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Discussion thread IV - COVID-19 (new coronavirus)

"It is dangerous to approach this virus like any other

Have found 570 mutations
K?ri points out, as an example, that a large number of mutations have accumulated in the virus despite the low mutation frequency because it has infected so many, it has been given so many opportunities for mutation. K?ri says that in 1,400 viruses that have been sequenced by deCode (Icelandic genetic analysis), 570 mutations have been found."

Adjusted Google translation from radionews in Iceland

https://www.ruv.is/frett/2020/04/17/...og-hverja-adra
 
This doctor has some serious questions about the recent study on Remdesivir

Jeremy Faust MD MS@jeremyfaust

The time has come to defend science against its own practitioners. Thread!!!!!!!!!! Spoiler: Remdesivir may work, but we won't find that out from a "study" with no fricking control group and with patients who statistically are *not expected to die anyway*.


Jeremy Faust MD MS@jeremyfaust

In conclusion, this study is not science. I beg of you, though: Let's insist upon science. Let's get GOOD data. REAL data. Controlled trial data. Then let's give the medications that are proven to work to the patients in whom they have been proven to work on, only.
 
Hear! Hear!
The WHO controlled trials are the ones we should be waiting for and looking at for a definitive answer.
Not enough countries are participating with thousands of individual trials all giving hints at an answer which are being jumped on in the absence of anything better. If you want to know what works you need lots of studies all following the same protocols using patients at different stages of disease, different age groups, and different doses of the the same drug, or combination of drugs. If these can be performed in different health care systems with different ethnic groups then the data is even better. Too much effort is being wasted on well meaning single studies which are not directly comparable. Statistical significance increase with cohort size!
 
I am interested to hear anyone's opinion on what Ontario is doing to prevent cases in nursing homes:
1) Hospital-based teams are going into nursing homes and testing everyone in the home when there is an outbreak (1 positive test). These teams have never worked outside a hospital before and have no knowledge of anything in these nursing homes.
2) Patients are no longer allowed to be transferred from hospitals to nursing homes. This will create a logjam of LTC patients in hospitals.
3) Staff may no longer work in more than one nursing home. Presumably, this doesn't apply to the hospital-based teams. This doesn't start until next week.
 
...Experimental infected cats can transmit SARS-CoV-2 through the air; some cats can cause severe morbidity or even death after infection. The incidence of young cats is obviously more serious than that of older cats. Histopathological observations confirmed that virus-infected cats can cause varying degrees of lung inflammation and intestinal mucosal damage; immunohistochemical studies have found epithelial and olfactory bulb cells of the upper respiratory tract (nasal cavity, palate, tonsils), mucosal gland epithelial cells of the trachea and bronchial mucosa , Intestinal mucosa epithelium and other parts have a large number of viral infections (Figure)...
.The study calls for close monitoring and protection of cats in epidemic areas to avoid contact with the source of infection and prevent them from becoming possible hosts of transmission or storage.....:tiphat:http://www.hvri.ac.cn/xwzh/zhdt/231683.htm
 
blacknail said:
I am interested to hear anyone's opinion on what Ontario is doing to prevent cases in nursing homes:
1) Hospital-based teams are going into nursing homes and testing everyone in the home when there is an outbreak (1 positive test). These teams have never worked outside a hospital before and have no knowledge of anything in these nursing homes.
2) Patients are no longer allowed to be transferred from hospitals to nursing homes. This will create a logjam of LTC patients in hospitals.
3) Staff may no longer work in more than one nursing home. Presumably, this doesn't apply to the hospital-based teams. This doesn't start until next week.
Click to expand...

Coronavirus exposes systemic cracks in nursing homes
BY COLIN PERKEL THE CANADIAN PRESS

POSTED APR 17, 2020 3:36 PM EDT
The brutal assault of the novel coronavirus on long-term care facilities in Ontario has exposed long-standing, systemic problems in a sector that otherwise seldom receives top-of-mind public attention.

