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  • welcome to another MedCram lecture and we can see here the numbers are

  • increasing but slowly here on the world ometer website seventy five thousand

  • seven hundred and thirty total deaths 2128 recovered sixteen thousand if we

  • look at the active cases in the close cases you can see that the number of

  • recovered has gone up slightly and seems to be doing that on a daily basis if we

  • look at the total worldwide cases you can see here that they are dwindling

  • overall but in looking at the cases that are outside of china we can see that

  • they continue to increase in terms of the number of deaths unfortunately those

  • continue to be increasing pretty much at a linear rate want to update you on the

  • situation with the Diamond Princess cruise ship that's docked outside of

  • Japan there was a statement put out by the CDC commending the Government of

  • Japan for the fact that they quarantine patients but there's been a lot of

  • international criticism of how Japan actually handled this and there's been

  • an intervention and basically the consensus if you read between the lines

  • is that this did not work very well there's currently more than a hundred US

  • citizens either on board the diamond princess or in hospitals in Japan and

  • they've been placed under the restrictions and they're saying that

  • they will be required to wait 14 days before coming home before they're

  • permitted to come on board flights however if an individual does make it to

  • the United States before that 14-day period ends they will be subject to a

  • mandatory quarantine until they completed that 14-day period so the CDC

  • is coming out with that statement and they want to make sure that everyone's

  • aware that they are taking this seriously I also want to quickly

  • highlight a letter that was submitted to the New England Journal of Medicine

  • dated yesterday February 19 it was an interesting look at about 18 patients

  • nine men and nine women meeting 59 years of age and what they did was they looked

  • at viral loads in the upper respiratory tract to see what they were based on

  • when the symptoms began and now these were people from Wuhan and

  • all of them except for one were symptomatic there was one person that

  • was asymptomatic and we'll talk about that in just a second

  • but you can see here the graphs of the CT value which is basically the viral

  • load and on the x-axis here is the number of days since the onset of

  • symptoms zero being here on the far left and what you can basically see is that

  • the viral load was quite high in the very early days of the symptoms and then

  • tapers off almost all of them being undetectable here towards 14 days now

  • please don't confuse these days as the incubation period this has nothing to do

  • with the incubation period this has to do with how long the symptoms last once

  • you get the symptoms an incubation period has to do with how long it is

  • between infection and the onset of symptoms the other thing to notice here

  • at the bottom is may be difficult to see but in terms of throat swabs versus

  • nasal swabs there was a higher viral count in the nasal swabs in general than

  • there was in the throat swabs meaning that this virus tends to potentially

  • congregate in the upper Airways there was one patient that was tested and was

  • asymptomatic and they say here that the viral load that was detected in the

  • asymptomatic patient was similar to that in the symptomatic patients which

  • suggests that the transmission potential of asymptomatic or minimally cyntha

  • matic patients and this is confirming what we had discussed earlier at the

  • beginning of this outbreak that potentially can be spread by

  • asymptomatic individuals and we will put a link in the description below to this

  • article as well as the CDC article another article that was submitted on

  • the same day yesterday was a perspective that was written by a number of

  • physicians and epidemiologists on their perspective of defining the epidemiology

  • of kovat 19 and how more studies are needed one of the interesting aspects

  • that they mention here is they may need to do testing in people that may not

  • meet the current definitions which is someone who has traveled from that

  • particular area of China and has symptoms and they say here a key point

  • of these recommendations is that viral testing should not be used only for

  • clinical CAIR I think that's an interesting point

  • if we really want to find out what the scope is of the infection especially in

  • China that there's gonna have to be a lot of people who are asymptomatic Lee

  • tested to see whether or not they had the virus at some point anyway I leave

  • that perspective there for your consideration in future updates we'll

  • plan on tackling the molecular biology of corona virus and contrast that and

  • compared to other viruses and that might give us a little bit of information

  • about what this virus likes to do please join us at make cram comm for our course

  • on the corona virus also multiple other courses thanks for joining us

welcome to another MedCram lecture and we can see here the numbers are

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