The early phase of the COVID-19 outbreak in Lombardy, Italy

[LKJ86]

The early phase of the COVID-19 outbreak in Lombardy, Italy

Cereda D, Tirani M, Rovida F, Demicheli V, Ajelli M, Poletti P, Trentini F, Guzzetta G, Marziano V, Barone A, Magoni M, Deandrea S, Diurno G, Lombardo M, Faccini M, Pan A, Bruno R, Pariani E, Grasselli G, Piatti A, Gramegna M, Baldanti F, Melegaro A, Merler S

(Submitted on 20 Mar 2020)

In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract specimen results, hospitalization, contact tracing. We provide estimates of the reproduction number and serial interval. The epidemic in Italy started much earlier than February 20, 2020. At the time of detection of the first COVID-19 case, the epidemic had already spread in most municipalities of Southern-Lombardy. The median age for of cases is 69 years (range, 1 month to 101 years). 47% of positive subjects were hospitalized. Among these, 18% required intensive care. The mean serial interval is estimated to be 6.6 days (95% CI, 0.7 to 19). We estimate the basic reproduction number at 3.1 (95% CI, 2.9 to 3.2). We estimated a decreasing trend in the net reproduction number starting around February 20, 2020. We did not observe significantly different viral loads in nasal swabs between symptomatic and asymptomatic. The transmission potential of COVID-19 is very high and the number of critical cases may become largely unsustainable for the healthcare system in a very short-time horizon. We observed a slight decrease of the reproduction number, possibly connected with an increased population awareness and early effect of interventions. Aggressive containment strategies are required to control COVID-19 spread and catastrophic outcomes for the healthcare system.

Subjects: Populations and Evolution (q-bio.PE)
Cite as: arXiv:2003.09320 [q-bio.PE]
(or arXiv:2003.09320v1 [q-bio.PE] for this version)

Source:https://arxiv.org/abs/2003.09320

 

[LKJ86]

The early phase of the COVID-19 outbreak in Lombardy, Italy

Cereda D, Tirani M, Rovida F, Demicheli V, Ajelli M, Poletti P, Trentini F, Guzzetta G, Marziano V, Barone A, Magoni M, Deandrea S, Diurno G, Lombardo M, Faccini M, Pan A, Bruno R, Pariani E, Grasselli G, Piatti A, Gramegna M, Baldanti F, Melegaro A, Merler S

(Submitted on 20 Mar 2020)

In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract specimen results, hospitalization, contact tracing. We provide estimates of the reproduction number and serial interval. The epidemic in Italy started much earlier than February 20, 2020. At the time of detection of the first COVID-19 case, the epidemic had already spread in most municipalities of Southern-Lombardy. The median age for of cases is 69 years (range, 1 month to 101 years). 47% of positive subjects were hospitalized. Among these, 18% required intensive care. The mean serial interval is estimated to be 6.6 days (95% CI, 0.7 to 19). We estimate the basic reproduction number at 3.1 (95% CI, 2.9 to 3.2). We estimated a decreasing trend in the net reproduction number starting around February 20, 2020. We did not observe significantly different viral loads in nasal swabs between symptomatic and asymptomatic. The transmission potential of COVID-19 is very high and the number of critical cases may become largely unsustainable for the healthcare system in a very short-time horizon. We observed a slight decrease of the reproduction number, possibly connected with an increased population awareness and early effect of interventions. Aggressive containment strategies are required to control COVID-19 spread and catastrophic outcomes for the healthcare system.

Subjects: Populations and Evolution (q-bio.PE)
Cite as: arXiv:2003.09320 [q-bio.PE]
(or arXiv:2003.09320v1 [q-bio.PE] for this version)

Source:https://arxiv.org/abs/2003.09320

View attachment 617413 View attachment 617414

'Every Single Individual Must Stay Home': Italy's Coronavirus Surge Strains Hospitals
March 19, 20201:59 PM ET

Daniela De Rosa, a 43-year-old veterinarian in Italy's southwest Campania region, made a video message over the weekend as she was hospitalized with COVID-19. Her video plea has gathered much attention in Italy, which has just surpassed China in the number of reported deaths from the new coronavirus.

