COVID-19 the 7th Human Coronavirus

Follow Marin Events

• HomeUpCOVID-19 the 7th Human CoronavirusBenefits of Water FlouridationEye Glasses MonopolySweeteners and their Glycemic IndexScarce evidence that Vitamins workCalifornia Single-Payer Healthcare BillVaccinationMosquitos & West Nile VirusQUACK WATCH PORTALThe 90+ Study on AGINGFake Olive OilCarcinogenicity of EMFBottled Water ConMarijuana  vs AlcoholWhat is a Root CanalEat to Live & Live for something ElseFibromyalgia and Chronic Fatigue Syndrome •
• H1N1 Flu Pandemic 2009Covid-19 sparing kids but killing the elderlyHow COVID-19 KillsWe’re not going back to normalDrug Trials for COVIDDrugs that may Treat COVID-19COVID19 News CA & MarinOxygen instead of VentilatorA Trump fireside chat •

 
Model As of April
8th from U Washington source (Deaths by Aug 4th - Assuming full social distancing through May 2020)

  Deaths per 100k  Deaths by  Aug 4th Invasive ventilators needed Peak ICU Bed shortage Peak Bed shortage ICU beds available Beds available Peak STAY AT HOME Order Educational facilities closed Non-essential services closed Travel severely limited
USA   60,415 16,524 *9,047 *15,852     11-Apr        
UK   66,314 20,862 23,745 85,029 799 17,765 17-Apr 23-Mar 23-Mar 20-Mar no
New York 4 13,307 5,008 5,173 9,617 718 13,010 8-Apr 22-Mar 18-Mar 20-Mar no
Connecticut 3.9 4,003 1,153 1,258 4,967 99 1,738 21-Apr none 17-Mar 23-Mar no
New Jersey 3.2 5,277 2,189 2,109 5,520 465 7,815 11-Apr 21-Mar 18-Mar 21-Mar no
Massachusetts 3.1 5,625 1,592 1,596 3,180 277 4,848 20-Apr none 17-Mar 24-Mar no
Rhode Island 2.9 848 254 258 676 41 795 25-Apr 28-Mar 16-Mar none no
N. Dakota 1.9 519 117 52 0 86 1,545 21-Apr none 16-Mar none no
Louisiana 1.5 946 341 0 0 477 7,204 4-Apr 23-Mar 16-Mar 22-Mar no
Michigan 1.3 2,103 1,404 372 0 742 10,154 7-Apr 24-Mar 16-Mar 23-Mar no
S Dakota 0.9 189 61 0 0 74 1,805 27-Apr none 16-Mar none no
Florida 0.7 4,357 1,323 0 0 1,695 20,184 21-Apr 3-Apr 17-Mar none no
Washington 0.6 700 149 0 0 341 4,907 2-Apr 23-Mar 13-Mar 25-Mar no
Alabama 0.6 634 228 0 0 474 5,743 20-Apr 4-Apr 19-Mar 28-Mar no
Iowa 0.6 565 159 0 0 246 4,297 27-Apr none 4-Apr none no
Oklahoma 0.6 697 193 0 0 467 5,457 23-Apr none 17-Mar 1-Apr no
Wyoming 0.6 67 26 0 0 44 1,069 29-Apr none 19-Mar none no
Tennessee 0.4 617 211 0 0 629 7,812 17-Apr 2-Apr 20-Mar 30-Mar no
S. Carolina 0.3 470 123 0 0 404 4,679 24-Apr 7-Apr 16-Mar none no
California 0.2 1,611 672 0 0 1,993 26,654 13-Apr 19-Mar 19-Mar 19-Mar no
Texas 0.2 2,042 582 0 0 2,259 28,633 22-Apr 2-Apr 19-Mar none no
Utah 0.2 163 46 0 0 170 2,771 25-Apr none 16-Mar none no

* Peak on April 11 --
1918 flu pandemic killed more people than Alabama could count!  --
Stanford on 1918 Flu: https://virus.stanford.edu/uda/

Results of 2 Different Intervention Combinations.  STUDY Summary, ORIGINAL STUDY(not peer reviewed), We’re not going back to normal  
81% of the populations of both UK and US would be infected, resulting in 510,000 deaths in Great Britain and 2.2 million in the US.
  Demand on intensive care beds would be 30 times greater than the availability, with capacity "exceeded as early as the second week in April".

