6 ms·

The key part of the summary to me is this: Although the L type (∼70%) is more prevalent than the S type (∼30%), the S type was found to be the ancestral versio

by lacker 7y ago

The key part of the summary to me is this: Although the L type (∼70%) is more prevalent than the S type (∼30%), the S type was found to be the ancestral version. Whereas the L type was more prevalent in the early stages of the outbreak in Wuhan, the frequency of the L type decreased after early January 2020. Human intervention may have placed more severe selective pressure on the L type, which might be more aggressive and spread more quickly. On the other hand, the S type, which is evolutionarily older and less aggressive, might have increased in relative frequency due to relatively weaker selective pressure. It's too early to really know for sure, but one thing that often happens with viruses is that over time, the less fatal versions spread more effectively. It might be that the L type is the more lethal type which killed so many people in Wuhan, and the S type is the more silent type that is spreading around the world with a lower mortality rate. Probably just wishful thinking on my part, but it's interesting to be aware of the possibility.

flukus 7y ago
> It might be that the L type is the more lethal type which killed so many people in Wuhan, and the S type is the more silent type that is spreading around the world with a lower mortality rate. I suspect this is the main reason we're seeing divergences in different countries, with South Korea getting the "good" type and Italy getting the bad one. > but one thing that often happens with viruses is that over time, the less fatal versions spread more effectively The key here is selection pressure more than time, with no controls in place there's no selection pressure until it runs out of hosts, until then it's highly successful and does not need to adapt. In this case we've added some artificial selection pressure. If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? On one hand your saving overall lives but you'd be purposefully infecting people with something that potentially has life long effects.
- mlyle 7y ago
  > If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? On one hand your saving overall lives but you'd be purposefully infecting people with something that potentially has life long effects. Nah-- there's no way to know the tradeoff in lives lost, etc. The "good" news is, versions that cause less acute sickness and death are going to be better at escaping quarantines and controls.
- AnimalMuppet 7y ago
  > If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? You're presuming that infection with the good type confers immunity to the bad type. So far as I know, that is not yet proven.
- empath75 7y ago
  I don’t think Korea has a less lethal strain, they’re just testing a lot of people and capturing more mild cases.
  - zaroth 7y ago
    I find this to be highly compelling. The “fatality rate” is the number of deaths divided by the number of known cases. There are several very significant variables which determine the number of known cases, but the upper bound is the number of people tested. Take for example in WA where the number of cases is ~40 and 10 deaths. The total number of tests last week was some number of hundreds. With a virus which can be extremely mild in the vast majority of cases and where a test costs thousands of dollars, it is reasonable to expect the total number of cases could be vastly understated.
    - flukus 7y ago
      The WHO has been reporting ~1% of cases are asymptomatic, this has it's own caveats because it comes after China's lock down but there's little reason to believe there a huge numbers of unknown cases out there, at least in countries testing well. > With a virus which can be extremely mild in the vast majority of cases I haven't seen a breakdown of how many get what the "mild" symptoms, but anything not requiring hospitalization including pneumonia are considered mild. Many of these mild cases would at least be going to their doctor to get a week off work. Edit - found a break down: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf https://www.who.int/docs/default-source/coronaviruse/who-chi... > As of 20 February 2020 and 12based on 55924 laboratory confirmed cases, typical signs and symptomsinclude:fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgiaor arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestiion (0.8%). Those symptoms are worthy of a doctor visit and skipping work.
      - vkou 7y ago
        > The WHO has been reporting ~1% of cases are asymptomatic, this has it's own caveats because it comes after China's lock down but there's little reason to believe there a huge numbers of unknown cases out there, at least in countries testing well. Unfortunately, the United States is currently a country that is not testing well.
- wpietri 7y ago
