Author: BigGuy

14 PERCENT of coronavirus patients tested positive a SECOND time in one Chinese region, health official admits

• It comes after a 40-year-old woman in Japan was diagnosed a second time
• Experts in virology say it throws into question the reliability of Chinese testing

Around 14 per cent of coronavirus patients tested positive a second time in one Chinese region despite being given the all clear. A health official in Guangdong Province told The New York Times that the patients had been discharged from hospital after testing negative for the virus but then fell ill again later. It follows reports in Japan of a 40-year-old woman who tested positive for a second time yesterday. Experts said patients should develop an immunity to stop reinfection. Professor Mark Harris, Professor of Virology, University of Leeds, said: ‘Although coronaviruses generally cause short-term self-limiting infections which are cleared, there is some evidence in the scientific literature for persistent infections of animal coronaviruses, mainly in bats.’ Professor Harris added: ‘The reports that patients who tested negative subsequently tested positive again is clearly of concern. ‘It is unlikely that they would have been reinfected having cleared the virus, as they would most likely have mounted an immune response to the virus that would prevent such reinfection. ‘The other possibility therefore is that they did not in fact clear the infection but remained persistently infected.’ Around 14 per cent of coronavirus patients in one region of China have been diagnosed a second time. Pictured: Medical staff treating coronavirus patients at a hospital in Wuhan

The secondary cases raise fears that patients have wrongly been declared free of the virus. A tour bus operator in Japan has also tested positive for coronavirus for a second time It’s not yet clear if the people who tested positive for a second time are contagious as 13 of those who were in close contact with more than 100 people after being discharged appear to have not passed it on, the health offical said. Patients in China must test negative twice and undergo a chest scan before they can be release.A woman in Japan who recovered from coronavirus and was released from hospital has tested positive again. The 40-year-old woman, who was initially infected after working on a tour bus with sightseers from Wuhan, tested positive for a second time yesterday. Government officials say it is the first known incident of this kind in Japan. The woman was first confirmed as infected with the coronavirus on January 29. After being discharged from hospital she tested negative for the virus on February 6, although she still had a cough at the time. She had no symptoms a week later, but returned to the doctor on February 21 complaining of a sore throat and chest pains. On Wednesday, she tested positive for the coronavirus for a second time, officials in Osaka said. The driver of the tour bus, which was carrying tourists from the city of Wuhan at the centre of the outbreak, also tested positive for the virus. Though a first known case for Japan, second positive tests have been reported in China where the disease originated late last year. At least 186 people in Japan have so far contracted the virus, with three deaths in the country linked to the outbreak. Prof Rowland Kao, Professor of Veterinary Epidemiology and Data Science at the University of Edinburgh, said: ‘Assuming that there is a minimal possibility of misdiagnosis, it still remains unclear from the published reports whether the person involved was likely re-infected, or whether this represents an infection that may have been partially cleared or perhaps has gone latent. ‘In either case, given the number of reported cases thus far, it would seem unlikely that this is a common occurrence, and thus should have only a small impact on the overall epidemic projections themselves.’ ‘Of possibly greater concern are the implications for control measures – should quarantine periods be extended? It also makes contact tracing even more difficult, potentially straining resources.’

Global screening efforts to prevent the rapid spread of coronavirus are likely to fail, according to new research warning that even best-case screenings of air travelers will miss more than half of infected people. The novel coronavirus has infected more than 80,000 people worldwide since its emergence in central China last month.

Traveler screening using temperature monitors and questionnaires is a key response measure, yet the World Health Organization (WHO) on Wednesday said for the first time the number of new cases outside mainland China exceeded those within it.

Researchers in the United States and Britain in a study published in the journal eLife used computer models to predict the impact of screening, based on the latest data of how the coronavirus behaves and how long it takes for patients to show symptoms.

Building on similar work in 2015, they found that many cases would inevitably be missed and called for a re-think in how nations screen passengers.

“If someone doesn’t realize they have been exposed, and doesn’t yet show symptoms, then they are fundamentally undetectable,” Katelyn Gostic, a postdoctoral scholar at the University of Chicago and lead author told AFP.

