Coronavirus: How dangerous a threat?

[gregrowlerson]

The UK is an Island. yet we are soon going to become one with the highest number of deaths. But for rules on this board, that's down to politics that cannot be discussed.

I was curious last week and looked on a flight app to see the number of aircraft over the UK. I noticed a lot less, but Heathrow was still busy. I looked an saw a flight had come in from JFK. What measures are been taken at airports? I bet nothing at all.

In recent weeks it seems that most people returning to Australia from overseas are being immediately escorted to hotels and forced to isolate for two weeks. Not sure if anything similar has been done in the UK.

 

[yaco]

I'd disregard the argument about spreading particles four metres in the air - First there is nothing to suggest COVID 19 is spread by aerosols and if this was the case lots more would be ill - These combination of SARS?/Ebola/HIV drugs is old hat in some parts of Asia - Health professionals have been using a cocktail of these drugs since the outbreak and they tend to be more aggressive in treating patients who reach ICU - Finally the death rate against positives seems to be lower in some Asian countries.

 

[Cookster15]

Very few Chinese students brought the virus to Australia - It's tough to do so when half of this cohort were already overseas at the end of January, and were banned from flying to Australia - You may have got some isolated cases from Mainland China before the ban on flights from Mainland China.

You may be right. I work near one of the Universities in Sydney which is also adjoining a major shopping centre. Our office was locked down for coronavirus fumigation the week before the national lockdown as one of the staff were found positive. I suspect the most likely source of infection was from the students who frequent the same shopping centre which many people from my workplace go to buy lunch.

 

[yaco]

In recent weeks it seems that most people returning to Australia from overseas are being immediately escorted to hotels and forced to isolate for two weeks. Not sure if anything similar has been done in the UK.

They are also being tested for COVID19.

 

[yaco]

You may be right. I work near one of the Universities in Sydney which is also adjoining a major shopping centre. Our office was locked down for coronavirus fumigation the week before the national lockdown as one of the staff were found positive. I suspect the most likely source of infection was from the students who frequent the same shopping centre which many people from my workplace go to buy lunch.

You are trying to find a needle in a haystack by pinpointing a Chinese student - Yes, it's probably an imported infection which could be from anyone - Reckon your staff member may have an idea of how they picked up the infection.

 

[Cookster15]

You are trying to find a needle in a haystack by pinpointing a Chinese student - Yes, it's probably an imported infection which could be from anyone - Reckon your staff member may have an idea of they picked up the infection.

Not really. There is other evidence and simple reasoning. You see within Sydney there were known COVID-19 infection hotspots. Where I work was near the centre of one of these. It is not proof of course but we know the uni has a large proportion of Chinese students and I know personally that they frequent this shopping centre as it is a short walk away. There is no other reason I can think of why this part of Sydney became an infection hotspot and our staff member I suspect visited this shopping centre. I don't know this staff member its a large company and the company claimed to have contacted everyone who had been in touch with the infected staff member. Nether I nor anyone in my team had been. Phew.

 

[Cookster15]

If countries were serious about the virus they would have all locked down their borders in the last week of January - My guess is Governments and their experts were hoping the virus would die out.

I think the delay was simply because China is Australia's largest export market. So the government didn't want to upset them until the time was right and China would not get upset. Yes it meant more infections were imported but that was the risk. In any case we are in much better shape so far than America or Europe.

 

[Mayomaniac]

While even Spain is opening up more fabrics and different industries Italy has extended the lockdown until May 3rd. Book stores and those who are selling children's clothing are allowed to reopen while people can't ride their bikes outside because Italy...
I really don't get the reasoning why those are allowed to reopen instead of others, but it's Italy.

 

[Eyeballs Out]

Regarding the number of false positives associated with an AB test ...
If you genuinely have a 4-5% false positive rate then I'd say that test is fairly useless. False negatives are one thing - you can see how it could easily be the case that your test isn't sensitive enough to find small amounts of ABs. But false positives ? ? How are you finding something that isn't there ? The most likely answer is that you are finding something else that looks similar to covid19 ABs (maybe ABs from a different coronavirus?) and you can't tell the difference. In that case you don't really have a covid19 AB test.
Actually knowing you have false positives is a bit of a problem though isn't it ? You're expecting (indeed very much hoping) that there will be lots of cases where someone hasn't had obvious symptoms but has had covid19. Even if they had a previous negative PCR test (showing no presence of virus) it could just have been taken in the wrong week. You could only really have a strong suspicion of false positive if someone asymptomatic has been regularly tested negative with the PCR and there there are not going to be many (if any) of those people around

 

[yaco]

I think the delay was simply because China is Australia's largest export market. So the government didn't want to upset them until the time was right and China would not get upset. Yes it meant more infections were imported but that was the risk. In any case we are in much better shape so far than America or Europe.

