Talk:COVID-19/Archive 13

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Expand research section with modelling research, request on 7 August 2020

The research section does not currently mention modelling research efforts and their uses. I suggest to add the following short paragraph which gives an overview on modelling approaches in use, right after the sentence ending with "as a COVID-19 treatment".

So the current text

No medication or vaccine is approved with the specific indication to treat the disease. International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers. In March, the World Health Organisation initiated the "Solidarity Trial" to assess the treatment effects of four existing antiviral compounds with the most promise of efficacy. The World Health Organization suspended hydroxychloroquine from its global drug trials for COVID-19 treatments on 26 May 2020 due to safety concerns. It had previously enrolled 3,500 patients from 17 countries in the Solidarity Trial. France, Italy and Belgium also banned the use of hydroxychloroquine as a COVID-19 treatment.

Can be expanded as

No medication or vaccine is approved with the specific indication to treat the disease. International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers. In March, the World Health Organisation initiated the "Solidarity Trial" to assess the treatment effects of four existing antiviral compounds with the most promise of efficacy. The World Health Organization suspended hydroxychloroquine from its global drug trials for COVID-19 treatments on 26 May 2020 due to safety concerns. It had previously enrolled 3,500 patients from 17 countries in the Solidarity Trial. France, Italy and Belgium also banned the use of hydroxychloroquine as a COVID-19 treatment.

Modelling research has been conducted with several objectives, including predictions of the dynamics of transmission, diagnosis and prognosis of infection, estimation of the impact of interventions, or allocation of resources. Modelling studies are mostly based on epidemiological models, estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID-19 including computational fluid dynamics models to study the flow physics of COVID-19, , retrofits of crowd movement models to study occupant exposure, mobility-data based models to investigate transmission, or the use of macroeconomic models to assess the economic impact of the pandemic. Enronc (talk) 00:37, 8 August 2020 (UTC)

@Enronc: That looks quite reasonable to me. I've slightly refactored your suggested addition to comply with WP:REFPUNCT and the references can be upgraded to templated citations to match the style used in the article. Otherwise, the content looks like a useful addition. What do others think? --RexxS (talk) 14:50, 8 August 2020 (UTC)

Nothing wrong with what's written and the sourcing looks good. My only concern is the article length and is this really about the disease itself? So I have no strong feeling for or against. MartinezMD (talk) 16:20, 8 August 2020 (UTC)

@RexxS: I have now fixed the references using the same templated citation and I have slightly shortened the text. Enronc (talk) 17:31, 11 August 2020 (UTC)

 Works for me Is this ready to be posted? P,TO 19104 (talk) (contribs) 17:15, 11 August 2020 (UTC)

Thank you, Enronc. I've shortened the author displays by using |display-authors=6 and added the new paragraph to the article. --RexxS (talk) 17:20, 11 August 2020 (UTC)

Thanks, please just remove "Enronc (talk) 00:37, 8 August 2020 (UTC)" from the article, as this was added by mistake Enronc (talk) 20:40, 11 August 2020 (UTC)

Facepalm Thanks to MartinezMD for fixing that already. --RexxS (talk) 21:13, 11 August 2020 (UTC)

References

 Done —Tenryuu 🐲 ( 💬 • 📝 ) 05:41, 13 August 2020 (UTC)

Updated symptoms section

Partly based on the sources that User:PainProf recommended in this discussion at WT:MED, I have re-written the ==Signs and symptoms== section to include current information, based upon recent (last few months) secondary sources. This allows us to cite many fewer sources total, and to focus on major themes (common symptoms, uncommon symptoms, pre-symptomatic vs asymptomatic, etc.) as identified by high-quality sources.

Thank you, PainProf, for recommending some good sources. I hope that in a few months, we can re-write this yet again, and that by then, the sources will (hopefully) have converged on the same view of symptom prevalence. One of my frustrations was reading in one source that the most common symptoms are A and B, and in the next, tha they're A, B, C, D, and E, and in the next, that they're A, B, C, and F, and so on.

In the meantime, I haven't touched the CDC-derived table, but I think it should probably be removed. The cited web page doesn't include these numbers. If anyone is particularly attached to that table (and the image below it, which repeats some of those numbers), let's talk about it. WhatamIdoing (talk) 01:21, 15 August 2020 (UTC)

Please add

This statement is incomplete and misleading "The CDC estimates for planning purposes that the IFR is 0.65% and that 40% of infected individuals are asymptomatic, suggesting a fatality rate among those who are symptomatic of 1.08% (.65/60) (as of 10 July)." It also means that CDC estimates that the true IFR is 0.24%. Why is this not included? Can we include this statement, it is very important, since that means .24% that are confirmed "infected" die from Covid. — Preceding unsigned comment added by TheSuperCE (talk • contribs) 00:41, 15 August 2020 (UTC)

TheSuperCE, I think something went wrong in someone's calculation. On the one hand, the CDC says that they're estimating a "true" IFR at 0.65%. Someone has assumed that asymptomatic individuals don't die (i.e., that sudden death doesn't count as a "symptom"), so they're "suggesting" that's really 0% of the people without symptoms plus 1% of the people with symptoms. In round numbers:

• The CDC says 6 out of 1000 infected people will die.
  • That's 0 deaths out of the 400 asymptomatic people, and 6 deaths out of the 600 with symptoms.

But you've calculated that all together, only two or three people out of the original 1000 will die? That doesn't match the previous numbers. WhatamIdoing (talk) 01:50, 15 August 2020 (UTC)

Please add the following to Infection_fatality_rate

From: https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf

'INTERNATIONAL GUIDELINES FOR CERTIFICATION AND CLASSIFICATION (CODING) OF COVID-19 AS CAUSE OF DEATH

2. DEFINITION FOR DEATHS DUE TO COVID-19

A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death.

A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19.

3. GUIDELINES FOR CERTIFYING COVID-19 AS A CAUSE OF DEATH

In view of COVID-19 it is important to record and report deaths due to COVID-19 in a uniform way.

A- RECORDING COVID-19 ON THE MEDICAL CERTIFICATE OF CAUSE OF DEATH

COVID-19 should be recorded on the medical certificate of cause of death for ALL decedents where the disease caused, or is assumed to have caused, or contributed to death.”

