Discover and read the best of Twitter Threads about #ncov2019

Most recents (24)

#COVID19 for the Nephrologist- Real life experience from Italy @caioqualunque Webinar now available on the ISN Academy
@caioqualunque Thank you for sharing your experience with the ISN community. On the panel ISN President @vjha126 Moderator @arvindcanchi. ISN education highlights by @gag_aggarwal
@caioqualunque STORY OF THE EPIDEMIC-Feb14 38yr old Italian starts with symptoms after being asymptomatic for weeks->Feb 20 only 3cases->fast forward to 2 weeks later the country is in lockdown #COVID #COVID2019italia #COVID2019india #COVID2019 #nCoV2019 #Covid_19
Read 39 tweets
Really pleased to hear that #nCoV2019 testing will be ramped up in the UK - it wont be easy but it will be worth it.
Heard some concerns about how well a nose/throat swab will work.
But I think that those concerns can be allayed by thinking about where most of the viral replcaition is taking place in different presentations/stages of the disease.
In a hospital setting (where initial concerns were raised about the sensitivity of the testing and sampling), the admissions will have pneumonia so most replication will likely be happening deep in the lungs - a throat swab might not be great
Read 7 tweets
A thread on #COVID19

Just a question on the Coronavirus: How can we know the accurate death rate if until about a week ago there was no accurate test (or ANY tests)? Also, there is still no accurate means of determining the number of people ACTUALLY infected...
1) virologists and health experts tell us that most of the people infected with #nCoV2019 show few or no symptoms whatsoever.

Doesn't this mean that the 'death rate' percentage cited by a breathless media is based on a woefully incomplete dataset, and...

...the ACTUAL death rate would therefore be MUCH lower than the figures being touted?

Also, if the death rate WAS higher than SARS, MERS, and H1N1- wouldn't there already be a massive amount of deaths in the US? So far in the US, the number of deaths is <100.

Read 10 tweets
1/ UK response to #covid19. Some people are saying we must follow the expert advice of the gov. and trust in their judgement. And I agree we should be trusting expert advice right now. But what we don't know is what's being said behind closed doors.
2/ We don't know if the gov. advisors are tearing their hair out, battling with Boris and Cummings to take it more seriously. None of know what is actually being said.
3/ They keep saying 'the scientific evidence informs our decisions,' and yet plenty of scientists and experts outside of the gov. are saying the response is weak.
Read 11 tweets
as long as corona virus doesn't cross throat it isn't serious

once it infects lungs, most (except children, pregnant women) develop cytokine storm immune reaction

Old, sick people will suffer. Need lots of Oxygen (ventilators & emergency care etc)

Hope govt paying oxygen bills

This is doctors in America trying to learn from experience of Italy


This will impact old people, sick/immune compromised people & vulnerable people without access to medical care

Only preventive option is SOCIAL DISTANCING

Read 36 tweets

Over 60 million Italian citizens under lockdown as #Coronavirus incidences surge. Over 9000 confirmed cases in Italy & rising.

The unfortunate consequence are the associated ethical concerns regarding resource allocation.

More Below

#COVID19 #nCoV2019 #2019nCoV

Incessant rising in cases warrants the question: are hospitals prepared for the associated influx of patients?

Further admissions require beds, PPE, ventilators, staff etc. What happens when resources run out, ventilators are all in use, or there aren’t enough staff?

Ultimately, scarcity of medical resources may pressure healthcare practitioners to decide who receives care. This is NOT a question anyone should ever have to answer.

Resources should never be the limiting factor of care

Read 6 tweets
1/ Notes from the front lines:
#Sharing from another physician:

From an ID conference in California


Infectious Disease Association of California (IDAC) Northern California Winter Symposium on Saturday 3/7.

In attendance were physicians from Santa Clara, San Francisco & Orange Counties who had all seen and cared for COVID-19 patients, both returning travelers and community-acquired cases. Also present was the Chief of ID for Providence, who has 2 affected Seattle hospitals.

