get me outta here
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Good advice, so which one would be best to use – is there something that doesn’t smell too much with cheap horrid Perfume? Dettol wipes have a pretty strong smell.
Coronavirus (COVID-19) Respiratory illness - Effect on Travel
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tgh
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Another interesting read.. those us who are not in the bar with the fatalists will end up knowing a bit about virology... 
From here : Thread by @angie_rasmussen: People are still freaking out over "asymptomatic" patients, so here's some info on virus incubation, symptoms, and lab confirmation of #nCoV…
People are still freaking out over "asymptomatic" patients, so here's some info on virus incubation, symptoms, and lab confirmation of #nCoV2019 #coronavirus tests. It's not unusual for patients to test negative (for this or any other virus) in the early days after infection.
When a virus infects a cell, it takes time to replicate itself inside that cell and produce new virus particles. The period of time when a virus is replicating but hasn't yet begun producing new virus particles (called virions) is called the eclipse.
During the eclipse phase, viral RNA (the genetic material of the virus) and proteins are produced in cells. Proteins are involved in replicating the virus, hijacking host cell functions, evading immunity, and making the virus "shell" (capsid/structural proteins).
Viral RNA is packaged into the capsids and the virus particles are released from the cell. They go on to infect other cells nearby and the process repeats, resulting in exponential increases in the amount of virus (called titer)
Current virus testing technology (qRT-PCR) detects viral RNA. These tests are sensitive, but there's a limit of detection. qRT-PCR can only detect virus if there are sufficient viral titers. Early in infection, there may not be enough RNA to reliably detect this.
Also, cells in the human respiratory tract are highly structured. There are different kinds of cells that are organized into tissues. Not all of these cells are susceptible to infection, and certain cell types may produce more virus than others.
There are also natural barriers, such as mucus, that trap viruses and prevent them from infecting cells. So it can take time to achieve detectable virus titers. That time depends on a whole lot of variables.
Infectious dose, mode of transmission, viral genetics, viral fitness, host genetics, host cell receptor expression, antiviral response, amount of mucus, other underlying conditions, sampling procedure--these can all impact titer and hence the time it takes to detect infection
Note I haven't even mentioned symptoms. That's because symptoms are largely due to the host response to infection, rather than the infection itself (S/O to host responses, that's what I study!).
For coronaviruses, symptoms are generally the result of host cells (either infected cells or other immune cells nearby) detecting that infection and triggering antiviral responses. This process is complicated and plays out differently in every infected host.
It's kind of like a football game. There are different specialized players on each side and different coaching strategies. Sometimes the host keeps the virus in check, sometimes the other way around.
But when a virus is able to spread--for example, to the lower respiratory tract--then the host response also is more widespread. That response to viruses includes inflammation. Localized, controlled inflammation is good--it's needed for immune function to clear virus
More widespread, uncontrolled inflammation is bad. That's how a patient gets pneumonia. When this happens, a patient is definitely symptomatic. These patients have plenty of detectable virus.
However, a patient who is asymptomatic but still infected might not. If a patient controls the infection locally, they might not be shedding tons of detectable virus. They might still be capable of transmitting virus, albeit less capable than a patient who is very sick.
Similarly, a patient in the very early stages of infection may test negative because virus titers have not yet met the threshold for detection, regardless of the eventual severity of disease. In both situations, it is not unexpected to have a negative nasal swab test.
The important things to note are that "OMG this patient is asymptomatic" or "OMG this patient tested negative and later tested positive" are not abnormal. These are fully consistent with how viruses replicate, spread, and cause disease.
Asymptomatic patients generally don't transmit virus as efficiently, because they have lower virus titers and because they aren't experiencing clinical features that encourage virus spread (coughing, sneezing, excess mucus production).
And patients with negative test results early in infection may likewise be capable of spreading virus, but are also less likely to do so because they aren't shedding very much virus. This is expected. It's just viruses doing what viruses do.
So I wish the media and some scientists would cut out all the Typhoid Mary hysteria. #nCoV2019 #coronavirus spread is not some aberration or a silent epidemic in which we'll all only find out we're doomed once it's too late.
