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orbemnews · 4 years ago

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Vaccines Won’t Protect Millions of Patients With Crippled Immune Systems For more than a year, Dr. Howard Wollowitz has mostly been cloistered inside his home in Mamaroneck, N.Y. As chief of emergency medicine at Montefiore Medical Center in the Bronx, Dr. Wollowitz, 63, was eager to help treat patients when the coronavirus began raging through the city last spring. But a cancer treatment in 2019 had obliterated his immune cells, leaving him defenseless against the virus, so he instead arranged to manage his staff via Zoom. A year later, people in Dr. Wollowitz’s life are returning to some semblance of normalcy. His wife, a dancer and choreographer, is preparing to travel for work at Austria’s National Ballet Company. His vaccinated friends are getting together, but he sees them only when the weather is nice enough to sit in his backyard. “I spend very little time in public areas,” he said. Like his friends, Dr. Wollowitz was vaccinated in January. But he did not produce any antibodies in response — nor did he expect to. He is one of millions of Americans who are immunocompromised, whose bodies cannot learn to deploy immune fighters against the virus. Some immunocompromised people were born with absent or faulty immune systems, while others, like Dr. Wollowitz, have diseases or have received therapies that wiped out their immune defenses. Many of them produce few to no antibodies in response to a vaccine or an infection, leaving them susceptible to the virus. When they do become infected, they may suffer prolonged illness, with death rates as high as 55 percent. Most people who have lived with immune deficiencies for a long time are likely to be aware of their vulnerability. But others have no idea that medications may have put them at risk. “They’ll be walking around outside thinking they’re protected — but maybe they’re not,” said Dr. Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society, which funds research on blood cancers. The only recourse for these patients — apart from sheltering in place until the virus has retreated — may be to receive regular infusions of monoclonal antibodies, which are mass-produced copies of antibodies obtained from people who have recovered from Covid-19. The Food and Drug Administration has authorized several monoclonal antibody treatments for Covid-19, but now some are also being tested to prevent infections. Convalescent plasma or gamma globulin — antibodies distilled from the blood of healthy donors — may also help immunocompromised people, although a version of the latter that includes antibodies to the coronavirus is still months from availability. “It’s a clear area of unmet need,” said Hala Mirza, a spokeswoman for Regeneron, which has provided its monoclonal antibody cocktail to a handful of immunocompromised patients through a compassionate use program. (Regeneron released trial results this week showing that the cocktail reduces symptomatic infections by 81 percent in people with normal immune systems.) It’s unclear how many immunocompromised people don’t respond to coronavirus vaccines. But the list seems at least to include survivors of blood cancers, organ transplant recipients, and anyone who takes the widely used drug Rituxan, or the cancer drugs Gazyva or Imbruvica — all of which kill or block B cells, the immune cells that churn out antibodies — or Remicade, a popular drug for treating irritable bowel disease. It may also include some people over age 80 whose immune responses have faltered with age. “We’re extremely concerned and interested in trying to see how we might be able to help those particular patients,” said Dr. Elad Sharon, an immunotherapy expert at the National Cancer Institute. As the pandemic spread, doctors who specialize in treating blood cancers or who care for immunocompromised people expected at least some of their patients to encounter difficulties. Dr. Charlotte Cunningham-Rundles, an immunologist at Icahn School of Medicine at Mount Sinai in New York, has about 600 patients who are almost entirely dependent on getting regular doses of gamma globulin to stay safe from pathogens. Even so, 44 of her patients became infected with the coronavirus; four died, and another four or five had long-term illnesses. (Chronic infections may offer opportunities for the virus to evolve into dangerous variants.) Steven Lotito, 56, one of Dr. Cunningham-Rundles’ patients, was diagnosed with a condition called common variable immune deficiency when he was 13. Before the pandemic, he had an active lifestyle, exercised and ate well. “I’ve always known to take sort of special care of my body,” he said. That included infusions of gamma globulin every three weeks. Despite taking careful precautions, Mr. Lotito caught the virus from his daughter in mid-October. He had a fever for nearly a month, and spent a week in the hospital. Convalescent plasma and remdesivir, an anti-viral drug, provided relief for a couple of weeks, but his fever returned. He finally felt better after one more infusion of gamma globulin, during which he sweated through four shirts. Updated April 15, 2021, 2:02 p.m. ET Still, after nearly seven weeks of illness, Mr. Lotito had no antibodies to show for it. “I still have to take the same precautions that I was taking, you know, a year ago,” he said. “It’s a little disheartening.” People like Mr. Lotito depend on those around them choosing to be vaccinated to keep the virus at bay, Dr. Cunningham-Rundles said. “You’re hoping that your entire family members and all your close colleagues are going to go out and get some shot, and they’re going to be protecting you with herd immunity,” she said. “That’s what you have to start with.” Dr. Cunningham-Rundles has tested her patients for antibodies and signed a few up for Regeneron’s monoclonal antibody cocktail. But many other people with such conditions are not aware of their risks or their options for treatment. The Leukemia and Lymphoma Society has set up a registry to provide information and antibody tests to people with blood cancers. And several studies are assessing the response to coronavirus vaccines in people with cancer, autoimmune conditions like lupus or rheumatoid arthritis, or who take drugs that mute the immune response. What You Need to Know About the Johnson & Johnson Vaccine Pause in the U.S. On April 13, 2021, U.S. health agencies called for an immediate pause in the use of Johnson & Johnson’s single-dose Covid-19 vaccine after six recipients in the United States developed a rare disorder involving blood clots within one to three weeks of vaccination. All 50 states, Washington, D.C. and Puerto Rico temporarily halted or recommended providers pause the use of the vaccine. The U.S. military, federally run vaccination sites and a host of private companies, including CVS, Walgreens, Rite Aid, Walmart and Publix, also paused the injections. Fewer than one in a million Johnson & Johnson vaccinations are now under investigation. If there is indeed a risk of blood clots from the vaccine — which has yet to be determined — that risk is extremely low. The risk of getting Covid-19 in the United States is far higher. The pause could complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy. Johnson & Johnson has also decided to delay the rollout of its vaccine in Europe amid concerns over rare blood clots, dealing another blow to Europe’s inoculation push. South Africa, devastated by a more contagious virus variant that emerged there, suspended use of the vaccine as well. Australia announced it would not purchase any doses. In one such study, British researchers followed nearly 7,000 people with Crohn’s disease or ulcerative colitis from 90 hospitals in the country. They found that less than half of patients who took Remicade mounted an immune response following coronavirus infection. In a follow-up, the scientists found that 34 percent of people taking the drug were protected after a single dose of the Pfizer vaccine and only 27 percent after a single dose of the AstraZeneca vaccine. (In Britain, the current practice is to delay second doses to stretch vaccine availability.) Likewise, another study published last month indicated that fewer than 15 percent of patients with cancers of blood or the immune system, and fewer than 40 percent of those with solid tumors, produced antibodies after receiving a single dose of the Pfizer-BioNTech vaccine. And a study published last month in the journal JAMA reported that only 17 percent of 436 transplant recipients who got one dose of the Pfizer-BioNTech or Moderna vaccine had detectable antibodies three weeks later. Despite the low odds, immunocompromised people should still get the vaccines because they may produce some immune cells that are protective, even antibodies in a subset of patients. “These patients should probably be prioritized for optimally timed two doses,” said Dr. Tariq Ahmad, a gastroenterologist at the Royal Devon and Exeter NHS Foundation Trust who was involved in the infliximab studies. He suggested that clinicians routinely measure antibody responses in immunocompromised people even after two vaccine doses, so as to identify those who also may need monoclonal antibodies to prevent infection or a third dose of the vaccines. Wendy Halperin, 54, was diagnosed at age 28 with a condition called common variable immunodeficiency. She was hospitalized with Covid-19 in January and remained there for 15 days. But the coronavirus induced unusual symptoms. “I was having trouble walking,” she recalled. “I just lost control of my limbs, like I couldn’t walk down the street.” Because she was treated for Covid-19 with convalescent plasma, Ms. Halperin has had to wait three months to be immunized and has made an appointment for April 26. But despite her condition, her body did manage to produce some antibodies to the initial infection. “The take home message is that everybody should try and get the vaccine,” said Dr. Amit Verma, an oncologist at Montefiore Medical Center. The gamble did not pay off in Dr. Wollowitz’s case. Without antibodies in his system to protect him, he is still working from home — a privilege he is grateful for. He was an avid mountain biker and advanced skier, both of which carry risk of injury, but with the coronavirus, he is playing it safe. In anticipation of returning to his normal lifestyle, Dr. Wollowitz is tuning his bicycles. But he said he foresaw himself living this way till enough other people are vaccinated and the number of infections in the city drops. “I’m not exactly sure what that date is,” he said. “I’m really waiting to get back out.” Source link Orbem News #Crippled #immune #Millions #patients #protect #systems #Vaccines #Wont

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sciforce · 4 years ago

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Potential of Using Machine Learning & AI During COVID-19

The medical application of machine learning & AI is one of the most principal and fast-growing fields of our expertise. Following the global rush for minimizing the coronavirus crisis effects, SciForce can not stay behind in the tremendous eHealth development.

The Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), popularly known as COVID-19, has become a matter of great concern globally since the end of 2019. While Pfizer/BioNTech, Moderna, AstraZeneca, and Sinovac vaccines have become household names and bring some light at the end of the tunnel, we've got more tasks to solve. Patients' diagnosis, treatment, and monitoring cause enormous pressure on healthcare providers worldwide. Healthcare software development turns out to be on the frontline. Given the pandemic peculiarities, the latest approaches of ML & AI have come to tackle the challenge.

Read on to find out the latest AI & ML corona-driven applications for the eHealth industry that help understand and battling the virus.

1. Diagnosis: Coping with the Challenge at Its Infancy

The efficient testing of the population is a key to curbing the spread of coronavirus. However, the available tests are not meeting the demand and resolving the problem to the end. RT-RCP aimed at the viral RNA is a time- and costs-consuming variant and is not widely applicable. Rapid antigen test detects the viral proteins but still is not a precise and guaranteed answer. The antibody test is only relevant to people who have already undergone the COVID-19.

Per recent researches, AI algorithms can diagnose the virus without using the RT-RCP test. Thus, machine learning algorithms detect coronavirus via blood or urine tests, analyzing the samples to predict the COVID-19. The data received from the blood test of the patients stands as the base for neural network analysis for RT-RCP test prediction based on the blood test parameters. ML algorithms of voice processing can help in diagnosing via coughing signal recording. Medical wearables are also widely used in telehealth systems and could be helpful for diagnostics. Hence, virtual visits to the health care providers become possible thanks to the natural language processing algorithm. The Health Center of the Medical University of South Carolina stands as a good example.

Mobile phones serve as great data-generating tools providing immediate access to the potential coronavirus hosts, opening the window of opportunities for epidemiological control as some Pacific Asian governments demonstrate it.

2. AI Assistance for a Treatment: Decision-Making, Recovery Prediction, and Patients' Prioritizing

In constant vital resource scarcity, machine learning algorithms can assist in multi-criteria decision-making for healthcare providers. It is beneficial when it goes about detecting and predicting the disease severity. Thus, medical personnel can prioritize the patients to respond to coronavirus disease and its outcomes. Text processing can help to compare the treatment plans and predict the patient's recovery. Patients prioritizing is particularly crucial in the state of the breathing equipment scarcity.

ML algorithms assist the selection criteria for such existent treatment practice as antibodies circulating blood transfusion. In this case, ML helps to detect whether a subject meets blood donor selection criteria and selects the most suitable plasma.

3. Monitoring Patients: Overcoming Limitations with Telehealth

Deep learning algorithms demonstrate efficacy in predicting patients' severity, mortality, and recovery. In March 2020, the researchers in Wuhan, PRC used the clinical variables of almost 200 hospitalized patients to develop a deep-learning algorithm and risk stratification score system to predict mortality.

One can use the same idea for predicting the disease severity of the patient. It helps forecast the coronavirus effects using clinical and laboratory data like a blood test or even voice signal.

Thus, telehealth gets the new dimension and scope with the pandemic outbreak and promises to show even more tremendous application soon. Combining classical epidemiological methods with deep learning algorithms, natural language processing to process electronic health records using other sensors (temperature, color sensor, camera, and microphone) can cause a paradigm shift for the eHealth industry. So, researchers in Spain show that using clinical variables of more than 10000 patients like age, fever, and tachypnea (abnormal respiration rate) to detect whether a person needs immediate intensive care unit admission.

4. Tackling the Pandemic and Control Regaining

Social distancing, contact tracing, and identifying COVID-19 cases are the crucial steps to keep the reproduction rate small. AI methods of large amounts of data processing come as a powerful tool for large-scale problem-solving. Tracing the person's contact and offering tools for a self-assessment come as one of the possible applications.

Policymakers can use different AI techniques to provide physical distancing among the population, along with surveillance video analysis (PRC), gathering spatio-temporal data provided by mobile phones, and identifying whether a person wears a facemask automatically. Interesting that deep learning methods like computer vision for facemask identification applied for the first time.

Image source

The hidden danger of this pandemic is in the fact that a lot of COVID-19 cases are asymptomatic. ML methods help create mobilized assessment centers based on spatio-temporal data of individuals analyzed. Developing self-organizing feature maps (SOFM) to monitor the epidemic in live time and a particular place is possible. Thus, one can build a projection model for a community spread among the population of a city.

