Coronavirus Sars-CoV-2/Covid-19 Megathread

[Legbiter]

How locked down is Spain now? Do you have testing, tracing and PPE sorted for when you relax?

[merithyn]

Thought this gallery in The Guardian was cute.

https://www.theguardian.com/world/gallery/2020/apr/27/running-free-spanish-children-released-from-lockdown-in-pictures

These are delightful. Thank you for sharing them.

[Syt]

https://www.theguardian.com/world/2020/apr/27/nhs-warns-of-rise-in-children-with-new-illness-that-may-be-linked-to-coronavirus?CMP=share_btn_tw

NHS warns of rise in children with new illness that may be linked to coronavirus

Doctors alerted to possibly fatal syndrome, which gives the small number of sufferers stomach pain and inflamed heart

Children are falling ill with a new and potentially fatal combination of symptoms apparently linked to Covid-19, including a sore stomach and heart problems.

The children affected appear to have been struck by a form of toxic shock syndrome. Some have been left so seriously unwell that they have had to be treated in intensive care. At least one has undergone extra corporeal membrane oxygenation (ECMO) treatment, which is used when someone's life is at risk because they can no longer breathe for themselves.

It is not known how many such cases have appeared, though it is thought to be a small number. But NHS bosses are so concerned that they have written to doctors alerting them to the existence of the syndrome and asked them to urgently refer any children who appear to have it to hospital.

In a letter to GPs in north London, reported by the Health Service Journal , NHS bosses said: "It has been reported that over the last three weeks there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.

"The cases have in common overlapping feature of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe Covid-19 in children.

"There is a growing concern that a Sars-CoV-2-related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases."

A version of the warning has been sent by the Paediatric Intensive Care Society to all specialist doctors working in paediatric intensive care units in UK hospitals.

The NHS letter continues: "Abdominal pain and gastrointestinal symptoms have been a common feature, as has cardiac inflammation. This has been observed in children with confirmed PCR positive Sars-CoV-2 infection as well as children who are PCR negative. Serological evidence of possible preceding Sars-CoV-2 infection have also been observed."

Sars-CoV-2 is the official name of the virus that causes the disease Covid-19.

Doctors have been told to "please refer children presenting with these symptoms as a matter of urgency".

One intensive care doctor told the Guardian: "There's been an utterly unexpected uptick in severely sick children with a late inflammatory response that we think is related to Covid-19. It's most unusual. A number have needed ICU [intensive care] and at least one has required ECMO."

It is not known if any children struck by the new syndrome have died.

Prof Russell Viner, the president of the Royal College of Paediatrics and Child Health, sought to reassure parents that children are generally unlikely to become very unwell due to Covid-19.

"We already know that a very small number of children can become severely ill with Covid-19 but this is very rare. Evidence from throughout the world shows us that children appear to be the part of the population least affected by this infection.

"New diseases may present in ways that surprise us, and clinicians need to be made aware of any emerging evidence of particular symptoms or of underlying conditions which could make a patient more vulnerable to the virus. However, our advice remains the same: parents should be reassured that children are unlikely to be seriously ill with Covid-19, but if they are concerned about their children's health for any reason they should seek help from a health professional."

The RCPCH's guidance for parents on symptoms and seeking advice is available here.

[merithyn]

This is going to keep happening. Until it's been around long enough to do real research, we're going to keep getting piecemeal data.

It's why we really need to take all of this seriously. We just don't know what impact this virus is going to have.

[Sheilbh]

Because of spare capacity in the NHS some services are re-opening, such as cancer treatments (which may have been suspended because of infection risk) which will be determined by the local Trusts.

Again they are repeating if you need treatment you can still access it - such as a heart attack or an accident - and the need to consider excess mortality figures because these cover the direct and indirect deaths. In this briefing they've explicitly said they're worried about people not seeking emergency services when they should.

Chris Whitty, the Chief Medical Officer, said they think the R is around 0.6-0.7 but fairly sure it's somewhere between 0.5 and 1. But there is no perfect solution that will allow everyone to do everything they want and keep R below 1.

