COVID-19 Coronavirus Containment Efforts

[morrobay]

There must be a large number of uncounted cases in most countries - in any case. We have estimates in the UK that up to 7% (5 million people) may have had the virus, going by random antibody tests etc.

If this is true and we have 40,000-50,000 deaths from COVID-19, that puts the mortality rate at about 1%. And, obviously, if the 0.4% is true, then we must have had more like 12.5 million cases in the UK.Who knows what's really going on here.

This answer to this question can only be expected after very widespread public antibody tests. Maybe 80% of any given population.

 

[mfb]

My question is more directed at informing the public instead of confusing the public.
I would write the headline for the TV news as follows.

110 Thousand Dead, 500 Thousand Recovered, 24 Million Infected

Failure to do so feeds the feeling that the real facts are concealed from us. It breeds conspiracy theories.

The 500,000 recovered only include former confirmed cases. The 24 million is an estimate about the total number of people who got infected at some point, most of them recovered by now.
There is just one metric we can measure reliably: If you get the disease and get tested positively, what is your chance to die? But even that needs care because deaths come faster than recoveries, so we can only include cases that were confirmed a while ago, not recent cases.

The one open case in New Zealand recovered. They now have zero known cases, with the last new case 17 days ago.

 

[Astronuc]

Although the Centers for Disease Control and Prevention didn't confirm community spread in California until February 27, a recent CDC report found that the virus actually began to spread in the country between January 18 and February 9. The US's first Coronavirus death, California autopsies have shown, happened weeks earlier than we originally thought. In Florida, at least 170 people who were later confirmed to have COVID-19 first reported their symptoms from December 31 to February 29, according to the https://www.miamiherald.com/news/state/florida/article242480931.html.

https://news.yahoo.com/coronavirus-likely-us-anyone-knew-115200361.html

US testing, meanwhile, lagged behind. Labs across the country didn't have functioning test kits until late February, more than a month after the Washington state case was confirmed. By March 15, the country had tested just 39,332 people, according to the Covid Tracking Project. South Korea, meanwhile, had tested more than 268,000 by then.

 

[kyphysics]

VACCINATION QUESTION:
Here' a weird question. Suppose we get an effective vaccine.

Joe - an 80 year old - goes to the doctor's office to get the vaccine. While waiting in the lobby, he catches COVID-19 from Sarah, who is waiting there to see her doctor for a separate reason.

Joe sees his doctor 45 minutes later and gets a vaccine (after he's caught COVID-19 from Sarah). Would a vaccine work if someone has caught COVID-19 already?

You can play around with the time intervals. Suppose Joe gets COVID-19 1...2...3 days prior to his vaccine appointment date/time.

 

[BillTre]

I believe that you can get a rabies immunization after getting bit by a rabid dog.
However, I would expect that these kinds of things would vary from disease to disease.
It could also vary among different people due to variations in their immune systems and how quikly they might react.

 

[kadiot]

Is it true that Singapore abandons PCR as criteria for releasing COVID-19 patients? Why? How about the rest of the world?

 

[Rive]

Would a vaccine work if someone has caught COVID-19 already?

Likely NO. On the 'natural' way to develop immunity would take ~ two weeks (the minimal length of the illness, starting from infection): likely the vaccine would do it within a comparable timeframe. On the other hand, the usual delay between infection and illness is just 3-5 days, but two weeks at most (not exactly clear due the asymptotic cases). So that Joe needs some unusual luck for the vaccine winning the race.

Rabies is a different story. The long incubation period (1-3 months) makes successful vaccination after exposure possible.

Is it true that Singapore abandons PCR as criteria for releasing COVID-19 patients? Why?

It was a news somewhere that PCR tends to provide false positive result even after the illness ended and the patient no longer infectious.

Looks like PCR is too sensitive and might 'fire' on dead (zombie, if you like ) viruses too.

