Naked Science Forum

Life Sciences => Physiology & Medicine => COVID-19 => Topic started by: syhprum on 24/01/2020 14:03:17

Title: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: syhprum on 24/01/2020 14:03:17
According to the Sun it is more dangerous than the 1919 Flu but the only believable report I have seen showed 23 deaths from 800 cases.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 24/01/2020 17:42:38
We don't know yet.
However, a couple of dozen deaths, in the whole of the Chinese population over the course of a month or more must be one of the lowest death rates ever measured.

Watch this space..
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 24/01/2020 22:01:19
I have also been thinking of this and the hoo har they made of sars, spanish flu killed 10 percent of those infected, supprisingly too it killed a large proportion of those in the prime of life, unlike general flu which kills the inferm mainly. Maybe people just didnt rest. If coronavirus where reasonably lethal it would have been pretty obvious, especially with the transient nature of todays society
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 25/01/2020 00:23:57
There are a lot of unknowns at this early stage:
- Just this past week it was confirmed that human-to-human transmission is possible. That makes it a lot more dangerous
- It was reported that, so far, most of the people who have died have been people with pre-existing medical conditions.
        + That suggests that it may be less dangerous to healthy individuals.
        + It also suggests that it won't produce the overactive immune response that was seen with the Spanish flu, which killed healthy young adults.
- When a new virus is introduced to humans, it takes a while to adapt to its new host
        + "New" viruses typically come from contact with animals ("Zoonotic" diseases)
        + This one appears to have spread from the Wuhan fish markets
        + Although it may have come from snakes (apparently, snakes are on sale in the fish markets...)
        + And it has some similarities to known bat viruses (snakes eat bats...)
- Adaptation to humans often means that it becomes more easily transmissible between humans (so it spreads farther)
- Adaptation also often means that it is less immediately lethal (so it spreads farther before the host dies)

Unlike earlier virus outbreaks, this one had a published RNA sequence very early. How this will be used is not so clear:
- Researchers in other countries can use this information to check people with a fever to see if they have the new coronavirus (or a descendent of it)
- In theory, it is possible to produce bacteria expressing the coronavirus surface coat proteins, which could be used to generate antibodies for treatment of acute cases
- It is not so clear whether the RNA sequence could be used to generate live virus directly, given our current state of technology. The whole RNA sequence of this virus is about 30,000 base-pairs long. Typical commercial RNA sequencing organisations today are reliably produce sequences of 100-200 base-pairs long (although this capability is increasing exponentially).
- Live virus is the traditional input to vaccine production. But the whole process can take up to 6 months, even for a well-tested process like regular updates to the influenza virus
- But recent advances in RNA vaccines may provide a faster route to a vaccine. Injecting an RNA sequence triggers human cells to produce the virus antigen. Injecting an adjuvant with the vaccine alerts the immune system, which then ramps up production of antibodies which detect this antigen, and directs an attack on it, ready for arrival of the real virus. It is said that new vaccines could be in production in as little as 2 months, using this technique.

See: https://en.wikipedia.org/wiki/Novel_coronavirus_(2019-nCoV)
http://sitn.hms.harvard.edu/flash/2015/rna-vaccines-a-novel-technology-to-prevent-and-treat-disease/
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: chris on 25/01/2020 11:10:40
This was our report earlier in the month on the new beta-coronavirus (https://www.thenakedscientists.com/articles/interviews/new-virus-appears-china) emerging from Wuhan City in China.

We'll have a more comprehensive update from tomorrow on the Naked Scientists. I'll post the link when we publish it.

Meanwhile, I did an extended discussion on the new coronavirus, viral biology and mechanisms of emerging infections with Radio New Zealand's Kim Hill last night (Saturday morning,NZ time). It's here: https://www.rnz.co.nz/national/programmes/saturday/audio/2018731235/coronavirus-latest-virologist-chris-smith
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 25/01/2020 22:06:10
Quote from: chris, on RNZ
(paraphrased)...the cytokine storm in the 1918 flu pandemic that killed many young, healthy adults...
Presumably, if there were a modern viral outbreak that caused a similar "cytokine storm", today we would be able to damp down the overactive immune response with a dose of steroids (or other immune suppressants)?
- Would this suppress the severe immune response, long enough for a reduced immune response to start attacking the virus (instead of the host)?

Steroids are relatively cheap, fairly well available and fairly stable in pill form.
- Would it make sense to have a national emergency stock of steroids, in case another similar pandemic occurs?
- Otherwise, the police could just raid the local gym!
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 25/01/2020 22:09:33
Do we need samples of live virus to test the effectiveness of any prototype vaccines or immunoglobulin therapies?

What sort of protocols are there to transport live virus samples to suitably equipped research labs around the world? (in hermetic containers, of course!)
- Or do we just wait until infected individuals arrive on our shores, and take a nose swab?
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 26/01/2020 09:26:16
Quote from: chris, on RNZ
(paraphrased)...the cytokine storm in the 1918 flu pandemic that killed many young, healthy adults...
Presumably, if there were a modern viral outbreak that caused a similar "cytokine storm", today we would be able to damp down the overactive immune response with a dose of steroids (or other immune suppressants)?
- Would this suppress the severe immune response, long enough for a reduced immune response to start attacking the virus (instead of the host)?

