Author: BigGuy

New cases of the novel coronavirus continue to increase worldwide and a Global Pandemic is near according to the World Health Organization (WHO). That includes 72,528 cases in China and 804 cases in 25 countries outside of China.

Some have questioned the accuracy of the statistics released by the Chinese government regarding the reported number of cases and deaths due to the outbreak. Now there are concerns about the accuracy of the laboratory tests used to confirm diagnoses. Reports suggest some people test negative up to six times even though they are infected with the virus, according to the BBC and Chinese media. Such was the case with Dr. Li Wenliang, the ophthalmologist who first identified the outbreak and was reprimanded by Chinese authorities when he tried to warn others. Dr. Wenliang developed a cough and fever after unknowingly treating an infected patient. He was hospitalized, testing negative for coronavirus several times before eventually receiving a positive result. On Jan. 30 the doctor posted: “Today nucleic acid testing came back with a positive result, the dust has settled, finally diagnosed,” according to the BBC. Dr. Wenliang passed away on February 7 in Wuhan, the epicenter of the outbreak.

False-negative test results, where patients are told they do not have a condition when they actually do, cause several problems. Patients may be turned away from hospitals and medical facilities when they require care. They may infect others at home, work, school, or in the community. Patients’ conditions may also worsen without treatment.

When faced with a highly infectious, potentially deadly pathogen, even a small number of false negatives can have a potentially serious and widespread impact on the larger population Doctors use a laboratory test called RT-PCR to diagnose severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, the virus that causes COVID-19 illness. RT-PCR detects and amplifies genetic material of interest. MedicineNet author Melissa Conrad Stöppler, MD notes that “RT-PCR has been used to measure viral load with HIV and may also be used with other RNA viruses such as measles and mumps.” However, RT-PCR tests for the novel coronavirus are not perfect and not always accurate. A recent study in the journal Radiology examined medical records from 167 patients with COVID-19 from Hunan province in China. Researchers found that five patients out of 167 — 3% of the study group — who had chest CT scan features suggestive of COVID-19 initially tested negative for SARS-CoV-2 infection by RT-PCR. The patients were isolated and all eventually were confirmed through repeated swab tests to have the infection False negatives comprised just 3% of the patient population in this study. However, failure to detect a small number of cases of the potentially deadly viral infection may have wide-ranging effects for patients and others who may become infected. The study authors note that RT-PCR tests may produce false negatives due to laboratory error or insufficient amount of viral material collected from the patient. Samples that are stored or handled improperly also result in false negatives. Tests may result in false negatives if the patient is tested too early in the course of infection and there is insufficient amount of virus to be detected. Improper sampling may result in a false negative. Another potential problem with test kits: Faulty reagents. The CDC recently admitted test kits they distributed resulted in inconsistent results due to a problematic reagent required for the test. They are now manufacturing the reagents using stricter quality control measures. In the middle of cold and flu season, it is possible that some people who are being tested for coronavirus do not actually have the infection. Symptoms like cough and fever are nonspecific and may occur with many conditions other than COVID-19. In addition to the possibility of false negatives, authors of the Radiology study note that lab testing for SARS-CoV-2 is time-consuming and that test kits may be in short supply due to the rising number of infections. So, what’s the solution? Doctors in Hubei recently started diagnosing COVID-19 clinically based on patients’ symptoms and lung imaging. These cases are reflected in the global tally of infected individuals. Clinically-diagnosed cases account for the approximately 15,000 new cases reported by China last week.

Professor Hunter calls for consistency in case definitions. That is what is needed to get an accurate picture of the extent of the outbreak and the true number of those who have been infected or died. Accurate numbers also help determine the potential danger for the rest of the world. Insufficient test kits, inaccurate test kits, changing definitions of what constitutes a confirmed case of COVID-19, and overdiagnosis and misdiagnosis of the illness make it difficult to determine the real number of those affected. Accurate diagnosis is necessary so that hospitals and resources are allocated to real cases. COVID-19 causes flu-like symptoms that worsen to fever, coughing, and shortness of breath. “Complications may include high fever, severe cough, difficulty breathing, pneumonia, organ failure, and death,” he states. “People may prevent or lower the risk of this viral infection by good hygiene, avoiding contact with infected people, not going into an outbreak area, and by leaving an outbreak zone,” Dr. Davis concludes.

