. Get a few things just-in-case.

Don't settle for the plain pop tarts if you like the frosted ones. :)
 
hat tip Shiloh to the change

hat tip to a FluTracker for the translation


Apparently diagnostic criteria for Hubei province changed again. 3rd change in 12 days.

Link to 6th version:

http://www.gov.cn/zhengce/zhengceku/...nt_5480948.htm


from page 4 of the attached pdf at the link above


SUSPECTED CASE - either fulfills one of the criteria under epidemiology and 2 under clinical; or no epidemiological evidence but fulfills all 3 of clinical signs

1 EPIDEMIOLOGY up to 14 days before symptom onset, has
1) history of travel to Wuhan or other places with reported cases, or reside in such areas
2) contact with confirmed case, by RT-PCR
3) contact with patients with fever or respiratory symptoms from Wuhan and adjacent areas or other areas with confirmed cases
4) part of a cluster with other confirmed cases

2 CLINICAL SIGNS
1) fever and/or respiratory symptoms
2) radiological evidence of coronavirus infection
3) normal or low white cell counts in early stage of illness, with low lymphocytes

CONFIRMED CASE

suspected case, plus either RT-PCR or genome sequence confirmation.
 
Interesting that oximeter level <93% is no longer used as a clinical indicator. Any idea why that has been removed?

Blood oxygen levels dropping has previously been used to classify suspect critical cases in absence of other confirmations.
 
hat tip Shiloh to the change

hat tip to a FluTracker for the translation


Apparently diagnostic criteria for Hubei province changed again. 3rd change in 12 days.

Link to 6th version:

http://www.gov.cn/zhengce/zhengceku/...nt_5480948.htm


from page 4 of the attached pdf at the link above


SUSPECTED CASE - either fulfills one of the criteria under epidemiology and 2 under clinical; or no epidemiological evidence but fulfills all 3 of clinical signs

1 EPIDEMIOLOGY up to 14 days before symptom onset, has
1) history of travel to Wuhan or other places with reported cases, or reside in such areas
2) contact with confirmed case, by RT-PCR
3) contact with patients with fever or respiratory symptoms from Wuhan and adjacent areas or other areas with confirmed cases
4) part of a cluster with other confirmed cases

2 CLINICAL SIGNS
1) fever and/or respiratory symptoms
2) radiological evidence of coronavirus infection
3) normal or low white cell counts in early stage of illness, with low lymphocytes

CONFIRMED CASE

suspected case, plus either RT-PCR or genome sequence confirmation.

It seems we are back to requiring a confirmed PCR or sequence confirmation for a confirmed case... so those with clinical signs and consistently negative PCr will only be a suspect case again. I wonder if China has succeeded in overcoming the numbers limitations for PCR testing, or if this will become the rate limiting step again? This will produce a marked drop in recorded case numbers, but may not reflect true numbers bearing in mind the numbers of false negative reports we have seen?
 
I cannot help but wonder if this is 'numbers massaging'. For example if testing capabilities are limited in numerous areas it will mask an exponential growth in case numbers in areas outside of Wuhan. Perhaps a prelude to relaxing quarantine lock downs, and if so perhaps more for domestic consumption than anything else? Or possibly to ease market concerns which have rebounded lately on improvements in Chinese epidemic numbers..
 
Twitter, so here. 5 Confirmed in Spokane Washington area

[quote:NawtyBits:MV80MjQ0MzgwXzc3ODEyMTI5XzJDRDdGMz Yy]
[quote:NawtyBits:MV80MjQ0MzgwXzc3ODEyMTA0XzYwNTBFRD VE]
Jen York
@KREMjen
NEW: Five patients who tested positive for #coronavirus are being transferred to Providence Sacred Heart Medical Center.



Spokane, Washington.

Jen York is a TV news anchor
[/quote]

Jen York
@KREMjen
?
2m
Replying to
@KREMjen
.@spokanehealth
says the hospital has a special isolation unit, one of only ten hospitals in the country with the specialized treatment center.
[/quote]

Jen York
@KREMjen
?
1m
They say patients will be transferred to #Spokane in approximately 1-2 days.

eta: https://twitter.com/KREMjen/status/1230302377254641665
 
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