Stephen Flynn

A paradoxical breath of fresh air, as far as honest reporting goes. Perhaps a step in the right direction

Audio transcript will likely be available at the above address around 2:15 to 3pm today. It is not available as of 1:14. Written transcript to follow "when our contractor delivers it." Thank you for the update Dr. Niman.

Durk Pearson and Sandy Shaw's writing is fun to read and hard to sort out from an evidence based point of view (in my view) “Cytokine Suppress® with EGCG helps support the body’s inflammatory response with the clinically researched extract of mung bean and EGCG from green tea.” Inflammation is a double-edged sword. The body perceives a threat, sends an alarm and militia respond destroying the threat. Over-reaction to a perceived threat appears to have been a big factor in the Influenza epidemic of 1918. Whether this is the case with the novel coronavirus, I don’t know. In a way I doubt it. Why? Because it’s taking too long for people to die. Severe overreaction can be called a cytokine storm which I suspect you know already. In such cases vitexin and isovitexin (in Sandy and Durk’s Cytokine Suppress) might help. But if an over-reaction is not occurring it could, conceivably, work in reverse, slowing an inflammatory reaction that is killing the virus. Who knows? For that supplement you could research vitexin and isovitexin (try: shttps://www.sciencedirect.com/science/article/abs/pii/S0367326X16304488 I suspect that over 2,000 years ago, Chinese herbalists were the best physicians in the world. Not too long-ago there was a fair amount of research looking to ancient Chinese medicines. The most remarkable outcome that I know of was the use of artemisinin (derived from Artemisia annua or Sweet Wormord). Tu Youyou was awarded (co-recipient) 2015 Nobel Prize in medicine, which has been quite useful for treatment of malaria. On the other hand, this novel coronavirus may have originated in Pangolins. Pangolin scales are purported by some Chinese to have great medicinal value yet I do not think that you can find a wit of valid research that they do much of anything. Humans by and large desire a cure. I’ve noticed that such a cure should not be free, but should be reasonably priced (less than $100, but not free). Though many swear by such cures usually there is no valid data other than the anecdotal, “well, it worked for me…” So far there has been no announcement that I know of relating to a successful drug or combination of drugs for the novel coronavirus though I am quite sure that many Practitioners/researchers are trying. Try reading Inhibition of SARS CoronavirusInfection In Vitro with ClinicallyApproved Antiviral Drug (2004) to get a hint of the complexity. Sixteen years have passed and I'm surprised that no concoction has shown at least some efficacy. Never forget the placebo effect either. See: https://www.health.harvard.edu/blog/the-placebo-effect-amazing-and-real-201511028544 Bacterial infections may or may not be playing a big part but, if appropriate for you, a pneumovax may prevent a secondary bacterial infection should one become ill. Hospitals, as necessary as they are, are dangerous places. Ask your Practitioner if one would be advisable for you. I think the series are two shots, perhaps at 0 and six months but I'm not sure.

Jon, your assumptions seem reasonable but keep in mind that the immune system can be a double-edged sword. The Influenza epidemic of 1918 actually caused greater deaths in the population with strong/intact immune systems. In that epidemic the very young and the very old were spared, while the population whose ages, with what one might say would have an “excellent” immune system, died. I tend to look at that epidemic (unrelated to the current coronavirus epidemic) as a virus that caused death by immune-system over-reaction. To create an analogy, it was like someone saw a bunch of mice in a kitchen, not knowing that mice are not particularly dangerous, freaked out, and started lobbing grenades. Indeed, the mice were destroyed but the collateral damage destroys the kitchen. In 1918 the group with less competent immune systems survived much better. So, looking at the immune system’s strength is not always so clear-cut. A great example to think about is the proverbial child with a peanut allergy who gets exposed to a few milligrams of peanut protein—and promptly dies. It was not the peanut that did the damage, it was his over-reactive immune system. Stress is clearly a general factor in illness susceptibility and survival, though hard to quantify. An ill person may or may not shed more virus, considering the above historical incident. Every virus is different and most virus mutate and not always in a direction towards lethality, but also in a direction away from lethality. Let’s hope this one eventually moves away from lethality.

