Talk:COVID-19/Archive 2

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Interferon lambda and CoV

Interferon-lambda 4 is an antiviral protein that protects humans against infections at epithelial surfaces such as the respiratory tract. There are hitherto surprisingly few cases of COVID-19 among subjects of African descent. Similarly, there was minor, if any, spread of the SARS coronavirus among Africans in the 2003 epidemic.

Genetic studies show that many subjects of African descent can produce interferon-lambda 4, whereas a large proportion of subjects of East Asian descent cannot produce this antiviral protein. It may thus be hypothesized that Africans are protected against COVID-19 as they naturally produce an antiviral protein that cannot be mounted by most East Asians. The variable degree of continental spread of the COVID-19 and the SARS coronaviruses may thus be explained by the racial difference of protection at epithelial surfaces. — Preceding unsigned comment added by 78.82.24.58 (talk) 20:53, 14 February 2020 (UTC)

Can you share some reliable sources saying this? Bondegezou (talk) 22:10, 14 February 2020 (UTC)

Management content dispute

TheFineTruthComb, please stop edit-warring. You added content, I removed it, but you are now repeatedly re-adding it. As per WP:BRD, if someone disputes your addition, you should discuss the matter on the Talk page and seek consensus.

The underlying problem is that you are ignoring WP:MEDRS, which states, "Ideal sources for biomedical information include: 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." See also WP:MEDREV. Content about the management of a condition should not be cited to magazine articles. We should also be avoiding primary research studies if possible. Bondegezou (talk) 22:20, 14 February 2020 (UTC)

Bondegezou Thanks for your feedback. I'm not just edit waring. I have added new references each time to try and make it more acceptable. I'm trying to find a way to write about this complex subject.

I am happy to modify or alter the approach to how this is written but you seem to be implying this cannot be written about for a significant period of time when the event has hopefully passed and more detailed scientific research can be done. Hopefully we can find a way to balance the fact this is very new information and as such some times scientifically unreliable with the fact it is the most imprortant virus related event on the planet for 100 years. Any guidance on how to do this or where to read on how to do this is much appreciated.

To comment on a couple of your reference requests one by one:

"Ideal sources for biomedical information include: review articles (especially systematic reviews)" -Obviously given that Covid-19 only appeared on December 31st there will not be any of these for at least 6 months.

"guidelines or position statements from national or international expert bodies." - There are references from the "Beijing branch of China’s National Health Commission" and some hospitals. — Preceding unsigned comment added by TheFineTruthComb (talk • contribs) 22:38, 14 February 2020 (UTC)

You can try out material and wording here, on the Talk page, and get consensus supporting it before adding it. There is no need for you to repeatedly re-add material to the article. Have respect for your fellow editors.

We should not be including potentially unreliable information just because we want to be quick. We don't have to report every new trial. If we can't follow WP:MEDRS, then it is better to say nothing. MEDRS has been carefully developed by the community here over many years. It works. We can't just ignore it.

Other parts of this article, and indeed of the Management section, are sticking to MEDRS. So, it is clearly possible to write useful content now while respecting MEDRS. Bondegezou (talk) 22:48, 14 February 2020 (UTC)

Psychological

Could someone double-check the psychological section please. Whispyhistory (talk) 18:47, 10 February 2020 (UTC)

Whispyhistory, done. I also moved to 'Management' because the virus is not directly responsible. These psychological effects are a consequence of policies and actions taken to control the infection and therefore need to be addressed as a part of comprehensive medical management. Moksha88 (talk) 03:35, 15 February 2020 (UTC)

cases without respiratory symptoms

I don't know if we can call it a respiratory disease entirely? --Almaty (talk) 05:36, 15 February 2020 (UTC)

References

would need MEDRS compliant sources to determine that "don't know if we can call it a respiratory disease entirely"--Ozzie10aaaa (talk) 18:50, 17 February 2020 (UTC)

New case fatality and infection fatality estimates

MRC outbreak research centre has come out with new estimates for both case fatality rate and infection fatality ratio: https://twitter.com/MRC_Outbreak/status/1226765905306234881, https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/ (COI declaration: spouse is co-author of https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf)

• Estimated infection fatality ratio: 1%

• Estimated case fatality ratio for travellers outside mainland China (mix severe & milder cases): 1%-5%

• Estimated case fatality ratio for detected cases in Hubei (severe cases): 18%

The difference in these numbers is infection fatality ratio refers to overall mortality rate for *all* cases, including people who have very mild cases and do not go to hospital. This is by definition estimated .

Case fatality rate refers to people who have a confirmed case of the disease. This is necessarily higher because their condition is more severe; and it varies quite a lot, hence the difference between confirmed cases outside mainland China, which have been caught by screening people for mild illness, and in Hubei province where the outbreak is the most severe. Mvolz (talk) 08:13, 10 February 2020 (UTC)

We have to be cautious here. The Imperial College paper is not WP:MEDRS compliant. Furthermore, is it usual practice to quote separate fatality rates for asymptomatic and symptomatic infections? I think quoting a rate of 18% is misleading. The Guardian quotes a more cautious 2%.[1] This is probably more accurate. Graham Beards (talk) 12:34, 10 February 2020 (UTC)

Agreed we should use caution, especially about including that 18% figure.

It is *not* usual to talk about asymptomatic versus asymptomatic rates, so that part of the article should be fixed/made more clear, if you are misinterpreting it like that! The article it isn't strictly wrong - it says "including asymptomatic" not "only asymptomatic" but I agree it's easy to misinterpret that, we should just all "all infected, including undiagnosed" or something similar.

It *is* usual to talk about the infection fatality rate (IFR) versus the confirmed case fatality rate (cCFR). IFR is an estimated rate for *everyone* infected, which includes asymptomatic and also subclinical cases, which may or may not be diagnosed, as well as those cases which are confirmed and diagnosed.

From an epidemiological standpoint, infection fatality rate (IFR) is much more useful than confirmed case fatality rates (cCFR), because of course those vary a lot depending on whether or not people are being screened, how the health system is faring, etc. So I think the IFR is much more useful/important to include than the cCFR, which can cause unnecessary panic. The 18% is of course terrible on a human scale, but people will see those numbers and confuse it with the IFR, i.e. they'll think that if they contract the virus they'll individually have an 18% chance of death which just isn't true. There's also a good thread explaining the difference here if that explanation didn't help: https://twitter.com/SRileyIDD/status/1220464674476625921 Mvolz (talk)

I think the Imperial study is close to MEDRS compliant in the circumstances of everything moving very quickly. It's better than a bunch of sources currently used. When quoting its conclusions, I think we should take their topline estimate, as per my initial edit, rather than the current text that tries to go into more detail. Bondegezou (talk) 17:28, 10 February 2020 (UTC)

I find these discussions and the MRC Centre for Global Infectious Disease Analysis analysis really puzzling. I think everybody can agree that CFR, calculating it by dividing the Deaths(D) by the Confirmed cases(C), can only be correctly calculated once the outbreak has ended and every single confirmed case has either died or recovered. Until then, the ratio of D/C is a known under-estimator. By contrast, the ratio of Deaths divided by the resolved cases D/(D+R) where R = Recovered is a known over-estimator. When the outbreak ends, both values should be the same. So... those 2 curves will converge over time. Using the current data, assuming that data is true(in doubt now) and no cure is found, I estimate that the current final CFR (the REAL one) is between 5.5% and 6%. The 2% and 3% figures are really naive and misleading. Why don't the "scientists" see this? It's just math.--AAAAA (talk) 14:46, 13 February 2020 (UTC)