—————————————————

Criticism: Not all deaths are the same. A person 95 years old suffering from cancer who is infected by COVID-19 (or suspected to have been infected) and then dies is not the same as a 20 year old with no underlying health conditions and a strong immune system who contracts the virus (is tested) and dies. However, WHO guidelines on how to record the death count for COVID-19 do not differentiate between the two. The media equates the two, for example giving comparisons to how many Americans died in the Vietnam War.

In what is perhaps the best documented field study in the world because of its isolation and the primary focus on eradicating the virus, the New Zealand statistics are revealing. To preface, on Friday 24 April 2020: Newshub reports:

“The Ministry of Health told Newshub every person who tests positive for the virus before or after death, or is considered a "probable case" is counted in New Zealand's official total.” “We are not currently separating out deaths with COVID19 versus deaths from COVID19”

While the NZ Ministry of Health does not separate deaths "with" COVID-19 and deaths "from" COVID-19 where there were no preexisting conditions, all 22 deaths it reported in its daily media briefing sessions were old people (three in 60's, seven in 70's, twelve over 80), suffering from underlying health condition with over three quarters in assisted living and over half living in Rosewood (Christchurch NZ) dementia unit. In other words, out of the 1,500 reported cases, no one died "from" COVID-19 in New Zealand, but 22 were "with" deaths where the old person died of preexisting conditions where the body was unable to fight off the virus because the old person's immune system was too weak. Old-age death is not unnatural death. Premature death from a virus is considered unnatural. The response to COVID-19 (shutting down the global economy) regards it as an unnatural pandemic, but the data cannot be trusted because it fails to differentiate the key fact: How many healthy people are dying and how many people listed in the death statistics were suffering underlying health conditions where the virus was the trigger not the manner of death?

See Wikiepedia's article on Manner of Death:

“In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a distinction is made between the cause of death (sometimes referred to as the "mechanism of death"), which is a specific disease or injury, versus manner of death, which is primarily a legal determination." “… A death by natural causes results from an illness or an internal malfunction of the body not directly caused by external forces, other than infectious disease. For example, a person dying from complications from influenza and/or pneumonia (infections), a stroke, a heart attack (internal body malfunctions), or sudden heart failure would most likely be listed as having died from natural causes”

———————————————————

Comment to the Editors (do not add this part to the article, if you choose to add it): This proposed addition has been written by a scholar, not a proponent of conspiracy theories. In the fog of fear, too many people promote a primary view and marginalize those who ask questions as conspiracy theorists. This proposal does not ascribe motivation, nor does it deny that COVID-19 is a serious virus where much is unknown. But when justification for closing the economy is to save lives, it is reasonable to note that the guidelines for recording deaths has changed from the traditional understanding of human life cycles. This is a pandemic that affects far more people than it infects. The WHO guidelines merit exposure so the public knows more about the source of the global death count.

Huriana Hanara (talk) 22:42, 13 August 2020 (UTC)

Welcome back to Wikipedia, Huriana Hanara. Unfortunately, even if I agreed with this analysis, adding it to the article would violate the Wikipedia:No original research policy. This is the type of content that needs to be published first off wiki, and only then could it be summarized (briefly) in a Wikipedia article. WhatamIdoing (talk) 22:08, 14 August 2020 (UTC)

Not just that, I wonder why this is required. Do we see this distinction made in any other WP medical articles? This seems only to introduce doubt in reported deaths without need. This has been something I've seen politicized on other websites. MartinezMD (talk) 05:47, 15 August 2020 (UTC)

I think that most people don't understand the way that causes of death are recorded now, so they think that, e.g., if someone has advanced cancer plus COVID-19, that it's being treated differently from if someone has advanced cancer plus influenza. It would probably be helpful to provide more education about how that works. WhatamIdoing (talk) 17:17, 15 August 2020 (UTC)

Not a sentence

The following phrase in the second 'graph of the article is not a sentence:

While the majority of cases result in mild symptoms, some progress to acute respiratory distress syndrome (ARDS) possibly precipitated by cytokine storm, multi-organ failure, septic shock, and blood clots.

The phrase does not contain either a verb or a subject, depending on whether "progress" is treated as a verb or a noun. In "some progress to acute respiratory distress syndrome", what does "some progress" do (it needs a verb) or what object does it progress (it needs a noun)? It could be as simple as "some cases progress to acute..." But I prefer to leave it to the experts. --RoyGoldsmith (talk) 18:48, 11 August 2020 (UTC)

It is most certainly a sentence. Some (subject noun) progress (verb). MartinezMD (talk) 19:17, 11 August 2020 (UTC)

It's an idiomatic construction in English (and Romance languages), where "some" (the plural indefinite article, i.e. an adjective) is treated as a pronoun referring to an antecedent. In this case, it means "some of the cases mentioned in the previous clause". You could just as easily write some of them, using the same construction. It only feels awkward because the verb "progress" is identical to the noun, so can be initially misread as "some progress" (adjective noun), and you wouldn't have the same effect if we had written "some deteriorate" or used any other verb which cannot be misconstrued as a noun. --RexxS (talk) 19:56, 11 August 2020 (UTC)

It's a sentence. The finite verb is "progress", which is pronounced differently to the noun "progress" where the stress is on the first syllable. Graham Beards (talk) 20:26, 11 August 2020 (UTC)

True, but if a Wikipedia editor misreads it as "Some progress" rather than "Some [people] progress", then many readers will, too. WhatamIdoing (talk) 23:17, 11 August 2020 (UTC)

To make it clear:

While the majority of cases result in mild symptoms, some do progress to acute respiratory distress syndrome (ARDS), possibly precipitated by cytokine storm, multi-organ failure, septic shock, and blood clots. Shtove (talk) 17:35, 15 August 2020 (UTC)

I prefer some of them as opposed to some do, if only because the "do" sounds a little too emphatic. —Tenryuu 🐲 ( 💬 • 📝 ) 19:04, 15 August 2020 (UTC)

The sentence in the lead currently says "While most people have mild symptoms, some people develop acute respiratory distress syndrome (ARDS) possibly precipitated by cytokine storm..." WhatamIdoing (talk) 21:32, 16 August 2020 (UTC)

COVID-19 and Myocarditis

It appears the majority (>60%) of people, including those with mild symptoms, have developed the myocardial inflammation, which is a serious condition. Here is a report with comments by expers published in CNN : [3]. So, according to this study, in a group of "100 patients recently recovered from COVID-19 ... cardiac magnetic resonance imaging revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), which was independent of preexisting conditions, severity and overall course of the acute illness, and the time from the original diagnosis." "Most of the patients, 67 recovered at home." "These studies suggest that the heart can be infected with no clear signs." according to one of the experts (CNN ref). Here is another secondary RS telling the same. Here is proposed pathophysiology of this. Should not this be included? My very best wishes (talk) 04:09, 6 August 2020 (UTC)

