Talk:COVID-19

Asymptomatic spread worse than thought -- needs to be updated urgently

"We now know that asymptomatic transmission likely [plays] an important role in spreading this virus," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Osterholm added that it's "absolutely clear" that asymptomatic infection "surely can fuel a pandemic like this in a way that's going to make it very difficult to control." In an article two weeks ago in the New England Journal of Medicine, Bill Gates, co-chair of the Bill and Melinda Gates Foundation, expressed concern about the spread of the disease by people who haven't yet developed symptoms, or who are only a bit sick. "There is also strong evidence that it can be transmitted by people who are just mildly ill or even presymptomatic. That means COVID-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people," he wrote, using the scientific word for the disease caused by the virus. 'Prolonged, unprotected contact' led to first known person-to-person coronavirus transmission in US, study says Others agree that people without serious symptoms play a substantial role in the spread of the new coronavirus. "Asymptomatic and mildly symptomatic transmission are a major factor in transmission for Covid-19," said Dr. William Schaffner, a professor at Vanderbilt University School of Medicine and longtime adviser to the CDC. "They're going to be the drivers of spread in the community." Osterholm urged public officials to be clearer about the way the virus is spread.

Source: https://us.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

73.195.225.148 (talk) 03:56, 15 March 2020 (UTC)

Anti-inflammatory drugs are possibly implicated in worsening of coronavirus disease

French minister for health Olivier Véran recently tweeted that anti-inflammatory drugs such as ibruprofen and cortosine may worsen the disease. Is there any official source on this that can be used as a reference, and how may we include it in this article ? JMS Hunt 2020 (talk) 17:55, 14 March 2020 (UTC)JMS Hunt 2020

Can't help with that. Have come across information that Chinese figures show administration of steroids is highly correlated with bad outcomes, but no reliable source. Shtove 19:58, 15 March 2020 (UTC)

Anti-inflammatories may aggravate Covid-19, France advises - The Guardian, 2020-03-14. This might be a reason for the high CFRs in Italy due to NSAID use, and in Iran due to steroids. -- Jeandré, 2020-03-18t05:04z

Putting on PPE

User:Dekimasu Putting on PPE definitely part of the management of someone with COVID19. Doc James (talk · contribs · email) 17:12, 9 March 2020 (UTC)

yes, agree--Ozzie10aaaa (talk) 20:40, 9 March 2020 (UTC)

Is there anything about it that is different from how protective gear would be put on when dealing with other infectious diseases? If not, then I think the step-by-step description is wandering into WP:NOTHOWTO. A simple statement that protective gear is used would suffice, without the graphic. For example, we mention intubation, but we don't have a description here of how intubation works. Dekimasuよ! 06:13, 10 March 2020 (UTC)

These are the specific level of instructions for PPE for this disease which are different than say the instructions were for Ebola which you can see Ebola_virus_disease#Putting_on_protective_equipment

This is not how to, but simple the recommendations from the CDC. Doc James (talk · contribs · email) 00:30, 11 March 2020 (UTC)

I really see no reason for having that image on this page specifically. The description makes sense, but a visual image for such a small section specifically for medially professionals putting on protective gear, seems unneeded to me. WikiVirusC^(talk) 14:03, 10 March, 2020

This a major aspect of treating this disease. We have a whole collection on apply PPE for Ebola_virus_disease#Putting_on_protective_equipment and than another for removing it. Doc James (talk · contribs · email) 05:29, 14 March 2020 (UTC)

Sequelae

Should we have a section on the consequences of recovering from COVID-19, separate from complications? Many voices claim "it's just a bad flu", others state that consequences are unknown, while a minority claim permanent lung or brain damage can result from the disease. — Preceding unsigned comment added by Dandv (talk • contribs) 04:51, 10 March 2020 (UTC)

Consequences are part of the prognosis.Cinadon36 09:39, 10 March 2020 (UTC)

Here's a source, albeit non-medical https://news.yahoo.com/people-fully-recover-coronavirus-left-103917303.html?soc_src=newsroom&soc_trk=com.apple.UIKit.activity.PostToFacebook&.tsrc=newsroom Victor Grigas (talk) 00:49, 14 March 2020 (UTC)

I've added a section, pointing to the closest original source I could find (South China Morning Post). I couldn't find anything on the Hong Kong Authority's website. -- Dandv 13:14, 15 March 2020 (UTC)

What you DO NOT want to add is that it is “just a bad flu”!! as Corona is not influenza at all. Corona virus 19 disease is an extreme COLD, which is a different animal than an influenza. It can cause pneumonia, and/or other symptoms, but is still not flu. Ragity (talk) 03:20, 17 March 2020 (UTC)

Antivirals

I removed a paragraph, because it resembled a list created by various sources, some of them non-RS. We should strive to find an article that presents this specific topic (research on antivirals) rather than using a dozen of questionable sources. Here is the text I removed.

Antivirals being tested include chloroquine, darunavir, galidesivir, interferon beta, the lopinavir/ritonavir combination, the RNA polymerase inhibitor remdesivir, and triazavirin. Umifenovir (Arbidol) and darunavir were proposed by the National Health Commission.

