COVID - 19 Friday update 28 Feb

well good morning welcome back now today is Friday the 28th of February think of got it right today 2020 now just before I do some interesting developments about the the covered 19 virus I know there's people joining this video new so I'm going to start doing a bit of background at the start before we do any developments now the first thing I want to say this morning is that someone who has got influenza on average each infected person with influenza is probably going to infect about 1.4 or 1.5 other people in epidemiology this is called the R nought value and it shows how transmissible the disease is so an average every person who's got flu is going to infect 1.5 other people now with coffered 19 that's higher it's probably 2.6 or even even as much as 3 so it seems to be spreading more rapidly than influenza which of course is a massive concern and it is what we're starting to see at the moment now something else that concerns me about this virus is it seems to persist on surfaces so if someone can breathe that out cough it out sneeze it out droplets onto a surface you can touch it with your hand and you can catch it from your hand that's why hand hygiene is so important with this virus now the clinical presentation is somewhat similar to influenza with fever achiness achy muscles all your muscles seem to achy just generally achy fever and dry cough is often a characteristic feature of this of this virus that covered 19 virus but in very many ways it's very similar to flu seasonal influenza now if there is a pandemic of this condition and we're going to be looking at this in a minute then perhaps 30 percent of the world's population would be infected in the first year of the infection if there is a pandemic 30 percent of the world's population now the death rate from this condition we've looked at quite a few different figures in these videos over the past good few weeks now but if you're asking me to sort of make an informed guesstimate which is an appalling thing to do with death rates but the death rate seemed to be about 0.1 to 1 percent overall it's more likely that you're going to die if you're older and if you have other comorbidities other diseases but the death rate massively massively depends on the quality of medical care you receive with good medical care the death rate is going to be much lower without medical care we can expect the death rate to be much higher so its death rate nought point 5 to 1% I'm not going to accept bets or quotes on that but but I am definitely saying it depends on the quality of the health care that you get now another characteristic of this virus is infection occurs early people become infectious early after they've been infected so it may be as little as 12 hours to 24 hours so if someone catches the virus and 12 to 24 hours after that they can be coughing the virus out shedding the virus potentially infecting other people now this is different from SARS is different from MERS this early infection way before the pin fected person has symptoms it's pre-symptomatic spread seems to be happening and they probably remain infectious for up to 14 days on some rare occasions more but 10 to 14 days is probably about the average time that people remain infectious and around about the median incubation period from when someone first gets the infection to when they first get clinical features is probably about seven days now it can be two days can be 14 days there are odd cases of it being more than 20 days but these are these seem to be unusual so we expect the incubation period the median to be around about 7 days now I get asked lots about reinfection now it seems that the genetics of this virus is probably relatively stable at least compared to an influenza so that means if the genetics are stable the protein characteristics of the outside of the virus will be relatively stable as well and that means once your immune system has learned to recognize it it should recognize it the next time if you re infected so this should mean that people are not going to be reinfected with this virus it should mean this now there are cases of people claiming to be reinfected and a big fuss is made about those that someone had the virus they got rid of it then they got it again raising the possibility of reinfection but from what we know about the genetics of the virus it's looking like reinfection is not going to be a big problem at the moment of course no one's got a crystal ball we don't know this is a new virus it's a novel coronavirus we're learning about it as we go along but so far it's looking like the genetics are fairly stable MERS and SARS for example remain fairly stable we weren't getting big mutations because if you get big mutations changes the protein of the virus then you could become reinfected because the immune system no longer recognizes the virus that you were infected with this is what happens you get infected with the virus that's the antigen then your body makes the antibody to it the immune protein the antibody kills the kills the virus and that's how you get better though that's what not as hopefully get better that's what normally happens and then the antibody persists and the white cells that know how to make the antibody persist in the in the in the blood so people should not get reinfected with this virus that's that's the current best thinking because it seems relatively stable so I'll get emails all the time about I've heard about the case of every infection as we as far as we know now we think people are going to be immune when they've had it but of course new evidence is coming in all the time so that's a bit of a background about this about this virus now we move on to today's developments [Music] it's now in covered 19 News tried to twenty-eighth 50 countries they spread to 50 countries now now what are the World Health Organization's saying about this more new cases in the rest of the world than in China so there's now