I am referring to every country closing their borders to visitors from all other countries, not just China - As we can see with Italy who was just about the first country to ban flights from China, this didn't work as it had to include all countries.

 

[Merckx index]

If you genuinely have a 4-5% false positive rate then I'd say that test is fairly useless.

As Levi's example does show, if the false positive rate is much higher. than the true positive rate, then, yes, the test is pretty useless. That didn't seem to be the case in that one German town, but I'm still trying to find out what the false positive rate was, or whether they even took that into account. I would think that all these plans by various countries to run Ab tests wouldn't be in the works if they thought the false positive rate was too high, but at this point I don't know.

Here's a study of Abs to portions of the spike protein of the original SARS-CoV, which they report had 100% specificity (no reaction with healthy patients).

https://sci-hub.tw/https://www.ncbi.nlm.nih.gov/pubmed/16522785

 

[Keram]

They are also being tested for COVID19.

Similar measure is in Slovakia. Everybody crossing border have to go to state quarantine (I dont know if it is possible to find everybody) and they are tested after couple of days. It seems effective. For example from 27 new cases reported today ( They always report yesterdays stats) 15 cases were from state quarantine. Also long awaited day come to Slovakia. They reported cured cases from people not required hospitalization so active cases dropped by 57 compared to yesterday.

 

[Chris Gadsden]

The US has finally....read Fed portion of gov'mint woken up to the fact that the trial periods are necessary to avoid heinous side effects and the rush by private copywritten cures to cash in. Fortunately they've accelerated several vaccine trials and anti-body testing protocols that will be Fed owned and open to commercial producers upon approval by Battelle labs and other smaller, non-profit based enterprises.
Trump has struggled here with his need for relevancy and being part of a solution he so seriously didn't consider and his more extreme followers considered a "loss of rights". It is now small thing that gun sales are soaring beyond the rate that occurred when....wait for it....a President of color was elected. He waited until yesterday to ask his "fundamental" religious base to not gather for en masse Easter, lest his feared negative numbers might go up. By numbers...I mean body count.
Fortunately our State Governors have authority over State level public access and have, for the most part pressed for less contact and a real litmus test before sending kids back to school or folks to work. They will be our buffer from a hasty urge to restart major employment without testing protocols. We have almost no testing available at all, despite whatever press you may see on your continent.
Meanwhile we have the Skeptical press suggesting that it will continue to just kill old people that were going to die very soon: see Foxnews with Hannity and Bill O'Reilly. They suggest we need to gauge that risk against the current economic consequences which would surely be dwarfed by a robust second or third wave of C-19.

I appreciate and admire that most country's medical officials are concerned with long term solutions and subsequent waves of infection, as well as inevitable mutations. Here, Donald just wants to get checks to people for a short term fix and some financial activity going so he can game his reelection campaign. I've survived recessions, stagflation, Vietnam and a lot of personal stresses that pale to the worldwide health and financial impacts we're seeing. I can only say the economic outfall will continue years past a vaccine and we need to prepare for that as much as the threats to health. We need serious fu*king leadership in the US and anywhere else.

Thank God on Easter the folks in New Zealand and a few other areas got it right.
Hopefully, really hopefully the US won't screw it up for everyone else.

Huh. We can’t even mention COVID Country of origin but we can still bash the current President of the USA. Seems legit.

Meanwhile it’s beginning to look like California may be past the worst of new cases:

https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/

 

[djpbaltimore]

Baltimore's post about the Ab false positive actually helps solve a problem I was puzzling over. In the German study, 2% of the subjects were positive with the virus, but 14% with the antibody. Germany, like Austria, has close to an equal number of active cases and recovered, so the 2% figure can be doubled to 4%. This is the fraction of the population (in that town) who have tested positive and shown symptoms.

But that still indicates that asymptomatics are about 70% of the infected people: (14-4)/14. If we asssume 4.4% of the population are false positives, though, the true proportion of Ab positives is 9.6%. The proportion of asymptomatics drops to 5.6/9.6 = 58%. This is much closer to the 50% figure emerging from other data, such as Iceland.

