khs

Here we reported a case of asymptomatic carrier of SARS-CoV-2 infection. A 50-year old woman, lived with her husband in Anqing (Anhui, China) with no significant past medical history, travel history to Wuhan or adjacent area, or exposure to wild animals. She took throat swab test for SARS-CoV-2 nucleic acid due to her husband’s close contact with patients who had SARS-CoV-2 infection. Her results were confirmed positive on February 6, 2020. But she did not report elevation of temperature measurement, nor respiratory or gastrointestinal symptoms and her chest CT scan showed no significant abnormalities. She was hospitalized on February 6 and treated with antiviral agents. During her hospitalization, apart from a mild elevation of liver enzymes after 10-day treatment of lopinavir/ritonavir, she was asymptomatic, with her blood cell count, live and renal function largely normal. Her subcutaneous oxygen saturation stayed above 97%. Chest CT scan was repeated on February 11 and 20, and both were negative for signs of viral pneumonia. Notably, a second set of throat swabs and anal swabs were sent to test for SARS-CoV-2 on February 19, and the results were still confirmed positive. This is a confirmed case of asymptomatic carrier of SARS-CoV-2 infection. Her persistent positive findings in both throat and anal swabs suggested the possibility of healthy carrier of the virus, which adds to the difficulty in preventing transmission of the disease. http://www.chinaxiv.org/abs/202002.00078 Full download: www.chinaxiv.org/user/download.htm?id=30309

Hi Dr @niman I have a few questions I would like to ask you regarding the various techniques nations are using to battle this virus. Having witnessed this virus take hold of the planet and the various solutions the nations have come up with, I legitimately don't know which country is doing it best. Here in the UK, the government are slowing down the spread of coronavirus (flattening the curve), rather than trying to stop it outright. They seem to think that the public will build up 'herd immunity' which will act as a buffer to help prevent further infections throughout the country. I have read a few pieces outlining why this is a bad idea [1] [2]. Completely isolating people seems to only work for the length of the isolation and as soon as people are released, reinfections occur and the country is back to square one. Especially in this globalized world where country borders are basically porous. Singapore appears to have effectively 'flattened the curve', but for how long do they need to keep operating on this level? Their numbers are still going up. Some questions: How can we create a vaccine or expect herd immunity when ADE [2] is an issue? How can a nation expect to defeat the virus by putting their entire economy and people into lock down when as soon as they're released there will be outbreaks again? (as is reported in China) Thanks Karl 1) “Flattening the Curve” is a deadly delusion https://medium.com/@joschabach/flattening-the-curve-is-a-deadly-delusion-eea324fe9727 2) Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry https://jvi.asm.org/content/94/5/e02015-19 3) Chinese studies link quarantines with coronavirus mutations that may make it more ‘insidious’ https://www.scmp.com/news/china/society/article/3074938/chinese-studies-link-quarantines-coronavirus-mutations-may-make

Text doesn't copy well....Not peer reviewed: https://www.medrxiv.org/content/10.1101/2020.02.22.20026500v1.full.pdf

Great - understood. I will refrain from posting anything that claims such a relationship. Thanks again.

Sorry, it was an accident, I had no idea it was a conspiracy theory. I will make sure I don't update the title again...

So this could of happened via recombination with another virus that had that cleavage site?

Sorry, I thought I made a mistake when I updated it so I changed it back. 🙂 Thanks for the clarification.

Sorry, I was in a rush when I posted this and did not post the actual study. The website does not seem to load in Chrome/Brave, but does in Firefox, so I downloaded the PDF and uploaded it here. ACE2 shedding and furin abundance in target organs may influence the efficiency of SARS-CoV-2 entry http://www.chinaxiv.org/abs/202002.00082 202002.00082v1.pdf

The new coronavirus has a HIV-like mutation that means its ability to bind with human cells could be up to 1,000 times as strong as the Sars virus, according to new research by scientists in China and Europe. https://www.scmp.com/news/china/society/article/3052495/coronavirus-far-more-likely-sars-bond-human-cells-scientists-say

A number of interesting observations regarding SARS-CoV-2 were made in this paper which have implications regarding treatment. "Unlike SARS-CoV infection,8 we found that viral load was highest during the early phase of the illness (3–5 days from first symptom onset, fever and myalgia were the only symptoms in Patient 1) and continued to decrease until the end of the second week. While she developed cough as well as shortness of breath and infiltration appeared on CXR at the end of first week of illness, the viral load already started to decrease at this phase. This may have a very important implication to determine the optimal time point for antiviral treatment intervention to prevent progression to severe disease. Second, the virus was detected from LRT specimens even before the development of LRT symptoms (cough, shortness of breath, and oxygen requirement) or visible infiltration on CXR. This may suggest that although the patient does not complain of any LRT symptoms, the virus is already there and causing insidious pathology, ultimately leading to LRT symptoms and chest infiltration later. However, the viral load starts to decrease in both URT and LRT specimens at the same time, which may puzzle the clinicians. Third, unlike in MERS-CoV revealing higher concentration of virus in LRT specimens, viral loads were similar in both URT and LRT specimens. Fourth, low concentration of genetic materials, especially E gene, was detected in urine and stool from the end of the first week until the patient recovered from the infection. However, rRT-PCR results did not meet the criteria for SARS-CoV-2 positivity. Further studies need to be performed in non-respiratory specimens such as urine and stool samples." https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e86

Apparently, ~40 or so of the 104 infections were due to a superspreader: https://www.livescience.com/coronavirus-superspreader-south-korea-church.html One women who went to church managed to infect almost 40 people that are known about.

Antibody-dependent enhancement (ADE) occurs when antibodies facilitate viral entry into host cells and enhance viral infection in these cells (1, 2). ADE has been observed for a variety of viruses, most notably in flaviviruses (e.g., dengue virus) (3-6). Peer reviewed paper: https://www.docdroid.net/uVOql5p/jvi02015-19full.pdf So it is potentially far worse the second time you get it, which makes it an extremely worrying virus considering it's potential r0 value.

"BINH XUYEN, Vietnam: Villages in Vietnam with 10,000 people close to the nation's capital were placed under quarantine on Thursday after six cases of the deadly new coronavirus were discovered there, authorities said." https://www.bangkokpost.com/world/1856784/vietnam-quarantines-area-with-10-000-residents-over-coronavirus

"The sudden cases emerging all around the country have left the authorities scratching their heads as to who is Patient Zero in each of these clusters, as they rush to contain the spread of the virus. While the Health Ministry has said there was still no evidence of any community spread, domestic media have cited experts who say that a "stealth outbreak" could already have happened." https://www.straitstimes.com/asia/east-asia/fears-of-stealth-outbreak-as-cases-emerge-across-japan

Abstract The novel coronavirus (2019-nCoV) is a recently emerged human pathogen that has spread widely since January 2020. Initially, the basic reproductive number, R0, was estimated to be 2.2 to 2.7. Here we provide a new estimate of this quantity. We collected extensive individual case reports and estimated key epidemiology parameters, including the incubation period. Integrating these estimates and high-resolution real-time human travel and infection data with mathematical models, we estimated that the number of infected individuals during early epidemic double every 2.4 days, and the R0 value is likely to be between 4.7 and 6.6. We further show that quarantine and contact tracing of symptomatic individuals alone may not be effective and early, strong control measures are needed to stop transmission of the virus. https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1 Funding Statement SS and RK would like to acknowledge funding from DARPA (HR0011938513). CX acknowledges the support from the Laboratory Directed Research and Development (LDRD) Program at Los Alamos National Laboratory. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.