"A worker in protective clothing cleans the floor of a pharmacy attached to the County Oak Medical Center in Brighton, England, after it closed following reports that a staff member was infected with the coronavirus" What a joke. Do people really think that swabbing the floor with bleach is enough? If an infected person touched, sneezed, laughed or even talked in that pharmacy then every single box and item on every shelf, every chair, every surface, is suspect to be a fomite (an object capable of causing infection). The pharmacy, the entire clinic should have been denuded of all items/materials that could not be positively disinfected. Although the infectivity does not appear to approach that of norovirus and some other pathogens.

Ouch. Talk about a super-spread event. Over 300 infected at one place (Amoy Gardens, SAR, 2003) Amoy Gardens is a private housing estate in the Jordan Valley area of Kowloon, Hong Kong completed from 1981 to 1987. It was the most seriously affected location during the 2003 SARS outbreak, with over 300 people infected there.Wikipedia Interestingly, I had an experience that comes to mind reading about this in an apartment house I owned. I had put two state-of-the-art Toto toilets in two units where the waste pipe was back-to-back. Toto uses very little water but is extremely efficient and reliable. Toto did this by increasing the opening of the tank entering the bowl. This "drops" the water fast at perhaps double the speed of a regular toilet, using less water and I've never had one clog--ever. But in this case, the "slug" of fast moving water in one apartment, moving down the waste pipe so quickly, overwhelmed the vent pipe creating a pulse of suction. (Caused by the back-to-back configuration) This caused the opposite toilet to "suck" back water, leaving a small opening where sewer gas could enter. I never thought of a viral risk but wanted no part of such a set-up and so replaced the new Toto toilets with an older version that dumped water slower, problem fixed though with more water usage. Birds nesting in vent pipes, bird carcass(es) that fell into vent pipes, or points where the vent pipe leaks all could contribute to a possible negative pressure situation where small amounts of waste gas (actually called sewer gas) might enter living areas. Such gas can carry minute viral infected droplets and even dried minute particulate materials that can carry virus. Several causes contributed to the Amoy Gardens cluster including dried up u traps, negative pressure caused by bathroom fans and a large crack in a waste-vent pipe. A great case study on Amoy Gardens cluster (SARS 2003) is at http://www.openscar.com/amoygardens.html PSK, Amoy Gardens is a case where, at least initially, virus was spread airborne, infecting a cluster, who then purportedly infected others. Virus can be spread by minute droplets and then from hand to doorknob or elevator button, to another. Yes the novel coronavirus can spread by cough/sneeze, laughter, (all airborne) as well as airborne from an improper sewer vent pipe leaving into a bathroom. I read someplace that feces tested positive with a high viral load from one victim. An excerpt from the above reference: Possible explanations for the outbreak Recent laboratory studies have shown that many SARS patients excrete coronavirus in their stools, where it could survive for longer periods than on ordinary surfaces. As many as 2/3 of the patients in this Amoy Garden SARS outbreak were also having diarrhea, contributing to a significant virus load being discharged in the sewerage in block E. It is probable that the index patient initially infected a relatively small group of residents within block E and subsequently to the rest of the residents in that block through the sewage system, person-to-person contact and the use of shared communal facilities such as lifts and staircases. These residents subsequently transmitted the disease to others both within and outside block E through person-to-person contact and environmental contamination. The bathroom floor drains with dried-up U-traps provided a pathway through which residents came into contact with small droplets containing viruses from the contaminated sewage. These droplets entered the bathroom floor drain through negative pressure generated by exhaust fans when the bathroom was being used with the door closed. Water vapour generated during a shower and the moist conditions of the bathroom could also have facilitated the formation of water droplets. The chance of exposure was increased given that the bathrooms in apartment units of Amoy Gardens were generally small in size (about 3.5 square metres). Contaminated droplets could then have deposited virus on various surfaces, such as floor mats, towels, toiletries and other bathroom equipment. Transmission of the disease by airborne, waterborne route and infected dust aerosols has been examined but these were not supported by the epidemiological picture and laboratory results.

My reference to the Metropole was the situation on the Diamond Princess.