Those issues range from who cares for the frail and how they do that to government funding levels and wait-lists for one of the 77,000 beds in the province’s 626 long-term care homes.

To date, more than 100 homes have seen more than 1,200 cases of COVID-19 among residents, accounting for about half the 478 known deaths in the province, according to data from the Integrated Public Health Information System. More than 620 staff have tested positive.

The incidence among residents and the roughly 80,000 people who look after them is, however, likely higher given relatively low levels of testing and lags in reporting.

Prime Minister Justin Trudeau noted the grim situation this week.

“One of the things we’ve seen over the past number of weeks is a far more severe impact on a number of seniors residences and long-term care centres than we had certainly hoped for, or more than we feared,” Trudeau said.

Experts, however, say the impact of COVID-19 shouldn’t have come as a big surprise given chronic problems in Ontario’s often cash-starved nursing homes _ one-third only meet 1972 standards for space and other requirements _ and the virus’s propensity to strike hardest at older adults and those in poorer health.

Both factors have been prominent in the rapid and lethal spread through what has in recent years effectively become a $4.2-billion publicly funded system of slow-motion palliative care....:tiphat:https://toronto.citynews.ca/2020/04/...nursing-homes/
 
Ran across this video today. Interesting discussion on the antibody study from CA that just came out. The interview is done with Dr. Jay Bhattacharya I think his title is Director of Medicine at Stanford (something along this path so I apologize if I got this wrong). He is the one who conducted the trial and is also currently going through data for two other studies, he talks about them in the video as well.

https://www.youtube.com/watch?v=k7v2F3usNVA
 
No surprise. I questioned this in the Treatment thread. Smelled funny. Apparently a private video was leaked to the press. This should be investigated by SEC.
That said, the fact that critical patients were not selected for the trial does not mean the drug has no value. By the time a cytokine storm is going on, another approach might be needed. Swedish Hospital in Seattle has been doing a compassionate use with another drug in those cases.
 
Covid 19 and the elephant in the room

By Aseem Malhotra - 16.04.2020

- snip -

But the elephant in the room is that the baseline general health in many western populations were already in a horrendous state to begin with. In the UK and USA more than 60% of adults are overweight or obese. How is this relevant to COVID-19?

OBESITY, THE REAL KILLER BEHIND COVID

It is well known in the medical literature that excess body fat induces immune dysregulation and chronic inflammation which is directly linked to the cytokine storm that is responsible for Acute Respiratory Distress Syndrome seen in influenza and other respiratory viruses. (4)

For example, in 2009 61% of patients admitted to hospital in California that died from H1N1 Influenza A were obese, which was 2.2 times more than the prevalence of obesity within the state population. Multivariate analysis suggested obesity was a novel risk factor for mortality from the virus. (5) Furthermore, obese adults shed influenza A virus 42% longer than non-obese individuals suggesting an additional role in transmission. (6)

Data from the first 2204 patients admitted to 286 NHS ICU’s with COVID- 19 reveal that 72.7% of them were overweight or obese. (7)


LINK TO FULL ARTICLE
 
https://www.sciencemediacentre.org/...ity-of-pets-to-the-covid-19-virus-sars-cov-2/
"It is really critical to remember that these studies were designed to establish animal models for testing of vaccines and drugs, not to establish what happens in everyday life with peoples pets.

“These studies use high doses of virus sprayed into an animals nose or injected into the trachea to induce initial infection, this is not what happens in a house with pets. Colleagues in Hong Kong have been closely monitoring pets there and have so far been a very tiny number of animals1 (2 dogs and one cat who were not sick) who appear to have contracted a mild infection from their owners. These animals do not appear to have had enough of an infection to actually be able to infect other animals or people. There has been one very similar case reported in one cat in Belgium2. This also appears to be what has happened in the well published case of the tigers at New York Zoo (who have contracted a mild infection from one of their keepers). One of the biggest Veterinary clinical pathology companies (IDEXX) have also been conducting qPCR testing on a large number of pets internationally, including in the USA and South Korea and have so far not detected any animals with infection3"
 
Medic sees evidence of serious long-term lung damage


Dive Medic: Long-term damage to the lungs after infection?


