Covid-19

[xu82]

The issue isnt that we dont have tests for everyone (anyone who says that is the issue is wrong) it is that we dont even have tests for everyone that has been confirmed to be in contact with those who have confirmed diagnosis including healthcare workers. The US was incredibly slow and bungled at the very least the test kits part.

This seems undeniable.

[Lloyd Braun]

Here's what Harvard's Medical Department had to say about it, I haven't read it, but I have a feeling if you read it, it'll basically be saying the same things I have: https://www.health.harvard.edu/blog/...-2020022719004

This link is mostly “old” data that is in all common terms. Which is fine and has value... There are some interesting tidbits coming out in the medical community regarding treatments and vaccination. The time to make a vaccine is actually only a few weeks away but the virus is supposedly mutating too rapidly for it to be effective. There is evidence of several medications being effective against this strain of coronavirus, one of which is chloroquine. This is a widely available medication in the US. Other antivirals that are likely effective may be less available. The Chinese have done a lot of research on this outbreak and for what it’s worth, have contributed a lot of data to the research community.

I do agree that mortality rates are poorly reported for many reasons. Further, there are likely hundreds (at minimum probably thousands) of undiagnosed cases that people survived. The WHO tries to factor those in but it is impossible to do so accurately. When it’s all said and done it will likely vary by country. Strangely enough Germany has a very good reported mortality rate thus far FWIW.

[scoscox]

Strangely enough Germany has a very good reported mortality rate thus far FWIW.

good news for midwesterners

[scoscox]

So, I guess doctor knowledge would come in handy, here are some actual facts about the Coronavirus and you guys can determine from there how you guys want to handle it:

- We've known about Coronavirus being a thing for a lot of years, it just happens this particular strain is a little more potent. The strain changes its genetic composition, which basically means a vaccine for the thing is pretty damn hard to generate due to phases of a clinical trial you have to go through in order to have anything approved in the first place. Coronavirus is the virus responsible for SARS (South Asian Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) that were prevalent however many years ago.

- For most people, this is NOT a deadly virus, and will produce mild flu-like symptoms. The people most at risk are the ones that are elderly and young children who have poor immune systems. Obviously anybody who is immunocompromised (ie cancer, HIV, autoimmune diseases like lupus, etc.) fall in that category as well. The fatality rate for this virus is actually around 2%, which is chance due to chance alone. The risk increases to 10% with a risk factor (ie smoking, diabetes, etc. or any of the conditions above), and 20% with two risk factors. The influenza virus that happens every winter actually has a higher case fatality rate. However, this is where the problem lies, as most people who have it, aren't debilitated by it, and go out into public and end up infecting people.

- The virus is transmitted via respiratory droplets, which means talking, coughing, etc. all those things can easily transmit the virus. The virus also isn't like other viruses where warm weather kills it off, it general does alright in warm weather. The best way to prevent transmission is to practice good hand washing skills. If you get a mask, just know that the mask doesn't really protect you, it protects other people from you more than anything. Also make sure you are wearing the mask properly if you do (or buy stock in 3M who's prices rise a lot during outbreaks, look at the pricing of 3M during the last epidemic of the Swine Flu for example). Don't touch your face, all that good stuff.

Ultimately I would say the severity should be a little above non-chalant, but now as crazy as people are making it out to be. Yes, it is associated with risks, but all viruses are associated with risks. If you fall under the categories above take special precaution, but if you're a young, healthy, human with not a lot of risk factors, even getting this virus wouldn't be that big of a deal. You should definitely avoid going into public if you are feeling sick, as the self-quarantine rules are in place to try to kill off the spread of it. Ultimately, this carries no higher risk than getting the seasonal flu, nor does it cause more deaths than getting the seasonal flu. Practice good sanitation habits, but don't be afraid to carry out your day to day activities.