Dr. Niman, the way the situation aboard the Diamond Princess is being handled seems absurd. “…the government was considering testing everyone on board before allowing them to disembark.” Had this been done at the onset it seems that mapping could have been done (and still possibly could) quantifying each individuals’ risk based upon location to a known infected individual. Then, by choosing passengers at the lowest risk of infection (meaning those far from a known infected individual, as well as considering location (stairways, elevators, etc.) groups of (?) could be moved off-ship, decontaminated, given new, temporary clothing, and taken to a place of temporary isolation, to await the requisite number of days whereby a newly infected individual would, with almost 100% specificity/sensitivity (which might require two tests, I’m guessing four days) could be proven negative. Then, if all those in that group prove negative, that entire group would be allowed to leave, allowing a newly selected group to inhabit that isolation site. Self-criticizing the above is the fact that cruise ships usually have three banks of elevators/stairs. Looking at the floor plan of Hotel Metropole (SARS 2003 super-spreader incident) (see link at bottom) I would say that elevators/stairs were a critical link. Therefore, on the Diamond Princess, this would likely be the case too. Additionally, even if personnel bring food to rooms in full protective gear, they become moving fomites dragging virus around the ship, particularly to elevators. It seems that the entire ship should now be considered a fomite. Am I insane thinking that, as each day passes, newly identified infections will be proven, thereby resetting any (~14-day) quarantine, over and over? Considering this as a possibility, it seems that this will drag out for months. Dr. Niman, would you care to comment, from a virologist’s point of view, am I correct in thinking the quarantine aboard the ship will not end very soon at all? See Diamond Princess Deck 8 deck plan: https://www.cruisecritic.com/diamond-princess-deck-plans/dp/?shipID=296&deck=8 See Ninth floor plan of Hotel Metropole showing incident infection room, and other rooms where occupants became positive during the 20003 SARS epidemic: https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome#/media/File:Hotel_Metropole_9th_floor_layout_SARS_2003.jpg

By Le Nga February 9, 2020 | 12:49 pm GMT+7 See: https://e.vnexpress.net/news/news/vietnam-confirms-14th-ncov-infection-case-in-vinh-phuc-4052458.html A 55-year-old woman in Vinh Phuc Province is Vietnam's latest confirmed case of novel coronavirus infection, the Ministry of Health said Sunday. This is the 9th confirmed case in the northern province alone. The woman is a neighbor of one of the eight workers of Japanese-invested Nihon Plast Company Limited sent to train for two months in China’s Wuhan City, Hubei Province, the epicenter of the epidemic. This 23-year-old infected worker had also infected three of her family members: her mother, sister and cousin. Upon returning to Vietnam last month, six of the workers have been confirmed to be infected with the nCoV. The 55-year-old woman went to the worker's house on January 28 for about one hour for Lunar New Year (Tet) celebration. She exhibited symptoms like fever, headache and runny nose on February 2.

The Diamond Princes may offer a preview of cases that occur within enclosed spaces. This brings to mind the super-spreading event which happened at the Metropole Hotel in Hong Kong during the 2003 SARS epidemic. From Wikipedia, relating to the 2003 SARS epidemic “The disease spread in Hong Kong from Liu Jianlun, a Guangdong doctor who was treating patients at Sun Yat-Sen Memorial Hospital.[34] He arrived in February and stayed on the ninth floor of the Metropole Hotel in Kowloon, infecting 16 of the hotel visitors. Those visitors traveled to Canada, Singapore, Taiwan, and Vietnam, spreading SARS to those locations.” I found the image of where the primary case was located on the 9th floor related to those who become infected in nearby room and those who did not interesting. I suspect a cruise ship layout may be similar. In case the image does not work see: https://upload.wikimedia.org/wikipedia/commons/d/d0/Hotel_Metropole_9th_floor_layout_SARS_2003.jpg Image Credit: By Christopher R. Braden, Scott F. Dowell, Daniel B. Jernigan, and James M. Hughes - Emerging Infectious Diseases Journal, Volume 19, Number 6—June 2013 , http://wwwnc.cdc.gov/eid/article/19/6/13-0192-f1.htm, Public Domain, https://commons.wikimedia.org/w/index.php?curid=26334381

You ask, "Why are people believing this image?" I suppose it might be because some don't believe the honesty of the regime's numbers. Personally I am not inclined to believe the official numbers. I'm also not inclined to trust these numbers either, but I found the article interesting and wanted to share it. That it is here on recombinomics does not imply that anyone here believes it. As you say, it's possible to fake any image. What I found intriguing was that supposedly this occurred several times, and each time the odd numbers bore a reasonable relationship to what seemed a likely reasonably expected number of cases. Admittedly, it's an odd article. Let's hope that the numbers officially being released are accurate numbers.