more new cases in the rest of the world than are occurring in China largely because China is implementing excellent shut down facilities and people are being quarantined and the Chinese population is very disciplined and able to comply with that the World Health Organization say this is a decisive moment and the virus can still be I've got maintained now that should be contained so the virus can still be contained this is what the WHI was saying it can be contained and the wh are saying it's not yet a pandemic but the whu-oh is saying the virus has pandemic potential and as we've said globally there was 548 new cases yesterday more new cases in the rest of the world than in China so the World Health Organization is calling on countries to be prepared with the right measures the World Health Organization tell us the virus can be contained now I agree with the World Health Organization on this with the right measures but we know that very often the right measures are not being taken and to be fair I think the right measures would be really quite draconian at this stage and they are not being taken everywhere base for sure you've got to bear in mind the English guilty of understatement whi risk assessment for region and world is high and for China it's is very high so that's the World Health Organization assessment of that now moving on to individual countries South Korea 427 new cases diagnosed on Friday that is a lot two thousand three hundred and thirty seven confirmed cases in South Korea and these are accurate figures I hundred believe 13 deaths in South Korea there's widespread community transmission so this is being spread from one person to another probably very often via these asymptomatic or pre-symptomatic carriers it's only 29 days since the first case in South Korea on the 20th of January so this gives us an idea of what we can expect in a country that's not previously had the virus with reasonably good containment measures that South Korea has with an advanced healthcare system as South Korea has in 29 days so just kind of relate these two figures in your mind that's kind of what we're looking at countries without such good containment without such a good health care of South Korea may not fare as well the South Korean government made money available money is being spent where it's needed 50 countries are restricting entry to people from South Korea some with an outright ban now I saw us on the news this morning in South Korea they have these drive-through tests so what we don't want is people going into hospital sitting in busy a-anyway to A&E waiting rooms spreading the virus we don't want people go into busy GP surgeries coughing on all the other people that are waiting to see the doctor so exactly what we don't want we don't want institutional spread we don't want to in hospitals so the South Koreans are having a drive through so the person sits in the car someone does the breathing rate the heart rate all that kind of stuff and then if you want to they get tested and the results are back in two days and in the meantime they're told to self quarantine self isolate at home while they're waiting for the results so I think you have to say that the testing in South Korea is is it the most advanced stage of any country in the world I'm very impressed yeah but yet still we have these two these two numbers which is a massive concern now Japan new cases no total cases that's the total all schools are closed from next weeks of Japan are going to close all schools now Iran a country that I am massively concerned about we looked yesterday at why there was huge delay where they're grieving and with ceremonies going on Iran and anniversaries of the Iranian Islamic Republic going on massive public meetings and elections kind of a triple whammy there in Iran that got this thing going now officially this 270 confirmed cases 28 deaths let's say it's probably more than that I've heard there was a death due to coronavirus on a night shift in this hospital and another thing that's been really concerning me about Iran is the high death rate I've been getting reports of death rates which were probably 5% or more appallingly high death rate now part of this is people can have difficulty accessing health care infrastructure but I've also been told that very often in Iran for these sorts of things they're using corticosteroids now corticosteroids should only be used by doctors who really know what they're doing and it sounds like in around there may be an overuse of corticosteroids but I put a question mark there because that's just from one one report but if people I've been given corticosteroids that would suppress the inflammatory response it would suppress the immune system and could be one of the explanations in combination with reduced availability of medical care why the case fatality rate in Iran is disturbingly high I had thought it might be due to a mutation of the virus but given the new data I've read in the past 24 hours about the relative genetic stability of the virus I'm very very hopeful that that is not the case I think what this does show the high death rate in Iran show how important our response to the viruses how important medical facilities are and how important it is not to give the wrong drugs schools and universities are closed in large parts of Iran as far as I know at the meet moment most events are canceled now Friday prayers this is massive for a run you know anything about the Islamic culture Friday prayers have been canceled in 23 cities that is that is a huge step to take now the religious authorities encourage people to visit shrines in Combe which was the epicenter of this outbreak and my understanding is large crowds are still visiting religious centers in in Combe and with the religious shrines in Koopman other places and I believe they're being told this because these religious shrines have healing powers so people are congregating there I understand in very large crowded numbers