Coronavirus epidemic update by pulmonologist Dr. Seheult of https://www.medcram.com/?utm_source=Youtube&utm_medium=Video&utm_campaign=Video+Link+Clicks&utm_term=Coronavirus+Epidemic+Update+9%3A+Fecal-Oral+Transmission%2C+Recovery+vs+Death+Rate+%28nCoV%29&utm_content=8Hjy3UfaTSc
This video details the novel coronavirus incubation period, the updated confirmed cases, deaths, and recoveries from the coronavirus. Dr. Seheult provides illustrations of how coronavirus spreads including new reports on the possibility of fecal-oral transmission and prevention.
– How Coronavirus Kills: Acute Respiratory Distress Syndrome (ARDS) & Treatment: https://youtu.be/okg7uq_HrhQ
PLEASE NOTE: This video was recorded on February 3, 2020. Our more recent COVID-19 updates can be accessed free at our website https://bit.ly/3Q39Bqo or here on YouTube: https://www.youtube.com/playlist?list=PLQ_IRFkDInv_zLVFTgXA8tW0Mf1iiuuM_
We’ve produced each COVID-19 video with the best information we could access at the time of recording. Naturally, some videos will contain information that has become outdated or replaced by better information or research.
That said, we believe each video contains concepts that have enduring value and reviewing how the response to COVID-19 has progressed over time may be of interest to you as well.
Source LINKS referenced in and for this video:
– Coronavirus tracker from Johns Hopkins: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
– https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30183-5.pdf
– https://ncov.dxy.cn/ncovh5/view/pneumonia (red and yellow graph)
– https://www.msn.com/en-us/health/medical/coronavirus-lurking-in-feces-may-reveal-hidden-risk-of-spread/ar-BBZxuIv
– https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001316?articleTools=true (incubation time)
– https://m.weibo.cn/status/4467854247970018?
– https://www.nejm.org/doi/full/10.1056/NEJMoa032867
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Speaker: Roger Seheult, MD
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Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.
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well welcome to another MedCram
coronavirus update and as of today we have 362 deaths which is up from 305
yesterday and we have 17,000 392 infected which is up from 14,000 556 now
this ratio that we’re looking at here is simply the ratio of confirmed deaths to
confirm infected of course people are going to be diagnosed with the infection
before they might have a chance of dying so there’s a time lag there so it’s not
an accurate case fatality or mortality rate but it is something that we can
look at and track the other thing that you might have noticed on the website
that we reference and we’ll make a link to it which is a nice official reporting
dashboard from Johns Hopkins is this 487 recovered we’ll talk more about that as
well what are the criteria for recovered and we’ll talk a little bit about the
Lancet article and also some reporting out of China today so in The Lancet
article which will give you a link to some really good information the
incubation period on average for these 41 patients that were admitted to a
hospital right there in the middle of this epidemic was 5.2 days but 95% of
all of them had the incubation period within 13 days and you know that for
citizens coming to the United States from that area they’re holding them for
at least 14 days to make sure that they do not have the virus incidentally there
was a German plane yesterday that flew in with German nationals and when they
screened them on the plane there was two people that were positive for
coronavirus on that plane so let’s look closer at this Lancet article because I
think it’s very instructive in terms of periods of time and looking at things so
here we have the infection that starts and that incubation pair would go right
in here so on average would be about you know five or six days and then the time
from symptom onset to admission to the hospital that’s a very key thing there
because most patients probably don’t even go to the hospital
and they may do just fine but for those that do go to the hospital it was noted
to be about a seven-day period and then from admission that was a hundred
percent of the cohort that was looked at in the study because they looked at
those 41 patients within a day of admitting to the hospital about 51% of
them developed shortness of breath another day later 27 percent went into a
RDS and if you want more information about a RDS look at our med cram video
on this channel titled how coronavirus kills then another day before they got
to the intensive care unit and they’re about 10 percent or four patients
require mechanical ventilation so what was the outcome of this study and I
think it was very interesting out of the 41 people at the time of publication of
this in The Lancet there were 28 people that were discharged home there were six
people that passed away that’s about 15% and of the 28 that is 68% which leaves
seven that were still alive and in the hospital being treated so the question
is is what were the criteria and this gets back to that number that we see on
the site what was the criteria for allowing these people to go home and
this is very important so from my understanding there are some guidelines
now that are being instituted nationally in China about what constitutes someone
that’s recovered and at least for this hospital it was 10 days without a fever
it was that the chest x-ray was improving because all 41 patients had
abnormal CT scans chest x-rays this next one is important it’s to be discharged
home there had to be no virus detected in the upper respiratory tract and so
that’s a pretty high bar and with that 68% of those people that enter the
hospital were able to go home and deemed cured we don’t know what happened to the
other seven so if we look at just those that entered into the hospital we’re
looking at about a 15% mortality rate in the least
and from there it could go up depending on what those other seven did if one or
two of those died then the mortality rate goes up I stress again this is not
the overall mortality rate of the virus this is the mortality rate for those
people that have to go to the hospital because their symptoms were so severe okay three other stories I want to talk
about real quick there was in the local Chinese media a story that I picked up
and I’ll work in the link to that one as well in the description below a doorknob
was found to have the RNA PCR of the corona virus on it so again this
highlights the need for hand hygiene carrying around alcohol-based hand
sanitizers make sure you’re washing your hands the other thing I want to
highlight is that there was some local media in China about a patient being
discharged home this is a patient that was 30 years old he was admitted on the
20th of January and he was being discharged today on the 3rd of February
again I looked very carefully at the media report of what was the criteria
and they did mention that this was the standard criteria for discharging a
patient home in this case the patient had a normal temperature times 3 days
and they were doing PCR to look specifically for the RNA of this virus
and it was negative and they were checking it at every 24-hour intervals
so this patient felt better the PCR was negative for the virus
wasn’t shedding it in other words and it’s temperature been normal for 3 days
so I think that adds a little bit more in terms of what that number means on
the website people that have recovered think about this though in terms of a
timeline the first thing that’s going to happen is someone’s gonna be a confirmed
case the second thing that could happen is they could die and then the third
thing that would happen is that they would recover obviously they’re not
going to recover after they die but these things are going to happen
in this order so it’s gonna take the longest to have a recovery it’s gonna
take the shortest to have a confirmed case and it’s gonna take intermediate
somewhere between that time to have a death
so look for in the future as we progress through this epidemic that the number of
recoveries is going to surpass the number of deaths and we hope that that
is by a large amount let’s talk a little bit about how it spreads so we all are
familiar with the common cold the flu and the importance for a mask and also
the need for eye protection in this case especially in the healthcare setting
what may be something that we may have underestimated and that is the
fecal-oral route and the reason why that’s the case and we’ll put a link to
this in the description it’s because the man in Washington State they found the
corona virus in his stool and why this is important is because this goes back
to 2002 2003 where there was a big outbreak of SARS in a particular
apartment complex in China and it was because of this toxic viral plume after
the man had diarrhea and that aerosolized the viruses into the air and
it went into the other apartments and that’s where the other people picked up
the virus and so it is possible that this fecal-oral route may be a big
determining factor but it highlights that fecal-oral
transmission of this virus is potentially in play and so washing hands
is an important thing to understand we are witnessing and in the middle of a
human tragedy that is pretty scary to say the least there are a lot of people
that are suffering but there are some things that we can do about this we can
educate ourselves we can understand the virus we can make sure that we’re doing
everything that we can to prevent that virus from spreading we can make a
difference thanks for joining us