MILAN (Reuters) – Italy raced on Sunday to contain the biggest outbreak of coronavirus in Europe, sealing off the worst affected towns and banning public gatherings in much of the north as the number of those infected jumped above 100. Authorities in the wealthy regions of Lombardy and Veneto, which are the focal point of the flare-up, ordered schools and universities to close for at least a week, shut museums and cinemas and called off the last two days of the Venice Carnival. “As of this evening, there will be a ban on the Venice Carnival as well as on all events, including sporting ones, until March 1 inclusive,” the regional governor of Veneto, Luca Zaia, told reporters. He said Sunday’s festivities in the packed lagoon city would continue to prevent any public order problems. The number of certified cases of the illness in Lombardy rose to 90 from 54 a day earlier, while in Veneto some 25 people had come down with the virus, including two people in Venice. Health officials reported isolated cases in the neighbouring regions of Piedmont and Emilia Romagna, saying the total number of known infections in Italy had risen to above 130. Two elderly people have died in the past 48 hours from the illness. The regional governor of Veneto, Luca Zaia, said he had dealt with numerous natural disasters during his long career, including floods and earthquakes. “But this is the absolutely worst problem that Veneto has faced,” he told reporters. Almost a dozen towns in Lombardy and Veneto with a combined population of some 50,000 have effectively been placed under quarantine, with locals urged to stay home and special permission needed to enter or leave the designated areas.

Lombardy is home to Italy’s financial capital Milan, and together with Veneto the two regions account for 30% of national gross domestic output. Any prolonged disruption there is likely to have a serious impact on the whole economy, which is already flirting with recession.

Fashion designer Giorgio Armani has said his fashion show scheduled to take place in Milan on Sunday would go ahead, but without any press or buyers present to prevent contagion, while four Serie A soccer matches were postponed across the north. Health authorities are struggling to work out how the outbreak started. The first cases were announced only on Friday and doctors do not know the source of the illness. Initial suspicion in Lombardy fell on a businessman recently returned from China, the epicentre of the new virus, but he has tested negative. In Veneto, doctors tested a group of eight Chinese visitors who had been to the town that was home to the first fatality, but again, they all tested negative. “We are (now) even more worried because if we cannot find ‘patient zero’ then it means the virus is even more ubiquitous than we thought,” Zaia said. Prior to Friday, Italy had reported just three cases of the virus – all of them people who had recently arrived from the Chinese city of Wuhan, where the virus first emerged last year. After the first confirmed cases, Italy suspended all direct flights to and from China, but did not keep tabs on those arriving from second countries. Italy’s far-right opposition League party has demanded that the government reintroduce border controls to try to prevent new arrivals, but Prime Minister Giuseppe Conte has rejected this. Austria’s Interior Minister Karl Nehammer said on Sunday that officials would meet on Monday to discuss whether Austria should unilaterally re-establish border controls with Italy.

https://youtu.be/HPy1CadwCrE

Health experts sounded the alarm Friday over the worldwide threat of the coronavirus, with officials warning of its “likely” community spread in the United States and the World Health Organization cautioning that “the window of opportunity is narrowing” for containing the outbreak worldwide. The COVID-19 coronavirus, which erupted in China in December, has killed at least 2,360 people and sickened at least 77,900 worldwide, the majority of cases in mainland China. Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters Friday that U.S. health officials are preparing for the coronavirus to become a pandemic.

“We’re not seeing community spread here in the United States, yet, but it’s very possible, even likely, that it may eventually happen,” she said. “Our goal continues to be slowing the introduction of the virus into the U.S. This buys us more time to prepare communities for more cases and possibly sustained spread.”