References

Any feedback is welcomed. Cinadon36 17:38, 10 March 2020 (UTC)

Someone included this info already. This is obviously an important info, and it is well sourced - based on the references above. If anyone wants to improve this content further, they are very welcome. My very best wishes (talk) 19:49, 11 March 2020 (UTC)

Hi! I've added MBJ Best Practices as the source for the list of trialled antivirals. Authors aggregated information about therapy investigations so we could use this source of information. Information is updated periodically. D6194c-1cc (talk) 20:40, 11 March 2020 (UTC)

@D6194c-1cc: Just seen it. Much better now. Cinadon36 22:23, 11 March 2020 (UTC)

Does this infringe copyright policy?

An illustration of the effect of spreading out infections over a long period of time on healthcare capacity managing patient volumes, known as flattening the curve

@Diannaa:, can we have your wisdom on this? The illustration is a property of the nz magazine, as I get it. Cinadon36 17:46, 10 March 2020 (UTC)

In either event, it's either meta or instructional, which is not really what we should be going for here. Dekimasuよ! 17:54, 10 March 2020 (UTC)

@Dekimasu: totally agree. Cinadon36 17:56, 10 March 2020 (UTC)

Agree that it's not appropriate for the article, but on copyright it looks fine. The creators released it on a CC-BY-SA licence.  — Amakuru (talk) 18:01, 10 March 2020 (UTC)

@Amakuru: Are you sure? I can not find the original creator. Is it Drew Harris? https://twitter.com/drewaharris/status/1233267475036372992 Maybe @splette https://twitter.com/splette/status/1236345661962039297. But the illustration on WP article, is created by thespinoff.co.nz. And there is no mention of the licence. Cinadon36 18:09, 10 March 2020 (UTC)

A reviewer at the Commons has checked and states that the license is okay. — Diannaa (talk) 20:11, 10 March 2020 (UTC)

@Diannaa: Great, thanks! Cinadon36 20:21, 10 March 2020 (UTC)

And you're happy to believe them when you didn't believe me? Why don't you ask that person if they're wrong as well?  — Amakuru (talk) 20:48, 10 March 2020 (UTC)

Well, I understand why you feel offended dear Amakuru, but see it from my perspective. I was told by one other user that is ok- I wasn't convinced. Then another editor had the same opinion as the first user. Why should I continue talking about it? I haven't really understand why I am wrong on it, but I am probably wrong since 2 users have an opposite opinion and I am not really familiar with copyright infringements. Thank you for your replies. Cinadon36 21:16, 10 March 2020 (UTC)

@Cinadon36: apologies for being snarky here earlier... you caught me at a bad time! To be honest, it's been tricky to trace the true origin of this graph, although everyone has attributed it along the way! The earliest version seems to be from the CDC in 2007, which they then reused again in 2017. Neither of those versions appear to release the copyright. Drew Harris then adapted his own version, as did Ros Pearce. CT Bergstrom made a version from all three of the above sources and Thomas Splettstößer adapted that still further, with the line "Feel free to use and share" but again no explicit licence. The Spin Off's version mentions Harris, Splettstößer and the CDC, and for the first time is released with a CC-BY-SA tag marked on the graphic, with the handles of the authors of this work. Is it a derivative work? If so, their CC-BY-SA might actually not be valid and we should delete it. But if the graph itself is just a generic un-copyrightable concept, with only the specific design deemed to be original, then our reuse of the Spin Off's work, maintaining their licence is acceptable. I don't know if the Commons user considered this and made a decision or not!  — Amakuru (talk) 23:11, 10 March 2020 (UTC)

Copyright is ok, but "flattening the curve" is probably just a layman's term instead of an established medical jargon, because the phrase was not mentioned in any of the scientific papers but first by an Economist article (see the probable genesis I listed on c:File:Covid-19-curves-graphic-social-v3.gif).--Roy17 (talk) 00:04, 11 March 2020 (UTC)

Or you could have asked the person who uploaded the image itself. This image is complete appropriate when it comes to a pandemic disease.Doc James (talk · contribs · email) 00:13, 11 March 2020 (UTC)

Here is a Lancet paper on the topic https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30567-5/fulltext

Technically it is known as "flattening the epidemic curve" but is often shortened to "flattening the curve"

Seriously this is basic epidemiology which I took 20 years ago in medical school.

