Why all these inconsistency regarding the news about the recent nCoV2019?
There is obvious discrepancy between the information given by the official authorities in China and other sources in China. For example; the official authorities in China said that about more than five million have left Wuhan since the start of nCoV2019 (at the end of December 2019), HOWEVER officially as well as a fact that the registered annual capacity of Wuhan airport is about 13 million (which means less than 1.1 million a month) so, here there is obvious discrepancy!! another example is that, officially till today about 5000 cases have been diagnosed with nCoV2019 in Wuhan which is increasing rapidly day by day, However, a nurse works in Wuhan she gave different information through you tube video in which she has said that the health situation in Wuhan is very critical and according to her, the diagnosed cases (two days ago the date in which she uploaded her video on the You Tube ) were 90,000 diagnosed cases (this another major discrepancy as well!!) what such situation might indicate, considering also it took about two weeks for the Chinese health authority to formally inform WHO about this outbreaks? considering the failure of all measures implemented so far by the Chinese health authority to control this nCoV2019 outbreak and declaration of the Chinese president that the situation is very critical, do you think, the Chinese health authority has underestimated the risk of this nCoV2019 outbreaks which lead to the delay in the official declaration about this outbreak which eventually might contributed to this obvious failure of all the implemented control measures and the spread of this new highly infectious virus to other countries all over the globe beyond China?
Compared to the other previous different viral outbreaks in Africa for examples where the resources are very limited, do you think the vast Chinese resources made any difference in the way the situation was handled and the outcomes so far considering both definitely required the imminent high support of WHO and all other international health organisations?
I'm surprised, that you are surprised by the fact, that a country, with the Great Firewall, might be hiding the official statistics.
Since it is a new strain, people are still trying to get a grasp of what exactly is it. That's why the several versions of news & information.
Updates in about 2 days since the launch of this discussion, the situation is the following:
Countries stepped up travel restrictions on arrivals from China on Friday 31/01/2020 after a global health emergency was declared over the coronavirus epidemic that has killed 213 people.
Nearly 10,000 people have been infected in China by the coronavirus and new cases were found abroad, with more than 20 countries now affected by the disease.
The World Health Organisation on Thursday (Yesterday) declared the outbreak a global health emergency, but said it was not recommending any international trade or travel restrictions
The US State Department raised its warning alert to the highest level, telling Americans "do not travel" to China
In Vietnam, Prime Minister Nguyen Xuan Phuc ordered the suspension of new tourist visas for Chinese citizens and foreigners who have been in China over the last two weeks.
Trade with China will also be "discouraged" until the outbreak abates, he said.
Japan, meanwhile, joined Britain, Germany and other countries that have recommended that their citizens avoid China.
I'm surprised, that you are surprised by the fact, that a country, with the Great Firewall, might be hiding the official statistics.
@ Marium Barianidza
This discussion only aim is to promote the basic requirement for any issue related to the humanity and living creatures.This basic requirement is the transparency. We are trying to see the facts and trying to share with each other, these facts which might be not so clear some times due to one reason or another! Any human life means a lot for all of us which we need to treasure and we are morally and professionally obliged to implement high standards of transparency ! Kindly, see the following you tube video
https://youtu.be/HE7Iz7HLpYg
@ Marium Barianidza
Please see the following (All what is needed is transparency!);
https://www.youtube.com/watch?v=HE7Iz7HLpYg
The title of this videa is : Coronavirus - Doctors Arrested for revealing the truth
Today the official figures about confirmed cases of 2019nCoV are as follows:
In China: 24329 and the total number in the world is 24530
Now in addition to China, it spreads in about 25 other countries.
Confirmed mortality cases are: 492 in China and one case in Philippines (the patient was a Chinese national),the total confirmed officially declared fatality cases are 493
https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases
Although the number of confirmed cases increased drastically (almost five times in one week, in spite of all the declared huge measured taken) , the mortality rate still maintains its first level ( about 2%)!
Today the death toll in China from 2019nCoV reached 1017 and the total number of diagnosed cases of 2019nCoV exceeded 42,000!