"I've been in isolation in a hospital room for so many days I've lost count," she says. "I have no contact with anyone other than doctors twice a day."

"Very few people understand what's happening. I want people to see I'm suffering," De Rosa continues.

"Every single individual must stay home and not endanger the lives of others," she insists.

Since the video was shared on Facebook last Sunday, it has racked up more than 11 million views.

As of Thursday afternoon, Italy has registered 41,035 diagnoses of the coronavirus and 3,405 deaths. The death toll is now higher than China's known COVID-19 deaths of over 3,200. Earlier this month, Italy became the first Western country to launch a nationwide lockdown to contain the outbreak, but despite strict measures, the number of cases continues to rise.

Italy has a universal health care system. But now, its hospitals and medical staff are overwhelmed, prompting anguished debate.

The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care has issued guidelines for what it calls a "catastrophe medicine"-like scenario. The college put it starkly: Given the serious shortage of health resources, patients with the "best chance of success and hope of life" should have access to intensive care, the organization says.

"If you have an 99-year-old male or a female patient, that's a patient with a lot of diseases. And you have [a] young kid that need to be intubated and you only have one ventilator, I mean, you're not going to ... toss the coin," says Carlo Vitelli, a surgeon and oncologist in Rome.

He's speaking just a few hours after operating on a perforated appendix of a young man who had been in contact with a person from northern Italy, where the virus has hit the hardest in the country. It was "an emergency operation done on somebody who was in quarantine," Dr. Vitelli says, "don't know if he's going to develop. I don't think so. But, you never know."

Italy is treating the coronavirus pandemic like a wartime emergency. Health officials are scrambling to set up more beds. In Milan, the old fairgrounds is being turned into an emergency COVID-19 hospital with 500 new beds; across the country, hospitals are setting up inflatable tents outdoors for triage.

Other countries can learn important lessons from Italy, says Dr. Giuseppe Remuzzi, co-author of a recent paper in The Lancet about the country's dire situation. The takeaways include how to swiftly convert a general hospital into a coronavirus care unit with specially trained doctors and nurses.

"We had dermatologists, eye doctors, pathologists, learning how to assist a person with a ventilator," Remuzzi says.

Some question why Italy was caught off guard when the virus outbreak was revealed on Feb. 21.

Remuzzi says he is now hearing information about it from general practitioners. "They remember having seen very strange pneumonia, very severe, particularly in old people in December and even November," he says. "This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China."

He says it was impossible to combat something you didn't know existed.

 

[Oldman1]

https://www.ouest-france.fr/sante/v...as-sont-apparus-des-novembre-en-chine-6778548

Coronavirus. The first cases appeared in November in China
"Patient Zero" was reportedly treated on November 17. Much earlier than what the Chinese authorities have announced so far. By the end of 2019, 266 patients were listed in China.

In its latest edition, the South China Morning Post , an English-language daily based in Hong Kong, generally very well informed of the situation in mainland China, claims that the Covid-19 would have been detected much earlier than the Chinese authorities announced so far. The first case - the famous zero patient was reportedly identified on November 17. The South China Morning Post, which had access to the databases of the Chinese authorities, claims that it is a 55-year-old man from Hubei province, where the city of Wuhan is located. epicenter of the epidemic.




Alert launched only on December 27

The coronavirus is said to have spread rapidly: one to five cases daily the following days, fifteen cases of contamination on November 27, 60 on December 20, 180 on December 27, 266 in total at the end of the year. As early as December 27, Zhang Jixian, a doctor at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, informed the authorities that it was not just atypical pneumonia, as the authorities claimed ten days later, but much of an unknown form of coronavirus.



Information that Beijing kept secret for weeks, delaying the implementation of containment measures in Wuhan, going as far as tracking down the first whistleblowers such as the ophthalmologist Li Wenliang, who died on February 7, has since been rehabilitated and has become a national hero.

