Prepping for a pandemic...3

[wheresmymojo]

Third thread on prepping for a pandemic and following the risk of a NCoV pandemic.

General NCoV Info

The estimated replication rate is R= 2 to 4.8 based on latest expert estimates. This means each infected person spreads the virus to between 2 and 4.8 people. This means it's a fairly contagious virus, probably around the level of swine flu or more.

Around 15-20% of cases are thought to be severe - that is resulting in the need for hospitalisation. Around 3-5% requiring ventilation.

The estimated mortality rate is around 1-2% at the moment. This may change as it is very difficult to estimate mortality.

Children tend to have milder symptoms. Those over 60 with underlying health issues and a history of smoking are more likely to be severe (although not exclusively this type of person).

Spread of NCoV

It is estimated that the average incubation period is 3-5 days but can be as long as 24 days.

It can be spread with no symptoms.

It can be spread via droplet (cough/sneeze), aerosol (breathing same air in very close quarters), bodily fluids, fecal/oral route and formites (via surfaces, up to 28 days in the right circumstances but up to 3-5 days in more typical circumstances).*

Updates*

As this is a novel virus and knowledge is constantly being updated - I will post updates as they become available with links to source.

I am not a medical expert so any opinions or conjecture of my own should be taken with a pinch of salt!

Morning round up

1
Thailand say prisoner tested negative before extradition (again, we have many examples now of multiple negative tests before a positive test)

2
Govt is monitoring impact of disruption to supply chains on medication - no impact so far but asking industry to start risk assessing and considering changes

https://pharmafield.co.uk/pharmanews/government-monitoring-impact-of-coronavirus-on-medicine-supplyy//_
_
3
Study looking at simulating how effective containment is against various scenarios (note - not peer reviewed). Graph taken from study in pics below
_
https://cmmid.github.io/ncov/isolationncontact_tracing/

4
I don’t know if anyone has been following the story of the Westerdam cruise ship? 1455 passengers and it has been refused entry to dock at 5(!) countries now. It’s been sailing the Pacific for a week looking to dock somewhere (anywhere).

It’s been refused by Thailand, Japan, Philippines, Guam & Taiwan because it previously docked at China. There are no known cases of CV aboard but no country wants them to dock in case they have it and have to deal with it. They are currently asking the US for help.

5
The number of suspected cases in China mysteriously drops by 5,000 (see pics)

Totally unsubstantiated personal theory warning ⚠️**

I'm starting to think that China is abandoning the idea of 'containment' and has decided just to go for mitigation instead.

Due to a combo of:

• Them changing the case definition to exclude asymptomatic cases
• The suspected cases dropping 5,000 without explanation
• The very aggressive rounding everyone up into quarantine

I feel like maybe they've made a decision that containment is hurting their economy so much (whilst not doing the same to US, etc) and is proving so difficult that they are taking measures to say 'look, we've reduced the numbers massively, success, back to work!'

There does come a point with every potential pandemic where it is decided that containment isn't possible and that only mitigation and dealing with the fall out in terms of deaths is possible (see Swine Flu - roughly as contagious as COVID and they realised they couldn't contain it).

I'm starting to think the WHO also realise this and this is why they have talked more about 'window of opportunity' - basically for Govts to prepare for it rather than expect to contain it.

With the clusters in Singapore, HK, Thailand and potentially now here & Germany (and I'm sceptical of the US numbers) I think we're fast reaching the tipping point IMO where containment is abandoned as an objective

China is running out or not doing tests. Those with positive tests and no symptoms are no counted as infected.

Those dying and untested are being listed as pneumonia as reason of death not Corvid19.

How is everyone's prepping doing ? I bought some more milton, dettol and vitamins need more parcetamol.

If you look at the graphs I posted in the morning round up - this basically suggests that once you get past the initial few cases you need to be able to contact trace 80%-100% of contacts to have a reasonably high chance of containment (at least that's how I'm reading it).

Dh is at top level management for a very large insurance company. He has been working on this all week. At the moment he's not worried, although it hasn't stopped me doing a little prepping

What is the best medication if you do get the virus to buy? Reading mixed things that lowering temperature by taking meds can do more harm than good

It is the sort of event that reminds people with dependants to buy insurance!

No he works in commercial lines. So mainly looking at impact on travel and business interruption.
He's had to write reports for chief exec and been pouring over figures.