Erin Epson, CDPH director of Hospital Acquired Infections, was also there to give updates on how CDPH and CDC are handling exposed health care workers, among other things. Below are some of the key take-aways from their experiences.
Read 22 tweets
I wanted to preface future bits of science with some personal perspective. I've been using Twitter as "science blog" for years and was posting observations on #nCoV2019 from Jan 11 (). 1/5
"Science Twitter" is a wonderful place and there has been fantastic dialog between scientists since January (shoutout to @arambaut, @cmyeaton, @K_G_Andersen, @richardneher, @MarionKoopmans, @RELenski, @firefoxx66, @AdamJKucharski, @SRileyIDD, @C_Althaus, @rozeggo). 2/5
My initial dialog with scientists has spiraled somewhat out of control and I now find myself with ~100k followers and rather than a dialog it's become more about reporting / outreach. This is intimidating but I'll do my best to with it. 3/5
Read 5 tweets
One if the reasons we should all do our bit is tgat here in the UK, according to this study:
There is 1 critical care (ICU/IDU) bed per 10,000 people.
There are approximately 65M people living in the UK. None of whom will have immunity to #nCoV2019 (except the tiny fraction that have already been infected).
The estimates for the number of people that could be infected in the first wave of the epidemic is impossible to predict, but let’s take a conservative estimate of 30%. Thats 65M x 0.3 = 19.5M. If it was lower, say 10% then that would be 6.5M
Read 5 tweets
There are several pharmaceutical and Biotech companies working round the clock to develop #covid19 vaccine ... I will shed some light on what’s in pipeline on this thread ... 👇
1- #Favilavir, the first approved coronavirus drug in #China- The National Medical Products Administration of China has approved the use of Favilavir, an anti-viral drug, as a treatment for #coronavirus.
The drug has reportedly shown efficacy in treating the disease with minimal side effects in a clinical trial involving 70 patients. The clinical trial is being conducted in #Shenzhen, Guangdong province. According to Clinicla Trials Arena.
Read 19 tweets
Two Chinese scientists published a now deleted paper on ResearchGate that we were able to retrieve. It claims #COVID2019 / #nCoV2019 may have originated from accidental Wuhan Center of Disease Control and Prevention leakage due to high risk behavior and bad operational security.
We make no assertions about the veracity or validity of the claims in this report, but present it here in full.
Roughly an hour before the paper was published, Chinese state media began talking about the need for stronger biosecurity laws and regulations.
Read 11 tweets
New analysis from me & @mandl suggests that preprints might have driven global discourse about #nCoV2019 (#COVID19) transmissibility prior to the publication of relevant peer-reviewed studies. Find our preprint here […] as well as an explainer thread below!
@mandl Assuming representativeness, we first collected Google search trend interest & MediaCloud news volume data on #nCoV2019 (#COVID19) transmissibility. We then curated relevant studies from Google Scholar & four popular preprint servers. (Discovery specs are noted in our preprint.)
@mandl After plotting search interest & news media volume, we overlaid when each of the relevant studies were published. We found that both search interest & news media RE: the transmissibility potential of #nCoV2019 (#COVID19) peaked before publication of the first peer-reviewed study.
Read 11 tweets
Let's talk seasonality and #covid19 #nCoV2019 #coronavirus.

There is an element of seasonal roulette with emerging viral diseases.

I have previously said #OnHere that China had a stroke of bad luck to have emergence in December, just as the flu season was getting underway.
The reason I mentioned before was that flu competes for space in hospitals, and causes Dx problems.

But there is another reason: flu and *all* respiratory viruses spread more in the wintertime.

Even measles — a rash, but which has respiratory transmission — is winter-dominant.
By emerging at the start of the N Hemisphere winter, the coronavirus #covid19 #nCoV2019 has all the advantages (to it) of the winter season. Not just confusion with flu, but the enhanced transmission that the winter brings to respiratory viruses.
Read 13 tweets
People are still freaking out over "asymptomatic" patients, so here's some info on virus incubation, symptoms, and lab confirmation of #nCoV2019 #coronavirus tests. It's not unusual for patients to test negative (for this or any other virus) in the early days after infection.
When a virus infects a cell, it takes time to replicate itself inside that cell and produce new virus particles. The period of time when a virus is replicating but hasn't yet begun producing new virus particles (called virions) is called the eclipse.
During the eclipse phase, viral RNA (the genetic material of the virus) and proteins are produced in cells. Proteins are involved in replicating the virus, hijacking host cell functions, evading immunity, and making the virus "shell" (capsid/structural proteins).
Read 21 tweets
SUPPLY CHAIN IN PERIL: according to the Chinese record, the human paradigm flip flops during a #GrandSolarMinimum
Dynasties, governments, & aristocracies all collapse setting the stage for massive upheaval. The supply chain is the first to go during this time.
Read here for an in-depth outline of what the #GrandSolarMinimum is and what is in store for us as I reflect on the historical record for scientific evidence.…
Big government is staking it's claim to retain power.

In preparation for this cosmic event, the CCP know their stooge, Xi, will be at risk. They set him up for lifetime rule.…
Read 9 tweets

An der Findung eines Maskierungsmechanismus für due Eindringproteine des CoronaVirus wurde gezielt geforscht.