In China the health authority announced that they now they confirmed that this virus is transmitting through the air (This is a bad news), however this will legitimatise the enforcement of Quarantine (as people might not follow the instructions to do so, so enforcement will be needed)
Many Chinese believe that there was a delay in handling such a serious health problem and that might be the reason of spreading the cases even to other countries. Two top Chinese officials from Hubei (where the virus started) have resigned as a consequence of public anger and public feeling of mishandling this serious health epidemic in China
Updates: COVID2019 (the name which was given to the 2019 nCoV by WHO) continues to attack and kill more people mainly in China (but even some cases in other parts of the world), the number of deaths in China from COVID2019 exceeds 1662 and the number of officially confirmed cases in China exceeds 66,0000. Yesterday, the French Health Authority announced the death of the first case (who was in France as a tourist Chinese national 80 years old) because of COVID2019. This will be the first confirmed death because of COVID2019 in Europe and outside Asia (the other only confirmed death was in Philippine few weeks ago and the victim was a Chinese national as well). There was official news of first confirmed case of COVID2019 in Egypt. HOWEVER, I am delighted to know that WHO announced that the Chinese authorities have set up Clinical Trials (This is excellent news!). These clinical trials will test the efficacy of wide variety of drugs which will range from existing non anti viral drugs, all the way through the Chinese medicine, as the Chinese have a long history of the herbal medicine (some of which can be effective) and these should be reporting in 2 to 3 weeks. As far as we know, these are Double Blind Randomised Controlled Clinical Trials of the highest order ( a group of patients will be given the tested active drug and other group of patients will be given a placebo) to compare the two (the experimental group and the control group) and this will give Quantitative data as to the efficacy of the tested drug (Good news which will report-we will know about- in few weeks time) LET US hope that this will come up with nice, effective cheap candidate (preferably some nice generic drugs really cheap) to treat this very serious infection (COVID2019)
Although very often, outbreaks of disease tend to effect very old people (because their immune system will be deteriorate some what and often they will have co morbidities (other diseases which will predispose them to infections) and very young people(children, because their immune system is not fully developed), much more than the other age groups. HOWEVER, the literature published from China in JAMA (very prestigious medical journal), shows through a retrospective study collected the data about the confirmed hospitalised cases of infants (it involved all hospitalised infants (from 28 days till 1 year old) who were diagnosed with COVID-2019 between 8th of December 2019 till 6th February 2020 (that is huge period of time, about two months).The study group were able to identify 9 infants. So if that is true, It is remarkably reassuring as it is a small number.9 infants were infected, 7 girls and 2 boys (so more girls than boys). Family of these infants had at least one member of their family diagnosed with COVID-2019 and infant infection occurred after a family member infection. TWO encouraging things here, even in hospital; they only found 9 infants between 28 days and 1 year age which is a remarkably a small number. and the other thing which is encouraging is non of the 9 infant required intensive care or mechanical ventilation or had a severe complications.
This is good news here as infants seem to be getting mild disease (if they get any at all). So, first of all they are very unlikely to get the disease and if they get the disease, it seems to be mild (which is just brilliant). The number of affected infants with COVID -2019 is absolutely very very small, BUT why is this? Probably lower risk of exposure ( as they kept in the home which is good) remember that all of them got the infection from affected family members. It appears infant may have a lower risk because they are not exposed to the virus as much as the rest of people in the streets and who are going to work for example. Another factor, incomplete identification due to mild or asymptomatic disease(infants may have preponderance of mild or asymptomatic disease) because this study talk only about hospitalised infants with COVID-2019. One of the recommendations emerged from this study is ; the infants of infected family members should be monitored to ensure early diagnosis of COVID-2019. Infants less than one year can not wear masks (that is a problem however we know that masks are that protective anyway) BUT adult carers should be careful by wearing masks and washing hands before contacting infants (infants need to be kept in cleaner environment as much as possible.One of the limitations of this study is being retrospective (as it might be very difficult to get all the information after the event) and another limitation is the small number of the cohort (only 9).Although infants tend to be less likely to get COVID-2019, having saying that this study proved they can still get the infection and we need to protect them. I am sure we will have more information about this point, however the information we have till this stage is fairly promising about infants in relation to COVID-2019 infection.
Why WHO did not declare COVID-19 as a pandemic disease yet in spite of the spread of the disease in quite number of countries including most of the continents and some of them have implemented very emergency measures to try to contain this uncontrollable disease so far!! the situation for example in Italy , South Korea and Iran is very critical. I think declaring Pandemic state of COVID-19 by WHO at this stage is very critical, important and realistic to gear up all the critically needed international measures in dealing with this disease (COVID-19) including funds at Pandemic scale.
https://www.google.com/amp/s/www.aljazeera.com/amp/news/2020/01/coronavirus-symptoms-vaccines-risks-200122194509687.html
@ Rasha Shakir Nima
Thanks for sharing this informative link from aljazeera channel, however I do think also our own views and interpretations (especially if the person of medical back ground) of the facts available so far are also quite important to contribute to proper handling of this disease (COVID-19) which still uncontrollable so far.