Summing It Up

It is better to predict the problem than to deal with its consequences. However, 2020 showed the globe that we still have a lot to work on for a reliable prognosis. There is not much data on the AI and ML methods to predict the pandemic humankind can face in the future. Meanwhile, the tremendous development of the vaccine and lateral applications for coronavirus diagnosis, treatment, and monitoring shed some light on the overall picture.

AI-based technologies have become great solutions for COVID-19 detecting without RT-RCP testing. They assist in multi-criteria decision-making for healthcare providers, overcome the limitations, and predict the upcoming epidemiological scenarios. It is all already happening now.

SciForce is ready to face the challenge and join the frontline to develop the solutions for coming challenges. The power of science has always empowered people to strive, especially during the last couple of years.

#healthcare #covid19 #coronavirus #flattenthecurve #machine learning #data science #artificial intelligence #data

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go-redgirl · 5 years ago

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The 12 deadliest viruses on Earth

By Anne Harding - Contributing Writer, Nicoletta Lanese - Staff Writer March 04, 2020

Humans have been battling viruses since before our species had even evolved into its modern form. For some viral diseases, vaccines and antiviral drugs have allowed us to keep infections from spreading widely, and have helped sick people recover. For one disease — smallpox — we've been able to eradicate it, ridding the world of new cases.

But we're a long way from winning the fight against viruses. In recent decades, several viruses have jumped from animals to humans and triggered sizable outbreaks, claiming thousands of lives. The viral strain that drove the 2014-2016 Ebola outbreak in West Africa kills up to 90% of the people it infects, making it the most lethal member of the Ebola family.

But there are other viruses out there that are equally deadly, and some that are even deadlier. Some viruses, including the novel coronavirus currently driving outbreaks around the globe, have lower fatality rates, but still pose a serious threat to public health as we don't yet have the means to combat them.

Mortality rates were far higher in populations outside of Europe, where people had little contact with the virus before visitors brought it to their regions. For example, historians estimate 90% of the native population of the Americas died from smallpox introduced by European explorers. In the 20th century alone, smallpox killed 300 million people.

"It was something that had a huge burden on the planet, not just death but also blindness, and that's what spurred the campaign to eradicate from the Earth," Adalja said.

Hantavirus pulmonary syndrome (HPS) first gained wide attention in the U.S. in 1993, when a healthy, young Navajo man and his fiancée living in the Four Corners area of the United States died within days of developing shortness of breath. A few months later, health authorities isolated hantavirus from a deer mouse living in the home of one of the infected people. More than 600 people in the U.S. have now contracted HPS, and 36% have died from the disease, according to the Centers for Disease Control and Prevention.

The virus is not transmitted from one person to another, rather, people contract the disease from exposure to the droppings of infected mice.

Previously, a different hantavirus caused an outbreak in the early 1950s, during the Korean War, according to a 2010 paper in the journal Clinical Microbiology Reviews. More than 3,000 troops became infected, and about 12% of them died.

While the virus was new to Western medicine when it was discovered in the U.S., researchers realized later that Navajo medical traditions describe a similar illness, and linked the disease to mice.

During a typical flu season, up to 500,000 people worldwide will die from the illness, according to WHO. But occasionally, when a new flu strain emerges, a pandemic results with a faster spread of disease and, often, higher mortality rates.

The most deadly flu pandemic, sometimes called the Spanish flu, began in 1918 and sickened up to 40% of the world's population, killing an estimated 50 million people.

"I think that it is possible that something like the 1918 flu outbreak could occur again," Muhlberger said. "If a new influenza strain found its way in the human population, and could be transmitted easily between humans, and caused severe illness, we would have a big problem."

Dengue virus first appeared in the 1950s in the Philippines and Thailand, and has since spread throughout the tropical and subtropical regions of the globe. Up to 40% of the world's population now lives in areas where dengue is endemic, and the disease — with the mosquitoes that carry it — is likely to spread farther as the world warms.

Dengue sickens 50 to 100 million people a year, according to WHO. Although the mortality rate for dengue fever is lower than some other viruses, at 2.5%, the virus can cause an Ebola-like disease called dengue hemorrhagic fever, and that condition has a mortality rate of 20% if left untreated. "We really need to think more about dengue virus because it is a real threat to us," Muhlberger said.

A vaccine for Dengue was approved in 2019 by the U.S. Food and Drug Administration for use in children 9-16 years old living in an areas where dengue is common and with a confirmed history of virus infection, according to the CDC. In some countries, an approved vaccine is available for those 9-45 years old, but again, recipients must have contracted a confirmed case of dengue in the past. Those who have not caught the virus before could be put at risk of developing severe dengue if given the vaccine.

Two vaccines are now available to protect children from rotavirus, the leading cause of severe diarrheal illness among babies and young children. The virus can spread rapidly, through what researchers call the fecal-oral route (meaning that small particles of feces end up being consumed).

Although children in the developed world rarely die from rotavirus infection, the disease is a killer in the developing world, where rehydration treatments are not widely available.

The WHO estimates that worldwide, 453,000 children younger than age 5 died from rotavirus infection in 2008. But countries that have introduced the vaccine have reported sharp declines in rotavirus hospitalizations and deaths.

The virus that causes severe acute respiratory syndrome, or SARS, first appeared in 2002 in the Guangdong province of southern China, according to the WHO. The virus likely emerged in bats, initially, then hopped into nocturnal mammals called civets before finally infecting humans. After triggering an outbreak in China, SARS spread to 26 countries around the world, infecting more than 8000 people and killing more than 770 over the course of two years.

The disease causes fever, chills and body aches, and often progresses to pneumonia, a severe condition in which the lungs become inflamed and fill with pus. SARS has an estimated mortality rate of 9.6%, and as of yet, has no approved treatment or vaccine. However, no new cases of SARS have been reported since the early 2000s, according to the CDC.

SARS-CoV-2 belongs to the same large family of viruses as SARS-CoV, known as coronaviruses, and was first identified in December 2019 in the Chinese city of Wuhan. The virus likely originated in bats, like SARS-CoV, and passed through an intermediate animal before infecting people.

Since its appearance, the virus has infected tens of thousands of people in China and thousands of others worldwide. The ongoing outbreak prompted an extensive quarantine of Wuhan and nearby cities, restrictions on travel to and from affected countries and a worldwide effort to develop diagnostics, treatments and vaccines.

The disease caused by SARS-CoV-2, called COVID-19, has an estimated mortality rate of about 2.3%. People who are older or have underlying health conditions seem to be most at risk of having severe disease or complications. Common symptoms include fever, dry cough and shortness of breath, and the disease can progress to pneumonia in severe cases.

The virus that causes Middle East respiratory syndrome, or MERS, sparked an outbreak in Saudi Arabia in 2012 and another in South Korea in 2015. The MERS virus belongs to the same family of viruses as SARS-CoV and SARS-CoV-2, and likely originated in bats, as well. The disease infected camels before passing into humans and triggers fever, coughing and shortness of breath in infected people.

MERS often progresses to severe pneumonia and has an estimated mortality rate between 30% and 40%, making it the most lethal of the known coronaviruses that jumped from animals to people. As with SARS-CoV and SARS-CoV-2, MERS has no approved treatments or vaccine.

Original article on Live Science.

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jwesulm · 5 years ago

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Social distancing for COVID-19: Buying time to reinforce the front

Hi everyone, just an update as a lot of you across several social media have been in touch with me about coronavirus Q&A’s and the possibility of posting up a weekly, detailed FAQ here on your questions; as some of you have heard, I’ve had to put that aside for now since, alongside primary duties, I’m working on applying a bioinformatic system I developed years ago in a bid to help more rapidly identify promising COVID-19 drug candidates. It’s a bit of ad hoc improvisation at best on a pre-developed resource, and even under the most optimistic scenarios there’s not going to be a cure with this, only some extra tools in the therapeutic arsenal to reduce COVID-19 severity and expedite recovery. But for that very reason, I wanted to don my public health hat one more time before going on quasi-social media hiatus, since even the most promising new SARS-CoV-2 treatment prospects won’t amount to much if the (already imminent) torrent of new COVID-19 cases rises even more steeply than it already is to swarm US hospitals: Please, please diligently follow all the social distancing measures being outlined by public health authorities to the letter, especially avoiding mass gatherings and taking pains to wash hands thoroughly after touching surfaces with high contact (such as doorknobs and handles).

I know how stir-crazy things are getting right now especially with all the mounting anxiety (and desire to assuage it with public get-togethers to greet springtime’s arrival), but having lately been in touch with medical colleagues in US epicenters like Seattle, NYC, San Francisco -- even unexpected hotspots like Kansas City, Phoenix, and Orlando -- I can’t emphasize this point enough: the nightmare scenarios we’ve been witnessing recently in parts of Italy, Spain, Britain and the Middle East aren’t worrisome hypotheticals anymore, they’ve already arrived in many regions of the United States. American hospitals are being inundated, we’re critically low on PPE (personal protective equipment) and test kits for complex reasons I don’t want to get into here, and healthcare workers are themselves suffering casualties from infection even with full-body protective gear -- the bottom line is we’re on a war footing in the US, in the most concrete sense imaginable. And we need assistance from all corners to relieve pressure on the front: the medical centers being overwhelmed with a rapid surge in COVID-19 cases. As abstract and intangible as it can often seem at times, social distancing and contagion control, practiced at an individual + small group level X millions of Americans, is absolutely crucial to flatten the curve and buy the time we need to get reinforcements in the form of additional ventilators and supplies, vaccines, and treatments to improve survival and recuperation.

While all of us are liable to slip up from time to time amid the strictures of the lockdowns and shelter-at-home orders, there are still far too many cases of heedless, gratuitous mass assemblages like the Spring Break parties down in Florida or the multitudes thronging in Bondi Beach, Australia. For all practical purposes, those crowds right now are mass Petri dishes for SARS-CoV-2 to multiply like mad and launch new chain reactions to infect millions more people. I realize this sounds grisly but regrettably, that’s how aggressive this microbial foe is. In the lingo of viral epidemiology, this betacoronavirus -- the taxonomic subgroup to which SARS-CoV-2 belongs -- has a significantly higher R0 (R naught) than the flu, a metric of its contagious capacity; is now known to linger in the air for potentially hours; and is transmissible on many fomites (surfaces with frequent human contact) for days. It has a long incubation period (now thought to be around five days) during which it can be disseminated before a victim is symptomatic, and is thus uniquely capable of exponential spread. The US was also relatively slow to ramp up testing compared to South Korea and Italy (with the Koreans testing 20,000 a day, until recently more than America in a month), which means that undetected community spread has been rampant in the USA for weeks. Brisk strolls in the park and exercise al fresco are fine to break the cabin fever, but especially at this point, large gatherings are a formula to mass-disseminate SARS-CoV-2 still further and utterly deluge America’s already limited supply of hospital beds, ICU rooms, ventilators, and hospital staff to provide treatment. Keep in mind that COVID-19 is slamming us on top of a ruthless flu season and an increase in other medical issues to boot, all of which are being pushed aside to triage for the novel coronavirus avalanche. And then you have another accelerant to the vicious cycle with the attrition from nurses and doctors falling ill (which is exactly what happened to me as a doctor in a previous epidemic from pertussis, requiring years to recover).

Not trying to sound dismal here, but to provide a critical reality check on how basic behavioral modification by communities across the USA, on a mass scale, is pivotal to prevent an overwhelming and potential collapse of the US healthcare apparatus if the caseload surges still further; as dark as things are right now, there is real prospect for hope on the horizon if we can make it through the gauntlet we’re facing in the next few months. We’ve been here before, after all, with horrific pandemics like the 1918 Spanish flu (a misnomer as it may have originated right here in Kansas in a WWI army barrack) and numerous smallpox, typhus, cholera, polio, yellow fever, and even plague epidemics ravaging the US before the era of mass immunization or antibiotics for bacterial contagions. Early vaccine research is promising, though it can’t be rushed much beyond the (likely minimum) 18 month lag time due to vaccines’ administration to healthy people, and the technical difficulty of ascertaining the most immunogenic cocktail to prime the immune system. And there are dozens of resourceful research and clinical groups across the world right now seeking to develop new COVID-19 drugs or redirect old ones, to which I’m contributing. Many countries have successfully beaten this thing and protected their populations with aggressive public health measures, particularly Taiwan, Vietnam, South Korea, Singapore, China (with rigorous control after the initial blunders and half-measures in Hubei), Hong Kong, and some countries in Europe and South America. COVID-19 takes a level of mobilization and mustering of public resources beyond any we’ve had to marshal in recent decades, far more than the H1N1 swine flu pandemic in 2009 or Ebola in 2014, but it can be and has been managed successfully. So we don’t have to despair, because new tools are on the way to help us prevail.