These are basic scientific facts. This is like arguing that someone can "own" / "copyright" the bell curse. Doc James (talk · contribs · email) 00:25, 11 March 2020 (UTC)

yes, agree.Doc James is making a logical point, I don't see what the problem is--Ozzie10aaaa (talk) 01:33, 11 March 2020 (UTC)

Doc James, that is a valid point. It is obvious that there is a strong consensus that the illustration is ok regarding copyright. My concern was on the illustration, how the one curve move into the other curve- I thought that was a creative element. Also there are two young persons talking- also a creative element. When I saw the graph on the Spin Off magazine, I was alarmed. Sorry for any inconvenience. Now it 's time to get busy with more interesting staff on CoVID-19. Cinadon36 07:22, 11 March 2020 (UTC)

Cinadon36 agree it's time to move on, but just as a final question, are you aware that the graphic itself has a "CC-BY-SA" label printed in the bottom right corner? Which should cover all original elements in the graphic itself. Or is your concern that although they labelled it, they maybe didn't follow all the steps required for an official CC licence? Either way it looks like the intent was to release it that way...  — Amakuru (talk) 07:30, 11 March 2020 (UTC)

@Amakuru:, I had noticed the CC-BY-SA label, but since there is no number next to it (ie CC-BY-SA 2.0, 3.0 etc), my though was it might not be valid. Also, I noticed that their cited refs (which weren't pretty clear) did not use a CC-BY-SA label. Thanks for asking. Cinadon36 07:52, 11 March 2020 (UTC)

You do realize it was created by an expert in the subject in question? Also we are working with them. They will add the number if we want. Ie they are experts in infectious disease outbreaks not CC licensing. If you can provide evidence that they got this wrong (which I do not think they have) than they will adjust it. Doc James (talk · contribs · email) 15:33, 11 March 2020 (UTC)

Now to the important stuff. Prevention happens at two levels individual and population. We need to address both and this graph is about population level measures, which are harder for many people to understand by the way. Doc James (talk · contribs · email) 15:36, 11 March 2020 (UTC)

Doc James I didnt realized that it was created by an expert, I thought it was regular artwork created by a magazine employee. But what do you mean with " we are working with them"? Who are "we"? No need to add a number at the licence, since everybody thinks it is ok. I was also convinced it is ok regarding copyrights, it is obvious that the case is closed. We can re-add this material if there is no objection. (there is no objection by me, I am rather neutral) Cinadon36 16:39, 11 March 2020 (UTC)

I asked them to release it under an open license and they did. This is the author Siouxsie Wiles. Doc James (talk · contribs · email) 16:44, 11 March 2020 (UTC)

I have reviewed this image and the original source (and related copyright permissions). The evidence meets our criteria and we should add in. Thanks for all your efforts to get permission for use JenOttawa (talk) 18:46, 12 March 2020 (UTC)

An additional point: this image is representative of a viral communication process in this pandemic, which is crucial from the perspective of history, which this will thankfully one day be. As such, ultimately a section on this image itself will be needed, capturing the provenance that's discussed here, and including a copy of the CDC one (which would be usable given its the product of US government employees in their work). Hildabast (talk) 21:31, 17 March 2020 (UTC)

It appears effective in encouraging people to perform all the social distancing methods at moment, a concept not easy to understand for a lot of people. Whispyhistory (talk) 04:50, 18 March 2020 (UTC)

Cause

Dozens of people infected early in the current outbreak worked in a live-animal market in the Chinese city of Wuhan, but tests of coronavirus samples found at the market have yet to identify a source . Even a Nature article has the courage to spell out that a meat market is a common focal point of may of the early cases, but let wikipedians shill for the Chinese government and make sure the origin is muddled as much as possible. Completely encyclopedic indeed. 2601:602:9200:1310:F16B:3EF1:CDC8:D561 (talk) 07:07, 11 March 2020 (UTC)

The cause is the virus, but the original biological source of the virus and the "patient zero" in China are unknown. It was not even well established if it came from this market. Please correct me with refs if I am wrong. My very best wishes (talk) 19:53, 11 March 2020 (UTC)

AND please assume good faith, even when referring to the ChiCom government. It’s a basic tenet of our project. Ragity (talk) 03:38, 17 March 2020 (UTC)

ICD-10 code

I've just restored {{medical resources}} and the ICD-10 code, as it was slowly removed over a number of days after an IP added "not mentioned at target". Effectively marking it as "citation needed" but via the use of a comment tag. My problem with that is:

1. Facts don't need citations
2. External links can't have citations – it sits below the reflist
3. Classifications don't work that way! They're not nomenclatures, and can't list every condition that a code covers.

With that said, the 2019 version of ICD-10 does state COVID-19 at U07.1, so I've requested the URL at {{ICD10}} is updated to fix the verification "problem". Little pob (talk) 09:25, 11 March 2020 (UTC)

New graph based on the China CDC data

Visualization of covid-19 data in China CDC Weekly 2020, 2(8), pp. 113-122

Case fatality rates by age group in China. Data through 11 February 2020.

3rd image

Hi everyone,

I found graph in connection to the reference 99 http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51 interesting, so I spent some time making an expanded version (attached to post). What do you think, would it be a good contribution to this article?

