Novel Coronavirus – China

[Spikecollie]

13 minutes ago, Dami said:

I'm not suggesting that people should go to a doctor at every little thing spike! It's bad enough that my local Doctors has gone from getting an appointment the same day to a two weeks wait. It's bad enough that as parents we get snotty 'we are watching you' letters from school when Bubs is off for a few days. 111 considered bubs issue important enough to be seen within 6 hours, I am not a time waster regarding Doctors, but my daughter was in alot of pain and couldn't move her neck as well as a fever and sore throat. We are talking about a school that told me to take my daughter to the doctors because she had 'a bit of a cough and brought up a bit of her dinner' The way things are going we will be getting sick notes for our children!

All i'm saying is in this 'it's only a cold' culture it is no surprise these viruses spread so quickly.  

I think you misread my post, Dami. I think people should be able to consult a doctor when they or their loved ones feel unwell. That's the cultural norm here.

What scares me is how we go on paying for this as we all get older and live longer.

We don't get 10 minute consultations here either, you get as long as you need. When I went to the doctor last Monday - he has non-appointment hours between 0800 and 1200 -  I waited for an hour and a half. If you have a scheduled appointment you get as long as you need too and those after you wait. You get a full, careful examination (in my case of a throat infection I got a full lung and heart check and a fever scan). You get an appointment or home visit same day too.

In France it is compulsory to have supplementary health insurance if you have a permanent job. Mine has just started. I pay 11€ a month, my employer pays 30€ and I can include my OH when he comes back for an extra 20€. It's a lot out of my small earnings but staves off a major hospital/medical bill should it come.

 

[Gael_Force]

Just now, nick sussex said:

It appears now all 5 new cases in France are Brits who picked up the virus from another Brit whose now gone back to the UK to infect people there ! 

Surely this person needs to be traced ASAP and put into quarantine .

Is it not the patient from Hove? ... and a result of contact tracing working as it should. Think the suspected cases in the one of the Spanish islands also connected. 

[swebby]

16 hours ago, 4wd said:

There is a theory that it is more easily spread and more deadly to Asian ethnicities due a to a genetic difference in a certain protein in the lungs.
That doesn't explain the limited spread in adjacent countries though, because it can't be more dangerous to the Chinese only surely.

I am curious to see a link for this theory, if it is not coming from a reputable scientific/medical source i'd take it with an extremely large pinch of salt. Viruses do not distinguish between racial groups, far as a virus is concerned, it only asks if you are human or not.

Viruses infect cells by binding to a suitable protein(s) on a cell wall. In the case of 2019nCoV, it has fortuitously found (from it's perspective) that humans are home to cells that have suitable protein for it to bind with, and, that there are lots and lots of humans to infect. The important bit here that i'm clearly stressing  is "humans"! It is exceptionally unlikely that one ethnic group has this protein(s) that are entirely absent from another group. If this was a case, blood transfusions and organ transplants would be impossible. The only likely difference you will possibly see between one population group and another in terms of susceptibility to a viral pathogen would be acquired immunity - i.e. a population already carries antibodies that recognise the virus and offers protection.

As for why it "appears" to be spreading in china more readily but is not cropping up in many other places? All sorts of possibilities.

1) and the most likely -  Sheer weight of numbers! The fact it was lunar NY probably resulted in lots of travel within the country just like we all go and see family at Xmas here in the UK. Yes there is plenty of international travel in respect to China but this is an incredibly small fraction compared to domestic travel. Think in terms of how many times do i fly a year vs how many times i go to the supermarket, go to the office, do the school run, etc - this is your answer, a very big number vs a very small one. 16 days ago there was 581 confirmed cases globally, 10 of these were outside china and that would be a good fit for domestic vs international travel.

2) Weather! I did look at the weather for Hubei for January. Generally cool (-4C to 8C), overcast and settled. Perfect conditions! Low UV, low heat, low aridity. Low in all things not great for a virus to survive outside a host, plus no bad weather to discourage going out/travelling.