 

[bhobba]

2 Billion doses of Oxford vaccine ready to go by September:
https://fit.thequint.com/coronaviru...-out-2-billion-covid-19-vaccine-doses-by-sept

Fingers crossed it passes phase 3 trials. I read where phase 2 trials were not as good as first hoped - some experts only give it 50-50 - but if it does work what an accomplishment.

UQ's vaccine to start human trials soon - if it shows as much promise as pre-clinical trials suggest (it gave greater immunity than those recovered from the virus) it too will have production ramped up.

Thanks
Bill

 

[mfb]

50/50 for a vaccine candidate is a really promising outlook if it didn't demonstrate benefits yet. 2 billion doses in September would be amazing.

New Zealand will remove all remaining internal restrictions today. The borders will stay closed to most international travel.
http://web.archive.org/web/20200608...-ardern-reveals-move-to-level-1-from-midnight

Countries started looking at "travel bubbles", especially in east Asia: Groups of countries with unrestricted travel between them, potentially with mandatory tests but without longer quarantine. China and South Korea have such an agreement. New Zealand and Australia was discussed before, but we'll see if that happens with NZ beating the virus and Australia still having new cases. Singapore is a candidate for agreements. Japan and Hawaii are interested in that approach, too.
The Schengen area countries opened many of their internal borders again.

 

[bhobba]

50/50 for a vaccine candidate is a really promising outlook if it didn't demonstrate benefits yet. 2 billion doses in September would be amazing.

Just watching a documentary on the Spanish Flu now. We have made enormous progress since then, but if we have 2 billion doses by September, and it works, that shows just what can be done when an all out effort is made using modern technology.

Thanks
Bill

 

[bhobba]

and Australia still having new cases.

Like the US we are having Black Lives Matter protests with 30,000 or more in close contact. People, including myself, are really worried it may get into Aboriginal communities (so far it hasn't) because if it does it's thought to be like it gets into nursing homes with a tragecly high death rate.

If not then I think a travel bubble with NZ quite likely.

Thanks
Bill

 

[bhobba]

Just after the documentary on the Spanish Flu there is one on the CEPI effort funded by Bill Gates. All are literally working 24/7 because they know its importance. To me it's humbling.

Thanks
Bill

 

[Vanadium 50]

People, including myself, are really worried it may get into Aboriginal communities (so far it hasn't) because if it does it's thought to be like it gets into nursing homes with a tragecly high death rate.

Why would the Aboriginal death rate be comparable to the death rate for the extreme elderly?

 

[bhobba]

Why would the Aboriginal death rate be comparable to the death rate for the extreme elderly?

They have very high rates of co-morbid conditions like Diabeties, Renal failure etc and are in constant contact within those communities:
https://www.bbc.com/news/world-australia-51971891

Thanks
Bill

 

[bhobba]

Joe sees his doctor 45 minutes later and gets a vaccine (after he's caught COVID-19 from Sarah). Would a vaccine work if someone has caught COVID-19 already? You can play around with the time intervals. Suppose Joe gets COVID-19 1...2...3 days prior to his vaccine appointment date/time.

I think in the developed countries they know that one from testing. What would probably be done is you go to a doctor/vaccination centre in your car where you park. A nurse or doctor comes out and gives you the vaccine in the car with the person giving the vaccine in protective gear to protect both people.

Thanks
Bill

 

[Vanadium 50]

They have very high rates of comorbid conditions like Diabeties, Renal failure etc:

But they have very low rates (edit I mean "fractions") of extreme elderly. (Which is another problem, but not this problem). The 80+ fraction, the people most at risk, is 0.6%, compared to 4% for Australians as a whole.

That population skews very young: if you apply the Massachusetts ratios to the Aboriginal population, you get a fatality rate of about one-fifth that of Massachusetts. You are correct that the prevalence of comorbidities is 2-3 times higher, but even if it's a factor of 5 and all fatalities are the results of comorbidities, that just gets you to the general population.

To get to nursing home rates, you need more like a factor of 100.

 

[bhobba]

To get to nursing home rates, you need more like a factor of 100.

Yes - the analogy in that sense is not good.