#nCoV2019 ist eine Biowaffe, im Rohr gezündet
"Die 5'-Endkappenstruktur der eukaryotischen mRNA hat wichtige Auswirkungen auf die RNA-Stabilität, das Prä-mRNA-Spleißen, den mRNA-Export und die Kernproteintranslation. "
Unroll please
Read 3 tweets
One of the most important unknowns in the #nCoV2019 epidemic is the total number of _infections_ as opposed to _cases_, as there may be many mild infections that do not rise to case definition. I sought to address this with phylodynamic methods here:… 1/9
Here, I started by following @arambaut's work (…) and set up to estimate viral population dynamics from sequence data alone. 2/9
@arambaut This measures how quickly observed genomes share ancestry to estimate the rate of exponential growth, arriving at an estimated doubling time of 7.2 days (95% CI 5.0-12.9), inline with previous modeling estimates from case data. 3/9
Read 9 tweets
Aerosol transmission of #nCoV2019 is confirmed. So this means in a practical sense that #CoronaVirus cannot be stopped—it WILL burn through the global population regardless.

So here are some ideas on preparing for the consequences.

At this time, there is a 4.3% mortality rate for the severely infected—JAMA published a recent retrospective and came to that figure. Such a high MR will lead to widespread panic, which will lead to social breakdown, including breakdowns in supply chains and infrastructure.

Obviously, there will be waves of infection. Where you are living might be disease-free now. But when it hits, everyone in your area will be sick—and panic—at the same time. So local medical infrastructure will be overwhelmed when you and/or your family get sick.

Read 10 tweets
Como ciudadano, el coronavirus me parece mucho más preocupante de lo que percibo en la gente de mi entorno aquí en España (2 casos a 9/2/20).

Abro hilo sobre lo que estoy leyendo estos días de epidemiólogos y científicos expertos en la materia:
Esta entrevista del 5/02 al profesor @neil_ferguson, director del J-IDEA (de @imperialcollege) alerta de que:

- los casos en China se están infraestimando por valor de x10
- resto del mundo x4
- hay 50.000 nuevos infectados diarios, cifra que se duplica cada 5 días
@neil_ferguson @imperialcollege . @HelenBranswell destaca las cifras de muertos e infectados totales del #2019nCoV frente al SARS (2002-2003) y MERS (2012-actualidad):

- en un mes ya hay más muertos por el nuevo coronavirus
- la tasa de infección es muy superior
Read 22 tweets
Starting a new thread on the unfolding research picture on #2019nCoV as the outbreak enters its 2nd month

This thread compiles scientific data (w links) on what we know so far on #nCoV2019

Note: Only scientifically sound research articles included
You can see the major research from the first month of #2019nCoV outbreak at this thread:

Or in this thread roll #nCoV2019 :…
1\ In a case-series of 138 hospitalized #2019nCoV patients in Wuhan, presenting symptoms included fever (99%), fatigue (67%), dry cough (60%). 10% initially developed diarrhoea & nausea. 41% were presumed nosocomial infection inc 40 (29%) medical staff.…
Read 33 tweets
Assuming that these 17,000 cases are representative of those who have sought care for #nCoV2019 in China so far, it seems plausible to me that the true % of mild *illness* (including those with symptoms so mild that they don’t warrant care-seeking) may be even higher yet. [1/2]
After all, it seems that most of the cases outside of China have been mild to date. I doubt that all of these cases would’ve sought care for their symptoms; instead, they were identified due to heightened international surveillance following the initial outbreak in Wuhan. [2/2]
PS: The epidemiological vocabulary choices here are intentional. Not all instances of illness are considered cases. Only those who *seek* care for their illness (on their own) — or are positively identified and *enrolled* in care (via surveillance efforts) — are considered cases.
Read 3 tweets
Insight into the spatial behavior of epidemics from @ohallats and colleagues. An initial outbreak will grow in its highly connected environment and subsequently seed outbreaks in other locations. These other outbreaks resemble a transposed copy of the first. 1/4
@ohallats #nCoV2019 in Wuhan went from an index case in ~Nov 2019 to several thousand cases by mid-Jan 2020, thus going from initial seeding event to widespread local transmission in the span of ~10 weeks. 2/4
@ohallats We believe that international seeding events started to occur in mid-Jan. Thus we have a critical ~10 weeks from then to late-March to contain these nascent outbreaks before they become sizable. 3/4
Read 4 tweets
The Shanghai government just announced some terrible news
The #Coronavirus IS airborne. It can be spread through the air EVEN if the infected person isn't present

Previously many doctors advice was to maintain a 1-2m distance and not wear a mask. This advice is now useless! 1/n
The virus particles bond with oxygen particles in the air and remain stable and float even after the infected person leaves. Entering this room and breathing these particles in will infect you. 2/n
These virus particles can come from someones spit, fecal matter, and other sorts of bodily fluid discharge.

N95 masks with a respirator are more important than ever now!

#nCoV2019 #coronaviruschina
Read 13 tweets

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