Infections in Kids & Pregnancy, South Korea, Spillover from Bats (Lecture 23)
Welcome to another MedCram SARS-COV-2, covid-19, update. We had a good conference, but it’s good to be back. What we’re going to talk about in this update are the new cases in South Korea. The new criteria once again for the diagnosis. A lot of you have been asking questions about infants and mother-infant transmission, and we’ll talk about that. We’ve got some data there that we’ll talk about, and also getting back to the source of where this virus actually came from. We’ll talk about some data there as well.
Once again, really appreciate all of the comments, all of the questions, and they are very good questions you all have. I’m keeping track of those as we go. So here is again the map, total deaths well over 2000; total recovered is around 18,000, and we can see the graphs here. We go to the WorldOmeter, they have similar numbers. We’ve already talked about how these numbers are underestimating. This we don’t know how much it’s underestimating. But we may have a better understanding once we start doing serologies because that will test for antibodies to the virus, and that will tell us a much better distribution of the population has seen this virus. We will talk more about that as we go.
Active cases and closed cases. Closed cases, 20,000. Looks like 89 percent of those have recovered. In the active cases, they are saying that 43,888 are mild condition. We just don’t know where we’re going with those at this point.
If we click on the graph for those active cases, you can see that they’re actually decreasing according to the statistics coming out of China. We’ve got here daily new cases. And remember we had this big jump on February 12th. We’ve talked more about that. Since that time, it’s been decreasing. Total cases outside of China are still continuing to increase, and that is, of course, a concern. If you exclude mainland China, and the daily cases were still seeing some of the highest new case reports here most recently.
And that brings us to this BBC News article talking about the South Korean sect that was identified recently as a hotbed. About 30 of the 53 cases identified today in South Korea came from the city of Daegu and was tied to one 61-year-old woman who tested positive for the virus earlier in the week. She belonged to this religious organization and is probably responsible for at least 30 of those cases. So, they are undergoing quarantine. We will put a link in the description below to this article.
Also, in the news we will talk about the Diamond Princess ship. Two people from Japan who were infected on that ship have died. They were both in their 80s.
Let’s move to this confusion mounts over China’s counting methods as coronavirus numbers swing wildly. And this is interesting because as it mentions here in the article, we have Hubei Province reporting 349 cases. That’s in the entire Province, and yet at the same time in the capital of that Province, Wuhan, there are 605 new cases all by itself. So what is it that is going on here?
It seems as though the provincial government is not confirming cases unless they actually have genetic testing. Whereas what’s going on in the city of Wuhan is they’re still going by the newly updated criteria, which is allowing physicians to diagnose. Even though they don’t have genetic testing, they still have these scans which show pneumonia in these patients with clinical signs that make it suspicious. If you read the article, it does go into the fact that there was a sudden spike, and the case numbers on February 12, which we discussed in a previous video was most likely due to the relaxing of the very stringent diagnostic criteria.
It’s not a coincidence that the new officials from the XX took over on the 12th, or around that time, and there’s been this thought that perhaps they wanted to clear the slate. Get as many diagnoses on the books as possible. And there’s this quote from the article, which basically states that the party boss of Wuhan was saying if there’s one more case where to be found in a household, that district party secretary would be held accountable. And that’s to show that there is probably a real push to try to get the numbers down. Now that the new policymakers in Wuhan have taken over. Anyway, we will put a link to this article also in the description below, so you can read it for yourself.
Okay, let’s move to an article that was published back on the 14th of February in JAMA, which is the Journal of the American Medical Association title. Novel coronavirus infection in hospitalized infants under one-year of age in China. So here the N number was only 9 patients, but it’s because they’re not really seeing a lot of covid-19 infections in these patients. Out of 75,000, they’ve only got about a hundred or so on the books in the pediatric population. So that could be because maybe the pediatric population isn’t as susceptible.
