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[Supine]

Rather surprisingly the main remdesivir clinical trial in China is having problems enrolling patients. So far they only have <200 patients signed up from the required 700.

To show effectives they need patients who haven't been given other products in the last thirty days. That's proving problematic.

 

[Cid]

Rather surprisingly the main remdesivir clinical trial in China is having problems enrolling patients. So far they only have <200 patients signed up from the required 700.

To show effectives they need patients who haven't been given other products in the last thirty days. That's proving problematic.

What constitutes other products in this case?

 

[Supine]

What constitutes other products in this case?

It'll be anything used to treat flu/covid so could.range from oxygen to other anti viral medications or probably Chinese herbal treatments. They basically need the fresh presentations at hospital who havnt had medical intervention.

 

[Cid]

It'll be anything used to treat flu/covid so could.range from oxygen to other anti viral medications or probably Chinese herbal treatments. They basically need the fresh presentations at hospital who havnt had medical intervention.

Yeah, I was wondering about the latter, since TCM is still widely used. I also wonder how the over-prescription of antibiotics is shaping up under this crisis.

 

[sihhi]

Situation in South Korea and in Daegu shows rapid cross-infection

Navy sailor tests positive for coronavirus in initial examination | Yonhap News Agency

(ATTN: CORRECTS accounts as case not confirmed yet) SEOUL, Feb. 20 (Yonhap) -- A South Ko...

en.yna.co.kr

South Korea's Hynix says 800 workers to stay home after trainee had contact with virus patient

South Korean chipmaker SK Hynix said on Thursday that 800 of its workers had quarantined themselves as a precautionary measure to prevent the spread of the coronavirus, but its production in the city of Icheon has not been affected. The move came after one trainee had close contact with a virus...

sg.finance.yahoo.com

Now 104 confirmed in total

The cases from the church in Daegu a super-spreading event:

She first developed a fever on 10 February but reportedly twice refused to be tested for the coronavirus on the grounds that she had not recently travelled abroad. She attended at least four services before being diagnosed.

So far, 37 other members of the church have been confirmed as infected.

Shincheonji claims that its founder, Lee Man-hee, has donned the mantle of Jesus Christ and will take 144,000 people with him to Heaven, body and soul, on the Day of Judgement.

Daegu’s municipal government said there were 1,001 Shincheonji members in the city, all of whom had been asked to self-quarantine, with 90 of them currently showing symptoms.

 

[elbows]

Yeah, I was wondering about the latter, since TCM is still widely used. I also wonder how the over-prescription of antibiotics is shaping up under this crisis.

I havent checked properly but I sort of expect many hospitalised cases will have been given the usual antibiotics to reduce the chance of secondary infections, including infections from medical equipment (eg from intubation).

 

[elbows]

The South Korea stuff is sad to hear about but not particularly unexpected (its one of the countries I've been droning on about recently).

Iran announcing its first two cases, and its first two deaths on the same day wasnt good.

China changed the case criteria for Hubei back to something more like what it was before the previous change, so a positive test result is required again. Good thing I wasnt trying to get a full picture from trends in these numbers in the first place.

Japan is getting more of the criticism it deserves for its handling of the boat. I hope their handling of the outbreak in their country improves and does not remind me of their response to Fukushima so much, but I have my doubts.

 

[Cid]

I havent checked properly but I sort of expect many hospitalised cases will have been given the usual antibiotics to reduce the chance of secondary infections, including infections from medical equipment (eg from intubation).

I meant in the context of Supine ‘s post. Overprescribing antibiotics has long been a problem in China, and any use of antibiotics would presumably rule a patient out wrt remdesivir trials.

 

[elbows]

Yes fair enough, I was off in another direction when I heard oxygen and medical intervention. It does sound like they've had particular trouble recruiting many mild cases, although I suppose there could be several other reasons for that.