3) Containment - the rest of the world were aware at a very early point and were taking measures at their borders and advising travelers of what signs to look out for.

Edited February 8, 2020 by swebby

[Bristawl Si]

3 minutes ago, Bristle boy said:

The issue with this strain of coronavirus is that normally healthy people who contract it are likely to think they have a severe common cold or a bout of flu.

And as health advice in the UK for many years has been to ride it out, take pain relievers to ease discomfort, and, more importantly, dont go to your doctors as there's nowt they can do. Therefore, there's a big chance people will contract it, but feel better within days or weeks (as per common cold or flu virus) i.e. many will not have a clue they've even caught this strain of coronavirus. 

Not saying there wont be cases where it is more severe, yes, as per influenza; deaths as per influenza as well, but many infected will not even realise.

John Edmunds, a professor at London School of Hygiene and Tropical Medicine, said modelling showed there were 'ten times more cases than have been reported - or even more'. But he adds

"It's a mild disease that might be missed if somebody doesnt seek healthcare"

And exactly that is likely to become an issue, in many countries. Would you, or do you, go to your docs when you have, or have had, a heavy common cold or a bout of influenza? I certainly dont. 

And therein lies the healthcare dilemma for most countries.

Should've added to above. The Brit on the cruise ship, who is on honeymoon, and was removed to go to a Jap hosp has now tested negative on his 2nd test, so the 1st test for this strain of coronavirus has turned out incorrect.

[nick sussex]

It might be a false sense of security but every time there’s a new case in France and it’s miles from here I breathe a sigh of relief ! 

I’m still perplexed by the lack of cases in Europe . We’re well past the point now where any incubation period could have hidden the number of cases .

Of course many won’t be diagnosed officially if they have milder symptoms and just stay at home but even with that and given just how interconnected we all are globally something just doesn’t add up .

 

[nick sussex]

I think most people would be good citizens and if they have any flu like symptoms would make an even bigger effort than normal to stay indoors and not risk infecting others .

What really annoys me is when you pop out to the chemist and people are coughing and sneezing and clearly not well . Surely they can get someone else to pick up their meds .

I now avoid my local chemist ! I tend to go to the big one in the Leclerc complex , because you can get non prescription meds from a separate counter and have a chance to avoid the flu/cold givers ! 

The French are notorious re being hypochondriacs , indeed even the doctors seem to be on a bonus for dishing out as many pills as possible ! 

Another thing I avoid is the waiting room in the local GP, another place where you’re a sitting target for more viruses ! 

[fujita5]

14 minutes ago, Bristle boy said:

Should've added to above. The Brit on the cruise ship, who is on honeymoon, and was removed to go to a Jap hosp has now tested negative on his 2nd test, so the 1st test for this strain of coronavirus has turned out incorrect.

I read that the Japanese have found that tests sometimes come out negative, then positive and then negative again during the infection. Not sure if the reports are true though.

[swebby]

12 minutes ago, Bristle boy said:

Should've added to above. The Brit on the cruise ship, who is on honeymoon, and was removed to go to a Jap hosp has now tested negative on his 2nd test, so the 1st test for this strain of coronavirus has turned out incorrect.

GreyWolf highlighted this as an issue a few days back.  My understanding is that PCR assays can be very sensitive to sample errors so the 2nd test could be a false negative?

This from yesterdays situation report from WHO suggests there are issues with the assay

"WHO is working with partners to strengthen global diagnostic capacity for 2019- nCoV detection to improve surveillance and track the spread of disease. WHO and partners have activated a network of specialized referral laboratories with demonstrated expertise in the molecular detection of coronaviruses. These international labs can support national labs to confirm new cases and troubleshoot their molecular assays."