Summary: Tencent has listed infection numbers vastly different than official numbers on repeated occasions. "...each time the screen with the large numbers appears, it shows a comparison with the previous day's data which demonstrates a "reasonable" incremental increase, much like comparisons of official numbers. This has led some netizens to speculate that Tencent has two sets of data, the real data and "processed" data" Article: Tencent may have accidentally leaked real data on Wuhan virus deaths; Tencent briefly lists 154,023 infections and 24,589 deaths from Wuhan coronavirus See https://www.taiwannews.com.tw/en/news/3871594 TAIPEI (Taiwan News) — As many experts question the veracity of China's statistics for the Wuhan coronavirus outbreak, Tencent over the weekend seems to have inadvertently released what is potentially the actual number of infections and deaths, which were astronomically higher than official figures. On late Saturday evening (Feb. 1), Tencent, on its webpage titled "Epidemic Situation Tracker", showed confirmed cases of novel coronavirus (2019nCoV) in China as standing at 154,023, 10 times the official figure at the time. It listed the number of suspected cases as 79,808, four times the official figure. The number of cured cases was only 269, well below the official number that day of 300. Most ominously, the death toll listed was 24,589, vastly higher than the 300 officially listed that day. Moments later, Tencent updated the numbers to reflect the government's "official" numbers that day. Netizens noticed that Tencent has on at least three occasions posted extremely high numbers, only to quickly lower them to government-approved statistics. Netizens also noticed that each time the screen with the large numbers appears, it shows a comparison with the previous day's data which demonstrates a "reasonable" incremental increase, much like comparisons of official numbers. This has led some netizens to speculate that Tencent has two sets of data, the real data and "processed" data. Some are speculating that a coding problem could be causing the real "internal" data to accidentally appear. Others believe that someone behind the scenes is trying to leak the real numbers. See article for screengrab images purportedly showing markedly differing tallies. Back on January 24, Dr. Jonathan Read (UK) predicted: “By February 4, he writes that "our model predicts the number of infected people in Wuhan to be greater than 250,000 (prediction interval, 164,602 to 351,396)." See https://www.forexlive.com/news/!/uk-virus-researchers-estimate-250000-people-in-wuhan-will-get-corona-virus-in-13-days-20200124 For a more thorough read on Jonathan Read’s prediction for February 4th see https://www.zerohedge.com/geopolitical/uk-researcher-predicts-over-250000-people-china-will-have-coronavirus-ten-days

John Hopkins GIS Dashboard appears broken now for two days. It was a great source while it lasted. Does anyone know why it’s no longer working or are there alternatives with regular updates? https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 GIS Dashboard In response to this ongoing public health emergency, we developed an online dashboard (static snapshot shown below) to visualize and track the reported cases on a daily timescale; the complete set of data is downloadable as a google sheet. The case data visualized is collected from various sources, including WHO, U.S. CDC, ECDC China CDC (CCDC), NHC and DXY. DXY is a Chinese website that aggregates NHC and local CCDC situation reports in near real-time, providing more current regional case estimates than the national level reporting organizations are capable of, and is thus used for all the mainland China cases reported in our dashboard (confirmed, suspected, recovered, deaths). U.S. cases (confirmed, suspected, recovered, deaths) are taken from the U.S. CDC, and all other country (suspected and confirmed) case data is taken from the corresponding regional health departments. The dashboard is intended to provide the public with an understanding of the outbreak situation as it unfolds, with transparent data sources.

Hospital Authority says services ‘seriously affected’ as about 2,700 staff skip work in bid to force government into total border shutdown City’s first human-to-human transmission of deadly virus confirmed as 15th patient infected through close contact with her son https://www.scmp.com/news/hong-kong/health-environment/article/3048738/coronavirus-hong-kong-leader-carrie-lam-declares “Hong Kong’s embattled leader has buckled under intense public and political pressure to announce a further closure of the city’s borders with mainland China to keep out the coronavirus that originated in Wuhan, but still stopping short of the total shutdown demanded by public hospital workers who vowed to escalate a strike they began on Monday. Chief Executive Carrie Lam Cheng Yuet-ngor on Monday said all border crossings would be closed, except for the Hong Kong-Zhuhai-Macau Bridge, Shenzhen Bay Port and the international airport, even as the city confirmed its first case of human-to-human coronavirus infection. The Centre for Health Protection said the city’s 15th case, confirmed on Sunday night to be the mother of a 39-year-old coronavirus patient from Whampoa Garden in Hung Hom, had been infected through close contact with her son.” After the first six checkpoints were closed, the number of Hong Kong, mainland and other travellers entering the city had dropped by 57 per cent, 62 per cent and 49 per cent respectively, she said. But as more than 100,000 people had still crossed the border on Sunday, the additional closures were necessary.