                   How interventions could impact available Intensive Care Beds. Chart B is a close-up.

Image: Imperial College COVID-19 Response Team

While both strategies pose challenges, the scientists found that SUPPRESSION measures:-

  1. Home Isolation of those with symptoms and others in the household and
  2. Social distancing
  3. Closure of Schools and Universities

 would reduce deaths by half and peak healthcare demands by two-thirds.

But the outbreak would still result in 250,000 deaths in Britain, and 1.1 to 1.2 million in the US, with the 'surge capacity' of intensive care units overwhelmed "at least
8 times greater than the availability".
Even if you set factories to churn out beds and ventilators and all the other facilities and supplies, you’d still need far more nurses and doctors to take care of everyone. We need to train people to assist nurses, and we need to get medical workers out of retirement.

There is no guarantee that initial vaccines will have high efficacy.
Similarly we can have millions of Test Kits available but we don't have enuf Protective Equipment to make those tests.
In the US, after May, 95% will still have not been exposed to this virus ! source

Wouldn't the best approach be to Isolate the Elderly and the Vulnerable for 6 to 9 months and let everyone else carry on as normal ? 
Creating Herd Immunity the fastest
(beyond Doing Nothing).
But our hospitals are so woefully under equipped ( Mar 19)-- too many would STILL die in this first phase because
38 percent of those sick enough to be hospitalized were younger than 55.(preliminary data) -- no doubt with one or more of these pre-existing conditions and they are resistant to isolation.

The Elderly and Vulnerable  must:-

  • Stay at home or keep away from people outdoors and never go anywhere else indoors other than home.

  • Never let anyone IN their home ( talk to visitors thru glass or have them stay 10 feet away from the door, downwind)

  • Shop online for Food Delivery or with neighborhood help (from younger healthy people). Food dropped outside door.

  • Try to avoid being infected at the peak where hospitals may not have enough resources ( beds + ventilators) for everyone.
  • Receive Financial Aid.
     

COVID-19 the 7th Human Coronavirus

March 2020: COVID-19 (Coronavirus) Wuhan, China has already surpassed the death tolls of SARS and MERS, over 3,000 (Mar 9th 2020).

  •  Death Rate China:2.3%, W.H.O.: 3.4%, Italy 6.3% (Mar 9th), S. Korea 0.8% (Mar 12th), Wuhan 5.8%
  • Academics believe that between 25% and 70% of the world will become infected.
  • In China the measure that made the biggest difference was closing down Public Transport.
  • There is no explanation, yet, for the low number of children so far diagnosed with the disease. ( relative to the proportion that get the Flu).
     No children died from SARS and few from MERS !
    Older mice’s fatalities were strongly related to immune systems overreacting to the SARS.
    That’s similar to how humans die of infections from the COVID-19. The aggressive response from their immune system is damaging them, even more than the infection itself !
    In China w
    hen testing people who come in contact with a confirmed case — children seemed to be getting infected at the same rate as adults.
    source Economist and Washington Post

    See Mysteriously sparing kids and killing the elderly
  • There  may be NO long-lasting immunity. We could be in for “Cold, Flu & Covid Seasons”. But The strains of the virus infecting people in the U.S. have only about 4 to 10 genetic variations between the strain that emerged in Wuhan, China.
    "That's a relatively small number of mutations for having passed through a large number of people," , "As of Mar 25th the mutation rate of the virus would suggest that the vaccine developed for it would be a single vaccine, rather than a new vaccine every year like the flu vaccine." source

     
  • New York still doesn’t trust the accuracy of the CDC's test for COVID-19 ! (Mar 2020)

Symptoms

Symptoms for the COVID-19 ( 80% mild or no-symptoms):

  • Fever (83-98%)
  • Cough (46-82%, usually dry)
  • Shortness of breath at onset (31%)
  • Myalgia or fatigue (11-44%)

But symptoms can get worse over several days, rather than quickly like the flu.

The incubation period is 6.4 days after exposure.
(only 2.5% will NOT show symptoms after 11.5 days) 
W.H.O says: Can be transmitted in areas with hot and humid weather

Flu Symptoms: fever* or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, some people may have vomiting and diarrhea, though this is more common in children than adults. 
*
not everyone will have a fever.