Yet this makes it all the more important to buy time for such relief and reinforcements to be produced and arrive at the front. And just to be clear, such public health measures are imperative for all demographics, including younger ones. Contrary to conventional wisdom at the outset, more recent findings are showing that COVID-19 is quite dangerous to children and young adults, much more so than initially thought. The early complacency about this may simply have resulted from the sheer scale of China’s all-out effort to contain the contagion once Wuhan’s and Hubei’s authorities woke up to it, and the similar success of Taiwan and South Korea with mass testing, tracking, and selectively targeted isolation. This nipped SARS-CoV-2’s spread in the bud in East Asia, not only forestalling further infection but also probably reducing viral load and severity of the infectious course among those who did catch it, particularly children. Unfortunately, the comparative lack of early testing, screening, tracking, and isolation in the US and many other Western countries translates into greater sick contact density and a potentially higher viral load for infections here, which raises the danger level for everyone, including kids and college students at beach parties. (For the technically-minded among you out there, the paper in Amer J Respir Crit Care Med, 2010, by DeVincenzo et al., has a good summary of how initial viral load can greatly exacerbate pediatric infection severity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001267/ ) We likewise know that there at least two major strains of this deadly coronavirus -- S-type and L-type -- and now possibly more given its high mutation rate.

Moreover, not only is COVID-19’s lethality at least an order of magnitude higher than the flu, but it also has an alarmingly high rate of serious illness in acute cases, and we know precious little about medium or longer-term sequelae; not to mention that SARS-CoV-2 is hardly confined to the lungs but has been shown to affect the liver and GI tract, kidneys, and even central nervous system in many patients. And it’s not yet clear why, but immunity to COVID-19 seems to wane precipitously in many patients infected by SARS-CoV-2, leaving them vulnerable to deadly re-infections -- a likely reason that initial attempts to achieve “herd immunity” through clustered infection (as opposed to immunization) in some countries, as trial-ballooned in e.g. the UK and Australia, have had catastrophic results and been abandoned. There’s not going to be a magic bullet or straightforward victory here. This is going to be a months-long grind as the infectious curve is flattened and new options emerge to mitigate contagious spread and facilitate recovery in those already afflicted. Meanwhile, communities across the country need to do everything possible to buy time for the aforementioned reinforcements to arrive, and this means rigorous adherence to social distancing and other measures announced by authorities to break the chain of contagion. We will get through this; please keep safe everyone. -- J. Wes Ulm, MD, PhD

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brajeshupadhyay · 5 years ago