Since then, China has caught up with its ignition delay, by transferring the data on the Covid-19 genome to the international community, by taking exceptional measures in Wuhan (closure of the megalopolis of 11 million inhabitants, construction of two hospitals in record time ), under the leadership of a major general, a trained biologist. Result: the epidemic is stopped , proclaimed Tuesday President Xi-Jinping, who left. In the meantime, alas, the coronavirus has spread to the whole planet.


https://www.ouest-france.fr/sante/v...-circulait-deja-en-italie-en-novembre-6791626

In search of the “zero patient”
Also in China, the appearance of cases from November 17, 2019 was revealed by the South China Morning Post . Long before January 8, when the Chinese authorities first spoke of the new coronavirus.



In Italy, the first proven cases are registered in Rome on January 31. They are two Chinese tourists who arrived in Milan eight days earlier. Since then, Italian researchers have struggled to trace the thread of contagion in order to get their hands on "the patient zero", the first person to have contracted the virus. Essential data to find the source of the epidemic and better manage it. At the end of February 2020, Professor Massimo Galli, director of the Sacco hospital in Milan, already explained that the epidemic was not recent : The The virus circulated unnoticed for several weeks, before the first known cases of the disease. His team is currently studying the Italian strain of the virus, in order to establish the course of the epidemic in the country.

 

[LKJ86]

https://www.ouest-france.fr/sante/v...as-sont-apparus-des-novembre-en-chine-6778548

Coronavirus. The first cases appeared in November in China
"Patient Zero" was reportedly treated on November 17. Much earlier than what the Chinese authorities have announced so far. By the end of 2019, 266 patients were listed in China.

In its latest edition, the South China Morning Post , an English-language daily based in Hong Kong, generally very well informed of the situation in mainland China, claims that the Covid-19 would have been detected much earlier than the Chinese authorities announced so far. The first case - the famous zero patient was reportedly identified on November 17. The South China Morning Post, which had access to the databases of the Chinese authorities, claims that it is a 55-year-old man from Hubei province, where the city of Wuhan is located. epicenter of the epidemic.




Alert launched only on December 27

The coronavirus is said to have spread rapidly: one to five cases daily the following days, fifteen cases of contamination on November 27, 60 on December 20, 180 on December 27, 266 in total at the end of the year. As early as December 27, Zhang Jixian, a doctor at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, informed the authorities that it was not just atypical pneumonia, as the authorities claimed ten days later, but much of an unknown form of coronavirus.



Information that Beijing kept secret for weeks, delaying the implementation of containment measures in Wuhan, going as far as tracking down the first whistleblowers such as the ophthalmologist Li Wenliang, who died on February 7, has since been rehabilitated and has become a national hero.

Since then, China has caught up with its ignition delay, by transferring the data on the Covid-19 genome to the international community, by taking exceptional measures in Wuhan (closure of the megalopolis of 11 million inhabitants, construction of two hospitals in record time ), under the leadership of a major general, a trained biologist. Result: the epidemic is stopped , proclaimed Tuesday President Xi-Jinping, who left. In the meantime, alas, the coronavirus has spread to the whole planet.


https://www.ouest-france.fr/sante/v...-circulait-deja-en-italie-en-novembre-6791626

In search of the “zero patient”
Also in China, the appearance of cases from November 17, 2019 was revealed by the South China Morning Post . Long before January 8, when the Chinese authorities first spoke of the new coronavirus.



In Italy, the first proven cases are registered in Rome on January 31. They are two Chinese tourists who arrived in Milan eight days earlier. Since then, Italian researchers have struggled to trace the thread of contagion in order to get their hands on "the patient zero", the first person to have contracted the virus. Essential data to find the source of the epidemic and better manage it. At the end of February 2020, Professor Massimo Galli, director of the Sacco hospital in Milan, already explained that the epidemic was not recent : The The virus circulated unnoticed for several weeks, before the first known cases of the disease. His team is currently studying the Italian strain of the virus, in order to establish the course of the epidemic in the country.