@AAAAA:: Your "scientists" are preoccupied with perception management and spin doctoring. Nobody wants to take the blame for rocking the boat and causing Joe Sixpack to panic. Especially not those esteemed reliable sources. CCP teached them a lot. Your estimation is pretty correct btw, albeit slightly optimistic. We'll figure it out soon enough.--89.206.114.184 (talk) 16:20, 13 February 2020 (UTC)

@89.206.114.184: As of Feb 12th, D/C=2.29% and D/(D+R)=19.8% (D=Deaths, C=Confirmed Cases, R=Recovered). Those 2 numbers will eventually converge. The way I estimated the final CFR is by using a mathematical shortcut: There's a difference in days between the average time from confirmation to death and the average time from confirmation to total recovery. Let's call it the "delta". I calculated such delta with different numbers. Using a delta of 11 days, we get these D/(D+R) ratios in the last few days: 6.49% 6.44% 6.05% 6.03% 6.10% 6.09% 6.02% 6.12%. Using a delta of 12 days, these are the ratios: 4.63% 4.94% 4.92% 4.75% 4.93% 5.06% 5.17% 5.20%. Delta lower than 11 days the numbers are dropping too fast. Delta higher than 12 days the numbers are increasing too fast. Seems that deltas of 11 days and 12 days will converge first. This makes me believe that if the data is real and no new treatment is found, they should converge somewhere slightly above 5.5%.--AAAAA (talk) 18:32, 13 February 2020 (UTC)

@AAAAA: as per Graham Beards' reminder, the article may be improved by providing correct methods for determining a disease's CFR. I'm not versed in maths at all, but principally it goes as follows: you take the number of those, who recovered and compare it to the number of those, who died as in D/(D+R), but only those, whose onset of symptoms is long enough ago that they would have also had the time to recover since. The reported median time from onset of symptoms to death is 14 days (range 6 to 41). I don't see any duration for recovery, but it will be 14 days + delta. I'dont understand how one can tell that ratios change too fast, nor will I when explained, but this may amount to original research. However, adding the right tools to the article won't. Also, I would calculate CCP numbers and rest of world separately, as they are well known to invent all their statistics, be it GDP or executions. Many WPs in other languages already do, and other talks have raised this point before.--89.206.117.126 (talk) 20:47, 13 February 2020 (UTC)

Please remember that Wikipedia is not a forum and this page is for discussing improvements to the article.Graham Beards (talk) 18:44, 13 February 2020 (UTC)

I guess some encyclopedias are more free than others. There are some seriously Communist methods at play here.
As for the CFR: it's
D_{present-delta}/(D_{present-delta}+R_present),
where delta=[median time between onset of symptoms and recovery]-[median time between onset of symptoms and death].--edit 89.206.113.95 (talk) 15:24, 16 February 2020 (UTC)

Again you are missing the point. Wikipedia is an encyclopedia. We do not calculate any epidemiological data; we quote it from reliable sources We do not publish any original research, which includes calculating these rates from raw data. This is Wikipedia policy. I am not contesting the accuracy of your formulation at all. It's just that it has no place here and contravenes this policy. Please do not resort to personal attacks and innuendos; they are not helpful. I am just upholding our established policies. Graham Beards (talk) 15:55, 16 February 2020 (UTC)

Maybe you're talking to the wrong person, since I didn't calculate anything. I simply pointed out a formula that has been in use for at least a century and that readers may want to apply to the outbreak at hand. This is by no means WP:OR, as its found in any epidemiological WP:MEDBOOK. Do with it as you please. Over the years it has proven quintessential to any ongoing epidemic and I was surprised, not finding it mentioned in that great encyclopedia of yours.
Also, taking my criticism of the clandestine sanctions against AAAAA as a WP:PA speaks volumes.--89.206.116.248 (talk) 18:57, 17 February 2020 (UTC)

Lysol and Clorox spray to kill virus on surfaces

Several articles discuss this topic. To date, CDC has not specified which products are effective but had an article on this topic. I am travelling and have only a smartphone so cannot edit the article but someone should include this topic. Peter K Burian (talk)

Hot soapy water will inactivate the virus because the particles are enveloped. We cannot be seen to be endorsing specific products. Graham Beards (talk) 15:38, 17 February 2020 (UTC)

The general term is Chlorine-releasing compounds. Graeme Bartlett (talk) 23:20, 17 February 2020 (UTC)

lopinavir/ritonavir

lopinavir/ritonavir are undergoing clinical trials, are the recommended treatment in Beijing, have been administered in Thailand, Malaysia, and South Korea, can be currently claimed for using health insurance in South Korea and have some significant health experts quoting how they have a positive effect. Furthermore, there is research giving the mode of action by which they help relieve symptoms. They seem like they should be present in this page. — Preceding unsigned comment added by TheFineTruthComb (talk • contribs) 22:22, 14 February 2020 (UTC)

Can you provide citations supporting this? These need to comply with guidance at WP:MEDRS. Bondegezou (talk) 22:24, 14 February 2020 (UTC)

Agree entirely with @Bondegezou: that this needs secondary sources, this page particularly should become clinical. Political discussions and the use of experimental drugs can go on the outbreak page. Expert opinion is very varied. Before being on the page describing the disease it should have had a secondary, scientific review of the expert opinion, at the very least, IMO. --Almaty (talk) 10:23, 18 February 2020 (UTC)

Asymptomatic transmission overemphasis

I did edit this on the weekend but it came back - I think logically we should state the symptoms first and then state that it may be asymptomatic in the lead. --Almaty (talk) 08:57, 18 February 2020 (UTC)

any 'asymptomatic' text should go in the body of the article...IMO--Ozzie10aaaa (talk) 19:10, 18 February 2020 (UTC)

"Cause of the outbreak"

The article states that "[t]he disease is the cause of the 2019–20 coronavirus outbreak", but isn't it actually the other way around? As in, SARS-CoV-2 causing the COVID-19 outbreak? --80.34.223.192 (talk) 12:04, 18 February 2020 (UTC)

An outbreak is an epidemiological phenomenon. The outbreak is an outbreak of the disease. The disease is the phenomenon behind the outbreak. Ergo, the disease is the cause of the outbreak. The virus is the cause of the disease.

But if the sentence is confusing, let's re-word it entirely to avoid any confusion. Bondegezou (talk) 17:09, 18 February 2020 (UTC)

The disease is the cause of the outbreak. This makes less sentence "It is the disease in the" Doc James (talk · contribs · email) 20:15, 18 February 2020 (UTC)

Wording

Should we use

"The virus is primarily transmitted via respiratory droplets from infected individuals when they cough, sneeze or exhale."

or

"It is primarily spread between people via respiratory droplets from infected individuals when they cough or sneeze."

Exhaling does not commonly produce respiratory droplets.

This is supported by the CDC[2] Doc James (talk · contribs · email) 19:57, 18 February 2020 (UTC)

would support the second choice per CDC ref--Ozzie10aaaa (talk) 20:46, 18 February 2020 (UTC)

Unless someone finds a serious source claiming that SARS-CoV-2 can be transported by ordinary exhaled breath, and that this is a "primary" mode of transmission, then "exhale" as a primary mode counts as WP:OR. Boud (talk) 21:54, 18 February 2020 (UTC)

It may be a US vs EU thing: ECDC: The virus seems to be transmitted mainly via respiratory droplets that people sneeze, cough, or exhale. Probably better sources are needed either way. Boud (talk) 21:57, 18 February 2020 (UTC)

Thinking aloud (credibility, not a source): At near-freezing winter temperatures, the water vapour in our breath can condense enough to see "clouds" of breath; the water droplets only need to be big/strong enough to carry SARS-CoV-2. Ordinary exhaling does not give your droplets high speeds; coughing or sneezing does. Boud (talk) 22:03, 18 February 2020 (UTC)

I favor the latter as I've mentioned before. It's redundant to use the adjective 'respiratory' and the verb 'breathe' (or anything similar to it) in this sentence. Moksha88 (talk) 03:08, 19 February 2020 (UTC)

Chloroquine press conference

See COVID-19#Chloroquine and check for wording compatibility with WP:MEDRS in the present context.

