BiochemAg97 said:

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Reveille said:

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Granitestate said:

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Thank you Doc and all health care providers. You are doing amazing work.

My question relates to a male in Italy who had tested positive. He had minor symptoms and then showed no symptoms by day 14. He was retested and still showed positive at day 21 and at day 30. Is it possible that asymptotic host can carry the virus for extended periods of time and would they still be able to infect those around them?

https://www.msn.com/en-xl/lifestyle/coronavirus-europe/why-do-italians-test-positive-after-symptoms-are-long-gone/ar-BB12BHDe?li=BB10Jn1k

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This is probably a better question for biochemAg97 as I don't know the exact specificity of the reverse transcriptase PCR test.

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there was a study in monkeys where they found in took up to a month to clear the virus from the initial infection. So not really surprising someone could continue to test positive for close to a month. In the monkeys, they reinfected them after they cleared the virus and then couldn't detect the virus, which suggests immunity is protective. They also directed one of the monkeys during the initial infection and found the virus in a lot of tissues. Not surprising it takes the immune system a good while to find everywhere the virus is hanging out.

There are other viruses that go dormant for a while. Some Herpes viruses are like that, which leads to cold sores that flare up periodically.




Specificity is hard to nail down without knowing the specific test. Improved specificity was a design requirement for the commercial tests in the US. RtPCR works by copying a piece of RNA, which requires a primer to specifically bind to a spot on the virus genome. If you have poor primer design, you can pick up other virus genomes (false negative) or miss some mutants of this virus. It actually takes some art and skill to identify a primer that is unique to this virus but isn't in a spot that is changing or at least encompass all variations.

There were rumors of the test in China being wrong half the time (not sure if that was false positive or false negative) and that CDC test was bad 30% of the time. I think the newer tests are significantly better. However, EUA doesn't require publishing the sensitivity and specificity data like you would for an approved test.

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good_ag said:

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Dr. Coates,

I keep reading in your facebook posts that Texas is about two weeks behind the nation as a whole. Does this mean Texas should be peaking in cases in the next week or so? The news mentioned two weeks ago that these next two weeks(last week and this week) were going to be extremely bad from a death standpoint. Was curious on your thoughts of when the Virus will peak in Texas? Thanks again for doing these!

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good_ag said:

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Dr. Coates,

I keep reading in your facebook posts that Texas is about two weeks behind the nation as a whole. Does this mean Texas should be peaking in cases in the next week or so? The news mentioned two weeks ago that these next two weeks(last week and this week) were going to be extremely bad from a death standpoint. Was curious on your thoughts of when the Virus will peak in Texas? Thanks again for doing these!

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Reveille said:

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Safe at Home said:

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As someone who was going through cancer treatments this time a year ago, my heart really goes out to people who can't get the treatments they need now because of the virus. It's stressful enough dealing with a major disease even when you can get treated on schedule.

But if I really thought that there was a 5% chance this virus would kill me if I became infected, I might have to think twice about going to the ER if I thought I was having a heart attack.

I've found your daily updates invaluable Dr. Coates, so I will ask this as respectfully as I can: do you think it's useful to post the daily update on fatality rate based on the number of officially confirmed cases? I know you have addressed this before, and you yourself have said that we can't really know the real denominator. Would you answer this - what would be your best estimate for the number of people that have actually been infected with the virus compared to the number of official cases?

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Who knows but gives us a way to measure the peaks. We are looking at new cases and deaths are a way to measure the peaks. It will allow us to see the improvements when they occur. But everyone always asks about it so I just keep it in there. Actually, I added Houston and Denton because of complaints that I wasn't including there numbers too. Now people in Wisconsin, Arkansas, Alabama and Michigan have all asked me to include their numbers but I told them I don't have the time but sent them a link where they can find them daily.

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Big Al 1992 said:

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Posted elsewhere but thought I'd get the docs thoughts -
When folks say over 80% that died from Covid19 had comorbidities can't that be said about folks that die from heart failure, pneumonia, cancer, stroke - that 80% of those folks had some type of comorbidity also? (ie obesity, COPD, diabetes, blood pressure) So would Covid19 be acting similar?