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23:44 (IST) Coronavirus in Puducherry Latest Updates Borders between Puducherry, Cuddalore & Villupuram sealed Boundaries of Puducherry with Cuddalore & Villupuram (both in Tamil Nadu) to be sealed from tomorrow. People to be allowed only for medical services. E-passes from Chennai will not be allowed here: Puducherry CM V Narayanasamy If you come with a certificate stating that you are not infected with the disease when you come from abroad, then you are allowed in Puducherry: Chief minister V Narayanasamy 23:36 (IST) Coronavirus in Delhi Latest Updates 1,859 new COVID-19 cases in Delhi today 1,859 fresh COVID-19 cases and 93 deaths have been reported in Delhi on Tuesday. Total number of positive cases stand at 44688 and death toll is at 1837: Directorate General of Health Services, Delhi 23:22 (IST) Coronavirus in Delhi Latest Updates Satyendar Jain to undergo COVID-19 test tomorrow Delhi's Health Minister Satyendar Jain who had tested negative for #COVID19 today, will once again undergo test tomorrow. He was admitted to Rajiv Gandhi Super Speciality Hospital after he complained of high fever and difficulty in breathing. 23:17 (IST) Coronavirus in India Latest Updates Health ministry issues SOPs to deal with stigma around COVID-19 "To address the stigma associated with coronavirus, the Union Health Ministry issued an illustrated guide, saying the pandemic is causing a difficult time and that rumours and misinformation create more stress and can "hamper Covid-19 recovery"," News18 reported. #CoronaVirusUpdates #IndiaFightsCorona@MoHFW_INDIA releases new illustrated guide to curb stigma associated with #COVID19.https://t.co/FFrYIry27g@PMOIndia @drharshvardhan @AshwiniKChoubey @PIB_India @COVIDNewsByMIB @CovidIndiaSeva @DDNewslive @airnewsalerts — Ministry of Health (@MoHFW_INDIA) June 16, 2020 23:06 (IST) Coronavirus in Telangana Latest Updates Over 40,000 COVID-19 tests in Telangana so far Reports said that after more than a month, the Telangana government released testing figures. The bulletin said that 44, 431 samples have been tested for coronavirus so far. 22:57 (IST) Coronavirus in Maharashtra Latest Updates 941 new COVID-19 cases in Mumbai The BMC said that 941 new COVID-19 cases and 55 deaths have been reported in Mumbai on Tuesday. Total positive cases stand at 60,142 and death toll is at 3165. 22:45 (IST) Coronavirus in Maharashtra Latest Updates Maharashtra govt says 1,328 COVID-19 deaths not added to toll Maharashtra chief secretary Ajoy Mehta on Tuesday said as many as 1,328 deaths, that took place due to COVID-19, were not reported as fatalities caused by the viral infection in the state. As many as 862 of these deaths occurred in the areas falling under the Brihanmumbai Municipal Corporation (BMC) limits, he said here, citing a fresh review of COVID-19 fatalities in the state carried out by authorities. This has now been corrected and fatality figures have been updated accordingly, he said. (PTI) 22:34 (IST) Coronavirus in Uttar Pradesh Latest Updates Allahabad SSP tests COVID-19 positive, says report "Hours after being transferred out of Allahabad, the Senior Superintendent of Police Satyarth Anirudh Pankaj tested positive for coronavirus today. He was shifted to Swaroop Rani Nehru Hospital's Covid-19 ward," News18 reported. 22:28 (IST) Coronavirus in Gujarat Latest Updates Jagannath Yatra to take place in Ahmedabad The Gujarat government reportedly allowed the Jagannath Yatra in Ahmedabad to take place amid the coronavirus curfew, India Today reported. "Yatra will go out with more than 200 devotees and [Home Minister] Amit Shah will also give 'Hajri'," the report quoted a statement as saying. 22:22 (IST) Coronavirus in Himachal Pradesh Latest Updates 3 COVID-19 patients in Himachal booked for not revealing test results Three COVID-19 patients have been booked for allegedly not revealing their test results and travelling to Himachal Pradesh's Mandi district from Delhi-NCR, police said on Tuesday. While two patients have been booked for attempt to murder under Section 307 of the IPC, one COVID-19 patient has been booked under sections 188 (disobedience to order duly promulgated by public servant), 269 (negligent act likely to spread infection of disease dangerous to life) and 270 (malignant act likely to spread infection of disease dangerous to life) of the IPC, Mandi SP Gurdev Chand Sharma said. (PTI) 22:03 (IST) Coronavirus in China Latest Updates Working from home encouraged under Beijing's Level II emergency "Under Beijing's Level-2 emergency response, working from home is encouraged while production will not be halted: Beijing Municipal Official told Global Times. People from medium and high-risk areas and personnel related to Xinfadi market are prohibited from leaving Beijing," Moneycontrol reported. 21:58 (IST) Coronavirus in Puducherry Latest Updates Puducherry CM says COVID-19 spread due to people arriving from Chennai Puducherry chief Mminister V Narayanasamy on Tuesday said medical experts had assessed that the fast spread of COVID-19 in the union territory in the past few weeks was largely because of arrival of more people from neighbouring Chennai and also those returning from abroad. "All the inter-State borders would be strictly monitored and none from neighbouring Tamil Nadu and Chennai would be permitted into Puducherry unless it is for medical care here," he told reporters here. (PTI) 21:53 (IST) Coronavirus in Maharashtra Latest Updates 2,701 new COVID-19 cases in Maharashtra The Maharashtra health department on Tuesday said that 2,701 COVID-19 cases and 81 deaths were reported in the state in the last 24 hours. The total number of cases in the state is now at 1,13,445, including 57,851 discharged and 5,537 deaths. 21:51 (IST) Coronavirus Pandemic Latest Updates WHO says over one lakh cases daily for 2 weeks The head of the World Health Organization says more than 100,000 confirmed cases of coronavirus have been reported worldwide each day over the past two weeks - mostly in the Americas and South Asia - and countries that have curbed transmissions must stay alert to the possibility of resurgence. Tedros Adhanom Ghebreyesus noted a new cluster of cases in Beijing, which went more than 50 days without a new case of COVID-19, and said the origin of that new series of cases is under investigation. (AP) 21:44 (IST) Coronavirus in China Latest Updates Beijing city raises COVID-19 emergency response level to II from III Beijing’s city government on Tuesday raised its COVID-19 emergency response level to II from III, according to state media. The Chinese capital has been battling with a fresh outbreak of the new coronavirus, with more than a 100 new cases confirmed in recent days. (Reuters) 21:36 (IST) Coronavirus in Haryana Latest Updates 550 new COVID-19 cases in Haryana Haryana on Tuesday reported the highest single-day spike of 550 cases. Additionally, 18 COVID-19 patients succumbed to the infection, the state health department said. 21:31 (IST) Coronavirus in Ladakh Latest Updates 94 new COVID-19 cases in Ladakh today 94 people tested positive for COVID-19 in Ladakh on Tuesday, taking the total number of virus cases in the union territory to 649, reports said. 21:14 (IST) Coronavirus in Canada Latest Updates Canada-US border closure extended to 21 July Canada-US border closure extended to July 21, reports AFP news agency quoting Prime Minister of Canada, Justin Trudeau 21:00 (IST) Coronavirus in Gujarat Latest Updates Gujarat reports 524 new COVID-19 cases Gujarat on Tuesday reported 524 new cases of coronavirus, taking the total number of cases in the state to 24,628. 28 patients also succumbed to the infection on Tuesday. 20:56 (IST) Coronavirus in Uttar Pradesh Latest Updates Prayagraj SSP tests COVID-19 positive, says report The Indian Express reported that Uttar Pradesh's Prayagraj SSP tested positive for COVID-19 on Tuesday. 20:44 (IST) Coronavirus in UK Latest Updates UK reports 233 new COVID-19 deaths The United Kingdom's death toll from confirmed cases of COVID-19 rose by 233 to 41,969 as of 1600 GMT on June 15, according to government data released on Tuesday. Earlier, a Reuters tally of official sources showed a toll of 53,077, taking into account cases where COVID-19 was mentioned on death certificates in England, Wales, and Northern Ireland up to June 5, and up to June 7 in Scotland. (Reuters) 20:42 (IST) Coronavirus in West Bengal Latest Updates 415 new COVID-19 cases in West Bengal The West Bengal health department on Tuesday said that 415 new coronavirus cases and 10 deaths were reported in the state in last 24 hours. Total number of cases in the state is now at 11,909, toll is at 495. 20:35 (IST) Coronavirus in Kerala Latest Updates Kerala reports 79 new COVID-19 cases today Kerala on Tuesday reported 79 COVID-19 positive cases, taking the total number of people under treatment for the virus infection in the State to 1,366. With the addition of the fresh cases, 2,621 people have so far been infected by the virus. Those who tested positive today include 47 from abroad and 26 came from other states, state health minister K K Shailaja said. "Two from Thiruvananthapuram and one each from Malappuram, Kannur, and Palakkad district contracted the disease through their contacts. One health worker from Pathanamthitta was also infected," the minister said in a release. (PTI) 20:33 (IST) Coronavirus in India Latest Updates Delhi hospitals follow MHA order over last rites of deceased COVID-19 patients Following Union Home Minister @AmitShah’s directions, all hospitals in #Delhi (Central/state/private) performed the last rites of #COVID19 deceased with consent/presence of their families/relatives.@HMOIndia @PIB_India @airnewsalerts @DDNewslive #IndiaFightsCorona — Spokesperson, Ministry of Home Affairs (@PIBHomeAffairs) June 16, 2020 20:29 (IST) Coronavirus in Punjab Latest Updates 104 new COVID-19 cases in Punjab today Punjab reports 104 new #COVID19 positive cases, taking the total 3371. Death toll stands at 72 after one death was reported today: Department of Information and Public Relations, Punjab 20:11 (IST) Coronavirus in US Latest Updates US politician Ilhan Omar's father succumbs to COVID-19 US Democratic congresswoman Ilhan Omar's father died due to complications over coronavirus on Tuesday. إِنَّا لِلّهِ وَإِنَّـا إِلَيْهِ رَاجِعُونَ Surely we belong to God and to him shall we return. It is with tremendous sadness and pain to say goodbye to my father, Nur Omar Mohamed. No words can describe what he meant to me and all who knew and loved him. pic.twitter.com/gb7q0gMXG2 — Ilhan Omar (@IlhanMN) June 16, 2020 20:03 (IST) Coronavirus in Odisha Latest Updates Odisha reports 108 new COVID-19 cases Reports said that 108 new cases of coronavirus were ereported in Odisha on Tueday, taking the total number of cases to 4,163 in the state. The toll stands at 11. The tally includes 1,175 active cases and 2,974 cured/recovered patients. At least 120 patients recovered today as the state reports a recovery rate of 71.43 per cent. 19:58 (IST) Coronavirus in Delhi Latest Updates Amit Shah, Harsh Vardhan, ICMR, Delhi LG meet over COVID-19 situation Union Health Minister Dr Harsh Vardhan, Director General of ICMR Dr Balram Bhargava, and Delhi Lieutenant Governor Anil Baijal arrive at Ministry of Home Affairs (MHA) for a meeting with Home Minister Amit Shah over coronavirus. Delhi: Union Health Minister Dr Harsh Vardhan, Director General of ICMR Dr Balram Bhargava, and Delhi Lieutenant Governor Anil Baijal arrive at Ministry of Home Affairs (MHA) for a meeting with Home Minister Amit Shah over #COVID19. pic.twitter.com/mTb0GwIJug — ANI (@ANI) June 16, 2020 19:48 (IST) Coronavirus in Delhi Latest Updates DDMA exempts asymptomatic govt officials from 7-day quarantine The Delhi Disaster Management Authority (DDMA) on Tuesday exempted constitutional and government functionaries and their staff members travelling across states on official work from the requirement of 7-day home quarantine, if they are asymptomatic, ANI reported. 19:38 (IST) Coronavirus in Maharashtra Latest Updates 21 new COVID-19 cases in Dharavi today 21 new cases of coronavirus were reported in Mumbai's Dharavi on Tuesday, taking the total number of cases in the densely populated area to 2,089. No deaths were reported in Tuesday, reports said. 19:27 (IST) Coronavirus in Delhi Latest Updates Delhi teacher succumbs to COVID-19 The North MCD reportedly said that teacher died due to the novel coronavirus, India Today reported. "She was working in our dry ration distribution center at the time. We had been in touch with her and according to her own statements she had been getting better till 3 days ago. According to her family, suddenly day before yesterday she started having breathing trouble and had to be hospitalised. She expired today afternoon. She has 2 children aged 4 years and 8 months," an official was quoted as saying by the report. 19:12 (IST) Coronavirus in Delhi Latest Updates Delhi Sikh Gurudwara management offers to set up COVID-19 care centres The Delhi Sikh Gurdwara Management Committee (DSGMC) on Tuesday "offered to create and operate Covid care centres for mild coronavirus cases in the national capital, in a letter to Chief Minister Arvind Kejriwal," News18 reported. 19:03 (IST) Coronavirus in Tamil Nadu Latest Updates Tamil Nadu reports 1,515 new cases Coronavirus cases in Tamil Nadu, one of the worst-affected states, touched 48,000 on Tuesday after 1,515 new cases were reported. "Chennai recorded 919 cases today, taking its tally to 34,245. With 49 deaths, the death toll rises in the state to 528. A total of 1,438 persons got discharged today while there are 20,706 active cases in the state," The Indian Express reported. 18:56 (IST) Coronavirus in Karnataka Latest Updates 317 new COVID-19 cases in Karnataka today Karnataka reported 317 new coronavirus cases on Tuesday, taking the total number of cases to 7,530 in the state. The death toll now stands at 94 after seven more fatalities were confirmed. 18:48 (IST) Coronavirus in Maharashtra Latest Updates Ex Maharashtra MP succumbs to COVID-19, says report Former Member of Parliament from Maharashtra, Haribhau Jawale reportedly succumbed to coronavirus in Mumbai on Tuesday, The Indian Express reported. "Jawale is the first senior politician to succumb to the novel coronavirus in Maharashtra. Jawale tested positive for Covid-19 in the first week of June. On June 3 a decision to move him to Mumbai was taken. Sources said his cough persisted after which he was transferred in an ambulance on oxygen support," the report said. 18:37 (IST) Coronavirus in Jammu and Kashmir Latest Updates 78 new COVID-19 cases in J&K 78 new cases of coronavirus were reported in Jammu and Kashmir on Tuesday. Of these, the UT government said that 16 are from Jammu division and 62 are from Kashmir division. Total number of cases stand at 5298 including 2454 active cases and 63 deaths. 18:23 (IST) Coronavirus in India Latest Updates Modi appeals to remain vigilant "Health infrastructure will need to be boosted with an emphasis on testing and tracing, economic activity will also need to be increased, said PM Narendra Modi in today's review meeting with Chief Ministers on Covid-19 situation. He asked the leaders to continuously keep driving in the fact that danger of the virus is not over yet, and the need to remain vigilant while opening up the economy," News18 reported. 18:06 (IST) Coronavirus in UK Latest Updates UK media says anti-inflammatory drug curbs risk of death due to COVID-19 Dexamethasone, a cheap anti-inflammatory drug for arthritis and other ailments, cuts risk of death in coronavirus patients who are on a ventilator by a third, UK media was quoted by ANI as saying. "Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalized patients. Results were announced Tuesday and researchers said they would publish them soon. The study is a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care. The drug was given either orally or through an IV. It reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients," AP reported. 18:00 (IST) Coronavirus in Delhi Latest Updates Delhi receives 300 COVID-19 isolation coaches from Railways Around 300 COVID-19 care isolation coaches will be placed on Tuesday at Delhi's Anand Vihar Terminal by the Centre in view of rise in COVID-19 cases. Northern Railways CPRO says "Only, people with mild symptoms will be kept here. Management of coach and patient will be done by the state." Delhi: Around 300 COVID care isolation coaches will be placed today at Anand Vihar Terminal by central govt in view of rise in COVID cases. Northern Railways CPRO says "Only, people with mild symptoms will be kept here. Management of coach & patient will be done by the state." pic.twitter.com/Bi0YGS7gwV — ANI (@ANI) June 16, 2020 17:56 (IST) Coronavirus in Uttarakhand Latest Updates Uttarakhand govt to jail people violating COVID-19 guidelines The Uttarakhand government is likely to start jailing and fining people for violations of coronavirus guidelines, The Times of India reported. "The Uttarakhand Epidemic Diseases (Amendment) Ordinance, 2020 came into force on Tuesday, providing for a jail term or a fine or both for the violation of Covid-19 curbs. The amendment ordinance, to which Governor Baby Rani Maurya gave her assent on Saturday, was notified in the state's official gazette on Tuesday," the report said. 17:47 (IST) Coronavirus in Maharashtra Latest Updates Maharashtra govt says 42 state cops succumbed to COVID-19 Maharashtra home minister Anil Deshmukh was on Tuesday quoted by News18 as saying that "at least 3,661 police personnel have tested positive for coronavirus in Maharashtra so far and of them, 42 have died of the infection". 17:34 (IST) Coronavirus in Assam Latest Updates Assam reports 10 new COVID-19 cases Assam minister Himanta Biswa Sarma said that the total number of coronavirus cases in the state rose to 4,319 on Tuesday after 10 new cases were reported in the state. 17:23 (IST) Coronavirus in Maharashtra Latest Updates Maharashtra govt allocates Rs 109 cr to Konkan division The Maharashtra government on Tuesday reportedly allocated Rs 109 crore to the Konkan division to "fight the novel coronavirus pandemic, of which Rs 35 crore will be utilised in Thane district that has the highest number of cases in the state after Mumbai," News18 reported. 17:15 (IST) Coronavirus in India Latest Updates Centre says decision on resumption of international flights to be taken next month Union civil aviation minister Hardeep Singh Puri on Tuesday said, "We are confident that in the coming month we will start taking decisions on the resumption of international flights. I do not want to put a timeline here, all stakeholders and travellers need to be taken into confidence." 17:06 (IST) Coronavirus in UP Latest Updates 516 new COVID-19 cases in UP today The Uttar Pradesh government said that 516 new cases of coronavirus were recorded in the state in last 24 hours, taking total number of active cases to 5,259. A total of 8,904 people (61% recover rate) have recovered while 435 others lost their lives due to the disease," said Principal Health Secretary Amit Mohan Prasad. 16:53 (IST) Coronavirus in Madhya Pradesh Latest Updates 21 new COVID-19 cases in Indore in last 24 hours At least 21 new cases of coronavirus were detected in Madhya Pradesh's Indore district in the last 24 hours, taking the COVID-19 count in the region to 4,090, a health official said on Tuesday. Besides this, four persons, including an 82-year-old man, have died of the deadly infection in the city, the official said, without providing specific dates for these deaths. The district's COVID-19 death toll now stands at 178, he said. As many as 2,892 persons have been discharged so far from hospitals in the district following their recovery, he added. (PTI) 16:50 (IST) Coronavirus in India Latest Updates Modi expresses sadness over COVID-19 deaths Prime Minister Narendra Modi on Tuesday "expressed grief over deaths due to the coronavirus pandemic in India" in his meeting with chief ministers on Tuesday, The Indian Express reported. 16:41 (IST) Coronavirus in India Latest Updates Modi says COVID-19 toll in India is one of the lowest in the world In the virtual meeting with CMs, Prime Minister Narendra Modi said that the COVID-19 toll in the country was "one of the lowest in the world". "Two weeks have passed since Unlock 1.0, our experience during this time could be beneficial for us in future. Today I will get to know ground reality from you, your suggestions will help in chalking out future strategy," he was quoted as saying by The Indian Express. "Speaking about the death toll, the PM said India is one of the states that has had the lowest number of deaths due to coronavirus. He also said that the recovery rate has gone above 50 percent in India," the report added. 16:33 (IST) Coronavirus in India Latest Updates PM asks CMs to ensure 100% use of masks "Don't imagine stepping out without mask," Prime Minister Narendra Modi was quoted as saying to CMs in the virtual meet on Tuesday. He asked them to ensure "100% usage of masks or face covers amid a spurt in coronavirus cases in the country," News18 reported. 16:25 (IST) Coronavirus in India Latest Updates Punjab, Kerala, Goa, Jharkhand CMS participate in PM meeting The Chief ministers of Punjab, Kerala, Goa, Uttarakhand, Jharkhand, and those of the northeastern states are among those taking part in the meeting with Prime Minister Narendra Modi. Coronavirus Outbreak LATEST Updates: The Delhi Disaster Management Authority (DDMA) on Tuesday exempted constitutional and government functionaries and their staff members travelling across states on official work from the requirement of 7-day home quarantine, if they are asymptomatic, ANI reported. Coronavirus cases in Tamil Nadu, one of the worst-affected states, touched 48,000 on Tuesday after 1,515 new cases were reported. "Chennai recorded 919 cases today, taking its tally to 34,245. With 49 deaths, the death toll rises in the state to 528. A total of 1,438 persons got discharged today while there are 20,706 active cases in the state," The Indian Express reported. Around 300 COVID-19 care isolation coaches will be placed on Tuesday at Delhi's Anand Vihar Terminal by the Centre in view of rise in COVID-19 cases. Northern Railways CPRO says "Only, people with mild symptoms will be kept here. Management of coach and patient will be done by the state." The Uttar Pradesh government said that 516 new cases of coronavirus were recorded in the state in last 24 hours, taking total number of active cases to 5,259. A total of 8,904 people (61% recover rate) have recovered while 435 others lost their lives due to the disease," said Principal Health Secretary Amit Mohan Prasad. During the past 24 hours, 10,215 COVID-19 patients were cured, taking the total to 1,80,012, the health ministry said on Tuesday. The recovery rate rises to 52.47 percent, which is indicative of the fact that more than half of positive cases have recovered from the disease, said the Ministry of Health and Family Welfare. More than 55,000 recoveries of COVID-19 patients were reported in Maharashtra, exceeding the total active cases in the state on Monday. While the count of recovered patients reached 56,049, the active cases were 50,554, according to the state health department. The recovery of over 5,000 patients also reduced the number of active cases in the state from 53,017 (on Sunday) to 50,554, despite 2,786 fresh cases being recorded on Monday. At present, the COVID-19 recovery rate has improved to 50.61% in the state, at par with the national average recovery rate. The COVID-19 recovery rate was high while fatalities were low in Tamil Nadu, Chief Minister E Palaniswami said in Chennai on Tuesday. In view of a slew of anti-COVID-19 initiatives being taken by the government, the recovery rate was high, he said adding adequate relief was also being provided to the poor people. The students of Class 10 and 12 of CICSE board can choose not to appear for pending exams and be marked as per their performance in pre-board exams or internal assessment, according to top officials. The board had also submitted the proposal before the Bombay High Court on Monday in response to a petition filed by a parent seeking directions to the authorities to cancel exams in view of the spike in COVID-19 cases. According to Gerry Arathoon, Chief Executive and Secretary, Council for the Indian School Certificate Examinations (CISCE), the students will have to communicate their option to their respective schools by 22 June. The exams which were postponed due to the lockdown to contain spread of coronavirus, are now scheduled to be conducted from 1 to 14 July. However, several parents have been demanding the exams be scrapped. Karnataka chief minister BS Yediyurappa said there is no need for another coronavirus lockdown in the state. He said he would ask Prime Minister Narendra Modi to help in acceleration of economic activities. Meanwhile, Uttar Pradesh’s Shamli district reported its first coronavirus death on Monday. Delhi Health Minister Satyendar Jain on Tuesday said he has been hospitalised here after running high-grade fever and suffering a sudden drop in his oxygen level. The 55-year-old minister has been tested for COVID-19, an official said. Congress leader Rahul Gandhi took a potshot at the Gujarat government, which recorded the highest COVID-19 mortality rate at 6.25 percent, a double of what Maharashtra has registered. Quoting figures from a BBC article, Rahul tweeted saying, "Gujarat Model exposed." Citing reasons like people reporting late to hospitals, lack of trust in the quality of healthcare facilities, low levels of testing in backward areas, the BBC pointed out why Gujarat recorded a high mortality rate. Two more deaths of members of Maharashtra Police personnel took the toll in the force to 42 on Tuesday. The total number of coronavirus cases climbed to 3,626 after 11 more tested positive for COVID-19, said the Maharashtra Police. The COVID-19 recovery was at 60.3 percent after 2,187 cops were cured of the infectious disease. Congress leader Sonia Gandhi hit out at Prime Minister Narendra Modi over the "ill-advised and insensitive" hike in fuel prices during the COVID-19 crisis. In a letter to the prime minister, she said, "It's duty and responsibility of the government to alleviate suffering, not put the people to still greater hardship. Government doing nothing short of profiteering off its people when they are down and out," amid the coronavirus outbreak. Delhi Health Minister Satyendar Jain has been admitted to the National Capital's Rajiv Gandhi Super Speciality Hospital (RGSSH) due to high fever and breathing trouble. He will be tested for coronavirus on Tuesday. In a tweet this morning, the 55-year-old AAP leader said: "Due to high grade fever and a sudden drop of my oxygen levels last night I have been admitted to RGSSH. Will keep everyone updated (sic)". In the past 24 hours, India registered 10,667 fresh COVID-19 cases and 380 deaths. The total number of positive cases in the country stood at 3,43,091, according to the latest data released by the health ministry on Tuesday. Prime Minister Narendra Modi will meet the chief ministers for over two days - Tuesday and Wednesday - to discuss the COVID-19 situation in the wake of rapidly spreading coronavirus disease. On Tuesday afternoon, Modi will hold a video-conference with chief ministers, Lieutenant Governors and administrators of 21 states and union territories. These include Punjab, Kerala, Goa, Uttarakhand, Jharkhand and the North-Eastern states. India saw a jump of over 11,000 novel coronavirus cases for the third consecutive day on Monday, taking the total number of infections to over 3.32 lakh, while the toll rose to 9,520 with 325 more deaths, the Union Health Ministry said. There are 1,53,106 active cases of the coronavirus disease (COVID-19), while 1,69,797 people have recovered and a patient has migrated, according to the ministry's data updated in the morning. The number of confirmed cases rose to 3,32,424 with 11,502 new infections in the last 24 hours, the ministry said. Prime Minister Narendra Modi is slated to interact with chief ministers of states and representatives of Union Territories on Tuesday and Wednesday to discuss ways to check the pandemic as a phased lockdown exit continues across the country. State-wise cases and deaths As many as 120 out of the 325 more deaths were from Maharashtra, followed by 56 from Delhi, 38 from Tamil Nadu and 29 in Gujarat. There were 14 more fatalities in Uttar Pradesh, 12 each in West Bengal and Madhya Pradesh, and 10 each in Rajasthan and Haryana. Five COVID-19 deaths were reported from Karnataka, followed by four in Jammu and Kashmir, three each in Telangana and Puducherry, and two each in Andhra Pradesh, Chhattisgarh and Punjab. A person each succumbed to the infection in Uttarakhand, Himachal Pradesh and Odisha. India is the fourth worst-hit nation by the pandemic after the US, Brazil and Russia. According to the Johns Hopkins University, which has been compiling COVID-19 data from all over the world, India is in the ninth position in terms of death toll. Of the total 9,520 deaths, Maharashtra tops the tally with 3,950 fatalities, followed 1,477 by Gujarat and 1,327 in Delhi. The toll from the pandemic rose to 475 in West Bengal, 459 in Madhya Pradesh, 435 in Tamil Nadu and 399 in Uttar Pradesh. There have been 292 COVID-19 deaths in Rajasthan and 185 in Telangana. The number of fatalities reached 88 in Haryana, 86 in Karnataka, 84 in Andhra Pradesh, and 67 in Punjab. Jammu and Kashmir has reported 59 COVID-19 deaths, followed by 39 in Bihar, 24 in Uttarakhand and 19 in Kerala. Odisha registered 11 coronavirus deaths so far, followed by eight each in Jharkhand, Chhattisgarh and Assam, and seven in Himachal Pradesh. Five people have succumbed to the contagion in Chandigarh and Puducherry, and one each in Meghalaya, Tripura and Ladakh, the ministry said. More than 70 percent of the deaths are due to comorbidities, it added. The maximum number of cases are from Maharashtra with 1,07,958 infections, followed by 44,661 in Tamil Nadu, 41,182 in Delhi and 23,544 in Gujarat. The tally rose to 13,615 in Uttar Pradesh, 12,694 in Rajasthan and 11,087 in West Bengal. The number of COVID-19 cases has gone up to 10,802 in Madhya Pradesh, 7,208 in Haryana, 7,000 in Karnataka, and 6,470 in Bihar. As many as 6,163 people have contracted the deadly disease in Andhra Pradesh, followed by 5,041 in Jammu and Kashmir, 4,974 in Telangana, 4,049 in Assam and 3,909 in Odisha. There are 3,140 cases of the pathogen in Punjab and 2,461 in Kerala, while 1,819 people have been infected in Uttarakhand and 1,745 in Jharkhand. A total of 1,662 people are afflicted with the disease in Chhattisgarh, followed by 1,076 in Tripura, 564 in Goa and 518 in Himachal Pradesh. The number of coronavirus cases rose to 458 in Manipur, 549 in Ladakh and 352 in Chandigarh. Puducherry has registered 194 COVID-19 cases so far, followed by 168 in Nagaland, 112 in Mizoram and 91 in Arunachal Pradesh. Sikkim has 68 COVID-19 cases, while there are 44 infections in Meghalaya and 38 in the Andaman and Nicobar Islands. Dadar and Nagar Haveli and Daman and Diu have registered 36 COVID-19 cases so far. Administrative measures In Telangana, the state government allowed private labs to conduct COVID-19 tests, while fixing the charges at Rs 2,200. It also fixed the fees for treatment in private hospitals. The Karnataka government also said private hospitals would be roped in to treat COVID-19 patients and uniform rates across the state would be fixed for everything from testing to treatment at those institutions. Maharashtra, the worst-hit state, announced that classes for 9-12 standards would begin from July 1, except for in the red zone areas, while classes for 6-8 standards would begin in August. The state also saw suburban train services in Mumbai, known as the city's lifeline, resuming after nearly three months, but only for ferrying people engaged in essential services. EMU train services for essential service staff, as identified by State Govt, has resumed in Mumbai suburban today after a gap of 85 days Systematic access control and social distancing being ensured These special suburban services will not be available for general passengers pic.twitter.com/VgDRbcu3yx — Ministry of Railways (@RailMinIndia) June 15, 2020 In Delhi, the number of COVID-19 tests would be increased to 18,000 per day from 20 June, the ruling AAP and the main Opposition party in the Delhi BJP said after an all-party meeting held by Union home minister Amit Shah. Besides, necessary equipment like oxygen cylinders, ventilators and pulse oximeters for treatment of COVID-19 patients will be provided by the Centre to Delhi and 37,000 beds will be arranged by the month-end for patients in Delhi. Nearly 5,000 tests per day are estimated to be done at present in Delhi, which recorded 1,647 new cases to take its tally to close to 43,000 while the death toll rose past 1,400. The Delhi government has also directed all laboratories and hospitals to work on their full potential, ramp up their COVID-19 testing capacity to meet the increased demand of processing samples and process the samples within 48 hours. Delhi's Health Minister Satyendar Jain said laboratory facilities under the Centre in the national capital are being extended to the city government. Centre asks states to augment healthcare infrastructure Amid reports of shortage of healthcare infrastructure, the Centre has asked states and Union Territories to engage with the private sector for augmenting such infrastructure and provisioning critical care at reasonable rates. There have been several reports indicating an emerging shortage of healthcare infrastructure, including hospitals with ICU beds, ventilators and oxygen-supported beds, for management of COVID-19 patients, the health ministry said. There have also been reports of overcharging by healthcare providers for COVID-19 treatment, it said in a statement. The ministry has asked the states and UTs to engage with the private healthcare providers to facilitate enhanced bed availability and critical care health facilities as well as to ensure fair and transparent charges for services provided. In this regard, some states have already taken an initiative and have reached an agreement with the private sector on reasonable rates and arrangements to provide critical care for in-patient admissions. PMJAY package and CGHS package rates are already available with the states and the rates of CGHS are fixed area wise, the statement said. In order to ensure that patients receive prompt, good quality and care at reasonable rates, it has been suggested to states to have consultations with the local private healthcare providers and arrive at reasonable rates, while factoring in cost elements for personal safety equipment for healthcare providers, the ministry said. It has been suggested that the rates, once fixed, must be widely publicised so that both the patients and service providers are fully aware and capacities are used optimally, it said. States have also been asked to proactively engage with the private sector health providers and consider pooling in public and private healthcare facilities, as this will help in providing prompt, good quality and reasonable health care to COVID-19 patients, the ministry said. With inputs from PTI

