The virus. PPE. Part 1

[Donnie]

https://www.businessinsider.com/wuhan-coronavirus-symptoms-24-days-after-infection-2020-2?r=US&IR=T

?? - has this found to be wrong now?

If you read the article it explains why it was probably never right.

Exactly.

14 days is a rule of thumb and a guide, rather than an absolute time limit, so the incubation period *could* be longer.

As with all these measures, there is an attempt to balance between prevention and cost/penalty. The disease could be prevented from spreading by simply ordering the entire population to remain at home for 5 weeks, but in that time the nation would collapse. 14 days is a good general estimate for many diseases.

Oh, so the science that says 2-14 days is wrong then, I'll ignore the advice from reliable sources I guess? "14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

 

[sphexx]

Exactly.



Oh, so the science that says 2-14 days is wrong then, I'll ignore the advice from reliable sources I guess? "14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

Think of it like the ’sunny 16‘ rule, rough guide that works most of the time and a sound basis to vary from with experience ... or something like that .

 

[Bobsyeruncle]

Exactly.



Oh, so the science that says 2-14 days is wrong then, I'll ignore the advice from reliable sources I guess? "14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

From the W.H O. Website
The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. These estimates will be updated as more data become available.

 

[ancient_mariner]

Oh, so the science that says 2-14 days is wrong then, I'll ignore the advice from reliable sources I guess? "14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

Which particular science was that?

 

[Peter10d]

Could this end up being the longest thread TP has had or do people think in a few weeks or months we will be talking about cameras and lenses again.

 

[DK602]

Which particular science was that?

I'm getting confused ( I know most would agree!)

..........but earlier you said this in response to my post:

Umm actually 2-14days is the incubation period, there is no "or more"

Yet the article says it can be more & you are now just saying it's a generalisation?

 

[sphexx]

Could this end up being the longest thread TP has had or do people think in a few weeks or months we will be talking about cameras and lenses again.

It’s only one thread, there are others and some of the posts (not mine) have been very informative.

 

[simon ess]

I'm getting confused ( I know most would agree!)

..........but earlier you said this in response to my post:



Yet the article says it can be more & you are now just saying it's a generalisation?

You must surely see that you're quoting two different people there.

Surely.

 

[sphexx]

You must surely see that you're quoting two different people there.

Surely.

Who, who? You are not quoting anybody but you post follows mine!

 

[simon ess]

Who, who

I've quoted them in my post. Can't you see it?

 

[DK602]

You must surely see that you're quoting two different people there.

Surely.

It is difficult at times!

The post I have quoted from @ancient_mariner is responding to which contributor?

..........and then I have quoted an earlier post from the same person that @ancient_mariner has replied to.

 

[sphexx]

I've quoted them in my post. Can't you see it?

Ah, sorry no, I expect you’re replying to the troll who I’ve put on ignore. I’ve never ignored someone before so I’m not familiar with how it works . Grovelling apology .

 

[simon ess]

@DK602

You're a troll pal.

End of.

 

[DK602]

@DK602

You're a troll pal.

End of.

Resorted to insults...................oh dear!

I don't see how trying to confirm an incubation period is being a troll?

I am not trying to argue with @Donnie just asking for confirmation of earlier statements.

 

[Donnie]

From the W.H O. Website
The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. These estimates will be updated as more data become available.

You beat me to it. yes, World Health Organisation, Public Health England and other actual health sources, not facebook twitter or other unreliable sources.

Also, just on a practical point, why do you think that the self isolation time period is 14 days???

 

[Donnie]

I'm getting confused ( I know most would agree!)

..........but earlier you said this in response to my post:

Umm actually 2-14days is the incubation period, there is no "or more".

Yet the article says it can be more & you are now just saying it's a generalisation?

You are deliberately or ignorantly mixing up the posts. I did not say that the incubation "or more" is a generalisation. My generalisation comment in full is below and still stands.

"14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

Resorted to insults...................oh dear!

I don't see how trying to confirm an incubation period is being a troll?

I am not trying to argue with @Donnie just asking for confirmation of earlier statements.

Whether you are genuinely just asking for confirmation then a) try quoting the correct posts and not deliberately or otherwise making it look like Im saying something Im not and b) reevaluate how you are communicating to people as the impression you are making certainly supports the views of those that are accusing you of being a troll.

 

[DK602]

Apologies @Donnie.

I earlier posted this comment:

Considering it can take 14 days or more to become symptomatic .......................

and you replied with this:

Umm actually 2-14days is the incubation period, there is no "or more". ...............

The article I linked to indicated that there could be a longer 'incubation period'; is this wrong?

Hope this helps clear any confusion?