And in response to the question from the member of the public - basically will I be able to hug my grandkids once the lockdown's lifted - it sounds like if you're vulnerable the lockdown won't be lifting

[Sheilbh]

https://www.theguardian.com/world/2020/apr/27/nhs-warns-of-rise-in-children-with-new-illness-that-may-be-linked-to-coronavirus?CMP=share_btn_tw

This was asked about at the briefing and said they've become aware of something that is like Kawasaki disease in children (which sounds awful). They want to share knowledge among clinicians and are asking researchers/experts to look into these cases now. But they really emphasised that it is very rare and in the vast majority of cases children don't get it or get a very mild service, but if you're concerned please call 111 or 999.

Chris Whitty said it's very plausible there's a link as it's an inflamatory condition and as there's a new disease going round and then a presentation of new symptoms in some individuals it's very possible they're linked. But it's too soon to say and they, frankly, don't know.

[crazy canuck]

This is going to keep happening. Until it's been around long enough to do real research, we're going to keep getting piecemeal data.

It's why we really need to take all of this seriously. We just don't know what impact this virus is going to have.

Yep

according to a recent study out of New York. (And, yes, children can get ill; about 6 per cent of confirmed cases become critically ill.)

The big unknown is how many children contract the coronavirus and don't have obvious symptoms and, just as importantly, how likely they are to infect others.

As with most everything coronavirus-related, there are more unknowns than knowns.

That's true about the back-to-school debate as well.

As Dr. Kellner says: "There needs to be public discourse about the risks and benefits. But we can't make these decisions based on dismissive comments like 'kids don't get sick.' It's way more complicated than that."

https://www.theglobeandmail.com/canada/article-its-dangerous-for-legault-to-suggest-parents-embrace-natural/

[Iormlund]

Factory restarted production today. As with many of my fellow engineers I was there at 5:45 when the first shift arrived (on a purely voluntary basis since technically we can start up to 9 AM). Workers were divided in groups of 10 and trained on the new procedures and PPEs.

We're working in "degraded mode" in many posts, since we are trying to ensure at least 2m separation between staff, which can be a real challenge. With little demand COVID is now our main focus. Which is good. News reports came today of a slaughtering plant not far from here where workers were forced to come in despite showing symptoms and PPEs were inadequate. By now 25% of the workers in that plant have tested positive.

I spent 6 hours welding at one of the machines in preparation last Friday. Masks are a pain in the ass, and will be even more so in a month or two when the Spanish summer arrives. It is physically taxing work that already required full protective wardrobe (long pants, anti-cut sleeves, thick anti-cut and heat gloves). Hydration is going to be an issue, I think. Most people will lose mask integrity protection just by drinking water.

The range of responses is interesting. Some have become completely withdrawn, even among those young and healthy. But most people have struck a balance. We meet to socialize at the canteen or outside with 2-3 meters separation. We'll see what happens when we get used to it. I can't really imagine working for a year or two and not sharing a coffee with my colleagues in the whole time.

[merithyn]

Two meat packing plants in Iowa make up something like 75% of the COVID cases in the state.

[Barrister]

Two meat packing plants in Iowa make up something like 75% of the COVID cases in the state.

A couple of meatpacking plants in Alberta have a very large percentage of our new cases as well.

[mongers]

......

And in response to the question from the member of the public - basically will I be able to hug my grandkids once the lockdown's lifted - it sounds like if you're vulnerable the lockdown won't be lifting

Shelf this is the assumption I've been operating on for the last two months as regard vulnerable family members.

For them the lockdown will continue until there's a vaccine or the virus miraclously disappears/beaten.

I've yet to acticulate this with them, but I'd think for many people surely they must have examined their situation and if similar would have reached the same conclusion?

[DGuller]

I guess even meat packing plants are not immune from poor and unsafe working conditions.

[Eddie Teach]

It's a jungle out there.

[Admiral Yi]

It's a jungle out there.

Nice one

[Sheilbh]

Shelf this is the assumption I've been operating on for the last two months as regard vulnerable family members.

For them the lockdown will continue until there's a vaccine or the virus miraclously disappears/beaten.

I've yet to acticulate this with them, but I'd think for many people surely they must have examined their situation and if similar would have reached the same conclusion?

It's been my assumption but I don't think people have realised yet. I remember reading an article recently where a cabinet minister (off the record) was saying precisely that people haven't clocked that they won't be able to see grandma for a long while.