Coronavirus. Community transmission in Washington State may already involve HUNDREDS of cases,

[pnwmom]

Last edited Sun Mar 1, 2020, 04:21 AM - Edit history (3)

according to Trevor Bedford, PhD, who is with the Vaccine and Infectious Diseases Division of the Fred Hutchinson Cancer Research Institute of Seattle.

The only reason the current few cases were discovered is because staff at Evergreen Hospital decided to test two patients with suspicious illnesses even though they hadn't engaged in overseas travel.

He posted this series of tweets tonight. (If you click on the link you can see the charts, too.)

ON UPDATE: On Feb. 23 the CDC was acknowledging 14 cases in 6 states. How many were there really? How many are there now? The CDC's website STILL says to suspect Covid-19 in people with foreign travel. But we're way past that now, and they need to admit that.

https://threadreaderapp.com/thread/1233970271318503426.html?fbclid=IwAR2tPpfh0U9tpC8kLV9Pw5mxmqgwazbvMX49N2qZU5jT7PHH4YSvamjoQ_0


The team at the @seattleflustudy have sequenced the genome the #COVID19 community case reported yesterday from Snohomish County, WA, and have posted the sequence publicly to gisaid.org. There are some enormous implications here. 1/9

This case, WA2, is on a branch in the evolutionary tree that descends directly from WA1, the first reported case in the USA sampled Jan 19, also from Snohomish County, viewable here: nextstrain.org/ncov?f_divisio… 2/9

This strongly suggests that there has been cryptic transmission in Washington State for the past 6 weeks. 3/9

It's possible that this genetic similarity is a coincidence and these are separate introductions. However, I believe this is highly unlikely. The WA1 case had a variant at site 18060. This variant is only present in 2/59 viruses from China. 4/9

I'd assess the p-value for this coincidence at 2/59=0.03 and so is statistically significant. Additionally, these two cases are geographically proximal, both residing in Snohomish County. 5/9

I believe we're facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China. 6/9

We will be working closely with @KCPubHealth and @WADeptHealth to investigate the full extent of the outbreak. 7/9

We're hoping to update soon with better estimates of the number of infections in Washington State using available data. 8/9

Thank you to the @seattleflustudy team, and particularly to @lea_starita, for exceptionally fast turnaround from diagnostic assay at @WADeptHealth to sequenced genome. 9/9

An update, because I see people overly speculating on total outbreak size. Our best current expectation is a few hundred current infections. Expect more analyses tomorrow.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm?fbclid=IwAR2JuJZ1OKBR-b4dDUbW2zJ__VdgkfHxwa6GNn9zs66sLWZVLueF59pEnik


"As of February 23, 14 COVID-19 cases had been diagnosed in the following six states: Arizona (one case), California (eight), Illinois (two), Massachusetts (one), Washington (one), and Wisconsin (one)."

[Yo_Mama_Been_Loggin]

1. That's reassuring

Jackson High School where the ill student attended school is about a 15 minute walk from my house.

[pnwmom]

2. We need to constantly wash our hands and keep wiping things down. n/t

[Moostache]

5. If this thing is actually mutating THAT fast, we need much more than soap and water...

WARNING - SPECULATION FOLLOWS....if you are really worried about this virus, PLEASE study virology, cell biology, microbiology and genetics (or earn a BS in Biochemistry and work in industry for 25 years)...then review data decide if I am crazy, alarmist or anything else...don't take my ramblings as gospel truth, but do the work to understand the possibilities...

IF transmission becomes any easier, the global population will be exposed in short order, this thing is moving around the globe already and we cannot stop it effectively yet (if ever)...that is obviously bad, but if additional mutations lead to increased mortality rates (beyond the widely theorized >2% right now), you start to understand two things:

1) NO ONE has been 100% forthright in how serious this really could be...
2) the markets don't lose $6 TRILLION because of Democratic Party "hoaxes"...

The follow up necessary to understand this further is "WHY?"...why #1 and why #2

#1 is easy...dire truths that could speak of enormous consequences to society are always 'managed in the modern era...think of how the climate change data has been slow rolled for decades (under estimating real warming rates and trends to be more palatable and less worrisome)....NOT an accident, PROBABLY NOT even all greed alone. There is no solution to this problem, so expanding the scope in the public consciousness serves no purpose to those in power and wishing to remain there (with heads still attached at the neck)...the truth is never what comes FIRST...always comes after many die, many others commit crimes and cover-ups collapse under their own weight.

