Dissensus Coronavirus Hub

[Yaak Pabst for the German socialist magazine Marx21] In many media it is claimed that the starting point of the coronavirus was an “exotic food market”« in Wuhan. Is this description true?

[Evolutionary biologist Rob Wallace] Yes and no. [...] Contact tracing linked infections back to the Hunan Wholesale Sea Food Market in Wuhan, where wild animals were sold. Environmental sampling does appear to pinpoint the west end of the market where wild animals were held.[...] The focus on the market misses the origins of wild agriculture out in the hinterlands and its increasing capitalization.

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This phylogeny [re: map at top of this thread] shows evolutionary relationships of HCoV-19 viruses from the ongoing novel coronavirus COVID-19 pandemic. All samples are still closely related with few mutations relative to a common ancestor, suggesting a shared common ancestor some time in Nov-Dec 2019. This indicates an initial human infection in Nov-Dec 2019 followed by sustained human-to-human transmission leading to sampled infections.
Site numbering and genome structure uses Wuhan-Hu-1/2019 as reference.

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The stress of captivity in these chaotic markets weakens the animals' immune systems and creates an environment where viruses from different species can mingle, swap bits of their genetic code and spread from one species to another, according to biologist Kevin Olival, vice president for research at the EcoHealth Alliance.

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Since the end of 2019, an outbreak of mystery pneumonia in Wuhan has been drawing tremendous attention around the world. [...] The causative agent of the mystery pneumonia has been identified as a novel coronavirus by deep sequencing and etiological investigations by at least 5 independent laboratories of China.

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Generally, the alphacoronaviruses and betacoronaviruses [which includes new coronavirus 2019-nCoV] can infect mammals, and the gammacoronaviruses and deltacoronaviruses can infect birds, but some of them can also infect mammals

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Not all cases have apparent connection with the Wuhan Huanan Seafood Wholesale Market that is believed to be original place of the outbreak of the 2019-nCoV. [...] Although 2019-nCoV broke out in Hunan Seafood Market of Wuhan, the possibility of the 2019-nCoV transmission from seafood to human is unlikely.

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Coronaviruses are a family of viruses that can lead to respiratory illness, including MERS and SARS. Coronaviruses are transmitted between animals and people and can evolve into strains not previously identified in humans. On January 7, 2020, a novel coronavirus was identified as the cause of pneumonia cases in Wuhan, Hubei Province of China.

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SARS-CoV-2 [current virus] is the seventh coronavirus
known to infect humans; SARS-CoV, MERSCoV and SARS-CoV-2 can cause severe
disease, whereas HKU1, NL63, OC43 and
229E are associated with mild symptoms

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It is improbable that SARS-CoV-2 emerged
through laboratory manipulation of a
related SARS-CoV-like coronavirus.

[...]

Instead, we propose
two scenarios that can plausibly explain
the origin of SARS-CoV-2: (i) natural
selection in an animal host before zoonotic
transfer; and (ii) natural selection in humans
following zoonotic transfer.

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Coronaviruses are RNA viruses that typically enter human cells when their glycoproteins bind proteins on the cell surface. SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) on human cells with higher affinity than does the virus that caused severe acute respiratory syndrome (SARS) in 2003.

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“Stay at home for 7 days if you have either:
a high temperature
a new, continuous cough.

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The following symptoms may appear 2-14 days after exposure. [incubation period]
Fever
Cough
Shortness of breath

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In an analysis of 12 patients who recovered from the SARS-CoV-2 coronavirus, doctors at the Hong Kong Hospital Authority (HKHA) found that several of them now have reduced lung capacity [...] That’s far too small a sample size to declare that COVID-19 necessarily causes long-term damage, but it could be a warning sign that doctors should keep an eye out for potential complications.

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Our finding is consistent with the evidence that high temperature and high humidity reduce the transmission of influenza, which can be explained by two possible reasons: First, the influenza virus is more stable in cold temperature, and respiratory droplets, as containers of viruses, remain airborne longer in dry air. Second, cold and dry weather can also weaken the hosts’ immunity and make them more susceptible to the virus. These mechanisms are also likely to apply to the COVID-19 transmission.

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Until now, two death cases have been recorded, and both of them are over 60 years old and have other diseases before the infection, one with abdominal tumor and chronic liver disease and the other with myocarditis and renal dysfunction.

