Coronavirus Cases on Cruise Ship Surge as U.S. Infections Top 300

[gristy]

Source: NY Times

Authorities across the United States reported 307 cases of coronavirus and 17 deaths as of Friday, with Florida reporting the first deaths on the East Coast. The number of infections does not count the 21 people who have tested positive aboard a cruise ship off California.

Read more: https://www.nytimes.com/2020/03/06/world/coronavirus-news.htm

---

That's the third increase in cases in reporting just today. Yesterday the U.S. was at 159 cases. (I've been keeping a record). OMG

[htuttle]

1. It will probably go exponential before Fall

Worse, since you can get it more than once, it will be hard to even keep track.

Especially if they don't test many people.

[fleabiscuit]

2. Question for all... if going out it public, such as a grocery store, is necessary...

Would you wear surgical a mask?

[sarcasmo]

3. Time article linked that will answer your question.

https://time.com/5794729/coronavirus-face-masks/

[du_grad]

4. This has been in the news and is making the rounds-may help you make a decision

The guy who wrote this is legitimate, as far as my googling has determined. All of this is pretty good advice. A couple of doctors on my FB friend list questioned the snake reference and the endorsement of zinc, however. I am a retired microbiologist but I have never worked with viruses. Perhaps the snake reference refers to other strains of coronavirus this doctor has researched. I think the nose covering is mostly to prevent you from touching your nose with your fingers, not to prevent you from inhaling aerosols. This virus, according to this guy, lives on surfaces. If you touch the surfaces to your nose, it can gain entrance to your lungs.

Here is another reference to the letter below: http://www.europe-solidaire.org/spip.php?article52289

"This is from an MD researcher who has worked with coronaviruses since the 1970s. Good information here about how to best protect yourself and your family while this new strain burns its way through the US.

Date: February 26, 2020 at 2:35:50 PM EST
Subject: What I am doing for the upcoming COVID-19 (coronavirus) pandemic.
Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
What I have stocked in preparation for the pandemic spread to the US:
1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.
3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email.

Good luck to all of us! Jim
James Robb, MD FCAP"

[morillon]

5. No, I'm not wearing a mask.

And I say that as a moderate-to-severe asthmatic with a WBC count at the lowest edge of normal. (WBCs are still lagging a couple years out from chemo.)

We're going shopping tomorrow. We'll go early, to avoid the biggest crowds.

Like the article says lower in the thread, we'll use disinfecting wipes on the shopping cart.

When we get home, we'll leave our shoes in the mudroom, and we might also change clothes and get a quick shower.

We'll wipe down the outsides of cans and cartons with disinfecting wipes.

I'm not wearing a mask. Those should be left for healthcare providers and people who actually are immunocompromised, as far as I'm concerned. A few years ago, I was one of those people, and I don't want to take away supplies that they need to be safe. I think it's a dick move to use PPE when supplies are scarce and healthcare providers and immunocompromised folks really need them.

[Blues Heron]

6. I thought they had 20 suspected cases on the ship and they got 20 positives

how is that a SURGE!!1!! ?

Who writes this shite?

[NickB79]

7. In a month there will be thousands

Tens of thousands by May. This is going to snowball fast, I'm afraid.

[DarleenMB]

8. This FLU season --

from 34million to 49million reported ill

16 to 23 million medical visits

350,000 to 620,000 hospitalizations

20,000 to 50,000 deaths.

(estimates from the CDC)


I cite these because all this fear mongering is doing nothing to help the COVID-19 situation. Yes, we all need to prepare and protect ourselves. but this constant hand wringing and doomsaying is not helping. At. All.

[gristy]

12. info from Johns Hopkins and a paper in The Lancet

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu

COVID-19: Approximately 3,460 deaths reported worldwide; 14 deaths in the U.S., as of Mar. 6, 2020.

Flu: 291,000 to 646,000 deaths worldwide; 12,000 to 61,000 deaths in the U.S. per year.

The COVID-19 situation is changing rapidly. Since this disease is caused by a new virus, people do not have immunity to it, and a vaccine may be many months away. Doctors and scientists are working on estimating the mortality rate of COVID-19, but at present, it is thought to be higher than that of most strains of the flu.

And here's good article on outbreak control. Key parameters R0 and the proportion of transmission that occurred before symptom onset are uncertain, and in that uncertainty lies danger.
[link:https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30074-7/fulltext|

Background
Isolation of cases and contact tracing is used to control outbreaks of infectious diseases, and has been used for coronavirus disease 2019 (COVID-19). Whether this strategy will achieve control depends on characteristics of both the pathogen and the response. Here we use a mathematical model to assess if isolation and contact tracing are able to control onwards transmission from imported cases of COVID-19.