March 20th, 2020 Meet Wuhan CoronaVirus Patient One - Maatje Benassi

https://twitter.com/x/status/1241697543681126400

 

[Oldman1]

March 20th, 2020 Meet Wuhan CoronaVirus Patient One - Maatje Benassi

https://twitter.com/x/status/1241697543681126400

https://www.ouest-france.fr/sante/v...as-sont-apparus-des-novembre-en-chine-6778548

Coronavirus. The first cases appeared in November in China
"Patient Zero" was reportedly treated on November 17. Much earlier than what the Chinese authorities have announced so far. By the end of 2019, 266 patients were listed in China.

In its latest edition, the South China Morning Post , an English-language daily based in Hong Kong, generally very well informed of the situation in mainland China, claims that the Covid-19 would have been detected much earlier than the Chinese authorities announced so far. The first case - the famous zero patient was reportedly identified on November 17. The South China Morning Post, which had access to the databases of the Chinese authorities, claims that it is a 55-year-old man from Hubei province, where the city of Wuhan is located. epicenter of the epidemic.




Alert launched only on December 27

The coronavirus is said to have spread rapidly: one to five cases daily the following days, fifteen cases of contamination on November 27, 60 on December 20, 180 on December 27, 266 in total at the end of the year. As early as December 27, Zhang Jixian, a doctor at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, informed the authorities that it was not just atypical pneumonia, as the authorities claimed ten days later, but much of an unknown form of coronavirus.



Information that Beijing kept secret for weeks, delaying the implementation of containment measures in Wuhan, going as far as tracking down the first whistleblowers such as the ophthalmologist Li Wenliang, who died on February 7, has since been rehabilitated and has become a national hero.

Since then, China has caught up with its ignition delay, by transferring the data on the Covid-19 genome to the international community, by taking exceptional measures in Wuhan (closure of the megalopolis of 11 million inhabitants, construction of two hospitals in record time ), under the leadership of a major general, a trained biologist. Result: the epidemic is stopped , proclaimed Tuesday President Xi-Jinping, who left. In the meantime, alas, the coronavirus has spread to the whole planet.


https://www.ouest-france.fr/sante/v...-circulait-deja-en-italie-en-novembre-6791626

In search of the “zero patient”
Also in China, the appearance of cases from November 17, 2019 was revealed by the South China Morning Post . Long before January 8, when the Chinese authorities first spoke of the new coronavirus.



In Italy, the first proven cases are registered in Rome on January 31. They are two Chinese tourists who arrived in Milan eight days earlier. Since then, Italian researchers have struggled to trace the thread of contagion in order to get their hands on "the patient zero", the first person to have contracted the virus. Essential data to find the source of the epidemic and better manage it. At the end of February 2020, Professor Massimo Galli, director of the Sacco hospital in Milan, already explained that the epidemic was not recent : The The virus circulated unnoticed for several weeks, before the first known cases of the disease. His team is currently studying the Italian strain of the virus, in order to establish the course of the epidemic in the country.

 

[LKJ86]

https://www.ouest-france.fr/sante/v...as-sont-apparus-des-novembre-en-chine-6778548

Coronavirus. The first cases appeared in November in China
"Patient Zero" was reportedly treated on November 17. Much earlier than what the Chinese authorities have announced so far. By the end of 2019, 266 patients were listed in China.

In its latest edition, the South China Morning Post , an English-language daily based in Hong Kong, generally very well informed of the situation in mainland China, claims that the Covid-19 would have been detected much earlier than the Chinese authorities announced so far. The first case - the famous zero patient was reportedly identified on November 17. The South China Morning Post, which had access to the databases of the Chinese authorities, claims that it is a 55-year-old man from Hubei province, where the city of Wuhan is located. epicenter of the epidemic.




Alert launched only on December 27

The coronavirus is said to have spread rapidly: one to five cases daily the following days, fifteen cases of contamination on November 27, 60 on December 20, 180 on December 27, 266 in total at the end of the year. As early as December 27, Zhang Jixian, a doctor at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine, informed the authorities that it was not just atypical pneumonia, as the authorities claimed ten days later, but much of an unknown form of coronavirus.