Best, Lejoon (talk) 20:08, 11 March 2020 (UTC)

I like it. Put it in. Bondegezou (talk) 20:31, 11 March 2020 (UTC)

Thank you! I replaced the previous figure in the mortality rates section, since this figure contains the same data. Lejoon (talk) 21:15, 11 March 2020 (UTC)

Hi, certainly this is nice work but I am not sure if the graph will actually help readers get the broader picture of the epidemiology of COVID19. The problem is that these numbers vary significantly in other countries, and if I recall correctly, there are differences among various provinces within China. Mortality by COVID19 in China reflects the situation where health services are overwhelmed suddenly by huge numbers of cases. That's why the high mortality numbers are similar only to Italy's numbers. Elsewhere the story is different. Cinadon36 21:51, 11 March 2020 (UTC)

So, the graphs/figure needs to be clearly labelled as reflecting the Chinese context, and we need text in the article describing how mortality has varied from region to region. Bondegezou (talk) 08:41, 12 March 2020 (UTC)

Good points. The graph states China and the date in the title. Do you think it needs to be clearer? Lejoon (talk) 10:21, 12 March 2020 (UTC)

Lejoon, yes, it is very clear, but people - general public might not understand the difference unless we make it crystal clear... Maybe we can add at the caption that numbers in other countries that have not been overwhelmed by the disease might be different. Otherwise, I am fine with it. Cinadon36 10:29, 13 March 2020 (UTC)

It makes everything too small. We should have this as three separate graphs in a gallery. Doc James (talk · contribs · email) 22:25, 11 March 2020 (UTC)

Yes this graph is confusing. Too much information. --The Cunctator (talk) 03:50, 12 March 2020 (UTC)

Sure. How about keeping the age distribution data with the age plot, and separating the other two graphs into their own pictures? Lejoon (talk) 10:21, 12 March 2020 (UTC)

User:Lejoon not sure what you mean. Can you show me? Doc James (talk · contribs · email) 15:00, 12 March 2020 (UTC)

User:Doc James Please see drafts on right-hand side. Lejoon (talk) 21:29, 12 March 2020 (UTC)

Draft, age case fatality rate

Draft, comorbidity and severity

We now have the third image for severity. Doc James (talk · contribs · email) 05:28, 13 March 2020 (UTC)

That's great! It's a very nice graph. Here's the comorbidity without severity. Lejoon (talk) 07:34, 13 March 2020 (UTC)

Comorbidity only

Oops, I should have checked the article first. Someone already cut the severity data out. Case closed I guess! But, I would still advocate for replacing the old age case fatality graph with mine, because knowing the distribution of the cases included is important in interpreting the data. E.g., there are only about 400 cases in the 0-9 age group. A single death in that group would have changed the death rate from 0.0 to ~0.25 %. Similar arguments can be made true for the other small groups. I don't think the inclusion of the age distribution bar in the bottom makes the graph too confusing for the average reader, but that's my opinion. Lejoon (talk) 07:41, 13 March 2020 (UTC)

Why is the colors of each bar different? I do not think the bar at the bottom is needed. People can find that in the ref. Doc James (talk · contribs · email) 02:25, 14 March 2020 (UTC)

Improve image

Case fatality rate depending on other health problems

Can you make the bars wider so the numbers on top are bigger? Doc James (talk · contribs · email) 02:33, 14 March 2020 (UTC)

Former Wuhan coronavirus wiki

Why is "Wuhan coronavirus" not listed under Other Names? It looks like some substantial basis of this page was actually from a page in January substantively named "Wuhan coronavirus," and omitting a term used for months by variety of news organizations, including the Times and CNN, reads in context like a political decision, not an encyclopedic one. -- Bighardsun (talk) 02:36, 12 March 2020 (UTC)

I agree! I added several colloquial names, partly because of a historian friend of mine complaining about how much work it is to track down references to a historical virus by all its different names. Statesman 88 (talk) 15:52, 13 March 2020 (UTC)

Highly irresponsible to list "runny nose" as a top-level symptom

It is very bad for the first paragraph of the Wikipedia article on COVID19 - i.e. one of the primary sources for information on the disease for the entire planet - to mention "runny nose" in the symptom list without a very strong caveat, when it almost definitely indicates hayfever or a rhinovirus. Rhinorrhea doesn't even appear in the WHO-China report as an observed symptom.

This is the version that I submitted, based on a careful reading of the literature, that has been reverted:

Those affected are likely to develop a fever and dry cough. Fatigue and shortness of breath are also common indicators. Sputum production, headache, muscle pain, and sore throat are less common symptoms. Nasal congestion or runny nose are uncommon and generally associated with hayfever or the common cold.

--The Cunctator (talk) 03:44, 12 March 2020 (UTC)

Uncommon symptoms should be discussed in the body not the lead IMO. Doc James (talk · contribs · email) 02:29, 14 March 2020 (UTC)

References

Inconsistency and proper naming

1. The article says "Time from exposure to onset of symptoms is generally between two and 14 days, with an average of five days." and then it says "The incubation period ranges from 1 to 14 days, with an estimated median incubation period of 5 to 6 days". The information should be consistent.

2. The article says "The disease is caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously referred to as the 2019 novel coronavirus (2019-nCoV)". Does it mean that the current "novel coronavirus" is incorrect?