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ladystylestores · 5 years ago

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Coronavirus in Africa: Contained or unrecorded?

Medical staff at the Chandaria Health Centre try on face shields in Nairobi, Kenya – 14 May 2020

The World Health Organization (WHO) has warned that nearly a quarter of a billion Africans could contract coronavirus in the first year of the pandemic, with between 150,000 and 190,000 of them dying.

Africa has had less than 100,000 cases so far, but WHO experts believe the continent will have a prolonged outbreak over a few years – and the huge focus on containing the virus has led to other health issues being neglected.

Here, five BBC reporters give a snapshot of what is happening in their countries:

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Congolese ‘probably had virus without knowing it’

By Emery Makumeno, Kinshasa

DR Congo is grappling with coronavirus and Ebola

The Democratic Republic of Congo confirmed its first case of Covid-19 in early March, but a doctor in the capital, Kinshasa, believes the disease arrived earlier.

“During December and January, I can’t remember how many patients came for medical treatment, coughing and with fever and headaches,” he said, referring to Covid-19 symptoms listed by the WHO.

“I am convinced that we, the medical staff, have been exposed to coronavirus already, without knowing it, and we have built a sort of immunity,” he added.

But DR Congo has carried out few tests to check the Covid-19 status of people, because of a lack of medical equipment.

Countries with successful testing strategies, such as South Korea and Germany, have rapidly reached at least 1% of their population, UK medical journal The Lancet points out.

If equipment is available, many African states could ramp up tests – they did more HIV tests between 1 October and 31 December than the 1% target for Covid-19 testing, The Lancet says.

Number of Covid-19 tests done in DR Congo by 18 May: 4,493

Tests required to make up 1% of population: 895,614

HIV tests done from 1 October to 31 December 2019: 203,859

Sources: Africa CDC; The Lancet

So far, DR Congo has recorded more than 1,600 cases of the virus – the ninth-highest number in Africa, according to WHO.

The first Covid-19 case was detected in La Gombe, the main business district in Kinshasa. The government moved swiftly to introduce a lockdown, but the virus has since spread to seven of the country’s 26 provinces – including the mining hub of Lubumbashi.

Story continues

The outbreak comes at a time when DR Congo – which has poor health services, and has been hit by decades of conflict in the east – is also grappling with an Ebola outbreak. It has killed more than 2,000 people since 2018.

The UN children’s agency, Unicef, has also raised concern about a reduction in vaccination rates, saying gains made from immunisation over the past two years could be erased.

Hundreds of thousands of children have not been vaccinated

Unicef said vaccinations were already declining at the beginning of this year, and that the effects of coronavirus will make it worse.

Hundreds of thousands of children had not received polio, measles, yellow fever and other vaccines.

DR Congo might lose its polio-free status and there could be a resurgence of other deadly diseases.

Health workers lacked equipment to protect themselves or the children from Covid-19, and parents were afraid to bring them to vaccination centres.

Short presentational grey line

Kenya hospital has ‘fewer patients but more corpses’

By Mercy Juma, Nairobi

To cover your face become the norm in Kenya

A major public hospital in Kenya’s capital, Nairobi, saw an almost 40% increase in respiratory illnesses such as tuberculosis, pneumonia and asthma between December and early March, a doctor who works there told the BBC.

However, the hospital had a sharp decline in such cases since mid-March, said the doctor, who spoke to the BBC on condition of anonymity as he was not authorised to speak to the media, added.

One reason was that the government had imposed a nationwide dusk-to-dawn curfew to contain the spread of coronavirus.

This has resulted in a drop in night-time admissions, but an increase in the number of dead people being brought to the hospital’s mortuary, the doctor said.

Some people have been desperate to get out of quarantine

People also seemed to be avoiding hospital for fear of being diagnosed with Covid-19 and being sent to quarantine centres, he said.

This is because quarantining has been controversial in Kenya, with the government forcing suspected Covid-19 patients to pay for their own confinement.

The price ranges from $20 (£16) to $100 a night, depending on the centre, though the government has now promised to cover costs at public quarantine centres.

Number of Covid-19 tests done in Kenya by 18 May: 44,851

Tests required to for 1% of population: 537,713

HIV tests done from 1 October to 31 December 2019: 2, 177,170

Sources: Africa CDC; The Lancet

Hostels at schools and universities as well as private hotels have been used as quarantine centres.

A video clip went viral last month, showing several people scaling a wall to flee a centre in Nairobi.

Those quarantined have complained that some centres are not much better than prisons, with poor hygiene and overcrowding making it impossible to practise social distancing.

Short presentational grey line

‘More patients and more corpses’ in northern Nigeria

By Ishaq Khalid, Abuja

Very little testing for Covid-19 has been done in Nigeria

There have been reports of more people falling ill and dying in Nigeria’s most populous state, Kano, since the outbreak of coronavirus nearly three months ago.

So, it is not surprising that President Muhammadu Buhari has extended the lockdown in the northern state to the end of the month.