https://www.scmp.com/news/china/society/article/3048619/coronavirus-patients-wuhan-ordered-go-quarantine-zones Anyone who refuses to relocate will be forcibly moved by the police, city government says as number of new cases continues to rise sharply. Anyone in Wuhan who is suspected of being infected with the new coronavirus or has been in close contact with a confirmed case must relocate to a dedicated quarantine center, local authorities said on Sunday, as the contagion shows no sign of slowing down in the city where it was first detected. People who had been professionally diagnosed as having a fever and pneumonia symptoms would be transported by specialist vehicle to one of the isolation sites, the city’s emergency headquarters said in a statement. “Patients shall cooperate,” it said. “Whoever refuses to cooperate will be subject to enforcement by the police.”

Coronavirus latest updates: First case reported in Africa (Ivory Coast) Note: "...to be tested." "There are, at this stage, suspicions of a case of pneumonia tied to the coronavirus,” https://www.thesouthafrican.com/news/what-is-coronavirus-latest-updates-first-case-reported-in-africa/ “As reported by CNN, a 34-year-old female student became the first person to be tested for the virus in Africa. The traveller, whose identity has been withheld for safety reasons, disembarked a flight from Beijing, at the Félix-Houphouët-Boigny International Airport, in Abidjan, Ivory Coast, on Saturday.” Possible case in Kenya “A Kenya Airways passenger who arrived in Nairobi on Tuesday (Jan.28) afternoon on a flight from Guangzhou displaying flu-like symptoms is the first suspected case of the Wuhan originating coronavirus in East Africa. The patient is currently being quarantined at Kenyatta National Hospital in Nairobi.” See https://qz.com/africa/1792684/ethiopia-nigeria-kenya-s-africa-ready-for-chinas-coronavirus/

Status on two possible cases in New Hampshire: LITTLETON, N.H. (WCAX) New Hampshire health officials say two people are in isolation at hospitals in Littleton and Concord waiting to see if they have the coronavirus. The New Hampshire Department of Health and Human Services says both people recently traveled to Wuhan, China, and developed respiratory symptoms. Officials at Littleton Regional Healthcare say they're taking care of a New Hampshire student who showed up at the emergency department a few days ago with mild flu-like symptoms. That student was put in intensive care to prevent cross-contamination. Test results on the cases are expected either Tuesday or Wednesday. (Feb 4-5) https://www.wcax.com/content/news/Two-possible-cases-of-Coronavirus-in-New-Hampshire-567350561.html

Wuhan Coronavirus (2019-nCoV) Global Cases (by Johns Hopkins CSSE). The Center for Systems Science and Engineering (CSSE) has been synthesizing data from multiple sources that have been studying the coronavirus outbreak, including the World Health Organization (WHO) and the centers for disease control and prevention in the U.S., China and Europe. The result is an online coronavirus dashboard and coronavirus map that displays the total confirmed coronavirus cases, the confirmed cases by region and the total number of deaths, which is sadly 81 as of Jan. 27. Link to online dashboard: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 Credit to Mark Spoonauer of Tom's Guide Since this covers the globe, Moderator, feel free to move this to where you want it.

State health officials announced Monday they are monitoring two people in New Hampshire with recent travel to Wuhan City, China, who have developed respiratory symptoms and are currently undergoing testing for novel coronavirus. CONCORD -- State health officials announced Monday they are monitoring two people in New Hampshire with recent travel to Wuhan City, China, who have developed respiratory symptoms and are currently undergoing testing for novel coronavirus. The two people being monitored in New Hampshire have more mild illness, according to health officials, but both sought healthcare for their illnesses and are recovering. They remain isolated until test results are available. Samples have been sent to the CDC for testing. https://www.wickedlocal.com/zz/news/20200127/two-patients-in-new-hampshire-being-tested-for-coronavirus No information is given as to where the two lived/worked, nor is information given as to where the two are being treated. Concord, the state Capitol is where NH Public Health officials are housed, this does not imply that the two came from Concord.