ICE77 (talk) 07:06, 12 March 2020 (UTC)

Cause and Pathophysiology

@Dekimasu:, I have noticed that you deleted one of my recent additions.[1] You are right, the info is not about the cause of COVID19. It is about the pathophysiology of the disease and I think it is a pretty important aspect. So I intent to re-introduce it, under the new section "pathophysiology". What concerns me, and lead me to placing that piece of text under "cause" section, is that I wanted to avoid fragmentation of the article into several sections. Anyway, I 'd like your opinion before I proceed to any changes. Cinadon36 14:19, 12 March 2020 (UTC)

I think it would go under "prognosis", but I still believe it is misleading to simply state that the disease "progresses into SARS". If that were the case, this article would not exist. The virus is different, the way the disease presents is different–it is not simply SARS. Dekimasuよ! 14:35, 12 March 2020 (UTC)

"The disease might progress into SARS". Would that be better? And I feel it is more related to the pathophysiology of the disease rather than prognosis. Also, COVID-19 could lead to cardiac or liver failure, as ACE2 enzyme is also present in liver and heart- we might add this piece, sourced, as well. Cinadon36 15:03, 12 March 2020 (UTC) PS- or we can leave the "progress into SARS" section out and make it like "As the alveolar disease progresses respiratory failure might develop and death might ensue."Cinadon36 15:08, 12 March 2020 (UTC)

The final version removes the part I was objecting to, so I am fine with it. As far as having a section called "pathophysiology" that is separate from the other current sections, I think there are several editors on this page who would argue that the language is too specialized. For my part, I think there are too many sections and consolidating them to some degree would be beneficial in terms of readability. Dekimasuよ! 15:58, 12 March 2020 (UTC)

@Dekimasu: Great, thanks, I will re-add it now. As for "pathophysiology", I share the same concern of being to technical. But a solution must be found. Maybe "mechanism"? I do not know...Cinadon36 17:21, 12 March 2020 (UTC)

Passing mention of this Wikipedia article in press

• https://www.wired.co.uk/article/wikipedia-coronavirus

---Another Believer _(Talk) 20:09, 12 March 2020 (UTC)

Request for semi-protected edit March 12,2020

I am uploading my scientific artwork, currently published - https://www.statpearls.com/as/pulmonary/52171/, to add to this wikiarticle.

I have additional images from the above article, will add all of them soon.

Image 1 - Transmission of SARS-CoV 2 [[2]]

Rbsingh91 —Preceding undated comment added 00:20, 13 March 2020 (UTC)

CT Imaging Needed for Diagnosis?

This sentence in the lead paragraph struck me as problematic, "The infection can also be diagnosed from a combination of symptoms, risk factors, and a chest CT scan showing features of pneumonia." I was curious to see who was making such a recommendation about imaging and diagnosis.

I then followed the link to the COVID-19 testing article and found this paragraph under 'CT Imaging':

"Chest CT scan, an imaging tool for pneumonia, is fast and relatively easy to perform. One research found that the sensitivity of CT for COVID-19 infection was 98% compared to RT-PCR sensitivity of 71%.[52] Most common CT scan findings were bilateral groundglass attenuation (patchy or diffuse) with subpleural dominance, crazy paving and consolidations at later stages. However, these findings are nonspecific and found as well in other types of pneumonia. No study yet has validated the accuracy and discriminatory value of CT scans to distinguish COVID from other viral pneumonia. Therefore, the CDC - does not recommend CT for initial screening, as emphasized in the COCA call on Thursday, 5 March. People with suspected COVID should be tested with RT - PCR -which is the most specific test.[citation needed]"

The first sentence was sourced to two references, the original manuscript and an article about the manuscript. I removed the latter as per WP:MEDPOP. While the last bit is unsourced, I agree with the reasoning. There is nothing about CT imaging findings which make a clinician think it's COVID-19. The features reported in both articles mimic the findings of other infectious pneumonia. Suggesting CT imaging is needed for diagnosis is misleading in my opinion, particularly when the findings have not been well validated in other countries and settings. I'm open to what others think. Moksha88 (talk) 02:51, 13 March 2020 (UTC)

Yes one can also make a clinical diagnosis. This was done in Wuhan during the peak of the outbreak. I am sure many others will be doing this aswell as the number of cases increase beyond testing capabilities. Doc James (talk · contribs · email) 02:35, 14 March 2020 (UTC)

Accusations of under reporting cases of coronavirus in China

There are accusations that China is altering, underreporting and trying to hide the real toll of coronavirus. 194.247.60.2 (talk) 09:44, 13 March 2020 (UTC)

That was from Feb 14th. It is old and proven basically to be false. Sham on the Guardian really. Doc James (talk · contribs · email) 02:34, 14 March 2020 (UTC)

References

Herd immunity

• https://www.msn.com/en-nz/news/world/majority-of-uk-needs-to-get-coronavirus-for-herd-immunity-chief-scientist-says/ar-BB1195At
• https://www.mirror.co.uk/news/uk-news/coronavirus-what-herd-immunity-how-21681418
• https://www.newsweek.com/herd-immunity-protect-coronavirus-covid-19-1492143
• https://www.nbcnews.com/now/video/experts-hope-herd-immunity-flattens-the-coronavirus-curve-80512581952
• https://www.wired.co.uk/article/herd-immunity-uk-coronavirus-robert-peston