Some updates:
The medical experts say that If someone catches the virus, in 12 to 24 hrs after that, they can coughing the virus out shedding the virus, potentially infecting other people. This different from SARS and MERS, as in COVID-19, pre symptomatic spread seems to be happening and properly will stay infectious for 14 days and in some rare occasion it is even more.
Genetics of this virus seems to be is properly relatively stable, at least compared to influenza, which means once your immune system recognise it, it will recognise it if you will be re infected. This should mean that the people will not get re infected with this virus. The information available till now show this fact, however, this is new virus and we are still learning about it day by day.
According to WHO, COVID-19 is already spread to 50 countries. WHO says it still can be contained by implementing the recommended right measures, however it is NOT a pandemic yet BUT it has a high pandemic potential.
According to WHO, if COVID-19 will be Pandemic, 30% of the world population will be infected in the first year of the infection.
Figures today show that; there were more new cases in the rest of the world than in China.
Drive through testing, test result in 2 days (This is being done in South Korea to prevent or at least reduce the institutional (Hospitals or health centres)spread.
The High death rate in Iran (about 5%) through unverified report from Iran said it could be due to overuse of corticosteroids in managing cases of COVID-19 . Corticosteroids can suppress the immune system and the inflammatory response, so they can make the situation much worse in COVID-19. However, in Iran also, schools and universities are closed, events are cancelled and Friday prayers are cancelled in 23 cities.
Updates;
Between yesterday and today (5th May 2020), some studies have reported their findings. These studies were done in two highly prestigious microbiological departments in China [Peking (Beijing) University School of life sciences and Institute Pastuer in Shanghai].
Scientists in the above mentioned Chinese institutes have taken 103 genomes of the SARS-CoV-2 to study them. They looked at phylogenetic (evolutionary) relationship between the viruses at the genomic scale.
They show that it seems to be there are two genetically distinctive forms of the virus causing COVID-19 disease (SARS-CoV-2). They named these form as; S and L form of the virus. So this can reflect a new mutation which can be considered as evolution of the virus from one form in to another.
This new development is significant as it will have implications which can be both, concerning or less concerning.
The implication of this new form of the virus, it might be more virulent and more transmissible. It might cause more severe form of the disease (COVID-19).
Although SARS-CoV-2 is generally described as relatively genetically stable RNA virus, but apparently, there have been a couple of changes in 2 SNPs (out of 26,000 to 32,000 bases) that make it. This meant that there are two main viral lineages (Strains) L and S types.
These two SNPs are found in the codons (genomic triple codons) which code for the protein of the spikes that help in transmitting the disease by adsorbing more efficiently in to ACE-2 receptors.
Geneticists think that there is ancestral form called S form of the virus (which is the first form but this still not clear enough) and this form carries on reproducing, so we got a lot of S forms probably all over the world.
However, at one point one S form mutated in to other form of the virus which is now is called L form which branches off the S ancestral form. L form is considered to be more infectious and more virulent, it can transmit more easily from person to person and it can cause more severe disease.
Mutated Later (L type) spreads more quickly about 70% of current cases (this was inside China)
S viral form of SARS-CoV-2 might be the one which causes the pandemic (this form appears to be less transmissible and less virulent causing less severe disease). Two of the discovered genetic changes between S and L lineages were in spike receptor-binding domain (RBD).
ACE-2 receptors are the cellular sites where the SARS-CoV-2 protein spikes fit in through a process called adsorption. These protein spikes are the ones which make the virus infectious and can get in to the inside the human cells to be replicated. So if there is a change in molecular confirmation of these viral protein spikes, it can mean that these spikes can fit in to the receptors more efficiently which can make the virus more transmissible.
The question we can raise now is, is it possible for the person to be infected with both forms at the same time, L and S type? (This is still needed to be clarified)
Some people say a vaccine which is under preparation, might not work on the mutated form of the SARS-CoV-2. This can mean also, we may need two vaccines instead of one vaccine.
However, the people who are designing the SARS-CoV-2 vaccine in about 35 laboratories all over the world are very clever scientists and know this possibility. They are trying to make a vaccine which is working on a highly conserved part of the viral (SARS-CoV-2) genome (the part which is not changing all the time). So, it is still likely and this very reassuring, that one vaccine can work on both viral forms (L and S)
We need to know as well that the antibody response of the human body to S and L forms of the virus might be slightly different. S form will elicit specific immune antibody response which might be slightly different from the antibody response to the viral L form.