We need to focus on improving testing, treating patients, and our fundamental understanding of virus pathogenesis (again, s/o to the host response!). The misdirected focus is harming our ability to adequately contain spread and is responsible for some truly coughty policy choices
The cruise ship sitch, involuntary quarantines and travel bans, confusing diagnostic criteria, criminalized epidemiology...these are all further complicating an already complex situation by fixating on this asymptomatic transmission issue, which, again, is just viruses virusing.
From here : Thread by @angie_rasmussen: People are still freaking out over "asymptomatic" patients, so here's some info on virus incubation, symptoms, and lab confirmation of #nCoV…
People are still freaking out over "asymptomatic" patients, so here's some info on virus incubation, symptoms, and lab confirmation of #nCoV2019 #coronavirus tests. It's not unusual for patients to test negative (for this or any other virus) in the early days after infection.
When a virus infects a cell, it takes time to replicate itself inside that cell and produce new virus particles. The period of time when a virus is replicating but hasn't yet begun producing new virus particles (called virions) is called the eclipse.
During the eclipse phase, viral RNA (the genetic material of the virus) and proteins are produced in cells. Proteins are involved in replicating the virus, hijacking host cell functions, evading immunity, and making the virus "shell" (capsid/structural proteins).
Viral RNA is packaged into the capsids and the virus particles are released from the cell. They go on to infect other cells nearby and the process repeats, resulting in exponential increases in the amount of virus (called titer)
Current virus testing technology (qRT-PCR) detects viral RNA. These tests are sensitive, but there's a limit of detection. qRT-PCR can only detect virus if there are sufficient viral titers. Early in infection, there may not be enough RNA to reliably detect this.
Also, cells in the human respiratory tract are highly structured. There are different kinds of cells that are organized into tissues. Not all of these cells are susceptible to infection, and certain cell types may produce more virus than others.
There are also natural barriers, such as mucus, that trap viruses and prevent them from infecting cells. So it can take time to achieve detectable virus titers. That time depends on a whole lot of variables.
Infectious dose, mode of transmission, viral genetics, viral fitness, host genetics, host cell receptor expression, antiviral response, amount of mucus, other underlying conditions, sampling procedure--these can all impact titer and hence the time it takes to detect infection
Note I haven't even mentioned symptoms. That's because symptoms are largely due to the host response to infection, rather than the infection itself (S/O to host responses, that's what I study!).
For coronaviruses, symptoms are generally the result of host cells (either infected cells or other immune cells nearby) detecting that infection and triggering antiviral responses. This process is complicated and plays out differently in every infected host.
It's kind of like a football game. There are different specialized players on each side and different coaching strategies. Sometimes the host keeps the virus in check, sometimes the other way around.
But when a virus is able to spread--for example, to the lower respiratory tract--then the host response also is more widespread. That response to viruses includes inflammation. Localized, controlled inflammation is good--it's needed for immune function to clear virus
More widespread, uncontrolled inflammation is bad. That's how a patient gets pneumonia. When this happens, a patient is definitely symptomatic. These patients have plenty of detectable virus.
However, a patient who is asymptomatic but still infected might not. If a patient controls the infection locally, they might not be shedding tons of detectable virus. They might still be capable of transmitting virus, albeit less capable than a patient who is very sick.
Similarly, a patient in the very early stages of infection may test negative because virus titers have not yet met the threshold for detection, regardless of the eventual severity of disease. In both situations, it is not unexpected to have a negative nasal swab test.
The important things to note are that "OMG this patient is asymptomatic" or "OMG this patient tested negative and later tested positive" are not abnormal. These are fully consistent with how viruses replicate, spread, and cause disease.
Asymptomatic patients generally don't transmit virus as efficiently, because they have lower virus titers and because they aren't experiencing clinical features that encourage virus spread (coughing, sneezing, excess mucus production).
And patients with negative test results early in infection may likewise be capable of spreading virus, but are also less likely to do so because they aren't shedding very much virus. This is expected. It's just viruses doing what viruses do.
