If, one wants to understand the cluster of coronavirus cases in the Red Deer area, it is explained by the most fundamental understanding of the spread of disease known to medical science, that is, disease follows migration, independent of the mode or the means of transportation.
More than 10,000 individuals have been tested in a score of counties in the State of New York, 2382 of those tested proved positive for the coronavirus. 549 of those who tested positive (23%) required hospitalization. Of those hospitalized, an alarmingly high number were under fifty (50) and otherwise healthy.
There are three things, you as the chief executive of this province, will have to implement in rather short order.
One, all patients in hospital with pneumonia of unknown cause, must be tested for the coronavirus.
Two, because all patients with pneumonia of unknown cause have not been tested for the coronavirus, it is critical that all healthcare workers be tested for the coronavirus.
Three, anecdotal evidence has existed since the SARS pandemic that the drug Ibuprofen increases the severity of some viral respiratory diseases. There are otherwise healthy young people in hospitals in Canada, Europe and the USA, who are on ventilators, with the common denominator of having tested positive for the coronavirus and having ingested Ibuprofen.
Increasingly, health authorities are now taking aspirin, acetaminophen (paracetamol), ibuprofen and a host of other pain treatments out of the over-the-counter system, and placing them with pharmacists, who can ascertain the reason a person is seeking pain relief and steer those who might be coronavirus positive away from ibuprofen.
As long as, we are advising people to self-quarantine, and they continue to self-medicate, removing ibuprofen from the shelves is the prudent course of action.
Kindly note, since this information was published, the airways have been full of contradictory statements on this issue. European health authorities continue to remove ibuprofen from the over-the-counter system, the French and Italian experience is noteworthy. We know how to conduct a clinical trial to bring the anecdotal onto a firm scientific basis.
In the interim, the precautionary principle must guide clinical practice and health advice.
In keeping with this fundamental principle of doing no harm, on Tuesday, the World Health Organization, WHO, recommended that ibuprofen and other NSAIDs drugs should not be taken. The most recent concerns about ibuprofen arose as a result of a study published in the medical journal The Lancet, and voiced by French Health Minister, Olivier Veran.
The issue of self-medicating in the midst of a pandemic must be addressed, and sound health advice is wanting.
I anticipate sound advice from your administration, Premier Jason Kenney.
I remain at your disposal.
E LaMont Gregory MSc Oxon - - - - - -
First Wave of Coronavirus Deaths in USA and Canada?
If one wants to understand the spread of the coronavirus at the community level, consider the case of the lawyer from New Rochelle, and the two NBA basketball players, who are confirmed cases of the novel coronavirus. The lawyer is known to have infected, at least 50 others, and the extent of the basketball players impact is just too soon to tell.
But the thing to remember, is that neither the lawyer, nor the basketball players were case zero, that is, they were not the first to acquire the novel coronavirus.
Each of these individuals acquired the infection from someone else, and the person they acquired the infection from, had also acquired the infection from someone else.
And unfortunately, both US and Canadian health officials continue to say that you can only get coronavirus from someone who is showing signs of illness.
This statement is blatantly false.
Studies coming out of Germany, over the last few days, confirm that a person, infected with the coronavirus, showing no signs of illness, is about one-thousand times more infectious than was a person with SARS who was asymptomatic, in the early stages of that infection.
These studies compared the mount of infectious material in the nasal cavity of asymptomatic coronavirus infected persons, with similar tests that were conducted on SARS patients who showed no clinical signs of illness (fever, cough, sneezing) in the early stages of that disease, and found 1000 times more infectious material in nasal cavity of the coronavirus patient, than in the earlier cases of SARS. And furthermore, these studies found that a person infected with the coronavirus is infectious before they shows and signs of illness, and after signs of illness have gone away. Other tertiary centres are replicating these studies.
This study is important, for anyone who is giving advice to the public or whose primary concern is containment, for that reason the abstract of this study is printed below:
Background: In coronavirus disease 2019 (COVID-19), current case definitions presume mainly lower respiratory tract infection. However, cases seen outside the epicenter of the epidemic may differ in their overall clinical appearance due to more sensitive case finding.
Methods: We studied viral load courses by RT-PCR in oro- and nasopharyngeal swabs, sputum, stool, blood, and urine in nine hospitalized cases. Infectious virus was detected by cell culture. Active replication was demonstrated by analysis of viral subgenomic replicative intermediates. Serology including neutralization testing was done to characterize immune response.