I'm surprised Herd immunity isn't covered in this article. Sun Creator^(talk) 13:55, 13 March 2020 (UTC)

User:Sun Creator there is no herd immunity. And we should be using better sources if we can. Yes herd immunity after enough people are infected and survive will be useful but not until a substantial population has it. And there is also the chance that this virus will mutate and herd immunity may be lessened. Doc James (talk · contribs · email) 05:46, 14 March 2020 (UTC)

Also, at the moment we do not know if past coronavirus infection provides effective immunity. Or has it been confirmed? --Gtoffoletto (talk) 15:02, 14 March 2020 (UTC)

We do not know if you can become infected again. Not enough people who have recovered yet. Likely the answer will be you will be immune for some time anyway. But the other question is how fast this virus mutates. Doc James (talk · contribs · email) 18:50, 14 March 2020 (UTC)

Where should this information be placed in the article? It seems an important point. Any sources on this you are aware about. --Gtoffoletto (talk) 19:27, 14 March 2020 (UTC)

There is a paragraph about immunity under Prognosis. -- Dandv 13:19, 15 March 2020 (UTC)

I know. I wrote it. --Gtoffoletto (talk) 15:37, 15 March 2020 (UTC)

ACE2 is not sensitive to ACE inhibitors nor angiotensin II receptor blockers

The following article mentions that ACE2 is upregulated by ACE inhibitors and Angiotensin II Receptor Blockers and TZDs. Reminder: ACE converts ANG I to ANG II(vasoconstrictor) and ACE2, ANG II to ANG1-7 (vasodilator) ACE2 is protective against lung inflammation in high levels but the CoVir19 causes it to decrease, thus the pro destructive effect. https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf Jetumele45 (talk) 03:16, 14 March 2020 (UTC)

Just a letter to the BMJ, but worth keeping an eye on: https://www.bmj.com/content/368/bmj.m325/rr

The active site of ACE2 appears to bind both angiotensin II and the SARS coronavirus spike glycoprotein through an FQ-containing motif shared by quinapril. The active site of ACE2 thus resembles the N terminal active site of ACE. In patients lacking the systemic blood pressure for an ACE inhibitor like quinapril, an ARB such as losartan could be substituted as a first approximation, since we found it useful for West Nile virus encephalitis. Shtove 19:54, 15 March 2020 (UTC)

Diagnostics

I suggest considering the use of this as a quality systematic review: PMID 32110875 LeadSongDog come howl! 18:43, 13 March 2020 (UTC)

Thanks User:LeadSongDog Added it to a couple of places. Doc James (talk · contribs · email) 19:01, 14 March 2020 (UTC)

Info on possible fecal-oral transmission of Covid-19 missing from article

Research out of China claims that the Covid-19 can be transmitted via the fecal-oral route but I could not find any mention of this in this Wikipedia article. Other medical sources claim the risk is low from fecal-oral transmission. Someone better equip to sort out this dispute should look through the medical sources I provided below and try and come up with at least a paragraph to add to the article on the differing points of view as to whether it can be transmitted through the oral-fecal route (as Chinese researchers have claimed) and if so how likely this is verses the oral/nasal transmission. Here are several mical publications that discuss this study and oral-fecal transmission of Void-19 in general:

• https://www.medpagetoday.com/infectiousdisease/covid19/85315
• http://www.cidrap.umn.edu/news-perspective/2020/03/study-covid-19-may-spread-several-different-ways
• https://www.idse.net/Emerging-Diseases/Article/03-20/GI-Tract-Possible-Route-of-Transmission-for-COVID-19-/57537
• https://www.medscape.com/viewarticle/926682
• https://www.medscape.com/viewarticle/926390
• https://www.cdc.gov/coronavirus/2019-ncov/php/water.html
• https://www.gastrojournal.org/article/S0016-5085(20)30281-X/fulltext
• https://www.mdmag.com/medical-news/gastrointestinal-issues-help-diagnose-coronavirus
• http://www.cidrap.umn.edu/news-perspective/2020/02/studies-show-covid-19-virus-likely-has-multiple-infection-routes
• https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
• https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/assumptions.html

Note: While I know that many of the above sources are WP:MEDRS compliant, I am not in a position to speak to all of them in this regard but I included one I wasn't 100% sure about as a jumping off point snd not because I expect every link above to be cited/used in the article. --Notcharliechaplin (talk) 20:56, 14 March 2020 (UTC)

WHO and Health Canada are great sources. As is the CDC. Doc James (talk · contribs · email) 00:17, 15 March 2020 (UTC)

Now 137. Very bad. Pandya101 (talk) 14:41, 17 March 2020 (UTC)

Now 150+ very bad Pandya101 (talk) 15:45, 18 March 2020 (UTC)

Citations lacking

"This is why social distancing is so important to saving the lives of others, not just to preserving one's own healthy status. This fact falsifies the argument that a young healthy adult can simply ignore the need for social distancing, accept a mild flu-like illness, recover, and move on: the problem with that otherwise-logical plan is that the person meanwhile serves as a link in the chain of wider transmission, causing more new cases to arise elsewhere, dooming some vulnerable people who might otherwise avoid infection long enough to survive past a burnout of the epidemic."