So I wish the media and some scientists would cut out all the Typhoid Mary hysteria. #nCoV2019 #coronavirus spread is not some aberration or a silent epidemic in which we'll all only find out we're doomed once it's too late.
We need to focus on improving testing, treating patients, and our fundamental understanding of virus pathogenesis (again, s/o to the host response!). The misdirected focus is harming our ability to adequately contain spread and is responsible for some truly coughty policy choices
The cruise ship sitch, involuntary quarantines and travel bans, confusing diagnostic criteria, criminalized epidemiology...these are all further complicating an already complex situation by fixating on this asymptomatic transmission issue, which, again, is just viruses virusing.
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Was only a matter of time IMO
7news.com.au
Travellers warned after Bali tourist tests positive to coronavirus
Global health authorities were increasingly sceptical of Bali’s apparent immunity to the coronavirus outbreak, but now, it seems, to have reached the island’s shores.
7news.com.au
PineappleSkip
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The pineapples report two further cases of COVID-travel disease (is that an AFF notifiable disease?).
Mrs Pineapple is booked to fly out of BNE on QF/AY via HKG to France and UK. I fly out on the same QF flight, connecting to ADD en route to work in Somaliland. On return I was to meet Mrs Pineapple in HKG to fly back together in CX. A fine plan. We depart in less than a week, returning mid March.
Got an email this morning from CX that CX155, our overnight HKG-BNE flight, has been cancelled, and they ‘ve rebooked me to overnight in HKG and get CX157, the formerly daily lunchtime flight, the next day.
Checking EF for mid March indicates CX has engaged in random acts of cancellation, leaving two flights HKG-BNE some days, no flights other days, and other cancellations leaving either CX157 or CX155 on the other days.
Rebooking will be fun, as I’m on a ticket issued by ET, and Mrs Pineapple is ticketed by AY. We are inclined to abandon hope if returning together. No word from AY yet on rebooking her phantom flight. Not sure if they’d go the overnight in HKG option, or reroute via SIN or HKG/SYD (CX 101 to SYD is a same day connection, but would require an onward connection to BNE).
I think ET would need to agree with any shift in my flight with cost consequences and I think it’s their their call whether they will stump up for accom in HKG. ET might also opt to reroute via SIN or BKK.
And of course either ET or AY might further reduce flights to Asia too - a month is a long time for an epidemic. We look forward to further correspondence.
cheers skip
Mrs Pineapple is booked to fly out of BNE on QF/AY via HKG to France and UK. I fly out on the same QF flight, connecting to ADD en route to work in Somaliland. On return I was to meet Mrs Pineapple in HKG to fly back together in CX. A fine plan. We depart in less than a week, returning mid March.
Got an email this morning from CX that CX155, our overnight HKG-BNE flight, has been cancelled, and they ‘ve rebooked me to overnight in HKG and get CX157, the formerly daily lunchtime flight, the next day.
Checking EF for mid March indicates CX has engaged in random acts of cancellation, leaving two flights HKG-BNE some days, no flights other days, and other cancellations leaving either CX157 or CX155 on the other days.
Rebooking will be fun, as I’m on a ticket issued by ET, and Mrs Pineapple is ticketed by AY. We are inclined to abandon hope if returning together. No word from AY yet on rebooking her phantom flight. Not sure if they’d go the overnight in HKG option, or reroute via SIN or HKG/SYD (CX 101 to SYD is a same day connection, but would require an onward connection to BNE).
I think ET would need to agree with any shift in my flight with cost consequences and I think it’s their their call whether they will stump up for accom in HKG. ET might also opt to reroute via SIN or BKK.
And of course either ET or AY might further reduce flights to Asia too - a month is a long time for an epidemic. We look forward to further correspondence.
cheers skip
I love to travel
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242 people died yesterday in China (source CNN). So much for the peak starting to drop off.
p--and--t
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One site reports the current hospitalised cases that are serious/critical as 8,217.
The reality is, if not one new case was discovered from today, and given the state of medical facilities and shortage of medical supplies at the epicentre, I would expect there will continue to be significant bad news until all 8,217 either pass away or eventually are discharged as recovered. Even at 1:8 chance, that's more than another 1,000 deaths.