[swebby]

2 hours ago, Spikecollie said:

Five new cases here in France in Haute Savoie as someone already pointed out. I chatted with my doctor this morning as he was leaving my neighbour after a home visit - outside formal medical visits we chat very socially with our médecins here in the small village. He says health professionals are as baffled as everyone else about the statistics but there is absolutely no sense of panic. French doctors are interested in the young/old factor - how few children seem (according to the data they have) to be affected but he also said there was suspicion about pollution making people more vulnerable. He also mentioned the "low exercise" culture in China augmented by long working hours (we're both run and cycle so we share the knowledge of what benefit that does to our bodies!). He also said, as I have picked up from my clients, that a lot of vulnerable people are becoming increasingly frightened for probably no reason, doing more damage to their health and well being than the virus probably ever will.

I gave three reasons above. This can be added as reasons #4 and #5.  It has also been mentioned on here, the Chinese do like their cigarettes = reason # 6.

[Bristawl Si]

5 minutes ago, swebby said:

GreyWolf highlighted this as an issue a few days back.  My understanding is that PCR assays can be very sensitive to sample errors so the 2nd test could be a false negative?

 

Just as high a chance that the 1st test was a false positive.

Edited February 8, 2020 by Bristle boy

[swebby]

Just now, Bristle boy said:

Just as high a chance that the 1st test was a false positive.

Indeed, and hopefully so for the individual concerned, some honeymoon cruise eh?

PCR is good and quick but will have limits, notably the availability of path labs to do the testing.  It would be very good news if someone develops an antibody based assay as this will make testing much easier.

[4wd]

42 minutes ago, swebby said:

I am curious to see a link for this theory, if it is not coming from a reputable scientific/medical source i'd take it with an extremely large pinch of salt. Viruses do not distinguish between racial groups, far as a virus is concerned, it only asks if you are human or not.

 

It's not the racial groups it's a subtle difference in the make up of proteins in the airways, to which the virus attaches itself 
From about 3:20 in this video he covers it.

 

[Dami]

Be thankful. A group of people are being quarantined in Milton Keynes,  20 minutes away from me and Hubs place of work. 

 

 

Edited February 8, 2020 by Dami

[Methuselah]

1 minute ago, Dami said:

Be thankful. A group of people are being quarantined in Milton Keynes,  20 minutes away from me and Hubs place of work. 

 

I wouldn't wish that on my worst enemy!

[Dami]

37 minutes ago, nick sussex said:

I think most people would be good citizens and if they have any flu like symptoms would make an even bigger effort than normal to stay indoors and not risk infecting others .

What really annoys me is when you pop out to the chemist and people are coughing and sneezing and clearly not well . Surely they can get someone else to pick up their meds .

I now avoid my local chemist ! I tend to go to the big one in the Leclerc complex , because you can get non prescription meds from a separate counter and have a chance to avoid the flu/cold givers ! 

The French are notorious re being hypochondriacs , indeed even the doctors seem to be on a bonus for dishing out as many pills as possible ! 

Another thing I avoid is the waiting room in the local GP, another place where you’re a sitting target for more viruses ! 

I worked in a pharmacy for just over a year but I don't remember getting any more illness than you normally would. But here's the thing.

When swine flu was hitting Hubs got it and was diagnosed and I went and got his prescription I was also quite pregnant. Unknown to me someone I worked with was also off sick with it but I didn't catch it all. Not even a blocked nose. So we figured I could of carried it. How many healthy people could be carriers?

Edited February 8, 2020 by Dami

[Spikecollie]

37 minutes ago, nick sussex said:

Another thing I avoid is the waiting room in the local GP, another place where you’re a sitting target for more viruses ! 

Scared the poo out of me last lundi matin. I needed a cert off work which you have to have but had to wait among coughing adults and infants. Did I pass my maladie onto them - them to me? Great system here but overused. I came home with a bundle of meds for 5€ which I have hardly used - I braved it out - could swallow with sore throat but went to work.

[fujita5]

There's a theory currently in development relating to ncov and flu..... the outcome can be affected by the viral load entering the body. Very low loads, e.g. a few rogue virus particles entering the body from a single droplet deposited on a surface, will lead to a proliferation of replicas of the virus, but the spread through the body is slow enough that the immune system can react and prevent major illness occurring.

However you'd be able to pass the infection on to a partner due to repeated close physical contact, potentially giving them sufficient viral load over a few days to develop the illness.

