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often the cause of the "common cold" is a coronavirus. Can you get the common cold more than once? Does a herd immunity exist for the common cold?

Most "common colds" are caused by rhinovirus not coronaviruses.

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The common cold, also known simply as a cold, is a viral infectious disease of the upper respiratory tract that primarily affects the nose.[7] The throat, sinuses, and larynx may also be affected.[5] Signs and symptoms may appear less than two days after exposure to the virus.[5] These may include coughing, sore throat, runny nose, sneezing, headache, and fever.[2][3] People usually recover in seven to ten days,[2] but some symptoms may last up to three weeks.[6] Occasionally those with other health problems may develop pneumonia.[2]

Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses being the most common.[1

https://en.wikipedia.org/wiki/Common_cold

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There are no vaccines against these viruses as there is little-to-no cross-protection between serotypes. At least 99 serotypes of human rhinoviruses affecting humans have been sequenced.[20][6] However, a study of the VP4 protein has shown it to be highly conserved among many serotypes of human rhinovirus, opening up the potential for a future pan-serotype human rhinovirus vaccine.[21] A similar result was obtained with the VP1 protein. Like VP4, VP1 also occasionally "pokes" out of the viral particle, making it available to neutralizing antibodies. Both peptides have been tested on rabbits, resulting in successful generation of cross-serotype antibodies.[22]

The successful introduction of human ICAM-1 into mouse has removed a major roadblocker in creating an animal model for RV vaccination.[22]

https://en.wikipedia.org/wiki/Rhinovirus

Rhinovirus is a member of the picornovirus family and unlike coronavirus, I believe it does not require the enzyme reverse transcriptase for reproduction and thus is not a "retrovirus."

https://en.wikipedia.org/wiki/Picornavirus

I do not know much about corona virus induced "colds." Maybe you can look them up.

Quote from RobertBryant

"scores of retired NHS doctors and nurses have told the Guardian that they are against returning to work to help tackle coronavirus,

with many saying it would threaten their physical and mental health. "

I think the way to do this in an urban area is: assign some hospitals to deal with coronavirus patients, while others should not accept them. I think they did that in China. Then, you put the retired doctors and nurses back to work in the latter, dealing only with ordinary illnesses. Ordinary illnesses do not stop during a pandemic! That puts the older doctors less at risk. Plus, they know how to deal with ordinary illness, whereas the coronavirus may need doctors who can learn new techniques quickly.

I guess you cannot do this in a rural area with only one hospital.

In a New York City hospital, the staff met and decided that young doctors and nurses should handle the coronavirus patients as much as possible, because the doctors are likely to get the disease, and young ones are more likely to survive.

Quote from Alan Smith

Latest survey shows marked change of attitude in the UK...

That's good.

Quote from JedRothwell

Chinese and Japanese researchers have confirmed that most patients who recover have acquired immunity

How did they do that? Where are you getting that?

Where recovered patients directly re exposed?

I find that statement strange.

Quote from seven_of_twenty

I do not know much about corona virus induced "colds." Maybe you can look them up.

yes rhinovirus is the main cause of colds, (that is why I said "many").

followed by coronaviruses (10-20%), influenza viruses (10-15%), and adenoviruses (5%). ...

Quote from JedRothwell

I think the way to do this in an urban area is: assign some hospitals to deal with coronavirus patients, while others should not accept them. I think they did that in China. Then, you put the retired doctors and nurses back to work in the latter, dealing only with ordinary illnesses. Ordinary illnesses do not stop during a pandemic! That puts the older doctors less at risk. Plus, they know how to deal with ordinary illness, whereas the coronavirus may need doctors who can learn new techniques quickly.

I guess you cannot do this in a rural area with only one hospital.

In a New York City hospital, the staff met and decided that young doctors and nurses should handle the coronavirus patients as much as possible, because the doctors are likely to get the disease, and young ones are more likely to survive.

That's good.

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If other countries want to copy China they should create fever clinics. People in Wuhan etc are constantly having their temperatures checked (basically every time they enter a building) with a wave over the forehead. If their temperature is high it’s off to the fever clinic. Once they are there they are met by healthcare workers in full protective gear. But they don’t even do an immediate coronavirus test, which is kind of surprising. They first do a blood test to get their white blood cell count and then a quick CT scan of the lungs.

The coronavirus test that has existed in China is supposedly a bit awkward and painful. They take a swab and stick it way up in your nasal cavity. Hopefully the testing coming on-line is not so invasive. But people say it feels like your brain is being stabbed when they do it.