Information that Beijing kept secret for weeks, delaying the implementation of containment measures in Wuhan, going as far as tracking down the first whistleblowers such as the ophthalmologist Li Wenliang, who died on February 7, has since been rehabilitated and has become a national hero.

Since then, China has caught up with its ignition delay, by transferring the data on the Covid-19 genome to the international community, by taking exceptional measures in Wuhan (closure of the megalopolis of 11 million inhabitants, construction of two hospitals in record time ), under the leadership of a major general, a trained biologist. Result: the epidemic is stopped , proclaimed Tuesday President Xi-Jinping, who left. In the meantime, alas, the coronavirus has spread to the whole planet.


https://www.ouest-france.fr/sante/v...-circulait-deja-en-italie-en-novembre-6791626

In search of the “zero patient”
Also in China, the appearance of cases from November 17, 2019 was revealed by the South China Morning Post . Long before January 8, when the Chinese authorities first spoke of the new coronavirus.



In Italy, the first proven cases are registered in Rome on January 31. They are two Chinese tourists who arrived in Milan eight days earlier. Since then, Italian researchers have struggled to trace the thread of contagion in order to get their hands on "the patient zero", the first person to have contracted the virus. Essential data to find the source of the epidemic and better manage it. At the end of February 2020, Professor Massimo Galli, director of the Sacco hospital in Milan, already explained that the epidemic was not recent : The The virus circulated unnoticed for several weeks, before the first known cases of the disease. His team is currently studying the Italian strain of the virus, in order to establish the course of the epidemic in the country.

CDC director says some coronavirus-related deaths have been found posthumously
Source:https://edition.cnn.com/world/live-...0-intl-hnk/h_1319f66f92245a2fe4ec63fe91ab66c9

During the House Oversight Committee discussion on the novel coronavirus response, the director of the US Centers for Disease Control and Prevention said some deaths from coronavirus have been discovered posthumously.

Rep. Harley Rouda asked CDC director Dr. Robert Redfield if it’s possible that some flu patients may have been misdiagnosed and actually had coronavirus.

"The standard practice is the first thing you do is test for influenza, so if they had influenza they would be positive," Redfield said.

Rouda then asked Redfield if they are doing posthumous testing.

Redfield said there has been "a surveillance system of deaths from pneumonia, that the CDC has; it’s not in every city, every state, every hospital.”

Rouda followed up and asked, “So we could have some people in the United States dying for what appears to be influenza when in fact it could be the coronavirus?”

The doctor replied that “some cases have actually been diagnosed that way in the United States today.”

 

[LKJ86]

CNBC: Death toll rises from mysterious lung illnesses linked to vaping, prompting CDC to sound alarm on e-cigarettes
PUBLISHED FRI, SEP 6 2019 1:08 PM EDTUPDATED FRI, SEP 6 2019 4:04 PM EDT
Source:https://www.cnbc.com/2019/09/06/cdc...-in-vaping-related-lung-disease-outbreak.html

At least three people have died from a mysterious lung illness doctors believe may be caused by vaping — a rising public health worry that has U.S. and state officials perplexed, the Centers for Disease Control and Prevention said Friday.

A new patient in Indiana died, in addition to the previously reported deaths in Illinois and Oregon, Ileana Arias, CDC’s acting deputy director of non-infectious diseases told reporters on a media call. Officials are investigating a fourth death, she said.

The CDC is urging people to avoid using e-cigarettes amid the outbreak.

“Until we have a cause and while this investigation is ongoing, we’re recommending individuals consider not using e-cigarettes,” said Dana Meaney-Delman, who is overseeing the CDC’s response. “As more information comes about and we can narrow down the specific e-cigarette products, we intend to revise that.”