It's only a theory at present but it would go some way to explaining the seemingly random nature of failed tests and silent carriers....

 

Edited February 8, 2020 by fujita5

[Methuselah]

34 minutes ago, Bristle boy said:

Just as high a chance that the 1st test was a false positive.

But that implies a true positive rate of only 50%, and I'd hope it was more like 80%...Neither does it take into account of (impossible in this instant, I know, but the principle remains?) the background probability of having the condition being tested for... 

[swebby]

8 minutes ago, 4wd said:

It's not the racial groups it's a subtle difference in the make up of proteins in the airways, to which the virus attaches itself 
From about 3:20 in this video he covers it.

 

 

Many thanks.

The video talks about ACE-2 being expressed in one group more than others (a study of only 8!?) but questions this and does go on to suggest that numbers in general plus high rates of smoking (also linked to increased expression of ACE-2) as far more likely issues.  

I was not aware of the link between ACE-2, an enzyme (a protease) that is mobile among and within cells, and SARs.  The idea being that the enzyme (ACE-2) binds to the protein spikes on the exterior of the virus membrane and this then allows to virus to bind on to protein receptors on the cell surface that recognise the ACE-2. Basically fooling the cell into thinking the virus is a bona fide part of the hosts hormone system, bit like a trojan horse, although i'd prefer "a wolf in sheep's clothing" as a metaphor.

Looks like it is a very good time to pack in the fags!

Note - we all have/produce ACE-2, it is however possible there are differences in how much between individuals. So everyone is susceptible.

[swebby]

11 minutes ago, swebby said:

The video talks about ACE-2 being expressed in one group more than others (a study of only 8!?) but questions this and does go on to suggest that numbers in general plus high rates of smoking (also linked to increased expression of ACE-2) as far more likely issues.  

.....

Looks like it is a very good time to pack in the fags!

Note - we all have/produce ACE-2, it is however possible there are differences in how much between individuals. So everyone is susceptible.

and yet the first review i read suggests nicotine actually reduces ACE-2 expression in lungs (while increasing ACE expression)

Nicotine and the renin-angiotensin system

WWW.NCBI.NLM.NIH.GOV

---

Cigarette smoking is the single most important risk factor for the development of cardiovascular and pulmonary diseases (CVPD). Although cigarette smoking has been in constant decline since the...

 

Ho hum, cell signalling pathways, Byzantine as always........

Anyways, stop smoking is sound advice!  And doubly so with a pulmonary virus doing the rounds.

[Snipper]

2 hours ago, swebby said:

 

Looks like it is a very good time to pack in the fags!

Never smoked. Decided to concentrate on booze, drugs and sex instead. 

[Gray-Wolf]

The 'grosser' side of smoking means the 'soft tissues' of the lung are all covered in 'gunk', so lessening the virus a chance to get to the tissue ( proteins?) it need to reproduce.......

 

Of course if 'it' gets in then all bets are off........

[Bristawl Si]

Update; maybe encouraging signs showing?

More than 34,800 people have been infected with the new coronavirus worldwide, the vast majority in China.

There have been 723 deaths in China and one death abroad, in the Philippines.

Of the 34,598 people infected within China, WHO Director General Dr Tedros Adhanom Ghebreyesus said almost 25,000 are in Hubei Province - the region where the outbreak was first reported, which has since become the epicentre of the virus.

Dr Tedros said that the virus is still concentrated in Hubei, and that over the last four days there appeared to have been a slight stabilisation in the number of cases.

However, he said it was still too early to say whether or not the virus has plateaued, as epidemics can often slow down before accelerating again.

But he added that the slow-down was "an opportunity" for them to work to contain the virus.

[Bristawl Si]

Although the number of deaths from the Wuhan virus now outnumber SARS deaths, the fatality rate is lower for the Wuhan virus.

The fatality rate for SARS was 9.6%, while around 2% of those who contracted the Wuhan virus have died.

[Wiltshire_snow_lover]

Seems to spread with ease