BA cancel all flights to and from China due to Coronavirus
Your assumption was on-target. Most investigation to date indicates cytokine storms developing in many/most COVID-19 (WHO's new official name for the disease caused by 2019-nCoV) cases that become fatal.
Knowing that may not be all that useful in a clinical sense, because there aren't really any good, established ways to deal with cytokine storms.
I don't think the fact that the fatalities are typically in older patients argues against the relationship. Remember, cytokine storms are explosive but ineffective immune responses that develop in later-stage illness.
A Google search for "coronavirus cytokine storm" will return many of the most useful results. This Lancet brief and the papers cited in it is a good place to start and has been widely cited in the short time since publication: https://www.thelancet.com/journals/l...305-6/fulltext
Knowing that may not be all that useful in a clinical sense, because there aren't really any good, established ways to deal with cytokine storms.
I don't think the fact that the fatalities are typically in older patients argues against the relationship. Remember, cytokine storms are explosive but ineffective immune responses that develop in later-stage illness.
A Google search for "coronavirus cytokine storm" will return many of the most useful results. This Lancet brief and the papers cited in it is a good place to start and has been widely cited in the short time since publication: https://www.thelancet.com/journals/l...305-6/fulltext
https://www.nationalgeographic.com/s...s-to-the-body/
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The virus is very transmissible, as evidenced by a case in China where 2 families were infected in a restaurant simply by sitting next to a third family which had an asymptomatic but infected member.
The real fear is if that virus gets to Africa, where physical contacts, handshakes and eating and sharing food using fingers is common place and cultural in rural areas. Also in Many African Sates have a very basic medical infrastructure.
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This practice is almost certainly correctly identifying most of the many new cases it's adding to the total, but it is also undoubtedly erroneously including other viral respiratory infections, since symptoms and radiological findings are more or less identical for the various viral infections.
Edit: Also, of course, clinical diagnosis won't find any asymptomatic carriers. But few of those individuals are probably being found in Hubei, anyway, given the size of the outbreak and the fact that they can't keep up with nucleic acid testing even for already-ill patients.
By the way, since this is PPRuNe, does anyone have a summary of overall flight cancellations at this point?
Last edited by OldnGrounded; 15th Feb 2020 at 22:46.
Ecce Homo! Loquitur...
https://www.thesun.co.uk/news/109720...eave-the-ship/
Elderly woman on coronavirus cruise diagnosed AFTER being cleared to leave the ship
AN 83-year-old US passenger aboard the luxury cruise ship Westerdam has been diagnosed with coronavirus a day AFTER she disembarked along with 2,200 other passengers and crew including 600 Americans.
Cambodia allowed the stricken ship to disembark in the port city of Sihanoukville on Friday after it was turned away by five other ports. Cambodian Prime Minister Hun Sen, who has been skeptical of the severity of the virus, personally distributed roses and shook hands with the Westerdam’s passengers as they disembarked........
Malaysia’s health ministry reported that the infected woman and her husband were among 145 passengers that flew to Malaysia on February 14. She was found with symptoms when she landed in Kuala Lumpur and was sent to a specialist designated hospital. She has been placed in isolation and is in a stable condition......
Elderly woman on coronavirus cruise diagnosed AFTER being cleared to leave the ship
AN 83-year-old US passenger aboard the luxury cruise ship Westerdam has been diagnosed with coronavirus a day AFTER she disembarked along with 2,200 other passengers and crew including 600 Americans.
Cambodia allowed the stricken ship to disembark in the port city of Sihanoukville on Friday after it was turned away by five other ports. Cambodian Prime Minister Hun Sen, who has been skeptical of the severity of the virus, personally distributed roses and shook hands with the Westerdam’s passengers as they disembarked........
Malaysia’s health ministry reported that the infected woman and her husband were among 145 passengers that flew to Malaysia on February 14. She was found with symptoms when she landed in Kuala Lumpur and was sent to a specialist designated hospital. She has been placed in isolation and is in a stable condition......
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Well not surprising if you are in a traditional Chinese family restaurant whee everyone shares the food from a single pot and picks up food bits with its own sticks on that pot..This is their culture. So I guess it is a bit more than just sitting around the same table...