#2 is more worrisome. SOMEONE knows the truth...in China, at CDC or WHO or NIH...in the USA, they have been muzzled (for now) and in China god only knows what happened to anyone with knowledge not approved for release by the Party...death or disappearance being impossible to rule out But, if one of them DID get word out - indicating that COVID-19 is something worse than what is already out in the public discourse or via back channel sources, something actively spinning out of control and already beyond our ability to stop entirely...well, we are going to find out in real time just what is more powerful in the end - nature, or self-interested inside dealing humans.

Or maybe the markets now infer that whenever Trump starts talking about shit he can barely pronounce, let alone understand AT ALL, that the prudent thing to do is to cut risk as much as humanly possible until he shuts up or the true depth of a problem is obvious...

My money is NOT on humans for the record.

[FBaggins]

26. I can decide that you're being alarmist without a background in biochem

An understanding of grammar is sufficient.

You can’t start a post predicated on how rapidly the virus is mutating... when the very point of the source’s analysis was that they could identify the case as almost certainly a community infection because there was almost no genetic variation from the original source virus.

IOW - it isn’t just alarmist speculation... it’s alarmist speculation based on bad data.

[LizBeth]

3. That takes it to about Jan 18. Our office got hit about a month ago.

Last edited Sun Mar 1, 2020, 04:17 AM - Edit history (1)

Started with a cough. Some fever. Three days feeling really drained, tired, bad. Cough persisted for about a week more. Kind of cough that you could not get air in lungs.

No congestion or cold stuff.

It hit a good three people in this office and none of us had anything like that in the past. I thought I had Bronchitis.

[BigmanPigman]

6. Where is your office located?

What medication did you take?

Welcome to DU....

[LizBeth]

15. Oregon. We get traffic, a lot from BC to Calif. Lots from Washington state.

[2naSalit]

7. I had something like that

exactly a year ago. And transmission was almost immediate. Was in a place I hadn't been for ages and had only been there maybe fifteen hours and I was nailed with symptoms you just described although not so serious a lack of air intake but otherwise very much the same. Took a few weeks to get rid of the cough entirely. Hmmm.

[LizBeth]

16. I have heard a lot of people with the same symptoms in the period we had it.

[2naSalit]

22. It was awful...

my friends and I were in a little tourist town to ski for a hew hours. We went to a couple bars and then to our room for the night. The very next morning we were both very sick. And of course, we in our boredom, started reading the local paper and on the top of the front page was the news the the whole town had been sick, or most of the town of 1100. Must have picked it up at the bar or the ski shop. We didn't go anywhere else.

What seems really scary about this new thing is that from reports of reinfection, it appears that immunity does not occur after having the illness. That means it can cycle and recycle through the population over and over again. That's scary.

[AllyCat]

4. Tonight, gissanddata reporting a death in Seattle.

First US fatality. So sad for the nearly 3000 dead and their families.

[fleabiscuit]

8. Yikes! nt

[KY_EnviroGuy]

9. Full web link for Nextstrain....

Nextstrain
Real-time tracking of pathogen evolution

Nextstrain is an open-source project to harness the scientific and public health potential of pathogen genome data. We provide a continually-updated view of publicly available data alongside powerful analytic and visualization tools for use by the community. Our goal is to aid epidemiological understanding and improve outbreak response. If you have any questions, or simply want to say hi, please give us a shout at [e-mail].

Link: https://nextstrain.org/

(snip)

This Website

This website aims to provide a real-time snapshot of evolving pathogen populations and to provide interactive data visualizations to virologists, epidemiologists, public health officials and citizen scientists. Through interactive data visualizations, we aim to allow exploration of continually up-to-date datasets, providing a novel surveillance tool to the scientific and public health communities.

Thanks for the OP, pnwmom......... ............

[pnwmom]

11. You're welcome. Thanks for your contribution! n/t

[KY_EnviroGuy]

13. Interesting info there, particularly running that spread map.

Click on "Play" to see the spread over time.

