Clinical features of patients infected with 2019 novel coronavirus
thelancet.com
thelancet.com
The internet is our immune system.
[0] https://twitter.com/nextstrain/status/1221181133884256256?s=...
[1] https://mobile.twitter.com/nextstrain/status/122154827481917...
The idea I think was that the strain originated at the market, from people handling and possibly consuming bats. But, the description above and figure 1B indicates the currently known patient 0 was not exposed to the market.
Also, what is the chance that a random person in the area has exposure to that market in say a week's time. If it is a central place in the city, and depending on the layout and public transportation, 60% weekly exposure to it might not be unusual for an average citizen there.
It maybe be conspiracy at this point but I find it highly suspicious that out of all the markets in the country, this epidemic started just around the corner from China's first (and only?) biosafety level 4 laboratory https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article, which just happened to have been built in response to the 2003 SARS epidemic, and so presumably has been working with those kind of viruses since.
But what’s the chance that sick people would have gone to the market when they were infectious and handled animals, produce, raw meat etc.
Having watched footage of some of the wet market I have no doubt it would be place for germs to spread efficiently. But it is still useful to figure out how the whole thing originated.
Is not impossible and is a question that must be answered. Good point.
https://www.sciencemag.org/news/2020/01/wuhan-seafood-market...
> It suggests they had a “most recent common ancestor”—meaning a common source—as early as 1 October.
what the quoted link says,
> The first case symptoms was recently reported to be December 1, 2019 5, although WHO has previously reported this as December 8, 2019 1. The estimate from BEAST is in agreement with these dates, giving a median date of December 2, 2019. This date is also consistent with prior phylogenetic analyses using fixed rates of the evolutionary rate of 2019-nCoV.
> This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01).
> Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious diseases."
In other words, data from every patient they had is reported in this paper, with or without their consent. That includes radiographic imaging, blood and respiratory specimens, including nasal and pharyngeal swabs, bronchoalveolar lavage fluid, sputum, and/or bronchial aspirates.
In a western country, one of the tenants of medical ethics is that, if you have capacity to consent, you can always refuse to give it. In my country, I would be personally liable for assault if I (invasively) collected these samples from patients _without_ their explicit consent.
It must be a terrifying situation to be in: sick, in respiratory distress, and isolated from your family and friends in a large hospital, surrounded only by presumably somewhat scared looking medical professionals wearing tightly fitting face masks. I just hope that patients were _verbally_ asked if they consented to the collection of bronchoscopy-obtained samples for research and hopefully their diagnosis and management: it is an unpleasant procedure that, like many things in medicine, carries a small but non-zero risk of serious injury or death.
In most of these cases, it is highly unlikely that any significant number of the patients will withhold their consent: so to not ask it is basically saying "we can't be bothered", there's no obvious scientific basis for such a waiver. When patients are incapacitated there are equivalent frameworks which take their personal circumstances into consideration.
Time is of the essence here. If I was put in the situation these researcher are in I would act first and take the risk of being put on trial later. Real ethics means sometimes you have to do more than just follow rules.
I do believe it's troubling times for everyone near this virus and we need as much information of the virus as possible. This is going past a regular 'patient confidentiality' line and into a 'prevent a possible disaster from occurring by getting on top of it soon'.
GP only said the death rate was lower (which necessarily means the infection rate is higher, not lower, assuming all the deaths used in the reported rate are real deaths associated with the disease of concern.)
There might be cause for some concern like for any form of disease, but calling it a war is ridiculous and inappropiate to describe the situation. Even a well intentioned reading of the statement leaves much to wish for.
The common cold kills more than 50,000 people a year. 90% of media reports are intentionally worded to dramatize the situation, so I don't think anything warrants this classification with respect to the people deceased.
This reaction is precisely the reason why some might think about restricting information about infections or simliar health hazards to the public.
If we are lucky the problem is not as bad as it appears, but so far nothing I have seen suggests this is anything other than very, very serious.
Always? That's just not true.
In the US, the CDC has the power to involuntarily quarantine AND EXAMINE people.
See their page about legal authority: https://www.cdc.gov/quarantine/aboutlawsregulationsquarantin...