“We estimate that on average, screening will miss about two-thirds of infected travelers.”

Gostic stressed that these misses were not the result of human error, but rather an inevitable by-product of how the virus behaves. The WHO says that the typical incubation period – that is the time between a patient contracting the virus and symptoms showing – is around 10-14 days. This means that patients could be contagious without even knowing it, rendering temperature tests searching for a tell-tale fever and even self-reporting of exposure largely useless. Upon screening, travelers fall into one of four categories: symptomatic but unaware of exposure; aware but asymptomatic; symptomatic and aware; and neither symptomatic nor aware. Gostic and the team found that the final category were completely undetectable by traditional screening methods, and travelers in the third category could only be caught if they were willing to self-report. Even assuming a best-case scenario where only one in 20 passengers were “subclinical” – that is, infected but not showing symptoms – the models predicted that 53 percent of cases would be missed. “Substantial fractions of the people who have tested positive in quarantine … did not show any detectable symptoms at the time of diagnosis,” said Gostic.“Some of these people may be true subclinical cases. Others will probably develop symptoms in a few days time. Either way, these stories illustrate the difficulty of screening, where the goal is to detect cases as early as possible, but where people simply don’t show detectable symptoms early in the course of infection.”

Gostic warned that the world may be at a “tipping point” where screening and even the kind of quarantine measures seen in the outbreak’s epicenter Wuhan are no longer effective.

“Governments should be thinking about pandemic mitigation,” she said. “But we should recognize the hard work and immense value that on-the-ground containment efforts have brought up until this point — providing time for healthcare workers and policymakers to prepare.

More coronavirus new infections outside China than inside – WHO

“Disruption to everyday life may be severe,” Nancy Messonnier, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, warned at a news conference Tuesday.

Schools could be closed, mass public gatherings suspended and businesses forced to have employees work remotely, she said. Messonnier said the coronavirus has caused sickness and death and sustained person-to-person transmission. That’s two of the three factors for a pandemic, she said. “As community spread is detected in more and more countries, the world moves closer to meeting the third criteria – worldwide spread of the new virus,” Messonnier said. Although the World Health Organization determined Monday that the term pandemic “did not fit the facts,” experts said it very soon could. Dennis Carroll, former director of the U.S. Agency for International Development’s Global Health Security and Development Unit, credited China’s “extraordinary control measures” with delaying the spread of the virus, but he said avoiding a pandemic is “very unlikely.” “The dramatic uptick of cases in South Korea, Iran and Italy are reflective of a self-sustaining spreading of the virus and a clear message that the horse is out of the barn,” Carroll, who leads the Global Virome Project science cooperative, told USA TODAY. Melissa Nolan, a medical doctor and professor of epidemiology at the University of South Carolina’s Arnold School of Public Health, cited new clusters in Iran, which faces at least 95 cases and has had 16 deaths, and Italy, which is dealing with 322 cases.

“If we continue to see focalized local transmission in areas outside of China, the WHO will need to reconvene,” Nolan told USA TODAY on Tuesday. “We are very close to seeing this virus becoming a pandemic.”

Nolan said responses to the outbreaks in Iran and Italy could help health officials in other countries prepare their own medical and quarantine policies before an outbreak. That is crucial, said Robert Glatter, an emergency physician at New York’s Lenox Hill Hospital who fears the world is on the “cusp” of a pandemic.

“Trying to contain a disease which spreads like influenza, in this case COVID-19, is almost impossible,” he said. “We are talking about rapid-fire and sustained transmission.”

Beyond an epidemic, which involves a defined region, a pandemic has global impact. It can be a moving target – there is no threshold, such as number of deaths or infections.

https://youtu.be/PphsLY_8gJs

WASHINGTON/CHICAGO (Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday alerted Americans to begin preparing for the spread of coronavirus in the United States after infections surfaced in several more countries.