  I'm not understanding how there could be "no selection pressure" for a virus. Since human bodies vary and infection is a complex process, it seems to me there's always selection pressure. And especially given that this appears to have recently made the jump from another species [1], there's no reason to think that the virus was somehow perfectly adapted to all of humanity. [1] https://www.cdc.gov/coronavirus/2019-nCoV/summary.html#anchor_1580079137454 https://www.cdc.gov/coronavirus/2019-nCoV/summary.html#ancho...
  - TheSpiceIsLife 7y ago
    I think we’re confounding two parts of evolution. Random mutation, and it’s sibling non-random cumulative natural selection (selection pressure). I guess it on what one defines as a selection pressure.
- remote_phone 7y ago
  I think it has to do with the number of hospital beds per capita. South Korea has over 12 per 1000 but Italy only has 3.1. That is probably making a huge difference. The US only has 2.8 per thousand which is horrifying, I hope the Italy situation doesn’t happen here.
  - umanwizard 7y ago
    It is already happening in the US, and the countermeasures being taken are totally inadequate. Please do everything you can to avoid infecting yourself and others.
  - dmurray 7y ago
    Wow, how are those numbers so different? You would think a functioning health care system in any developed country would be similar. The controversial topic in the US isn't really the quality or quantity of healthcare, it's about who pays for it. You might tell me it's because of something unique and bad in the US system, and we should see the Scandinavian countries to see how it should be done - but no, Denmark 2.6, Canada 2.5, Sweden 2.2 all have fewer beds per capita than the US. It's Japan and Korea who are the outliers at the top at 12 and 13. [0] It really must be a cultural/lifestyle thing. Would I really spend 4 times as much of my life in a hospital bed if I lived in Korea? And if so, would that really be a good thing? I assume usage is reasonably high in both, the beds don't sit empty waiting for a pandemic. Or you might remind me that those countries have famously old populations. But that's not it either. Japan has an old population, but still only twice as many 70+ as the USA (according to the population pyramids at [1]). And Korea has the same proportion as the US. It makes me wonder if they are comparing like with like: maybe some of the reported hospital beds in Korea would be considered to be in nursing homes or convalescence centres in Europe or the US. [0] https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... [1] https://www.populationpyramid.net/republic-of-korea/2020/ https://www.populationpyramid.net/republic-of-korea/2020/
    - mysterypie 7y ago
      It is indeed very strange that Korea and Japan should have 400% more hospital beds per capita than the U.S., Canada, or Scandanavia. I tried to dig into the OECD methodology[0] to see if they mentioned anything noteworthy, but nothing grabbed my attention. Their notes about the U.S.[1] and Korea[2] seem pretty similar. I'm wondering if in Japan and Korea, people stay in hospitals for longer periods for the same condition than in the U.S. For example, in the U.S. mothers giving birth would stay in the hospital for a week or more in 1950s from what I heard, but these days they are discharged after a couple days. What's a typical stay for uncomplicated childbirth in Japan and Korea? If it's a week or 10 days, then that would give a possible datapoint for having many more beds. [0] https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_REAC https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_REAC [1] Notes about the United States: Coverage: AHA-registered hospitals in the United States. U.S. hospitals located outside the United States are excluded. Includes all the AHA registered hospital beds for all types of hospitals. Estimates are for all AHA registered hospitals. AHA-registered hospitals include facilities such as short-term general, psychiatric hospitals, wards, rehabilitation institutes, maternity homes, tuberculosis hospitals, leprosariums and alcoholic treatment institutions. Estimates exclude U.S. associated areas such as Puerto Rico and AHA non-registered hospitals. [1] Notes about the Korea: Coverage: Hospitals: all sorts of medical institutions equipped with wards of at least 30 beds. Excludes day-care beds, emergency beds, surgical tables, recovery trolleys, delivery beds and cots for normal neonates.
- abiogenesis 7y ago
  If we can reduce the lethality to near zero levels, we'll call it a vaccine.
deleted 7y ago
[deleted]
mysterypie 7y ago
> L type is the more lethal type and the S type is the more silent type Well that's easy to remember, L=lethal and S=silent. But I imagine there is a prosaic explanation for the haplotype naming. Anyone know what the L and S stand for? Googling hasn't turned up anything for me.

