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[Orang Utan]

Time of the year innit. I'm full of cold, my g/f is full or cold, my work colleagues are full of cold etc etc.

aye, but people will freak out all the same - we don't respond rationally to such things

 

[Cid]

aye, but people will freak out all the same - we don't respond rationally to such things

People should probably be used to it by now, it’s not a new thing.

 

[Orang Utan]

People should probably be used to it by now, it’s not a new thing.

i don't think we'll ever 'get used to' anxiety about illness and death

 

[Cid]

i don't think we'll ever 'get used to' anxiety about illness and death

No, but that’s clearly not what I meant. Masks this time of year are not a new thing.

 

[Orang Utan]

No, but that’s clearly not what I meant. Masks this time of year are not a new thing.

it wasn't that clear actually, but it is a new thing. i only saw it occasionally on the Tube in London but never elsewhere.

 

[maomao]

Edgy atmosphere in the docs this morning - couple of people wearing facemasks, which I thought was just silly paranoia. It probably is, but the situation wasn't helped when a patient had a fit, vomited and lost consciousness right it front of me in the waiting room. Probs flu or something else, but I could see people looking agitated.

If it was 'stomach flu'/norovirus that's one of it's routes of transmission and is very efficient. Good luck.

 

[farmerbarleymow]

So some people will be given the placebo, and this trial could run until April. But what happens if the treatment does work really well? Surely that could become obvious quite quickly? The guy in the US who was given the treatment on compassionate grounds recovered very rapidly once the drugs were administered. They won't just keep giving the placebo to loads of people and letting them die all through February and March, right?

If a treatment under trial is clearly very effective I'd expect the trial to be halted on ethical grounds. The same presumably applies the other way round if a treatment is killing people.

 

[sihhi]

Is that specific to ncov or could that be said for anyone hospitalised and placed into intensive care for a respiratory infection?

Any numbers on how many ncov patients who require intensive care and survive? How many of those had underlying conditions?

It's specific to nCov2019, MERS and SARS.

Dr. Li Wenliang, one of the 8 doctors who sounded the alarm on 1st January and was arrested on 2nd January has died.

This is an interesting table of when the first cases of healthcare worker infection were recorded in establishments with more than 15 DNA confirmed cases :

Finally, cases show just how easily this virus can spread:

In the first case of rapid transmission, a man in Hangzhou, Zhejiang Province, was infected with coronavirus after spending only 50 seconds with a confirmed patient at a hospital while neither of them were wearing masks, according to a report by Beijing Evening News.

In another case, a 56-year-old man in Ningbo, Zhejiang Province, was infected with the virus after spending only 15 seconds with a confirmed patient at a local market stand. Both were also not wearing masks at the time.

Both men have no history of living or traveling in the epidemic area within 14 days of the onset of the disease, did not have any contact with wild animals, and did not know any confirmed patients.

After checking surveillance videos that recorded the two patients' movements and collating their activities, the police discovered on Wednesday that the two men both had short contact with confirmed patients while not wearing masks, the first on January 22 and the other on January 23.

 

[8ball]

If a treatment under trial is clearly very effective I'd expect the trial to be halted on ethical grounds. The same presumably applies the other way round if a treatment is killing people.

Yep, this is bang on. There are lots of trials that get stopped (ie. the regular ones you never hear of) that get terminated if early data reviews show it is unethical to continue to use a placebo (or, as is usually more common) a comparator drug for a proportion of the patients.

And yes, if something turns out horrifically toxic (or very obviously ineffective), the converse happens.

 

[farmerbarleymow]

In another case, a 56-year-old man in Ningbo, Zhejiang Province, was infected with the virus after spending only 15 seconds with a confirmed patient at a local market stand. Both were also not wearing masks at the time.

If true that's remarkably efficient.

 

[Chilli.s]

3rd uk case

 

[maomao]

Would have thought the doctor would be young and fit enough to make it. Perhaps the sheer amount of the virus he was picking up made it worse. Poor sod.