Also, one of the relevant laws (https://www.govinfo.gov/content/pkg/USCODE-2011-title42/html...) says this:
>>> (d) Apprehension and examination of persons reasonably believed to be infected
>>> (1) Regulations prescribed under this section may provide for the apprehension and examination of any individual reasonably believed to be infected with a communicable disease in a qualifying stage and (A) to be moving or about to move from a State to another State; or (B) to be a probable source of infection to individuals who, while infected with such disease in a qualifying stage, will be moving from a State to another State. Such regulations may provide that if upon examination any such individual is found to be infected, he may be detained for such time and in such manner as may be reasonably necessary.
Health officials at the state level also have similar powers. Here's a summary of state-level laws: https://www.ncsl.org/research/health/state-quarantine-and-is...
In many cases, the government has various powers like arresting, fining, or jailing people for violating quarantine or entering private property to investigate.
That's a big deal, and most countries have strict law in place to stop it happening in most situations. There are some exceptions for people who are unable to make that choice, but this is limited to people who are not conscious, or who have severe learning disability, or who are currently severely mentally ill.
While some might be scared that much that they approve of these measures, I am just glad not to live in China.
This kind of bait is not needed on Hacker News. Keep that on reddit or facebook or whatever.
Decay of the west bit aside, the parent has a point. Do you freak patients out by getting them to sign things when they are already in quarantine and fearing for their lives? Or do you prioritise research and response?
related: "Conducting Research in Disease Outbreaks" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/
I actually find this to be an interesting ethical dilemma. On one hand, I would probably agree that this specific situation demands a degree of urgency and action such that the rights of an individual should be subjugated, to some extent, to the needs of society as a whole.
On the other hand, if we do accept that there are scenarios where this is a necessary trade-off, who gets to decide which outbreaks qualify? Could someone just invent one to circumvent medical ethics requirements whenever they prove inconvenient?
I guess it's not entirely dissimilar to arguments over limits on freedom of expression in cases where a person's speech can be deemed to cause harm to others (e.g. the canonical yelling fire in a crowded theatre). Where and how do you draw the line?
HIV is rather fragile, no? It only spreads in specific bodily fluids and shows very little viral load when dormant.
2019-nCoV spreads in air. That's a significantly hardier virus that produces quite a lot of virus particles that are way easier to detect.
In addition, please remember that molecular biology was just getting started when the AIDS epidemic hit. AIDS (1981) predates PCR (1983). Molecular biology and computing have come a long way in 40 years, and we have a lot more tools at our disposal nowadays.
I suspect that part of this comes from the fact that people thought the disease was thought to target gay men. In fact, AIDS was originally called GRID -- Gay-Related Immune Deficiency. There was plenty of (truly awful) folks out there who felt that it was some sort of cosmic justice.
(She was in Beijing during 2003, and saw SARS first hand)
That's not accurate:
29 March 2003
Dr. Carlo Urbani, an expert on communicable diseases, died today of SARS. Dr. Urbani, worked in public health programs in Cambodia, Laos and Viet Nam. He was based in Hanoi, Viet Nam. Dr. Urbani was 46.
Like the other comments has pointed out, Dr. Carlo Urbarni is a doctor who died from SARS. He's the one who warned the WHO about the new desease.
I'm curious why you think so. This report is very detailed from a medical point of view, if you want current numbers there are other news sites for that. Besides, why do you need the current numbers, so you can panic faster?
Are we a pre or post internet civilisation?
Honestly 4chan is doing better than this. Reading through their noise is better than the clean data coming out of the officials. For example they have people in pools of blood on the street with people in the bio suits China are using.
Maybe it's obvious people will throw up blood with this new SARS, but the officials aren't mentioning it. Sperm may contain the virus for months. Again obvious, not seeing it on official feeds.
Also, how is lifetime of the virus in sperm relevant at all and do you have a source for it? I couldn't find anything online about that and can't think of how it could affect anyone.
Aren't mentioning it? How can you say that?
The linked article directly addresses this right in the Findings section, where it says, "haemoptysis (two [5%] of 39)".
Wikipedia's definition (https://en.wikipedia.org/wiki/Hemoptysis): "Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs."
So 5% of (that small sample size of) patients cough up blood.
I managed to guess the correct URL:
https://www.who.int/docs/default-source/coronaviruse/situati...
This says 2741 confirmed cases in China and 2798 globally.