It would be nice if at least a preprint on BiorXiv came out as something that medical researchers could look at as opposed to a press conference reported by Xinhua (with an anecdote for convincing the layperson, which I did not include in the text). The time scale for peer review and meta-review will presumably be a few months.

If chloroquine turns out to be effective as suggested by the press conference, then the death rate should drop rapidly: chloroquine is cheap and most likely already in good supply in the warmer areas of China. Boud (talk) 23:45, 18 February 2020 (UTC)

@Bondegezou: In this edit that removed my version of the chloroquine claim, the proposal was that under WP:MEDRS, we have to wait for more solid evidence than a Xinhua report of a press conference. My concern in Wikipedia saying nothing is that rumours will fly (such as the anecdote given in the press conference, which does not constitute evidence), and NPOVing the claim in proper context is better than saying nothing, in bureaucratic obedience to a guideline. Pretending that research only exists with certain knowledge can contribute to the easiness effect in science education; presenting the complexity and uncertainty in real research is one way of combatting that. Anyway, here's an archive of the article, in case it gets modified by Xinhua later.

Since WP:MEDRS keeps getting cited, I'll quote something of what it actually says: Speculative proposals and early-stage research should not be cited to imply wide acceptance. For example, results of an early-stage clinical trial would not be appropriate in the Treatment section on a disease because future treatments have little bearing on current practice. The results might – in some cases – be appropriate for inclusion in an article specifically dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly when citing secondary sources, may be appropriate in research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing").

• The partial quote Speculative proposals and early-stage research should not be cited would be misleading. For good reason, it says Speculative proposals and early-stage research should not be cited to imply wide acceptance (bold added). Did the removed text imply wide acceptance? No.
• Early-stage research should not go in a treatment section. Is it in a treatment section in the removed text? No. It's in a Treatment research section that got renamed to Management.
• Does the removed text clearly identify the level of research cited? Partly: "unpublished" research clearly establishes the type of research; but "The chloroquine showed" is too strong and needs copyediting; "The exploratory research suggested that effects of the chloroquine" would be consistent with the WP:MEDRS quoted above.

So I don't understand how, apart from the last point where "showed" was too strong, the proposed (removed) text fails WP:MEDRS, once the wording is improved to reduce any chance of overconfidence in the claim. Boud (talk) 00:26, 19 February 2020 (UTC)

No, that's not usually how MEDRS is interpreted. You're talking about a news report of a tiny study: you're not even talking about a paper in a journal. The safest thing to say is nothing. Bondegezou (talk) 09:34, 19 February 2020 (UTC)

eradication or elimination

Which is attempted at the moment?

Eradication of infectious diseases — Preceding unsigned comment added by 88.115.204.102 (talk) 05:28, 19 February 2020 (UTC)

A containment strategy is attempting eradication. Bondegezou (talk) 14:21, 19 February 2020 (UTC)

Prognosis vs. Epidemiology

We currently have a section called Prognosis followed by a section called Epidemiology, but they cover much the same content, with slightly different numbers. Should we merge or more clearly differentiate? Bondegezou (talk) 09:43, 20 February 2020 (UTC)

• more clearly differentiate...IMO--Ozzie10aaaa (talk) 22:36, 20 February 2020 (UTC)

Wording III

We should use the words referenced in the paper when naming the symptoms of COVID-19. In the cited paper for symptoms, they are listed as "Fever", "fatigue" and "dry cough", among others, while in the article "fatigue" is referenced as "tiredness." Using wording congruent to the paper is important and at the same time, tiredness seems rather like an oversimplification of what fatigue is. — Preceding unsigned comment added by Thetsunamisam (talk • contribs) 05:49, 20 February 2020 (UTC)

they are more or less, synonymous--Ozzie10aaaa (talk) 22:41, 20 February 2020 (UTC)

Change of wording in "Management - Alternative Medicine" section

I would like to reccomend that

"Chinese health authorities recommend the use of traditional Chinese medicine (TCM) to prevent or treat the disease."

be changed to something along the lines of

"Chinese health authorities recommend the use of traditional Chinese medicine (TCM) in addition to standard medical supportive care to prevent or treat the disease."

This is a minor change but helps reduce the somewhat misleading wording of the current phrasing, which, in particular to someone not reading carefully (unfortunately a common occurence these days), could leave the impression that Chinese health authorities are *only* recommending TCM, rather than what they actually lay out in their diagnostic and treatment plans, which is to use TCM in conjunction with antivirals and other supportive, evidence-based treatments. — Preceding unsigned comment added by Neonpixii (talk • contribs) 17:53, 21 February 2020 (UTC)

Done. Bondegezou (talk) 18:09, 21 February 2020 (UTC)

ClinicalTrials.gov

This is an authoritative US Government registry of clinical trials. Although the trials as self-reported, I do not see why it cannot be used as a reference. There is no independent 3rd party source for clinical trials, since they are invisible unless the sponsors report them. --Zeamays (talk) 16:32, 20 February 2020 (UTC)

That is a good reason for them not to be in the article at all. Wikipedia is based upon reliable, independent, secondary sources, not primary sources. As I wrote in my edit summary, quoting from the site itself, "Information on ClinicalTrials.gov is provided by study sponsors and investigators, and they are responsible for ensuring that the studies follow all applicable laws and regulations. NLM staff do not verify the scientific validity or relevance of the submitted information beyond a limited quality control review for apparent errors, deficiencies, or inconsistencies." There is nothing authoritative about the site, nor is it global in scope, and in your reversion you asked to take this to the talk page, but I had already pointed this out on talk beforehand. Dekimasuよ! 16:40, 20 February 2020 (UTC)

You are correct about the facts of where the information originates, but much information on Wikipedia can be traced to self-reporting. Also, its being cited for the existence of these trials, not the trial results. There is simply no other way to obtain this information, and WP does make an exception for that, also I can't immediately give you an abbreviation for that. Do not revert this until you obtain consensus. At the moment this is your personal opinion. --Zeamays (talk) 17:29, 20 February 2020 (UTC)

I was the second editor to revert the addition on this page. I was not the first, nor the third, so it looks like the editor who hasn't obtained consensus is clear. I'll wait for someone else to revert again, sure. The general link does not act as a source for anything in particular, in the same way we wouldn't cite www.google.com when making a specific statement, so I would suggest that you not be surprised if it is removed again, I am not sure what part of my comment you are considering personal opinion. Meanwhile, you have now added the source to the page four times in the last three hours, plus several other times at Severe acute respiratory syndrome coronavirus 2 in the last 24 hours. I suggest you stop instead of violating the WP:3RR, and also note that the shortcut is WP:BRD, not WP:BRBD. Dekimasuよ! 17:58, 20 February 2020 (UTC)

This edit needs to be fixed either way. Dekimasuよ! 18:07, 20 February 2020 (UTC)

Apologies first off. I replied to this straight after Zeamays first posted, but it appears my edit did not go through.

I objected to the edit for two reasons. Firstly, the link given was just to the database, not to any specific trials. So the citation did not support any piece of text. We don't have inline citations to things that might be useful. We give inline citations to specific texts.