Contagion

Contagious for 14 days after showing symptoms? STUDY: The time from infection to onset of symptoms (incubation period) was five days among all but one patient. The average duration of symptoms was eight days, while the length of time patients remained contagious after the end of their symptoms ranged from one to eight days.

STUDY Mar 20:-  
asymptomatic or mild cases combined represent about 40–50% of all infections. “can be highly contagious when they have mild or no symptoms”, 

STUDY Mar 16:- 86% of infections had unobserved symptoms. And per person, these infections were 55% as contagious as observed symptoms infections.
Due to their greater numbers, unobserved symptoms infections were the infection source for 79% of observed symptoms cases.

Undiagnosed COVID-19 — appear to fuel the rapid spread of the disease

Mar 8th:- A new study at medRxiv.org of nine people who contracted the virus in Germany suggests that people are mainly contagious before they have symptoms and in the first week of the disease.
Infectious viruses were isolated from nose and throat swabs and  phlegm samples during that first week.
Patients produced thousands to millions of viruses in their noses and throats, about 1,000 times as much virus as produced in SARS patients which explain why
COVID-19 is so infectious.
When you are mildly ill or just getting sick, you’re putting out a whole lot of virus.
After about 10 days or so, you’re not likely to be infecting other people.

even though children typically only exhibit mild symptoms if infected, they can shed the coronavirus long after symptoms disappear.

COVID-19 will infect 2.5 people on average compared with 1.5 for the Flu.   ---- 
three times as infectious as flu

Immunity

One study conducted by Taiwanese researchers found that survivors of the SARS had antibodies that lasted for up to three years—suggesting immunity. Survivors of MERS were found to last just around a year.
The degree of immunity could also differ from person to person depending on the strength of the patient’s antibody response.
Younger, healthier people will likely generate a more robust antibody response, giving them more protection against the virus in future.

What are possible complications from COVID-19?

The most serious complication of COVID-19 is a type of pneumonia that’s been called 2019 novel coronavirus-infected pneumonia (NCIP).
Results from a 2020 studyTrusted Source of 138 people admitted into hospitals in Wuhan, China with NCIP found that 26% of those admitted had severe cases and needed to be treated in the intensive care unit (ICU).
About 4.3% of these people who were admitted to the ICU died from this type of pneumonia.
So far, NCIP is the only complication specifically linked to the 2019 coronavirus.
W.H.O says - Even if you've been PCV13 Pneumonia vaccinated it will make no difference. 

Other complications (source):

Feb 11th: China CDC’s analysis of 44,672 patients (more than 36,000 — or 81 percent — were mild) found that this was the fatality rate in patients who reported:-

  •   0.9% - no other health conditions
  • 10.5% - cardiovascular disease 
  •   7.3% - diabetes 
  •   6.3%  - chronic respiratory diseases such as COPD
  •   6.0%  - hypertension
  •   5.6%  - cancer
  •   2.6%  - missing?

 Some of the most serious symptoms of Covid-19 result from an immune system on the rampage.
Chinese scientists found: An extreme immune response called cytokine storm, a flood of immune cells and the biochemicals they produce,
tears through lung tissue.
(Possible Treatment: anakinra, a cytokine-targeting therapy)
see
How COVID-19 can kill
see
TABLE 1
source StatNews
source ChinaCDC:

A couple of deadly Human Coronaviruses:-

  1. SARS (Severe Acute Respiratory Syndrome.)
    Nov 2002 Guangdong province in southern China.
    8,098 people were infected, and 774 died. It spread to 24 countries.
    Death Rate: 9.5%

    Declared Under Control and stamped out, in 6 months,(July 2003) by
    • International Cooperation and
    • strict, Public Health measures like
      • Isolation,
      • Quarantine and
      • Contact Tracing.

    Came from civets(a member of Mongoose family) infected by bats
    But the COVID-19 has much milder symptoms in most cases, making it harder to catch and isolate.
     

  2. MERS, (Middle East Respiratory Syndrome),
    first reported in Saudi Arabia in 2012.
    2,494 cases, with 858 deaths, in 27 countries.
    Death Rate:34%

    Came from camels infected by bats

Other Viruses

Flu:- In the US in 2016-2017:- 29 million illnesses, 500,000 hospitalizations and 38,000 deaths. A Death Rate of 0.1% but over  65 it's 0.83%

H5N1 is a variant of influenza, previously only infected birds.