She said the CDC is working with state and local health departments “to ready our public health workforce to respond to local cases.” These measures include collaboration with supply chain partners, hospitals, pharmacies and manufacturers to determine what medical supplies are needed. She said the “day may come” here where we have to shut down schools and businesses like China has done. Meanwhile in Geneva, the director-general of the World Health Organization, alarmed by the recent spread of the coronavirus from Iran, warned Friday that while the chance to contain the virus globally still exists, “the window of opportunity is narrowing.”

“We still have a chance to contain it, but we have to prepare for other eventualities,” said Tedros Adhanom Ghebreyesus. “This could go in many directions, it could be even messy.

It is in our hands now … we can reverse or avert serious crisis. If we don’t, if we squander this opportunity, then there could be a serious problem on our hands.” Among other measures, Tedros called for financial aid to help countries fighting the virus to buy critical medical equipment and to strengthen their health systems. The world community, he said, has a “fighting chance” to contain the spread of the virus, but we “must not look back and regret that we failed to take advantage of the window of opportunity that we have now.” Tedros, speaking to reporters in Geneva, said the new cases in Iran show how the virus, which originated in Wuhan, China, is now moving not only to second countries, but to third countries in a lengthening chain of transmission. “The cases that we see in the rest of the world, although the numbers are small, but not linked to Wuhan or China, it’s very worrisome,” Tedros said. “These dots are actually very concerning.”

The Global Health Security Index, which was issued last year, found that only 13 of nearly 200 countries score in the top tier, suggesting that most of the world would struggle to deal with a major outbreak of a deadly infectious disease such as Ebola.

The index is a project of the Nuclear Threat Initiative (NTI) and the Johns Hopkins University Center for Health Security, with research by The Economist Intelligence Unit. The CDC reported that at least 35 people in the United States are infected with the virus. Of those, 14 were travelers who fell ill after returning from a trip abroad, while 21 were were people “repatriated” by the State Department. Messonnier, of the CDC, said more infections are expected from among passengers on the Diamond Princess cruise ship and are in quarantine. She said they are “they are considered at high risk for infection” because they may have come in contact with infected persons on the ship.

A smartphone plant in the South Korean city of Gumi is temporarily closed so it can be disinfected after one employee tested positive for coronavirus, Samsung Electronics Co. confirmed on Saturday. The plant is scheduled to be reopened on Monday.Employees who have been in contact with their colleague in question have voluntarily quarantined themselves, Samsung claimed, adding that the production of smartphones is not likely to be affected. So far, two people in South Korea have died due to the virus, and 433 infections have been confirmed, although the latter figure could be higher.

VIENNA (Reuters) – The World Health Organization (WHO) is concerned about the number of coronavirus cases with no clear epidemiological link, although the total number of cases outside China remains relatively small, its director general said on Saturday.

Cases with no clear link include those with no travel history to China or contact with a confirmed case, Tedros Adhanom Ghebreyesus said in a briefing.

China has reported 75,569 cases to the WHO, including 2,239 deaths, he said. According to available data, the disease remains mild in 80% of coronavirus patients, and is severe or critical in 20% of patients, he said. The virus has been fatal in 2% of reported cases. The risk of death increases for older patients, Tedros said, adding there were relatively few cases among children. Outside China, there have been 1,200 cases in 26 countries, with eight deaths, Tedros said. That includes one confirmed case on the African continent, in Egypt, he said. He called the reported decline in new cases in China welcome news but said it had to be interpreted very cautiously, adding, “It is far too early to make predictions about this outbreak”. A WHO-led international team of experts, which has been on the ground in China for the past week, will travel to Wuhan, the epicenter of the virus outbreak, on Saturday. “Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems,” Tedros said. The WHO is calling for $675 million to support countries, especially those which are most vulnerable, he said, adding it has identified 13 countries in Africa that are seen as a priority because of their links to China. It has shipped more than 30,000 sets of personal protective equipment to several African countries, and is ready to ship almost 60,000 more sets to 19 countries in coming weeks, Tedros said. The WHO has also appointed two specialists as special envoys to help African countries prepare for the potential arrival of the virus: the director of the Africa Centres for Disease Control and Prevention, John Nkengasong, and the director general of the Center for Vaccine Development in Mali, Samba Sow.