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The new CoV, 2019‐nCoV, which belongs to betacoronaviruses based on sequence analysis, can also infect the lower respiratory tract and cause pneumonia in human, but it seems that the symptoms are milder than SARS and MERS.

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Coronaviruses are a family of large, enveloped, positive-stranded RNA viruses that cause upper respiratory, gastrointestinal and central nervous system diseases in humans and other animals. Human coronaviruses HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1 circulate in humans and cause mild respiratory diseases. However, the outbreak of SARS-CoV in 2002 and MERS-CoV in 2012 showed that coronaviruses can cross the species barrier and emerge as highly pathogenic viruses.

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We found preliminary evidence that higher initial viral load is independently associated with worse prognosis in SARS. Mortality data for patients with SARS should be interpreted in light of age, comorbidity and viral load. These considerations will be important in future studies of SARS.

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Most people who catch Covid-19—the disease caused by the novel coronavirus—start showing symptoms roughly five days after infection, disease analysts at Johns Hopkins University said on Monday, in the largest such study of known cases world-wide.

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It would seem that, terrorism having been exhausted as the cause of measures of exception, the invention of an epidemic could offer the ideal pretext for extending them beyond all limits.

The other factor, no less worrying, is the state of fear which has manifestly spread in recent years in the minds of individuals and which translates into a real need for collective states of panic, to which the epidemic offers again the ideal pretext.

Thus, in a vicious and perverse circle, the limitation of freedom imposed by governments is accepted in the name of a desire for security which has been induced by these same governments which are now intervening to satisfy it.

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But once again, with regard to absolutely legitimate concerns, it is necessary not to lose our sense of proportion. It seems to me that what is happening in Italy today, with the chaotic and rather grotesque overlapping of national and regional prerogatives, has more the character of a breakdown of public authorities than that of a dramatic totalitarian grip.

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The [British] government’s new measures, its experts said, took into account these behavioural factors, such as the potential for “fatigue” – the idea that public adherence to quarantines might wane over time.

The implied logic was that asking less of the public this week could buy greater compliance down the line, when it is most crucial.

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According to [Prof. Susan] Michie [director of the Centre for Behaviour Change at University College London], governments often use what is termed the COM-B model of behaviour change, which states that in order to arrive at a particular, desired behaviour, people need to have the requisite capability, opportunity and motivation (COM). “Unless you can tick all three of those, the behaviour is not going to happen,” she said.

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Germany’s Health Ministry confirmed a report in newspaper Welt am Sonntag, which said President Donald Trump had offered funds to lure the company CureVac to the United States, and the German government was making counter-offers to tempt it to stay.

[...]

Welt am Sonntag quoted an unidentified German government source as saying Trump was trying to secure the scientists’ work exclusively, and would do anything to get a vaccine for the United States, “but only for the United States.”

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The legislation provides paid leave, establishes free testing, protects public health workers, and provides important benefits to children and families.

[...]

The Special Supplemental Nutrition Program for Women Infants and Children (WIC) – $500 million to provide access to nutritious foods to low-income pregnant women or mothers with young children

[...]

The Emergency Food Assistance Program (TEFAP) – $400 million to assist local food banks to meet increased demand for low-income Americans during the emergency.

[...]

$100 million for USDA to provide nutrition assistance grants to Puerto Rico, American Samoa, and the Commonwealth of the Northern Mariana Islands tin response to the COVID-19 public health emergency.

[...]

Includes $5 million for the Department of Labor to
administer the emergency paid sick days program.

[...]

Includes $250 million for the Senior Nutrition program

[...]

Waiver Exception for School Closures Due to COVID-19. Provides the Secretary of Agriculture the authority to issue nationwide school meal waivers during the COVID-19 emergency, which will eliminate paperwork for states and help more schools quickly adopt and utilize flexibilities.

[...]

This section defines an “emergency leave day” as a day in which an individual is unable to work due to one of four qualifying reasons related to COVID-19:
• The worker has a current diagnosis of COVID-19.
• The worker is quarantined (including self-imposed quarantine), at the instruction of a
health care provider, employer, or government official, to prevent the spread of COVID-
19.
• The worker is caring for another person who has COVID-19 or who is under a quarantine
related to COVID-19.
• The worker is caring for a child or other individual who is unable to care for themself due
to the COVID-19-related closing of their school, child care facility, or other care program.