  • It was discovered in August, 2003. The Chinese government swiftly killed 1.5 million chickens .
  • Further cases were closely monitored and isolated. By the end of the year there were 18 known cases in humans. Six people died.
  • This was seen as a successful Global Response, and the virus was not seen again for years.
  • Containment was possible because people who got it became extremely ill.
  • Fatality Rate of 60%. Yet since 2003, the virus has killed only 455 people.

Ebola, has surged in Africa and has a much higher fatality rate than COVID-19.

 

News

NIH Trials on Hydroxychloroquine       -----    Drug Trials LOCAL

April 6th study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress.  
Infection can mimic a heart attack. They have taken patients to the cardiac catheterization lab to clear a suspected blockage, only to find the patient wasn’t really experiencing a heart attack but had COVID-19.  Original Study

April 6th Bronx Zoo tiger tests positive for COVID-19 Did you give it to your pet?

April 4th STUDY:- New study identifies characteristics of patients with fatal COVID-19
..... "The greatest number of deaths were in males median age 65.8. - 72.9 percent were men with conditions including hypertension, coronary heart disease and diabetes."
80 0 percent of patients had very low counts of eosinophils (cells that are reduced in severe respiratory infections) on admission. Complications included respiratory failure, shock, acute respiratory distress syndrome (ARDS) and cardiac arrhythmia, among others.
while respiratory symptoms may not develop until a week after presentation, once they do there can be a rapid decline, as indicated by the Short duration between time of admission and death (6.35 days) .
eosinophilopenia — (abnormally low levels of eosinophils in the blood) — may indicate a poor prognosis
A combination of antimicrobial drugs (antivirals, antibiotics) did not significantly help these patients. The majority of patients studied died from multiple organ failure.

March 30th Oxygen instead of Ventilator ?

March 30 STUDY:- One in five COVID-19 patients often infected with other respiratory viruses, preliminary study reports.   One in 10 hospital admissions who are diagnosed with a common respiratory virus, are co-infected with the COVID-19 virus.
If there is a diagnosis of influenza or rhinovirus, or other respiratory virus, a hospital may erroneously discharge the patient without COVID testing."

STUDY March 27th: How to Increase Capacity?

  • setting up additional beds by
    • repurposing unused operating rooms,
    • pre- and postrecovery rooms,
    • procedural areas,
    • medical and nursing staff quarters, and
    • hallways.
  • For example, in UW Medicine, the use of such strategies has enabled planning to increase bed capacity temporarily by 65%.
  • Currently, one of the largest constraints on effective care may be the lack of ventilators.
    One supplement to ventilator capacity is using anesthesia machines freed up by deferring or cancelling elective surgeries.
  • The use of mobile military resources including the National Guard has the potential to address some capacity limitations, particularly given the differently timed epidemics across states.
  • Other innovative strategies will need to be found, including the construction of temporary hospital facilities as was done in Wuhan, Washington state, New York.

Mar 27th Studies indicate that the official lab counts may be missing as many as 9 in 10 deaths.

Mar 19th  half of the 300 to 400 COVID-19 patients treated in ICU in Paris were younger than 65, and, half in the Netherlands were younger than 50.
Original report CDC - Among 121 US patients known to have been admitted to an ICU, of adult cases reported:
 7%   age ≥85,
46% aged 65–84,
36% aged 45–64,
12% aged 20–44
So finding and forced Isolation of the under 65's who have hypertension and diabetes ( as well as everyone over 64) is what is needed with Trump's "Tweepothesis". ( include Cardiovascular disease, Chronic respiratory disease and cancer)

Mar 17th:- New York Gov. just announced that he'd been advised that the Peak will be in 45 days ( May 11th) that would make the end (another 45 days) at June 25th -- a total of about 13 weeks ( This conforms to the 12-14 weeks spike of the1918 Flu Pandemic ( see below)
(Contrary to some “Experts“ that think it may spike no longer than 8 weeks. Where a hot May-June slows the virus compared with the 1918 Flu that peaked in Oct-Nov-Dec )   

Mar 17th:- US Deaths=100 means 4,500 infected ( at 2.3%) The only useful numbers are deaths from which you can extrapolate Infections using 2.3%  or 3.4% - If it's an Italy-like scenario so many of the deaths are caused by lack of hospital capacity - so stick to 2.3%.