Results: Seven cases had upper respiratory tract disease. Lower respiratory tract symptoms seen in two cases were limited. Clinical sensitivity of RT-PCR on swabs taken on days 1-5 of symptoms was 100%, with no differences comparing swab and sputum samples taken simultaneously. Average viral load was 6.76x10E5 copies per swab during the first 5 days. Live virus isolates were obtained from swabs during the first week of illness. Proof of active viral replication in upper respiratory tract tissues was obtained by detection of subgenomic viral RNA. Shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after about one week.
Conclusions: The present study shows that COVID-19 (the disease) can often present as a common cold-like illness. SARS-CoV-2 (the virus that causes the disease) can actively replicate in the upper respiratory tract, and is shed for a prolonged time after symptoms end, including in stool. These findings suggest adjustments of current case definitions and re-evaluation of the prospects of outbreak containment.
- - - - - -
Research underway in Iceland may prove as significant to our understanding of the coronavirus, as the Galapagos Islands were to the 'Origin of Species'.
Scientists are in a position to compare the virus in infected persons who came to Iceland directly from Wuhan, with what appears to be a mutation of that same virus, found in persons who came to Iceland from North America some six weeks later. Preliminary results, find agreement with the German work reprinted above, in that, the virus from Wuhan attacked the lower respiratory tract, while the mutated version largely involves upper respiratory tissues.
- - - - - - The question to ask is, what do we know about the SARS-CoV-2 virus that causes the disease COV-19?
The answer to that question, requires a thorough understanding of the genetic structure of SARS-CoV-2, which alone can facilitate the development of diagnostic tests, vaccines and medicines.
I will not revisit the topic here, but what follows does not consider the mutations that are taking place as the virus presents in more and more host cells, which are already infected with other viruses with which the SARS-CoV-2 virus can share nucleic material and produce new strains of viruses, as discussed in part 1 of this series.
Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2, is a positive-sense single-stranded RNA virus. Family: Coronaviridae; Genus: Betacoronavirus; Order: Nidovirales.
It should be understood that there are two principal groups working on the current pandemic. Those scientists concerned with the virus, and the development of diagnostic tests, vaccines and medicines.
And, those medical practitioners and scientists concerned with disease prevention, spread, transmissibility, and treatment.
Let us return to the letter to Premier Jason Kenney of Alberta, above. Specifically, the first of the three things suggested that the premier, will have to implement in rather short order:
One, all patients in hospital with pneumonia of unknown cause, must be tested for the coronavirus.
This as one of the painful lessons of SARS 2003.
Retrospective analysis of deaths from known SARS cases and of pneumonia deaths of unknown cause occurring at the same time, led us to understand that the SARS virus was already circulating within our hospitals, and our hospital personnel before we knew how widespread the outbreak, epidemic, and then the eventual SARS pandemic would become.
After there had not been any cases of community transmission for over four weeks, and the SARS pandemic was thought to have passed, the virus remained in pneumonia patients in hospital, and a relaxation in infection and disease control measures, resulted in a second and lethal wave of the virus, of which 40% of those infected were health care workers.
And again, in this pandemic, the group most vulnerable to infection is not being tested.
The most vulnerable group to exposure and infection with the pneumonia causing SARS-CoV-2 virus, are those in hospital being treated for pneumonia. Treatments which mask the addition of another virus into the mix, as those who care for the patients in hospital with pneumonia of unknown cause are exposed.
And note, that the SARS-CoV-2 virus is producing viral shedding, infectious material, at a rate that is 1000 times higher than the rate of production of SARS 2003 virus.
A week ago, the hospital in St Albert would have been an ideal candidate for testing all pneumonia patients, and screening all hospital personnel, prophylactically.
However, with the sudden outbreak of SARS-CoV-2 cases in St Albert, it is now imperative to test all pneumonia patients and hospital personnel in that hospital, urgently.
The safety of that hospital can only be known by testing.
Not to do so, will place the hospital at risk of closure, altogether.
- - - -
Confirmed cases of Novel Coronavirus in Alberta, continue to grow, yet no plans for what to do when a primary home-based caregiver becomes ill, are in place, the prospect of having two victims in these cases looms, the homeless and consumption site protocols are simply non-existent.
