Misinformation, Infection Severity, Cruise Ship, & Virus Origins (Lecture 20)
Welcome to another MedCram lecture! Total confirmed cases is 73,000 approximately; total deaths is 1,873; total recovered is 12,887. And that ratio of total recovered to total deaths has been increasing. If we go to the WorldOmeter website, we look at the total cases that have been diagnosed. Again here, we see that big jump on February 12th because of the expansion of the diagnostic criteria and leveling off once again as we saw.
Total deaths, however, continued to increase although there seems to be some leveling off. If we look again at more case statistics, we can get that broken down, and we’ve been looking at these carefully. The number of daily new cases seem to be leveling off worldwide. However, if we look at new cases outside of China, they seem to be accelerating. We’ll have more on that in a little bit.
There’s an interesting article that was published on the website of NPR. It was a transcript of an interview that was done with Carl Bergstrom, who is a professor of Biology at the University of Washington, who talks about something that’s spreading even faster than the virus. That’s false information, and it’s an interesting discussion about misinformation, about how many are infected, how it’s spreading, and the source of how this virus came about. And it discusses the different motives for why there might be missing information about this. I think it’s an interesting read, and I will include a link in the description below.
So given that, let’s go ahead and take a look at this article, which is out of the University of Minnesota. The Center for Infectious Disease Research and Policy talks about a lot of things that have happened in the last 24 hours. One of the big things that’s come out is a report from basically the Chinese version of the CDC. And of course, many things in xx are controlled by the government.
But it’s interesting to look to see what they are reporting. This is a study that came out that looked at 72,000 patient records, of which 44,000 were lab-confirmed cases, and 16,000 were suspected cases, and over 10,000 were part of the newly expanded clinical criteria for the coronavirus, and there were almost 900 asymptomatic cases. So what they’re showing here is what proportion are mild, severe, and critical.
And it kind of confirms what we had been seeing in the beginning, which was that about 80% of the cases that were diagnosed were mild, and the vast majority of these cases were in people aged 30 to 79. So what did they see? About 14% of these illnesses were severe, and about 5% of them were critical, and then here’s the interesting part because we always discussed if you could compare the number of deaths at a particular point in time with the number of confirmed cases at a particular point in time, and that was a concern for many, including myself, because patients can be diagnosed very early, but it takes quite a while for them to die obviously from the virus.
And so, how far back did you need to go to have a case fatality rate? Well, when they looked at these after it was said and done, they looked at the overall case fatality rate, and it turns out to be, in their analysis, about 2.3 percent. And just as we suspected what we see in a lot of viral pneumonia cases with influenza, there were 1,023 included in the study. Most of these were people who are age older than 60, and those who had underlying medical conditions.
Now, there was a study that was published in JAMA that showed that a number of healthcare workers at the very beginning of this outbreak were infected. A lot of them know XXX. This confirmed that about 1,700 healthcare workers were infected in the outbreak, and 5 of them fatally, one of those, of course, was Dr. Li, who was at the early portion of the epidemic, and he warned a number of his colleagues about this and was reprimanded, of course, by the xx government.
The events that marked the severe acute respiratory syndrome, or SARS, and the Middle East Respiratory Syndrome coronavirus, MERS-COV, were sometimes associated with super spreader events, and it didn’t seem like there was any evidence of that occurring in this particular outbreak.
The other big news is that there seems to be, and they’re looking at, a decline in the number of cases that are diagnosed in China. Now, this maybe because of the quarantining, and if they release that quarantine, we may see that shoot up again. It’s also of course as you have more and more people infected, it’s more difficult for the virus to infect more people because it can’t infect someone that’s already infected. So the WHO is asking people to take this with a grain of salt, and see how things go.
The other interesting story in all of this is what is going on on the Diamond Princess cruise ship, which has been quarantined in the Yokohama Port since February 3rd. And as of yesterday, there were another 99 more people on this cruise ship that tested positive, raising the total to 454. And so the US State Department had evacuated more than 300 U.S. citizens and their family members who have been on the Diamond Princess. Interestingly, between when they got off the ship and when they got to the airport, U.S. officials had learned that about 14 passengers who have been tested turned positive for covid-19, which is the illness that is produced by the virus. These people were still put on the plane but put into a specialized part of the aircraft, and it says here isolated according to standard protocol. These people aren’t going to arrive at Travis Air Force Base or the joint base in San Antonio, Texas.
There has also been a lot of talk about where did this coronavirus actually come from, and there is a preprint publication. That means that this has not been peer-reviewed, and this was made available by an international group of virologists. Some of them out of southern California at Scripps who looked at their analysis of the genome of this coronavirus, and they described as it says here: “it’s notable features and scenarios that likely led to its evolution.” They proposed two scenarios: natural selection in a host animal before the virus jumped to humans, or natural selection and humans fall in transmission from animals to people.
And if we look at this article, as you can see here, it comes out of Scripps Research in La Jolla California, and also the University of Edinburgh in the UK, as well as New York, Sydney, Australia, New Orleans and Germantown, Maryland.
Talks about the different possible origins of this SARS-COVID-2, which is the name of the virus. In this, they talked about the binding sites of the SARS-COVID-2 genome, specifically to the human ACE-2 receptor, and in their discussion, you can see the breakdown of these sites where they analyze it and the mutations and contact residues of the SARS-COVID-2 spike protein. And the conclusion that they come to is interesting.
They say that it is improbable that the SARS-COVID-2 emerge through a laboratory manipulation of existing SARS-related coronavirus. They go on further to say that either this thing mutated before it went in humans or after went in humans. And they talked more about the adaptation to humans. Finally, in their conclusion, they say that it’s currently impossible to prove, or disprove, the other theories of its origin, and whether or not further data will help resolve this issue. And so we’ll put a link in here to this article as well.
Some of the things that we’ll be talking about in upcoming updates is exactly how does this virus infect cells, and how does it replicate and reproduce. We will get into a little bit of molecular biology. Thanks for joining us.