Italy’s coronavirus crisis could be America’s

Aggressive and sustained testing gave South Korea 1/7 the Death Rate of Italy ! This includes enforcing a law that grants the S. Korea government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease.
The authorities can then make some of this public, so anyone who may have been exposed can get themselves - or their friends and family members - tested.
.....
placed in self-quarantine and monitored remotely through a smartphone app, or checked regularly in telephone calls, until a hospital bed becomes available...
South Korea’s government also uses
location data to customize mass messages sent to cellphones, notifying every resident when and where a nearby case is confirmed.
South Korea changed the law to allow the state to gain access to medical records and share them without a warrant. In normal times many democracies might find that too intrusive. Times are not normal.
 South Korea did well over a quarter of a million tests. By the time South Korea had done 200,000 tests, we had probably done less than 1,000.


South Korea Testing "phone booths"  video
"One person at a time can enter one side of this glass-walled booth, they grab a handset, and they are connected with a hospital worker standing on the other side of the glass," .
Using a pair of rubber gloves set into the wall, the health care worker can swab the patient without potentially exposing themselves to the virus.
"The hospital is able to tell the patient their results within seven minutes
They don't have direct contact with a health care worker
."

Mar 8th: Italy: The death count tripled from 133 to 366 (from 2.3% to 5%), and infections rose by a single-day record of 1,492 to hit 7,375
 

Taiwan reins in spread of coronavirus (March) closing its borders in late January to most travellers from China, as well as imposing heavy fines on anyone found violating self-quarantine orders, and shuttering schools and universities.

 

Germany. there only have been 239 deaths. The country's nursing corps,13 nurses per 1,000 people, which is some of the highest. "The higher number of nurses show that nurses are the backbone of the hospitals, especially in ICU care.

Disinfectants

Use Disinfectants with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite(bleach) .
Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are
less effective.

Homemade virus killer. Add  ¼ cup Concentrated Regular Bleach to ½ gallon water, ( 1 part to 10); apply bleach solution to surface,  ; let stand 5 minutes. Rinse and air dry.

Hand Sanitizer Guide to Local Production Ethanol 96% or Isopropyl alcohol 99.8%, Hydrogen peroxide 3%, Glycerol 98%

Drugs

There's a possibility of drug shortages from disruptions to the pharmaceutical supply chain in China.
“We’re very concerned about the intermingling of our supply chain with China in particular,”
“There are 20 drugs with ingredients made exclusively in China"

Gilead: Study to Evaluate the Safety and Antiviral Activity of Remdesivir (GS-5734™) in Participants With Severe Coronavirus Disease (COVID-19) 
“The mistake generally made these days is to think that [just] any antiviral would be effective against [the coronavirus]. This is, of course, not true,”.............  ..........
several papers showing that remdesivir is effective against SARS, MERS and related bat coronaviruses, as well as some of the common cold coronaviruses. ScientificAmerican   ( Fast Track for "compassionate use")

 Favipiravir (Brand Avigan)

Virus Manufacturers       .... more on Vaccine & Drug Companies       Clinical Trials

PROBABLY JUST TRUMP HYPE New insights on the antiviral effects of Chloroquine against coronavirus: what to expect for COVID-19? Brand name Plaquenil ( in Pharmacies now. Your doctor can prescribe )     NIH Trials on Hydroxychloroquine    Drug Trials LOCAL

Convalescent Plasma as a potential therapy for COVID-19

Several marketed drugs with excellent safety profiles such as metformin, glitazones, fibrates, sartans, and atorvastin, as well as nutrient supplements and biologics could reduce immunopathology, boost immune responses, and prevent or curb Acute Respiratory Distress Syndrome (ARDS) The Lancet

STUDY: An antibody that had been taken from a SARS patient years ago and noticed that it latched onto a specific place in that virus. The team then discovered that the same SARS antibody latched onto virtually the same spot on the novel coronavirus. The antibody did not grip it quite as hard, but it helped identify the spot as a possible weak point in the makeup of the virus.