-This passage seems judgmental and speculative to me and is lacking in direct citations. At best it should be summarizing the arguments of a published source. — Preceding unsigned comment added by 2604:2000:1382:C0C6:F562:E72:60D8:9211 (talk) 23:39, 14 March 2020 (UTC)

Have toned it down some. Doc James (talk · contribs · email) 00:16, 15 March 2020 (UTC)

Till now about 100+ in India only. Pandya101 (talk) 12:38, 15 March 2020 (UTC)

Now cross 115. Worry. God bless. Pandya101 (talk) 13:33, 16 March 2020 (UTC)

Concerns of citing non peer-reviewed research eg arXiv etc

While I understand that wikipedia cites both primary sources and reliable secondary sources (eg news articles), I have some concerns about manuscripts being cited that are not peer-reviewed in the context of COVID-19. Pre-print servers such as arXiv play a vital role in science but papers may not yet be peer-reviewed. The risk that if someone sees 'A study has shown this' and a citation to arXiv most reader will think this is a peer-reviewed study. I'm not saying we should remove the citations but should we state 'a non peer-reviewed study' when referring to these? Genesis12~enwiki (talk) 14:38, 18 March 2020 (UTC)

WikiProject COVID-19

I've created WikiProject COVID-19 as a temporary or permanent WikiProject and invite editors to use this space for discussing ways to improve coverage of the ongoing 2019–20 coronavirus pandemic. Please bring your ideas to the project/talk page. Stay safe, ---Another Believer _(Talk) 16:38, 15 March 2020 (UTC)

Article

• White House Coronavirus Task Force SandyGeorgia (Talk) 18:23, 15 March 2020 (UTC)

Should information on the risk of exposure by occupation be added?

The NYT article https://www.nytimes.com/interactive/2020/03/15/business/economy/coronavirus-worker-risk.html used as Source the O*Net, Bureau of Labor Statistics. Income and employment statistics are from May 2018, the most recent Occupational Employment Statistics release. I was not sure if and how to do it. A student of mine thought of adding the risk to some of teh pages of professional hazards of specific occupations. TMorata (talk) 12:14, 16 March 2020 (UTC)

In my opinion premature. David notMD (talk) 20:02, 16 March 2020 (UTC)

Semi-protected edit request on 16 March 2020

Please add the additional symptoms as found on the WHO Webiste: "The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea." https://www.who.int/news-room/q-a-detail/q-a-coronaviruses#:~:text=symptoms --Find-the-evidence (talk) 22:51, 16 March 2020 (UTC)F.T.E Find-the-evidence (talk) 22:51, 16 March 2020 (UTC)

They are already mentioned in the article. See table at "Signs and symptoms" section. Cinadon36 23:10, 16 March 2020 (UTC)

Yah tiredness is so none specific. Can be mentioned in the body. Doc James (talk · contribs · email) 02:23, 17 March 2020 (UTC)

It's a very bad idea to edit the list of the most common symptoms according to your opinions instead of the reliable sources, and it's a very bad idea to make a different list in the introduction than in the symptoms section's table based on different sources, the CDC and WHO. --Espoo (talk) 08:40, 17 March 2020 (UTC)

"Common symptoms include" and "the most common symptoms are" have different meanings. "Nonspecific" is a technical term meaning that the symptom is self-reported and not necessarily associated with disease. Dekimasuよ! 09:19, 17 March 2020 (UTC)

I don't understand your answer, especially since it contradicts what you said in the edit summary ("common symptoms != the most common symptoms"). --Espoo (talk) 12:04, 17 March 2020 (UTC)

The stable version says “Common symptoms include...” and you have been arguing that the stable phrasing constituted an “incorrect list of the most common symptoms”. The stable version is not claiming to be such a list. While the WHO notes that tiredness is a common symptom, it is not a symptom that is helpful in identifying whether or not someone is suffering from COVID-19, so it has not been considered essential to include in the introduction to the article. The fact that the CDC and the WHO use slightly different wordings in describing common symptoms is also not one of the most important facts to put in the lede. Dekimasuよ! 12:12, 17 March 2020 (UTC)

I agree Dekimasu. There is no need to attribute statements on symptoms. There is a broad consensus that symptoms mimic other common upper resp. infections. See also WP:YESPOV: Avoid stating facts as opinions. Uncontested and uncontroversial factual assertions made by reliable sources should normally be directly stated in Wikipedia's voice" Cinadon36 13:18, 17 March 2020 (UTC)

This is the CDC list[3] fever, cough, shortness of breath. Doc James (talk · contribs · email) 17:36, 17 March 2020 (UTC)

 Not done: Closing this request for now as edit requests need a clear consensus to be implemented. If consensus changes in favor please feel free to re-open. Alucard 16_{❯❯❯ chat?} 06:55, 18 March 2020 (UTC)

some stuff about UV rays to disinfect

currently not in the article

The Westin Houston Medical Center's LightStrike robot uses UV light to disinfect hotel rooms.
https://news.yahoo.com/hotels-using-technology-mitigate-covid-19-103220513.html

Device uses UV light to fight spread of germs and viruses, such as COVID-1 “Actually, even ebola is an easy virus to kill for UV,” Said Berland.