However, this number would have to be revised upwards somewhat to account for the recent negatives that haven't yet developed Abs. For example, if half of the currently negative people haven't developed Abs. then the proportion of asymptomatics would be 6.6/10.6 = 62%. In fact, this may be the assumption, because according to one report, the 14% became 15% by "eliminating overlap between the two groups", IOW, they assumed that !% of the population tested negative but did not have Abs yet. I'd have thought that number was lower, but anyway, probably 60% is about as high a proportion of asymptomatics as this study would imply.

This makes me wonder how a mortality rate of 0.37% was calculated. Did they take into account some false positive rate? I assume they would, but if they did, the 14% or 15% rate reported would be inaccurate and misleading--unless the actual rate was higher than that, and they got that after subtracting false positives. But I haven't been able to find any information on this.

Edit: Yes, it turns out that some experts have questioned the sensitivity (false negatives) and selectivity (false positives) of the Ab test used in Germany. This suggests to me that they didn't make any correction for false positives. I don't even know what that 4.4% figure I used is based on. I went back to Levi's original tweet, and he throws it out as though it were some fixed constant. It depends on the Ab, and probably, the person doing the assay. Maybe he got it from the German group, but then again, why didn't the group point that out when they were reporting to the media?

https://www.sciencemediacentre.org/...v-2-virus-in-residents-of-gangelt-in-germany/

I also wonder what they used as the mortality rate prior to taking into account the Ab information. According to a story in German, they used a Johns Hopkins estimate of 1.98%. But that is very worrisome, because it's very close to the naive mortality rate (deaths/cases), which is known to be an underestimate. For April 7, that rate was 1.87%; on April 8 it was 2.07%, so they do seem to be using that. But then how do they go from there to 0.37%?

In regard to the German data, I don't have enough experience with the tests that are currently being developed to say whether some of the error in measurement is due to the high throughput nature of the pinprick tests that are going through the FDA approval process. It is quite possible that the boutique ELISAs to detect CoV antibodies like used in smaller studies by researchers might have a lower false positive rate.

Alternatively, it might also be that people with marginal infections develop marginal amounts of antibody that is difficult to differentiate from non-immune sera. That marginal amount may be sufficient for some immunity, but it might be difficult to detect. I have seen that from animal studies in my own lab. Even identical inbred mice can respond vastly different to an immune challenge. Positive/ negative is often less instructive than the quantitative titers. Setting the threshold for what is positive is somewhat arbitrary TBH. If you raise it, you will probably have fewer false positives, but quite possibly more false negatives. The beauty of PCR is the amplification steps, there is nothing like that in ELISAs, so noise around the baseline can be problematic.

Posting before those articles get traction here.

https://twitter.com/x/status/1249689642992951296

View: https://twitter.com/angie_rasmussen/status/1249689642992951296

 

[movingtarget]

The UK is an Island. yet we are soon going to become one with the highest number of deaths. But for rules on this board, that's down to politics that cannot be discussed.

I was curious last week and looked on a flight app to see the number of aircraft over the UK. I noticed a lot less, but Heathrow was still busy. I looked an saw a flight had come in from JFK. What measures are been taken at airports? I bet nothing at all.

Australia also with only 24 million people doesn't have the density of population that many US and European cities have. The majority of Australians live on the outskirts of cities even in Sydney, in suburbia not in the CBD or city centre. Also Australia only has eight states and territories which makes it much easier to shut down borders and with huge distances between the largest cities.

 

[jmdirt]

I'd disregard the argument about spreading particles four metres in the air - First there is nothing to suggest COVID 19 is spread by aerosols and if this was the case lots more would be ill - These combination of SARS?/Ebola/HIV drugs is old hat in some parts of Asia - Health professionals have been using a cocktail of these drugs since the outbreak and they tend to be more aggressive in treating patients who reach ICU - Finally the death rate against positives seems to be lower in some Asian countries.

I've read so many things that they are mashing together, but something I read said that viral droplets needed to be 5 microns to be viable, and particles that size fall out of the aerosol quickly.

While I'm glad that people are researching every aspect of this disease, lab tests are not always directly applicable to real world. For example the splatter test that was on the home page of CN is shocking at first, but my last five rides have been in a steady 20 mph wind with gusts above so that completely changes how the splatter will behave.

 

[Unchained]

False positives because of rushed,faulty or fake test would certainly be bad..but false negatives because of the same or additional unmentioned..way way way more dangerous. Spreading w social wildfire force because you received a clear test will be deadly.
testing is a major component of everything..economy,education..social ills from isolation and fear.
vaccines are going to change everything..so will medicines that mitigate the effects..but testing is the major pillar of life going forward.
masks and sanitizer for every man woman and child..x2 or 3..