There will be those who will fall ill in public, naturally EMS will be called, however the first on the scene will be members of our police forces, as in the case when a diabetic goes into shock, or an opioid overdose, and any number of other causes of sudden illness as well as accidents. Here is an opportunity to prepare a specialist group of constables to respond to these inevitable occurrences.
We all remember how well the mayor and chief of police responded to those 80 constables, who requested training in policing certain communities before the attack in downtown Edmonton.
The chief of police in Edmonton has steadfastly refused to move, save two officers, members of the marijuana squad to other duties, this includes the hundreds and hundreds of thefts of catalytic converters from vehicles in every neighbourhood in Edmonton.
Donald Trump's excuse that he is too busy to have his annual physical is nonsensical, and feeds speculation concerning his underlying cardiovascular health.
... the possibility that containment efforts will be effective, diminish by the day
E LaMont Gregory MSc Oxon
Trump administration and State of Washington health officials report that a death that occurred today, 29 February 2020, is the first Novel Coronavirus fatality in the United States, however, this author is aware of a Death Certificate, dated the 8th of January, on which the Montrose, Colorado Coroner listed as cause of death; septicemia, pneumonia, influenza and coronavirus.
... a person infected with the novel coronavirus, may not have a fever, but is nonetheless infectious, and can pass the disease on to others
It ought to be understood that for some individuals, even the most common respiratory viruses can pose a significant health risk. Including asthmatics, those with underlying cardiovascular medical conditions, and those with impaired immune systems. In addition, there are certain groups of people with traits which make some viral diseases worse. Age can also be a factor, especially for the very young and the elderly. And, of course, an individual's state of health will impact on the severity of any viral exposure.
It should also be understood that it is possible to have more that one viral infection at the same time, just as it is possible to have a toothache and still fall and break one's arm or leg. And, an infection with one or more viruses is not a safeguard against a bacterial, fungal, or other parasitic infection.
This article will discuss how the disease novel coronavirus which was reported to be the result of animal-to-human transmission, became a human-to-human transmissible disease.
Before delving into the intricacies of the pronounced and rather rapid changes that have occurred in the novel coronavirus's evolution, there are several factors which ought to be considered concerning the continued spread of the disease.
... a lack of testing, will result in under reporting cases, but is not, in any way, indicative of the true incidence of coronavirus infected persons
In part, the lack of data on the true incidence of coronavirus infected persons in the United States is a result of the failed coronavirus test kits, and is further exacerbated by the narcissistic idiocy emanating from 1600 Pennsylvania Avenue.
But we must take a closer look at the statement by the CDC that the coronavirus test kits produced 'false negatives' due to failed test kit reagents.
In fact, using standard tests it takes 45 minutes to 1 (one) hour to confirm whether or not a person has the novel coronavirus, according to the president of the American Hospital Association. However, as organized by the CDC and the Trump Administration, it is taking 3 (three) to 5 (five) days. Not only does this deprive health officials of the true incidence of the disease, it also negates the ability to put in place effective community containment measures, in a timely manner.
Today, 21 March 2020, the FDA approved the 45 minute to 1 hour coronavirus test kit, for use in all 50 states. I want to thank all those from health authorities and medical schools around the globe, who read about the 45 minute test on this site and followed through and, those efforts led to today's positive result.
Therefore, the presumptive period of uncertainty, can be eliminated. A person can be tested and know the result before having contact with any other person.
false positives, and false negatives
A false positive, in medical testing, is an error in which a test result indicates improperly the presence of a condition, or a disease - a positive result - when in reality the condition or disease is not present.
An example; an investigation of protein deficiency in a population in northern Vietnam, began with a close house-to-house survey of available foods in each household, and from the survey data it was concluded that those living in these households would lack adequate protein intake. In other words, they would be positive for the condition of protein deficiency.
However, a significant number of the those from a significant number of households, when subjected to actual protein blood tests, were not protein deficient. The initial survey results included a significant number of false positives, that is, survey results indicated protein deficiency in individuals that did not actually have protein deficiency.
Naturally, the efficacy of chemical reagents for the blood tests were verified, as well as, repeat blood samples were taken, neither of which solved the false positive conundrum.
One of the researchers undertook a thorough re-examination of the original survey papers, and observed that on several occasions those conducting the surveys had written in the comments section how some residents had shown them their snail collections in which they took some pride, but the researchers had not included the snails as a food source.