A grave digger at the Abattoir Graveyard in the main city, also known as Kano, told the BBC: “We have never seen this, since the major cholera outbreak that our parents tell us about. That was about 60 years ago.”

Prof Musa Baba-Shani – the head of department of medicines at Aminu Kano Teaching Hospital, the main hospital in the state – told the BBC that they have been treating more patients with illnesses such as asthma, pneumonia, and tuberculosis, as well as chest pains and sore throats.

The professor, who works with the respiratory diseases unit of the hospital, said there had been an increase of between 40% and 45% in the number of respiratory cases in about the last months.

He attributed the rise to the closure of many hospitals in the state, especially private clinics, because of a lack of protective gear for medics. This has forced more patients to seek treatment at the Aminu Kano Teaching Hospital.

Prof Baba-Shani said some of those with respiratory illnesses were diagnosed with coronavirus, and referred to the treatment centres set up for Covid-19 patients.

He decried the slow testing for coronavirus in Africa’s most-populous country, which has a population of around 200 million. It would be better for both patients and hospitals if testing was speeded up, he said.

Number of Covid-19 tests done in Nigeria by 18 May: 33,970

Tests required to for 1% of population: 2,061,396

HIV tests done from 1 October to 31 December 2019: 1,160,920

Sources: Africa CDC; The Lancet

Another doctor at the hospital, who asked not to be named because he was not authorised to speak to the media, said some people were avoiding seeking treatment because they feared contracting Covid-19 in hospitals.

In north-eastern Yobe state, an unusually high number of people – 471 people – have died in the past five weeks.

It is unclear whether the deaths are linked to coronavirus, but the state’s health commissioner, Dr Muhammad Lawan Gana told the BBC that a preliminary investigation had found that most of the dead were elderly people with pre-existing health conditions such as hypertension and diabetes.

Nigeria has more than 6,000 confirmed cases of coronavirus, the third-highest in Africa.

The commercial capital, Lagos, is at the epicentre of the outbreak, but a lockdown imposed at the end of March has been partially eased, raising fears that the virus could spread.

“It’s tough decision, but I think it was the wrong call,” said Dr Andrew Iroemeh, who works at a Covid-19 isolation centre in the city,

“It’s recommended [that] for a lockdown to be relaxed we should have a consistent reduction in the rate of infection for at least 14 days. We haven’t seen that,” he added.

Short presentational grey line

‘Few signs of virus’ in Ethiopia

By Kalkidan Yibelta, Addis Ababa

Ethiopia has banned gatherings of more than four

Respiratory infections are common in Ethiopia, Africa’s second most-populous state, with a population of more than 100 million. Research shows they are the third major cause of death each year, after neonatal disorders and diarrheal diseases.

The coronavirus outbreak does not seem to have led to more patients with respiratory infections being admitted to hospitals over the past few weeks.

A doctor in the capital, Addis Ababa, told the BBC that he was looking for signs of unreported Covid-19 cases but he did not detect anything unusual.

Number of Covid-19 tests done in Ethiopia by 18 May: 59,029

Tests required for 1% of population: 1,149,636

HIV tests done from 1 October to 31 December 2019: 136,307

Sources: Africa CDC; The Lancet

There was no increase, for example, in the number of patients with pneumonia, a severe complication caused by the virus.

Similar reports were given by a doctor and a nurse the BBC spoke to in eastern and southern Ethiopia respectively.

In recent days, the number of cases detected daily has risen from single to double digits. This has raised some concern, but the overall number is still low – less than 400.

This is despite the fact that Ethiopia, unlike many other states, has not introduced a lockdown, taking limited measures, such as a ban on sporting events and gatherings of more than four people, to curb the spread of the virus.

The doctor in Addis Ababa said Ethiopians might have been spared the worst of the virus because of less foreign travel, or there may be other unknown factors at play.

He said people should take precautions to prevent the spread of the virus as the possibility of a surge could not be ruled out.

Short presentational grey line

Uganda to focus on ‘verbal autopsies’

By Catherine Byaruhanga, Kampala

Traders have been ordered to sleep in markets to reduce the risk of them taking the virus to their homes

Uganda has imposed one of the strictest lockdowns in East Africa and so far it has one of the lowest number of Covid-19 cases in the region – around 260 – and no deaths.

Most of the testing in Uganda has been on truck drivers who arrive from neighbouring states. Last week, Health Minister Ruth Aceng said that of the 139 confirmed cases at the time, 79 were truck drivers.

The President of the Uganda Medical Association, Dr Richard Idro, said that doctors around the country had not reported seeing more patients with respiratory illnesses, though the lockdown – which includes a ban on travel – could have prevented them from going to hospital.

People with mild symptoms of coronavirus might have also stayed at home, resulting in some cases going unrecorded.

Number of Covid-19 tests done in Uganda by 18 May: 87,832

Tests required to constitute 1% of population: 457,410

HIV tests done from 1 October to 31 December 2019: 2,098,734

Sources: Ugandan government; The Lancet

In a recent address, Uganda’s President Museveni said the government planned to carry out “verbal autopsies”https://ift.tt/2HfCbR7; in communities to find out whether people might have died from Covid-19.

The government has promised to distribute free masks to all citizens above six years old over the next two few weeks before easing lockdown measures.

Ugandans on social media have generally been sceptical about the plans, pointing to the delays in giving food to 1.5 million people in and around the capital, Kampala, after they lost their income because of Covid-19 restrictions.

If the mask distribution is successful, Mr Museveni has promised that shops will be allowed to open, public transport will be back on the road but carrying half the number of passengers and food market vendors – who have been sleeping at their stalls under the president’s orders – will be allowed to go home at the end of each day.

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asfeedin · 5 years ago

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How does the new coronavirus compare with the flu?

Editor’s note: This article was revised on April 30 with the latest information on COVID-19.

Since the new coronavirus was first discovered in January, many people have compared it with a more well-known disease: The flu.

Many of these comparisons pointed to the perhaps underappreciated toll of the flu, which causes millions of illnesses and tens of thousands of deaths every year in the U.S. alone. (During the current flu season, the Centers for Disease Control and Prevention (CDC) estimates that there have been 39 million to 56 million flu illnesses and 24,000 to 62,000 flu deaths in the U.S., although that number is an estimate based on hospitalizations with flu symptoms, not based on actually counting up every person who has died of flu.)

The new coronavirus disease, COVID-19, has caused more than 1 million illnesses and 60,000 deaths in the U.S. as of April 29, according to data from Johns Hopkins University.

Related: Is 6 feet enough space for social distancing?

Both COVID-19 and the flu are respiratory illnesses. But COVID-19 is not the flu. Research so far indicates that COVID-19 spreads more easily and has a higher death rate than the flu.

Scientists are racing to find out more about COVID-19, and our understanding may change as new information becomes available. Based on what we know so far, here’s how it compares with the flu.

Symptoms and severity

Both seasonal flu viruses (which include influenza A and influenza B viruses) and COVID-19 are contagious viruses that cause respiratory illness.

Typical flu symptoms include fever, cough, sore throat, muscle aches, headaches, runny or stuffy nose, fatigue and, sometimes, vomiting and diarrhea, according to the CDC. Flu symptoms often come on suddenly. Most people who get the flu will recover in less than two weeks. But in some people, the flu causes complications, including pneumonia. The overall hospitalization rate in the U.S. for flu this season is about 68 hospitalizations per 100,000 people, according to the CDC.

With COVID-19, doctors are still trying to understand the full picture of disease symptoms and severity. Reported symptoms in patients have varied from mild to severe, and can include fever, cough and shortness of breath, according to the CDC. Other symptoms may include fever, chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell. COVID-19 symptoms appear to come on more gradually than those of flu, according to Healthline.

Older adults and people with underlying medical conditions, including heart disease, lung disease or diabetes, appear to be at higher risk for more serious complications from COVID-19, compared with people in younger age groups and those without underlying conditions.

The overall hospitalization rate for COVID-19 in the U.S. is about 29 hospitalizations per 100,000 people as of April 18, although the hospitalization rate for adults ages 65 and older is higher, at 95 hospitalizations per 100,000 people, according to the CDC. However, because fewer people have likely gotten COVID-19 in the U.S. than have gotten the flu, the odds of becoming hospitalized if you have a confirmed case of COVID-19 are thought to be higher than the odds of being hospitalized with influenza.

Children are a high risk group for complications from flu, but this doesn’t seem to be the case for COVID-19 — few children have been hospitalized with the new coronavirus. A study of COVID-19 cases in the United States published March 18 found that, among 4,226 reported cases, at least 508 people (12%) were hospitalized, and of these, less than 1% were younger than 20 years old. In addition, no fatalities among children were reported.

It’s important to note that, because respiratory viruses cause similar symptoms, it can be difficult to distinguish different respiratory viruses based on symptoms alone, according to the World Health Organization.

Related: Can homemade masks protect you from COVID-19?

Coronavirus science and news

Death rate

The death rate from seasonal flu is typically around 0.1% in the U.S., according to news reports.

Though the death rate for COVID-19 is unclear, almost all credible research suggests it is much higher than that of the seasonal flu.

It’s important to note that there is no one death rate for COVID-19; the rate can vary by location, age of person infected and the presence of underlying health conditions, Live Science previously reported.

Among reported COVID-19 cases in the U.S., nearly 6% have died. This is what’s known as the case fatality rate, which is determined by dividing the number of deaths by the total number of confirmed cases. But the case fatality rate is limited for a few reasons. First, not everyone with COVID-19 is being diagnosed with the disease — this is in part due to testing limitations in the U.S. and the fact that people who experience mild or moderate symptoms may not be eligible for or seek out testing. As the number of confirmed cases goes up, the fatality rate may decrease.

Researchers from Columbia University recently estimated that only 1 in 12 cases of COVID-19 in the U.S. are documented, which they said would translate to an infection fatality rate of about 0.6%, according to The Washington Post. But even this lower estimate is still at least six times higher than that of the flu. (The case fatality rate in people who become sick with flu may be 0.1%, but when you account for people who become infected with flu but never show symptoms, the death rate will be half or even a quarter of that, the Post reported.)

What’s more, unlike the flu, for which there is a vaccine, everyone in the population is theoretically susceptible to COVID-19. So while the flu affects 8% of the U.S. population every year, according to the CDC, between 50% and 80% of the population could be infected with COVID-19, according to a study published March 30 in the journal The Lancet. In the U.S., that would translate to 1 million deaths from COVID-19 if half the population becomes infected and there are no social distancing measures or therapeutics, the Post reported.

Another limitation with the case fatality rate is that some people who are counted as confirmed cases may eventually die from the disease, which would lead to an increase in the death rate. For example, South Korea initially reported a case fatality rate of 0.6% in early March, but it later rose to 1.7% by the beginning of April, according to New Scientist.

Related: Why are more men dying from COVID-19?

It’s also important to note that estimates of flu illnesses and deaths from the CDC are just that — estimates (which make certain assumptions) rather than raw numbers. (The CDC does not know the exact number of people who become sick with or die from the flu each year in the U.S. Rather, this number is estimated based on data collected on flu hospitalizations through surveillance in 13 states.) . A recent study posted on the preprint database medRxiv emphasized this point when it found that the number of confirmed and probable COVID-19 deaths in New York City was 21 times higher than the number of reported flu deaths over the same period, from Feb. 1 to April 18.

Virus transmission

The measure scientists use to determine how easily a virus spreads is known as the “basic reproduction number,” or R0 (pronounced R-nought). This is an estimate of the average number of people who catch the virus from a single infected person, Live science previously reported. The flu has an R0 value of about 1.3, according to The New York Times.

Researchers are still working to determine the R0 for COVID-19. Preliminary studies estimated an R0 value for the new coronavirus to be between 2 and 3, according to a review study published Feb. 28 in the journal JAMA. This means each infected person has spread the virus to an average of 2 to 3 people.

Some studies suggest COVID-19 has an even higher R0 value. For example, a study published April 7 in the journal Emerging Infectious Disease used mathematical modeling to calculate an R0 of nearly 6 in China.

It’s important to note that R0 is not a constant number. Estimates can vary by location, depending on such factors as how often people come into contact with each other and the efforts taken to reduce viral spread, Live Science previously reported.

Pandemics

Seasonal flu, which causes outbreaks every year, should not be confused with pandemic flu, or a global outbreak of a new flu virus that is very different from the strains that typically circulate. This happened in 2009 with the swine flu pandemic, which is estimated to have infected up to 1.4 billion people and killed between 151,000 and 575,000 people worldwide, according to the CDC. There is no flu pandemic happening currently.

On March 11, the WHO officially declared the outbreak of COVID-19 a pandemic. This is the first time the WHO has declared a pandemic for a coronavirus.

Related: When will a COVID-19 vaccine be ready?

Prevention

Unlike seasonal flu, for which there is a vaccine to protect against infection, there is no vaccine for COVID-19. But researchers in the U.S. and around the world are working to develop one.

In addition, the flu has several treatments approved by the Food and Drug Administration (FDA), including antiviral drugs such as amantadine and rimantadine (Flumadine), and inhibitors of influenza, such as oseltamivir (Tamiflu) and zanamivir (Relenza). In contrast, the FDA has yet to approve any treatments for COVID-19, although approval for remdesivir, an antiviral initially developed to treat Ebola, is pending.