What is also not clear at the moment is that if immunity elicited against one form can or cannot give cross immunity against other form of the virus?
This is currently unclear.
As there were a few reported cases of COVID-19 re infection, however there is no study about them yet but the presence of two viral lineages with possibility of variations in human body immune response might be the scientific explanation of that re infection. This also might mean that there will be waves of the infection (unfortunately).
The other thing which the scientists and experts in the field do not know about yet is that if a person can be infected with two forms of the SARS-CoV-2 at the same time will make the disease [COVID-19] a more virulent disease. This is unclear at the moment.
Updates:
WHO and other international reliable trustworthy sources announced today ( Friday the 6th March 2020) that the number of the confirmed cases of COVID-19 all over the world exceeded 100,000 cases and the total number of deaths is 3400 which gives Case fatality Rate (CFR) of 3.4 (This is very concerning).
More than 80% of the confirmed cases of COVID-19 are in China and about 90% of total deaths from COVID-19 all over the world are in China as well. Today China probably recorded the least number of newly confirmed cases of 143 SINCE the start of this viral outbreak in December 2019 and 30 new deaths (which might reflect the efficiency of extra ordinary measures that are being taken by Chinese authorities to delay this outbreak)
COVID-19 already spread in 91 countries all over the world.
The countries which are being hardly hit by COVID-19 after China are; South Korea (6284 confirmed cases including new 196 today and total of 42 deaths), Iran (total number of confirmed cases 4747 including 1234 new confirmed cases today (very concerning!) and total deaths of 124), Italy (49 new death cases today which gives total of 194 cases) and France (577 confirmed cases including 200 new cases today and 9 deaths).
The figures of the new confirmed cases are increasing exponentially in Iran in spite of all vast measures taken there and CFR is also increasing hugely in Iran and Italy (These are very concerning!!)
However with all these developments about COVID-19, WHO did not announce it as PANDEMIC YET!!
According to many experts, COVID-19 Pandemic is the worst since the 1918-1919 Influenza pandemic which was caused by N1H1 Influenza virus.
In Italy, People are rushing down from north Italy (epicentre of COVID-19 in Europe) to south Italy. The same phenomenon of rushing out just before the dead line was seen in Wuhan (Hubei-China).
Today Chinese authorities announced that there has been ONLY 44 new cases in Wuhan (quite remarkable after they were recording thousands new cases daily). No new cases outside Hubei .In the rest of China, only3 back flow cases who were abroad and flew back to China [ this current situation in China nothing than super and amazing!}
Why is this?
Because China closed down tenths (10s) of millions of people. This comes under the Non Pharmaceutical Interventions (N.P.Is)
No treatment yet, no vaccine yet BUT the Chinese have got down the number of daily new cases from few thousands to 44 by implementing the Non Pharmaceutical Interventions (N.P.I.s). So this can be done. China was experimenting on a large scale. It is a very solid evidence of high effectivity of N.P.I.s measures.
After disastrous start in China (suppressing doctors, suppressing information,..etc) complete disaster at the start. Now moving on into this absolutely brilliant response with the high cooperation of the Chinese people.
Such situation need the people to be very well engaged to understand why this is so important and when they did that in China , the Chinese people have brilliantly complied with these non pharmaceutical interventions (THEY ARE WORKING!) . This concrete evidence shows that this virus (SARS-CoV-2 which causes COVID-19) can be defeated, but, we have to work together and WE NEED TO MOVE FROM REACTIVITY TO PROACTIVITY.
Unfortunately in Western World, they are not sufficiently PROACTIVE YET! Therefore, the global containment (which is critically needed now) is not achieved.
Today Wednesday 11th March 2020;
In the light of 122, 331 cases and 4, 389 deaths of COVID-19 worldwide, the World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus addressed a press conference and he told the reporters in Geneva that (The new coronavirus [COVID-19] outbreak can now be characterised as a PANDEMIC).
"We're deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction." He added.
He also stated on twitter that "Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear or unjustified acceptance that the fight is over, leading to unnecessary suffering and death"
Outside China, the number of the new cases of COVID-19 has increased 13 times in the last two weeks.
In Europe, COVID-19 confirmed cases reached 22,000 (twenty two thousands) and 930 deaths.
He indicated also that 90% of total cases worldwide were recorded in four countries (China, Italy, Iran and France).
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