In this week’s coverage of the coronavirus epidemic, the TWiV team discusses the fatality rate, China’s initial reaction to the outbreak, conspiracy theories, how long the virus remains infectious on surfaces, and evidence for virus in the intestinal tract.
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Show notes at microbe.tv/twiv
Interesting new findings from the first large scale (n=1000) clinical study:
https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1
Median incubation period only 3 days.
Previous incubation time estimates were 5-6 days.
This means, the virus spreads extremely fast, given an R0=3 the case doubling period might be less than 3 days !
Potentially multiplies 2^10 = 1000 fold in just 4 weeks. Million-fold in two months …
Also cannot be effectively detected by fever screening:
“Notably, fever occurred in only 43.8% of patients … such patients may be missed if the surveillance case definition focused heavily on fever detection ”
Also: 75% manifested as pneumonia, 40% needed oxygen therapy, 5% ICU, ARDS
This is not the flu. Thats why they called it the “Wuhan PNEUMONIA” in the first place.
Reassuring: case fatality rate significantly below SARS/MERS. Mild cases might have gone undetected/treated at home.
After MERS WHO wants to avoid naming the NCoV after a region, country, or city. China has suggested NPC for Novel Pneumonia Cornavirus.
A “modest proposal” for a name that fits the epidemic history: CPC for Concealed Pneumonia Cornavirus.
It’s a pity that we are not able to properly name a virus anymore.
until 40 years ago it was not a problem at all to simply use the origin location name (Hong-Kong flu, etc. )
until 20 years ago we used at least salient, “catchy” acronyms like AIDS and SARS.
But now, all we are able to come by with is a bureuocratic, awkward charcter strings like “2019nCoV”
I wish this were only a matter of taste, but in reality it is problematic because it hinders the flow of information in the internet, because, e.g., there is not a single unique hash tag or search term to use.
“Based on phylogeny, taxonomy and established practice, the CSG formally recognizes this virus as a sister to severe acute respiratory syndrome coronaviruses (SARS-CoVs) of the species Severe acute respiratory syndrome-related coronavirus and designates it as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).” https://www.biorxiv.org/content/10.1101/2020.02.07.937862v1
Meanwhile to conciliate the gov’t that concealed so much from citizens and scientists with severe local and global consequences, the WHO leaped into action today with the name COVID-19.
If a name associated with entire regions (SA, ME) is concerning, let’s wield the brush more accurately and call it CPC Pneumonia Cornavirus or CPC for short.
The final thing I’ll say about the SARS-Cov-2 name (that WHO is running from) is that the people of China are not the ones who object to calling things by the most correct name .
“Around 5 p.m. on December 30th, Li Wenliang, an ophthalmologist at Wuhan Central Hospital, messaged his college-classmates group on WeChat. He told them that “seven confirmed cases of sars†were in quarantine at the hospital, then followed up with a correction: it was an unspecified coronavirus, which later became known as 2019-nCoV.” https://www.newyorker.com/news/news-desk/how-the-coronavirus-has-tested-chinas-system-of-information-control
Regional lethality difference is curious. I had a thought about that.
While it may be due to environmental differences, its an evolutionary paradigm that pathogens can tend to evolve to be less debilitating for the host because it helps them to spread if the host is mobile and active and therefore alive.
With so many cases collected in Wuhan could the virus have mutated already?
If there were two strains in Wuhan, a slower spreading more lethal strain and a faster spreading less lethal strain it would also fit this observation.
Will people be repeat sequencing the wild viral genome?