February 21, 2020
...The last few days have seen a perceptible flattening in growth of Covid-19 cases in China (click here), raising hopes that the epidemic has peaked. (Though there are doubts about the accuracy of China’s count.) That supports the emerging consensus on the Wuhan quarantine in particular: that, at minimum, it bought China and the world time to prepare. Crucially, the time lag allowed public health agencies to devise and distribute a diagnostic test that hospitals can use to identify patients ill with the novel coronavirus.
“Measures on movement restriction have delayed the dissemination of the outbreak two or three days within China and a few weeks outside China,” Sylvie Briand, director of Infectious Hazard Management at the WHO, told reporters this week. “Those measures, if well implemented, could have an impact on the propagation of the outbreak.”...
Casting doubt on China's census of patients promotes the idea the virus has not reached it's peak of virulence in the country. That is probably a good speculation.
February 22, 2020
...The international COVID-19 response (click here) has been focused on avoiding a pandemic, of which many experts suggest we could be in the early stages. As of Feb 18, 2020, WHO reported 804 total confirmed cases and three deaths in 25 countries outside China. In addition to confirmed cases from travellers to Wuhan and on cruise ships, countries including Singapore, Japan, Thailand, and South Korea have identified clusters of locally transmitted cases. The numbers are small, but the rate of secondary and tertiary transmission is of grave concern and misinformation and fear are rampant. Thousands of medical workers in China are thought to have COVID-19 and, as countries implement scaled up diagnosis and surveillance, the risks from inadequate protective gear and shortages in testing kits are heightened. The first confirmed case in Africa (in Egypt) is worrying, as weak primary health-care systems could undermine preparedness. WHO has called for more investment in surveillance and preparedness, but governments have been slow to take heed. A huge amount of funding has been committed for vaccine platforms but, even with four candidates in development, there is unlikely to be a viable vaccine for at least another 12–18 months. Dozens of clinical trials of treatment are underway, but it will be weeks or months before the results are known....
What does that mean? With reports here and there becoming common place, it means the virus is not contained. While quarantining China has proven to slow the spread, the new areas of the world now reporting in only proves the opportunity to contain it is probably coming to an end. Basically, the window is closing on a potential worldwide pandemic.
The question is will it become an epidemic?
To Third World countries this is just another thing.
February 22, 2020
By Goma and Kampala
There are so many crises in Congo. (click here) ” Gervais Folefack, who co-ordinates the emergency programmes run by the World Health Organisation (who) in the Democratic Republic of Congo, has mastered the art of the understatement. The country has been shattered by war and corruption. “All the time we are responding to crises,” says Dr Folefack. He lists the most recent: Ebola, measles, cholera. To them, he may well have to add covid-19, a respiratory disease that originated in China. Those who would need to respond to a surge in covid-19 cases are already busy with the Ebola outbreak that began in 2018. “We are trying to prepare,” continues Dr Folefack, but there is simply not enough time.
So far 99% of confirmed cases of the new coronavirus have been in China. Of the 1,000-odd cases outside mainland China, more than half have been on the Diamond Princess, a cruise ship docked in Japan; the rest are scattered among 27 countries, mostly in Asia....
I am afraid global travel will have to be curtailed and use of electronic media must replace what would usually be essential meetings for whatever purpose it is being held. It is just not a good idea to travel at this time. The new cases in the USA have connections to China, but, diagnosis connected to travel to the Wuhan area does not spell complete containment yet.
...And the warnings come as the United States (click here) reported over the weekend finding three more cases, the country’s third, fourth, and fifth. Two were diagnosed in California. One is a traveler from Wuhan, where the outbreak is believed to have started, who was diagnosed in Orange County. The other is someone who visited Wuhan who was diagnosed in Los Angeles County. The fifth case was diagnosed in Arizona and is a student at Arizona State University; the person had also traveled to Wuhan....
The problem with Covid- 19 is it's manifestation. First it is a flu like illness and the pneumonia is absent in the early stage not showing up until Day 9.
...The results (click here) also showed that the timing of positive swabs changed. On the first day of illness, 80% of oral swabs were positive in a small group of patients, but by day 5, 75% of anal swabs were positive for COVID-19 virual RNA, and only 50% of oral swabs were still positive in the same patients with lab-confirmed COVID-19.
"These data suggested a shift from more oral positive during early period (as indicated by antibody titres) to more anal positive during later period might happen," the authors said.
The results of the study are the first to show COVID-19 could be transmitted via respiratory, fecal-oral, or body fluid routes, the authors say. They also warn that a patient with negative oral swabs after several days of illness may still be capable of transmitting the virus....
It is no longer believed it is solely transmitted through aerosol. That means washing hands is very important and there is no indication the synthetic hand sanitizers work. Good old fashioned soap and water and firm hand washing UNDER RUNNING WATER it necessary at this time. Rinse hands from the wrist down under that running water.
...China’s health minister, Ma Xiaowei, warned Sunday that the virus seems to be becoming more transmissible and the country — which has taken unprecedentedly draconian steps to control the virus — was entering a “crucial stage.”...
...The finding suggests stool can contaminate hands, food, water, and, as with the other study, it points to multiple routes of transmission....
...The authors also provided a timeline for infection: "Among 56 patients who could provide the exact date of close contact with someone with confirmed or suspected SARS-CoV-2 infection, the median incubation period from exposure to symptoms was 4 days (interquartile range 3-5 days). The median time from onset of symptoms to first hospital admission was 2.0 (1.0-4.3) days."
SARS-CoV-2 is another name for the COVID-19 virus....
The thing to remember when reading reports of individuals and the virulence of the illness once contracted brings to mind several things. To begin, everyone is different by if no other measure their birthday. The important fact to remember is that it is easily spread and there is no reason to think lightly of this virus. At least, not yet.
The pandemic is real and the Third World is seeing individuals that are infected. The chance of them spreading the virus is real and potentially there are undiagnosed cases.
As each person is healthier than others there are those that are less healthy than the "norm." How the symptoms manifest and how severe they are is not important. What is important at this time is containment REGARDLESS of virulent strains that might be less virulent in some or most people. The spread has to be contained. Once that is resolved, then the degree people were sick can be assessed, but, viruses are RNA and when they get hold of DNA they replicate quickly. Covid-19's RNA is still out there and probably doing well on fomite (objects or materials which are likely to carry infection, such as clothes, utensils, and furniture.)
...In a study from The Lancet Infectious Diseases, meanwhile, investigators detailed the first case of COVID-19 in a Vietnamese woman who acquired the virus in China. The woman lived in Wuhan for business for 2 months in December and January and did not report visiting the Wuhan seafood market or having close contact with any person with influenza-like symptoms....
If people do well after contracting the disease, that is wonderful. But, at this time there are too many variables to make any definitive conclusions except containment is vital.
2019-nCoV is also another term used for the same virus. There is nothing wrong with having a variety of names for the same entity just so long as people understand there are several names that have evolved out of the identification of the disease in multiple countries. Some languages do not lend itself easily to standard English language. What is important is that there is a global understanding of the disease and it's identity and name.
