New JAMA paper on 138 pts w/ nCoV pneumonia in a Wuhan hosp. Median age 56; 41% were hosp acquired infxn; all pts w/ bilat lung opacities on CT; 36% needed ICU; time from first sx to ARDS 8 days; and…. (2/x)
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This thread pertains to important new info or developments re: the 2019nCoV epidemic happening over this past weekend, and underscores what we still need to learn on an urgent basis. Starting with new developments: (1/x)
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…6 deaths; 47 discharged; rest still hospitalized. Quite sobering overall, though again we know many mild cases are not getting dx’ed or seen in hosp. https://jamanetwork.com/journals/jama/fullarticle/2761044 … (3/x)
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These JAMA stats on HCW infxns are first since early in outbreak when one cluster of HCW infxns was reported. It’s a surprisingly high # of infxns in 1 hospital. Shows transmissibility of virus. Are other Wuhan/Hubei hosps struggling w same # of HCW infxns? (4/x)
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In HK there are 36 known nCoV cases, with the HK Centre for Health Protection saying that chances of stopping the spread of virus “depended on how many virus carriers there were who showed little or no symptoms.” https://www.scmp.com/news/hong-kong/health-environment/article/3049749/coronavirus-nine-members-same-family-test … (5/x)
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Singapore’s Ministry of Health has clear and current dashboard of its cases https://www.moh.gov.sg/2019-ncov-wuhan and substantial transparent discussion of local cases https://www.channelnewsasia.com/news/singapore/wuhan-coronavirus-singapore-virus-new-cases-local-transmission-12390118 … (6/x)
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Singapore released superb video of Prime Minster Lee describing current nCoV situation in Singapore. A great example of strong leadership and highly effective communication https://www.youtube.com/watch?v=oNw1pyksKHo … (7/x)
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Cruise ship off Japan continues to quarantine thousands, w 130 people now w/ nCoV --greatest concentration of persons w nCoV outside of China. This approach is not ethical or effective, passengers should be let off ship and quarantined in another safer location (8/x)
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No cases of nCoV in African continues, but there is very little diagnostic testing capacity in Africa. That will change shortly when nCoV diagnostics are distributed to many African countries by WHO. (9/x)
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Still don’t have info on China’s surveillance strategy-what are criteria for testing outside Hubei? What severity of illness is required for testing? Is previous Hubei travel required for a test? How many tests being done a day? This info will help gauge severity et al (11/x)
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Still don’t have detailed info on mechanism of spread. Beyond resp droplet spread, is there aerosol or fecal transmission? Any more information on the earlier reports of asymptomatic transmission that was said to have occurred in China (though w/out details provided) (12/x)
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Dep DG of Med Admin of National Health & Family Planning Commission of PRC, Jiao Yahui, said that due to the lack of medical resources, mortality rate in Wuhan has reached 4.9%. Meanwhile, the death rate for China as a whole is said to have remained at a steady 2.1%. (13/x)
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Does that mean that in Wuhan some of the deaths have been because there were not enough ventilators or oxygen for the sick? If so, that is important for other governments' planning efforts. (14/x)
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