A Vietnamese food specialists, at a nearby university solved the riddle. The consumption of snails was associated with the time the French had had influence in that area and the consumption of escargot (snails), which are a rich source of protein had continued to the present. A re-visit to the homes of the false positives, and the inclusion of snails as a food source, allowed the researchers to correct and remove the false positives from their results.
With that understanding, now consider the false negatives associated with the failed CDC Wuhan Coronavirus test kits, which were distributed all across the United States.
A false negative, is an error in which a test result indicates that a condition, or a disease, is not present - a negative result - when in reality the condition or disease actually exists, that is, the tested individual has the condition or the disease being tested for.
The CDC would have become aware that there was a problem with the Wuhan Coronavirus test kits, when doctors who examined patients became suspicious, when other tests of the same individuals were positive for the disease, while at the same time the CDC tests kits indicated that the disease was not present.
In final analysis, the only way that a false negative can be corrected, is for the same individual to be re-tested, by the same or another means, and the result of re-testing confirms that they do, in fact, have the disease. CDC admits false negatives, the question is how many were there, and when and where did these false negatives occur.
The CDC test kits were specific for the Wuhan Coronavirus.
The evidence for this interpretation has multiple sources, including a death certificate form the Montrose Colorado Coroner on the 8th of January 2020. And the frantic activities of CDC directors and administrators, when reports from doctors across the US began to question the efficacy of the CDC Wuhan Coronavirus test kits, because they were getting positive results for coronavirus with other testing methods. Including the CDC telling doctors and testing labs to hold on, and not cause unnecessary panic, while the CDC got to the bottom of the problem.
The more fundamental question is how in a laboratory, handling biohazardous material, in which every procedure, and at every step of every procedure requires quality control and bio hazard control sign-offs, by multiple staff members, high enough in the organisation to be a signatory before the next step or procedure can commence. And when this system fails there procedures for identifying where the system failed, and at what precise juncture the failure occurred. The information statement identifying the error as one of false negatives, just does not rise to the level of sufficient explanation.
After the Sigma teams finish their work, this is a matter for the FBI.
The delay in testing has consequences that will endure, first because a person with the coronavirus can be symptom free, and yet infectious, that is, while there are scant or no outward signs of a person being sick, they can pass the virus on to others. Because of this fact alone, the actual numbers of 2019-nCoV cases is much (significantly) higher than the numbers reported, thus far.
The Hound of the Baskervilles
... the dog, did not bark
One of the important facts concerning our understanding of the development of the novel coronavirus disease process, is that an infected individual, that is, a person infected with the novel coronavirus may not have a fever, but is nonetheless infectious, and therefore, can pass the disease on to others.
Attention must also be given to the fact that by the end of the first week of February 2020, in excess of 800 Americans had been evacuated from Wuhan directly and returned to the United States. This is in addition to an unknown number of Americans and others who passed through Wuhan or had contact with someone who had been exposed in Wuhan, while touring China, including some who were joining friends on various cruises as part of their extended trip around the Orient and others who were on world tours.
This is illustrated clearly by recent cases in the State of Texas and Georgia. In Texas, an individual was repatriated from an overseas area of coronavirus outbreak, and then quarantined for a period of 14 days. At the end of the 14-day quarantine, the individual did not have a fever, or other outward signs of illness and was released into the general population.
Some ten days later, the same individual, after 14 days in quarantine and another 10 days in the community, presents at hospital severely ill with a now confirmed case of the novel coronavirus.
Despite, this dramatic and convincing evidence, and many other cases emanating from the State of Washington, and the experience of Japanese health officials with the cruise ship Diamond, Canadian officials are now asking those who recently travelled to China or Iran to self-quarantine themselves for 14 days before re-entering community life.
It will come as no surprise that with what we have already gleaned from the Edmonton coronavirus case that it is in keeping with what is known about the Texas example, in terms of the slow development of the disease, and the lack of symptoms until weeks after the initial exposure, as in the Texas example. And, now there is similar case reported in the state of Georgia, which cast further doubt on the wisdom of the 14-day quarantine period.
It is evident that the suggested 14-day quarantine regime, is not evidence-based.
These are the same officials that the public will have to rely upon for critical information as the novel coronavirus outbreak advances.
The advice suggesting a 14-day quarantine period, will only help spread the novel coronavirus at the community level. But those officials will not be able to say that they based their advice on the best available evidence, or the accumulated experience at the time they gave the clearly erroneous advice.