How long is COVID-19, SARS , MERS & Flu Infectious on Surfaces?

MIT researcher says droplets carrying coronavirus can travel up to 24 feet (8 meters) 

COVID-19 STUDY Mar 11th:  (awaiting peer revue)  

  • in the air for up to 3 hours.
  • on copper for up to 4 hours,
  • on cardboard up to 24 hours
  • on plastic and stainless steel up to 2 to 3 days

22 studies including SARS and MERS concluded that the respiratory viruses can remain infectious on surfaces for up to 9 days at room temperature.
Dissipate faster at higher temperatures. Survive the longest in low-temperatures.
"There's probably a very low risk of it spreading from products or packaging that are shipped over a period of days at ambient temperatures", said Dr. Timothy Brewer, professor of epidemiology and medicine at the UCLA. Source Reuters

It's normally spread thru coughing or sneezing.
                                                                

STUDY:-Patients with the COVID-19 extensively contaminate their bedrooms and bathrooms, underscoring the need to routinely clean high-touch surfaces, basins and toilet bowls.
It's killed by twice-a-day cleaning of surfaces and daily cleaning of floors with a commonly used disinfectant.

The Flu virus can survive on hard surfaces for 24 hours .
As droplets in the air for several hours; low temperatures increase their survival in the air.

Myths

Pandemics invariably have a large spike in the sick. (see below)
Places like Marin have a high proportion of elderly.
Here's what Hospitals need to do. Take Kaiser, Marin as an example.
Kaiser needs to do something drastic, -- something like -- turn soon-to-be-empty Terra Linda High School into a Hospital Annex. Or erect Tents.
And have available 200+ beds , ventilators etc...
Hospital Erects Medical Tent

 As of March 10, California can test 7,400 people a day, Washington can test 1,000 and Oregon can test only 40 and the U.S. had tested a couple thousand people.
Compared with
South Korea, that is testing 20,000 people a day !
Aggressive and sustained testing gave South Korea 1/7 the Death Rate of Italy !

COVID-19 is more genetically related to SARS than MERS but both are betacoronaviruses ( not "Common") with their origins in bats.

Flu: Caused by any of several different types and strains of influenza viruses.

To learn from? - The 2009 (H1N1)pdm09, (Swine Flu), Pandemic: A New Flu Virus Emerges  Death Rate of 1.28%

 

l

The 7 Human Coronaviruses ( Source: )

Common Human Coronaviruses

  1. 229E (alpha coronavirus)

  2. NL63 (alpha coronavirus)

  3. OC43 (beta coronavirus)

  4. HKU1 (beta coronavirus)

Other Human Coronaviruses

  1. MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)

  2. SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)

  3. SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)

Two of the four Common Coronaviruses ( Source: )

COVID-19, is not the same as  229E or OC43 , two Common Coronaviruses, that cause the Common Cold.
 [
the most common cause of the Cold  is from many different strains ( 800+ mutations) of the Rhinovirus, responsible for over 50% of colds and half of all asthma attacks, and is a factor in bronchitis, sinusitis, middle ear infections and pneumonia.]                     

 229E and OC43 cause 5 to 30% of “Common Colds” and remain localized to the epithelium of the upper respiratory tract and elicit a poor immune response, hence the high rate of reinfection.
There is no Cross-Immunity between human coronavirus-229E and human coronavirus-OC43, and it is likely that new strains are continually arising by mutation selection.

The illness from the Common Coronaviruses lasts 7 days, with typical symptoms of a sore throat, rhinorrhea, fever, cough, and headache, indistinguishable from the common colds caused by rhinoviruses.
Asymptomatic, (fails to show symptoms), infections are frequent .

Occasionally they cause lower respiratory tract infections and otitis media (middle ear).
There is no evidence of either of these viruses causing enteric disease (intestinal)  in humans, despite the finding of coronavirus-like particles in the stools of such patients.

TABLE 1.  Patients, deaths, and case fatality rates, as well as observed time and mortality
for n=44,672 confirmed COVID-19 cases in Mainland China as of February 11, 2020.