Steroids are relatively cheap, fairly well available and fairly stable in pill form.
- Would it make sense to have a national emergency stock of steroids, in case another similar pandemic occurs?
- Otherwise, the police could just raid the local gym!
That does not seem wise to me, corona virus and a handicapped immune system seem to equal seriousness, just like flu.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 26/01/2020 09:36:20
That does not seem wise to me, corona virus and a handicapped immune system seem to equal seriousness, just like flu.
Unless what kills you isn't the virus, but an over-excited immune system.
And that's what a cytokine storm is.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: chris on 26/01/2020 10:08:10
Quote from: chris, on RNZ
(paraphrased)...the cytokine storm in the 1918 flu pandemic that killed many young, healthy adults...
Presumably, if there were a modern viral outbreak that caused a similar "cytokine storm", today we would be able to damp down the overactive immune response with a dose of steroids (or other immune suppressants)?
- Would this suppress the severe immune response, long enough for a reduced immune response to start attacking the virus (instead of the host)?

Steroids are relatively cheap, fairly well available and fairly stable in pill form.
- Would it make sense to have a national emergency stock of steroids, in case another similar pandemic occurs?
- Otherwise, the police could just raid the local gym!

They jury is currently out. The rationale sounds reasonable, but there are other factors, like superinfection, prolonged shedding of the virus, and intensification of the existing infection owing to immunosuppression.

In the wake of Wuhan, the Chinese are currently doing a randomised trial, testing whether steroids administered to severe pneumonia cases will help, or hinder recovery. No results have been circulated yet.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: chris on 26/01/2020 10:11:37
Do we need samples of live virus to test the effectiveness of any prototype vaccines or immunoglobulin therapies?

What sort of protocols are there to transport live virus samples to suitably equipped research labs around the world? (in hermetic containers, of course!)
- Or do we just wait until infected individuals arrive on our shores, and take a nose swab?

No, we don't need to transmit samples internationally. The nature of the nucleic acids in coronaviruses (which are positive-sense RNA viruses) means that the genetic material itself is infectious; so by sharing the sequence of the virus online, scientists internationally have been able to start working on the virus and even make their own strains by artificially synthesising the nucleic acid and then transfecting it into cells, whereupon (and I'm simplifying here) it begins the infective cycle as though the virus had infected for real.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 26/01/2020 21:18:03
Quote from: chris
artificially synthesising the nucleic acid and then transfecting it into cells,
Does this mean that researchers today are able to generate intact RNA strands of 30 kilobases?
- Compared to commercial services that sell strands of a few hundred bases?

I would expect that many strands of a few hundred bases each would not be able to produce a live virus with a full set of genes
- Even if the boundaries of each short segment were selected to contain a whole gene
- And genes are typically larger than 200 bases

I guess there are security concerns about what size RNA segments can be ordered anonymously over the internet...
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: chris on 27/01/2020 19:05:21
Quote from: chris
artificially synthesising the nucleic acid and then transfecting it into cells,
Does this mean that researchers today are able to generate intact RNA strands of 30 kilobases?
- Compared to commercial services that sell strands of a few hundred bases?

I would expect that many strands of a few hundred bases each would not be able to produce a live virus with a full set of genes
- Even if the boundaries of each short segment were selected to contain a whole gene
- And genes are typically larger than 200 bases

I guess there are security concerns about what size RNA segments can be ordered anonymously over the internet...

There are various ways of doing it; one is to produce a DNA version, which is easy, and reverse transcribe it into the RNA message.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 30/01/2020 17:35:03
At present the virus is at 7700 infected, 170 dead, mortality rate 2 percent. Again alot of these people have weakened immunity etc. How many people are estimated to have had the disease and not shown serious symptoms ?
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 30/01/2020 21:03:16
A few days ago, an Australian lab cultured the coronavirus from an infected patient.
- It will be used as input to vaccine preparation and testing

It is now being stored in a high-tech biosecurity facility for research purposes.
- Of course, infected people are still walking around shedding the virus into the environment, outside the walls of this high-tech facility...
See: https://www.abc.net.au/news/2020-01-29/wuhan-coronavirus-created-in-australian-lab-outside-of-china/11906390
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 04/02/2020 20:05:45
Apparently, labs dealing with dangerous viruses have 4 levels, from 1 to 4.
- Level 4 is used for diseases like ebola which are lethal and have no effective treatment. This involves wearing a "spacesuit"
- Level 3 is used for diseases like SARS, MERS and 2019-nCoV, and uses a controlled airflow

In a research setting, live virus is useful for:
- Creating and testing an antibody screening test
- Developing an animal model of the disease

