Name: コロナウイルス（COVID-19）の更新：コミュニティ感染とパンデミックの状況 (Coronavirus (COVID-19) Update: Community Transmission and Pandemic Status)
Uploaded: 2021-01-14T09:29:27.000Z
Duration: 19 min 13 s
Description: VoiceTubeの動画で発音を聞きながら英語表現を覚えよう！学べる英語：新型コロナウイルス,新型肺炎,COVID-19

Today I am talking Corona virus once again with important updates on the diseases spread.

And there's a lot to talk about community transmission now occurring within the U.

Whether it's accurate to call it a pandemic yet.

And, of course, whether it's time to start panicking before any of that, let me first talk about the name because not everyone has heard yet that this virus and this disease have been renamed.

Two and 1/2 weeks ago, there were joint announcements.

In one, the International Committee on Taxonomy of Viruses announced that novel Corona Virus 2019 has been formally renamed SARS cov to in order to highlight its genetic similarity to the original SARS virus.

This made sense to two virologists, but there was some criticism that people might mistakenly link stars Kobe to to the more deadly SARS disease of 2003 caused by the virus now generally known as SARS.

Meanwhile, the W H O named disease caused by this virus Cove in 19 for Corona Virus Disease 2019.

I personally think they took a confusing name and made it even worse, but I won't talk any more about disease naming conventions today.

That was the topic of my last video about the outbreak.

The number of cases, the number of fatalities, the case, fatality rates and how many countries were talking about.

As of February 29th confirmed cases in China are up to 8 80,000 while the rest of the world has 7000.

The disease has now been found in over 60 countries, including particularly notable outbreaks in South Korea, Italy and Iran.

19 has remained 2 to 2.5% when considering all cases.

But there are very important predictors of mortality.

In the 1st 6 weeks or so, the outbreak, the measured case fatality rate ranged from literally zero among Children under nine to 15%.

Among those 80 on over, with an inflection point between the ages of 60 and 70.

The presence of chronic disease is predictably a risk factor, especially cardiovascular disease, respiratory diseases like COPD and diabetes.

Being male has been identified as a risk factor for death, though it's not yet known if that's an independent risk factor or if it's due to confounding factors like men and China being much more likely to smoke than women.

And there's also important difference in case fatality rate between countries.

For example, the measured 2 to 2.5% overall rates is mostly driven by China, since that's where the vast majority of cases still are.

But outside China, the rate appears to be closer to 1% or even less possible.

Explanations for the difference include China Feeling to identify Moloch cases, which makes their case fatality rate falsely elevated well.

The excess deaths in China is because your health care system is stretched well beyond the capacity to deal with this.

I see you beds and ventilators for the most critically ill there.

And Europe, when the full brunt of the disease hits us, will likely be under two and may even be under one.

But it's too early to say yet with any confidence.

Iran on the other hand has reported 43 deaths among 600 cases.

This is almost certainly because they've been struggling to identify milder cases rather than because of disease or the virus or somehow different there.

It's not really an obvious place for a Corona virus to have spread early on, and still the country was probably particularly unprepared for it.

There have been a few particularly notable stories about the virus has spread.

These include the nightmare quarantine of the cruise ship Diamond Princess off Japan after a handful of passengers tested positive for the virus.

As many as 700 cases have been linked to the ship, and it will be an interesting investigation as to how many of those cases and ultimate deaths.

We're directly caused by the in retrospect, terrible decision to quarantine the passengers on board rather than evacuate them, and due to the reportedly lacks onboard quarantine procedures.

Another important story about the outbreak concerns South Korea, where their local outbreak has been strongly linked to a religious group called the Shin Jeong Gi Church of Jesus, who happened to believe their founder is the literal second coming of Jesus Christ.

This group was particularly prone to facilitating the spread because of the style in which they worship.

They're packed together very closely and frequently.

Shouting during service is spreading respiratory droplets.

Ah, they also reportedly encouraged worshippers to come to service is even when ill.

And both the church's secretive and the church of secretive about membership do the fear of members being ostracised in the community, which makes tracking down case contacts for public health officials much more difficult.

These situations with a Diamond Princess and the Shin Jeong GI Church highlight the divers challenges that exist when trying to contain an epidemic.

And then there is the new story about community transmission here in the U.

There have now been two confirmed cases of Coben 19.

Here in California, you have no relevant travel or known contact history one in Solano County on to 26 1 announced on to 28 just one town away from where I work at Stanford.

We have no idea how they became infected, though, notably in that first case in Solano County.

It's very close to Travis Air Force Base, where some of the evacuees from the Diamond Princess were isolated upon returning to the U.

And from where there were some horrifying stories about staff being untrained and unequipped to be interacting with possible Corona virus cases.

That could be a coincidence, but maybe not.

They're also probable Corona virus cases in Oregon and Washington who saw their first krone virus death today on these cases have no obvious source of transmission.

And there's a long term care facility in Washington in which over 50 people have patients, have staff are reporting symptoms over all, these new cases are important for three reasons.

First, this is the first evidence of community transmission in the U.

Where one person from the community who has no contact China or Asia, is transmitted to somebody else.

We're likely at the inflection point where the number of cases are going to start climbing much more quickly.

This won't be predominantly because of a sudden overnight explosion of cases, but rather an artifact of the fact that testing is becoming more widespread.

Community transmission has almost certainly been going on here for several weeks undetected people feeling mildly ill and assuming that they just have a bad cold or the flu.

There are probably dozens, if not hundreds, of Americans walking around with Corona virus.

The second reason is that there is early evidence of potential spread in health care facilities, at least in the Solano County case.

There was a significant delay in the diagnosis in my case because of CDC initially declined UC Davis's request to test the patient for Corona virus.

This led to healthcare workers potentially being exposed.

Combining this with the fact that it's believed that a symptomatic individuals can spread the disease.

It's easy to imagine hospital based spread could have occurred the other patients, which may have happened at the facility in Washington.

Given that we have no vaccines and that the mortality rate is particularly high in the elderly and the chronically ill, the idea of outbreaks occurring in hospitals and nursing homes is really scary.

And the third reason is that the UC Davis case in particular highlighted the potential problem with the CDC, serving as he sold gatekeeper to Corona virus confirmation testing in the United States.

Had UC Davis had access to the test directly, many fewer health care workers would have been potentially exposed.

However, the problem with Cuban 19 testing it's actually a lot more complicated than just We need to be testing more people.

That's kind of a huge rabbit hole that I'm I'm not gonna jump down right at this moment.

And at least as a few days ago, the CDC has approved strategies to increase test availability, so hopefully this will soon not be quite as big a problem.

This brings me to one of the key questions for today has Corona virus or Coben 19.

If you prefer crossed the threshold to becoming a pandemic.

To answer that question, we need to first discuss what is a pandemic.

It actually does not have a universally agreed upon definition, but one definition used by the W.

H O is quote an epidemic occurring worldwide or over a very wide area, crossing international boundaries and usually affecting a large number of people.

For better or worse, the W H O can apply slightly different standards to different diseases, depending on how they want to message preparedness to the public and how they want to allocate resources.

Being devious, but rather gives them a little flexibility in combating different diseases because not all worldwide outbreaks warrant the equivalent response.

O director general has recently further clarified that a determination of whether a disease should be classified as a pandemic is based upon its geographical distribution, the severity of the associated disease and the impact it has on society in general.

Almost four weeks ago, in a prior video here on strong medicine, I asserted that Corona virus remained an epidemic and not a pandemic.