That's something new there. After reading it, I feel like it is medically verifiable. I may try including it. GeraldWL 13:07, 6 August 2020 (UTC)

Update: There is a mention on acute myocarditis on the Pathophysiology section. I don't know if that is the same as the studies you cited here. GeraldWL 13:14, 6 August 2020 (UTC)

What makes Jacqueline Howard an expert on the relationship between COVID-19 and myocarditis? A study cannot possibly be extrapolated to make a claim that "the majority (>60%) of people, including those with mild symptoms, have developed myocardial inflammation". Please stop trying to use primary studies to make biomedical claims. --RexxS (talk) 16:17, 6 August 2020 (UTC)

I linked 4 sources above and 3 of them are secondary. More sources can be found because that was widely discussed in a variety of sources. This seems to be highly significant (as RS say) and deserves inclusion. Yes, ~60% is just the number obtained for a relatively small group of human subjects in one of the studies. But the secondary RS also cite other studies. More studies will be certainly done. My very best wishes (talk) 16:26, 6 August 2020 (UTC)

You linked 4 articles:

1. https://edition.cnn.com/2020/07/28/health/covid-heart-damage-two-studies/index.html – a news report on two primary studies
2. https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916?T=AU – a primary study
3. https://jamanetwork.com/journals/jamacardiology/fullarticle/2768915 – an editorial reporting on a two primary studies
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199677/ – a secondary source proposing a novel hypothesis

We don't get our medical content from news reports, so that rules out the first. We don't use primary studies or editorials to write medical content so that rules out the second and third. That leaves the fourth, which confirms that "a number of coronavirus disease 19–related myocarditis cases have been reported", but we already knew that. It also states "the pathophysiology is still speculative" and "The long-term impact of COVID-19 myocarditis, including the majority of mild cases, remains unknown." So what content exactly are you thinking of using that source for? --RexxS (talk) 22:26, 6 August 2020 (UTC)

Well, this page currently uses a lot of primary sources and reliable news sources, and I think this is fine. All such sources (and 4 sources above) qualify and can be used per WP:RS which is the policy and overrides guidelines like WP:MEDRS. No one suggests using preprints or unreliable sources. Using such RS is reasonable here because this is a currently developing event. There are few scientific reviews on many aspects of this subject. Sure, a lot of aspects are poorly understood right now. But we simply summarize what available RS say on the subject right now per WP:NPOV. I do not see any problem with this. My very best wishes (talk) 01:53, 7 August 2020 (UTC)

You can't use the numbers. It simply mentions the single case series (14 out of 21 people). That portion is not secondary. To be a secondary report of the occurrence requires an evaluation of more than one series, and a significantly larger series than that. MartinezMD (talk) 23:01, 7 August 2020 (UTC)

No, according to primary and secondary RS [4], the group included 100 adults, and >60% got it. But whatever. I started the thread to see if there is a consensus to include this info. Apparently, no consensus. Let's wait until more people will have heart problems after the COVID (without knowing this must be checked and treated if needed), and there will be more statistical data. My very best wishes (talk) 05:39, 9 August 2020 (UTC)

The REVIEW article only mentions the 21 patients. The primary studies I'm not looking at. MartinezMD (talk) 05:45, 9 August 2020 (UTC)

Two things. First, this is a strong secondary RS per WP:RS, and it tells it. Secondly, peer-reviewed research articles published in mainstream scientific journal are also perfectly valid references per WP:RS; they are used in a huge number or WP pages, and rightly so. So, I do not see any problems with including this well sourced info in terms of our policies, or just using common sense. This is not misinformation. Quite the opposite. This is something important to know for people who are thinking they are perfectly healthy after the COVID. Some of them are definitely not, even though they do not know about it, according to these studies. My very best wishes (talk) 05:59, 9 August 2020 (UTC)

That people with COVID get myocarditis, I agree. That 2/3 of them do, no, there isn't enough power to know with reasonable certainty. We're talking about an infection that affects millions. You can't generalize a series of 100 to them. That is the part to which I'm objecting. We have to wait for a proper MEDRS secondary source for the figures. MartinezMD (talk) 06:37, 9 August 2020 (UTC)

I completely agree that a single study should not be generalized to millions and I never suggested that it should be generalized. OK. My very best wishes (talk) 04:13, 12 August 2020 (UTC)

@My very best wishes: We do not use CNN (or other news sources) for medical content here. A news report on primary studies is not peer-reviewed, and so is not a valid MEDRS source. And that is the end of it. If this latest development turns out to be meaningful, it will be covered by peer-reviewed MEDRS sources, and we can then include it. A number of editors have been sanctioned under WP:GS/COVID19 (which you were alerted to here) for repeatedly pushing against consensus-supported MEDRS sourcing requirements. Editors trying to work here are doing so under pressure and are committing a lot of their personal time. They are running out of patience having to repeatedly explain to people who refuse to listen, and it is becoming disruptive. If you continue to push for the use of unacceptable sources for medical content, I will impose santions on you in my capacity as an uninvolved administrator. Take this as a warning. Boing! said Zebedee (talk) 06:51, 9 August 2020 (UTC)

Thank you for clarifying things on your talk page [5]. My very best wishes (talk) 22:56, 16 August 2020 (UTC)

@My very best wishes: Never mind what problems the page already has with sourcing. It doesn't give you licence to make it worse. It doesn't matter what you think is fine. The community does not accept primary and low-quality sources for biomedical content.

WP:RS is a content guideline, not a policy, exactly as WP:MEDRS is. You'll find that WP:RS links to MEDRS twice and contains 15 mentions of how MEDRS applies to biomedical content. So get your facts straight.

Using any of the three weak sources in the article breaches MEDRS and you'll find yourself sanctioned if you do so, after being warned about it. See Wikipedia:General sanctions/Coronavirus disease 2019, in particular the Application notes section.

The fact that there are few high quality secondary sources is a reason not to go scratching through primary sources to try to write about breaking news. When the issue is covered in a good quality review – and if it holds up, it will be eventually – that will be the time for us to write content for it and not before.