How many days worth of paracetamol etc per person would you say is wise to get, please?

You can only buy, at most, two packs of 16 at a time. I have plenty but I just made a habit of slinging generic cheapo ones in my shopping trolley/basket as and when. And storing safely at home out of the reach of children.

Am definitely getting more concerned - yes, it’s half term next week but DP is working away in Birmingham in the NEC with vast amounts of public. He thinks I’m being hysterical about the whole thing so won’t be observing handwashing/increased hygiene rules.

The Westerdam cruise ship has now been allowed to dock in Cambodia, according to the Guardian live page.

I'll ask again how is everyone's prepping going. Where are the shortages people are finding ?

Hand gel, wipes and masks seem the obvious ones? Anyone care to predict the next shortage ?

craptv and miss1973 fever is our bodies response to a virus and helps us fight it by raising our temperature to a level that is uncomfortable for the virus. It also makes us feel ill which means that we stay in bed and don't try and soldier on, which means our body can dedicate all its resources to fighting the infection. Personally I won't be be taking paracetamol if I get sick. It's symptomatic treatment and won't in any way treat the infection and might even hinder our bodies own responses. It makes you feel better but doesn't help you get better.

*body's not bodies

This is only good advice to a certain degree. If a fever gets too hot for too long you risk long term damage. Now, usually by that point, under normal circumstances, you'd be so unwell they you would have sought medical help but given that we don't know how badly the shit might hit the fan, it's worth having something in the house to reduce a temperature.

Miss1973HulaHoopChampion re days worth of paracetamol, when I had swine flu, I had a temperature of 40+ for six days in a row. Not sure if cv would be similar, but I would think about a week, if you count mild fever as well.

Ooh...@dingit I may know your husband then.

I work in mid level management in insurance and have worked for several of the large insurers (and it's a small world).

Yes...all commercial insurers will be doing the same at the moment. Taking the latest info on spread and mortality and forecasting potential impact and losses.

This won't be too bad from an insurance business perspective because (just personal thoughts):

• The majority of any deaths won't be workers (sorry, morbid reality)

• The estimates are to expect a 25% absenteeism rate for those ill/looking after children out of school. Enough to cause challenges but not enough for a close down.

On a personal level though those things don't mean it won't be a bumpy ride IYSWIM.

Fourtea do you know how hot/long is problematic? I know it can cause febrile convulsions in the very young. In adults, as far as I'm aware (and I'm not a doctor!) the main reason they suggest seeking help when fever is very high or prolonged is because it indicates a possible serious illness (meningitis, sepsis etc). I'd be really interested to see some research as I couldn't find any with a quick Google.

Interesting theory mojo on the Chinese tactic now and course of action. I actually kind of wonder if the British government really have lost any expectation of containing or even slowing the spread. I saw an expert a minute ago on the news saying they thought they were only catching 1 in 3 cases which arrive in the uk. If the government know this they must be assuming it will start to spread now

My late partner was in high-level casualty claims and used to talk with me about emerging risks. I wonder what he'd have thought about this situation.

Another quick look bought up this www.seattlechildrens.org/conditions/a-z/fever-myths-versus-facts/

Not linked to any studies but am assuming it's a reputable source. Basically says you're good up to 42°

Obviously, in normal circumstances you would seek medical care, I imagine, with a prolonged fever over 40°, but possibly reassuring if we are unlucky enough to ever be in a situation where that's not possible

I read a theory earlier about the Chinese figures. Basically commenting on the high death/survival figures (extremely high death rate of 19%) and speculating that they are actually reporting the correct death/survival rate so that the Chinese are not later criticised for not warning the world.

So they are downplaying the overall numbers affected but reporting an accurate 19% death (which logically mirrors the 80% minor infection 20% serious/critical infections percentage).

But who knows until a few weeks down the line.

You're right, for a fever to be a problem of itself in a healthy adult, I think you need to nudge above 41.5c, which is phenomenally high. But for 16p worth of paracetamol I'd have broke and took it at 40c

With children, as you say, febrile convulsions are a worry.

Not a medic - in any way

Yep, my kids are too old for febrile convulsions, thank goodness. And whilst, thankfully, kids seem to be getting this mildly, it can't hurt to have a bit of Calpol in the cupboard.