Re: The Georgia Governor says he just learned of asymptomatic

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New England Journal of Medicine letter on Jan 30

Apr 2, 2020, 10:56 AM

This letter was first published on January 30 in the USA's leading medical journal NEJM. This would have been top of mind in every infection disease expert in every office in every state and federal level. Alarms were pulled, but people like Gov Kemp chose to ignore them.

https://www.nejm.org/doi/full/10.1056/NEJMc2001468

Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany | NEJM

Correspondence from The New England Journal of Medicine — Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany

"The novel coronavirus (2019-nCoV) from Wuhan is currently causing concern in the medical community as the virus is spreading around the world.1 Since identification of the virus in late December 2019, the number of cases from China that have been imported into other countries is on the rise, and the epidemiologic picture is changing on a daily basis. We are reporting a case of 2019-nCoV infection acquired outside Asia in which transmission appears to have occurred during the incubation period in the index patient.

A 33-year-old otherwise healthy German businessman (Patient 1) became ill with a sore throat, chills, and myalgias on January 24, 2020. The following day, a fever of 39.1°C (102.4°F) developed, along with a productive cough. By the evening of the next day, he started feeling better and went back to work on January 27.

Figure 1.

Timeline of Exposure to Index Patient with Asymptomatic 2019-CoV Infection in Germany.
Before the onset of symptoms, he had attended meetings with a Chinese business partner at his company near Munich on January 20 and 21. The business partner, a Shanghai resident, had visited Germany between January 19 and 22. During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China, where she tested positive for 2019-nCoV on January 26 (index patient in Figure 1) (see Supplementary Appendix, available at NEJM.org, for details on the timeline of symptom development leading to hospitalization).

On January 27, she informed the company about her illness. Contact tracing was started, and the above-mentioned colleague was sent to the Division of Infectious Diseases and Tropical Medicine in Munich for further assessment. At presentation, he was afebrile and well. He reported no previous or chronic illnesses and had no history of foreign travel within 14 days before the onset of symptoms. Two nasopharyngeal swabs and one sputum sample were obtained and were found to be positive for 2019-nCoV on quantitative reverse-transcriptase–polymerase-chain-reaction (qRT-PCR) assay.2 Follow-up qRT-PCR assay revealed a high viral load of 108 copies per milliliter in his sputum during the following days, with the last available result on January 29.

On January 28, three additional employees at the company tested positive for 2019-nCoV (Patients 2 through 4 in Figure 1). Of these patients, only Patient 2 had contact with the index patient; the other two patients had contact only with Patient 1. In accordance with the health authorities, all the patients with confirmed 2019-nCoV infection were admitted to a Munich infectious diseases unit for clinical monitoring and isolation. So far, none of the four confirmed patients show signs of severe clinical illness.

This case of 2019-nCoV infection was diagnosed in Germany and transmitted outside Asia. However, it is notable that the infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific.3

The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum viral load in a convalescent patient (Patient 1) arouse concern about prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019-nCoV detected on qRT-PCR in this patient remains to be proved by means of viral culture.

Despite these concerns, all four patients who were seen in Munich have had mild cases and were hospitalized primarily for public health purposes. Since hospital capacities are limited — in particular, given the concurrent peak of the influenza season in the northern hemisphere — research is needed to determine whether such patients can be treated with appropriate guidance and oversight outside the hospital.

Camilla Rothe, M.D.
Mirjam Schunk, M.D.
Peter Sothmann, M.D.
Gisela Bretzel, M.D.
Guenter Froeschl, M.D.
Claudia Wallrauch, M.D.
Thorbjörn Zimmer, M.D.
Verena Thiel, M.D.
Christian Janke, M.D.
University Hospital LMU Munich, Munich, Germany
rothe@lrz.uni-muenchen.de

Wolfgang Guggemos, M.D.
Michael Seilmaier, M.D.
Klinikum München-Schwabing, Munich, Germany

Christian Drosten, M.D.
Charité Universitätsmedizin Berlin, Berlin, Germany

Patrick Vollmar, M.D.
Katrin Zwirglmaier, Ph.D.
Sabine Zange, M.D.
Roman Wölfel, M.D.
Bundeswehr Institute of Microbiology, Munich, Germany

Michael Hoelscher, M.D., Ph.D.
University Hospital LMU Munich, Munich, Germany

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

This letter was published on January 30, 2020, and updated on February 6, 2020, at NEJM.org."

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This IS LIKELY a virus where herd immunity will do a lot of good. It's not like the flu in the frequency and severity of mutations, at least so far. Then there's the antibody longevity in survivors, which will play a key role. Those who get this initially, and survive, will likely be immune to most future mutations as well. If you catch this in 2-3 years from now, it will likely be less severe, but those who originally got it, they will not catch it.

Just from personal experience, INITIAL sufferers of the original (novel) swine flu virus in 2009, especially those who had complications, developed a massive immunity to the swine flu, and many similar flu strains. And that immunity lasts for years. It's still active in fact, in me for example. Now those who subsequently got the swine flu in later years, and not the very initial strain, don't get that same immunity level from antibodies when they recover. But last year 4 out of the five of us in our house got the 2018 version of the swine flu. No one got as sick as I did in 2009. EVERYONE got a flu shot too, which helps. But I didn't get a flu shot, and didn't catch it either. And today we have far less complications from swine flu than the original version. Partly because of the vaccine and herd immunity, and partly because the virus changed too. I haven't had any flu since 2009. It has run through our house a good 4 or 5 times since. This year as well.

And odds are future mutations will be limited because this thing already has all the perfect tools to spread, way more than the flu. This was a coronavirus that mutated DOWN to become more easy to spread, and less lethal than SARS/MERS. China recently detected a mutation infecting survivors, who otherwise showed NO SYMPTOMS. Zero.

You can track the mutations on this link, I've posted it before. All US strains descend from two strains. Italy has a much more diverse group of strains than any other country though. All going at once. Even though they have tested the genomes on less samples, the variety of those genomes is far more diverse than the US. That's the benefit of the early travel restrictions and the lack of them for Italy that Trump boats about.

https://nextstrain.org/ncov

The Georgia Governor says he just learned of asymptomatic

it's not even funny anymore.....cdc is right in his back yd***

The benefits of a University of Georgia education.

Re: The Georgia Governor says he just learned of asymptomatic

Yep. Some spread it before any symptoms appear

This was common knowledge 2 months ago

2/24 was the report date on case Tiggity mentions

Naw, this was recent, in the US I think. But yeah, China

New England Journal of Medicine letter on Jan 30

And shuzzam, who knew....this is the newest old news we're

So much of this stuff is common sense that seems uncommon

Honestly, in reality, most healthcare providers who treat

I'm more concerned about herd immunity

Luckily, so far, it's limited itself in mutations.

We just don't need them all getting it at the same time

Normalcy bias is the problem

I read that. He and I jumped on this about the same time.

Trump said "The coronavirus is very much under control in

ok

I would lean toward incompetent fool

I follow a girl on facebook who is that backwoods

Yes it was.

TWSS***

Re: Yep. Some spread it before any symptoms appear

Voting for morons against our own self interests was bound

Bro, imma be wealthy one day and those tax breaks are

He obviously doesn't come to Tigernet

He should've asked Arkansas Senator Tom Cotton in January

Like I've been saying. Kemp is an idiot.***

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