Baseline characteristics Confirmed cases,
N (%)
Deaths,
N (%)
Case fatality
rate, %
Observed time,
PD
Mortality,
per 10 PD
Overall 44,672 1,023 2.3 661,609 0.015
Age, years          
 0–9 416 (0.9) 4,383
 10–19 549 (1.2) 1 (0.1) 0.2 6,625 0.002
 20–29 3,619 (8.1) 7 (0.7) 0.2 53,953 0.001
 30–39 7,600 (17.0) 18 (1.8) 0.2 114,550 0.002
 40–49 8,571 (19.2) 38 (3.7) 0.4 128,448 0.003
 50–59 10,008 (22.4) 130 (12.7) 1.3 151,059 0.009
 60–69 8,583 (19.2) 309 (30.2) 3.6 128,088 0.024
 70–79 3,918 (8.8) 312 (30.5) 8.0 55,832 0.056
 ≥80 1,408 (3.2) 208 (20.3) 14.8 18,671 0.111
Sex          
 Male 22,981 (51.4) 653 (63.8) 2.8 342,063 0.019
 Female 21,691 (48.6) 370 (36.2) 1.7 319,546 0.012
Comorbid condition          
 Hypertension 2,683 (12.8) 161 (39.7) 6.0 42,603 0.038
 Diabetes 1,102 (5.3) 80 (19.7) 7.3 17,940 0.045
 Cardiovascular disease 873 (4.2) 92 (22.7) 10.5 13,533 0.068
 Chronic respiratory disease 511 (2.4) 32 (7.9) 6.3 8,083 0.040
 Cancer (any) 107 (0.5) 6 (1.5) 5.6 1,690 0.036
 None 15,536 (74.0) 133 (32.8) 0.9 242,948 0.005
 Missing 23,690 (53.0) 617 (60.3) 2.6 331,843 0.019
Case severity§          
 Mild 36,160 (80.9)
 Severe 6,168 (13.8)
 Critical 2,087 (4.7) 1,023 (100) 49.0 31,456 0.325
 Missing 257 (0.6)
Period (by date of onset)          
 Before Dec 31, 2019 104 (0.2) 15 (1.5) 14.4 5,142 0.029
 Jan 1–10, 2020 653 (1.5) 102 (10.0) 15.6 21,687 0.047
 Jan 11–20, 2020 5,417 (12.1) 310 (30.3) 5.7 130,972 0.024
 Jan 21–31, 2020 26,468 (59.2) 494 (48.3) 1.9 416,009 0.012
 After Feb 1, 2020 12,030 (26.9) 102 (10.0) 0.8 87,799 0.012

Abreviation: PD, person-days.       -, not applicable.
* The Wuhan-related exposure variable, only includes a total of 37,269 patients and 919 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.
 The comorbid condition variable, only includes a total of 20,812 patients and 504 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.
§ The case severity variable, only includes a total of 44,415 patients and 1,023 deaths and these values were used to calculate percentages in the confirmed cases and deaths columns.
source ChinaCDC:
There were a total of
72,314 patient records.
They don't include 10,567 (14.6%) clinically diagnosed cases (
 patients who demonstrate all the symptoms of Covid-19 but have either not been able to get a test or are believed to have falsely tested negative. )
And they omitted the 16,186 (22.4%) suspected cases.

If we hypothesis that if the excluded 28k patients DID have COVID-19 and all recovered( not likely) then we can multiply the above percentages by 2/3.
Most likely
some of the "MISSING" 23k, that had 2.6% deaths, did have one of the
Comorbidities?  And one would expect the severity of illness in the Pre-Existing Condition ( and age related) patients would be less likely to be missed as few of them would be "mild".

BEWARE THIS IS LOGARITHMIC !


These numbers better indicate the REAL number of Infections. On Day 35, 2,715 Deaths at 2.3% Death Rate gives 118,043 Detectable Infections, Mar 19th


But who knows and WHO doesn't what the REAL Infection Count is ? -- WHO Situation Reports

Relative Performance of US Cities during the 1918 Flu Pandemic

There were 115,340 excess pneumonia and influenza deaths in the 43 cities during the 24 weeks analyzed. (Excess Death Rate, EDR, 500 per 100,000 population)
Every city adopted at least 1 of the 3 major categories of nonpharmaceutical interventions.

