Coronavirus - Health aspects

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How did the virus get aboard the Diamond Princess? Did it make a port call, or one of the passengers board from China? Wuhan is landlocked...

I thought it came about because a previous passenger was later found to be infected with the virus. He had left the ship early.

I see Rewahoo quoted the relevant info.
 
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That resonated with me too, and one has to wonder if 'hiding' (in its various forms), would/will be the slightest bit beneficial. (Although I wouldn't suggest rushing to the epicentre.)
That's front and center in my mind too. I think I will just 'live my life', only limiting my movement if there's an outbreak. I know that won't keep me perfectly safe from contracting the virus since the outbreaks happen two (or so) weeks after people have been spreading it. But my goal is to not to contract it when the facilities are overwhelmed. But I think getting it "out of the way early" might not be such a bad thing (of course not seeking it or going to the local epicenter). The benefit of getting it early would apply if you got it very, very early, I think, because once it hits a geography, I think it'll hit hard and fast. Optimally, I'd like to keep out of the morass and wait for the vaccine, but assuring that with certitude is nearly impossible unless we get a seasonal reduction in transmission rates.
 
Here's a plan. Go find one of the American passengers who was confirmed as infected but only had mild symptoms. That could mean that they had a slightly mutated and weaker form of the virus. Then hang out with them for a day or so and you'll catch it too. If all goes well, you'll also have mild symptoms but also build up some immunity against the more dangerous strains of the virus.

What could possibly go wrong?
 
Here's a plan. Go find one of the American passengers who was confirmed as infected but only had mild symptoms. That could mean that they had a slightly mutated and weaker form of the virus. Then hang out with them for a day or so and you'll catch it too. If all goes well, you'll also have mild symptoms but also build up some immunity against the more dangerous strains of the virus.



What could possibly go wrong?


Great plan. You go first. Right behind you.
 
The regular old flu just about did me in last year (and I had the vaccine and took Tamiflu) so what chance do I have against this new virus:confused:?
 
How does one person spread to 40 others because she went to a church service?

Unless the service was in a small cave or something?
 
So the cruise ship case zero timeline seems to be murky according to that article:

1) ship "set out on a 29-day voyage from Singapore to Yokohama on January 6"
2) "visited 14 ports total," somewhere during this
3) "he boarded the ship on January 20 in Yokohama before
4) disembarking five days later in Hong Kong" & tested positive -- did he debark due to illness? ie symptomatic? How long until he was tested?
5) ship continues on various ports of call until ("Along the way, the ship had stopped at 14 ports")
6) quarantined at port of Yokahama in Japan. "arriving at the Japanese city on February 3." - was the quarantine immediate or was the ship being serviced for some time prior to locking it down?
 
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How does one person spread to 40 others because she went to a church service?

Unless the service was in a small cave or something?

Remember, this stuff is highly contagious. Spreads easily and a church service probably means close quarters, hand shaking or similar contact, possibly communion, and more than likely someone sneezing or coughing.
 
Remember, this stuff is highly contagious. Spreads easily and a church service probably means close quarters, hand shaking or similar contact, possibly communion, and more than likely someone sneezing or coughing.

My understanding is that this religious group is more like a cult; they were denied a permit to build a larger structure because of it, and they have been gathering in a very small space for the services, so the situation could have been even worse than a regular church setting, as for the proximity to the other people.
 
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How does one person spread to 40 others because she went to a church service?

Unless the service was in a small cave or something?

I can easily envision it. In my church, there comes a time when you greet everyone around you, usually with a handshake and the words 'Peace be with you.' They do the same with everyone around them and so on and so on. That's a lot of direct contact. Also, there is always a cookie and cakes etc buffet at coffee hour in the attached hall after the service. It is quite crowded. This is the reason authorities in various places banned church services during the 1918 Spanish Flu pandemic.
 
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Communion?

The church at the center of the S Korea infection isn't some small congregation:

https://www.nbcnews.com/health/heal...-death-infections-linked-church-rise-n1139821

I can easily envision it. In my church, there comes a time when you greet everyone around you, usually with a handshake and the words 'Peace be with you.' They do the same with everyone around them and so on and so on. That's a lot of direct contact. Also, there is always a cookie and cakes etc buffet at coffee hour in the attached hall after the service. It is quite crowded. This is the reason authorities in various places banned church services during the 1918 Spanish Flu pandemic.
This makes sense. While 40 people sounds like a lot, if 1000 were exposed and there were multiple encounters, it could be much worse, and probably will.
 
