welcome to another MedCram lecture and we can see here the numbers are
increasing but slowly here on the world ometer website seventy five thousand
seven hundred and thirty total deaths 2128 recovered sixteen thousand if we
look at the active cases in the close cases you can see that the number of
recovered has gone up slightly and seems to be doing that on a daily basis if we
look at the total worldwide cases you can see here that they are dwindling
overall but in looking at the cases that are outside of china we can see that
they continue to increase in terms of the number of deaths unfortunately those
continue to be increasing pretty much at a linear rate want to update you on the
situation with the Diamond Princess cruise ship that's docked outside of
Japan there was a statement put out by the CDC commending the Government of
Japan for the fact that they quarantine patients but there's been a lot of
international criticism of how Japan actually handled this and there's been
an intervention and basically the consensus if you read between the lines
is that this did not work very well there's currently more than a hundred US
citizens either on board the diamond princess or in hospitals in Japan and
they've been placed under the restrictions and they're saying that
they will be required to wait 14 days before coming home before they're
permitted to come on board flights however if an individual does make it to
the United States before that 14-day period ends they will be subject to a
mandatory quarantine until they completed that 14-day period so the CDC
is coming out with that statement and they want to make sure that everyone's
aware that they are taking this seriously I also want to quickly
highlight a letter that was submitted to the New England Journal of Medicine
dated yesterday February 19 it was an interesting look at about 18 patients
nine men and nine women meeting 59 years of age and what they did was they looked
at viral loads in the upper respiratory tract to see what they were based on
when the symptoms began and now these were people from Wuhan and
all of them except for one were symptomatic there was one person that
was asymptomatic and we'll talk about that in just a second
but you can see here the graphs of the CT value which is basically the viral
load and on the x-axis here is the number of days since the onset of
symptoms zero being here on the far left and what you can basically see is that
the viral load was quite high in the very early days of the symptoms and then
tapers off almost all of them being undetectable here towards 14 days now
please don't confuse these days as the incubation period this has nothing to do
with the incubation period this has to do with how long the symptoms last once
you get the symptoms an incubation period has to do with how long it is
between infection and the onset of symptoms the other thing to notice here
at the bottom is may be difficult to see but in terms of throat swabs versus
nasal swabs there was a higher viral count in the nasal swabs in general than
there was in the throat swabs meaning that this virus tends to potentially
congregate in the upper Airways there was one patient that was tested and was
asymptomatic and they say here that the viral load that was detected in the
asymptomatic patient was similar to that in the symptomatic patients which
suggests that the transmission potential of asymptomatic or minimally cyntha
matic patients and this is confirming what we had discussed earlier at the
beginning of this outbreak that potentially can be spread by
asymptomatic individuals and we will put a link in the description below to this
article as well as the CDC article another article that was submitted on
the same day yesterday was a perspective that was written by a number of
physicians and epidemiologists on their perspective of defining the epidemiology
of kovat 19 and how more studies are needed one of the interesting aspects
that they mention here is they may need to do testing in people that may not
meet the current definitions which is someone who has traveled from that
particular area of China and has symptoms and they say here a key point
of these recommendations is that viral testing should not be used only for
clinical CAIR I think that's an interesting point
if we really want to find out what the scope is of the infection especially in
China that there's gonna have to be a lot of people who are asymptomatic Lee
tested to see whether or not they had the virus at some point anyway I leave
that perspective there for your consideration in future updates we'll
plan on tackling the molecular biology of corona virus and contrast that and
compared to other viruses and that might give us a little bit of information
about what this virus likes to do please join us at make cram comm for our course
on the corona virus also multiple other courses thanks for joining us