Quote from Deleo

It makes what the Chinese have done with reducing the cases as dramatically as they have look like an amazing accomplishment, almost miraculous.

It is remarkable. But it seems less miraculous and more attainable when you see that Korean and Japanese officials learned important lessens from China and accomplished the same thing. This shows that democratic societies can also use these methods. The restrictions imposed in Japan do not seem onerous to me. They will hurt the economy of course. They will bankrupt many small businesses. But the government is doing all it can to help workers and families stay afloat, with things like 70% worker's comp.

Quote from Deleo

1. Why is the death rate higher in Italy than other countries?

Good question! Lots of people are asking. I have no idea. The hypothesis I have seen most often is because the Italian population is old. Maybe . . . but the Japanese population is even older, and they have one of the lowest mortality rates.

Quote from Deleo

2. Can the U.S. and Europe do testing on a level near South Korea?

Sure! Why not? You just shove a stick up people's noses. It takes only a second. It hurts, they say. In Korea they are doing it at drive-through clinics. Here is a video of an American reporter going through the test, and getting a stick shoved up his nose by a sympathetic Korean nurse:

https://www.cnn.com/2020/03/02…korea-hnk-intl/index.html

(Okay, we can't do it in the U.S. because we don't have enough test kits. Only 8,000 were deployed as of a few days ago. Mr. Trump was asked about this and he said it isn't his fault. It's Obama's fault. It is good to know that Obama is still in charge in some sense. Imagine how much worse things would be if Trump had made any decisions or was in charge of anything these last 3 years. Trump also said he had nothing to do with closing the pandemic office at the White House. He didn't know about it. So he's off the hook.)

Quote from Deleo

3. As China opens back up and people go back into society will the virus come back or will it stay below 50 cases per day? To me this is the biggest question.

I think they have a handle on that. The W.H.O. report described their plans. They are doing it in stages, being careful at every step. Before a factory re-opens, they disinfect it, then they test everyone who will go back to work. They will continue to test people. If someone gets sick, and they will immediately track down everyone he has been in contact with, and isolate and test everyone. No doubt this will cost a lot, and it will go on until a vaccine becomes available, but they can't stay locked down for a whole year.

Japan is doing similar things.

Quote from oldguy

How did they do that? Where are you getting that?

Where recovered patients directly re exposed?

I think they test for antibodies. I know the Chinese monitor the heck of the whole population of Wuhan. Step out of your house more than once a week, and your cell phone lights up with a policeman asking "what are you doing outside?" If anyone is reinfected, they will know.

It is the largest medical research experiment in history. They are going to learn a lot about public health in general, not just this virus. It reminds me a little of the search for Malaysia Airlines Flight 370. They never found the airplane. They spent hundreds of millions of dollars. You might think that money was wasted. But, it turns out, they collected a terrific amount of images and data on the ocean floor, and learned more about it than all previous research. It will ultimately be a great benefit. All scientific research is valuable. Always. Just doing it is valuable, even if you don't discover anything, especially for young researchers.

Quote from JedRothwell

They are going to learn a lot about public health in general,

The Chinese politburo may ..cannot? learn... about its own ill health.. unfortunately..

and about the root cause of political footdragging and suppression in the early days in Wuhan which empowered the virus..

and before that the inaction on live markets which enabled the virus.

What can we learn..? and do?

Here is a useful article in $ terms.

What’s your risk of dying of COVID-19 - or inadvertently allowing the death of someone in your community?

"If we value such life at more than $1M, in terms of what we’d pay to reduce the risk of accidental death of an elderly relative,

that means your actions to eliminate the risk of COVID-19 transmission over 4 days are worth about $1000 to your community, or $250/day

https://www.linkedin.com/pulse…ntly-death-someone-scott/

Had a call from someone that flew to the Canary Islands today. On landing they got an email saying holiday cancelled. Then another saying return flight cancelled. At hotel was told hotel closing on Monday. Consulate closed for weekend. Airline swamped with calls.

Quote from CWatters

Had a call from someone that flew to the Canary Islands today.

To many idiots live on this world....

Quote from CWatters

Had a call from someone that flew to the Canary Islands today.

To many idiots/ignorants live on this world....