So we summarise only what good secondary sources say about biomedical claims, the same as any other article on the wiki. Let's hope you finally do see the problem with your suggestions before an uninvolved admin has to step in and enlighten you. --RexxS (talk) 23:56, 7 August 2020 (UTC)

Arbitrary break

Independently of the specific debate above...

In brief, per several potential medrs:

• despite anecdotal attributions, myocarditis remains clinically unproven as a direct consequence of infection (i.e. as distinct from an indirect, post-infectious consequence, as apparently occurs in MIS-C - cf PMID 32787714).
• one barrier is that clinical demonstration may depend on autopsy findings (and raised troponin levels are not diagnostic).
• as with myocardial injury, it is a plausible and pertinent concern which deserves clinical/pathophysiological research [and therefore might potentially deserve some mention on the page?].

@WAID et al: hope this helps (feel free to say if it's redundant :-) 86.191.67.253 (talk) 13:38, 11 August 2020 (UTC)
Fwiw, personally I feel it could be DUE to mention the relevance of the issue/s (though I certainly wouldn't want to press the point). 86.191.67.229 (talk) 09:21, 14 August 2020 (UTC)
Adding: The question is also of potential relevance to athletes returning to sport after COVID-19.[6] 86.191.67.229 (talk) 13:19, 14 August 2020 (UTC)

References

Note that precisely because COVID-19 is such an important health problem, there is not going to be a problem with sticking to MEDRS in cases like this. Major health agencies such as the CDC will fast track their evaluation of new evidence relative to the normal situation. So, if heart problems are likely to have a big impact on the the way patients should be treated given what the evidence now suggests, then they will issue new guidelines. Because MEDRS gives a lot of weight to reports of organizations like the CDC, one can then cite those reports.

A good example is the effect of wearing face masks. If the pandemic had not happened and on social media the idea that we should all wear face masks had gone viral, then pretty much the same evidence would have been available as there is now to support that idea. This would then not be enough to meet the MEDRS requirements. But because COVID-19 is an important health issue, the CDC has decided to evaluate that same evidence and written reports on it, and MEDRS allows one to use those reports. Now it is true that there is a little more evidence for the use of face masks from observations of the spread during this pandemic, but that's all primary evidence that we cannot use. But the CDC can and has used that evidence, while normally they would have waited for a lot more evidence that from secondary review articles. Count Iblis (talk) 04:37, 13 August 2020 (UTC)

I think it was bad idea to provide a lot of weight to statements by organizations led by political appointees, such as even CDC. The instructions by such organizations in the beginning of the pandemic were more or less misleading, including using masks. The CDC modified recommendations about schools under political pressure, and so on. I would trust a lot more to scientific publications and views by independent and well recognized experts. But I do agree there is no scientific consensus on this issue so far - simply because there are not enough studies. Which does not preclude citing the existing RS, in my opinion. And BTW, even FDA is famous for approving certain drugs it should not approve. My very best wishes (talk) 15:30, 14 August 2020 (UTC)

Extended-confirmed-protected edit request on 16 August 2020

N95 Face Masks

Rickmouser45 (talk) 22:10, 16 August 2020 (UTC)

To editor Rickmouser45:  Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. P.I. Ellsworth  ed. ^put'r there 00:38, 17 August 2020 (UTC)

"Draft:Kung Flu" listed at Redirects for discussion

A discussion is taking place to address the redirect Draft:Kung Flu. The discussion will occur at Wikipedia:Redirects for discussion/Log/2020 August 17#Draft:Kung Flu until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Hog Farm _Bacon 19:36, 17 August 2020 (UTC)

Badly sourced article

Many parts of the article are badly sourced, citing only WHO, CDC etc. Now imagine for a moment that you are someone who doesn't trust the WHO (and why would you, they have lied before) or the CDC, or any of the big semi-political organisations. Now the article will be almost entirely unsourced! It's little use having an article that would only convince someone who already trusts the WHO / whatever because he can just go to their site and has probably already done so anyway. You need to cite actual studies and independent sources more. — Preceding unsigned comment added by 77.61.180.106 (talk) 15:19, 18 August 2020 (UTC)

The WHO and CDC are not badly sourced. These are national and international authorities in their field. If someone does't believe them, then that person has other problems. See conspiracy theory. MartinezMD (talk) 17:52, 18 August 2020 (UTC)

Medical content needs to be sourced well. WP:MEDRS gives these examples of the highest quality sources: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies.

Because most of the academic effort concerning COVID-19 is research, most of the literature is research studies and case reports – both primary sources. There has been less interest in producing reviews so far, and reviews are difficult to produce because the relevant primary sources that they will be based on are changing so rapidly. Nobody is likely to be publishing textbooks about COVID-19 while the knowledge base is still expanding, so we're unlikely to find sources there. That leaves most of our top quality sources as "guidelines or position statements from national or international expert bodies". Fortunately, they are producing usable sources, and so it's no coincidence that much of our content is based on them.

If you're one of the misinformed unfortunates who believe the conspiracy theories and political propaganda flung around about WHO, CDC, NHS, etc., you're probably better off forgetting about Wikipedia and sticking with YouTube for your medical content. --RexxS (talk) 19:59, 18 August 2020 (UTC)

'Prevention' section relies too much on CDC

The section on 'prevention' mostly cites the CDC and therefore is quite US-centred. — Preceding unsigned comment added by Lewis, of Campbell (talk • contribs) 05:49, 17 August 2020 (UTC)

well then come up with another source and make an edit or a proposal for one if you think there are other good sources that say something different. MartinezMD (talk) 06:12, 17 August 2020 (UTC)

Lewis, of Campbell, is there any content you think should be changed? Or do you think the actual content is approximately right, and it just feels wrong to have so many followed by a citation to the US government? WhatamIdoing (talk) 05:02, 18 August 2020 (UTC)

WhatamIdoingI think the content should be left there, yes, but other examples could also be added and more citations included. I will try doing so now. Lewis, of Campbell (talk) 07:04, 18 August 2020 (UTC)

See #Badly sourced article. --RexxS (talk) 20:00, 18 August 2020 (UTC)

The ∆382 variant of SARS-CoV-2 seems to be associated with a milder infection

See here. Count Iblis (talk) 16:25, 21 August 2020 (UTC)

Geographic and Genomic Distribution of SARS-CoV-2 Mutations

http://frontiersin.org/articles/10.3389/fmicb.2020.01800/full in particular http://frontiersin.org/files/Articles/555497/fmicb-11-01800-HTML/image_m/fmicb-11-01800-g005.jpg describes the evolution of the strains of SARS-CoV-2:

At the beginning of the COVID-19 pandemic (December 2019) the most commonly retrieved genome was the reference one (clade L), but the first mutated virus appeared in sequence databases at the beginning of 2020 (clade S) alongside other, less clearly defined, sequences (generic clade O). The clade V (mutated in NSP6 and ORF3a) appeared around mid-January 2020, around the same time as the original clade G (Figure 5B). The first detection of subclades GH and GR can be placed more than a month later, at the end of February 2020. Sequencing efforts, mostly located in North America and Europe, have demonstrated an ever-increasing frequency of G, GH, and GR genomes, which have gradually become the most represented sequences in the GISAID database ...