 School closure and public gathering bans activated concurrently represented the most common combination implemented in 34 cities (79%); this combination had a median duration of 4 weeks (range, 1-10 weeks) and was significantly associated with reductions in weekly EDR. The cities that implemented nonpharmaceutical interventions earlier had greater delays in reaching peak mortality

There was a statistically significant association between increased duration of nonpharmaceutical interventions and a reduced total mortality burden.
source  ----------- see Graph
Some of the OTHER Interventions:
Transit Capacity Limited, Warnings posted in Theatres

Interventions like those above will be particularly hard to implement in the US when there was a record 53 million low-wage workers in 2019, 44% of all active workers in the United States.
More than half were women. Two-thirds were in their prime earning years. 40% were supporting children at home.
They earned a median
annual salary of $17,950.

September through November 1918, influenza and pneumonia sickened 20% to 40% of U.S. Army and Navy

1918 Flu Pandemic Comparison of 4 cities - School Closure and Public Gathering Bans vs Isolation & Quarantine.


Exemplified by St. Louis and Denver
They gave up on School Closure and Banned Gatherings after about 6 weeks which resulted in a 2nd Peak higher than the first !! 
If you don't keep the:- Schools closed and Public Gatherings Banned for 3 months continuously
you'll get a spike in the 2nd half higher than the first !

Sustained interventions are beneficial and need to be “on” throughout the particular peak of a local experience.
Many of the 43 cities in the study experienced 2 peaks of excess pneumonia and influenza mortality.

Peaks frequently followed the sequential activation, deactivation, and reactivation of interventions, highlighting the transient protective nature of interventions and the need for a sustained response.

For example, Denver(cumulative EDR=631/100 000 population) responded twice with an extensive menu of interventions that included public gathering bans, school closure, isolation and quarantine, and several ancillary interventions and these actions are reflected temporally in its 2-peak mortality curve.

In dual-peaked cities, activation of interventions was followed by a diminution of deaths and, typically, when interventions were deactivated, death rates increased.

source Page 651

But these 2 cities with 358 and 631 deaths per 100,00 and peaks of 60 and 70 had lower peaks than (452 peak 90) for New York( with no ban on Gatherings nor School closings)  and (807 peak 130) for Pittsburgh ( prematurely allowed Gatherings and was late in closing schools) .
 But why didn't Denver(631) beat New York(452) in
Total Mortality Burden?



Deadly second wave ( Don't see much of a First Wave? )
The second wave of the 1918 pandemic was much deadlier than the first.
The first wave had resembled typical flu epidemics; those most at risk were the sick and elderly, while younger, healthier people recovered easily.
By August, when the second wave began in France, Sierra Leone, and the United States,[93] the virus had mutated to a much deadlier form.
October
1918 was the deadliest month of the whole pandemic.[94]

This increased severity has been attributed to the circumstances of the First World War.[95] In civilian life, natural selection favors a mild strain. Those who get very ill stay home, and those mildly ill continue with their lives, preferentially spreading the mild strain. In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus.
The second wave began, and the flu quickly spread around the world again. Consequently, during modern pandemics, health officials pay attention when the virus reaches places with social upheaval (looking for deadlier strains of the virus).[96]

The fact that most of those who recovered from first-wave infections had become immune showed that it must have been the same strain of flu. This was most dramatically illustrated in Copenhagen, which escaped with a combined mortality rate of just 0.29% (0.02% in the first wave and 0.27% in the second wave) because of exposure to the less-lethal first wave.[97] For the rest of the population, the second wave was far more deadly; the most vulnerable people were those like the soldiers in the trenches – adults who were young and fit.[98]  source


 

Bats

During flight, a bat's body temperature spikes to over 100 degrees Fahrenheit. Its heart rate can surge to more than 1,000 beats per minute.

"For most land mammals, these are signals that would trigger death," Bats live it every day.

Bats have developed special immune systems to deal with the stress of flying.
 

Their bodies make molecules that other mammals don't have, which help repair cell damage. And their systems don't overreact to infections, which keeps them from falling ill from the many viruses they carry (and also prevents conditions like diabetes and cancer).
 

This shows that it's not always the virus itself but the body's response to the virus that can make us sick.

Even though bats may be the source of viruses that affect humans, they could also be the source of potential therapies if we study their immune systems.   source

 

Postmortem

What went wrong with coronavirus testing in the U.S.

 

The missing six weeks: how Trump failed the biggest test of his life

 

Questions? info@MarinInfo.org