[...]

$500 million would be reserved for emergency grants to states which experienced at least a10 percent increase in unemployment.

[...]

This section requires private health plans to provide coverage for COVID-19 diagnostic testing, including the cost of a provider, urgent care center and emergency room visits in order to receive testing. Coverage must be provided at no cost to the consumer.

[...]

This section requires the National Disaster Medical System to reimburse the costs of COVID-19 diagnostic testing provided to individuals without insurance.

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[Yaak Pabst] The neoliberal restructuring of the health care system has worsened both the research and the general care of patients, for example in hospitals. What difference could a better funded healthcare system make to fight the virus?

[Rob Wallace] There’s the terrible but telling story of the Miami medical device company employee who upon returning from China with flu-like symptoms did the righteous thing by his family and community and demanded a local hospital test him for Covid-19. He worried that his minimal Obamacare option wouldn’t cover the tests. He was right. He was suddenly on the hook for US$3270. […] The obvious solution is a national health service—fully staffed and equipped to handle such community-wide emergencies—so that such a ridiculous problem as discouraging community cooperation would never arise.

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[re: Solidarity Response Fund] Funds will go towards actions outlined in the COVID-19 Strategic Preparedness and Response Plan to enable all countries – particularly those most vulnerable and at-risk, and with the weakest health systems – to prepare for and respond to the COVID-19 crisis including rapidly detecting cases, stopping transmission of the virus, and caring for those affected.

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The [NHS] document also states that:

- The health service cannot cope with the sheer number of people with symptoms who need to be tested because laboratories are “under significant demand pressures”.

- From now on only the very seriously ill who are already in hospital and people in care homes and prisons where the coronavirus has been detected will get tested.

- Testing services are under such strain that even NHS staff will not be swabbed, despite their key role and the risk of them passing the virus on to patients.

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[Yaak Pabst] What effects to the production methods of agribusinesses have on this?

[Rob Wallace] The capital-led agriculture that replaces more natural ecologies offers the exact means by which pathogens can evolve the most virulent and infectious phenotypes. You couldn’t design a better system to breed deadly diseases.

[YP] How so?
[RW] Growing genetic monocultures of domestic animals removes whatever immune firebreaks may be available to slow down transmission. Such crowded conditions depress immune response. High throughput, a part of any industrial production, provides a continually renewed supply of susceptibles, the fuel for the evolution of virulence. In other words, agribusiness is so focused on profits that selecting for a virus that might kill a billion people is treated as a worthy risk.”
[…]
[YP] What would be sustainable changes?
[RW] In order to reduce the emergence of new virus outbreaks, food production has to change radically. Farmer autonomy and a strong public sector can curb environmental ratchets and runaway infections. Introduce varieties of stock and crops—and strategic rewilding—at both the farm and regional levels. Permit food animals to reproduce on-site to pass on tested immunities. Connect just production with just circulation. Subsidize price supports and consumer purchasing programs supporting agroecological production.
[…]
[RW]We should demand food systems be socialized in such a way that pathogens this dangerous are kept from emerging in the first place. [...]Big picture, we must heal the metabolic rifts separating our ecologies from our economies.

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In recent years, due in part to farming practices, micro-organisms which used to live apart came together and started exchanging genetic material, sometimes just fragments of DNA and RNA. When these organisms made the “jump” to human beings, disasters sometimes began for us.

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[re: Rob Wallace's book Big Farms Make Big Flu] These epidemics can be loosely grouped into two categories, the first originating at the core of agroeconomic production, and the second in its hinterland.

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Ironically, the attempt to suppress such outbreaks through mass culling—as in the recent cases of African swine fever which resulted in the loss of almost a quarter of the world’s pork supply—can have the unintended effect of increasing this selection pressure even more, thereby inducing the evolution of hyper-virulent strains.

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[Rob Wallace] A sense of solidarity and common respect is a critical part of eliciting the cooperation we need to survive such threats together. Self-quarantines with the proper support–check-ins by trained neighborhood brigades, food supply trucks going door-to-door, work release and unemployment insurance–can elicit that kind of cooperation, that we are all in this together.