Secondly, this is a WP:PRIMARY source and Wikipedia prefers secondary sources, WP:MEDRS more so. Bondegezou (talk) 19:35, 20 February 2020 (UTC)

@Zeamays: you are also violating WP:BRD and are one step away from violating WP:3RR. Do not WP:EDITWAR. Get consensus for the addition you want here before re-adding. Bondegezou (talk) 19:39, 20 February 2020 (UTC)

Agree we should be using high quality secondary sources rather than primary sources generally. Doc James (talk · contribs · email) 05:29, 22 February 2020 (UTC)

Recent management edits

@Ozzie10aaaa: that was a big revert. Would you like to talk through your concerns? The additional citation and clarifying mask recommendations seem like slamdunks to me. Re-organising the management section to bring together advice rather than repeating similar advice from each country seems sensible to me. Bondegezou (talk) 12:22, 23 February 2020 (UTC)

To go through my edits in more detail:

• [3] Adding an additional link to a recent publication in a good medical journal seems obviously of value.
• [4] It's dangerously misleading to say advice includes "wearing surgical masks" with no additional context. Advice in most countries is that most people should not wear masks.
• [5] Instead of saying "Singapore says this, that and the other... The US says this, that and the other...", it seems more sensible to say "Everyone says this, everyone says that, everyone says the other". Bondegezou (talk) 12:28, 23 February 2020 (UTC)

User:Bondegezou I apologize for your edits getting reverted my intention was to revert[6] user Tsukide, again apologies--Ozzie10aaaa (talk) 13:03, 23 February 2020 (UTC)

Aha. I will re-do my edits then. Bondegezou (talk) 13:15, 23 February 2020 (UTC)

thank you--Ozzie10aaaa (talk) 13:38, 23 February 2020 (UTC)

The standard of English being used in these articles

Trying to read in simple English is cumbersome and doesn't flow easily. It conveys too little information across more words and is generally more vague. We are presuming that any reader of normal Wikipedia would have reasonable literacy skills and would have come across healthcare information before, so there's no reason to remove "normal" words from this article. These complex words and phrases are similar to legal doublets in that they convey a complex meaning that would otherwise take many words to explain. I agree that there are words which can be too complex (PCR test was the example I used last time), but even these terms can be used if written within context.

I think that anyone who is unable to read in normal English should be guided to the Simple English Wikipedia article since much of the information here is written in normal prose. The relevant articles on that encyclopedia need to be expanded by the users who constantly write simple English in this article. A URL could be placed at the top of the article to the Simple English Wikipedia article.

Tsukide (talk) 18:05, 23 February 2020 (UTC)

I agree with you. The page reads more like a student's lecture notes than an encylopaedic article. Perhaps this proseline problem has arisen because of the piecemeal way the article has evolved and it hopefully will resolve itself over time. I think editors should take note of your comments and make more effort to integrate their contributions to obtain smoothly-flowing prose. The current staccato style is a pain to read.Graham Beards (talk) 18:33, 23 February 2020 (UTC)

So we have the sentence "The coronavirus is primarily spread through human-to-human transmission via respiratory droplets that people exhale (cough or sneeze)."

We do not need both "spread" and "transmission", they mean the same thing.

One can more simple state "It is primarily spread between people by respiratory droplets produced during coughing or sneezing." which is normal prose.

One does not need to say "exhale (cough or sneeze)" but can simple say cough or sneeze... Doc James (talk · contribs · email) 00:57, 24 February 2020 (UTC)

Both the "spread" and the bracket instances were because you kept removing transmission and exhale from the text, despite those two words being better and more descriptive. Tsukide (talk) 06:25, 24 February 2020 (UTC)

Wat do you think of the compromise I put on the other article which is just a wikilink to droplet precautions which you can both expand @Tsukide: @Doc James:--Almaty (talk) 13:37, 24 February 2020 (UTC)

What is actually wrong with the following: "Infection is primarily through human-to-human transmission via respiratory droplets that people sneeze, cough or exhale"? The term "human-to-human transmission" is widely used in several health advisories and "sneeze, cough or exhale" is written in a EU health advisory. Tsukide (talk) 14:43, 24 February 2020 (UTC)

I agree with Tsukide that we have to include 'exhale'. The ECDC explicitly includes 'exhale'. Unless we have a reliable source that says that the ECDC is wrong, then we have to include "exhale". Small droplets can be included in exhaled air when exhaling without sneezing or coughing; the disadvantage for the virus is that it's not shot out at high speed, so its chance of finding its next human carrier and getting into respiratory pathways are lower. Boud (talk) 15:50, 24 February 2020 (UTC)

We have the CDC which says "Via respiratory droplets produced when an infected person coughs or sneezes."[7] Doc James (talk · contribs · email) 16:39, 24 February 2020 (UTC)

So shouting is harmless? Graham Beards (talk) 16:42, 24 February 2020 (UTC)

I guess the question is which is most concerning. WHO also mentioned breathing so adjusted to "The virus is primarily spread between people by respiratory droplets produced during breathing or coughing." Doc James (talk · contribs · email) 16:51, 24 February 2020 (UTC)

Breathe not breath

In the very first paragraph ot says " It is primarily spread between people by small droplets from infected individuals when they breath or cough." Breath is a noun. Breathe is a verb. You should use the word "breathe" especially when you're talking about something like this. Christianmusician06 (talk) 18:00, 24 February 2020 (UTC)

Thank you for spotting this. Graham Beards (talk) 18:51, 24 February 2020 (UTC)

Semi-protected edit request on 24 February 2020

!!! Lopinavir/Ritonavir (Kaletra) ineffective!!!

Source: https://translate.google.com/translate?hl=en&sl=auto&tl=en&u=https%3A%2F%2Fwww.thepaper.cn%2FnewsDetail_forward_6097825 https://www.thepaper.cn/newsDetail_forward_6097825

Short: On February 21, the team of Infectious Diseases and Immunology of Shanghai Public Health Clinical Center published its latest coronavirus drug research in the Chinese Journal of Infectious Diseases.

During the discussion, the research team pointed out that neither the lopinavir ritonavir group nor the abidol group was superior to the control group in improving clinical symptoms and accelerating virus clearance. The incidence of adverse reactions in the lopinavir ritonavir group was higher than that in the control group, which may be related to the dose or duration of the drug used. However, because there is no data on the dosage and duration of the two drugs, the study initially adopted a standard 5-day treatment regimen, and the effectiveness of a longer course or a larger dosage regimen needs to be further explored. However, the research team also mentioned that it may be that the two drugs do not have a good inhibitory effect on the new coronavirus. Psilosoph (talk) 14:13, 24 February 2020 (UTC)

It would help if we can find the actual research paper, rather than just a news report about it. I had a look, but wasn't able to. Bondegezou (talk) 14:52, 24 February 2020 (UTC)

The reason why we should keep "There is no vaccine or specific antiviral treatment, with efforts typically aiming at managing symptoms and supportive therapy." until some major organization like WHO or the CDC states otherwise. Doc James (talk · contribs · email) 16:53, 24 February 2020 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. Eggishorn (talk) (contrib) 20:47, 24 February 2020 (UTC)

Wording

We should generally write the lead in easier to understand English:

We have "It primarily spreads between people via respiratory droplets from infected individuals as they sneeze or cough."

Which is significantly better than "The primary mode of infection in humans is human-to-human transmission, which generally occurs via respiratory droplets from infected individuals which they sneeze, cough or expire."