Thanks
Bill

 

[nsaspook]

50/50 for a vaccine candidate is a really promising outlook if it didn't demonstrate benefits yet. 2 billion doses in September would be amazing.

New Zealand will remove all remaining internal restrictions today. The borders will stay closed to most international travel.
http://web.archive.org/web/20200608...-ardern-reveals-move-to-level-1-from-midnight

Countries started looking at "travel bubbles", especially in east Asia: Groups of countries with unrestricted travel between them, potentially with mandatory tests but without longer quarantine. China and South Korea have such an agreement. New Zealand and Australia was discussed before, but we'll see if that happens with NZ beating the virus and Australia still having new cases. Singapore is a candidate for agreements. Japan and Hawaii are interested in that approach, too.
The Schengen area countries opened many of their internal borders again.

How many asymptomatic carriers and cases are estimated to be in NZ?

https://www.abc.net.au/news/2020-06-08/coronavirus-update-world-reaches-400000-virus-deaths/12331358

At least half of Singapore's newly discovered Coronavirus cases have shown no symptoms, one of the leaders of the Government's virus task force said.

Singapore has one of the highest infection tallies in Asia, with more than 38,000 cases, because of mass outbreaks in dormitories for its migrant workers.

It has been easing restrictions very gradually, and had reopened schools and some businesses last week after a two-month lockdown.

"Based on our experience, for every symptomatic case you would have at least one asymptomatic case," task force leader Lawrence Wong said.

 

[mfb]

One or two asymptomatic cases would be easy to miss, but they won't stay contagious for that long. You would need a group of many people, infecting each other over time, but all asymptomatic or at least without diagnosis, to have the virus survive that long.

 

[nsaspook]

https://www.cnbc.com/2020/06/08/asy...-arent-spreading-new-infections-who-says.html

Preliminary evidence from the earliest outbreaks indicated that the virus could spread from person-to-person contact, even if the carrier didn’t have symptoms. But WHO officials now say that while asymptomatic spread can occur, it is not the main way it’s being transmitted.

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” Dr. Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, said at a news briefing from the United Nations agency’s Geneva headquarters. “It’s very rare.”

That's good news.

 

[fresh_42]

 

[BillTre]

View attachment 264377

I have strong allergies to pollen right now.
This is how I think of the world, except these would be pollen grains rather than viruses.

 

[ChemAir]

I have strong allergies to pollen right now.
This is how I think of the world, except these would be pollen grains rather than viruses.

I try not to view it this way, but sometimes, my sinuses believe otherwise.

 

[bob012345]

https://www.cnbc.com/2020/06/08/asy...-arent-spreading-new-infections-who-says.html
That's good news.

Gee, that would have been useful information before the lockdowns and 30 million people lost their jobs...

 

[bob012345]

View attachment 264377

If you could see the virus would you still go out? For sure, I'd just walk around it.

 

[atyy]

https://www.cnbc.com/2020/06/08/asy...-arent-spreading-new-infections-who-says.html

https://www.cnbc.com/2020/06/09/who...coronavirus-spread-much-is-still-unknown.html

The WHO has clarified its remarks - both of these points were in the original remarks but not widely reported.
- The WHO is using [standard] technical terminology in which "asymptomatic" refers to people who are infected but never have any symptoms, not even mild ones. Asymptomatic people are distinguished from pre-symptomatic people who later develop symptoms.
- The estimates that asymptomatic transmission is rare is preliminary, based on a few studies, and more data is needed.

Gee, that would have been useful information before the lockdowns and 30 million people lost their jobs...

The WHO's report (Feb 28) on data from China stated "Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission."

Apart from the uncertainties in that conclusion, that initial estimate was made with most of China in lockdown-like conditions, so it was not clear whether it would apply more broadly.

The experiences of South Korea, Japan, Taiwan, Hong Kong, Singapore in the early phase did suggest that testing and tracing with social distancing without a lockdown could acceptably manage the spread of the disease, although some of those did later have semi-lockdowns.