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The coronavirus epidemic in the UK will last until next spring and could lead to 7.9 million people being hospitalised, a secret Public Health England (PHE) briefing for senior NHS officials reveals.

[...]

The document says that: “As many as 80% of the population are expected to be infected with Covid-19 in the next 12 months, and up to 15% (7.9 million people) may require hospitalisation.”

[...]

Experts advising governments worldwide on the way epidemics grow and eventually decline say there will be a rapid rise in cases to a peak – and then a falling off.

[...]

That will mean a peak at around the end of May to mid-June, when the NHS will be under great pressure. The strategy of all countries is to delay that peak and stretch it out over a longer period of time, so that health services are better able to cope.

[...]

In the summer months especially, the case numbers are expected to reduce

[...]

There is still a worry that the virus could resurge in the autumn or winter months, which means planning for the long term will be necessary.

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Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,” Kissler says. In this future, COVID-19 may become like the flu is today—a recurring scourge of winter. Perhaps it will eventually become so mundane that even though a vaccine exists, large swaths of Gen C won’t bother getting it, forgetting how dramatically their world was molded by its absence.

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There are various vaccine strategies for CoVs. Inactivated viruses, live-attenuated viruses, viral vector-based vaccines, subunit vaccines, recombinant proteins and DNA vaccines were developed but tested only in animals so far. As there is no effective therapeutics or vaccines, the best way to deal with severe infections of CoVs is to control the source of infection, early diagnosis, reporting, isolation, supportive treatments, and timely publishing epidemic information to avoid unnecessary panic.

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In an essay published online today March 13 in the Journal of Clinical Investigation, Casadevall and Liise-anne Pirofski, MD, chief of the Division of Infectious Diseases at the Albert Einstein College of Medicine, write that the infusion of antibody-containing serum from convalescing patients has a long history of effective use as a stopgap measure against infectious diseases
[...]
In this instance, individuals who recover from COVID-19 and are still in their convalescent phase would be asked to donate serum containing the antibodies that would then be processed for injection into sick patients and in those exposed to SARS-CoV-2.
[...]
Casadevall and other physicians are now trying to establish the practice of using convalescent sera as a preventive and treatment for COVID-19, in specific U.S. hospital networks and ultimately nationwide.

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In a March 13 Journal of Clinical Investigation article, Casadevall and Liise-anne Pirofski of the Albert Einstein College of Medicine proposed the stop-gap measure of using plasma (serum) from the blood of survivors until a vaccine and antiviral medications are available.

In this Q&A with Global Health NOW, Casadevall says clinical trials could begin in 3–4 weeks provided that they clear all the regulatory steps. If that happens, he anticipates widespread availability by early summer.

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Diagnostics company Cepheid on Saturday said it has received emergency authorization from the U.S. Food and Drug Administration to use its rapid molecular test for point-of-care patients that can detect the virus that causes COVID-19 in 45 minutes.

[...]

Cepheid said tests will begin to ship on Friday, March 27 with plans to roll it out by Monday, March 30.

[...]

The test, called SAR-CoV-2 Xpert Xpress, was developed by Cepheid, a Sunnyvale, California, company was designed to detect SARS-CoV-2, the virus that is causing COVID-19.

Cepheid uses a testing machine called GeneXpert that can run a full test in 45 minutes. There are currently more than 23,000 automated GeneXpert systems worldwide, with nearly 5,000 of them in the U.S., Cepheid said in a statement.

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Existing vaccines work by providing the body with inactivated or fragmented viruses, allowing the immune system to prep its defenses ahead of time. By contrast, Moderna’s vaccine comprises a sliver of SARS-CoV-2’s genetic material—its RNA. The idea is that the body can use this sliver to build its own viral fragments, which would then form the basis of the immune system’s preparations. This approach works in animals, but is unproven in humans.

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Because the fact is that, despite the government’s call to isolate oneself, people may soon be forced to “gather together” to tend to the needs of production. According to the latest initial estimates, the epidemic will already cause China’s GDP slow to 5 percent in this year, below its already flagging growth rate of 6 percent last year, the lowest in three decades. Some analysts have said Q1 growth could sink 4 percent or lower, and that this may risk triggering a global recession of some sort. A previously unthinkable question has been posed: what actually happens to the global economy when the Chinese furnace begins to grow cold?