Doc James (talk · contribs · email) 06:47, 13 February 2020 (UTC)

Agreed. Just for sentence structure and readability, it's much better. Also, the wording is similar to how the CDC explains transmission. - Wikmoz (talk) 07:42, 13 February 2020 (UTC)

agree as well, with both editors above--Ozzie10aaaa (talk) 11:47, 13 February 2020 (UTC)

Do we need to clarify that you don't have to be directly sneezed/coughed on, but that virus particles survive on surfaces for some period, and then get picked up by touching things? Bondegezou (talk) 11:52, 13 February 2020 (UTC)

Yes but maybe in a separate sentence. Doc James (talk · contribs · email) 21:14, 13 February 2020 (UTC)

Wikmoz & Doc James, I agree with you both wholeheartedly on this point. I rewrote the sentence to what Doc James had above but realized somebody reverted (or undid) my edit shortly thereafter. With a page that undergoes rapid editing like this one, what's the best way to signal your reasoning to other readers? Should I have started a new thread in the talk page and referenced it in my edit summary? Sure, it might not avoid someone else undoing the edit but at least the thought behind the edit is available for all to see.

Also, the current sentence now states, "Infection in humans primarily spreads between people via respiratory droplets from infected individuals when they sneeze, cough or breathe." Is it redundant to add "breathe" when we already state "respiratory droplets" and "sneeze" and "cough"? Moksha88 (talk) 03:46, 15 February 2020 (UTC)

Why would the inclusion of ‘breathe’ be considered redundant? It means something very different from cough or sneeze. More detail doesn’t make it harder to understand, it adds more important details that enhance understanding. Gootyam (talk) 23:56, 6 March 2020 (UTC)

This does not reflect the source in question

"There are no vaccines nor effective treatments, with efforts typically confined to management of symptoms and supportive measures." Doc James (talk · contribs · email) 00:18, 14 February 2020 (UTC)

References

yes agree... does not reflect the source in question--Ozzie10aaaa (talk) 01:26, 15 February 2020 (UTC)

Have adjusted to "There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care, and experimental measures."

Treatment can be effective. It is just not specific. Doc James (talk · contribs · email) 05:35, 22 February 2020 (UTC)

Thought I'd borrow this heading (is that allowed?). At the end of the first paragraph under epidemiology it says "Pauline Vetter, in an editorial in The BMJ noted that mortality outside of Hubei province seems to be lower than within Hubei". However, I don't believe the source bears that out. What it does say is that most fatalities have been in Hubei province and that it may be possible that environmental factors in the area explain the sustained transmission of the disease in that area, but neither of these match the sentence on Wikipedia. CrisH7 (talk) 10:31, 2 March 2020 (UTC)

@CrisH7: I think it is allowed but I do not believe it is a good practice to talk about lots of things in the same section. So, I 'd suggest we move it to a different section. Nevertheless, Vetter writes: "The estimated overall case fatality rate is around 2% but outside of Hubei province the figure is around 0.05 or less, not so far from the mortality observed with seasonal influenza." Cinadon36 10:40, 2 March 2020 (UTC)

Ah, must have missed that. I'm always tempted to remove my comments in such situations, but I assume someone wants to keep them for posterity. CrisH7 (talk) 11:04, 2 March 2020 (UTC)

Masks

The article states Transmission can be limited by washing hands, good hygiene, and wearing surgical masks yet two of the cites says they do not recommend wearing masks. CaGlwwWEDymzc7KBQC8u (talk) 11:28, 14 February 2020 (UTC)

Indeed some better explanation is probably due, though care should be taken to avoid WP:SYN issues. My understanding of the recommendation against masks is more for public health reasons (prevent disruptions of the mask supply to places that actually need them) than efficacy. That said you could also make the case that masks can provide a false sense of security/safety—I believe there was a study some decades ago that showed surgical wound infection rates were lower where the surgeon was not wearing a mask, but this was attributed to the greater care the surgeon needed to take not to breathe towards the patient’s wound when not wearing a mask. 199.66.69.88 (talk) 18:49, 14 February 2020 (UTC)

No, the recommendations against masks is that they don't particularly work (doi:10.1111/j.1467-9566.2012.01466.x, doi:10.1177/153567601001500204). We have to stick with what WP:MEDRS-compatible sources say. If two of the cites say they do not recommend masks, we should remove reference to masks from the text. Bondegezou (talk) 19:00, 14 February 2020 (UTC)

I agree with that. The medicos I am close to are sceptical about even the usefulness of the higher quality masks they can access, and certain that those generally available to the public are next to useless. We must not mislead our readers into thinking masks will make them safe. HiLo48 (talk) 21:59, 14 February 2020 (UTC)

It's a WP:SYN issue as 199.66.69.88 stated. To be clear: WHO, CDC, and NHS strongly recommend that individuals who have or suspect they have COVID-19 should wear surgical masks. This is to limit risk of transmission to others. For those who are not sick, the recommendation is to use a N95 respirator (or equivalent) when caring for or exposed to sick individuals. Please see Wuhan_coronavirus_outbreak#Respiratory_hygiene for relevant details and citations. - Wikmoz (talk) 06:22, 15 February 2020 (UTC)

In the workplace, certified face masks (P2 Australia, N95 US...) are use to give some protection against particulates like crystalline silica dust, asbestos and microbiological aerosols like infectious droplets of COVID-19. Surgical masks are to protect the patient from doctor or a potentially infected person. The media almost universally portrays surgical masks and similar masks (which are also uncertified) for COVID-19 as giving protection to the wearer. However just wearing a proper particulate face mask does not mean a lot of protection. These masks depend on a good facial seal (fit) to be effective. Facial hair makes a good fit impossible. Fake masks abound on Amazon and eBay. Though face masks are not recommended by competent authorities, many people are using the wrong masks. This wiki should briefly explain the choices and link to another wiki explaining the limitations of surgical masks and other non-protective masks. Deeuubee (talk) 03:06, 7 March 2020 (UTC)

viral load

https://en.wikipedia.org/wiki/Viral_load - does this make a difference in high infection areas? It is not well written as an article - but seems relevant here, — Preceding unsigned comment added by 109.240.3.81 (talk) 02:34, 26 February 2020 (UTC)

It's not relevant here. Viral load tests are only performed routinely for infections that cause a persistent viraemia such as HIV and hepatitis B. I have read some research papers reporting the measurement of the amount of coronaviruses in samples but how the results correlate with epidemiology is unknown.Graham Beards (talk) 20:27, 26 February 2020 (UTC)

"The test can be done on respiratory or blood samples"[41]

I couldn't verify the sentence using source given. On the other hand, according to WHO..."Serological testing may be useful to confirm immunologic response to a pathogen from a specific viral group, e.g. coronavirus. Best results from serologic testing requires the collection of paired serum samples (in the acute and convalescent phase) from cases under investigation" WHO, p4 Cinadon36 23:15, 26 February 2020 (UTC)

The testing of paired sera is a standard, albeit a little dated, diagnostic test. I will add the WHO paper to the references.Graham Beards (talk) 23:42, 26 February 2020 (UTC)

Ok thanks Graham Beards. Cinadon36 12:17, 27 February 2020 (UTC)

Request for Comment on table of coronavirus cases

Please participate in the RfC on a change to the table of coronavirus cases + deaths per country. Xenagoras (talk) 19:49, 28 February 2020 (UTC)

commented--Ozzie10aaaa (talk) 11:17, 29 February 2020 (UTC)

masks update

says when to use masks - perhaps we shoudl encorporate this rather than speculate why or why not to use them. Saying masks are not recommended (as the article says now) is not true -they are recommended by WHO in particular circumsatnces, these ones. Other health authorities might recommend certain masks and in certain cases. — Preceding unsigned comment added by 109.240.3.81 (talk) 09:38, 29 February 2020 (UTC)

PLEASE make the following changes:

replace reference 25 with this one: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