 

[nsaspook]

https://www.cnbc.com/2020/06/09/who...coronavirus-spread-much-is-still-unknown.html

The WHO has clarified its remarks - both of these points were in the original remarks but not widely reported.
- The WHO is using [standard] technical terminology in which "asymptomatic" refers to people who are infected but never have any symptoms, not even mild ones. Asymptomatic people are distinguished from pre-symptomatic people who later develop symptoms.
- The estimates that asymptomatic transmission is rare is preliminary, based on a few studies, and more data is needed.

She was pretty specific that tracking and controlling symptomatic carriers should be the highest priority so I understood her remarks to be mainly about how contact tracing resources should be used when asymptomatic people are identified during a tracing.

 

[atyy]

She was pretty specific that tracking and controlling symptomatic carriers should be the highest priority so I understood her remarks to be mainly about how contact tracing resources should be used when asymptomatic people are identified during a tracing.

Yes. The contact tracing strategy in Singapore focuses on symptomatic cases for tracing, because those are the cases that can in practice be identify by testing - given that there are not enough resources for testing everyone, typical policies only test symptomatic people (more recently, also asymptomatic people in high risk groups), of which only a fraction will have COVID-19. However, one can then isolate close contacts of a positive case for 14 days (approx maximum incubation period). Some of the close contacts will be symptomatic, while others may be pre-symptomatic or asymptomatic. In this way, although one does not generally test asymptomatic cases, some fraction of asymptomatic cases can be prevented from spreading the infection while they are in isolation. However, there is not a need to test a close contacts under isolation until they develop symptoms. If there were a lot of asymptomatic transmission, rather than being mostly symptomatic transmission, this strategy would not work (the early phase of Singapore's outbreak suggests that it worked).

 

[Astronuc]

Coronavirus Cases Are Rising in 20 U.S. States, With Sharp Spikes in Arizona, North Carolina and California
https://www.newsweek.com/coronaviru...kes-arizona-north-carolina-california-1509382

Updated data from The New York Times showed on Monday that health officials in 20 U.S. states have confirmed rising case counts over the past seven days, with sharp spikes reported in North Carolina, Arizona and California. All three states, like most others in the U.S., have recently begun to reopen.

North Carolina saw its highest single-day increase in cases on June 6, with 1,370 new diagnoses confirmed. In a press release, the state's Department of Health and Human Services said the number of individuals testing positive for the virus increased by 10 percent, while related hospital admission rates exceeded 700 for three of the previous five days.

Forbes reports 21 states are experiencing increases in Covid-19 cases. Of course testing is up, but apparently so are new infections. Hospitalizations are increasing in some areas.
https://www.forbes.com/sites/tommyb...rnia-arizona-and-north-carolina/#6a575aeb6d5e

Texas Department of State Health Services figures show 1,935 people were admitted as hospital patients for coronavirus-related treatment. That is up from a previous record of 1,888 on May 5.

https://www.npr.org/sections/corona...ng-covid-19-hospitalizations-as-state-reopens

Highest level of cases are in counties with metropolitan areas:
https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83
Harris County, 4.713 million (Houston, 2.326 million) 14918
Dallas County, 2.636 million (Dallas, 1.345 million) 12347
Tarrant County, 2.103 million (Fort Worth, 895008) 6369
Travis County, 1.274 million (Austin, 964254) 3512
El Paso County, 720403 (El Paso, 682669) 3333
Bexar County, 2.004 million (San Antonio, 1.493 million) 2763
Potter County, 117415 (Amarillo, 199924) 2763
Randall County, 137713 (Amarillo) 737

Nearby counties have higher levels of cases than counties further away from metro areas.
Positive Covid-19 cases, 77253, with 1853 fatalities
Fatalities in Dallas 264, and in Houston 262. Houston has almost twice the population of Dallas.