....I can easily envision it. In my church, there comes a time when you greet everyone around you, usually with a handshake and the words 'Peace be with you.' They do the same with everyone around them and so on and so on. That's a lot of direct contact. Also, there is always a cookie and cakes etc buffet at coffee hour in the attached hall after the service. It is quite crowded. This is reason authorities in various places banned church services during the 1918 Spanish Flu pandemic.

That is the practice in the Episcopal Church.

Family story here: My maternal Grandmother told her kids that her first husband died from the 1918 Spanish Flu. After Grannie died my Mother happened to talk with a friend of her Mother. That woman said that Grannie was not widowed by the flu epidemic but her husband gambled away his worker's pay and committed suicide. Mom responded, "Saved Mom the bother." Grannie would have been happy not to explain why she wasn't attending church services.
 
That just means that nobody trusts what Japan did except for the Japanese government officials :whistle:

I wonder how much influence/control the local gov't had, as it seems it was a joint effort mostly directed by the cruise line.

Otherwise why were the cruise staff not quarantined like everyone else ?
Why were not nurses in full gear going room to room like in a hospital ?

Perhaps they should have turned away the ship and prevented it from docking, treating it like a plague ship in the 1500's ?
 
How did the virus get aboard the Diamond Princess? Did it make a port call, or one of the passengers board from China? Wuhan is landlocked...

While the exact source of the outbreak on the Diamond Princess is yet to be determined, it is suspected to be linked to a 80-year-old man from Hong Kong who had recently made a brief visit to mainland China.

The man boarded the ship on January 20 in Yokohama before disembarking five days later in Hong Kong, where he tested positive for the virus after seeking medical attention for symptoms including a cough.

https://www.scmp.com/week-asia/heal...virus-how-diamond-princess-cruise-ship-became

I thought it came about because a previous passenger was later found to be infected with the virus. He had left the ship early.

I see Rewahoo quoted the relevant info.


Yes. It started with a single 80-year-old man. He was onboard the ship for a 5-day leg. He got off in HK, and was found to be sick from the virus.

And that's when authorities said, "OMG, you shared the virus with other passengers on the ship too, who are still onboard". And he surely did.


Wuhan is certainly landlocked, but with travel nowadays, you can go from Wuhan to another continent in 24 hours. Doctors in Wuhan sounded the alarm way back on Dec 30. The above cruise passenger boarded the ship on Jan 20.
 
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The CDC updates their US Cases page 3 times a week - Mondays, Wednesdays and Fridays.

They've split out separately the people repatriated to the US via State Department chartered flights, and these folks are held in quarantine at various US military bases. 18 now from the Diamond Princess, and 3 from Wuhan.

Otherwise 14 cases from earlier. Looks like they've completed testing 414 people.

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

I'm still waiting to see if any more people test positive from Westerdam. It's been a few days, and no more reports.
 
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Not contained in China. Singapore looks like one big cruise ship. Cases spiking in S Korea and quarantines looming. Japanese cases starting to spike. Free international travel to the rest of the world from all of those places except China. Hard to imagine this will not spread all over the place.



Singapore is doing a fantastic job of tracing, detecting and treating. Check moh.gov.sg to see what China should be doing. It is probably the best place to be if you contract the virus in terns of quality of care. They have had no deaths and their rate of new infection is rapidly declining. We are in Singapore at the moment and they are taking rational precautions, masks if ill, checking temps, providing compensation if quarantined and making healthcare easily accessible.
 
A few things that need to be observed as of today. There appears to be no immunity whatsoever after recovering as there are now several cases who completely recovered and were infected again. This means a vaccine is very unlikely. SARS (which is very similar to COVID-19) been around since 2002 and there are candidate vaccines available that make it through animal trials. So, expecting a vaccine before it is out of control is very unlikely.

Incubation is now looking like it can be up to 28 days and patients who are aviremic (negative in the RT-PCR test) have developed disease 2 to 3 days after being released from quarantine yet the 14 day quarantine is still what is being imposed. Also, there is now very strong evidence of fecal transmission and likely food transmission. It is still very early and the disease is not yet well understood and that is even if it doesn't mutate again.

As we are seeing we have super-spreader events now in Iran, South Korea, and Italy and if this continues it will rapidly spread. It just takes a few to cause an exponential increase. Fever is not a good predictor yet all we have to screen air flights. At this point the genie is out of the bottle and due to a complete disregard for shutting down all international travel this is IMHO uncontainable. Estimates I have seen predict 44% of the world will be infected by 31 December. This is, of course, speculation but we are already seeing it spreading. The fatality rate seems to be consistent at around 2.5% which is perhaps the only good news unless you are older and have some medical pre-existing conditions that make you more susceptible. I note a good article I read about the ACE-2 receptor which is increased in smokers 10-fold. This is the receptor the virus uses to enter the cell and a good target for a vaccine and/or therapeutic. So, a smoker over the age of 75 with heart disease, COPD, or diabetes is at a much higher risk for adverse consequences. A very substantial group are asymptomatic. It can be a simple infection in most people.
 