 

[Donnie]

Yes essentially it is as the who and phe say either 1-14 or 2-14 with most exhibiting symptoms on day 5. I really don't recommend taking medical advice from businessinsider.com or similar to be quite honest.

 

[Bobsyeruncle]

Yes essentially it is as the who and phe say either 1-14 or 2-14 with most exhibiting symptoms on day 5. I really don't recommend taking medical advice from businessinsider.com or similar to be quite honest.

But they say "estimates" so does that not mean it could be longer ?

 

[Donnie]

Ive worked in the NHS long enough to know the "cover your arse just in case" language which has over about 20 years taken lessons from politics. It's the same as dettol saying 99.999999% of all known germs.
Look, honestly, if there was a chance of the "or more" all those being isolated coming back from cruise ships etc where there are definite cases wouldn't be isolated for 14 days only.

 

[Retune]

If you read the article it explains why it was probably never right.

The odd '0-24' days incubation period range that the 24 day claim seems to be based only appears in the medRxiv preprint version of Guan et al: 'Clinical characteristics of 2019 novel coronavirus infection in China'. In the published version in NEJM they quote an interquartile range (2-7 days) instead, and they revise up the median estimate from 3 to 4 days, based on a subset of cases where they had a clearer idea of when the exposure took place. They also define incubation period in terms of the 'potential earliest date of contact of the transmission source', which may not be the true incubation period because the patient might not have been infected at the earliest opportunity (if there was more than one contact, or contact was continuous). It's also notable that (as far as I can tell from the way they present their data) everyone was either living in Wuhan, or had visited Wuhan, or had contact with someone from Wuhan within the previous 14 days. Although you can't rule out a long incubation period from this data set (viruses do unexpected things all the time) there's no clear evidence of it in the published study. For that, you'd need a case where you had a clear contact and could rule out any subsequent contact (i.e., a patient who had been quarantined for, say, 24 days before the onset of disease).

 

[DK602]

Ive worked in the NHS long enough to know the "cover your arse just in case" language which has over about 20 years taken lessons from politics. It's the same as dettol saying 99.999999% of all known germs.
Look, honestly, if there was a chance of the "or more" all those being isolated coming back from cruise ships etc where there are definite cases wouldn't be isolated for 14 days only.

Isn't the isolation a waste of resources and money though?

If we have no immunity to it then the isolation only slows the spread?

Would it not be better asking the people to self isolate and keep the resources treating other NHS demands?

 

[Donnie]

Isn't the isolation a waste of resources and money though?

If we have no immunity to it then the isolation only slows the spread?

Would it not be better asking the people to self isolate and keep the resources treating other NHS demands?

It's not a waste if we are talking of those that are definitely positive or have been in close contact with a positive case. Self isolation is only for those that are well and have returned from somewhere where the risk is higher.

as for slowing the spread, it is a good thing to do that so we don't have all NHS resources being completely overwhelmed which in itself will increase the likelyhood of deaths.

 

[redsnappa]

There will be many people who have the virus but because of their good immune system they will not show any symptoms of infection but they will be carriers and will go on to infect others.

 

[Donnie]

There will be many people who have the virus but because of their good immune system they will not show any symptoms of infection but they will be carriers and will go on to infect others.

How do you know this?

 

[DK602]

It's not a waste if we are talking of those that are definitely positive or have been in close contact with a positive case. Self isolation is only for those that are well and have returned from somewhere where the risk is higher.

as for slowing the spread, it is a good thing to do that so we don't have all NHS resources being completely overwhelmed which in itself will increase the likelyhood of deaths.

Don't want to be seen to cause arguments but just discussion:

We have no cure for this (at the moment) so I don't see why hard pressed NHS workers should be involved in this quarantine - sure the army would be better placed?

 

[arclight]

There will be many people who have the virus but because of their good immune system they will not show any symptoms of infection but they will be carriers and will go on to infect others.

Yes, indeed, I have heard that from numerous medical men in the last few weeks. No later than this morning on LBC there was a virologist who said that very thing. He also stated that on average someone infected with flu would infect 1 other person, but someone infected with Covid 19 could be expected to infect 3 other people. The higher Covid 19 infection rate is attributable to it being more virulent.

Been a bad day in Italy. 1300 more people have found to be infected. The current total is 7375 of which 366 have died. That is a 5% fatality rate which is way above what is anticipated for Covid 19. Gov. has been too slow in imposing the quarantine.

 

[Retune]

How do you know this?

Virus production in the respiratory tract comparable to that seen in symptomatic cases has been demonstrated in a patient who never developed symptoms. Other patients who later become symptomatic have also been shown to produce significant amounts of virus late in the incubation period. Whether the virus can be transmitted efficiently from asymptomatic patients (who presumably aren't coughing) is less clear.