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prior to circulation enhancing the resilience of such diseases, the basic logic of capital helps to take previously isolated or harmless viral strains and place them in hyper-competitive environments that favor the specific traits which cause epidemics, such as rapid viral lifecycles, the capacity for zoonotic jumping between carrier species, and the capacity to quickly evolve new transmission vectors. These strains tend to stand out precisely because of their virulence.

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It would seem that, terrorism having been exhausted as the cause of measures of exception, the invention of an epidemic could offer the ideal pretext for extending them beyond all limits.

The other factor, no less worrying, is the state of fear which has manifestly spread in recent years in the minds of individuals and which translates into a real need for collective states of panic, to which the epidemic offers again the ideal pretext.

Thus, in a vicious and perverse circle, the limitation of freedom imposed by governments is accepted in the name of a desire for security which has been induced by these same governments which are now intervening to satisfy it.

Click to expand...

But once again, with regard to absolutely legitimate concerns, it is necessary not to lose our sense of proportion. It seems to me that what is happening in Italy today, with the chaotic and rather grotesque overlapping of national and regional prerogatives, has more the character of a breakdown of public authorities than that of a dramatic totalitarian grip.

Click to expand...

The [British] government’s new measures, its experts said, took into account these behavioural factors, such as the potential for “fatigue” – the idea that public adherence to quarantines might wane over time.

The implied logic was that asking less of the public this week could buy greater compliance down the line, when it is most crucial.

Click to expand...

According to [Prof. Susan] Michie [director of the Centre for Behaviour Change at University College London], governments often use what is termed the COM-B model of behaviour change, which states that in order to arrive at a particular, desired behaviour, people need to have the requisite capability, opportunity and motivation (COM). “Unless you can tick all three of those, the behaviour is not going to happen,” she said.

Click to expand...

Germany’s Health Ministry confirmed a report in newspaper Welt am Sonntag, which said President Donald Trump had offered funds to lure the company CureVac to the United States, and the German government was making counter-offers to tempt it to stay.

[...]

Welt am Sonntag quoted an unidentified German government source as saying Trump was trying to secure the scientists’ work exclusively, and would do anything to get a vaccine for the United States, “but only for the United States.”

Click to expand...

The legislation provides paid leave, establishes free testing, protects public health workers, and provides important benefits to children and families.

[...]

The Special Supplemental Nutrition Program for Women Infants and Children (WIC) – $500 million to provide access to nutritious foods to low-income pregnant women or mothers with young children

[...]

The Emergency Food Assistance Program (TEFAP) – $400 million to assist local food banks to meet increased demand for low-income Americans during the emergency.

[...]

$100 million for USDA to provide nutrition assistance grants to Puerto Rico, American Samoa, and the Commonwealth of the Northern Mariana Islands tin response to the COVID-19 public health emergency.

[...]

Includes $5 million for the Department of Labor to
administer the emergency paid sick days program.

[...]

Includes $250 million for the Senior Nutrition program

[...]

Waiver Exception for School Closures Due to COVID-19. Provides the Secretary of Agriculture the authority to issue nationwide school meal waivers during the COVID-19 emergency, which will eliminate paperwork for states and help more schools quickly adopt and utilize flexibilities.

[...]

This section defines an “emergency leave day” as a day in which an individual is unable to work due to one of four qualifying reasons related to COVID-19:
• The worker has a current diagnosis of COVID-19.
• The worker is quarantined (including self-imposed quarantine), at the instruction of a
health care provider, employer, or government official, to prevent the spread of COVID-
19.
• The worker is caring for another person who has COVID-19 or who is under a quarantine
related to COVID-19.
• The worker is caring for a child or other individual who is unable to care for themself due
to the COVID-19-related closing of their school, child care facility, or other care program.

[...]

$500 million would be reserved for emergency grants to states which experienced at least a10 percent increase in unemployment.

[...]

This section requires private health plans to provide coverage for COVID-19 diagnostic testing, including the cost of a provider, urgent care center and emergency room visits in order to receive testing. Coverage must be provided at no cost to the consumer.

[...]

This section requires the National Disaster Medical System to reimburse the costs of COVID-19 diagnostic testing provided to individuals without insurance.

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