Category Archives: public health

Influenza a greater threat than Coronavirus

“The public health system has a playbook to follow for pandemic preparation — regardless of who’s president or whether specific instructions are coming from the White House. Those plans were put into place in anticipation of another flu pandemic, but are designed to work for any respiratory-borne disease.” click here

“There have been 2,462 [Coronavirus] associated deaths worldwide; no deaths have been reported in the United States. Fourteen cases have been diagnosed in the United States, and an additional 39 cases have occurred among repatriated persons from high-risk settings, for a current total of 53 cases within the United States.” click here

“Influenza has already taken the lives of 10,000 Americans this season, according to the U.S. Centers for Disease Control and Prevention. At least 19 million have caught the flu, and an estimated 180,000 became so ill they landed in the hospital.” click here

Wuhan, China Coronavirus cases under-reported

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Daily confirmed coronavirus cases in Singapore, Hong Kong, Taiwan, South Korea, Japan Thailand, and USA

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click here for the source of the above figure.

 

 

2019-nCoV originated from a laboratory?

Botao Xiao and Lei Xiao The possible origins of 2019-nCoV coronavirus. DOI: 10.13140/RG.2.2.21799.29601

The 2019-nCoV has caused an epidemic of 28,060 laboratory-confirmed infections in human including 564 deaths in China by February 6, 2020. Two descriptions of the virus published on Nature this week indicated that the genome sequences from patients were almost identical to the Bat CoV ZC45 coronavirus. It was critical to study where the pathogen came from and how it passed onto human. An article published on The Lancet reported that 27 of 41 infected patients were found to have contact with the Huanan Seafood Market in Wuhan. We noted two laboratories conducting research on bat coronavirus in Wuhan, one of which was only 280 meters from the seafood market. We briefly examined the histories of the laboratories and proposed that the coronavirus probably originated from a laboratory. Our proposal provided an alternative origin of the coronavirus in addition to natural recombination and intermediate host.

Novel Coronavirus incubation period is 14 days; Breathing trouble 5 days later

“The illness appears to be less severe outside China, but a new study reports that this virus often looks benign to start with. It begins with a mix of mild symptoms that can look like the common cold, or resemble gastro. But some patients go on to develop breathing trouble five days later, and may need the ICU (Intensive Care Unit) by day 8. Sometimes people get released from medical care, but then have to return the next week. So not only must we wait 14 days for the incubation period, there may be another 8 days (or more) before we know how many will need emergency life support and we can begin to calculate the fatality rate.” click here

Clinical characteristics of people infected by the 2019 novel coronavirus, Wuhan, China

Dawei Wang, MD; Bo Hu, MD; Chang Hu, MD; et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585

Key Points

Question  What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China?

Findings  In this single-center case series involving 138 patients with NCIP, 26% of patients required admission to the intensive care unit and 4.3% died. Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients.

Meaning  In this case series in Wuhan, China, NCIP was frequently associated with presumed hospital-related transmission, 26% of patients required intensive care unit treatment, and mortality was 4.3%.

Abstract

Importance  In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective  To describe the epidemiological and clinical characteristics of NCIP.

Design, Setting, and Participants  Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Exposures  Documented NCIP.

Main Outcomes and Measures  Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.

Results  Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).

Conclusions and Relevance  In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.

Corona virus is very infectious, not something to ignore

“A horrific though unverified video has leaked out of China, allegedly from a hospital in Wuhan, showing dead bodies laying in a corridor unattended, with sick people sitting next to them waiting for treatment.”  click here