And when they looked at these nine, first of all, they found that only four of them had fever, only two of them had upper respiratory infection symptoms. One of them was completely asymptomatic, and they were tested because the family had tested positive. They wanted to make sure. In terms of the number of infants with severe complications, or on the ventilator in the ICU, the number was 0. Again I will leave a link to this article in the description as well, so you can read it for yourself.
So with all of these infections going on, the CDC has put out some answers to questions about pregnant women. One of the questions was “are infants born to mothers at increased risk?” And so that’s an interesting question. It looks as though based on limited case report, adverse infant outcomes, or preterm birth, have been reported among infants born to mothers positive for covid-19 during pregnancy. However, it is not clear that these outcomes were related to maternal infection. And at this time, the risk of adverse infant outcomes is not known.
Here’s another question: can pregnant women with covid-19 pass the virus to their fetus or newborn? And it seems as though in limited recent case series, none of the infants have tested positive for the virus that caused covid-19. And additionally, when they looked at the amniotic fluid, they were not able to find virus in there either. Of course, when the birthing process occurs, there can be a mixing of bodily fluids, and that could be the source of infection in an infant’s after the birthing process. With zika virus, that can cross the placenta. It appears as though coronavirus does not at this point.
Well, that brings us to one of the last stories that we want to talk about. This was a really kind of concerning article that I saw here on NPR: New Research: Bats Harbor Hundreds of Coronaviruses, And Spillovers Aren’t Rare. We will put a link to this in the description below.
So what is this? Here, you can see these researchers actually taking samples of saliva from bats and actually taking a rectal sample. And when were they doing this? Not recently, but three years ago when they were doing studies because of the SARS outbreak from 2002, which was linked to bats. So the story talks about an organization called Eco Health Alliance, that was going out in Borneo, but they also did research in China at the time, and they collected specimens from bats, and what they found was actually quite disturbing.
They found that there were over 400 different species of coronaviruses in these bats. Now, remember these bats live in caves; they live together and they commune together, and so there’s a lot of crossovers that can occur.
Previous thinking on this was that these coronaviruses could not really jump into humans because they had to go into something that was closer to humans or that had to get a mutation, so it could bind to human receptors, for instance, the ACE2 receptor that we see in SARS, and actually the virus that causes covid-19.
They thought that spillovers were rare. What they found was concerning because they looked at these viruses, and they found that these things could infect human cells. In fact, they took some of these coronaviruses that they found in these bats; they put them on a petri dish that were lined with human cells, and the coronavirus is, at least some of them, could infect these human cells without a problem.
So then they decided to go visit some humans that were living around these caves where the bats were to see if in fact these coronavirus has already jumped into humans, and when they went into the caves to do the research, they found water bottles around the caves because in the summertime, it’s kind of cool, and humans tend to go in there. And also the people that were living in the area said oh, yeah bats fly into the house, and sometimes we kill them. So there is this crossover.
Well, when they did test the humans for signs, symptoms, genetic traces of these coronaviruses, they found them, and so they concluded that spillover does occur. Of course, this is kind of in a rural area. And so this may not explode into an epidemic because it’s not in a city centre, and the symptoms may be very mild.
Okay, now fast-forward here. Three or four years later, of course, when this new coronavirus breaks out, what they did was they took the RNA from this coronavirus, and they compared it to the 400 different strains of the coronavirus that they identified earlier in China and says here they found an extremely close match. They said in fact that a viral taxonomist would probably call it the same virus species.
They say that suggests that this current outbreak, which has infected tens of thousands of people, could have come, here’s the word “could,” have come directly from bats. There is a larger takeaway. He says that these bat SARS-related coronaviruses are actively spilling over into the human population. Not all of them will spark a deadly pandemic, but the more frequently spillovers, the greater the chances that this could potentially be happening.
In future updates, we’re going to talk about the molecular biology of coronavirus. How it infects the cell. Let’s get down to the nitty-gritty. Compare it to the behavior of other viruses. Other viruses that have been brought up in this discussion. For instance, HIV.,etc. And how is it that these viruses do different things? What is it that they do? What are their targets? That’s we’re going to try to answer. Thanks for joining us.