 

[nsaspook]

As least in Oregon the large increase was from one location, not a general population increase.
https://www.kptv.com/news/oha-spike-in-covid-19-cases-due-to-handful-of-outbreaks/article_996230bc-a9ef-11ea-837a-57853006c04c.html

OHA reported https://www.kptv.com/news/oregon-health-authority-reports-146-new-covid-19-cases-highest-daily-count-since-pandemic-began/article_2a9ad22a-a8f9-11ea-ab64-2f45915ea9bc.html in Oregon on Sunday.

OHA says that increase in cases is in part due to an outbreak at Pacific Seafood. OHA says there were 124 confirmed cases there. OHA says 95 percent of the people who were tested at Pacific Seafood were asymptomatic.

https://www.kptv.com/news/oregon-health-authority-reports-146-new-covid-19-cases-highest-daily-count-since-pandemic-began/article_2a9ad22a-a8f9-11ea-ab64-2f45915ea9bc.html

Pacific Seafood says they tested 376 workers at their Newport facilities and found 124 cases. The vast majority, 95 percent, did not report any symptoms and none of their workers have been hospitalized, according to the company. They have since suspended production at all five sites in Newport.

Health officials are working with the business to address the outbreak and protect workers’ health. The risk to the general public is considered low.

 

[bhobba]

Gee, that would have been useful information before the lockdowns and 30 million people lost their jobs...

There is a lot we are still finding out about this disease. First we had evidence from California there was a lot of asymptomatic cases and that's how it got into the population then became difficult to control. This also reduced the death rate because it was thought the number of actual cases was much higher - from what I read I thought it was about .2% which is like a bad flu season where they got the circulating strain totally wrong in the vaccine. But that turned out to be wrong - I don't think we still know the true death rate even now, but my sense now is about between .5 to 1% - here in Aus it's actually a bit higher than that at about 1.5% and we do a lot of testing.

The new thing they are talking about here in Aus where even in winter we still get a good amount of sunshine is can this virus survive in sunshine. The thinking is no. That being the case this isolation stuff may not be as effective as first thought, if you do your interactions outside eg instead of shutting down restaurants allow outside eating areas to remain open.

Thanks
Bill

 

[bhobba]

As least in Oregon the large increase was from one location, not a general population increase.

As we get better control of this thing spot outbreaks which we hopefully clamp down on quickly will I think become more common. The whole of Australia had no cases for the first time yesterday. But we have increased testing even above the large amount we were doing. You want to see a doctor about anything and you have any Covid symptoms you can't see the doctor until you have had the Covid test. But thankfully they have now really reduced the time - it only took a day for my sister who had a bad cough - it was negative. Officially they say 1-5 days but I think that is somewhat pessimistic. She drove to where they had the testing centre, remained in the car, they took the swab, so the actual test was done without the wait of taking the sample to the laboratory.

Thanks
Bill

 

[anorlunda]

The WHO's report (Feb 28) on data from China stated "Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease.

Meanwhile on 6/9/2020 ABC News Report, they reduced that to simply, "yes asymptomatic transmission can occur." It is yet another case where the news is factually correct, but it leads the public to believe that the news is edited to serve an agenda.

 

[Astronuc]

I received an email from a colleague this morning that a neighbor has tested positive for Covid-19. The neighbor has a fever and other symptoms. The neighbor claims to have limited contact with the outside world since March, yet likely he/she goes shopping for necessities. Also, the neighbor has no idea where he/she was exposed.

A week ago, a friend and colleague disclosed that he might be exposed to Coronavirus after interaction with some friends from his church. Two of his friends began to show symptoms and subsequently tested positive. Neither friend knows how they were exposed.

These are examples of community spread, which is ongoing. Too many folks do not wear a face covering (mask) in public, nor are they careful in social distancing.

In order to safely re-open an economy, folks must wear masks and observe some reasonable distancing to prevent/mitigate person-to-person transmission.

 

[nsaspook]

While I agree we must wear masks the necessities of living in summer weather will require modifications to 100% coverage.

https://pittsburgh.cbslocal.com/202...ia-hot-weather-complicates-face-mask-wearing/