Covid-19 News

Quote from Alan Fletcher

Nature https://www.nature.com/articles/d41586-020-00361-5 says the transmission rate R0 may vary between 1.5 and 4.5

R0 varies a great deal from one environment to another. Apparently it is very high on a cruise ship. No surprise, that. I expect it would be lower in a spread out, low population density area such as rural Texas. It can be lowered by steps such as washing your hands. So both ends of that range may be plausible. I do not know how wide the range might be. Could it range from 1.5 to 4.5 depending on circumstances?

The R0 is probably very high in a chaotic, crowded waiting room full of sick patients waiting for hours. That is a public health nightmare.

Quote from JedRothwell

crowded waiting room full of sick patients waiting for hours

1.7 million Americans develop hospital-acquired (nosocomial infections) infections each year - and about 99,000 deaths each year

Quote from oldguy

1.7 million Americans develop hospital-acquired (nosocomial infections) infections each year - and about 99,000 deaths each year

Yup. I think it happened to me once. A bad case of pneumonia.

See:

How American Health Care Killed My Father

https://www.theatlantic.com/ma…-killed-my-father/307617/

Zero infection control on Diamond Princess.. expert testimony

many comments..Diamond Petridish...

https://www.researchgate.net/profile/Iwata_Kentaro/research

Just math

NextBigFuture

Still early days and figures all over the place. Depends what question you ask.

A total of 1,716 health workers have become infected and 5 have died (0.3%).

The same article says; The case fatality rate of COVID-19 appeared to be about 2.5 percent.

IMHO I guess the Diamond Princess cruise ship is not a source of normal stats for transmissibility because (as other members on this board have pointed out) it probably provides an artificial environment where the likelyhood of transmission is increased when people are trapped in a bubble and sharing the same air ventilation. However it may be a relatively reliable source of stats for fatality rate (although most "cruisers" are on the elder side of the bell curve).

Of course the stats are of great interest to those of us trying to get a handle on the magnitude of the threat, but each number represents an accumulation of personal tragedies and suffering.

Quote from ZenoOfElea

it probably provides an artificial environment where the likelyhood of transmission is increased when people are trapped in a bubble and sharing the same air ventilation.

On a ship? I don't think so. It is not an airplane. Not pressurized. It is at sea level. I assume the blowers can bring in fresh air to every vent, without recycling any air. They have an unlimited supply of clean air. Not sure. I just looked up cruise ship HVAC but it is a complicated subject.

Cruise ships are notorious for spreading disease, such as diarrhea. I don't think that is from air. It is from the food, food prep., surfaces, public bathrooms, water supply and so on.

I read that cruise ships that have had infections have to be cleaned out and sterilized by specialized cleaning crews.

Ships have unlimited clean air, and unlimited supplies of cold water for cooling the engines. Of all modes of transport, they are the best situated thermodynamically.

Quote

Trump thinks the Coronavirus will "miraculously" go away in April when it gets "warmer."

No Covid-19 in Africa yet - why?  1981 book "In the eyes of darkness" predicted a 2020 pneumonia like illness that will spread throughout the world, starting in Wuhan

Quote

Cruise ships are notorious for spreading disease, such as diarrhea. I don't think that is from air. It is from the food, food prep., surfaces, public bathrooms, water supply and so on

Most human respiratory viral diseases are spread most easily when infected people touch or blow their nose, or cough in their hands, and then touch a surface. Then, an uninfected person touches the same surface and transmits the infection to themselves by touching their nose, mouth or eyes which we do subconsciously all the time. Another method, by inhaling an aerosol someone else sneezed or coughed or breathed out is also a transmission route but usually less effective. Of course food handling and preparation can also spread the virus as can simply handing someone an item if the item is exposed to secretions or aerosol. There is also spread by close personal contact like kissing or even shaking hands.

In any given exposure, the factors determining whether or not someone acquires an infection depends on 1) quantity of virus taken in 2) vitality of virus (is it dried out, overheated, etc.) 3) virulence of strain and 4) susceptibility of host. Susceptibility and eventual response to infection seem to depend on genetics, age, and general physical condition. It's complicated.

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Well, so much for the effectivity of the 14 days of quarantine on the diamond princess, it allowed Covid-19 to travel to Napa county

I think only to a new quarantine in the US and then a special isolation area in a hospital when clinically ill. I don't believe there are yet any USA cases in the open population though I think we can expect them.

Quote from seven_of_twenty

Most human respiratory viral diseases are spread most easily when infected people touch or blow their nose, or cough in their hands, and then touch a surface.

Sure. I get that. People breathing the same air in a room will spread an infection, when someone sneezes. But I do not think they "share the same air ventilation" on a ship. They do on an airplane. Maybe even a big building without good heat exchangers? But I believe cruise ship ventilation system are one-way. The air comes from outside and it is distributed to all vents. It does not circulate around and around. Disease cannot be spread by the ventilation system. I think I read that somewhere. It makes sense that's how it would work.