Federal health officials are reviewing 450 possible cases linked to vaping across 33 states, including the 215 cases it has previously reported, Meaney-Delman said. It’s unclear what exactly is causing the disease, officials said Friday. Until they have more information, the CDC is urging consumers not to buy e-cigarette products off the street or add any substances that are not intended by the manufacturer, the agency said.

Many of the patients who became sick said they vaped THC, a marijuana compound that produces a high. Some reported using both THC and e-cigarettes while a smaller group reported using only nicotine, Meaney-Delman said.

New York officials on Thursday said they are narrowing their focus to vitamin E acetate. Federal officials on Friday said it’s too early to pinpoint one substance.

The FDA is analyzing more than 120 samples for the presence of a broad range of substances, including nicotine, THC, other cannabinoids, cutting agents, opioids, toxins and poisons, Mitch Zeller, director of the Food and Drug Administration’s Center for Tobacco Products, said on the call. Lab tests have shown a “mix of results,” and no one substance or compound, including vitamin E acetate, has shown up in all of the samples tested, he said.

Doctors published detailed reports of the cases they’ve treated in the New England Journal of Medicine on Friday in hopes of defining the illness and helping other doctors recognize it.

Patients in many cases experienced gradual symptoms, including breathing difficulty, shortness of breath and chest pain before being hospitalized. Some people reported vomiting and diarrhea or other symptoms such as fevers or fatigue.

X-ray images from the patients typically show shadows similar to the ones seen in patients with viral pneumonia or acute respiratory distress syndrome, said Dr. Dixie Harris, a pulmonologist with Intermountain Healthcare in Salt Lake City, who has worked on 24 cases in Utah.

That led her to perform bronchoscopies on the first few patients. Doctors did not find any infections. Then they considered it might be related to vaping. All of Harris’ patients said they vaped. Some used nicotine. Some used cannabinoids, including THC or CBD. Others used both, making it even more difficult for doctors to pinpoint a culprit.

“My stance is overall, as a lung doctor, I don’t want anybody putting anything into their lungs,” she said. “But I do think there is something going on and there is one common thing making all these lungs react.”

 

[Oldman1]

CDC director says some coronavirus-related deaths have been found posthumously
Source:https://edition.cnn.com/world/live-...0-intl-hnk/h_1319f66f92245a2fe4ec63fe91ab66c9

During the House Oversight Committee discussion on the novel coronavirus response, the director of the US Centers for Disease Control and Prevention said some deaths from coronavirus have been discovered posthumously.

Rep. Harley Rouda asked CDC director Dr. Robert Redfield if it’s possible that some flu patients may have been misdiagnosed and actually had coronavirus.

"The standard practice is the first thing you do is test for influenza, so if they had influenza they would be positive," Redfield said.

Rouda then asked Redfield if they are doing posthumous testing.

Redfield said there has been "a surveillance system of deaths from pneumonia, that the CDC has; it’s not in every city, every state, every hospital.”

Rouda followed up and asked, “So we could have some people in the United States dying for what appears to be influenza when in fact it could be the coronavirus?”

The doctor replied that “some cases have actually been diagnosed that way in the United States today.”

View attachment 617489 View attachment 617490

https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/[URL]https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/[/URL]

CDC: 80,000 people died of flu last winter in U.S., highest death toll in 40 years
By ASSOCIATED PRESS

SEPTEMBER 26, 2018



NEW YORK — An estimated 80,000 Americans died of flu and its complications last winter — the disease’s highest death toll in at least four decades.

The director of the Centers for Disease Control and Prevention, Dr. Robert Redfield, revealed the total in an interview Tuesday night with The Associated Press.

Flu experts knew it was a very bad season, but at least one found size of the estimate surprising.

“That’s huge,” said Dr. William Schaffner, a Vanderbilt University vaccine expert. The tally was nearly twice as much as what health officials previously considered a bad year, he said.