PLEASE add this reference for general public not wearing a mask in this Coronavirus: WHO holds briefing on Covid-19 outbreak – as it happened https:// youtu . be/26iWUiSHYtg

as the current ref 24 is not about and does not mention masks REF 25 also does not say anything about the general public wearing masks, but the new one here from youtube is the WHO saying this about masks at around 52min

There is also a dispute about information about masks at Talk:Misinformation_related_to_the_2019–20_coronavirus_outbreak#Refining_what_this_article_is_about. Input would be welcomed. Bondegezou (talk) 16:03, 29 February 2020 (UTC)

the incubation period

I heard that the incubation period might be 1 to 27 days, instead of 1 to 14 days. On WHO's website, they said that the incubation period is 1 to 14 days, but I don't know when they last updated the website. Sylvia.pa (talk) 09:58, 29 February 2020 (UTC)

Yes, my thoughts exactly. That sentence needs to go, as it gives undue weight to a rare incidence, it also fails WP:MEDRS Cinadon36 10:40, 29 February 2020 (UTC)

Reframing the "Alternative Medicine" section

It might be a good idea to reframe the Alternative Medicine section to make it clear that TCM has not been established as an effective or safe treatment for the coronavirus. That info is in the last sentence, but could it be in the first? Here's what I'm thinking:

Despite the fact that the efficacy and safety of Traditional Chinese Medicine (TCM) has not been established in coronavirus infections, Chinese health authorities recommend the use of TCM in addition to standard medical supportive care to prevent or treat the disease.

I'd just hate to see someone opt for pseudoscience instead of getting real medical treatment. --BevansDesign1 (talk) 19:56, 29 February 2020 (UTC)

Israeli (MIGAL) vaccine

I see this isn’t mentioned. Has it been debunked? - Scarpy (talk) 19:58, 29 February 2020 (UTC)

Why should it be mentioned? Doesnt pass WP:MEDRS. Cinadon36 20:35, 29 February 2020 (UTC)

[[8]] — Preceding unsigned comment added by 184.53.0.49 (talk) 21:12, 29 February 2020 (UTC)

Still fails WP:MEDRS.Cinadon36 09:20, 1 March 2020 (UTC)

yep--Ozzie10aaaa (talk) 13:42, 1 March 2020 (UTC)

A minor but annoying typo

Whoever has edit permissions, please correct:

The CDC recommends that healthcare providers first gown, then put on a mask or respirator. This is >>>THAN<<< followed by goggles or a face shield, and finally gloves that cover the wrists of the isolation gown.[81] MreeBiPolar (talk) 15:03, 9 March 2020 (UTC)

Gilead and Ascletis are not testing vaccines

Read the source references! They are testing antivirals.(please sign your posts)

"The disease is the cause of the 2019 coronavirus outbreak"

Is this the right wording? I would say that the cause of the outbreak is the virus (SARS-CoV-2), and that the outbreak is the spreading of the disease. I suppose in one sense the characteristics of the disease (infectiousness) are causing the outbreak, but seeing as the outbreak is also "causing" instances of the disease, it still feels like a weird tautology. Would you say "the disease influenza is the cause of flu outbreaks"? Perhaps, but maybe "[Covid-19] is the disease which was spread in the 2019 coronavirus outbreak" would be better? 81.106.108.123 (talk) 01:31, 2 March 2020 (UTC)

Oh whoops, looks like somebody was already talking about this up the page. Still, maybe that makes more of a case for different wording. 81.106.108.123 (talk) 01:34, 2 March 2020 (UTC)

We should be very careful when using the word "cause". It needs strong RS to support it. Cinadon36 07:38, 2 March 2020 (UTC)

"Diarrhea or upper respiratory symptoms are less frequent"

Signs and symptoms: "Diarrhea or upper respiratory symptoms (e.g. sneezing, runny nose, sore throat) are less frequent."

Main outbreak topic: "Unlike other coronaviruses, including SARS and MERS, COVID-19 patients may also develop gastrointestinal symptoms such as diarrhoea." (citation)

Based on the latest NEJM report, it looks like many of these don't support a COVID-19 diagnosis. From the list, only sore throat registered at a significant 13.9%.

The way I read it, nasal congestion (4.8%), nausea or vomiting (5%), and diarrhea (3.8%) seem to be in line with the general population and thus more likely to indicate an infection is not COVID-19.

The paragraph that includes all percentages is great. I'm just concerned about WP:SYNTH in the presentation of "less frequent" and rare symptoms.

- Wikmoz (talk) 08:50, 1 March 2020 (UTC)

doi:10.1016/j.jaut.2020.102433 would seem useful here to avoid any SYNTH. Let's follow what that says. Bondegezou (talk) 10:46, 1 March 2020 (UTC)

Yes, I read the citation but can't make sense of it. The authors point to these studes for MERS and SARS, which had diarrhea incidence rates of 26% and 20-25% respectively. I have to be missing something. - Wikmoz (talk) 21:21, 1 March 2020 (UTC)

Apparently, the self reported frequency of diarrhea in China is <1% so I guess there's a 2.8% spike among COVID-19 patients (or at least patients in high stress situations). Leaving the statement in this topic as is accordingly. The "Unlike other coronaviruses..." statement is incorrect though so I replaced it with the raw WHO symptom frequency data, which includes diarrhea. - Wikmoz (talk) 23:08, 2 March 2020 (UTC)

Order of sections

Not sure if this fits in with the Wikipedia style book but I'd suggest moving the Prognosis section much further up the page. Given the hysteria that seems to be developing - the clearly stated prognosis of a fatality rate of around 2% (of which at least some, maybe the majority, are in relatively high risk groups) would be a useful counter to the "France has started rationing face masks" type of headline. — Preceding unsigned comment added by 5.80.243.239 (talk) 21:47, 3 March 2020 (UTC)

per MEDMOSWikipedia:Manual_of_Style/Medicine-related_articles the answer is no--Ozzie10aaaa (talk) 23:35, 3 March 2020 (UTC)

RfC concerning COVID-19 navbox

I started an RfC concerning pointing to the template namespace in the COVID 19 navbox. See Template talk:COVID-19#RfC on linking to template namespace to participate.  Bait30  ^Talk? 18:06, 3 March 2020 (UTC)

commented--Ozzie10aaaa (talk) 23:40, 3 March 2020 (UTC)

Origin

Please add section

Origin As per published report from WHO it is a zoonotic virus and probably originated from bats but intermediate carriers are not detected. This can lead to catastrophic disaster if the same group of bat can expand across different geographies. DBigFacts (talk) 13:18, 4 March 2020 (UTC)

 Not done: The first part of your statement might be appropriate for the Severe acute respiratory syndrome coronavirus 2 article, but the second part contains editorial language and is not appropriate. —KuyaBriBri^Talk 16:47, 4 March 2020 (UTC)

References

Draft:Coronavirus_(Disambiguation)

As per earlier talk, I've created a draft disambiguation page. Please check & edit

What happens next? Robertpedley (talk) 18:40, 1 March 2020 (UTC)

It's not a good idea to have several venues for this discussion. Please decide where it should be and direct editors there.Graham Beards (talk) 20:16, 1 March 2020 (UTC)

Ok Graham Beards please refer to discussion here Talk:Coronavirus#Draft:Coronavirus_(Disambiguation) Robertpedley (talk) 20:56, 4 March 2020 (UTC)

Fibrosis

I've seen several sources claiming that COVID-19 can cause long-term/permanent damage even in survivors, including fibrosis. Anyone want to add this? 72.209.60.95 (talk) 04:53, 5 March 2020 (UTC)

This is an important point, but the key is: what sources? We can consider adding them if you show us. Dekimasuよ! 04:56, 5 March 2020 (UTC)

Here is one source:

"Autopsies show severe damage to COVID-19 patients' lungs and immune system, according to a doctor in Wuhan reached by the Global Times, who called for measures to prevent fibrosis of the lungs at an early stage of the disease. [...]