Are this info, clade diagram and/or graphs of distribution worth including? Cheers, cmɢʟee⎆τaʟκ 01:38, 21 August 2020 (UTC)

In addition to being a primary research article, the GISAID clade nomenclature used is problematic, and there are multiple competing nomenclatures (NextStrain, Pangolin). Hoping for better sources; it's a fascinating subject. — soupvector (talk) 02:01, 21 August 2020 (UTC)

Thanks, @Soupvector: I'll skip this resource for now. If you or anyone else has better sources and would like me to draw an infographic, please ping me. Cheers, cmɢʟee⎆τaʟκ 02:29, 22 August 2020 (UTC)

Semi-protected edit request on 24 August 2020

A mutation of the COVID-19 virus that is "10 times" more infectious has been detected in Malaysia. The country's Health Ministry director-general Noor Hisham Abdullah said the community had to be more careful, after a D614G mutation of the novel coronavirus was detected. The mutation was detected by the Malaysian Institute for Medical Research, as a result of isolation and culture tests on three cases from the country's Sivagangga cluster and one case from the Ulu Tiram cluster. ```` Joannethong (talk) 09:45, 24 August 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. @Joannethong. Seagull123 Φ 16:58, 24 August 2020 (UTC)

You need a decent quality source: see WP:MEDRS. We don't write our medical content from newspaper reports. --RexxS (talk) 23:47, 24 August 2020 (UTC)

References

People who test positive, but have no symptoms

The section on Symptoms gives a good breakdown of what symptoms people have, but it does not mention how many people do not have any symptoms at all. At first I thought that maybe they don't qualify as having the disease COVID-19 if they have the SARS-COV-2 virus but no symptoms - but then I would hope to find the information on asymptomatic carriers in the SARS-COV-2 article, and it isn't there. So would it be worth adding this information to the article?--Gronk Oz (talk) 12:01, 25 August 2020 (UTC)

Some people are infected with the virus but do not develop noticeable symptoms at any point in time.[43] These asymptomatic carriers tend not to get tested, and they can spread the disease.[44][45][43] Other infected people will develop symptoms later (called pre-symptomatic) or have very mild symptoms (called paucisymptomatic), and can also spread the virus. - that's the last sentence in the "Signs and Symptoms" section here - it could possibly be expanded with another sentence or so, but a CTRL+F finds ample mention of asymptomatic throughout the article from my cursory glance. -bɜ:ʳkənhɪmez (User/say hi!) 18:09, 25 August 2020 (UTC)

@Gronk Oz: The first paragraph of the Transmission section also contains this:

A June 2020 review found that 40–45% of infected people are asymptomatic.

Oran DP, Topol EJ (June 2020). "Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review". Annals of Internal Medicine. doi:10.7326/M20-3012. PMC 7281624. PMID 32491919.

Does that meet your concerns? The same information can be found in Transmission of COVID-19 #Duration of transmissibility. --RexxS (talk) 18:12, 25 August 2020 (UTC)

@RexxS: Yes, that is just what I was looking for, and I am embarrassed that I missed it. Thanks for not slapping me with a trout.--Gronk Oz (talk) 09:45, 26 August 2020 (UTC)

Discussion at Wikipedia talk:WikiProject COVID-19 § Very general taking stock of our COVID-19 coverage so far

 You are invited to join the discussion at Wikipedia talk:WikiProject COVID-19 § Very general taking stock of our COVID-19 coverage so far. {{u|Sdkb}} ^talk 07:18, 28 August 2020 (UTC)

New study published in BMJ on children and young people

Just a note for information and interest that an observational cohort study has been published in the British Medical Journal:

• Swann, Olivia V.; Holden, Karl A.; Turtle, Lance; et al. (27 August 2020). "Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study". BMJ. 370. doi:10.1136/bmj.m3249. ISSN 1756-1833.

It's a good quality primary source, confirming much of what is already known about the effect of COVID-19 on young people, and adding a few new insights.

I am emphatically not suggesting that we use it to write content, as its findings should be reflected in secondary sources in the near future. --RexxS (talk) 14:35, 28 August 2020 (UTC)

Steroids/Meds

A meta analysis has been published showing reduced mortality for patients with severe/critical disease with the use of steroids. Also, in the US, remdesivir has received emergency authorization use for all hospitalized patients, not just severe/critical as had been approved previously. I don't have time to add it at the moment, but placed the information here for other editors or for me to add later. MartinezMD (talk) 04:05, 3 September 2020 (UTC)

@MartinezMD: I think Whywhenwhohow has been updating Dexamethasone with some related content and may be able to add something useful here on the topic. --RexxS (talk) 16:28, 3 September 2020 (UTC)

@MartinezMD: I added both. --Whywhenwhohow (talk) 18:38, 3 September 2020 (UTC)

Thank you! MartinezMD (talk) 19:45, 3 September 2020 (UTC)

Nature editorials series

@WAID: I see Nature is starting to publish a series of dedicated editorials, with the first one titled "Progress report on the coronavirus pandemic" [7]. While editorials are not generally considered medrs-compliant, I feel this series might conceivably be useful. Hence this heads-up. 86.186.168.223 (talk) 14:24, 19 August 2020 (UTC)

Thanks. Those will be useful as background information, if nothing else. WhatamIdoing (talk) 15:24, 19 August 2020 (UTC)

A pleasure. A useful perspective, imo, on a very rapidly changing knowledge base. Fwiw, the narrative review-style approach, which has been given the seal of approval by the editorial office of the #1 scientific journal, seems to me fully reliable all round (especially in the unprecedented circumstances). Just my 2c, 86.186.168.223 (talk) 19:04, 19 August 2020 (UTC)