Also informative to click on some of the DNA tracking threads on the line chart above. Those in the USA are in dark orange.

KY.......

[pnwmom]

14. I just read all the way to the bottom and saw Dr. Bedford's name among the contributors.

What important work they are all doing.

Thanks again for pointing me to it.

[calimary]

18. Nextstrain.org - a keeper.

[Mrs. Overall]

10. Thank you for posting this. Just read this entire thread on Twitter--

very interesting information and very concerning for those of us who live in the Seattle area.

[pnwmom]

12. People should be concerned EVERYWHERE, not just in Seattle. Here's why.

A week ago we learned of our first case here in Washington. Then it was a few more cases. Now Dr. Bedford expects it is really in the hundreds.

Well, also a week ago, the CDC was admitting 14 cases in 6 states. How many MORE cases are there in those states and in other states where they've been having limited testing?

[Warpy]

17. Undoubtedly, with it spread to patients in a nursing home

It will also be interesting to find out where that case in Chicago came from.

I don't think containment is possible now. Too many people seem to be passing this bug on before they know they're ill. It's also a persistent bug, people testing positive for it after they've recovered and it does survive on surfaces after drying out.

We're not all doomed, but this thing is worse than the flu and people will be knocked down by it for a couple of weeks with fever and coughing fits.

People on international sites are reporting panic buying of staple foods. Here, the market was out of peanut butter and TP and it was weird to see the empty shelves, made me wonder just what the hell people are going to do with jars of peanut butter and a whole closet full of bog rolls. People are weird.

[marybourg]

20. Everything seemed normal in my supermarket

in AZ last night. I myself bought PB and the shelves seemed normally stocked. I didn’t look at the TP shelves.

[GopherGal]

24. Not all normal in Target in MA yesterday

They had a sign saying they're out of masks, thermometers, and Purell.

A week ago I had to go to 3 stores before finding thermometer probe covers (and no, there were still none in this store)

Toilet paper shelves were about half empty, and some space on the bottled water shelves as well. Bread still seemed to be in stock, so it wasn't a total pre-blizzard situation.

[wnylib]

19. Due to the wide differences in

degree of infection, from so mild that it is unnnoticed, to serious enough to cause death, I am wondering if there is another factor besides the age and general health of the individual.

Is it possible that the virus has two (or more) forms, or mutations? Or that some people have a genetic vulnerability?

I am also thinking of the 2 forms of Plague in Medieval Europe. One was airborne and the other was not. But in those cases, the symptoms differed, too. I think it was the airborne one that did not produce the black buboes.

Has anyone else considered the possible effects of covid 19 on the US elections? The candidates are traveling around the country, exposing themselves to crowds. A few of them are in the age category of most vulnerability, although both Warren and Biden appear to be in good health.

People in crowds at rallies could also pose a risk of viral spread to each other.

[2naSalit]

23. I have thought about how it could spread period.

I caught something that sounds a lot like this last year at this time and I managed to pick it up in one of two public places and was ill in less than twelve hours... and down for over a week, killed the fever after two days but had to kill another fever a few days later.

I think it could be a real factor though I don't have any idea how everyone will deal with it.

[wnylib]

25. I also had something similar to this

last year. It happened within about 12 hours of getting a flu shot. I usually don't get one because of an allergy to substsnces used in vaccines. But my PA persuaded me to try a non-allergic version.

I developed a dry cough, but the most bothersome problem was trouble breathing. I have asthma, but it's related to specific allergens and is not chronic. I use an inhaler if I get exposed to something that triggers an attack, maybe once a month, usually less than that. But I had to use it several times a day, for days at a time. Felt too tired to do anything. (ON EDIT: also had a low grade fever)

Then I saw the doc for something else and told him how I felt. My BP was high, too, which he said came from using the inhaler so much. He thought I got the flu from the shot. Put me on a different inhaler and I was fine a couple days later.

[localroger]

21. It's like an iceberg

However big the part is that you can see, the part you can't see is much larger.

[Trueblue Texan]

27. I honestly think...

I got whatever crud I've got from a voting machine on Super Tuesday. I wish I'd used hand sanitizer afterwards Those voting machines are evil things. I'm feeling much better now but this illness felt very much like one I had a couple of weeks ago.