The diving doctor and senior senior physician at the Innsbruck University Hospital, Frank Hartig warns of long-term lung damage in divers after a coronavirus infection . With at least six Covid – 19 Patients in Innsbruck who are also divers, Harting observed that their lungs are still severely damaged even five to six weeks after their recovery were – even though the patients felt free of symptoms.

“There is a young person to the 40 years old who got sick because of the infection about a week He comes over a month later, supposedly healthy, for a check. Then the result comes from the X-ray, and I can't believe my eyes, because the patient sitting in front of me should actually be ventilated, “he quotes Austrian “standard”.

Hartig said to the Austrian news agency APA regarding the six divers: “The damage to the lungs is irreversible.” He further emphasized: “They are probably lifelong patients , it is not a question of whether they are diving again or not. “

To what extent these observations can be generalized is currently not clear. Hartig's urgent advice: Who symptomatic of Covid – 19 was ill, should be examined thoroughly before the next dive and X-ray the lungs allow. Otherwise it could be life-threatening for divers under water. Hartig has now published his observations in the diving magazine Wetnotes.
 
Les r?sultats montrent que les furets peuvent ?tre utilis?s comme mod?les animaux pour le vaccin contre le SRAS-CoV-2 et l'?valuation des m?dicaments; les chiens, les porcs, les poulets et les canards ne sont pas sensibles au SRAS-CoV-2, et ont une importance directrice importante pour le tra?age de l'h?te viral; plus important encore, Les chats sont tr?s sensibles au SRAS-CoV-2. L'?tude appelle ? une surveillance ?troite et ? la protection des chats dans les zones ?pid?miques afin d'?viter tout contact avec la source d'infection et de les emp?cher de devenir des h?tes potentiels de transmission ou de stockage.
http://www.hvri.ac.cn/xwzh/zhdt/231683.htm
donc

https://science.sciencemag.org/conte...b7015.full.pdf

Si le silence concernant les rongeurs plus ou moins modifi?s est surprenant, au moins ceci est publi?, avec une belle bibliographie. Donc les allemands et les chinois ont fait, les autres , eux font quoi ?
 
Testicles may increase coronavirus risk: Study

by Anthony Leonardi
| April 18, 2020 04:10 PM

A new study from India shows men may be more susceptible to the novel coronavirus than women because of their reproductive organs.

Researchers in Mumbai and New York reportedly found that the coronavirus puts men at additional risk by binding with a protein in cells called angiotensin converting enzyme 2, which is found in tissues within the lungs, heart, gastrointestinal tract, and testicles.

The researchers, Dr. Aditi Shastri and Dr. Jayanthi Shastri, hypothesize the virus has an additional entry point in men while simultaneously being protected from the immune system. However, there is not clear evidence yet to support the hypothesis.

Aditi Shastri told the Los Angeles Times that if the virus hides within the testes, it could potentially be sexually transmitted: “I would definitely consider that virus could be secreted into seminal fluid."..:tiphat:https://www.washingtonexaminer.com/n...rus-risk-study
 
JJackson said:
Re the infectious period.
Yesterdays TWiV 601 was an interview with a German Corona virus researcher on their experience and research. The gist was that the virus remained in the deep lung for a long time but that neither URT or fecal samples were infectious apart from early in the disease. They could get RNA in PCR tests but could not infect vero cells although around symptom onset, and a few days after, viral titers were very high and grew well.
https://www.microbe.tv/twiv/
Click to expand...