In general, the CDC recommends the following to prevent the spread of respiratory viruses, which include both coronaviruses and flu viruses: Wash your hands often with soap and water for at least 20 seconds; avoid touching your eyes, nose and mouth with unwashed hands; avoid close contact with people who are sick; stay home when you are sick; and clean and disinfect frequently touched objects and surfaces.

Wearing cloth face coverings in public and practicing social distancing — or staying at least 6 feet (1.8 meters) away from other people — is also recommended to prevent the spread of COVID-19.

Originally published on Live Science.

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drdeepikasclinic · 9 months ago

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antti-nannimus · 5 years ago

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Wash Your Hands Rupert Beale 2230 words

I first heard about coronaviruses in 1999. Their special cunning is in the huge length and complexity of their RNA genome. RNA is much less stable than DNA, so RNA viruses tend to be short. We measure them approximately in kilobases (kb) of information. Polio is a mere 7 kb, influenza stacks up at 14, and Ebola weighs in at 19. Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-CoV-2), the causative agent of Covid-19, is 30 kb. That’s quite normal for a coronavirus, but close to the chemical limits of information storage for RNA – about as long as a strand of RNA can be without collapsing. The viruses therefore need some clever tricks to survive. I remember being fascinated by the RNA ‘pseudoknot’ and ‘slippery sequence’, which allow the viral genome to be read in two different ways simultaneously; the virus can regulate expression of different genes according to the way they are read.

Virologists need more than clever tricks: we also need cash. Twenty years ago, funding wasn’t available to study coronaviruses. In 1999, avian infectious bronchitis virus was the one known truly nasty coronavirus pathogen. Only poultry farmers really cared about it, as it kills chickens but doesn’t infect people. In humans there are a number of fairly innocuous coronaviruses, such as OC43 and HKU1, which cause the ‘common cold’. Doctors don’t usually bother testing for them – you have a runny nose, so what?

When Sars broke out in 2002 we had no effective vaccine for any coronavirus, no antiviral drugs, minimal clues about how it caused disease and very little idea about the dynamics of transmission. It killed a reported 774 people, about 10 per cent of everyone it infected. In retrospect we were lucky that the Sars outbreak of 2002-3 was so nasty: it was easy to spot when someone had it, isolate them and treat them as best we could. There was a brief, intense flurry of funding, which rapidly subsided along with the virus. In 2012 a new, seriously pathogenic coronavirus emerged, Middle East respiratory syndrome related coronavirus (Mers). Like Sars it came to us from bats, but unlike Sars it arrived via dromedary camels – the intermediate host. It’s even nastier than Sars, killing about 30 per cent of people it infects (858 in total), but it doesn’t transmit well between humans. Covid-19 is especially difficult to deal with as most cases are mild. You have a cough, a sore throat, maybe a fever, maybe no symptoms at all – so what?

As the US health secretary Michael Leavitt put it in 2006, ‘anything we say in advance of a pandemic happening is alarmist; anything we say afterwards is inadequate.’ The Chinese government, for all its undoubted faults, instituted rational measures to contain the spread of the virus from its origin in Wuhan. Public transport, schools, large gatherings of any kind – all shut down. Known cases isolated, contacts traced and strict quarantine enforced. Enormous new hospitals built in less than a fortnight. Oxygen and ventilatory support supplied no matter the cost. Medics deployed from across the country, working extraordinary hours. Failure to comply not an option.

The current ‘multi-focal epidemic’, or ‘pandemic’ as virologists would usually describe it, has at the time of writing caused 3408 deaths. If governments move rapidly to contain and delay the spread, and effectively provide optimal medical care, we can expect a case fatality rate just under 1 per cent – though there is still a lot of uncertainty about this. South Korea is showing what a medium-sized country with a democratic government should do. They quickly ramped up their testing capacity, educated the public about self-isolation, shut down large gatherings, restricted travel, increased hospital capacity. They have allocated 30 trillion won (£19 billion) to the response. They have confirmed 6593 cases, but only 42 deaths so far – though only 41 people have been declared to have recovered. The main effort has been in rapid and efficient testing. Detecting and isolating mild cases delays the spread of the disease and reduces the proportion of the population that will be infected. ‘Social distancing’ – reducing human contact – can be achieved by shutting schools, universities, public transport etc, and can mitigate the undetected spread of untested mild cases. The approximately 20 per cent of severe cases requiring hospital treatment, and the roughly 5 per cent of critical cases requiring intensive care, thus do not all arrive in a short time-frame. Resources are not overwhelmed, and lives can be saved.

In countries where rapid testing and isolation do not happen, the disease will at its peak rapidly overwhelm the ability of hospitals to cope, and the case fatality rate will be much higher. The global case fatality rate is above 3 per cent at the moment, and if – reasonable worst case scenario – 30-70 per cent of the 7.8 billion people on earth are infected, that means between 70 and 165 million deaths. It would be the worst disaster in human history in terms of total lives lost. Nobody expects this, because everyone expects that people will comply with efficient public health measures put in place by responsible governments.

Things do not look good in Iran. There was a cluster of cases in Qom. No containment measures were put in place until a number of people had died. The disease spread across Iran and to neighbouring countries, destroying any lingering hope for global containment – though that was always going to be a long shot given the number of cases emerging from China in the early phase of the pandemic. Tehran’s official figure of 4747 cases is likely to be between ten and a hundred times lower than the true number. The World Health Organisation is now involved and the reality may become apparent in the next few weeks. The initial lack of testing and lack of isolation of cases – denialism by the regime – is likely to lead to healthcare services being overwhelmed and tens or hundreds of thousands of deaths.

Most democratic governments will follow South Korea rather than Iran. The UK’s record on testing and isolation of cases has so far been pretty good, though we need to increase testing capability. The announcement on 5 March that containment was no longer realistic and that we are moving towards a policy of delay is exactly right. Politicians will have to make some brave and possibly unpopular decisions on the advice of public health officials.

In the US the response so far has been slow. The situation isn’t helped by a president who keeps suggesting that the virus isn’t that bad, it’s a bit like flu, we will have a vaccine soon: stopping flights from China was enough. Tony Fauci, the director of the National Institute of Allergy and Infectious Disease, deftly cut across Trump at a White House press briefing. No, it isn’t only as bad as flu, it’s far more dangerous. Yes, public health measures will have to be put in place and maintained for many months. No, a vaccine isn’t just around the corner, it will take at least 18 months. Fauci was then ordered to clear all his press briefings on Covid-19 with Mike Pence in advance: the vice president’s office is leading the US response to the virus. ‘You don’t want to go to war with a president,’ Fauci remarked.

The Centres for Disease Control and Prevention (CDC) are in charge of testing for and responding to the outbreak in the US. Astonishingly, their website reports that ‘CDC is no longer reporting the number of persons under investigation (PUIs) that have been tested, as well as PUIs that have tested negative. Now that states are testing and reporting their own results, CDC’s numbers are not representative all of [sic] testing being done nationwide,’ and: ‘As of 4 March 2020, 1524 patients had been tested at CDC. This does not include testing being done at state and local public health laboratories, which began this week.’ As a result, the US has reported only 233 cases. But by piecing together analysis of the genomes of viruses isolated from patients, virologists have shown that Sars-CoV-2 must be circulating undetected in the US. There was a very worrying case in California, where a patient was immediately suspected by his doctors to have Covid-19, but wasn’t tested because he didn’t meet the narrow CDC criteria. Five days later, he tested positive.

The US response will be complicated by its lack of socialised healthcare. Most cases in healthy young people will be mild. Your chance of death as a fit thirtysomething is probably much lower than 0.1 per cent. If you smoke, have diabetes, heart disease or a pre-existing lung condition, or are immunosuppressed, your chance of death is much higher. If you are in your eighties, it’s approaching 15 per cent. People often don’t go to the doctor in the US because they are understandably fearful of the huge costs they may incur. New York City and Washington State have already mandated that testing should be free; we must hope this becomes universal soon. Part of the public health response will have to be self-isolation of possible mild cases. You must not go to work. Will it be possible to convince the US public that they will have to endure some economic hardship to protect their vulnerable compatriots?

The US as a whole is immensely wealthy, and doesn’t have an excuse not to put in place stringent testing and isolation procedures. What about poorer countries? A few cases have been reported in sub-Saharan Africa. There is infrastructure in place to monitor influenza pandemics, which can be repurposed to test for Sars-CoV-2. But to ramp it up to the scale that South Korea has achieved is probably not realistic for a country like Malawi. The test at the moment is expensive, and requires a complicated machine as well as trained staff. There are efforts beginning in the UK, and no doubt elsewhere, to develop a simple ‘point-of-care’ test that could be self-administered. But even a prototype is several months away. Low and middle-income countries will have to put in place measures to increase ‘social distancing’, which could cause significant hardship.

For all its huge genome and clever tricks, Sars-CoV-2 has significant vulnerabilities. It has a fairly feeble fatty envelope, which it needs to sneak into cells. That’s destroyed by soap, and by alcohol – so washing your hands carefully or smearing them in alcohol hand gel will kill the virus. Most transmission is either by very close contact – someone coughs or sneezes in your face – or because a droplet containing the virus touches your hands, and then you touch your face; the virus gets into the body especially easily through the membranes in the eyes, nose and mouth. Expect to be bored to tears over the coming months by pious injunctions to wash your hands. It doesn’t seem like much, but it’s going to reduce the risk at least somewhat.

The second great vulnerability of the virus is that it has to take great pains copying its genome. All RNA viruses (influenza, for example) have a special enzyme that copies RNA into RNA. These RNA-dependent RNA polymerases are usually very sloppy copyists. They do not bother with proofreading, and make huge numbers of errors. This high mutation rate enables them to evolve very rapidly; that’s one reason we need a new flu vaccine every year. Coronaviruses have to be much more careful, or else their huge genome will accumulate too many errors. Their mutation rate is therefore lower, so we may be able to develop a fairly effective vaccine – though it will take a year or two, assuming it’s possible at all.

We can also target the virus with drugs. Remdesivir was developed to target the Ebola polymerase, and may also work against Sars-CoV-2. It certainly works in a Petri dish, and there are ongoing clinical trials in China and the US to see if it works in humans. Sars-CoV-2 produces many of its genes in long, multi-functional proteins that need to be chopped up – by its own ‘protease’ enzymes – into the right chunks. Such proteases have been successfully targeted by antiviral drugs in viruses like Hepatitis C. In my lab we are trying to work out which human proteins Sars-CoV-2 needs to replicate, and the interactions between virus and host may also be good drug targets. But we are a long way off, so in the meantime, what should we do?

I received an email from a colleague in infectious diseases. His message was in no way reassuring. He made three main points:

1. This is NOT business as usual. This will be different from what anyone living has ever experienced. The closest comparator is 1918 influenza.

2. EARLY social distancing is the best weapon we have to combat Covid-19.

3. Humanity will get through this fine, but be prepared for major changes in how we function and behave as a society until either we’re through the pandemic or we have mass immunisation available.

I am writing in haste. This is a fast-moving situation, and the numbers are constantly changing – certainly the ones I have given here will be out of date by the time you read this. What’s very clear is that we must comply immediately with whatever measures competent public health authorities urge us to take, even if they seem disproportionate. It’s time to increase ‘social distance’ in all sorts of ways. And wash your hands.

6 March

Rupert Beale Rupert Beale is a Clinician Scientist Group Leader at the Francis Crick Institute.

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What Is the Coronavirus? Symptoms, Treatment and Risks

An international outbreak of respiratory illness caused by a novel coronavirus has killed at least 106 people and sickened about 4,500, according to the Chinese health authorities.

The outbreak began in Wuhan, China, apparently at a market selling live poultry, seafood and wild animals. Now the virus has turned up in a dozen other countries, including Japan, South Korea, France, Australia and the United States. Investigators in still other nations, and in several American states, are evaluating possible cases.

Officials in China have closed transportation links from and within Wuhan and other affected cities. Schools have been closed in affected regions. Sales of tourist packages from China to other countries have been halted. Major attractions and festivals have been closed down, as well as movie theaters.

Five cases have been confirmed in the United States: one in Washington State; one in Chicago; one in Arizona; and two in California. All patients had recently traveled to China. More than 100 other patients are being tested.

But much is still unknown about the newly identified virus, including how easily it is transmitted and how often it causes severe disease that can lead to death. Here’s what we have learned so far about the virus and the outbreak.

What is a coronavirus?

Coronaviruses are named for the spikes that protrude from their membranes, which resemble the sun’s corona. They can infect both animals and people, and can cause illnesses of the respiratory tract, ranging from the common cold to dangerous conditions like Severe Acute Respiratory Syndrome, or SARS, which sickened thousands of people around the world — and killed nearly 800 — during an outbreak in 2003.

How dangerous is it?

Health officials around the world are alarmed, but it is hard to accurately assess the lethality of a new virus. On Thursday, the World Health Organization declined to declare the outbreak a global health emergency.

“When we get a new infectious disease, we learn about the most severe cases first, the top of the pyramid as it were,” said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center.

“As the investigation goes on, we often learn there are less severely infected people, and even people who are infected who don’t get sick at all.”

By comparison, roughly 200,000 people are hospitalized with the flu each year in the United States, and about 35,000 people die.