At the peak Feb 4th, nearly 4,000 new cases were being added per day (20% increase over previous day) . Yesterday it was just over 2,000 (5% increase over previous day).
Coronavirus Cases: Statistics and Charts - Worldometer
Updated Statistics, graphs, and data tables showing the total number of cases, cases per day, cases by country, cases outside of Hubei in China, recoveries and discharges, newly infected, active cases, outcome of closed cases: death rate vs. recovery rate for patients infected with the COVID-19...
www.worldometers.info
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p--and--t
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14K new cases today
Wow, how things can change in 24 hours.
I wonder if that is being driven by the house to house searches by police in Hubei province?
At a exec briefing, we were "strongly advised" not to travel. If it continues to grow in Asia, and we have containment here in oz, then there will be the risk of further travel bans, worryingly of HK and SIN. You may end up in quarantine on your way back..
The conference I was going to attend in SIN is going to be cancelled - due to poor local and international attendance and also they are heavily ramping up for CoViD-19.
The conference I was going to attend in SIN is going to be cancelled - due to poor local and international attendance and also they are heavily ramping up for CoViD-19.
The 14K new cases includes for the first time "clinically diagnosed cases" as well as RT-PCR confirmed(which was the only criteria previously). The chinese government have added this "to make it easier for these patients to receive treatment early".
p--and--t
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So does that mean we should see the "suspected" figure to drop in concert with the policy change?
tgh
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epidemic
– reported on Thursday 14,840 new confirmed cases, almost 10 times the number reported a day earlier, and new deaths attributable to the contagion rose to 242, more than double on the day.
This brings the totals announced by the province’s health commission to 48,206 and 1,310, respectively, as of Wednesday.
Officials in Hubei had reported 94 fatalities and 1,638 newly confirmed cases a day earlier.
Hubei’s health commission said in its daily statement that it had changed the diagnostic criteria used to confirm cases, effective Thursday, meaning that doctors have broader discretion to determine which patients are infected.
“From today on, we will include the number of clinically diagnosed cases into the number of confirmed cases so that patients could receive timely treatment,” the health authority said in a statement, which did not provide further details about the new criteria.
– reported on Thursday 14,840 new confirmed cases, almost 10 times the number reported a day earlier, and new deaths attributable to the contagion rose to 242, more than double on the day.
This brings the totals announced by the province’s health commission to 48,206 and 1,310, respectively, as of Wednesday.
Officials in Hubei had reported 94 fatalities and 1,638 newly confirmed cases a day earlier.
Hubei’s health commission said in its daily statement that it had changed the diagnostic criteria used to confirm cases, effective Thursday, meaning that doctors have broader discretion to determine which patients are infected.
“From today on, we will include the number of clinically diagnosed cases into the number of confirmed cases so that patients could receive timely treatment,” the health authority said in a statement, which did not provide further details about the new criteria.
p--and--t
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Seems lots of people have been relying on dear old FB and the water cooler chats for information. WHO is trying to change that...
thenewdaily.com.au
The biggest myths about the coronavirus busted by the WHO
Believe it or not, you can't catch coronavirus in China Town. It’s not carried by pets, caused by vaccines or cured by hand dryers.
PineappleSkip
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I have no confidence in any of the numbers coming out of PRC any more, or the explanations. Looking at the numbers over time shows a continued trend of exponential growth, and the claim about change in calculation looks like a fudge to explain the irregularity in numbers.
Here’s an alternative hypothesis. China shows slowing growth in new cases for a few days to allay the (immense) fears of the masses there about COVID. This was at the same time Dr “she’ll be right” Zhong Nanshan predicts a peak in the next few days. He’d unsuccessfully predicted the same a week before. A WHO team finally arrives in China the day before yesterday, and yesterday the WHO director-general rings the alarm bells louder yesterday, and comments that
Meanwhile CX have sent me another email; they’ve bumped my HKG-BNE flight another day and now propose I overnight two nights in HKG. Looks like chaos there to me.