The coronavirus spreads at least 13 feet, travels on shoes: CDC

The coronavirus can travel through the air at least 13 feet — more than twice as far as social distancing guidelines, according to a report from the Centers for Disease Control and Prevention…

nypost.com

Chloroquine study called off after irregular heartbeats detected in patients

Researchers called off a small Brazilian study on the anti-malaria drug chloroquine’s ability to combat coronavirus after some participants experienced potentially fatal heart complications. …

nypost.com

 

[movingtarget]

What scientists now know

Five months on, what scientists now know about the coronavirus

Medical researchers have been studying everything we know about Covid-19. What have they learned – and is it enough to halt the pandemic?

www.theguardian.com

 

[Alpe d'Huez]

I'm not sure about friends in Europe or overseas, but there's a lot of talk here in the US about, "when to reopen the country. Or economy." I find such statements, especially the latter, to be really misleading, almost irrational spin. It's almost implying there's some sort of spigot, and we just shut it off for a little while while this virus thing happens, and when that's calmed down enough, or we mitigate it's risk enough, we can turn the spigot back on and continue on our happy, merry way.

Maybe it has to do somewhat with American hubris, or that we can be so very full-tilt capitalist driven, as if that solves everything? Maybe it's just optimistic language, but I have a real hunch this thing isn't going to easily be eradicated. Both a truly effective treatment, plus vaccine, are going to take some time even with effective social distancing and quarantines. Even once that's the case, I don't see the world, let alone the US economy, just going back to way it was a year ago quickly, or easily at all.

Curious others thoughts on all this, especially the tone from those in Europe and the rest of the planet.

 

[djpbaltimore]

You were saying, Alpe. IMO, there is a lot of poor understanding of infectious disease underlying this hopefulness. And that most places are not hard hit at the moment.

https://twitter.com/x/status/1249748172949409804

View: https://twitter.com/ryanstruyk/status/1249748172949409804

 

[Cookster15]

I'm not sure about friends in Europe or overseas, but there's a lot of talk here in the US about, "when to reopen the country. Or economy." I find such statements, especially the latter, to be really misleading, almost irrational spin. It's almost implying there's some sort of spigot, and we just shut it off for a little while while this virus thing happens, and when that's calmed down enough, or we mitigate it's risk enough, we can turn the spigot back on and continue on our happy, merry way.

Maybe it has to do somewhat with American hubris, or that we can be so very full-tilt capitalist driven, as if that solves everything? Maybe it's just optimistic language, but I have a real hunch this thing isn't going to easily be eradicated. Both a truly effective treatment, plus vaccine, are going to take some time even with effective social distancing and quarantines. Even once that's the case, I don't see the world, let alone the US economy, just going back to way it was a year ago quickly, or easily at all.

Curious others thoughts on all this, especially the tone from those in Europe and the rest of the planet.

There is big pressure in Australia to ease restrictions due to the economic costs too. The thing is there is a link between public health and the economy - mental health. When many people lose their jobs or source of income this should not be ignored. There needs to be a balance between controlling COVID-19 and maintaining a functioning economy. I am not sure what this balance is but first step is to recognise this.

 

[search]

As Levi's example does show, if the false positive rate is much higher. than the true positive rate, then, yes, the test is pretty useless. That didn't seem to be the case in that one German town, but I'm still trying to find out what the false positive rate was, or whether they even took that into account. I would think that all these plans by various countries to run Ab tests wouldn't be in the works if they thought the false positive rate was too high, but at this point I don't know.

there was some discussion about it in Germany, also between the virologists. The company (EUROIMMUN) producing the test which was used in Heinsberg said results are 99% correct, so that's the accurancy also taken into account for the numbers of the study - whether this is correct or not is not entirely clear though, as this antibody test has not been validated (yet) by any independent institute.

The UK ordered some (well, 3.5 million...) of the old testkits two weeks ago or so, and they all turned out to be useless

https://www.pressreader.com/article/281732681608623

As you pointed out though, meanwhile there are better tests being developed, and maybe also on the market already.

 

[Oldermanish]

I'm not sure about friends in Europe or overseas, but there's a lot of talk here in the US about, "when to reopen the country. Or economy." I find such statements, especially the latter, to be really misleading, almost irrational spin. It's almost implying there's some sort of spigot, and we just shut it off for a little while while this virus thing happens, and when that's calmed down enough, or we mitigate it's risk enough, we can turn the spigot back on and continue on our happy, merry way.