I've added it into a Further reading section for now. --RexxS (talk) 22:02, 19 August 2020 (UTC)

As a first approximation, pieces in academic journals that are labeled "review", including narrative reviews, are useful for Wikipedia:Biomedical information, and publications labeled "editorial" are not, because of MEDRS and fairness. I like the formulation, "whatever the game, whatever the rules, the rules are the same for both sides". In other words, if I'm going to remove claims I think are bad with the excuse that someone sourced them to an editorial, then I can't be citing editorials for stuff I think is good. MEDRS has to assume that all editors have the same level of (non-)expertise and (poor) judgment, or we end up with a POV-pushing mess. WhatamIdoing (talk) 16:23, 20 August 2020 (UTC)

I'll echo WAID's analysis of the standards needed for sources used to write content, and my strong preference would be to not use editorials for medical content. Nevertheless, that source does a decent job of making a progress report from the view of a very prestigious journal. Our guidance at Wikipedia:Further reading #Relation to reference sections gives this advice:

Further reading is not a list of general references. General references are sources actually used by editors to build the article content, but that are not presented as inline citations. By contrast, Further reading is primarily intended for publications that were not used by editors to build the current article content, but which editors still recommend.

If editors are happy to recommend the Nature editorial to our readers, it will stay; otherwise it will be removed. We can let other editors decide. --RexxS (talk) 21:04, 20 August 2020 (UTC)

FWIW, just for the sake of clarity (@WAID et al.): I originally suggested this publication, based on the relevance (imo) of its narrative perspective on recent history, which can be helpful. IMO, Further reading is a suitable collocation, though personally I'd tend to feel it could be relied upon – if needed – for key observations that may go under the radar in many typical medrs, such as review papers and guidance. But I didn't mean to suggest using it to trump such sourcing. 86.140.161.248 (talk) 12:53, 5 September 2020 (UTC) (OP)

Long term effects section

This is a poor section of the article. It is filled with news reports, opinion, weak studies. Most of it meet does not meet MEDRS. It needs significant clean up. MartinezMD (talk) 03:09, 8 September 2020 (UTC)

Hi, MartinezMD, that would be me. I do not usually edit medical articles as I know there are plenty of more qualified people than I, so I was not familiar with MEDRS, but using the usual wp standards of RS and "write for a general audience", I wrote much of that section after doing a quick skim of recent articles. This is a topic which has been in the news for months now, and I believe useful to readers. While I do understand something about scientific literature, and what constitutes gold-standard studies, etc., the fact of the matter is that these do not exist as yet because COVID-19 has not been with us for long enough. What does one do in a case like this? I found yesterday that while there are a few studies reporting on specific effects like cardiac injury, liver enzymes, etc., there is as yet (unsurprisingly) nothing written up and published on the longterm effects described by so many in so many other reputable sources. As an example of future research, there's the St Vincent's Sydney ADAPT study, written up in many reliable news media ([8], [9], [10], [11]), and there are several others around the world. In the meantime, there is widespread coverage in other media and medical organisations' websites (e.g. National Heart, Lung, and Blood Institute (US), The Guardian Australia, BMJ1 BMJ2 and BMJ3). I think that we would be doing our readers a disservice to dismiss or ignore completely what is reported in news media, but I will gladly hand over to someone who can improve the section, or make another suggestion as to how to deal with the topic. Laterthanyouthink (talk) 07:29, 8 September 2020 (UTC)

Re: "...these do not exist as yet because COVID-19 has not been with us for long enough. What does one do in a case like this?" Generally, I'd say don't write about it yet. Or, at least, only write something minimal as covered by appropriate sources and leave out anything speculative or not well sourced. (But I will add, Laterthanyouthink, thank you for making the effort with what sources we have). Boing! said Zebedee (talk) 08:12, 8 September 2020 (UTC)

Okay, thanks Boing! said Zebedee - I'm going to leave it to others now, but will just add this one Management of post-acute covid-19 in primary care - a BMJ practice guideline - because I saw it and wondered where this kind of material sits. Laterthanyouthink (talk) 13:46, 8 September 2020 (UTC)

I think it's perfectly ok to say they are investigating things, but some things shouldn't be in the article like some slang terms ("long-haulers" fro example) unless it becomes well-established, or the use of observational studies, like the Lancet 100-patient observational study. That kind of study is usually ripe with reporter bias. MartinezMD (talk) 15:47, 8 September 2020 (UTC)

Protection of the wearer from masks

There is growing evidence that masks protect the wearer, particularly from a fatal dose. https://link.springer.com/article/10.1007/s11606-020-06067-8 https://www.inverse.com/mind-body/masks-breathing-in-less-coronavirus-means-you-get-less-sick. I think this is an impactful issue that should be addressed in the article. I am going to add a statement and reference to this effect. — Preceding unsigned comment added by Chogg (talk • contribs) 18:10, 8 September 2020 (UTC)

I'm interested to hear thoughts from others on this topic. — Preceding unsigned comment added by Chogg (talk • contribs) 18:28, 8 September 2020 (UTC)

It's just one person's theory based on weak observational data. No basis for inclusion in the article at this time. MartinezMD (talk) 19:00, 8 September 2020 (UTC)

Hi MartinezMD, I don't think I agree with your argument. The reference is a peer reviewed paper written by the Associate Division Chief of a leading centre for infectious disease control (UCSF) and a professor of public health at Johns Hopkins Bloomberg School of Public Health. They lead probably 100s of specialists in this field. It has also been picked up in the UK. It seems to me there is little evidence against this idea. I recommend that the language I use 'increasing evidence' should reflect this rather than remove entirely from the article. Perhaps 'recent evidence' would be a better alternative. The cost and impact of this information means that a conservative approach would be to include some reference to this information. I suppose I don't entirely understand you reasoning for such an extreme recommendation as to delete entirely. If further counter evidence is available I might agree with you, but for now I would leave it in. Thoughts? — Preceding unsigned comment added by Chogg (talk • contribs) 19:58, 8 September 2020 (UTC)

@Chogg: It's not a matter of agreement among editors here. It's a matter of policy. A peer reviewed paper still is not necessarily a WP:MEDRS source because primary sources are peer-reviewed as well.