Third UK case was caught elsewhere in Asia. I have three colleagues off to Thailand over the next couple of months. Hope it doesn't go nuts there.

 

[8ball]

Would have thought the doctor would be young and fit enough to make it. Perhaps the sheer amount of the virus he was picking up made it worse. Poor sod.

Perhaps the amount of high-grade polonium being pumped into his home water supply by the angry and embarassed authorities didn't help.

 

[maomao]

Perhaps the amount of high-grade polonium being pumped into his home water supply by the angry and embarassed authorities didn't help.

That's Russia. They just fucking shoot you in China.

 

[8ball]

That's Russia. They just fucking shoot you in China.

Must admit, wasn't too sure about their methods, but in this particular case we know we are not dealing with unusually large, fast-moving viruses made of lead, so more creativity might be required.

 

[cupid_stunt]

3rd uk case

The third person in the UK to be diagnosed with coronavirus did not catch it in mainland China, England's chief medical officer has said.

The patient, who caught the infection elsewhere in Asia, was diagnosed in Brighton, it is understood.

Source BBC

That's a bit too close to me.

 

[8ball]

That's a bit too close to me.

Tbf, that's a lot less scary than the third person catching it from an unknown source in the UK.

 

[Chilli.s]

Stay at home don't go out.

 

[Cid]

Would have thought the doctor would be young and fit enough to make it. Perhaps the sheer amount of the virus he was picking up made it worse. Poor sod.

Third UK case was caught elsewhere in Asia. I have three colleagues off to Thailand over the next couple of months. Hope it doesn't go nuts there.

Yeah, 34 years old. Initial thought was perhaps it was more deadly when it kicked off, but that is probably wrong - iirc elbows etc mention it hasn't evolved much.

Also I do wonder about number of cases in places like Russian, India, various central Asian places. All have significant populations in China, but very few reported cases. Could be a number of reasons for that of course, but concern there that some have just gone unnoticed.

 

[sihhi]

Yeah, 34 years old. Initial thought was perhaps it was more deadly when it kicked off, but that is probably wrong - iirc elbows etc mention it hasn't evolved much.

Also I do wonder about number of cases in places like Russian, India, various central Asian places. All have significant populations in China, but very few reported cases. Could be a number of reasons for that of course, but concern there that some have just gone unnoticed.

I listened to Russian news all their deportees from Wuhan tested negative. Also most Russians in Heilongjiang and the north east.

 

[Orang Utan]

Stay at home don't go out.

that's a bit alarmist unless you're elderly or immunocompromised. even then the risk is small

 

[Chilli.s]

that's a bit alarmist unless you're elderly or immunocompromised. even then the risk is small

In truth it's not an actual sergestion, more a joke to lighten what could become a serious thing.

 

[maomao]

Yeah, 34 years old. Initial thought was perhaps it was more deadly when it kicked off, but that is probably wrong - iirc elbows etc mention it hasn't evolved much.

Viral load can have a big effect on severity of flu so maybe just being surrounded by it constantly for weeks did for him.

 

[8ball]

STAY INDOORS

 

[Cid]

I listened to Russian news all their deportees from Wuhan tested negative. Also most Russians in Heilongjiang and the north east.

I mean Russian students and the like rather than the longer term minority groups... Really just a thought, as there were quite a few when I was in Nanjing.

 

[maomao]

I mean Russian students and the like rather than the longer term minority groups... Really just a thought, as there were quite a few when I was in Nanjing.

There's tonnes of Russians at most language learning schools. Only outnumbered by Japanese and Koreans.

 

[elbows]

Yeah, 34 years old. Initial thought was perhaps it was more deadly when it kicked off, but that is probably wrong - iirc elbows etc mention it hasn't evolved much.

Also I do wonder about number of cases in places like Russian, India, various central Asian places. All have significant populations in China, but very few reported cases. Could be a number of reasons for that of course, but concern there that some have just gone unnoticed.