The math; let us say that the initial exposure in the Texas case occurred some seven days, before the individual was repatriated. Fourteen days in quarantine with no fever. And, another seven day in the community before they began to experience symptoms of infection, and another three days before they were severely ill with the virus.
Therefore, the individual had acquired the disease, but did not show any signs of being ill for, at least, 28 days. The individual was asymptomatic, that is, showed no signs of being ill, from the time they became infected, until three days before they presented severely ill at hospital. The high incidence of the 2019/2020 seasonal flu in the community in which this individual resided, should be noted with interest.
It begs the question, where did the idea of the 14-day quarantine period, originate?
In a nutshell, the 14-day quarantine period is the result of decisions made by little people, sitting behind big desks, exercising power. And, has nothing to do with an evidenced-based approach to disease surveillance, containment, or an understanding of the nature of the transmission cycle of the novel coronavirus. And, no matter which alternative words, one might suggest to convey this statement of fact, the facts, remain the same.
William A Silverman, one of the pioneers of evidence-based medicine, whom most will remember that early in his career using the technique of a clinical trial, proved that the indiscriminate use of oxygen was the direct and specific cause of retinopathy of prematurity. And, this stood against the conventional wisdom of his day.
Whether we were sitting in his living room across the bridge, or in a conference room at one of the tertiary teaching hospitals, or at a college high table dinner, Silverman could be heard saying, 'we have these infants, who have infections, we can see that the germs and the products of those germs are occupying all the sites, but these infants are not developing fevers.'
'It's like the hound in that wonderful story by Sir Arthur Conan Doyle, what was it about that hound?
The hound, did not bark.
And so we have these infants that have infections, and some are also infectious, but they do not develop fevers until the infection process is at a critical stage, and all the sites for healthy cellular activity are occupied by the infecting agents and their products.'
'These infants have infections, that develop slowly, they don't develop fevers, that clinical sign that tells us that there is a medical problem for us to address, but they are nevertheless infectious.
And as we tried to bring the care of the high-risk neonate onto an evidenced-based and scientific footing, we established our Special Care Babies Units (SCBU), and our Neonatal Intensive Care Units NICU), waves of infections would spread through our wards with swift and lethal consequences.
'We must,' Silverman would implore, 'come to understand what is going on with these infected infants, who do not develop fevers, depriving us of an early warning sign that there may be problems ahead. We must come to understand what is going on with these infected infants, who have infections, which can be passed on to others, but do not bark, as it were.'
The lesson of retinopathy, is an iatrogenic outcome of unquestioned treatment options. With a sense of urgency, in relation to the waves of infections sweeping through our wards, we must know with certainty that they are not the result of either medical examinations or treatments.
Years later when the Aids outbreak crisis was ravaging communities, Silverman reminded us that we had seen this sort of infectious process before.
And now, the novel Coronavirus.
... biological realities
And then there are the biological realities, those gifts and trinkets sneezed or coughed upon, then exquisitely wrapped preserving perfectly the germs upon them. And through the marvel of high-speed international travel that package within the 72-hour germ life cycle, is opened by its recipient on the other side of the globe. As they grasp the gift tears swell up in their eyes and then with germ-laden hands they reach up and wipe the tears away.
Epidemiology, Mike Pence, is about the details of disease transmission.
This scenario also excludes those who were travelling with diplomatic or administrative passports on official business or otherwise, and the large number of American and other business travellers in Wuhan for the reasons that made Wuhan a manufacturing powerhouse in China, whose means of transportation do not find their way into the commercial airline category.
In fact, testing in China and Japan has produced additional diagnostic techniques that will enhance identification of coronavirus infected persons. The sudden and dramatic increase in the number of confirmed and reported cases during the second week of February 2020, can be explained, in part, by the realization that a CT lung scan can accurately diagnose lungs infected with the coronavirus. These are the sorts of advances that come about by the sheer number of tests conducted, and the ability to compare the outcome with other test results.
The fact that nearly 30 million Americans do not have medical health insurance and the knowledge that hospitals have been billing patients in excess of $3,200 for a coronavirus test, which was already paid for with taxpayer money, will result in large numbers of people not seeking the urgent health care assistance they need themselves, and that the larger community requires to treat the sick and save others from becoming sick.
