2019 Novel Coronavirus Covid-19 Discussion

Forums › Health and fitness › 2019 Novel Coronavirus Covid-19 Discussion

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#2484445 15-May-2020 13:48

DS248:

Proportion of imported cases significantly higher in AU. Means each imported case on average generated significantly fewer local cases in AU

That's basically the Ruby Princess, which is a large enough number to really skew the numbers in Australia (and NSW in particular)

https://www.abc.net.au/news/2020-04-23/coronavirus-across-australia-if-ruby-princess-never-docked/12172314

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neb

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#2484453 15-May-2020 14:07

tdgeek:
Interesting, exactly the same basis as hand washing.

https://www.stuff.co.nz/world/europe/121524341/coronavirus-scientists-call-for-research-on-whether-mouthwash-can-prevent-spread-of-covid19

Gargling as a hygiene measure is a big thing in Japan. Nothing to do with Covid19, "ugai" is done there the same way hand washing is done elsewhere. It's been heavily studied over there, e.g. this first Google hit.

frednz

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#2484454 15-May-2020 14:09

How effective will a Covid-19 vaccine be? I was interested to read the article linked to below which suggests that Covid-19 could be a virus that proves resistant to vaccination.

I've seen a number of people saying that we can't get rid of this virus until a vaccine is available, but even then, it mightn't be possible to completely eradicate it.

https://nymag.com/intelligencer/2020/04/will-there-be-a-coronavirus-vaccine-maybe-not.html

From the above:

Hopes for a return to normal life after the coronavirus hinge on the development of a vaccine. But there’s no guarantee, experts say, that a fully effective COVID-19 vaccine is possible.

That may seem counterintuitive. So many brutal viral diseases have been conquered by vaccination — smallpox, polio, mumps — that the technique seems all but infallible. But not all viral diseases are equally amenable to vaccination. “Some viruses are very easy to make a vaccine for, and some are very complicated,” says Adolfo García-Sastre, director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine at Mount Sinai. “It depends on the specific characteristics of how the virus infects.”

Unfortunately, it seems that COVID-19 is on the difficult end of the scale.

A closely related virus of the same family, SARS, circulated in Asia from late 2002 to mid-2003 and killed more than 700 people. “They really are very similar viruses, both virulent and contagious,” says Rachel Roper, a professor of immunology at East Carolina University who took part in efforts to develop a SARS vaccine.

It’s possible, Roper fears, that COVID-19 could be a virus that proves resistant to vaccination. “This may be one,” she says. “If we have one, this is going to be it, I think.” The FDA has never approved a vaccine for humans that is effective against any member of the coronavirus family, which includes SARS, MERS, and several that cause the common cold.

DS248

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#2484455 15-May-2020 14:13

Fred99: ...

99.8% average specificity is useless for population screening in NZ. At known population infection rates, you'd need better than 99.97% specificity to see anything above background noise from false positives even if you included all the confirmed cases in the population study. More useful in the UK - but even there only 0.3% of the population has had diagnosed infection so 0.2% "false positives" is a lot of noise. If you assume that maybe the real infection figure is 1%, so serology tests will give ~ 1 in 5 "false positives", then there's huge risk if this kind of testing is used to assume immunity and to send "recovered" people back into risky environments. (that's not mentioned in that article - but has been commented on regularly as a method to get people "back to work" / create some "immunity passport" system).

Agree, not useful here for general population screening, which is why I did not suggest it. But may be useful for testing around local clusters.

Reason for suggesting testing probables was to clarify actual numbers, especially for more recent cases. An issue because a significant proportion of our local cases are 'probable' cases (~one third of local cases in the last two weeks).