"The autopsy results Liu shared inspired me a lot. Based on the results, I think the most important thing now is to take measures at an early stage of the disease to protect patients' lungs from irreversible fibrosis," Peng noted. [...]

The patient, an 85-year-old man, exhibited similar pathological changes to those caused by SARS and MERS. Fibrosis in his lungs was not as serious as was seen in SARS patients, but an exudative reaction was more apparent, possibly due to the short course of his disease."

72.209.60.95 (talk) 05:07, 5 March 2020 (UTC)

Areas

Which areas are mostlty affected Yash Sharma qwe123 (talk) 05:10, 6 March 2020 (UTC)

please see 2019-20 coronavirus outbreak for areas(countries affected), however if your referring to what areas of the body please see signs and symptoms in this article--Ozzie10aaaa (talk) 13:36, 6 March 2020 (UTC)

JAMA tagged as "better source needed"?

Curious to see JAMA (cited as reference 125 under the heading Research/Antiviral) tagged as "better source needed". Is this perhaps an accidental tagging? Wayne 23:09, 5 March 2020 (UTC)

if per MEDRS there's a better source, then....--Ozzie10aaaa (talk) 13:37, 6 March 2020 (UTC)

Semi-protected edit request on 7 March 2020

Change "outbreak was first idenhttp://backreaction.blogspot.com/tified on 31 December 2019" to "outbreak was first identified on 1 December 2019" Grishkin (talk) 04:23, 7 March 2020 (UTC)

 Done DarthFlappy (talk) 14:53, 7 March 2020 (UTC)

Artificial Intelligence Efforts ?

It would be great to cover and date stamp some of the AI efforts / claims reported by the Wall Street Journal today: https://www.wsj.com/amp/articles/biotech-companies-tap-ai-to-speed-path-to-coronavirus-treatments-11583451564 — Preceding unsigned comment added by 5.148.105.170 (talk) 23:23, 7 March 2020 (UTC)

Immunity against corona

• Protection against Corona Virus*

I think people should drink more hot fluids to build immunity against flu and corona virus - hot water, tea, coffee, milk, porridge, black tea with ginger, turmeric and cinamon. Also to eat more onions, garlic, tomatoes, carrots for immunity. Also not to use much air conditioner in hot weather - keeping ac temperetures at 25 degrees centigrade and above is safe so your body doesnt get too cold. Also sit more in open air than closed rooms.

Tangawizi (ginger tea) sold in tz on streets is very good for immunity.

Also keep at home - Vicks and Jivan San Jivan (indian herb) to be mixed for hot steam vapour inhaling to cure flu. Steam is considered the best cure for flu. Nafizbnasser (talk) 21:42, 16 March 2020 (UTC)

The article (and Talk) is best kept to information that is strongly supported by good medical research. David notMD (talk) 00:00, 17 March 2020 (UTC)

Prognosis

I deleted a paragraph [9]. It seems to me that there were numerous issue: "According to WHO, based on analysis of 44,000 cases": I think it is not WHO but a Chinese organization "The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team" [10]. "and 3.7% of cases are fatal": It also seems wrong. The article says "overall case fatality rate of 2.3%". There is only one "3.7" number in the article and that is not the correct "overall case fatality rate". Why do such an errors appear in a prominent article? Or am I misunderstanding something? — fnielsen (talk) 23:23, 5 March 2020 (UTC)

I think we definitely need the number in the article. Is the "overall case fatality rate of 2.3%" of [11] the most appropriate? Are there updates? — fnielsen (talk) 23:25, 5 March 2020 (UTC)

"No deaths had occurred under the age of 10 as of 26 February 2020" is based solely on data (or lack thereof) from China's CDC. It may be premature to assume that no deaths under age 10 have occurred. It looks more like China just chose not to report any numbers in that age range. Numerous articles have raised suspicion over the accuracy of China's reporting, many suggesting that underreporting of COVID-19 in China is politically motivated, perhaps to deflect criticism of their handling of the outbreak and deficiencies in their healthcare system infrastructure, and/or to convince their own citizens to return to work. One obviously glaring statistic that casts suspicion on China's COVID-19 reporting is the large discrepancy in the reported death rate in China vs. the rest of the world. — Preceding unsigned comment added by 75.169.219.121 (talk) 20:17, 8 March 2020 (UTC)

Missing antiviral

where are oseltamivir and peramivir etc ?? in trial treatments section ~ av8dok

Do you have sources discussing these? Bondegezou (talk) 11:10, 9 March 2020 (UTC)

Community transmission UK

The UK now has two confirmed cases of community transmission, one a woman in her 70s and the other a man in his 80s, both had underlying conditions and both have since died.

BBC News - Coronavirus: Man in 80s is second person to die of virus in UK https://www.bbc.co.uk/news/uk-51771815 Margo (talk) 06:16, 8 March 2020 (UTC)

this should be at 2019-20 coronavirus outbreak--Ozzie10aaaa (talk) 20:37, 9 March 2020 (UTC)

Research centers

Duke-NUS along with Arcturus is also working on a vaccine

https://www.biospectrumasia.com/news/26/15542/arcturus-duke-nus-to-develop-covid-19-vaccine-for-singapore.html

104.128.175.161 (talk) 03:08, 8 March 2020 (UTC)

should be in vaccine article Coronavirus vaccine--Ozzie10aaaa (talk) 20:56, 9 March 2020 (UTC)

v2.0 : draft in progress, help welcolme

I searched dozens of papers for key characteristics of the COVID19. I need help for SARS, MERS. Seasonal flu is just for personal reference and is expected to be removed soon. If you have info for a cell, contribution welcome. Yug (talk) 15:47, 8 March 2020 (UTC)

Characteristics of patients who have been infected with
SARS-CoV-2, MERS-CoV, and SARS-CoV ()

Virus	SARS-CoV-2	MERS-CoV	SARS-CoV	H1N1, H3N2
Disease	COVID-19	Middle East respiratory syndrome	Severe acute respiratory syndrome	Seasonal flu
Epidemiology
Detection date	December 2019	June 2012	November 2002	Endemic (n.a.)
Detection place	Wuhan, China	Jeddah, Saudi Arabia	Guangdong, China	Endemic (n.a.)
Confirmed cases	88,585	2494	8096	5~15,000,000/y
Case fatality rate	3,043 (3.44%)	858 (37%)	744 (10%)	290-650,000 (0.1%)
Basic reproduction number	2.2 (95% CI:1.4–3.9) 2.68 (95% CI:2.47–2.86)			1.3
Serial interval period	7.5±3.4 days (95% CI:5.3–19)
Demographic
Age average	49	56	39.9
Age range	21–76	14–94	1–91
Male:female ratio	2.7:1	3.3:1	1:1.25
Health-care workers	16	9.8%	23.1%
Symptoms
Fever	40 (98%)	98%	99–100%
Dry cough	31 (76%)	47%	29–75%
Dyspnea/short breath	22 (55%)	72%	40–42%
Diarrhea	1 (3%)	26%	20–25%
Sore throat	0	21%	13–25%
Ventilatory support	9.8%	80%	14–20%
Prognostic/Evolution
Incubation	5.5 days (1–14) or 5.2 days (95% CI:4.1–7.0)			2-4 days
Onset	Day 0			Day 0
First medical visit	+4.6 days (95% CI:4.1–5.1)
Hospital admission	+7.0 days (4.0–8.0) or +12.5 days (95% CI:10.3–14.8) +9.1 days (95% CI:8.6–9.7)
Dyspnea/short breath	+8.0 days (5.0–13.0)
ARDS	+9.0 days (8.0–14.0)
Mechanical ventilation / ICU	+10.5 days (7.0–14.0)
Recovery	+22.2 days (95% CI:18–83)
Dead	+14 days (6–41) or hospitalization + 12.4 +22.3 days (95% CI:18–82)
Notes