by lacker 7y ago

flukus 7y ago

> It might be that the L type is the more lethal type which killed so many people in Wuhan, and the S type is the more silent type that is spreading around the world with a lower mortality rate. I suspect this is the main reason we're seeing divergences in different countries, with South Korea getting the "good" type and Italy getting the bad one. > but one thing that often happens with viruses is that over time, the less fatal versions spread more effectively The key here is selection pressure more than time, with no controls in place there's no selection pressure until it runs out of hosts, until then it's highly successful and does not need to adapt. In this case we've added some artificial selection pressure. If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? On one hand your saving overall lives but you'd be purposefully infecting people with something that potentially has life long effects.

mlyle 7y ago
> If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? On one hand your saving overall lives but you'd be purposefully infecting people with something that potentially has life long effects. Nah-- there's no way to know the tradeoff in lives lost, etc. The "good" news is, versions that cause less acute sickness and death are going to be better at escaping quarantines and controls.
AnimalMuppet 7y ago
> If there are places with only the bad type of the virus I wonder if we could ethically introduce the good type? You're presuming that infection with the good type confers immunity to the bad type. So far as I know, that is not yet proven.
empath75 7y ago
I don’t think Korea has a less lethal strain, they’re just testing a lot of people and capturing more mild cases.
- zaroth 7y ago
  I find this to be highly compelling. The “fatality rate” is the number of deaths divided by the number of known cases. There are several very significant variables which determine the number of known cases, but the upper bound is the number of people tested. Take for example in WA where the number of cases is ~40 and 10 deaths. The total number of tests last week was some number of hundreds. With a virus which can be extremely mild in the vast majority of cases and where a test costs thousands of dollars, it is reasonable to expect the total number of cases could be vastly understated.
  - flukus 7y ago
    The WHO has been reporting ~1% of cases are asymptomatic, this has it's own caveats because it comes after China's lock down but there's little reason to believe there a huge numbers of unknown cases out there, at least in countries testing well. > With a virus which can be extremely mild in the vast majority of cases I haven't seen a breakdown of how many get what the "mild" symptoms, but anything not requiring hospitalization including pneumonia are considered mild. Many of these mild cases would at least be going to their doctor to get a week off work. Edit - found a break down: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf https://www.who.int/docs/default-source/coronaviruse/who-chi... > As of 20 February 2020 and 12based on 55924 laboratory confirmed cases, typical signs and symptomsinclude:fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgiaor arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestiion (0.8%). Those symptoms are worthy of a doctor visit and skipping work.
    - vkou 7y ago
      > The WHO has been reporting ~1% of cases are asymptomatic, this has it's own caveats because it comes after China's lock down but there's little reason to believe there a huge numbers of unknown cases out there, at least in countries testing well. Unfortunately, the United States is currently a country that is not testing well.
wpietri 7y ago
I'm not understanding how there could be "no selection pressure" for a virus. Since human bodies vary and infection is a complex process, it seems to me there's always selection pressure. And especially given that this appears to have recently made the jump from another species [1], there's no reason to think that the virus was somehow perfectly adapted to all of humanity. [1] https://www.cdc.gov/coronavirus/2019-nCoV/summary.html#anchor_1580079137454 https://www.cdc.gov/coronavirus/2019-nCoV/summary.html#ancho...
- TheSpiceIsLife 7y ago
  I think we’re confounding two parts of evolution. Random mutation, and it’s sibling non-random cumulative natural selection (selection pressure). I guess it on what one defines as a selection pressure.
remote_phone 7y ago
I think it has to do with the number of hospital beds per capita. South Korea has over 12 per 1000 but Italy only has 3.1. That is probably making a huge difference. The US only has 2.8 per thousand which is horrifying, I hope the Italy situation doesn’t happen here.
- umanwizard 7y ago
  It is already happening in the US, and the countermeasures being taken are totally inadequate. Please do everything you can to avoid infecting yourself and others.
- dmurray 7y ago
  Wow, how are those numbers so different? You would think a functioning health care system in any developed country would be similar. The controversial topic in the US isn't really the quality or quantity of healthcare, it's about who pays for it. You might tell me it's because of something unique and bad in the US system, and we should see the Scandinavian countries to see how it should be done - but no, Denmark 2.6, Canada 2.5, Sweden 2.2 all have fewer beds per capita than the US. It's Japan and Korea who are the outliers at the top at 12 and 13. [0] It really must be a cultural/lifestyle thing. Would I really spend 4 times as much of my life in a hospital bed if I lived in Korea? And if so, would that really be a good thing? I assume usage is reasonably high in both, the beds don't sit empty waiting for a pandemic. Or you might remind me that those countries have famously old populations. But that's not it either. Japan has an old population, but still only twice as many 70+ as the USA (according to the population pyramids at [1]). And Korea has the same proportion as the US. It makes me wonder if they are comparing like with like: maybe some of the reported hospital beds in Korea would be considered to be in nursing homes or convalescence centres in Europe or the US. [0] https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... [1] https://www.populationpyramid.net/republic-of-korea/2020/ https://www.populationpyramid.net/republic-of-korea/2020/
  - mysterypie 7y ago
    It is indeed very strange that Korea and Japan should have 400% more hospital beds per capita than the U.S., Canada, or Scandanavia. I tried to dig into the OECD methodology[0] to see if they mentioned anything noteworthy, but nothing grabbed my attention. Their notes about the U.S.[1] and Korea[2] seem pretty similar. I'm wondering if in Japan and Korea, people stay in hospitals for longer periods for the same condition than in the U.S. For example, in the U.S. mothers giving birth would stay in the hospital for a week or more in 1950s from what I heard, but these days they are discharged after a couple days. What's a typical stay for uncomplicated childbirth in Japan and Korea? If it's a week or 10 days, then that would give a possible datapoint for having many more beds. [0] https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_REAC https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_REAC [1] Notes about the United States: Coverage: AHA-registered hospitals in the United States. U.S. hospitals located outside the United States are excluded. Includes all the AHA registered hospital beds for all types of hospitals. Estimates are for all AHA registered hospitals. AHA-registered hospitals include facilities such as short-term general, psychiatric hospitals, wards, rehabilitation institutes, maternity homes, tuberculosis hospitals, leprosariums and alcoholic treatment institutions. Estimates exclude U.S. associated areas such as Puerto Rico and AHA non-registered hospitals. [1] Notes about the Korea: Coverage: Hospitals: all sorts of medical institutions equipped with wards of at least 30 beds. Excludes day-care beds, emergency beds, surgical tables, recovery trolleys, delivery beds and cots for normal neonates.
abiogenesis 7y ago
If we can reduce the lethality to near zero levels, we'll call it a vaccine.

deleted 7y ago

[deleted]

mysterypie 7y ago

> L type is the more lethal type and the S type is the more silent type Well that's easy to remember, L=lethal and S=silent. But I imagine there is a prosaic explanation for the haplotype naming. Anyone know what the L and S stand for? Googling hasn't turned up anything for me.