The paper introduces a novel hypothesis. When there is actual solid evidence that has appeared in a good quality secondary source, then we'll have something to write about. It doesn't matter if there's little evidence against the idea. Ideas are not medical facts. If you're having difficulty in understanding the difference between primary and secondary sources, I suggest studying WP:PSTS and asking if you are unsure. This article is under general sanctions and editors need to adhere to the highest standards when adding content. --RexxS (talk) 20:12, 8 September 2020 (UTC)

As above. The same could've been said about hydroxychloroquine. There was a lot of suggestion it could be helpful but ultimately has not been shown to be helpful. Since this is a massive pandemic, it is important to stick to established facts. This is also an encyclopedia, not a place to promote the latest theories. See WP:NOTEVERYTHING - "A Wikipedia article should not be a complete exposition of all possible details, but a summary of accepted knowledge regarding its subject." MartinezMD (talk) 20:36, 8 September 2020 (UTC)

OK. Thanks for the clarification. I think that makes sense to me. If I come across evidence from a secondary source that supports this I'll come back. I do appreciate this is an important issue to judge appropriately. I hope I'm being helpful. — Preceding unsigned comment added by Chogg (talk • contribs) 23:08, 8 September 2020 (UTC)

Political interference and misinformation

See here. It's best to include a section on political interference and misinformation. Count Iblis (talk) 06:32, 12 September 2020 (UTC)

Patient Zero?

Posssible patient zero: November, 2019 Marinla (talk) Marinla (talk)

References

I'm not sure how best to convey this information, but we know that SARS-CoV-2 was in the sewage in Spain from as early as March 2019. Here's my reference: https://www.reuters.com/article/us-health-coronavirus-spain-science/coronavirus-traces-found-in-march-2019-sewage-sample-spanish-study-shows-idUSKBN23X2HQ

Please consider incorporating this into the article ! Thank you :) — Preceding unsigned comment added by 204.174.232.2 (talk) 00:19, 3 September 2020 (UTC)

The original poster is correct. It was also brought to light that the first infected person was probably in September or October of 2019 in China but the WHO and China kept it "under wraps" — Preceding unsigned comment added by 2600:1700:fb1:530:9420:5d74:ca9:511f (talk • contribs) 02:59, 21 September 2020 (UTC)

I have seen no reliable sources claiming that either WHO or China were deliberately hiding information about a novel infection in September or October 2019. One might even wonder why the logged-out editor believes that they knew there was something worth hiding back then. WhatamIdoing (talk) 15:52, 21 September 2020 (UTC)

Gender differences

The summary in Coronavirus disease 2019 § Sex differences seems to contradict Gendered impact of the COVID-19 pandemic. The current section summary reports that "Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders." The breakout article claims there are differences.

To avoid content duplication and contradictory claims, I'd like to replace the summary with a transcluded copy of the breakout intro paragraph. However, it looks like it's in bad need of an update. It includes the text, "From a purely medical perspective: mortality due to COVID-19 is significantly higher in men..." Anyone up to the challenge? - Wikmoz (talk) 07:04, 21 September 2020 (UTC)

I agree that it needs an update. I'd rather not transclude anything here. I think we'd be better off just making the updates in both places.

It is possible for both of these statements to be true: there is no significant difference in susceptibility on the basis of sex, and significantly more men die. The first says that being biologically male isn't the problem (e.g., a male non-smoker has the same risk as a female non-smoker). The second acknolwedges that men smoke more. WhatamIdoing (talk) 15:57, 21 September 2020 (UTC)

Asymptomatic cases rate

Hello,

I recently undid an edit which changed the number to 16% based on a WHO brief. I did this because upon investigation, the WHO brief itself is citing doi:10.1101/2020.05.10.20097543 - which is a preprint. Given that the WHO is not providing this number based on their review of the evidence, and that the article cited is a preprint, I think it is premature to use that number and citation at this time. However, I tried to find a newer systematic review than the one currently cited, and couldn't - so I figured I'd post here to see what others think. Thanks, -bɜ:ʳkənhɪmez (User/say hi!) 06:28, 18 September 2020 (UTC)

Hi. I made that edit on the good faith of WHO being a reliable secondary source. The Oran DP, Topol EJ review is just one among many used in the systematic review, so I thought it was more accurate. Feelthhis (talk) 06:46, 18 September 2020 (UTC)

@Berchanhimez: sorry, but that's exactly the sort of original research that we don't allow Wikipedia editors to do. We have to work on the assumption that the experts at the WHO are familiar with a whole range of sources and make an informed decision on the statements they make. We can't do detective work and disallow a secondary source because we're dissatisfied with what we think was a source used by the secondary source. It may be that whoever decided to use the 16% figure was aware of other research that gave similar results and therefore had more confidence in it than you have. But we cannot read the minds of the experts who make the statements and we have to accept their judgement in place of our own. It's fine for us editors to assess the quality of a source, but not to discard a quality secondary cause because of our own misgivings about its methodology, etc.

Nevertheless, I agree that the WHO source should not be summarised by a bald "16% asymptomatic" statement. It is far more nuanced than that:

The extent of truly asymptomatic infection in the community remains unknown. The proportion of people whose infection is asymptomatic likely varies with age due to the increasing prevalence of underlying conditions in older age groups (and thus increasing risk of developing severe disease with increasing age), and studies that show that children are less likely to show clinical symptoms compared to adults. Early studies from the United States and China reported that many cases were asymptomatic, based on the lack of symptoms at the time of testing; however, 75-100% of these people later developed symptoms. A recent systematic review estimated that the proportion of truly asymptomatic cases ranges from 6% to 41%, with a pooled estimate of 16% (12%–20%). However, all studies included in this systematic review have important limitations. For example, some studies did not clearly describe how they followed up with persons who were asymptomatic at the time of testing to ascertain if they ever developed symptoms, and others defined “asymptomatic” very narrowly as persons who never developed fever or respiratory symptoms, rather than as those who did not develop any symptoms at all. A recent study from China that clearly and appropriately defined asymptomatic infections suggests that the proportion of infected people who never developed symptoms was 23%.