more reports about infections in prison located in two places there in Iran now New Zealand has got a case that as far as I know it's someone who traveled from around to New Zealand so New Zealand got its first case Italy the European epicenter of the outbreak number of confirmed cases rise five deaths on Thursday now the super spreader sometimes at the start of epidemics there can be super spreaders or in fact many people now the Italian epidemiologist now seem to believe that this was this was someone who had not been to China an Italian had not been to China and this man woman I don't know had been feeling ill since the 14th of February diagnosed on the 20th of February sent home from hospital with flu medications because my understanding there as the doctor said you can't have covered 19 because you haven't been to China so what they're saying now is it probably been in contact with someone who'd been to China so you know quite a few people had so this guy who seems to be the super spreader had reported to health authorities was discharged given anti viral flu medication and presumably went on in spreading the covered 19 virus now I'm not I'm not criticizing anyone here I'm just reporting what I understand it it's easy to be wise after the event I understand the Pope is being tested after shaking hands I think with people from Iran I'm not sure about that but the Pope is unwell and being tested in Vatican City presumably unknown cases are ceding other areas and countries so pre-symptomatic people from Italy are seeding other areas of Italy and seeding other countries I believe because of this pre-symptomatic transmission Israel traveler from Italy has been confirmed and there's another confirmed case I believe in Israel bringing their total t2 now the u.s. 60 confirmed cases and there does appear to be cases without any epidemiological link to China so unfortunately the solution looks like community spread is probably starting in parts of the u.s. tenerife the people isolated in the hotel the jet air two airlines refusing to fly people home unless they test negative so quite what's going to happen to those people there I don't know I know some are choosing to self isolate in their rooms not mixing with other guests I'm just hoping the infection does not spread around that hotel I believe is in Santa Cruz in Tenerife official cases in Spain in total cost Tenerife is part of Spain is 25 now Saudi Arabia this is this is this is interesting the band as far as I understand the band all religious pilgrims this is massive the hundreds do I'm not quite sure when the Hajis Jew Buddhist if the Saudis have banned all religious pilgrims that's just a huge step for Saudi to take and people from infected countries but if refusing any access to all Islamic religious pilgrims that's a huge step now lots of questions about dogs no no I got too excited about this now a dog in Hong Kong apparently whose owner had the virus has been tested what they've described as weak positive now what the heck weak positive means I don't know does sound a bit suspicious to me but the dogs not sick and the Hong Kong veterinary officer has said that dogs can't get it in dogs don't spread E so don't worry about your dog at the moment would seem to be the advice from the Hong Kong veterinary officer I'm looking forward to what weak positive means but as far as we know at the moment there's no evidence that dogs are getting this and there's no evidence that dogs are certainly no evidence that dogs are spreading the disease so carry on being kind to dogs please now China the number of new cases is going down dramatically it has to be said this is impressive it is impressive there was still tragically 44 deaths on Thursday but just to give an example of other communication from Hunan Province 96 million people now apparently they've only got 150 active cases now he says only but it is coming down they've had no new cases for three days and this is why I believe this is why the communities are closed down so people live in their communities their blocks of flats or whatever often associated with the supermarket and they don't leave those communities they are staying put they are not intermingling they're not walking around the city very much they're not talking they're not certain not traveling to other countries they're not traveling to other parts of China and we looked at the situation yesterday in Chen do where this is operating with people having passes to get in and out of their buildings and all sorts of restrictions and people that have been diagnosed with the virus being given the option to be taken to a quarantine center or tape paper tape being put over their door food being delivered and pasta through the window so they are self isolated in a guaranteed way at home and the vast majority of people are complying with that the odd people that are persistently not compliant with that are being removed to quarantine centers which sounds reasonable to me I must say the Chinese are doing a pretty incredible job here in in reducing the R nought very considerably so these people this was in Hunan that they're not allowed to leave I've had emails like this from all over the country showing how well the country is shut down not allowed to move you leave community without an emergency with our an emergency infections getting temperatures getting taken when they go in when they go out all that kind of stuff the infection risk is now described as low and the hope in to open the schools and universities again in one month in Hunan as my report says so the Chinese have taken these amazing measures actually to to isolate the population and reduce the spread and if all the world did this as the w-h-o said this could be contained unfortunately that's not happening everywhere

Channel: Dr. John Campbell

Views: 396,295

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: cmIRMHzBZdU

Length: 21min 1sec (1261 seconds)

Published: Fri Feb 28 2020