 

[LKJ86]

CNBC: Death toll rises from mysterious lung illnesses linked to vaping, prompting CDC to sound alarm on e-cigarettes
PUBLISHED FRI, SEP 6 2019 1:08 PM EDTUPDATED FRI, SEP 6 2019 4:04 PM EDT
Source:https://www.cnbc.com/2019/09/06/cdc...-in-vaping-related-lung-disease-outbreak.html

View attachment 617491

At least three people have died from a mysterious lung illness doctors believe may be caused by vaping — a rising public health worry that has U.S. and state officials perplexed, the Centers for Disease Control and Prevention said Friday.

A new patient in Indiana died, in addition to the previously reported deaths in Illinois and Oregon, Ileana Arias, CDC’s acting deputy director of non-infectious diseases told reporters on a media call. Officials are investigating a fourth death, she said.

The CDC is urging people to avoid using e-cigarettes amid the outbreak.

“Until we have a cause and while this investigation is ongoing, we’re recommending individuals consider not using e-cigarettes,” said Dana Meaney-Delman, who is overseeing the CDC’s response. “As more information comes about and we can narrow down the specific e-cigarette products, we intend to revise that.”

Federal health officials are reviewing 450 possible cases linked to vaping across 33 states, including the 215 cases it has previously reported, Meaney-Delman said. It’s unclear what exactly is causing the disease, officials said Friday. Until they have more information, the CDC is urging consumers not to buy e-cigarette products off the street or add any substances that are not intended by the manufacturer, the agency said.

Many of the patients who became sick said they vaped THC, a marijuana compound that produces a high. Some reported using both THC and e-cigarettes while a smaller group reported using only nicotine, Meaney-Delman said.

New York officials on Thursday said they are narrowing their focus to vitamin E acetate. Federal officials on Friday said it’s too early to pinpoint one substance.

The FDA is analyzing more than 120 samples for the presence of a broad range of substances, including nicotine, THC, other cannabinoids, cutting agents, opioids, toxins and poisons, Mitch Zeller, director of the Food and Drug Administration’s Center for Tobacco Products, said on the call. Lab tests have shown a “mix of results,” and no one substance or compound, including vitamin E acetate, has shown up in all of the samples tested, he said.

Doctors published detailed reports of the cases they’ve treated in the New England Journal of Medicine on Friday in hopes of defining the illness and helping other doctors recognize it.

Patients in many cases experienced gradual symptoms, including breathing difficulty, shortness of breath and chest pain before being hospitalized. Some people reported vomiting and diarrhea or other symptoms such as fevers or fatigue.

X-ray images from the patients typically show shadows similar to the ones seen in patients with viral pneumonia or acute respiratory distress syndrome, said Dr. Dixie Harris, a pulmonologist with Intermountain Healthcare in Salt Lake City, who has worked on 24 cases in Utah.

That led her to perform bronchoscopies on the first few patients. Doctors did not find any infections. Then they considered it might be related to vaping. All of Harris’ patients said they vaped. Some used nicotine. Some used cannabinoids, including THC or CBD. Others used both, making it even more difficult for doctors to pinpoint a culprit.

“My stance is overall, as a lung doctor, I don’t want anybody putting anything into their lungs,” she said. “But I do think there is something going on and there is one common thing making all these lungs react.”

CNN: US is "looking into" why young people are getting coronavirus
From CNN Health's Jacqueline Howard
Source:https://www.cnn.com/world/live-news...0-intl-hnk/h_2fe6383c4ac9154ea1e48cbeafe15a42

US Surgeon General Dr. Jerome Adams said the US is looking into why young people in the country are being diagnosed with the novel coronavirus.

"So far the demography definitely seems to be very different in the United States versus in other countries that saw this hit earlier," US Surgeon General Dr. Jerome Adams said on the "Today" show on Monday morning.

"And we're looking into that," Adams told NBC's Savannah Guthrie.

"There are theories that it could be because we know we have a higher proportion of people in the United States and also in Italy who vape," Adams said. "We don't know if that's the only cause."

In New York state so far, more than half of coronavirus cases — 53% — have been among young people between the ages of 18 and 49, Gov. Andrew Cuomo noted on Sunday.

 

[Menthol]

Ups...

A war thread.