What you should know about the Corona virus

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What you should know about the Corona virus

Postby BillB » Thu Mar 19, 2020 6:32 am

What is the Coronavirus?
The word Coronavirus indicates a large family of viruses which belong to the family of Coronaviridae, of the order Nidovirales, and comprise of large, single, plus-stranded RNA as their genome. Several members of the Coronavirus family may cause mostly mild respiratory disease in humans; however, notable exceptions that have gained worldwide recognition include the Severe Acute Respiratory Syndrome (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the early 2000s and again in 2013. These caused some patients to succumb to fatal severe respiratory diseases. Recently, the word coronavirus has been used to describe the β-coronavirus 2019-nCoV, also called the novel coronavirus (nCoV) or Covid19. This is the seventh member of the family of coronaviruses that infect humans, and a new strain that has not been discovered in humans before. Like SARS-CoV and MERS-CoV, it belongs to the β-CoV. This virus is zoonotic, with Chinese horseshoe bats (Rhinolophus sinicus) being the most likely origin. From Wuhan, Hubei province in China, this virus has since spread around the world and the World Health Organization declared it a global pandemic on March 11 2020. As of March 12 2020, 2019-nCoV has been recognized in 52 countries, with a total of 125 048 confirmed cases and 4613 deaths.

Emerging evidence suggests the 2019-nCoV mutations may lead to different strains which predominate in geographical locations. For example, the strain in Italy is thought to be more virulent as compared to the one in Australia, which evolved from the original in Wuhan.

How is it spread?
It is thought to be passed directly from person to person by aerosolised particles and respiratory droplets, as well as contact transmission, such as the direct contact with oral, nasal, and eye mucous membranes after touching contaminated surfaces. Whether it can be spread through aerosols or vertical transmission (from mothers to their newborns) is yet to be confirmed. The fecal–oral routes is a potential person-to-person transmission route as the virus has been found in fecal samples of affected patients.

The asymptomatic incubation period for individuals infected with 2019-nCov has been reported to be ~1–14 days. It has been estimated to be 5 to 6 days on average.

Although patients with symptomatic 2019-nCoV have been the main source of transmission, the virus can be spread from an asymptomatic person. This makes controlling its spread challenging, as it can be difficult to identify and quarantine individuals in time. Recovering patients have been reported to have transmit the virus.

How likely is someone infected?
How quickly this disease spreads between people is known as its transmission rate. The transmission of a disease is measured by something called a reproductive number, which is the average number of people that are infected from an infectious person. The reproductive number for 2019-nCoV is estimated to be between 2-4. For comparison, seasonal flu is about 1, so 2019-nCoV can spread more rapidly than seasonal flu. It is thought to spread faster than the two other coronaviruses- SARS and MERS.

The 2019-nCoV’s cell receptor is the human angiotensin-converting enzyme 2 (ACE2), which lines mucosa and the gastrointestinal tract. The high affinity between ACE2 and 2019-nCoV S protein also suggested that the population with higher expression of ACE2 might be more susceptible to 2019-nCoV. People in close contact with individuals with symptomatic and asymptomatic 2019-nCoV, including health care workers and other patients in the hospital, are at higher risk of infection.

How do I know if I have the 2019-nCoV?
Symptoms may include fever, cough, and myalgia or fatigue. The chest CT will demonstrate abnormal findings consistent with infection. Less common symptoms include sputum production, headaches, haemoptysis, and diarrhoea.

What happens if someone is infected?
Most individuals who are infected by 2019-nCoV will have mild symptoms and recover fully. We don’t exactly know how many individuals will be seriously affected, but a suggested fatality rate (which is the cumulative deaths divided by cumulative cases) based on China data is between 0.39% and 4.05%. Based on more information from other affected countries, this is now thought to be between 3 and 4%. This fatality rate is lower than that of SARS (≈10%) and MERS (≈34%) and higher than that of seasonal influenza (0.01% to 0.17%). It is important to remember that this virus strain is new and medical professionals do not have a lot of data to be sure about this fatality rate for 2019-nCoV. There are also concerned that there are a lot more infected individuals who are asymptomatic who are either unaware or have recovered from the virus and hence are not accounted for. This of course will significantly affect the true prevalence and mortality rate.

We do know that 2019-nCoV is more likely to affect older males. While it can affect all ages, adults are affected more than children. The risk to pregnant women is the same as to non-pregnant women. Patients with comorbidities such as heart disease, lung disease, diabetes and other medical problems are less likely to recover. Older individuals and those with c-morbidities are at greater risk, and mortality rates of up to 18% have been reported in this vunerable group.

How is it treated?
So far, there has been no evidence from randomized controlled trials to recommend any specific treatment. Management is symptomatic. Clinical trials are underway to investigate interventions that are potentially more effective (e.g., lopinavir, remdesivir).

Why is the government cancelling large events and telling people to stay home? Is this just an over-reaction?
The Australian prime minister announced yesterday a ban on non-essential events of more than 500 people. In an outbreak, social distancing or staying home as much as possible helps slow the spread of the virus. This is necessary because it “flattens the curve” (see figure). Our healthcare system has a capacity, and can only see so many patients at a time, with the added problem of health care professionals themselves getting sick too. If everyone gets sick at the same time, the healthcare system gets overwhelmed, and thus there will be a backlog of patients. While a majority of people will be fine regardless, the elderly, people with medical comordibites and those needing to be hospitalised, may not receive emergency care necessary for survival. If we slow the spread of the virus over a longer period of time, the healthcare system will be less likely to be strained and patients can get the care that they need.
BEWARE .... I'm looking at your teeth .....
R1200 GSA 2009, K1200 LT 1999 "insurance w/off", Suzuki DR 650 2012, C650GT "gone" 2018 R 1200 RT
BillB
 
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Re: What you should know about the Corona virus

Postby JeffD » Sun Mar 22, 2020 9:39 pm

Thanks Bill, that's by far the most concise, helpful information on Corona virus I've read yet. Thanks for the responsible, well thought out post.
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