Everything I've heard about the outbreak so far reports that children have been uniquely unaffected by this

[GIMMFD]

This link is mostly “old” data that is in all common terms. Which is fine and has value... There are some interesting tidbits coming out in the medical community regarding treatments and vaccination. The time to make a vaccine is actually only a few weeks away but the virus is supposedly mutating too rapidly for it to be effective. There is evidence of several medications being effective against this strain of coronavirus, one of which is chloroquine. This is a widely available medication in the US. Other antivirals that are likely effective may be less available. The Chinese have done a lot of research on this outbreak and for what it’s worth, have contributed a lot of data to the research community.

I do agree that mortality rates are poorly reported for many reasons. Further, there are likely hundreds (at minimum probably thousands) of undiagnosed cases that people survived. The WHO tries to factor those in but it is impossible to do so accurately. When it’s all said and done it will likely vary by country. Strangely enough Germany has a very good reported mortality rate thus far FWIW.

Ah, I figured it would have some decent information, someone sent it along to me, I just hadn't had a chance to look through it. My apologies! The problem with vaccines are that, the virus does mutate very quickly, basically the virus is a single-stranded RNA, positive sense, helical capsid, and enveloped. So to break that down a little bit, basically a positive sense RNA virus is very similar to mRNA, mRNA is basically the genetic code that gets translated into proteins in you body, which proteins obviously have a vast variety of functions. Because of that it means that human hosts immediately translate this into protein. Now, the capsid is like a shell almost for the virus, and enveloped means that the capsid is coated with fats, this is also acquired by the host. This basically ends up protecting the genetic make up of the virus and allows for it to communicate with hosts. The protection is very strong, it protects it from stuff like radiation, acids, temperature, etc. Then, we gotta understand that RNA viruses mutate more than DNA viruses, and this is because RNA viruses kind of lack a "proof-reading" function that DNA viruses do. That's the whole basis of how the viruses is changing itself. The timing is sensitive, and it's the regulation more of having to do clinical trials, which is necessary to assess side effects, efficacy, etc. It's just really hard to try to streamline that process to make an effective vaccine.

I did see the reports out on Chloroquine seeming to be pretty effective. It's undergoing the clinical trial phase for Coronavirus actually. This is a basically a drug used to treat Malaria. The way it works for Coronavirus is a little bit different than what it does for Malaria. It basically goes into one type of your cells, makes that environment more basic, and then interferes with another process that allows for the virus to get into your cells. Chloroquine is actually a pretty relatively safe drug, so I could see that becoming one of treatments moving forward. The other drug they researched that seemed to be effective was the anti-viral Remdesivir, which was seen as promising for SARS/MERS, and is clinical development for treatment of Ebola. I have think that one may be a little tougher to get in the United States, so this is true. I still do think that these treatments will be held off unless it's for severe cases, with the typical treatment being still the quarantine and letting your immune system fight off against it however. Sorry for all the medical jargon, hopefully I simplified it well enough to be followed, because I do think us as the medical community are very bad at communicating in ways that people can understand, and that can lead to fears.

Yup, that's the thing, it's incredible difficult to try to follow up with recovery cases, not to mention the amount of people who might have had it, mistaken it for the common flu, and never went to go get it checked out. It's definitely something I think people should be weary about, but I definitely think a lot of the fear is from not exactly knowing what's going on about the virus, and what it's characteristics and stuff are. Ultimately, we don't know everything about this virus, but we do know the general characteristics of Coronavirus to be able to help communicate and hopefully negate some of the worries. Obviously if there's any questions by anybody here, I'm more than happy to try to simplify it a bit more and make some analogies that will make sense! I also want to express I'm in no way trying to be combative or anything, in case any of this comes off as arrogant or what not. Just enjoy a good discussion about medicine from time to time!

[smileyy]

I suspect that the actual number of infected is 100-1000x larger than the number being reported.