Here’s an alternative hypothesis. China shows slowing growth in new cases for a few days to allay the (immense) fears of the masses there about COVID. This was at the same time Dr “she’ll be right” Zhong Nanshan predicts a peak in the next few days. He’d unsuccessfully predicted the same a week before. A WHO team finally arrives in China the day before yesterday, and yesterday the WHO director-general rings the alarm bells louder yesterday, and comments that
In other words, the WHO says don’t believe the numbers out of China. (The same could be said about many other places) Suddenly, with the WHO in town China shows a sudden jump in numbers, which appear to have returned to the same underlying trajectory. China needs to find an explanation of the shift.
Meanwhile CX have sent me another email; they’ve bumped my HKG-BNE flight another day and now propose I overnight two nights in HKG. Looks like chaos there to me.
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tgh
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Looks like chaos there to me
Travel via HK ? ..only for the young and bulletproof imo….
Many of the patients found to be infected with the coronavirus in Hong Kong have not visited the mainland recently. It is believed that a community outbreak of the deadly virus in the city is spreading
multimedia.scmp.com
Travel via HK ? ..only for the young and bulletproof imo….
Many of the patients found to be infected with the coronavirus in Hong Kong have not visited the mainland recently. It is believed that a community outbreak of the deadly virus in the city is spreading
Coronavirus: community outbreak in Hong Kong
Many of the patients found to be infected with the coronavirus in Hong Kong have not visited the mainland recently. It is believed that a community outbreak of the deadly virus in the city is spreading.
PineappleSkip
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Sorry, I meant chaos at CX where they are reshuffling flights. And pineapples are definitely not bullet proof and don’t regard extended stopovers in HKG as optimal right now. However, I’d assess the HKG contagion risk today, as before, as similar to that for travel via SIN, where there are similar case numbers and also clusters of locally acquired cases. In a month’s time, who knows.
cheers skip
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drron
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I am keeping a close eye on the SIN Ministry of health site.
Press conference yesterday-
3 more cases.
None had been to china but even with Singapore's health system things can fail.one of the new cases-
"Case 48
5. Case 48 is a 34 year-old male Singapore Citizen with no recent travel history to China but was in Malaysia on 26 January 2020. He is currently warded in an isolation room at the National Centre for Infectious Diseases (NCID).
6. He reported onset of symptoms on 1 February, and had sought treatment at four general practitioner (GP) clinics on 2 February, 4 February, 7 February, 9 February and 10 February. He went to NCID on 10 February, and was subsequently confirmed to have COVID-19 infection on 11 February afternoon.
7. Prior to hospital admission, he had visited Plaza Singapura (68 Orchard Road), Star Vista (1 Vista Exchange Green) and Fusionopolis (1 Fusionopolis Place). He also went to work at Grace Assembly of God (Tanglin) (355 Tanglin Road) and Grace Assembly of God (Bukit Batok) (1 Bukit Batok West Avenue 4). He stays at Bukit Batok Street 25."
Went on 5 occasions to a GP clinic (4 different ones) before going to the National centre for Infectious diseases and being diagnosed.
Press conference yesterday-
3 more cases.
None had been to china but even with Singapore's health system things can fail.one of the new cases-
"Case 48
5. Case 48 is a 34 year-old male Singapore Citizen with no recent travel history to China but was in Malaysia on 26 January 2020. He is currently warded in an isolation room at the National Centre for Infectious Diseases (NCID).
6. He reported onset of symptoms on 1 February, and had sought treatment at four general practitioner (GP) clinics on 2 February, 4 February, 7 February, 9 February and 10 February. He went to NCID on 10 February, and was subsequently confirmed to have COVID-19 infection on 11 February afternoon.
7. Prior to hospital admission, he had visited Plaza Singapura (68 Orchard Road), Star Vista (1 Vista Exchange Green) and Fusionopolis (1 Fusionopolis Place). He also went to work at Grace Assembly of God (Tanglin) (355 Tanglin Road) and Grace Assembly of God (Bukit Batok) (1 Bukit Batok West Avenue 4). He stays at Bukit Batok Street 25."
Went on 5 occasions to a GP clinic (4 different ones) before going to the National centre for Infectious diseases and being diagnosed.
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