I would devote more than one sentence to summarising the key information from that briefing, especially the range 12% to 20% and the Chinese 23% estimate, along with the actual extent remaining unknown. Cheers --RexxS (talk) 13:41, 18 September 2020 (UTC)

RexxS, I'm not particularly sure how it qualifies as "original research". Just as the New York Times publishing an opinion piece does not mean they're throwing their weight behind it, the WHO quoting a preprint does not mean it is suddenly a reliable source. I furthermore would like to quote the opening page of the brief: This

scientific brief is not a systematic review. Rather, it reflects the consolidation of rapid reviews of publications in peer-reviewed journals and of non-peer-reviewed manuscripts on pre-print servers, undertaken by WHO and partners. Preprint findings should be interpreted with caution in the absence of peer review. - the WHO itself is telling us to take caution in using data from preprint sources just because they quoted it in their brief. Honestly, this reeks of something similar to money laundering to me - we would never consider using the fact from a preprint in the article, but it's now completely okay just because it was republished (not endorsed) by the WHO? That makes absolutely no sense. -bɜ:ʳkənhɪmez (User/say hi!) 22:55, 18 September 2020 (UTC)

@Berchanhimez: WP:Original research occurs when an editor interprets a source rather than neutrally summarises it. You did the former. If the NYT or any other publisher publishes a statement, it does "throw its weight behind it", or at least imbues it with whatever reputation the publisher has. That's an important factor in how Wikipedians determine the reliability of a source: a piece published in the Sun isn't going to carry the same weight as a similar piece published in the Guardian, for example. Likewise when the WHO publishes a statement on a medical matter, it does so with the weight of its expertise as a recognised authority on medical issues. You have no idea how many articles the authors of the WHO brief had examined when they chose to mention the preprint study. They are the experts in the field and you are not. When the WHO prints its consolidation of sources, (not reprints it), it does give a kind of endorsement to the source. That is the function of secondary sources, and we value that so much that we strongly prefer secondary sources to primary ones, and even more so for medical content. Nevertheless, it rightly warns readers to "interpret with caution" preprint findings, although that is irrelevant to Wikipedia editors, who must not interpret sources at all, merely summarise them in as neutral a manner as possible. Finally, if you believe that the WHO brief is not a reliable source, you can test that at the Reliable Sources Noticeboard, but I doubt you'll find any support for that view. --RexxS (talk) 01:50, 19 September 2020 (UTC)

RexxS, I did not interpret anything. The WHO clearly calls it out as a preprint, and the WHO specifically calls for caution when using preprint. I'm not sure why you're trying to argue that it's not a preprint because it was "re"printed... that makes no sense whatsoever. I'll cede though, because I don't really feel like explaining this again. -bɜ:ʳkənhɪmez (User/say hi!) 02:01, 19 September 2020 (UTC)

@Berchanhimez: You think you did not interpret anything; I'm sure you did. We agree that the the WHO warns about interpreting preprints, so I'm not sure what point you're trying to make there. I have never argued that the preprint in question is not a preprint; please don't put words in my mouth. I do argue, however that the WHO brief is not a preprint, and I'm baffled that you seem to confuse the two sources. Preprints are made available early precisely for other researchers and experts to examine them and reach carefully considered conclusions. We think it's fine for experts to do that; but we forbid Wikipedia editors from doing the same. I fail to see why you're having such a hard time in making sense of the concept. --RexxS (talk) 02:21, 19 September 2020 (UTC)

RexxS, to me, the WHO brief does not "examine" the preprint and "reach carefully considered conclusions" - at least not in the form it was added to the article prior. In the way it was added to the article, it was basically a "reprint" (pardon the word choice here) of the preprint statistic, without including any of the "commentary" offered by the WHO about the limitations of the studies in the (preprint) systematic review. That is what I meant when I was referring to "laundering" the statistic - while yes, using the WHO source for their commentary on the preprint I agree with, using it to source the preprint statistics themselves with no inclusion of the actual secondary source (the WHO statements on them) is shady at best. If the statistic wouldn't be okay on its own sourced to the preprint itself, it should not suddenly become okay to place in the article on its own by sourcing a "copy" of that statistic in another source. The commentary is a different story, and I apologize for not realizing the distinction you were making. Hopefully I explained better now... I'm going to rest from my week now, apologies for misunderstanding. -bɜ:ʳkənhɪmez (User/say hi!) 02:48, 19 September 2020 (UTC)

We've had problems in the past with editors deciding that some (apparently good) sources didn't "really" have enough evidence behind a claim, and therefore the editor was overruling the source. There's a fine line between the Wikipedia:Editorial discretion we have to allow volunteers (e.g., I personally refuse to add a source that I believe is flawed in some way) and prohibited types of original research (e.g., I refuse to let others cite that source, because I analyzed the source and decided, out of my own understanding, that it's flawed).

That said, if we include that, it's probably a good idea to hedge the statement significantly: "According to a single, preliminary report cited by the WHO", etc.. WhatamIdoing (talk) 00:14, 21 September 2020 (UTC)

I would think that if the WHO says something in their voice, then they are the authority being cited (not whatever specific source they might cite). Doesn't the WHO's decision to use a particular estimated rate carry more weight than our perception of the source they cite? — soupvector (talk) 03:06, 21 September 2020 (UTC)

I wouldn't classify the WHO statement as original research. We need to consider whether it meets this threshold in WP:MEDRS (emphasis added):

Wikipedia policies on the neutral point of view and not publishing original research demand that we present prevailing medical or scientific consensus, which can be found in recent, authoritative review articles, in statements and practice guidelines issued by major professional medical or scientific societies (for example, the European Society of Cardiology or the Infectious Disease Society of America) and widely respected governmental and quasi-governmental health authorities (for example, AHRQ, USPSTF, NICE, and WHO), in textbooks, or in some forms of monographs.

So the question is not whether the number will be adjusted in the future or not, or whether the source of the number is one (or multiple) preprint studies. It's whether the number as presented by the WHO in the cited source is the current scientific consensus. I think the addition of context around the number as suggested by RexxS would to a fine job of presenting the data for what it is, current consensus on the range of the number that doesn't yet have a more accurate estimate. Particularly the focus around the systemic review the WHO cited: studies which estimated 6-41% IFR, with the pooled estimate being 12-20%. Bakkster Man (talk) 19:24, 21 September 2020 (UTC)

@Bakkster Man: it's only original research when we impose our own interpretation of a source, of course. If the WHO says one set of results are more trustworthy than another set of results, then it's fine for us to report that judgement. What I worry about is when an editor decides for themselves that one set of results discussed in a secondary source is more reliable than another set of results discussed in the secondary source, without any indication from the secondary source. That would be an instance of WP:OR. I hope that makes my comment clearer. --RexxS (talk) 11:20, 22 September 2020 (UTC)

Yes, that's more clear and I understand what you're saying. Bakkster Man (talk) 14:04, 22 September 2020 (UTC)