 

[Donnie]

How do you know this?

Yes, indeed, I have heard that from numerous medical men in the last few weeks. No later than this morning on LBC there was a virologist who said that very thing. He also stated that on average someone infected with flu would infect 1 other person, but someone infected with Covid 19 could be expected to infect 3 other people. The higher Covid 19 infection rate is attributable to it being more virulent.

Been a bad day in Italy. 1300 more people have found to be infected. The current total is 7375 of which 366 have died. That is a 5% fatality rate which is way above what is anticipated for Covid 19. Gov. has been too slow in imposing the quarantine.

I can see where the figures for flu infecting 1 other may come from but covid 19 is so new that I do wonder where the 3 figure comes from as Ive not seen that theres enough evidence out there yet to attribute that as a fact.

Virus production in the respiratory tract comparable to that seen in symptomatic cases has been demonstrated in a patient who never developed symptoms. Other patients who later become symptomatic have also been shown to produce significant amounts of virus late in the incubation period. Whether the virus can be transmitted efficiently from asymptomatic patients (who presumably aren't coughing) is less clear.

Indeed, and therein lies my point about the quote from redsnappa ie

There will be many people who have the virus but because of their good immune system they will not show any symptoms of infection but they will be carriers and will go on to infect others.

"many people" "because of their good immune system" "will go on to infect others" The first 2 cannot be quantified and there is no attempt to do so on the WHO or PHE sites and is hence pure speculation, the third as you say above @Retune "Whether the virus can be transmitted efficiently from asymptomatic patients (who presumably aren't coughing) is less clear."

 

[Donnie]

It's not a waste if we are talking of those that are definitely positive or have been in close contact with a positive case. Self isolation is only for those that are well and have returned from somewhere where the risk is higher.

as for slowing the spread, it is a good thing to do that so we don't have all NHS resources being completely overwhelmed which in itself will increase the likelyhood of deaths.

Don't want to be seen to cause arguments but just discussion:

We have no cure for this (at the moment) so I don't see why hard pressed NHS workers should be involved in this quarantine - sure the army would be better placed?

Im not sure I understand where you are coming from to be honest. NHS is there to care for the ill but also have a preventative health protection role. Im not sure what role you are thinking for the army?

 

[DK602]

Im not sure I understand where you are coming from to be honest. NHS is there to care for the ill but also have a preventative health protection role. Im not sure what role you are thinking for the army?

My views on quarantine is it is just the same as imprisoning someone especially if we have no cure. The army have extremely well trained medical staff and this virus could easily overwhelm the NHS.

There are still many other critical cases happening everyday that will still require medical help from the NHS (heart attacks etc.)

 

[Donnie]

My views on quarantine is it is just the same as imprisoning someone especially if we have no cure. The army have extremely well trained medical staff and this virus could easily overwhelm the NHS.

There are still many other critical cases happening everyday that will still require medical help from the NHS (heart attacks etc.)

Ah I see now what you meant. Yes indeed the NHS still has to carry on and part of the plans are to move into the delay phase to help ease those pressures which will include cancelling of operations, clinics and other non urgent appointments to help deal with it. Also, the self isolating plan helps to reduce this pressure by spreading it over a longer period of time than if we simply let everyone catch it in a short time as then there would be a huge spike in those needing hospital admission.

For the worst cases requiring ICU beds / ventilators. I saw an NHS spokesman saying that there are plans in place to open extra wards for those requiring ventilators etc should the need arise but having worked in the NHS including intensive care I know there are not a hundred plus ventilators sat around waiting to be used and if somehow enough ventilators did become available, where will you get the nurses?

As for the army, yes they may be of some help but there are only about 11,000 nurses in the army I believe vs the 660,000 in the NHS and to be fair, the army need their nurses for the army in the first instance if you see what I mean?

 

[Retune]

I can see where the figures for flu infecting 1 other may come from but covid 19 is so new that I do wonder where the 3 figure comes from as Ive not seen that theres enough evidence out there yet to attribute that as a fact.

Well, it's an estimate rather than a fact, and the number you get depends on the mathematical model, your data set and assumptions. But there's now quite a lot of data from China and elsewhere, and several studies have attempted to pin down a value for 'R0', with most estimates in the 2-3 range - see for example Table 1 in this paper:

https://www.mdpi.com/2077-0383/9/2/571

 

[ancient_mariner]

Oh, so the science that says 2-14 days is wrong then, I'll ignore the advice from reliable sources I guess? "14 days is a good general estimate for many diseases" - Do you realise how much of a generalisation that is?