Methods
We developed a stochastic transmission model, parameterised to the COVID-19 outbreak. We used the model to quantify the potential effectiveness of contact tracing and isolation of cases at controlling a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-like pathogen. We considered scenarios that varied in the number of initial cases, the basic reproduction number (R0), the delay from symptom onset to isolation, the probability that contacts were traced, the proportion of transmission that occurred before symptom onset, and the proportion of subclinical infections. We assumed isolation prevented all further transmission in the model. Outbreaks were deemed controlled if transmission ended within 12 weeks or before 5000 cases in total. We measured the success of controlling outbreaks using isolation and contact tracing, and quantified the weekly maximum number of cases traced to measure feasibility of public health effort.

Findings
Simulated outbreaks starting with five initial cases, an R0 of 1·5, and 0% transmission before symptom onset could be controlled even with low contact tracing probability; however, the probability of controlling an outbreak decreased with the number of initial cases, when R0 was 2·5 or 3·5 and with more transmission before symptom onset. Across different initial numbers of cases, the majority of scenarios with an R0 of 1·5 were controllable with less than 50% of contacts successfully traced. To control the majority of outbreaks, for R0 of 2·5 more than 70% of contacts had to be traced, and for an R0 of 3·5 more than 90% of contacts had to be traced. The delay between symptom onset and isolation had the largest role in determining whether an outbreak was controllable when R0 was 1·5. For R0 values of 2·5 or 3·5, if there were 40 initial cases, contact tracing and isolation were only potentially feasible when less than 1% of transmission occurred before symptom onset.

Interpretation
In most scenarios, highly effective contact tracing and case isolation is enough to control a new outbreak of COVID-19 within 3 months. The probability of control decreases with long delays from symptom onset to isolation, fewer cases ascertained by contact tracing, and increasing transmission before symptoms. This model can be modified to reflect updated transmission characteristics and more specific definitions of outbreak control to assess the potential success of local response efforts.

[TexasBushwhacker]

13. I agree and like COVID-19

most hospitalizations and deaths are among the elderly and others with weak immune systems.

[womanofthehills]

14. The average age of those in China who developed acute respiratory distress - 61

https://www.statnews.com/2020/03/03/who-is-getting-sick-and-how-sick-a-breakdown-of-coronavirus-risk-by-demographic-factors/

Yesterday, I also read (but can't find article) that more people in their 40's and 50's were becoming ill in China in the last few days. Way less people getting the virus, but somewhat younger.

[keithbvadu2]

9. Trump won't let the Americans on the cruise ship back into America because he considers those cases

Trump won't let the Americans on the cruise ship back into America because he considers those cases not counting against America's 'count'.

He thinks the lower count makes him look good.

[soryang]

10. 17 deaths suggests there are already thousands of infected people.

they are just not testing enough people. a failure to coordinate contact investigation and tracking with testing and quarantine just means the outbreak will spread in an uncontrolled fashion.

[SunSeeker]

11. Yep. I can't believe Dr. Fauci is not speaking up about the woefully insufficient testing.

The scientists appear to have been muzzled in the Trump administration.

[denem]

15. Make that 464 cases :(

[moriah]

16. And 19 deaths.

45 passengers from Diamond Princess and 21 from Grand Princess (getting diagnosed before hitting US soil) makes our total case load of ppl who got sick on US soil and potentially transmitted it to others at 398.

What's concerning to me is that not just does it have a fairly long incubation period, but even if you get "sick"", you can't tell if you just have/had a bad cold unless it hits your lungs. The Washington State index case's course of case suggests it took 9 days of fever before his lungs got involved (day 9 of illness was when he started needing supplemental oxygen, which he hadn't before, and it showed pneumonia which was unresponsive to IV antibiotics but was responsive to an experimental antiviral).

So for someone not connected to a case to meet CDC criteria for testing (lower lung involvement with neg flu test), that means the guy in Memphis who was just diagnosed as a "spot case", and the one in Tulsa diagnosed a few days ago, likely each were sick for awhile, spewing virus out, before their states got permission to test even THEM let alone their contacts.

So seeing a case in the two states bordering mine, with cases all up the highway from Tulsa to Missouri as well...

We won't know if people just have a cold until it turns into pneumonia. And by then they've spread it to at least one person, if they've been in healthcare settings, other people who may have lowered resistance because they're sick with something else.