BEIJING (Reuters) – China reported a sharp decrease in the number of new deaths and new cases of the coronavirus on Saturday, while its central bank predicted a limited short-term economic impact and said the country was confident of winning the fight against the epidemic. Mainland China had 397 new confirmed cases of coronavirus infections on Friday, down from 889 a day earlier, with the vast majority of those in the epicenter of Hubei province, the National Health Commission said. The 31 new infections recorded in the rest of the country was the lowest since the commission started compiling nationwide data on Jan. 20, and sharply down from 258 new cases the previous day.

But the numbers continued to rise elsewhere, with outbreaks worsening in South Korea, Italy and Iran and Lebanon, prompting a warning from the World Health Organization that the window of opportunity to contain the international spread was closing..

South Korea saw another spike in infections with 142 confirmed cases, taking its tally to 346, about half related to people who attended a church service. Concerns about the virus weighed on U.S. stocks on Friday, driven by an earlier spike in cases in China and data showing stalling U.S. business activity in February. The virus has spread to some 26 countries and territories outside mainland China, killing 11 people, according to a Reuters tally, and among the WHO’s biggest concerns was cases without links to China. “We still have a chance to contain it,” Tedros Adhanom Ghebreyesus, WHO director-general, said on Friday. “If we don’t, if we squander the opportunity, then there will be a serious problem on our hands.” An outbreak in northern Italy worsened with its first death, an elderly man, among 17 confirmed cases including its first known instance of local transmission. Japan confirmed four new coronavirus cases on Saturday, among those a teacher who had shown symptoms while working at her school. Japan is facing growing questions about whether it is doing enough to contain its spread, and unease about whether it could scupper this year’s Tokyo Olympics. Organizers of the games on Saturday postponed the start of training for volunteers. The total number of confirmed cases in mainland China rose to 76,288, with the death toll at 2,345 as of the end of Friday. Hubei reported 106 new deaths of which 90 in Wuhan.

But new, albeit isolated findings about symptoms of the coronavirus could complicate efforts to thwart it, including the Hubei government’s announcement on Saturday that an elderly man took 27 days to show symptoms after infection, almost twice the presumed 14-day incubation period.

That follows Chinese scientists reporting that a woman from Wuhan had traveled 400 miles (675 km) and infected five relatives without showing signs of infection, offering new evidence of asymptomatical spreading. State television on Saturday showed the arrival in Wuhan of the “blue whale”, the first of seven river cruise ships it is bringing in to house medical workers, tens of thousands of which have been sent to Hubei to contain the virus. Senior Chinese central bank officials sought to ease global investors’ worries about the potential damage to the world’s second-largest economy from the outbreak, saying interest rates would be guided lower and that the country’s financial system and currency were resilient Chen Yulu, a deputy governor of the People’s Bank of China, said policymakers had plenty of tools to support the economy, and that they were fully confident of winning the war against the epidemic. Some analysts believe China’s economy could contract in the first quarter from the previous three months due to the combined supply and demand shocks caused by the epidemic and strict government containment measures. On an annual basis, some warn growth could fall by as much as half from 6% in the fourth quarter. Most expect a rebound in the spring if the outbreak can be contained soon and factories can return to normal production. However, transport restrictions remain in many areas and while more firms are reopening, the limited data available suggests manufacturing is still running at low levels and disruptions are starting to spillover into global supply chains. Finance leaders from the Group of 20 major economies were set to discuss risks to the world economy in Saudi Arabia this weekend. Another center of infection has been the Diamond Princess cruise ship quarantined in Japan since Feb. 3, with more than 630 cases accounting for the biggest cluster outside China. Four more Australian evacuated from the ship tested positive, in addition to two previously identified. A second plane with 82 Hong Kong residents returned home on Saturday and 35 British passengers were due to arrive home. U.S. health officials said they were preparing for the possibility of the spread of the coronavirus through communities and would force closures of schools and businesses.

The United States has 13 cases within the country and 21 among Americans repatriated on evacuation flights from Wuhan and the Diamond Princess.