^ I'm not medically intelligent - if developing a vaccine is very unlikely, how are people to survive this virus. Simply upon their own immune systems?

If the medical community is not able to cure it, how are they "treating" it? Or are the victims simply hospitalized as a quarantine measure left to fight it on their own?
 
Cats are susceptible to species specific corona viruses. They often show up in kittens as chronic upper respiratory infections. The weaker ones die, and the stronger ones may have low grade but chronic URI's for their entire lives. Symptoms may disappear entirely for years.

When they get older and their immune systems weaken, the dormant virus may reappear and mutate into a deadly form that causes FIP (feline infectious peritonitis). Her's an article on FIP.

https://www.vet.cornell.edu/departm...e-health-topics/feline-infectious-peritonitis.

This disease is fatal, although there is a recently developed treatment that is showing some promise.

One has to wonder whether human corona viruses are capable of going dormant than reappearing in mutated forms. My guess is we are about to find out.
 
Old m, thanks for the perspective. I have come to much the same conclusion. What is the eventual outcome here? Do we end up with another constantly mutating virus that ends up requiring an annual vaccine like influenza?
 
Best advice is to assume nothing, including assuming they can ever vaccinate against this.

This is just my humble opinion, but I think the reason Ebola was and is contained and this CoronaVirus is not well contained comes down to the nature of our global economy. The countries in Africa were not tightly integrated into our supply chain, and or travel habits. Thus they were able to be effectively quarantined. China is proving not so easily quarantined , and this is what the WHO is referring to as the "tipping point" lately.

Our leaders may be faced with a choice, largely shut the whole world down economically and "MAYBE" stop the spread; or try to reduce travel and contagion and keep the economy going and REDUCE the spread. Its clear to me they are choosing the latter, and I don't know that if I were a decision maker that I would not do the same.

Don't worry about what you can't control, but try to be well informed, so if it arrives in the your geography in bulk you can act appropriately.
 
Ronstar - It is probably not as big a problem as it sounds. It is a problem for the weak and immunocompromised and particularly those over age 75. Most people who get sick recover. You are correct, it is your own immune system that eventually fights it off. The observations of several re-infections indicate that the immune system, while it can kill it off, cannot prevent a re-infection in some individuals. We do not know if this is typical or atypical. There are two strategies for developing a vaccine. The easiest and most common is to develop antibodies against viral surface proteins, some of which may punch holes in the virus and kill it. Then there are antibodies that bind to the cell receptors and block adhesion. The last strategy is a cellular one in which the vaccine pushes the immune system to develop lymphocytes specific to the viru to kill it directly. The latter will likely end up being the way it gets solved. It is tricky stuff to do and normally takes years of development and testing. You have to run a vaccine through 2 separate species of animal models showing specificity and efficacy as well as safety. The last is the major problem for most new drugs and requires safety testing at multiple doses and routes in multiple sub-populations (men, women, children, pregnant, immunocompromised, elderly, all different races separately and combined, etc.). The safety trials are the toughest and most expensive to get through and takes a lot of time. Then you have efficacy testing which you have to perform in an at risk population with a significant prevalence of disease in double blinded trials and show that it actually protects. A "fast" vaccine to get full approval takes at least 10 years of testing and sometimes billions of dollars. Emergency vaccines can be authorized if the risk/benefit ratio mandates it but this can have consequences long term.

Ebola is an easier problem to manage as it is very hot, has a short incubation time and also short time to death. It is also an old disease which in the good old days was handled by locking the sick up in their huts and setting them on fire eliminating the local problem. The fact that Ebola (and the equally or worse other hemorrhagic fever viruses like Marburg, Lassa Fever, Crimea Congo fever, and the like) kill so quickly it actually makes it a lot easier. Most people are unaware that all of these diseases are currently a problem in Africa with both Ebola and Lassa causing hundreds of deaths a year in Arica. We don't hear about it as it really poses little threat to western countries. We also don't hear much about the seasonal influenza which is killing people at a much higher rate than the Coronaviruses. Why we are so concerned about this particular virus is beyond me. It is the slower disease like the coronaviruses which pose the biggest problem for isolation. Also, if Ebola had emerged in China (large population centers with large movements) it would have had a very different scenario.

So, IMHO this is not as huge a problem as one might assume. Yes, it will spread and infect a lot of people. Some will die but this is really no different than normal influenza.

Here is a good article about influenza:https://www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-deaths.htm
 
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