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If other countries want to copy China they should create fever clinics. People in Wuhan etc are constantly having their temperatures checked (basically every time they enter a building) with a wave over the forehead. If their temperature is high it’s off to the fever clinic. Once they are there they are met by healthcare workers in full protective gear. But they don’t even do an immediate coronavirus test, which is kind of surprising. They first do a blood test to get their white blood cell count and then a quick CT scan of the lungs.

It's more than "surprising." It's downright bizarre for several reasons. First, forehead temperatures are notoriously and obviously inaccurate because they can't take into consideration ambient temp, wind, and probably other factors. They tend to read low by 0.5 degrees C or more compared to sublingual or tympanic temps. And of course, much worse yet, temperature tests won't detect those who are incubating the virus but do not yet have symptoms. And the elderly tend to have less temperature elevation.

The rest is just as weird. I don't know specifically about COVID-19 but many if not most viral illnesses do not feature elevated white cell counts. In fact, sometimes the opposite or changes in the "differential count" -- some types of cells are up, others are down, the total count is unchanged or lower. Maybe they are only looking for the complication of bacterial infection and pneumonia over the viral infection. A CT is useful but extreme and involves substantial radiation and cost. Also, it can not diagnose COVID-19 specifically and can be abnormal in other pneumonias, bacterial or viral.

If it were me, I'd get a history (ask questions), measure the temperature with a tympanic thermometer (using disposable covers), measure the oxygen saturation with a simple fingertip oximeter ($25 these days) and absolutely but for sure (!) run a real time PCR test for the actual virus.

About the test being painful: sure, if someone who has no idea about the anatomy of the nose just rams the probe up your nose! It's only slightly to moderately unpleasant just like an influenza test if the operator knows what they are doing. It helps to be gentle and if one nostril shows resistance to probing, use the other and in extreme cases, do a back of the throat swab through the mouth or spray a bit of lidocaine first. This isn't the middle ages.

Quote from Shane D.

Will my new found respect for this 19th in the coronavirus series, turn out to be justified, or will it turn out that I have been spooked into submission by the sensationalism...again?

Italy, France and Spain are in lockdown. Only food stores and pharmacies are open. Obviously, this is not sensationalism. That train left the station weeks ago.

Quote from Shane D.

Guess when this is all over with (and it will be over fairly soon I predict),

Let us hope it is not over "fairly soon." The faster it goes, the more people will die. If it is only 3 months, millions of people may die. It it lasts 6 to 8 months, hundreds of thousands will die.

Quote from seven_of_twenty

About the test being painful: sure, if someone who has no idea about the anatomy of the nose just rams the probe up your nose!

I posted a video of an American reporter undergoing the test in Korean drive through testing station. He squirms around and then says something like: "that hurt, but it was over quickly." The nurse seemed to know what she was doing. She had been doing it all day long.

I got a flu test with swab like that. Maybe they don't have to go as deep, but it didn't bother me at all.

Shane D.

Standard process is some will overreact and some will underreact. Some think it is the end of the world while some think it is fake news.

In 2009 the H1N1 pandemic had the WHO panicking but as far as most people are concerned it was a non-event. A pointless panic of experts crying wolf. After all "only" 600,000 people died!

What I am learning (to my surprise) is how long the scientific process takes to get to the facts about a new virus.

When it first appeared the Chinese goverment tried to ignore it, then went into panic mode simply because they had no way of knowing how deadly this new virus was.

All sorts of figures for R0 and the Case Fatality Rate have been guessed at.

And even now, after 3 months, the experts still do not have this pinned down.

So initially it makes good sense to assume a worst case scenario because if it turned out to be another Spanish flue, or a high CFR like SARS then by the time you know for sure it is too late to stop it.

I heard a program on the BBC the other day where they were talking about the history of epidemics and mentioned some historical cases of dealing with smallpox and I found this link to it;

Lessons for dealing with coronavirus: A tale of two cities—and smallpox

Bottom line was;

1894 in Milwaukee, Wisconsin smallpox epidemic led to month long rioting. The authorities applied forced isolation and vaccination but only for immigrants whereas the wealthy were allowed to self isolate at home.

1947 in New York millions lined up patiently to be vaccinated. The official response was even-handed and involved community groups in the process of getting everyone to buy-in.

The success of the Chinese response was discussed.

The Chinese are to be praised for their success and showing what works with this virus. History will remember the success.

Thing is in hindsight they were lucky. Apparently millions left Beijing when they heard a lock down was coming. And history shows that it was not unlikely that the Wuhan situation could have turned into mass rioting, but it didn't.