As the US Congress undertakes legislation to fund the United States response to the coronavirus outbreak, they may well want to consider holding the American people harmless, that is, the federal government of the United States should pay 100% of all costs associated with the coronavirus outbreak. The last thing that will help address the spread of the disease, is to have a large segment of the population not seeking care, because of the potential costs they might incur.
A wise decision on the part of the current premier of Alberta, would be to forestall removing younger spouses from their husbands Senior's plan, as the coronavirus takes hold in Alberta, for precisely this reason. We do not want anyone not seeking the urgent medical attention they need because of the chilling effect of incurring costs, do we?
An increase in health fees of some $700 for the younger spouse of a senior, would be in addition to a recent average increase in rent costs of $600 per annum.
The prime minister of Alberta, would be well served to review the Emergency Preparedness Plans. In addition, it should prove helpful to have those health experts that you trust, to share with you the results of the evidence-based literature searches on the relevant subjects. The Cochrane database will be especially meaningful, in this regard. Then when you speak on this subject, you will be referencing the same set of known facts, as the professional medical community must, in order to fulfil their sworn obligation, to do no harm.
In the United States, as an added benefit for Americans, this will give the federal government of the United States, some meaningful experience in operating a single-payer health care delivery system, albeit single issue specific.
In addition, it is worth noting that the rural health care delivery system and structure in the US has been decimated over the last three years, and now we have the prospect of hundreds and hundreds of rural residents having to travel to larger urban centres for care, when any working system of containment, would suggest that large numbers of infected people not travel to larger urban centres.
Mike Pence was charged with the responsibility of managing the message coming from doctors and health officials, but the information coming out of Washington State, not coordinated through Pence, suggests that there are, as of the second day of March, 2020, more than 500 cases of coronavirus in that state alone. The sudden outbreak in New Rochelle, New York may become the model of how swift and comprehensive containment measures are conducted. The Italian approach is also worth following closely.
This is in keeping with the information coming from health care workers, and a more direct source, which suggests that more than one thousand 1000+ of the false negatives were corrected to positive coronavirus results.
Remembering that the only way to correct a false negative, in this case, is to confirm that the individual actually had the coronavirus. And, it was this fact that prompted the current administration to attempt, albeit feebly, to control what is said about the coronavirus outbreak.
The CDC now acknowledges that a number of the deaths attributed to the 2019/2020 seasonal flu, were, in fact, the result of infections with the novel coronavirus. This was the result of re-testing samples already in their possession.
It would be beneficial, to restore trust in that august body to be able to say that they did this as a routine quality control and assurance measure, but, in reality, they were just getting ahead of information that was about to be made public, in spite of their desire to continue to conceal it.
This would indicate that the projection of the number of cases of the coronavirus in the State of Ohio, by Ohio Governor Mike DeWine, is within the realm of statistically provable probability.
All that is needed is for those who are already on the state payroll, or who are funded by the state, with the relevant skills, to conduct a sample of the population. A few clusters that are representative of flu death clusters in the state of Ohio would provide definitive answers to these questions. And, in addition, a retrospective re-testing of serological evidence of flu cluster deaths will uncover the same results as those now coming from the CDC.
... the problem in a nutshell
The core essential messages one should derive from these articles:
80%+, more than 4 out of every 5 individuals, who contract the novel coronavirus, will be infected and infectious, that is, they will be able to pass the disease on to others, before they show any clinical signs of being ill themselves.
In the early stages of the development of the novel coronavirus disease, due in part to its slow development, the fever response is not elicited.
The absence of a fever does not indicate that a person is not infected and cannot pass the coronavirus on to others. Because, an infected person can pass the virus on to others well before eliciting the fever response due to their own infection with the coronavirus. This is not the first virus in which the fever response was not elicited in the early stages of an infection taking hold.
If, however, an individual has a certain type of Influenza virus, or acquires a certain type of Influenza virus after being infected with the novel coronavirus, an interaction between the two viruses, triggers a more aggressive and rapid development of the novel coronavirus infection.
In which case, prudent medical intervention to forestall the development of pneumonia and septicemia, in the novel coronavirus and Influenza virus infected patient, is required.
Much will be made of the Ro factor (pronounced: r-zero factor). Basically, the higher the Ro number the more rapid and extensive the spread of the disease. Conceptually, in relation to the novel coronavirus, the higher the Ro number the more the spread of the coronavirus will resemble compound, as opposed to simple interest.