Proportion of imported cases that are 'probable' is a lot lower.

tdgeek

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#2484459 15-May-2020 14:17

That's what Ive read often. It may keep mutating and end up as a permanent Winter virus, weakened by mutation and where there is some antibodies present in most of us

DS248

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#2484466 15-May-2020 14:28

wellygary:

DS248:

Proportion of imported cases significantly higher in AU. Means each imported case on average generated significantly fewer local cases in AU

That's basically the Ruby Princess, which is a large enough number to really skew the numbers in Australia (and NSW in particular)

https://www.abc.net.au/news/2020-04-23/coronavirus-across-australia-if-ruby-princess-never-docked/12172314

Yes, and a few other cruise ships. They still have potential to generate downstream local cases, particularly in the case of the Ruby Princess as the passengers were disembarked without quarantining. Bigger risk source than quarantined arrivals by air so they did well to get on top of the situation after the fact.

frankv

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#2484481 15-May-2020 15:01

tdgeek:
That's what Ive read often. It may keep mutating and end up as a permanent Winter virus, weakened by mutation and where there is some antibodies present in most of us

From what I've read, none of the mutations has changed the structure of the virus, which suggests that it mutates slowly structure-wise. Therefore (a) it won't weaken much, and (b) a single round of vaccination (which might involve several injections over a period of time) would wipe it out. Assuming a vaccine can be developed.

Fred99

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#2484513 15-May-2020 16:03

frankv:
tdgeek:

That's what Ive read often. It may keep mutating and end up as a permanent Winter virus, weakened by mutation and where there is some antibodies present in most of us

From what I've read, none of the mutations has changed the structure of the virus, which suggests that it mutates slowly structure-wise. Therefore (a) it won't weaken much, and (b) a single round of vaccination (which might involve several injections over a period of time) would wipe it out. Assuming a vaccine can be developed.

Yep - there have been thousands of mutations observed in the genome that haven't changed how the virus functions. "They say" - it mutates about 25% as fast as influenza.

But I think there may be some big hurdles to develop a vaccine. ADE (Antibody-dependant enhancement) was observed in animal trials for SARS and MERS vaccines. This is immune over-reaction - so initiates cytokine storm type event - so if an infection happens after vaccination, you might end up with many cases of an acute respiratory syndrome (or affecting other organs) rather than many cases of a mild disease.

Antibody levels also drop away quite quickly with SARS - whether that means that a vaccine won't last long isn't really known. If you're only protected for a couple of years and there are 7 billion people to vaccinate - then there's a practical issue if the goal is total eradication.

I don't think there's a lot of hope it'll "weaken". There's not much advantage to the virus to mutate to a less lethal form as it's not particularly lethal anyway and it's highly successful just as it is - transmits perfectly from people with mild disease to kill a couple of people per hundred - after they've passed the virus on. The only thing limiting it at the moment is changed human behaviour, so if mutation makes it more easy to transmit despite present measures, then we've got a bigger problem.

mattwnz

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#2484550 15-May-2020 16:43

Fred99:

There's not much advantage to the virus to mutate to a less lethal form as it's not particularly lethal anyway and it's highly successful just as it is - transmits perfectly from people with mild disease to kill a couple of people per hundred - after they've passed the virus on. The only thing limiting it at the moment is changed human behaviour, so if mutation makes it more easy to transmit despite present measures, then we've got a bigger problem.

The problem is that if on average there is a 20% chance of hospitalization and a 1-2% chance of dying from it the first time you get it, when you get it again, you again could have the same 20% chance of needing hospitalization / 1-2% chance of dying the next time, and that those odds increase as you get older. The odds are lot worse for older people. Potentially if we don't get a vaccine, this could decrease the average lifespan of humans, which has only been increasing over the last century.

We also don't know how we long are immune for for after getting it, and whether having had it in the past may help with the odds .There seems to be quite a lot of misinformation about this antibody test. I saw one headline in the UK a few days ago, saying it was 100% effective at picking up people, and would have immunity to the virus for 3 years , and it will be used to allow people to return to work safely. But can no longer find that article. From what I can see there is no evidence someone will have immunity for 3 years, because there hasn't been the testing done to show this. Also the test isn't 100% accurate from what I have read in other stories about it, may the author just rounded up.

I am pretty sure I recall watching a movie or TV show that as part of the setting, there had been a virus pandemic that caused the world to shutdown, and it was a vaccine that hadn't been properly tested, that made things even worse and nothing ever recovered from it.

The good thing is that the more time that goes on, the more we are learning. One with think that with all our medical advancements, that we can come up with a vaccine, and things will only advance more. The person who comes up with the vaccine will no doubt win a Noble prize. We do also want to make sure that vaccines are well tested, because history has shown the problems that occur when vaccines are not properly tested. We don't want the cure to cause worse problems than the virus.