The announcement signaled a change in tone for the Atlanta-based U.S. health agency, which had largely been focused on efforts to stop the virus from entering the country and quarantining individuals traveling from China. “The data over the past week about the spread in other countries has raised our level of concern and expectation that we are going to have community spread here,” Dr. Nancy Messonnier, the CDC’s head of respiratory diseases, told reporters on a conference call. What is not known, she said, is when it will arrive and how severe a U.S. outbreak might be. “Disruption to everyday life might be severe” and businesses, schools and families should begin having discussions about the possible impact from the spread of the virus, Messonnier cautioned. In a teleconference later on Tuesday, Dr. Anne Schuchat, the CDC’s principal deputy director, said that while the immediate risk in the United States was low, the current global situation suggested a pandemic was likely. “It’s not a question of if. It’s a question of when and how many people will be infected,” Schuchat said. Separately, U.S. Health and Human Services (HHS) Secretary Alex Azar told a Senate subcommittee there will likely be more cases in the United States, and he asked lawmakers to approve $2.5 billion in funding to fight the outbreak after proposing cuts to the department’s budget. “While the immediate risk to individual members of the American public remains low, there is now community transmission in a number of countries, including outside of Asia, which is deeply concerning,” Azar said, adding that recent outbreaks in Iran and Italy were particularly worrying. Believed to have originated from illegal wildlife sold in the Chinese city of Wuhan late last year, the new coronavirus has infected some 80,000 people and killed close to 2,700 in China. Although the World Health Organization says the epidemic has peaked in China, coronavirus cases have surfaced in about 30 other countries, with some three dozen deaths reported, according to a Reuters tally. Growing outbreaks in Iran, Italy and South Korea have raised concerns that coronavirus will surface in other nations and worsen in those that have already reported infections, further denting a global economy that had already been hit by a dependence on China. Global and U.S. stock markets fell sharply again on Tuesday, as investors feared the epidemic would further damage an already slowing world economy.[nL1N2AP0YR][nL1N2AP11A] The White House’s top economic adviser, Larry Kudlow, said the U.S. economy would be able to ride out any disruption from the global spread of coronavirus, adding that he did not expect the Federal Reserve to cut interest rates to blunt the disease’s economic impact. U.S. Senator Chuck Schumer, however, said Republican President Donald Trump and his administration had been caught “flat-footed” and lacked a comprehensive plan to deal with the coronavirus. He called for at least $3.1 billion in additional funding to fight it.

“The Trump administration has shown towering and dangerous incompetence when it comes to the coronavirus,” said Schumer, the Senate’s top Democrat. “Mr. President, you need to get your act together now. This is a crisis.”

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said it would be at least a year before a coronavirus vaccine could be made available to the public.

But Fauci said testing Gilead Sciences’ (GILD.O) antiviral drug remdesivir for potential treatment of coronavirus could be done in a “reasonable amount of time.”

‘DEADLY CONSEQUENCES’

U.S. Secretary of State Mike Pompeo told reporters that Iran may have covered up information about the spread of coronavirus there, and he accused China of mishandling the epidemic through its “censorship” of media and medical professionals.

“The United States is deeply concerned by information indicating the Iranian regime may have suppressed vital details about the outbreak in that country,” Pompeo told reporters as Iran’s coronavirus death toll rose to 16.

“All nations, including Iran, should tell the truth about the coronavirus and cooperate with international aid organizations,” Pompeo said.

His remarks, coming less than two months after a short-lived U.S.-Iranian military clash and the signing of a U.S.-China trade deal, could inflame tensions with Tehran and Beijing.

Beijing last week revoked the credentials of three Wall Street Journal correspondents over a column China said was racist. The United States has said it was considering a range of responses to their expulsion.

“Expelling our journalists exposes once again the government’s issue that led to SARS and now the coronavirus: namely censorship. It can have deadly consequences,” Pompeo said, referring to the 2002-2003 outbreak of Severe Acute Respiratory Syndrome, which also emerged from China.

“If China permitted its own and foreign journalists and medical personnel to speak and investigate freely, Chinese officials and other nations would have been far better prepared to address the challenge” of coronavirus, he added.

Despite the coronavirus epidemic, Pompeo said the United States still planned to host a special meeting with the 10-member Association of Southeast Asian Nations (ASEAN) in Las Vegas in March.