Maybe it has to do somewhat with American hubris, or that we can be so very full-tilt capitalist driven, as if that solves everything? Maybe it's just optimistic language, but I have a real hunch this thing isn't going to easily be eradicated. Both a truly effective treatment, plus vaccine, are going to take some time even with effective social distancing and quarantines. Even once that's the case, I don't see the world, let alone the US economy, just going back to way it was a year ago quickly, or easily at all.

Curious others thoughts on all this, especially the tone from those in Europe and the rest of the planet.

I agree and didn't mean to introduce the obvious political polarity as noted by Mr. Gadsen above for any other reason than to note that it exists. Realistically the cost of restarting shuttered businesses will cost much but significantly less than the need to shut down again. On an international basis it would be chaotic beyond comprehension to have revolving border openings and closures so it isn't going to be easy or neat. Internationally there will be a reckoning with what it will take to avoid outbreaks again as well as a great opportunity to create some balance between economics and environment. Hopefully a dose a clean air will also clear some minds to what really matters. Hopefully we won't see a rush to fill power vacuums by aggressive regimes.

We can see the visible signs of failed businesses here already and it is truly unfortunate that many will not restart. While the impact was felt here in Seattle earlier than most of the US, that cyclical experience hasn't made most sensible people less cautious about the risks of reengaging the work force. The President claims the authority today to direct the various states to "reopen" at the same time 6 East Coast state Governors are collaborating and asserting their obligation and will to so. Watching this divergence of attitude in real time is not reassuring.

 

[djpbaltimore]

there was some discussion about it in Germany, also between the virologists. The company (EUROIMMUN) producing the test which was used in Heinsberg said results are 99% correct, so that's the accurancy also taken into account for the numbers of the study - whether this is correct or not is not entirely clear though, as this antibody test has not been validated (yet) by any independent institute.

The UK ordered some (well, 3.5 million...) of the old testkits two weeks ago or so, and they all turned out to be useless

https://www.pressreader.com/article/281732681608623

As you pointed out though, meanwhile there are better tests being developed, and maybe also on the market already.

That doesn't totally surprise me. I think there is probably more error resulting from their sampling methodology than in their assay. It does give an important estimate of prevalence in a hard hit area which is needed.

Read that the German academy of science weighed in on the 're-opening'. Suggested that the prerequisite on the gradual relaxation of precautions is that 'new infections stabilize at a low level and the health system is not overloaded'. I think that will be language common to many such statements. It is a lot easier said than done. There will almost certainly have to be built in triggers for secondary lockdowns.

 

[Koronin]

I'm not sure about friends in Europe or overseas, but there's a lot of talk here in the US about, "when to reopen the country. Or economy." I find such statements, especially the latter, to be really misleading, almost irrational spin. It's almost implying there's some sort of spigot, and we just shut it off for a little while while this virus thing happens, and when that's calmed down enough, or we mitigate it's risk enough, we can turn the spigot back on and continue on our happy, merry way.

Maybe it has to do somewhat with American hubris, or that we can be so very full-tilt capitalist driven, as if that solves everything? Maybe it's just optimistic language, but I have a real hunch this thing isn't going to easily be eradicated. Both a truly effective treatment, plus vaccine, are going to take some time even with effective social distancing and quarantines. Even once that's the case, I don't see the world, let alone the US economy, just going back to way it was a year ago quickly, or easily at all.

Curious others thoughts on all this, especially the tone from those in Europe and the rest of the planet.

Both Governor Newsom (Cal) and Governor Cuomo (NY) have said that to reopen it has to be done very slowly. Governor Cuomo talked about it today in his press briefing that it's basically likely very slowly turning the water faucet back on. He also reminded everyone that the economy isn't fully closed as essential things are still open and he was saying it's likely that they will started adding to what is essential to start opening things slowly that way. On Friday Governor Newsom said they are working on a very detailed plan on how to very slowly start reopening California.

For the treatment the Gilead drug (I posted something on it on the previous page) is currently in clinical trials as well as being used for compassionate reasons. The clinical trials results they should be getting back very soon with that information released at the end of April or beginning of May. The information on their drug that has been released is from compassionate use which is showing positive signs and the hope that their trials show the same or better would be scaled up trials and possibly emergency approval.

edited to add:
Today during Governor Newsom's press briefing, he said that Tuesday (tomorrow) in his daily press briefing that he will start laying out how California will start to reopen things.