Fred99

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#2484563 15-May-2020 17:08

mattwnz

The problem is that if on average there is a 20% chance of hospitalization and a 1-2% chance of dying from it the first time you get it, when you get it again, you again could have the same 20% chance of needing hospitalization / 1-2% chance of dying the next time, and that those odds increase as you get older. The odds are lot worse for older people. Potentially if we don't get a vaccine, this could decrease the average lifespan of humans, which has only been increasing over the last century.

We had about 1500 cases - and very few hospitalised (but we did have a >1% case fatality rate).

I think the 20% figure (which I'd also used in the past) is probably high because those with mild symptoms never got diagnosed and counted. (ie China's 82,000 cases was probably at least double that - the case fatality rate is 5.6% - where it's been contained by intense testing, the case fatality rate is much lower.

Based on that original data, we should have had 2-300 hospitalised - and perhaps 30 on ventilators.

But yeah - it's got every potential to become a seasonal disease, like flu - but at least 10x worse fatality rate, and then there's whatever long-term damage from systemic infection - as well as lungs, it damages the circulatory system, kidneys, liver etc and could cause all kinds of things, auto-immune disease etc.

mattwnz

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#2484577 15-May-2020 17:11

DS248:

Yes, and a few other cruise ships. They still have potential to generate downstream local cases, particularly in the case of the Ruby Princess as the passengers were disembarked without quarantining. Bigger risk source than quarantined arrivals by air so they did well to get on top of the situation after the fact.

This virus really shows how much international travel and incoming people into the country without quarantining, is such a big factor in this. We are all animals, and mostly all animals entering NZ are quarantined for 6 months minimum to prevent them bringing in disease. But we don't do this for humans, and quarantine doesn't seem to be a palatable solution for some reason.
IMO opening up a bubble to any countries that haven't eliminated this virus, risks a repeat. The only countries I would be happy opening up to at this point in time are some of the pacific island countries that have had no cases, or have shown to have eliminate it. Australia still has CT and they appear to also be investigating opening their bubble to other countries including Japan, which means that they would also be joining our bubble. IMO the risk shouldn't be more than the reward. It is already going to cost NZ the best part of 100 billion by the time it is over according to at least one top NZ economist.

ezbee

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#2484578 15-May-2020 17:13

On the Flip side of this all road deaths have been way down during this whole thing.
Road injuries should also be proportionate reduction.

https://www.transport.govt.nz/mot-resources/road-safety-resources/road-deaths/

Have not seen any numbers from hospitals on the numbers of Injuries and other accident Fatalities.
I would expect that this has all been down over this period by a large amount given reports of A&E being empty.
Alcohol has not been so available , and Drunken parties limited, so drunken accidents and deaths probably down.

In Japan they have found that suicides are actually down, maybe as people are distracted by the whole unfolding of this.
https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors

mattwnz

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#2484597 15-May-2020 17:24

ezbee:

In Japan they have found that suicides are actually down, maybe as people are distracted by the whole unfolding of this.
https://www.theguardian.com/world/2020/may/14/japan-suicides-fall-sharply-as-covid-19-lockdown-causes-shift-in-stress-factors

This doesn't surprise me. I know people who have mental health issues with stress and anxiety, and they have said that this has actually been the best they have felt in a long time due to now being in lockdown and things being out of their control. Obviously depends on the person though and their situation.

vexxxboy

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#2484598 15-May-2020 17:24

studies show that the average 80 year old in the UK has a 11% chance of dying in a year the corona virus adds 9.3 % to that figure, there is an interesting article in the Telegraph, behind a paywall so not worth linking it, that shows you different age groups and scenarios of how it could effect the UK in the coming months.

Common sense is not as common as you think.

PolicyGuy

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#2484605 15-May-2020 17:44

ezbee:

On the Flip side of this all road deaths have been way down during this whole thing.
Road injuries should also be proportionate reduction.

https://www.transport.govt.nz/mot-resources/road-safety-resources/road-deaths/

So, looking just at April, the lockdown saved a few more road traffic deaths than COVID-19 has caused.
[Average road deaths 2016-2019 is 33. 2020 was 9, saving 24]

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