Meanwhile, one of the Singapore cases that was publicly reported as positive on Feb 19th, has the same kind of long delay between initially seeking treatment, and detection, as I have mentioned previously with a few of the prior cases they detected:

He reported onset of symptoms on 28 January and had sought treatment at a general practitioner (GP) clinic on 1 February, 5 February, 6 February and 10 February. He went to NCID on 18 February, and subsequent test results confirmed COVID-19 infection on 19 February morning.

https://www.moh.gov.sg/docs/librariesprovider5/default-document-library/press-release---three-more-cases-discharged_-one-new-case-of-covid-19-infection-confirmedfa895d58592a4c1088f51937bc311479.pdf

 

[elbows]

Ignoring the stupid headline, this opinion piece is worrying but not surprising.

It's informative for describing a number of ways the system will come under immense strain at one of the first hurdles, if public information campaigns arent timed properly or lack the right emphasis or magnitude.

Other stuff, such as their personal protective equipment training being cancelled due to a shortage of kits, underlines specific concerns about the supply chain, but also the fragile state of things at the best of times due to longterm underfunding.

I work at a walk-in health centre. The coronavirus super-worriers are a problem | Anonymous

A public information campaign is urgently needed to tell people that all bar the very ill should access help from home, says an anonymous lead clinician

www.theguardian.com

 

[elbows]

As for the timing of new public health messages in the UK, I suppose its a tricky moment right now. If they start some stuff 'too soon' then it might panic people even more initially, especially as there have been no recent UK positive cases so we have been in a sort of holding pattern for a while now. We can already see from a few other countries what the updated message might look like, and how it emerges in response to signs of wider community spread. I suppose my default assumption is that we wont get that stuff until/unless community spread is confirmed or at least close to being confirmed in the UK. But it is possible they could start sooner, especially if the situation in some countries other than China leads to a widespread conclusion that this is an inevitable pandemic, even before such a scenario is detected as happening in the UK.

Meanwhile in the current phase, I was slightly surprised that more was not made of the person who presented themselves at a London hospital unannounced. The media and the health officials they quote did complain loudly about this case, as an example of what not to do, but this attention seemed very brief. But I suppose again its a case of struggling to sustain such messages when there isnt any new UK news to keep fuelling this angle.

 

[Marty1]

Can anyone on here make sense if this and know if it’s legitimate?

https://www.med.unc.edu/orfeome/files/2018/03/a-sars-like-cluster-of-circulating-bat-coronaviruses-shows-potential-for-human-emergence.pdf

 

[maomao]

Can anyone on here make sense if this and know if it’s legitimate?

https://www.med.unc.edu/orfeome/files/2018/03/a-sars-like-cluster-of-circulating-bat-coronaviruses-shows-potential-for-human-emergence.pdf

Yes

 

[elbows]

Can anyone on here make sense if this and know if it’s legitimate?

https://www.med.unc.edu/orfeome/files/2018/03/a-sars-like-cluster-of-circulating-bat-coronaviruses-shows-potential-for-human-emergence.pdf

This blog post from 2015 describes the study, and some of the responses to it in the media at the time:

Bat SARS-like coronavirus: It's not SARS 2.0! | Virology Blog

A study on the potential of SARS-virus-like bat coronaviruses to cause human disease has reawakened the debate on the risks and benefits of engineering viru ...

www.virology.ws

I havent checked but it would not surprise me to learn that a bunch of half-baked theories and suspicions are making use of this sort of work to try to 'prove' something sinister in regards the Covid-19 outbreak.

 

[Marty1]

This blog post from 2015 describes the study, and some of the responses to it in the media at the time:

Bat SARS-like coronavirus: It's not SARS 2.0! | Virology Blog

A study on the potential of SARS-virus-like bat coronaviruses to cause human disease has reawakened the debate on the risks and benefits of engineering viru ...

www.virology.ws

I havent checked but it would not surprise me to learn that a bunch of half-baked theories and suspicions are making use of this sort of work to try to 'prove' something sinister in regards the Covid-19 outbreak.

a recombinant virus was created in which the gene encoding the spike glycoprotein of SARS virus was swapped with the gene from a bat virus called SHC014.

Think that article you linked is basically saying the Coronavirus was created in a lab

 

[Cid]

Think that article you linked is basically saying the Coronavirus was created in a lab

It's saying a coronavirus was created in a lab. Or rather assembled from other bits of coronavirus... With the aim of seeing what might happen in the wild.

 

[Cid]

I was going to say probably not in Wuhan. But Wuhan does in fact have a level 4 virology lab, so conspiracy-theorise away...