The real fear is if that virus gets to Africa, where physical contacts, handshakes and eating and sharing food using fingers is common place and cultural in rural areas. Also in Many African Sates have a very basic medical infrastructure.
The real fear is if that virus gets to Africa, where physical contacts, handshakes and eating and sharing food using fingers is common place and cultural in rural areas. Also in Many African Sates have a very basic medical infrastructure.
You been there or just a newspaper reading like any mortal here?
(forgive me the little irony... I respect your point)
Last edited by JanetFlight; 16th Feb 2020 at 00:11.
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Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents
Recent update numbers in BNO few minutes ago...
@BNODesk
UPDATE: China's National Health Commission reports 166 new cases and 3 new deaths outside Hubei province since yesterday.
Crisis averted... Maybe
@BNODesk
UPDATE: China's National Health Commission reports 166 new cases and 3 new deaths outside Hubei province since yesterday.
Crisis averted... Maybe
There has been a lot of talk about inaccurate test results.
NAAT (nucleic acid amplification tests) for resp infections generally have very good accuracy per se. NAAT has been a major advance over earlier techniques. There is no reason to believe NAAT will be any different for this virus.
https://www.ncbi.nlm.nih.gov/pubmed/21073292
https://bmcinfectdis.biomedcentral.c...879-017-2227-x
BUT, a big problem is adequate sample collection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185851/
The more accurate sampling techniques are more likely to induce aerosolization of respiratory secretions (coughing, sneezing) and hence pose greater risk to the tester. Threat swabs are very poor (possibly no better than a coin toss), but are quick and easy and less dangerous to the tester. Nasopharyngeal washings are the opposite in every regard.
Imagine an environment where an entire province has been isolated for the greater good, where there is a sense of being abandoned, where the state has failed to provide sufficient PPE, where health care workers (who have their own families to look after) are getting infected.
Now imagine what tests are being done.
The technology per se is probably good. But like everything else, testing breaks down when the system itself starts to break down.
NAAT (nucleic acid amplification tests) for resp infections generally have very good accuracy per se. NAAT has been a major advance over earlier techniques. There is no reason to believe NAAT will be any different for this virus.
https://www.ncbi.nlm.nih.gov/pubmed/21073292
https://bmcinfectdis.biomedcentral.c...879-017-2227-x
BUT, a big problem is adequate sample collection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185851/
Respiratory virus detection is highly dependent on the type of sample collected, the time of collection after the onset of clinical symptoms, the age of the patient, and the transport and storage of the sample prior to testing (48, 49). Several different upper respiratory tract specimens are applicable for testing, including nasopharyngeal (NP) washes, NP aspirates, and NP swabs placed in virus transport media (48, 49). There are limited data that support the use of combined nose-throat swabs for influenza A virus testing by NAAT (14). Detection of 12 respiratory viruses using a NAAT panel was significantly less sensitive with oropharyngeal swab specimens (54.2%) than with either nasopharyngeal swabs (73.3%) or nasopharyngeal wash specimens (84.9%) (33). This may be due to the substantially lower viral loads in the oropharynx than in the nasopharynx (23).
Imagine an environment where an entire province has been isolated for the greater good, where there is a sense of being abandoned, where the state has failed to provide sufficient PPE, where health care workers (who have their own families to look after) are getting infected.
Now imagine what tests are being done.
The technology per se is probably good. But like everything else, testing breaks down when the system itself starts to break down.
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Well, that's part of the problem. It's a part that is magnified by the fact that NAAT copies contaminating DNA as well as the genetic material being tested. In the real world, in Hubei, the results include simply enormous numbers of false negatives. In an interview, last week, with CCTV, Wang Chen, director of the Chinese Academy of Medical Sciences, said that the false negatives were running between 30% and 50%.
It really doesn't look like there's a reasonable alternative, at this point, to relying upon clinical diagnosis, notwithstanding its obvious drawbacks. Reliable, rapid and readily-available tests and the ability to administer them properly just doesn't exist in the main outbreak environment.
It really doesn't look like there's a reasonable alternative, at this point, to relying upon clinical diagnosis, notwithstanding its obvious drawbacks. Reliable, rapid and readily-available tests and the ability to administer them properly just doesn't exist in the main outbreak environment.
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We’re well off R&N original topic; any further discussion take it to https://www.pprune.org/jet-blast/629...rus-china.html