But while some scientists say the new virus appears to be less severe than other coronaviruses, like SARS and MERS, it is not clear whether the Chinese authorities have been fully transparent about the number of infections and deaths, or even whether these figures are being carefully tracked.

“The information we know is changing rapidly,” said Dr. Julie Vaishampayan, chairwoman of the public health committee of the Infectious Diseases Society of America. “Whenever a new virus comes out, it takes a while to learn about it. There are going to be a lot of changes.”

How is it transmitted?

The Wuhan coronavirus is most likely transmitted through coughing and sneezing, as is the case with influenza and other respiratory viruses, Dr. Vaishampayan said.

Scientists are scrambling to understand how easily the virus is transmitted. A close examination of one family, published on Friday in the medical journal The Lancet, suggested that the virus was passed from one ill relative to six others; only two had contact with the initial patient.

The Chinese Center for Disease Control and Prevention analyzed 198 confirmed cases in Wuhan. Researchers found that 22 percent had direct exposure to the meat market, and 32 percent had contact with people who had a fever or respiratory disease.

But roughly half had neither been to the market nor had contact with anyone who was sick. Sixteen health care workers were infected while caring for patients, the report said.

Researchers at Imperial College London estimated that in the current outbreak, each infected person has passed the virus to 2.6 other people, on average. But statistical models produced so early in an outbreak often turn out to be wrong.

How many people have been infected, and how many have died?

About 4,500 people are known to have been infected, and at least 106 have died. Most of those infected lived in Wuhan, a city of 11 million in central China, or had recently traveled there.

Epidemics caused by other members of the viral family, SARS and MERS, have had high death rates: 10 percent for SARS, and about 35 percent for MERS. It is too soon to know the death rate for the new virus.

Influenza kills more people every year, but its mortality rate is only about 0.1 percent. The number of the deaths is high because so many people become infected. The death rate of the pandemic Spanish flu in 1918 was about 2 percent.

Widespread coronavirus epidemics have the potential to take a heavy toll, so the health authorities scramble to stamp them out.

A major concern is that with both SARS and MERS, a few patients inexplicably became “superspreaders” who infected huge numbers of people. At a hospital in Seoul, South Korea, in 2015, one man with MERS transmitted it to 82 patients.

Where did the new coronavirus outbreak start?

On Jan. 8, The New York Times reported that Chinese researchers had identified a new coronavirus as the pathogen behind a mysterious illness that had sickened 59 people in Wuhan.

The cases were linked to a market that sold live fish, animals and birds. The market was later shut down and disinfected.

What treatment is available?

The main treatment is supportive care, including making sure the patient is getting enough oxygen, and using a ventilator to push air into the lungs if necessary, Dr. Vaishampayan said. Patients should rest and drink plenty of fluids “while the immune system does its job and heals itself,” she said.

No drugs have been approved for any coronavirus diseases, including the Wuhan coronavirus, though an antiviral medication called remdesivir appears to be effective in animals. Chinese officials are experimenting with at least one other H.I.V. drug to treat the infection.

Scientists were very quick to identify the virus, and officials with the National Institutes of Health said that advances in technology may make it possible to test a vaccine against the Wuhan coronavirus within three months.

What is the source of the outbreak?

Animals are the most likely primary source of the outbreak, but it is still not clear which animals. Past outbreaks of similar illnesses, including SARS, also are believed to have emerged from live animal markets. The coronavirus that causes MERS is transmitted to humans by camels.

But though the first patients sickened by the Wuhan coronavirus were thought to have contracted the disease at the market, the illness can also be transmitted from person to person. A growing number of people, including medical professionals caring for patients, have become infected. That makes the virus more difficult to contain.

What are the health authorities doing to contain the virus?

The Chinese authorities have closed off transportation links from and within Wuhan and other affected cities, encircling roughly 50 million people. Bus service has been curtailed, as has travel abroad. The government is building two new hospitals to handle coronavirus patients; they will be finished in about two weeks.

Large public gatherings and performances were banned in Wuhan, and the government announced that all residents were required to wear masks in public to help prevent the disease from spreading. Movie theaters were closed throughout much of the country.

Governments around the world have been screening passengers who originated from Wuhan at ports of entry for signs of illness. North Korea temporarily barred foreign tourists, most of whom come from China.

What are the symptoms of infection?

Symptoms include fever, severe cough and difficulty breathing or shortness of breath. The illness causes lung lesions and pneumonia. Milder cases may resemble the flu or a bad cold, making detection difficult. The incubation period — the time from exposure to the onset of symptoms — is believed to be about two weeks.

On Friday, the Chinese authorities said they had seen cases that did not meet the usual description. In these patients, the first symptoms were gastrointestinal, including diarrhea.

On Sunday, Ma Xiaowei, head of China’s national health commission, asserted that infected people could spread the virus even if they did not have symptoms. The statement surprised and perplexed American experts.

I’m traveling to China. What can I do to protect myself?

The Centers for Disease Control and Prevention has warned against all nonessential travel to China. The C.D.C. urged all who must go to practice enhanced precautions — avoiding contact with anyone who is sick, as well as with animals and the markets in which they are sold.

Anyone who is older or has an underlying health condition should consult with a health provider before making a trip to China.

Dr. Schaffner, of Vanderbilt University Medical Center, said travelers should practice “good hand hygiene” — washing hands frequently and avoiding touching their faces — and maintain a distance from anyone who is coughing and sneezing.

Travelers should monitor their health upon their return. If a cough or fever develops, call health providers before going in, so they can prepare and put protective measures in place.

Should I wear a mask?

If you have a respiratory infection, wearing a mask helps protect the people around you from illness by reducing the risk of spreading the infection, experts say. Wearing a surgical mask may somewhat protect you from infection in a crowd if there is an outbreak, but, generally, surgical masks are not closefitting enough to filter all the air you are breathing in.

Experts say you are better off washing your hands frequently throughout the day.

At the moment, the risk of infection with the new coronavirus in the United States — where there are only five confirmed cases so far — “is way too low to start wearing a face mask,” Dr. Rabinowitz said. “The risk is very, very low to the general public.”

What are U.S. health officials doing to prevent an outbreak here?

American health officials are working closely with the W.H.O. and state and local health departments to monitor the situation. The C.D.C., which has activated an emergency response system, has dispatched workers to major airports to screen incoming passengers from Wuhan for signs of illness, and it has developed a diagnostic test for the virus, technically called the 2019-nCoV virus.

The C.D.C. has instructed hospitals around the country to ask patients who come in with fever or respiratory illness about recent travel to Wuhan or about contact with anyone who recently traveled to Wuhan.

C.D.C. teams are providing assistance with state investigations and helping to track down anyone who may have come in contact with the infected individuals. C.D.C. personnel have been dispatched to airports to help screen passengers arriving from China.

_______

Karen Zraick contributed reporting.

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Coronavirus Kills Third Person, Spreads to South Korea and More Chinese Cities

BEIJING—A newly identified virus originating in central China has spread quickly around the country and across Asia, infecting 156 new patients in Beijing, Shanghai, Shenzhen and other densely populated cities, and reaching South Korea for the first time—a major escalation in the pneumonia-like disease’s transmission.

The number of confirmed cases of the new coronavirus—part of a class of pathogens that can cause illnesses ranging from the common cold to the deadly severe acute respiratory syndrome, or SARS—has more than tripled to 218 cases, according to Chinese state media and health authorities.

Zhong Nanshan, one of China’s best known epidemiology experts who leads an expert committee on the outbreak for China’s cabinet-level National Health Commission, said in an interview on state broadcaster China Central Television Monday that there was a human-to-human transmission of the virus, which has now claimed three lives.

President

Xi Jinping

on Monday urged authorities to make efforts to prevent and control the spreading infection, according to the state-run Xinhua News Agency. Officials should “release outbreak information in a timely manner and deepen international cooperation,” he said.

Share Your Thoughts

How worried are you about the new virus spreading from central China? Join the conversation below.

Beijing, Shanghai and the southern metropolis of Shenzhen—three of the country’s biggest and most prosperous cities—confirmed a total of 14 patients infected with the pneumonia-causing virus, all of them on Monday, according to state media and local authorities.

South Korean authorities, meantime, said Monday that a 35-year-old Chinese woman who had flown into the country from the central Chinese city of Wuhan, where the outbreak first occurred, had contracted the coronavirus.

The sudden spread of the disease raises fresh concerns as tens of millions of Chinese citizens travel this week for the annual Lunar New Year, many of them to their hometowns. It is also likely to spark questions over the transparency of disclosures by Chinese health authorities.

China is working with other countries to prevent and control the outbreak, Chinese Foreign Ministry spokesman Geng Shuang said at a regular media briefing in Beijing on Monday. “We’ve formulated prevention and control plans, treated patients, monitored their close contacts, conducted epidemiological research and released information in a timely matter,” he said.

A cyclist rides near a large seafood and livestock wholesale market in Wuhan where the disease is believed to have first broken out. Photo: str/Shutterstock

Health authorities in Wuhan, a densely populated city of 19 million people, said Monday that the number of patients infected with the new coronavirus has jumped to 198, from 62 on Sunday. The statement said 35 of those cases were severe, while nine were critical.

The death of a third infected patient occurred over the weekend, Wuhan authorities said Monday, without offering any specifics. In the case of the two earlier fatalities, authorities had previously said the men suffered from existing illnesses.

A number of Chinese provinces—including Shandong on the east coast, Sichuan in the interior and southwestern Yunnan and Guangxi on the border with Vietnam—are all monitoring suspected coronavirus cases of their own, China Central Television said Monday. Separately, five suspected cases were reported by health authorities in coastal Zhejiang province, just south of Shanghai on the country’s east coast.

While the newly discovered coronavirus is believed to be less serious than SARS, which killed hundreds of people after its outbreak in southern China in late 2002 and early 2003, the pneumonia-like virus is in the same class of pathogens and appears to be spreading quickly.

Going Viral

Since it first appeared in the central Chinese city of Wuhan last month, a newly identified coronavirus has spread across China and into neighboring countries.

New coronavirus cases

Confirmed

Dead

Wuhan

Japan

China

Guangdong province

Shanghai

Thailand

Beijing

500 miles

500 km

Japan

South Korea

Confirmed

Dead

Wuhan

Japan

China

Guangdong province

Shanghai

Thailand

Beijing

500 miles

500 km

Japan

South Korea

Confirmed

Dead

Wuhan

Japan

China

Thailand

500 miles

500 km

Shanghai

Thailand

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Beijing

Japan

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Japan

China

Thailand

500 miles

500 km

Confirmed

Dead

Wuhan

Guangdong province

Shanghai

Thailand

Beijing

Japan

South Korea

Chinese health authorities haven’t reached any conclusions about the new coronavirus’s origins and its spread. A number of patients were exposed to a large seafood and livestock wholesale market in Wuhan where the disease is believed to have first broken out, but others have said they didn’t visit the market and only came into contact with people in Wuhan.

The Wuhan market is close to the city’s main railway station, an important travel hub in the center of the country.

The World Health Organization said earlier Monday that the spread of the disease was likely the product of “some limited human-to-human transmission occurring between close contacts.”

Wuhan authorities have been recommending that people wear a face mask and pay attention to fever and coughing symptoms.

In numerous instances, infected patients had traveled to Wuhan and showed symptoms of fever and fatigue.

The Chinese patient in South Korea had flown into Incheon International Airport from Wuhan and was quarantined by airport authorities before being transferred to a medical center for treatment, according to South Korea’s Centers for Disease Control and Prevention.

Likewise, the previous three patients that have been identified outside China—two Chinese tourists in Thailand and a man from Japan—had all traveled from the Wuhan area.

South Korean authorities are in the process of identifying crew members and other passengers who were in close contact with the Chinese patient during her flight. They received reports of seven people with coronavirus-like symptoms and have released four of them. Authorities are separately monitoring 14 patients, according to Jung Eun-kyeong, director of KCDC.

In Shanghai, the one confirmed case was a 56-year-old female who had traveled from Wuhan, according to the city’s health authorities.

Beijing has five confirmed cases, according to state media; a district authority has said that two patients had returned from Wuhan.

One of the confirmed cases in southern Guangdong province is 10 years old, according to local authorities. Most of the other infected patients who have been identified by authorities have been elderly.

China’s national health commission said it has issued a new detection kit and is asking regional authorities to step up testing, which could uncover more previously unknown cases.

The sharp uptick since the weekend has sparked questions over whether authorities are underreporting cases or failing to disclose information in a timely fashion. At a hospital affiliated with Tsinghua University in the northern Beijing district of Changping, doctors believed that they had a coronavirus case, but they were instructed not to disclose the information as of early Monday, according to a person familiar with the matter. A spokeswoman said Monday that the hospital would disclose information based on the city government’s instructions.

A separate independent estimate by scholars at Imperial College London said that more than 1,700 people in Wuhan are likely to have symptoms of the virus and could be infected with it, based on modeling of cases of the virus discovered in Thailand and Japan and estimates of the number of people passing through Wuhan’s international airport.

In the U.S., where no cases have so far been detected, the Centers for Disease Control and Prevention and Department of Homeland Security’s Customs and Border Protection have begun screening people traveling from Wuhan for fevers, coughs or difficulty breathing.

—Xiao Xiao and Eun-Young Jeong contributed to this article.

Write to Chao Deng at [email protected]

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