There are various thoughts as to why the death rate in Wuhan is worse. But I am now tending to prefer the waiting game, because some of the patterns and differences could be down to the stage things (and early patients) have reached there but not reached in other places yet. Alternatively, I will not be surprised if nowhere else ends up with quite the same pattern of hospital admissions and deaths as Wuhan.

Mutations are a feature of this type of virus, and I think I have struggled to explain which bits of the mutation stories in the media I (and some virologists etc that I read the thoughts of on twitter) take issue with. I'll have another quick go.

I think it was when I was looking at H5N1 bird flu that I first became aware of the idea that a virus might start off in humans in a rather deadly form, and that this is not ideal for the virus, and for that and other reasons if it evolves to spread more in humans, it will also become less deadly at the same time.

Well, maybe things turn out that way sometimes. But its not some hard and fast rule, and there are some flaws to the logic that killing the host is always bad for the virus. The virus cares about replicating and spreading. And the relationship between having enough opportunities to spread and not being too severe or deadly to the host is not so simple either.

I also expect that this sort of explanation for the origin of an outbreak being more deadly than that seen in a subsequent wider spread, ends up covering for some of the other reasons, that for one reason or another are not of so much interest to the media. For example when it comes to the current estimates for mortality rate, even when some articles point out how flawed these numbers are at this stage, it wont stop those numbers being quoted and used in articles that do not point out their limitations. Later, if a very different death rate is observed elsewhere, it is easy to assume that this is down to some change that has happened to the virus. But in fact it might just be our perception of the viruses deadliness that has changed. Or the myriad of other factors that make a difference, such as peoples behaviour (which can have a real effect on transmissibility, and timely clinical presentation), alertness and readiness of medical services to respond, general health or susceptibility of the population varying in different places, etc.

A couple of tweets to illustrate one of my points in detail that I couldnt come out with using my own limited knowledge.

 

[elbows]

Also the mutation stories, and expert willingness to provide such stories in the first place, are a much better fit with other sorts of outbreaks than this one.

The standard scenario for that sort of thing is that there is an outbreak of something that has not yet showed a good ability for sustained human to human transmission. So most of the cases got it directly from animals, or they were doctors and other healthcare workers with close contact to patients, and then a few other intermittent human to human cases, but no evidence of much broader human to human transmission.

Well, thats a pretty much perfect scene for the sort of mutation story I've been having a go at. Because we normally only notice these animal->human incidents in the first place when they happen to cause severe disease, so there is the 'disease starts off too horribly deadly to contemplate' bit. But human to human transmission is still weak, so thats the bit you worry might get much stronger via some future mutations. Chuck in the 'it will hopefully become less deadly at the same time it becomes more spreadable' and thats it, all the ingredients are available for the mutation story. Including context and a relationship with our hopes and fears for the future of the outbreak that seems to make sense.

Things like H5N1 bird flu (and some subsequent varieties), and SARS and MERS fit the above much better than this coronavirus has, and mutation came up as a reason why the world should care about those limited outbreaks and provide the funds and capabilities to deal with them. This coronavirus on the other hand already seems quite capable of human to human spread, so attempts to recycle that mutation story and blend it into this one doesnt quite work in the same way, the context isnt such a neat fit at all.

 

[weltweit]

Does anyone know the state of the travel restrictions in China and neighbouring countries?

I think I overheard that restrictions inside China are staying put for the time being, but that Hong Kong is still allowing visitors from the mainland on the promise that they quarantine themselves for 14 days. I must say that seems very trusting.

 

[cupid_stunt]

Does anyone know the state of the travel restrictions in China and neighbouring countries?

I think I overheard that restrictions inside China are staying put for the time being, but that Hong Kong is still allowing visitors from the mainland on the promise that they quarantine themselves for 14 days. I must say that seems very trusting.

BBC TV News is reporting panic buying in HK, due to rumours of the border about to be closed, because of the strike by medical workers & general public concerns.