(I'm sure that's been mentioned somewhere, dunno how I missed that)

e2a: ah yeah, early on there were various conspiracy theories weren't there? Just being forgetful.

 

[Supine]

Can anyone on here make sense if this and know if it’s legitimate?

https://www.med.unc.edu/orfeome/files/2018/03/a-sars-like-cluster-of-circulating-bat-coronaviruses-shows-potential-for-human-emergence.pdf

Gene splicing has been around for a while. I'm pretty sure one of the studies linked to earlier (Lancet maybe) debunked this being a man made virus. There were too many sections unique to covid-19 to make it anything but a natural phenomena.

 

[elbows]

Think that article you linked is basically saying the Coronavirus was created in a lab

There are a bunch of coronaviruses we know about. Some of them have existed in human populations for a long time, they are some of the viruses that are responsible for 'the common cold'.They were studied a bit, but were not much of a priority.

Then in 2003 the SARS outbreak happened, and then later the MERS. These are also coronaviruses, but with more serious implications for human health, so research and experimentation in this area picked up massively.

It is not in dispute that various labs have worked with various coronaviruses for years, including experiments where the coronavirus was altered in some way.

Nor would I dispute that lab accidents can happen. I have mentioned before that the 1977 H1N1 flu pandemic points in the direction of a lab release. The main indicator of that possibility involved various clues specific to that particular strain of flu at that time. It was so similar to a 1950 sample that was used in labs, that the possibility seemed more plausible than the other, natural possibilities.

But for theories about Covid-19 coming from a lab to gain any merit, they have to demonstrate something similar, or some other conclusive revelation has to emerge. I cannot completely exclude the possibility, but I'm pretty sure I can exclude all the people quacking about it right now because they dont have the evidence of that at all. Mostly they have the same thing that many theories have, which is just wide-eyed disbelief upon discovering something about the way the world already worked, that was already publicly acknowledged long ago, and then making a huge leap while sloppily joining dots. That sort of dot joining is usually rubbish, and when the dots consist of extremely technical papers and data, I expect to see plenty of unscientific humbug and conclusions that are well wide of the mark. I keep an open mind to the actual possibilities, but not the narratives built on imagined smoking guns that are nothing of the sort.

 

[elbows]

I was going to say probably not in Wuhan. But Wuhan does in fact have a level 4 virology lab, so conspiracy-theorise away...

(I'm sure that's been mentioned somewhere, dunno how I missed that)

e2a: ah yeah, early on there were various conspiracy theories weren't there? Just being forgetful.

Unfortunately I believe some of those theories must have gained traction recently. I've done a great job of utterly avoiding them myself, but I keep seeing mainstream responses to them, and I find it very easy to imagine what the theories are.

Its also easy to imagine that Marty1 has read some but knows we will take a massive shit on his source if he reveals it, hence this roundabout way of bringing it up via some of their 'evidence' rather than the actual conspiracy articles/sites.

 

[elbows]

Still I might have had a direct look at some of the theories if I thought any of them were likely to be well balanced or suitably tentative, or if I was lacking faith in the natural explanations.

But frankly there is likely to be so much discovered about natural animal reservoirs of coronaviruses that are quite similar to the one thats caused this outbreak in humans, that I would rather spend any time I have for the subject on that stuff for now.

For example I just saw this, which I havent read properly yet, but sounds like it certainly builds on the pangolin picture.

By the way SARS-CoV-2 is one of the names for the virus in the current outbreak (its the disease in humans thats been called Covid-19, not the actual virus) but there are still disputes about what the virus name should be. But since SARS-CoV-2 is what its referred to as in this tweet, I had to mention this.

 

[elbows]

From the 'trying to turn an overreaction into a useful message' department...

FUKUOKA -- A train in this southwestern Japan city was delayed by several minutes on the evening of Feb. 18, after a passenger hit an emergency button because someone else was coughing without wearing a mask.

A transportation bureau representative commented, "We'd like to ask people to refrain from pushing the emergency notification button just because there is someone without a mask. We're calling on passengers to show proper manners when they cough, and want to publicize this more."