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Reveille said:

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Who knows but gives us a way to measure the peaks.

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Safe at Home said:

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As someone who was going through cancer treatments this time a year ago, my heart really goes out to people who can't get the treatments they need now because of the virus. It's stressful enough dealing with a major disease even when you can get treated on schedule.

But if I really thought that there was a 5% chance this virus would kill me if I became infected, I might have to think twice about going to the ER if I thought I was having a heart attack.

I've found your daily updates invaluable Dr. Coates, so I will ask this as respectfully as I can: do you think it's useful to post the daily update on fatality rate based on the number of officially confirmed cases? I know you have addressed this before, and you yourself have said that we can't really know the real denominator. Would you answer this - what would be your best estimate for the number of people that have actually been infected with the virus compared to the number of official cases?

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maroonbeansnrice said:

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OK. And I'm not criticizing you Safe At Home, and I'm slightly concerned about the docs on this board (unles I missed it) weighing in.

WTF? If I am having a heart attack I am going to the ER, Covid be damned.

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Reveille said:

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BiochemAg97 said:

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Reveille said:

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Safe at Home said:

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As someone who was going through cancer treatments this time a year ago, my heart really goes out to people who can't get the treatments they need now because of the virus. It's stressful enough dealing with a major disease even when you can get treated on schedule.

But if I really thought that there was a 5% chance this virus would kill me if I became infected, I might have to think twice about going to the ER if I thought I was having a heart attack.

I've found your daily updates invaluable Dr. Coates, so I will ask this as respectfully as I can: do you think it's useful to post the daily update on fatality rate based on the number of officially confirmed cases? I know you have addressed this before, and you yourself have said that we can't really know the real denominator. Would you answer this - what would be your best estimate for the number of people that have actually been infected with the virus compared to the number of official cases?

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Who knows but gives us a way to measure the peaks. We are looking at new cases and deaths are a way to measure the peaks. It will allow us to see the improvements when they occur. But everyone always asks about it so I just keep it in there. Actually, I added Houston and Denton because of complaints that I wasn't including there numbers too. Now people in Wisconsin, Arkansas, Alabama and Michigan have all asked me to include their numbers but I told them I don't have the time but sent them a link where they can find them daily.

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Guess I shouldn't bother asking for Austin area then. Lol

Don't worry, I know where to find the numbers myself.

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LOL Yyou made me laugh! BiochemAg you have been very helpful to me and everyone here. So if I remember I will add in Austin for you!!!

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• Based on the currently available genome sequence data, we proved that SARS-COV-2 genome has a much lower mutation rate and genetic diversity than SARS during the 2002-2003 outbreak.
• The spike (S) protein encoding gene of SARS-COV-2 is found relatively more conserved than other protein-encoding genes, which is a good indication for the ongoing antiviral drug and vaccine development.
• Minimum Evolution phylogeny analysis revealed the putative original status of SARS-CoV-2 and the early-stage spread history.
• We confirmed a previously reported rearrangement in the S protein arrangement of SARS-COV-2, and propose that this rearrangement should have occurred between human SARS-CoV and a bat SARS-CoV, at a time point much earlier before SARS-COV-2 transmission to human.
• We provided first evidence that a mutated SARS-COV-2 with reduced human ACE2 receptor binding affinity have emerged in India based on a sample collected on 27th January 2020.

Reveille said:

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Today's update!

https://www.facebook.com/1998386763777604/posts/2670807409868866/?sfnsn=mo

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Granitestate said:

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A research paper shows the average incubation period (95% of cases) is 5.1 days.

97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.

https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

Contact tracing can help us identify suspects based on duration of proximity to an identified positive. Is the guidance to self quarantine the suspect for 14 days or would 6 days with a negative test result be sufficient? Essentially does the benefit of self-quarantine from day 7 thru 14 for <5% outweigh the risk? If so, what about the 99% percentile? Should self quarantine extend to 30 days?

Thank you

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