when I listened I had thought Drosten were probably wrong about the containment and it went
to Italy and >50% of the world just from that Shanghai-woman via Webasto/Munich.
But I checked again ...
@c_drosten , Apr 13 ...[102] sequences from Germany ... https://civnb.info/sequences/
and someone had anonymously leaked the semi-secret GISAID-mutations until mid-March (thanks a lot)
And then I read the Vo-paper.
@cmyeaton [Vo-paper] ... full of interesting results.... [compare with Drosten's Munich cluster]
https://medrxiv.org/content/10.110
The 3 Shanghai-Webasto mutations are C00241T,C03037T,A23403G.
Then somewhere,somehow C14408T joined the 3 and is now seen everywhere.
Italy Feb19;France Feb20,NL,CH,I Feb23;D-BW,Brazil,Finland,Spain Feb24,England,Ireland Feb25
Mexico Feb26
Maybe some other airplane from Shanghai with a C14408T superspreader.
They really should have checked all these airplane contacts including the Shanghai-Webasto flight.
They should also have asked in Vo about fever+cough in Jan or China/Germany travel history
btw. I just saw this : [add to the Drosten immune podcasts]
@florian_krammer Excellent review of human immune responses to coronaviruses!
The best one I found so far. I already cited it https://medrxiv.org/content/10.110
 
obesity can't be the "elefant". Other countries found no relation. And I very much doubt that there is a significant correlation between
prevalence of obesity and COVID-deaths per M
 
Zhong Nanshan: China's epidemic situation is still under control and masks cannot be completely abandoned


2020 年 04 月 17 日 02:23 Source: The Beijing News




　　Academician Zhong Nanshan's live video for the first time shared China's "new crown full path" experience; controlling social distance and wearing masks are more successful prevention and control experiences
　　China's epidemic is still under control and masks cannot be completely abandoned
　　Zhong Nanshan said that one of the most successful experiences of China's national defense control is the upstream prevention strategy. "This is one of the most successful experiences in China, which can further reduce the number of infections." In addition, controlling social distance and wearing masks are also more successful empirical methods for prevention and control in China. "
　　Beijing News Yesterday, Academician Zhong Nanshan, together with Dean He Jianxing and Associate Dean Li Shiyue of Guangzhou Respiratory Health Research Institute, broadcast live video for the first time to share China ’s screening of asymptomatic patients, diagnosis of suspected cases, treatment of diagnosed patients, and severe ICU program to The "New Crown Full Path" experience of the later detection and online answer to the focus of the frontline doctors of anti-epidemic problems.

　　Talk about the onset
　　Fatigue and cough are more likely to become the first symptom of asymptomatic patients
　　Zhong Nanshan said that China is currently paying more attention to people with asymptomatic infections. According to the data, the incubation period of asymptomatic patients is mostly 3-7 days, and the highest incubation period may be 14 days. During the incubation period, many patients may not have symptoms, or the symptoms are very mild, and patients Is unclear.
　　Zhong Nanshan said that from the data, about 50% of asymptomatic patients have no symptoms of fever. Therefore, fever is not the core symptom of asymptomatic patients, and fatigue and cough are more likely to become the primary symptoms of asymptomatic patients.
　　Speaking of China's anti-epidemic experience, Zhong Nanshan said that one of China's most successful experiences in national epidemic control is upstream prevention strategies. Zhong Nanshan said that once the patient is infected with the new coronavirus, relevant departments will pay close attention to their close contacts. When someone is diagnosed, they need to be isolated at home, and their close contacts will also be isolated. "I think this is one of the most successful experiences in our country, which can further reduce the number of infections."
　　"On the other hand, controlling social distance and wearing masks is also a relatively successful experience in prevention and control in China." Zhong Nanshan said that even though China's current epidemic prevention has achieved certain results and fewer newly diagnosed patients, most people continue to abide by these rules .
　　Talking about diagnosis
　　Many mild patients have no abnormalities in lung CT imaging
　　Zhong Nanshan said that CT diagnosis is indeed very necessary, which depends on the application of CT equipment. He introduced that a small number of patients had no abnormalities and no imaging findings on routine CT examinations, but they had a positive virus test.
　　"In this case, I hope that there will be more advanced CT diagnostic technology, so that patients can be identified at an early stage." Zhong Nanshan said that many patients did not have abnormal CT imaging of the lungs throughout the course of the disease, they entered In the recovery period, this is also the performance of very mild patients.
　　Zhong Nanshan pointed out that new coronary pneumonia generally causes lung damage to patients and whether other organs are damaged. He believes that this is related to the patient's own complications.
　　"These patients may already have a disease, and you can see that the ultrasound and electrocardiogram change very quickly, so I think that patients with many comorbidities will find other organs damaged." Zhong Nanshan said that during the autopsy process, he did not see Clear damage to other organs based on the virus.
　　Zhong Nanshan said that at present, he observed that the patients showed some problems of the renal tubules, and there may be some damage to the renal tubules and necrosis of the renal tubules. "Other research teams have also found that 25% to 30% of patients will We found a very obvious kidney damage, which is what we currently know. "