If the R0 of this virus were much different then their delayed response may have been too late to stop it.

If the CFR were much higher then the Chinese might have had mass rioting anyway.

Quote from Shane D.

I am in that category. I did not take this seriously until recently, although I am not yet at the level of hysteria much of the population has reached. My attitude was not "stupid" up until now, as there is a historical rationale to it. You see, I have been conditioned beforehand, as has the public, to not take these things too seriously.

As we all know, there have been many of these scares before which did not turn out as predicted. Like the "boy who cried wolf", we just block it out after a certain point.

Will my new found respect for this 19th in the coronavirus series, turn out to be justified, or will it turn out that I have been spooked into submission by the sensationalism...again? Guess when this is all over with (and it will be over fairly soon I predict), I, and you, will know the answer to that. If another false alarm, it will be all that much harder to convince me, and the public next time. Then, if it is the real deal...then what?

Something the authorities, and especially the media, even some here, should take into consideration IMHO.

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Sensationalism is when people speculate or draw unwarranted conclusions from data that could indicate different things.

Throughout Europe the same exponential increase due to community transmission exists. We know that to reduce/stop it requires extreme measures, we have examples of that in China (not easily replicable in the West) or japan, korea - maybe replicable.

The fact that exponentially increasing infection rate happens is simple epidemiology and backed up by theory, observation and the closest historical analog - the Spanish flue outbreak. Not sensationalism. The numbers are real.

The only scenarios that don't involve v large number of deaths mean fast v large behaviour change and reorganisation of society (lock down older people, organised deliveries, v good social isolation for all, good hygiene, etc).

The delay here between infections and observed cases means that whatever level you start doing these extreme measures at - even if they work - you get some large multiple (20X - 100X) peak cases before the results are seen.

A bit like climate change but on a timescale of weeks not 100s of years.

The debate is all about the possibility for and consequences of extreme societal behaviour change. In democracies you can't be sure people will do what you tell them.

Personally I find the UK govt ideas about "delay extreme measures because they can't last long" weird. Maybe it is true people will get stir-crazy cooped up for 6 months instead of 4? Certainly it is true the economy will suffer more, and therefore people's businesses go under. Maybe that has behavioural consequences. Frankly, all of that is speculation - we just don't know. If you are a pessimist then delaying extreme measures a few weeks might just over long term be better, under some modelling scenarios. There is no doubt that in the short term it will be much worse.

What I find very encouraging about the UK is the rumours of a proposed extreme self-isolation lockdown for all older people, with govt organised supplies etc. Isolating those most at risk of adverse consequences has obviously multiple benefits: because they have the highest chance of clogging up hospitals when infected. Ideally, you would give everyone at low risk (say under 40, no existing conditions) CV right away. Although we can't be sure that immunity will work it is highly likely it will mostly work. Having 40% of your population immune then makes all the other self-isolation measures much more effective. Of course, ethically, giving 40% of your population a disease that will kill 0.2% of them is not possible, so what is best from a utilitarian point of view cannot happen. Also even doing this would mean 56,000 serious cases at the same time, which would stretch health service capacity and more would die than if given best treatment.

When people in NHS in UK are asked (in R4 this morning) whether the modelling indicates there will be enough intensive care beds they say we are planning to increase capacity by 7X. Not answering. Because everyone knows there will not be enough. That is true under all scenarios, so it is a question of how much not enough.

We will need to see the modelling but I'd expect models like that are what the govt is trying for. Just they don't seem consistent with delaying social distancing measures now. i suspect Boris of being weak-willed unable to make tough decisions until everyone can see they are needed - at which point you are 2 weeks too late and have many more deaths. But equally, I'd guess he has some scientific cover based on modelling as above. It is just that the behavioural modelling is all speculative and probably wrong - whereas the epidemiological modelling is not.

Another characteristic of BJ is that he hates to be unpopular and he will now be caving in to the calls for tougher measures quicker - so time is lost, and lives are lost, but less than were he not to cave.

Trump's inaction: "CV is a hoax" "CV is a foreign problem, will not affect us" will be written down by historians as greatly increasing US death toll. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

In addition: in the UK 10 years of running down the NHS will dramatically decrease resilience now. Those responsible for that will be seen as trading one (debatable) model of economic good for many of the lives that will be lost, unless we are very very luckly and social isolation and behaviour change now is amazingly effective and fast. Seems unlikely.

Edited for being too political. Shane