[scoscox]

https://twitter.com/normmacdonald/st...37479674281984

the current media-centric debate of whether or not it's appropriate to label the virus with its country of origin made me think of this norm tweet

[xubrew]

Ah, I figured it would have some decent information, someone sent it along to me, I just hadn't had a chance to look through it. My apologies! The problem with vaccines are that, the virus does mutate very quickly, basically the virus is a single-stranded RNA, positive sense, helical capsid, and enveloped. So to break that down a little bit, basically a positive sense RNA virus is very similar to mRNA, mRNA is basically the genetic code that gets translated into proteins in you body, which proteins obviously have a vast variety of functions. Because of that it means that human hosts immediately translate this into protein. Now, the capsid is like a shell almost for the virus, and enveloped means that the capsid is coated with fats, this is also acquired by the host. This basically ends up protecting the genetic make up of the virus and allows for it to communicate with hosts. The protection is very strong, it protects it from stuff like radiation, acids, temperature, etc. Then, we gotta understand that RNA viruses mutate more than DNA viruses, and this is because RNA viruses kind of lack a "proof-reading" function that DNA viruses do. That's the whole basis of how the viruses is changing itself. The timing is sensitive, and it's the regulation more of having to do clinical trials, which is necessary to assess side effects, efficacy, etc. It's just really hard to try to streamline that process to make an effective vaccine.

I did see the reports out on Chloroquine seeming to be pretty effective. It's undergoing the clinical trial phase for Coronavirus actually. This is a basically a drug used to treat Malaria. The way it works for Coronavirus is a little bit different than what it does for Malaria. It basically goes into one type of your cells, makes that environment more basic, and then interferes with another process that allows for the virus to get into your cells. Chloroquine is actually a pretty relatively safe drug, so I could see that becoming one of treatments moving forward. The other drug they researched that seemed to be effective was the anti-viral Remdesivir, which was seen as promising for SARS/MERS, and is clinical development for treatment of Ebola. I have think that one may be a little tougher to get in the United States, so this is true. I still do think that these treatments will be held off unless it's for severe cases, with the typical treatment being still the quarantine and letting your immune system fight off against it however. Sorry for all the medical jargon, hopefully I simplified it well enough to be followed, because I do think us as the medical community are very bad at communicating in ways that people can understand, and that can lead to fears.

Yup, that's the thing, it's incredible difficult to try to follow up with recovery cases, not to mention the amount of people who might have had it, mistaken it for the common flu, and never went to go get it checked out. It's definitely something I think people should be weary about, but I definitely think a lot of the fear is from not exactly knowing what's going on about the virus, and what it's characteristics and stuff are. Ultimately, we don't know everything about this virus, but we do know the general characteristics of Coronavirus to be able to help communicate and hopefully negate some of the worries. Obviously if there's any questions by anybody here, I'm more than happy to try to simplify it a bit more and make some analogies that will make sense! I also want to express I'm in no way trying to be combative or anything, in case any of this comes off as arrogant or what not. Just enjoy a good discussion about medicine from time to time!

Really appreciate your insight and all this information.

I know these are loaded questions, but do you feel there are things that aren’t being done that should be done? And do you feel that there is anything being done that really doesn’t matter or help?

Are we better prepared now than we were for the swine flu/H1N1 outbreak ten years ago that I think ended up killing over 12,000 Americans?

[Lloyd Braun]

My opinion: we are not better prepared for this because we do not have adequate testing in the community. Every state has testing but it is a complicated process to have an individual tested. I believe there are only 75 or so labs currently able to test. Symptoms are fairly mild for most people, so they will not likely go to the ER for this, they will end up at their doctors office or urgent care/minute clinic. This will lead to more rapid transmission in the community. The screening questions for identifying someone at risk (recent travel or contact with someone who traveled) are essentially out of date everyday as more communities have diagnosed illness. If you have any question on whether we are prepared or not, call your local doctor’s office and ask if they can test for it. The answer is likely no, which is frankly unacceptable at this point.

[SemajParlor]

Serious question - is anyone actually concerned about the status of the NCAAT ?

I have gone back and forth some days thinking this will get uncontrollably bad, some days thinking this is the twitter / freakout generation.

I will humbly say , I don't know what is going to happen in the next 1-2 months, which I think for a lot of people adds to the panic.