Yug (talk) 10:41, 2 March 2020 (UTC)

References

https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf This is a good source (Angunnu (talk) 11:36, 3 March 2020 (UTC))

https://www.who.int/csr/don/24-february-2020-mers-saudi-arabia/en/ For MERS (Angunnu (talk) 11:38, 3 March 2020 (UTC))

Interesting but wouldn't it violate WP:SYNTHESIS? Cinadon36 15:54, 8 March 2020 (UTC)

There is no abusive conclusion, just informative data. Yug (talk) 16:34, 8 March 2020 (UTC)

Your case fatality rate looks like WP:OR. We should be citing what the literature reports on this, not trying to calculate the number directly from data we have available. Bondegezou (talk) 12:11, 10 March 2020 (UTC)

Per Wikipedia:No_original_research#Routine_calculations Yug (talk) 19:04, 11 March 2020 (UTC)

Indeed, I think such numbers can be included on the page, at least for the coronavirus disease, but they all must be sourced. For example, where the basic reproduction number for the seasonal flu came from? My very best wishes (talk) 20:20, 11 March 2020 (UTC)

Case fatality is not a routine calculation. We have discussed this numerous times and repeatedly come to that conclusion. Bondegezou (talk) 08:46, 12 March 2020 (UTC)

One simply needs a better source for ref [b]. This is 3.4% according to WHO [12], and this number is widely cited here and elsewhere. This is key number, and it absolutely must be included, even in the lead. Right now it only appears on the page in connection with false statements by Trump. Must be fixed. My very best wishes (talk) 16:01, 12 March 2020 (UTC)

The article should definitely talk about mortality rates, but it should do so based on numbers given in WP:MEDRS-compliant sources. Bondegezou (talk) 08:55, 13 March 2020 (UTC)

@Bondegezou: I'am quite tired of the petty "CFR is not routine calculation". Per wikipedia :

"Case fatality rate (CFR) — sometimes called case fatality risk or case fatality ratio — is the proportion of deaths from a certain disease compared to the total number of people diagnosed with the disease for a certain period of time."

So yes, CFR is Wikipedia:No_original_research#Routine_calculations. Then, interpretation need to be an informed reader about its limitations. The stage of the epidemic matters, the date, the undetected / detected ratio matters for a better understanding. This shouldn't encourage to censor the CFR routine calculation. It either fall on the reader to instruct her/himself by clicking on Case fatality rate and reading it, or to us to add ref notes duplicating the Case fatality rate article's content. But pretending we cannot do a routine division is surprisingly petty, while it also force-hand us to fall back upon outdated and therefor less relevant external sources, degrading the quality of the information we provide. Yug (talk) 17:49, 14 March 2020 (UTC)

The matter has been discussed multiple times now on the main article's Talk page and the consensus is that this is not a routine calculation. It is not "petty" to respect an expressed consensus. Bondegezou (talk) 20:26, 14 March 2020 (UTC)

FYI, I made the following change in the article: Added to the intro "...or SARS-1)" and "...or SARS-CoV-1)", as alternate names being used in the year 2020. Acwilson9 (talk) 18:24, 24 March 2020 (UTC)

Citation overkill

"the world could independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.[13][55][56][57][58][59][60]" Is there any particular reason for so many refs? If I recall correctly, I removed some of them, but they have been re-inserted somehow. Cinadon36 15:51, 8 March 2020 (UTC)

tagged it[13]--Ozzie10aaaa (talk) 20:40, 9 March 2020 (UTC)

Thanks, didn't know we had such a template. Cinadon36 21:05, 9 March 2020 (UTC)

Antibody testing

There's a reference to yicaiglobal which on Feb 25th stated that "China is producing [...] 350,000 antibody test kits each day" But 2 days later we have sciencemag.org saying "In what appears to be a first, disease trackers in Singapore have used an experimental antibody test for COVID-19 to confirm that a suspected patient was infected with the coronavirus. [...] Researchers around the world are racing to develop antibody tests,".

Either there was a huge miss of information from China to Singapore & others or the yicaiglobal article is wrong. Wrong either in that they misreported the officials or the officials said something which was not a reflection of reality.

Bearing WP:MEDRS in mind I'm not sure what we should do. Just remove the reference, or qualify it? --TFJamMan (talk) 11:46, 5 March 2020 (UTC)

There is indeed a lot more info about antibody testing! China ships it already to the EU, produces it, but noone tells it in the EU press. I don't know why, especially because this is good news: "Xiamen University has developed rapid testing kit for the COVID-19 antibody with results available in 29 minutes. The testing kit has been approved by the EU and exported to countries including Italy, Austria and the Netherlands." source: Shine.cn --Horia mar (talk) 00:04, 10 March 2020 (UTC)

Immunity anyone?

From an epidemiological and predictive point of view, it is essential to know whether past patients can be re-infected. What do we know about that? There is nothing in here. — Preceding unsigned comment added by Frederic Y Bois (talk • contribs) 17:21, 7 March 2020 (UTC)

please see antibody testing chapter, here above! :) --Horia mar (talk) 00:10, 10 March 2020 (UTC)

Revert

Any reasonable explanation for this. Most of that passage doesn't cite medical sources anyway. - ☣Tourbillon ^A ? 11:29, 10 March 2020 (UTC)

Hi, thanks for opening a discussion. Here is my view:

• "Most of that passage doesn't cite medical sources"--> this is not an argument for inclusion, rather it is an argument for exclusion of the rest of the passage.
• Industry announcement that they will work on vaccine, or are currently working, is kind of advertisment. When they present a vaccine and it is validated by third parties, then we can add info on the article.
• It is not best practice to duplicate text from other articles.[14]
• In my opinion, this edit[15] should be reverted per WP:BRD.Cinadon36 11:58, 10 March 2020 (UTC)

Fair enough, but that opens the question why only this statement was removed, while the rest was not. I wouldn't call this an industry announcement, the company is based in the national technology park (Sofia Tech Park). The company itself has not issued any statements. Furthermore STP is a government structure, not a pharmaceutical industry organisation, and its announcement states that they will support further efforts, both financially and through their R&D infrastructure. - ☣Tourbillon ^A ? 12:26, 10 March 2020 (UTC)

It is not the role of Wikipedia to report every piece of vaccine research activity. We should stick to WP:MEDRS-compliant sources and take a 'helicopter view' rather than getting lost in the details. So, I would be happy to see lots of this sort of material removed. Bondegezou (talk) 13:18, 10 March 2020 (UTC)

Coronavirus vaccine

I have created Coronavirus vaccine, as this will inevitably be needed to line up with our existing articles about developed and experimental vaccines. BD2412 T 18:31, 8 March 2020 (UTC)

shouldn't it be called Coronavirus 19 vaccine research(as the title may mislead readers to think there already is a vaccine approved/tested/available...Ebola for example, didn't get a vaccine approved and that worked until recently, and even now it only works on Zaire ebolavirus)--Ozzie10aaaa (talk) 20:34, 9 March 2020 (UTC)

We are discussing that matter at Talk:COVID-19 vaccine. Input welcome there. Bondegezou (talk) 13:19, 10 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)

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)

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.[16] 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 [[17]]

Rbsingh91 —Preceding undated comment added 00:20, 13 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

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)

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