That's not how military ships work. Especially not submarines! I saw an exhibit of submarine air treatment history at the NRL one-room museum in Washington.

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I see you are not getting at all the grave implications of the news article I posted. The article says expressly that the persons being treated in Napa were released from the quarantine period, first from the Diamond Princess, and then in the military base in the USA:

I don't think it does. They were transferred from the military base, not released from it. And they were taken directly to hospital with high level biohazard containment facilities.

The current practice in the US is to quarantine new arrivals from endemic areas or who were exposed in other ways. This is done on a military base in physical isolation and some barrier protection but without high level biohazard isolation. It is limited to patients without symptoms or if symptomatic, with positive tests for influenza and negative test for COVID19. Patients who test positive for COVID19 or those who have unexplained high fever or other symptoms are transferred to hospitals which have negative pressure rooms and protocols for maximum biohazard isolation and that is where they are treated and sorted out.

Quote

The two patients arrived Monday at Queen of the Valley from Travis Air Force Base in Solano County after they were flown to the military base from Japan. The two patients were among 400 passengers evacuated from the Diamond Princess cruise ship in the waters of Japan, Brinkerhoff said.

The general US public was never exposed to these patients. So why were they infected despite onboard quarantine on a ship? Because quarantine on a ship is grossly ineffective. What you end up with is a rolling cycle of infection due to various types of contamination. This does not happen under the sort of relative isolation at the military installations where the detainees are kept in the US and only healthy and/or serology negative individuals are kept. If you were saying nobody should be released after 14 days on a ship, you're right. As to whether 14 days on the military base is sufficient, I don't know where the number came from. Possibly it's from China. If someone knows, please provide a link. I don't know how bullet proof this number is but the CDC is staking its reputation on it.

In any case, so far as I know, there are no known community acquired cases of COVID19 in the US. All cases are within restricted military installation and hospital biohazard facilities. If you know an exception, I'd like to see the link please.

ETA: the NY Post article linked above about reinfection and a longer incubation period is very frightening ... if it's true. The NY Post has a long history of being an unreliable and biased source in politics and I know no reason it would be better in biomedicine issues. If someone knows of scholarly or more reliable source for those allegations, please link it. And BTW, NextBigFuture is an execrable source as well. About as good as e-catworld.com.

The US has a doctor patient non disclose likely being enforced in the only areas being tested All Dem states, its unlikely numbers will be added to keep up with all this any time soon.

SOCALLED Public health officialS on Diamond Petridish were not Infection control specialists

https://www.msn.com/en-nz/news…-BB10doJg?ocid=spartandhp

Japan had difficult situation.. foreigners.. especially rights conscious Americans

Japanese law jurisdiction over DP was unclear

In Australia there is Notifiable Disease law which overrides Confidentiality

But law is unclear on cruise ships

These may well become the Pariahs of tourist spots due to local protest..

2006 West Australia

Investigation of respiratory illness on a cruise ship In response to concerns raised through the Communicable Disease Control Network Australia (CDNA) regarding high rates of respiratory illness aboard a cruise ship (MV Funchal) circumnavigating Australia for 4 weeks from mid February, CDCD initiated an investigation, also involving the Environmental Health Directorate (EHD), Eastern Goldfields Population Health Unit and PathWest. High rates of illness had also been noted on a previous visit to Fremantle in mid January, when 6 cases of influenza A were diagnosed amid widespread reports of illness. Investigations

The public health team boarded at Esperance to inspect health, hygiene and food safety practices, and test water cooling systems and the swimming pool. Throat and nose swabs, and blood samples were taken from passengers who reported experiencing a respiratory illness, all of whom completed a questionnaire. Results Laboratory results revealed the presence of 3 common winter respiratory viruses (influenza A, parainfluenza and human metapneumovirus* [HMPV]), that are transmitted through droplet and aerosol spread.

Predisposing factors which exacerbated the severity of illness and transmissibility were the passengers’ mean age of 71 years,

additional chronic medical conditions, the low uptake of influenza vaccine (the local seasonal influenza vaccine was only just available),

poor personal hygiene practices such as not covering the mouth when coughing, and the close,

prolonged contact between passengers in an enclosed environment.

Influenza virus is also known to persist on environmental surfaces which may have exacerbated the problem.

Many passengers delayed seeking medical attention on board preferring to wait until they could access a free service under Medicare at the next port of call

Bad breaking news from New York (Japanese news channel):

CDC is reiterating/investigating the high New York death toll/rate for influenza 2019/2020 that was 15'000 so far.

Guess what happened ! Already a high rate of corona infections found being responsible for dead US New York citizens...

Hope to get more details soon. South Korea just climbed to 200 infections and starting Chinese quarantine measures. May be totally exaggerated.