Man hits emergency button on train in Japan after passenger coughs without mask - The Mainichi

FUKUOKA -- A train in this southwestern Japan city was delayed by several minutes on the evening of Feb. 18, after a passenger hit an emergency button

mainichi.jp

 

[Yossarian]

"Uh-oh, somebody is coughing without a mask on this train, I'd better hit the emergency button so the train can stop and we can all spend a few more minutes with his droplets."

 

[sihhi]

I recommend NYT journalist Farnaz Fassihi on Iran

Brother of dead coronavirus patient in Qom is a member of Iran's central medical committee. He disputes government account, says his brother was 60, not elderly & had no existing health issues, caught the virus in the streets of Qom. He accuses officials of "cover up."

Several more suspected coronavirus cases reported in other cities in Iran. Tehran shut down a potentially contaminated subway station in downtown & Isfahan disinfecting subway stations.

 

[elbows]

The implications seem broadly in line with what was suspected via anecdotal evidence and previous data. So there isnt much point me keep saying 'this makes containment harder' because I think we were already working with these assumptions. Still worthy of putting this detail on the record though I think.

Our analysis suggests that the viral nucleic acid shedding pattern of patients infected with SARS-CoV-2 resembles that of patients with influenza and appears different from that seen in patients infected with SARS-CoV. The viral load that was detected in the asymptomatic patient was similar to that in the symptomatic patients, which suggests the transmission potential of asymptomatic or minimally symptomatic patients. These findings are in concordance with reports that transmission may occur early in the course of infection and suggest that case detection and isolation may require strategies different from those required for the control of SARS-CoV. How SARS-CoV-2 viral load correlates with culturable virus needs to be determined. Identification of patients with few or no symptoms and with modest levels of detectable viral RNA in the oropharynx for at least 5 days suggests that we need better data to determine transmission dynamics and inform our screening practices.

 

[sihhi]

"Uh-oh, somebody is coughing without a mask on this train, I'd better hit the emergency button so the train can stop and we can all spend a few more minutes with his droplets."

I imagine the alarm ringer's aim was to reinforce the main message the government have been stressing:

Japan PM Abe urges people with cold-like symptoms to avoid work, school

Prime Minister Shinzo Abe has advised people across the country not to go to work or school if they develop cold-like symptoms, as the country grapples with the spread of a new coronavirus originating in China.

english.kyodonews.net

 

[Yossarian]

Hong Kong's health secretary, meanwhile, should probably have worn a different outfit to a press conference on virus control efforts...

 

[elbows]

Seems rather appropriate to me, and probably did to her too.

 

[elbows]

I recommend NYT journalist Farnaz Fassihi on Iran

Brother of dead coronavirus patient in Qom is a member of Iran's central medical committee. He disputes government account, says his brother was 60, not elderly & had no existing health issues, caught the virus in the streets of Qom. He accuses officials of "cover up."

Really I hope not to have to use her as my main Iran source, and anyway her source for that particular piece of news was the Farsi version of radio Farda (US-funded).

Anyway I looked into this because 'Iran's central medical committee' was too vague for my tastes.

Via the original article, I am left with a reason to believe that it might be the Islamic Association of Iranian Medical Society that is being referred to. And according to wikipedia that is an Iranian reformist political party.

Islamic Association of Iranian Medical Society - Wikipedia

en.wikipedia.org

«منبع انتقال کرونا در ایران هنوز مشخص نیست»، شناسایی مورد مشکوک در مترو شوش

یک عضو شورای مرکزی انجمن اسلامی جامعه پزشکی ایران که برادر خود را در قم بر اثر ابتلا به ویروس کرونا از دست داده است از تلاش مقام‌های بیمارستانی برای «خاموش نگاه داشتن» موارد این بیماری انتقاد کرد و از مرگ «ده‌ها» نفر در قم با علائمی مشابه وی خبر داد.

www.radiofarda.com

I dont have any farsi skills to confirm this properly myself, I had to rely on her telling someone the source on twitter, then machine translation to point me in the right direction. And then I just looked for stuff that looked the same to me visually in the first proper line of that article, and the name as shown on wikipedia, and they looked rather similar to me.

 

[elbows]

Still a useful source for finding out what stuff I need to find more out about elsewhere though, so thanks for the tip!

For example I learnt that Iran has elections tomorrow