Ive worked in the NHS long enough to know the "cover your arse just in case" language which has over about 20 years taken lessons from politics. It's the same as dettol saying 99.999999% of all known germs.
Look, honestly, if there was a chance of the "or more" all those being isolated coming back from cruise ships etc where there are definite cases wouldn't be isolated for 14 days only.

So is science you are citing for this is your experience, or are you able to refer me to any published data confirming that this particular disease definitively never has an incubation period longer than 14 days?

FWIW yes, I knew how much of a generalisation that was.

 

[Donnie]

Well, it's an estimate rather than a fact, and the number you get depends on the mathematical model, your data set and assumptions. But there's now quite a lot of data from China and elsewhere, and several studies have attempted to pin down a value for 'R0', with most estimates in the 2-3 range - see for example Table 1 in this paper:

https://www.mdpi.com/2077-0383/9/2/571

Interesting, there's a lot of assumptions but it's a fairly consistent 3(ish) based on the data thus far and is quite high if accurate. :-/

 

[Donnie]

So is science you are citing for this is your experience, or are you able to refer me to any published data confirming that this particular disease definitively never has an incubation period longer than 14 days?

Sorry, I don't believe Im clear on what you're asking but you seem to be asking if the science Im citing (2-14 days) is based on my experience? But Ive already said that is information from WHO and PHE?

Ive worked in the NHS long enough to know the "cover your arse just in case" language which has over about 20 years taken lessons from politics. It's the same as dettol saying 99.999999% of all known germs.
Look, honestly, if there was a chance of the "or more" all those being isolated coming back from cruise ships etc where there are definite cases wouldn't be isolated for 14 days only.

(edit to include this quote you were referring to for clarity)

Also, you seem to want me to point you to published data confirming COVID-19 never has an incubation period of longer than 14 days? I think thats like looking for data on the 0.000000001% of bacteria dettol doesn't kill? It's akin to trying to prove something doesn't exist just because you believe it.

 

[ancient_mariner]

Sorry, I don't believe Im clear on what you're asking but you seem to be asking if the science Im citing (2-14 days) is based on my experience? But Ive already said that is information from WHO and PHE?

Also, you seem to want me to point you to published data confirming COVID-19 never has an incubation period of longer than 14 days? I think thats like looking for data on the 0.000000001% of bacteria dettol doesn't kill? It's akin to trying to prove something doesn't exist just because you believe it.

No, I'm not really asking you anything. You suggested the 14 day period was plenty (backside covering) because of your experience. The point is that there's still quite a lot of unknowns about this infection, and it's a very confident person who states that the 14 day period is absolutely, definitely 99.999999% certainly enough. 14 days is a good period, and most likely IS enough in most cases, but may not be enough in every case.

 

[Donnie]

No, I'm not really asking you anything. You suggested the 14 day period was plenty (backside covering) because of your experience. The point is that there's still quite a lot of unknowns about this infection, and it's a very confident person who states that the 14 day period is absolutely, definitely 99.999999% certainly enough. 14 days is a good period, and most likely IS enough in most cases, but may not be enough in every case.

Ah, ok I see. The backside covering bit is indeed down to experience but you've inaccurately attributed the 14 days being plenty to my comment. The comment was in fact pointed at the above 14 day ie the "or more". The 14 days is likely based on many years of medical data including influenza outbreaks, the SARS epidemic etc and modelling to take account of initial cases, rate of spread, even the weather. But you yourself take the view of it being most likely enough in most cases, but may not be for every case which only reinforces my comments about backside covering.

 

[sphexx]

Ah, ok I see. The backside covering bit is indeed down to experience but you've inaccurately attributed the 14 days being plenty to my comment. The comment was in fact pointed at the above 14 day ie the "or more". The 14 days is likely based on many years of medical data including influenza outbreaks, the SARS epidemic etc and modelling to take account of initial cases, rate of spread, even the weather. But you yourself take the view of it being most likely enough in most cases, but may not be for every case which only reinforces my comments about backside covering.

I can’t see saying that 14 days is best estimate but given the novel nature of this virus, it could incubate for longer, is backside covering, it’s just a statement of the obvious IMNVHO . I think that you may have a different , understandable, meaning for backside covering (ie in NHS) than ordinary mortals .

 

[Donnie]

I can’t see saying that 14 days is best estimate but given the novel nature of this virus, it could incubate for longer, is backside covering, it’s just a statement of the obvious IMNVHO . I think that you may have a different , understandable, meaning for backside covering (ie in NHS) than ordinary mortals .

14 days as an estimate of what? the range is 1 or 2 to 14 days. Again I'll point out that all (reliable) advice and treatment ie isolation precautions is 14 days, not "14 or so" days.