This and more from the ABC Health podcast, with an update focusing on 2019-nCoV (30 minutes):
https://www.abc.net.au/radionational/programs/healthreport/coronavirus-how-bad-is-it-and-how-do-we-stop-it/11926064
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Border on 22/02/2020 15:41:47
It's interesting information.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 23/02/2020 01:02:52
The new estimation is not very. Corona viruses are also known as the common cold. This one is apparently a new version, mild thus not visible and therefore hard to control. Nothing to worry about. Of the foreign cases listed the mortality rate is about 0.5 percent, similar to a bad flu, but that is the cases identified. It is possible that you have had corona virus by now, 10 weeks is enough time for a world spread, which is what is beginning to show up. I have had a cold recently, lots of chinese students went back home to china until mid january, quite possible. I think there is something else going on in china. We will see soone enough when measured against other winters average death rates.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 23/02/2020 08:36:51
This corona virus may tell us something about the quality of government.
- In China, the doctor who first mentioned a mysterious outbreak was censored* by the government.
- In some other countries (eg Indonesia), the government claims that there are zero cases, while modeling of travel patterns suggest that there is almost certainly some cases there.

Unfortunately, viruses don't follow government policy...

*Edit: I meant censured, but censored works, too...
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 23/02/2020 18:49:05
Corona viruses are also known as the common cold.
Except that most common colds are not caused by coronaviruses and most coronaviruses don't cause the common cold.

This one is apparently a new version, mild thus
Most new viruses are anything but "mild".

Of the foreign cases listed the mortality rate is about 0.5 percent, similar to a bad flu,
So, what you are calling a mild cold has something like 5 times the mortality rate of flu, even with the best available medical treatment.

We will see soone enough when measured against other winters average death rates.
No; We almost certainly won't.
Either this new bug will become widespread in which case it will be incredibly obvious, or it will be controlled in which case the additional mortality from undiagnosed infections will be lost among the seasonal flu deaths.


Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: chris on 24/02/2020 22:13:44
Current estimate of the mortality rate is 0.4% vs 0.1% for the flu; current reproduction rate is 2-3 vs 1.5 for the flu. So twice as spreadable and twice as lethal.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 25/02/2020 09:27:22
Apparently the recent intensive monitoring of people in quarantine showed that some people who are asymptomatic are shedding just as many virus particles as people who have symptoms.

That increases the chance that it could spread unobserved - asymptomatic people will not be detected by temperature checks at the airport.
Read the transcript, or listen (10 minutes):
https://www.abc.net.au/radionational/programs/healthreport/coronavirus-pandemic-status-edges-closer/11994674
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 25/02/2020 13:40:32
Current estimate of the mortality rate is 0.4% vs 0.1% for the flu; current reproduction rate is 2-3 vs 1.5 for the flu. So twice as spreadable and twice as lethal.
For a doctor that is a very tardy statement.  What sort of flu, swine, spanish or 2018 variety that was quite viralent also.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 25/02/2020 19:19:39
For a doctor that is a very tardy statement. 
Seemed pretty timely to me.

What sort of flu, swine, spanish or 2018 variety that was quite viralent also.
Presumably the flu that just gets referred to as "the flu" rather than, "Spanish flu" or "Swine flu".
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 27/02/2020 19:41:58
A new victim profile aired on the TV is that this virus is almost exclusively killing older men (60+) who have compromised respiratory systems, not the young, not the middle aged, not the female. Thought is that bad lifestyles, air pollution and industrial disease are main vunerabilities.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 27/02/2020 20:08:29
Most diseases have a higher death toll in older people, but that's still going to be a problem if it takes hold.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Bored chemist on 27/02/2020 21:30:53
I gather Pence is in charge of the response to the virus.
So I guess we will find out plenty about the mortality rate etc.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: costarican on 01/03/2020 19:17:46
The latest numbers: The novel coronavirus has killed more than 2,900 people worldwide, the vast majority in mainland China.
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: costarican on 01/03/2020 19:18:39
Today the first US death was reported
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: evan_au on 10/03/2020 08:49:47
A new daily podcast about the latest on the coronavirus, from ABC radio (Australia): Coronacast, around 10 minutes per episode.
- One of the hosts qualified as a medical doctor

I see that there is another podcast that picked the same name at the same time; the ABC one has an orange background.
See: https://www.abc.net.au/radio/programs/coronacast/
or search for it on your podcast app...
Title: Re: How dangerous is the Wuhan City 2019-nCoV coronavirus?
Post by: Petrochemicals on 17/06/2020 11:03:38
Quote from: chris, on RNZ
(paraphrased)...the cytokine storm in the 1918 flu pandemic that killed many young, healthy adults...
Presumably, if there were a modern viral outbreak that caused a similar "cytokine storm", today we would be able to damp down the overactive immune response with a dose of steroids (or other immune suppressants)?
- Would this suppress the severe immune response, long enough for a reduced immune response to start attacking the virus (instead of the host)?

Steroids are relatively cheap, fairly well available and fairly stable in pill form.
- Would it make sense to have a national emergency stock of steroids, in case another similar pandemic occurs?
- Otherwise, the police could just raid the local gym!
That does not seem wise to me, corona virus and a handicapped immune system seem to equal seriousness, just like flu.
I stand corrected

https://www.independent.co.uk/news/health/dexamethasone-coronavirus-drug-trial-oxford-steroid-treatment-covid-19-a9568641.html