The UV machines Violet Defense sells should not be used on your hands or body. It is just to clean surfaces.
https://www.fox35orlando.com/news/device-uses-uv-light-to-fight-spread-of-germs-and-viruses-such-as-covid-19

China cleans bank notes in bid to limit coronavirus COVID-19 spread
Last week, China's central bank, the People's Bank of China, announced it would be cleaning thousands of bank notes by using ultraviolet light or high temperatures to cut off the spread of infection through money exchanges.
https://www.abc.net.au/news/2020-02-21/china-cleaning-money-limit-coronavirus-covid-19/11983364

DMBFFF (talk) 05:56, 18 March 2020 (UTC)

Management of mild to moderate symptoms

Hi all

Just a query about whether we should be covering the management of people who have the milder symptoms, in particular fevers. I came to look at this article because there are conflicting rumours flying around in my circles about whether people should or shouldn't take ibuprofen to manage the COVID fever. For example [4]. It would be nice to see the best WP:MEDRS advice on that and other home treatments. Thanks  — Amakuru (talk) 09:57, 18 March 2020 (UTC)

Yeap, a quick note wouldnt be a problem. Cinadon36 10:12, 18 March 2020 (UTC)

I couldnt find WHO statement on ibuprofen...Cinadon36 12:24, 18 March 2020 (UTC)

Overlap of Research and Experimental treatment sections

Obviously all treatment at the moment is subject to research. How do we handle those two sections? It's really messy right now. The Experimental treatment section seems a bit cleaner but contains a lot of research almost necessarily. The Research section seems really messy with random quotes and questionable sources (why is Elon Musk in there? Love the guy but I wouldn't take medical advice from him honestly) --Gtoffoletto (talk) 11:42, 18 March 2020 (UTC)

I think we need to cut down on the news stuff (WP:NOTNEWS) and focus on medical literature (WP:MEDRS). That will help us focus. Bondegezou (talk) 11:50, 18 March 2020 (UTC)

I agree. Started cleanup. --Gtoffoletto (talk) 12:22, 18 March 2020 (UTC)

I've tried moving research to the Research section, and leaving the Management section to focus on actual recommendations for treatment (even if preliminary). More clean-up still needed! Bondegezou (talk) 15:44, 18 March 2020 (UTC)

grammar fix needed

In the "signs and symptoms" section, there's a sentence "As is common with infections, there is a delay from when a person is infected with the virus to when they develop symptoms, know..." That should be "known" not "know." I can fix, as it's all locked down, but I am sure one of you fine people can. (Just trying to help) 198.70.2.200 (talk) 13:12, 18 March 2020 (UTC)

Done thanks. --Gtoffoletto (talk) 13:16, 18 March 2020 (UTC)

It is a bit old, but also the most trusted (I think at least) that we can find out there - and the 3.4% we are listing is also arguably old and from the same sources.

I can combine some additional fact from those other data sources - any specific ones? I have been searching for others, but really hard to find. Twrobins (talk) 16:04, 18 March 2020 (UTC)

OK, I will try to hunt down some additional sources - really hard to find though. Any suggestions appreciated! Please add here and I will work on it.

On the age of that report - yes, I would agree it is a bit old, but also (I believe) the most trusted source. It also appears that is the source where the 3.4% comes from - so it itself is a moving/old stat.

I'll prep an edit as well with the above in mind. Twrobins (talk) 16:13, 18 March 2020 (UTC)

Case Fatality Rate is falling dramatically and currently 0.7% - from WHO

The CFR is hugely important and the media seems to have overlooked this critical stat - on the page it is currently listed as 3.4% - but Case Fatality Rates at the very beginning of a data set are not reliable. At the minimum here on Wikipedia we should list both what the current prediction is - 0.7% - versus what the early numbers were.

https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

Page 12, Paragraph 5 and the graph on page 13 shows the progressive fall in CFR

I am happy to do any specific written content if it helps, or someone with more Wikipedia experience might be better to champion this through. Twrobins (talk) 14:57, 18 March 2020 (UTC)

That's a pretty old report... Unfortunately CFR is rising in some parts of the world. --Gtoffoletto (talk) 15:19, 18 March 2020 (UTC)

The CFR is very context dependent. Let's try to present what several sources say, and be clear about what context each number refers to. Bondegezou (talk) 15:33, 18 March 2020 (UTC)