In addition to the damage to the heart, brain, and kidneys, the damage to the central nervous system is not so obvious.

　　Talk about treatment
　　Lianhua Qingwen is suitable for mild and non-severe patients
　　Zhong Nanshan said that Lianhua Qingwen had an inhibitory effect on the virus. There were 284 patients in the clinical study. The recovery rate of the treatment group was higher than that of the control group, but there was no significant difference from severe to mild. Therefore, Lianhua Qingwen Capsule may be more suitable for mild and non-severe patients with new crowns.
　　For the treatment, Zhong Nanshan said that inhaling a mixed gas of hydrogen and oxygen can relieve patients' difficulty in breathing, especially in critically ill patients. The research data on the inhalation of hydrogen-oxygen mixed gas will be published by the team in the next few weeks.
　　Introducing plasma therapy, Zhong Nanshan said that new coronavirus antibodies can be detected in the blood of patients in the rehabilitation period, and patients are regularly used in the plasma of the rehabilitation period. The viral load decreases significantly over time and then turns negative.
　　Zhong Nanshan said that China promotes the use of IGG and IGM for testing. “We not only use PCR testing (nucleic acid testing), but also add plasma antibody testing, especially for those patients whose PCR is recovering during the recovery period.” Zhong Nanshan said These patients actually have antibodies to this virus in their bodies. Adding plasma antibody testing is a very good opportunity to allow us to better monitor the outbreak, which is worth promoting.
　　Talking about epidemic prevention
　　Prevention and control is very important during the resumption of production
　　Talking about whether China's epidemic prevention measures should be maintained, Zhong Nanshan said, "Everyone must maintain the understanding that China's epidemic situation is still in the control stage, and masks cannot be completely abandoned. The situation in China and abroad is different.
　　Zhong Nanshan said that he very much hopes that the epidemic in European countries will enter the platform period as soon as possible. During the platform period, the epidemic situation may show a restriction or a downward trend, so that more people can resume work and production, but prevention and control at this time are very important. "Imported cases are worth noting. There are imported cases on the Sino-Russian border and elsewhere, and they will continue to spread to other people. This is a big problem."
　　Zhong Nanshan said that some countries should not resume work urgently. The government may want to balance economic development and epidemic prevention. Health should be the first consideration.
　　In response to the United States, Zhong Nanshan said that although the number of global cases has tended to slow down or decline, the United States is an exception. The control measures adopted by the United States are not enough. It may take another week to see the changes in the epidemic before it can enter the platform stage of the epidemic, depending on what action the United States takes.
　　Beijing News reporter Xu Meihui Chen Qinhan


http://www.chinanews.com/sh/2020/04-17/9159408.shtml
 
I've been wondering about that, too. They seem to have had a shortage of masks so maybe it takes a critical percentage of people wearing masks to make a difference, like with herd immunity? Here where I live about 50% of people are wearing masks in the big grocery stores, but almost 100% in small stores. I feel safer in the small stores.
 
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