Talk:COVID-19/Archive 6

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Clarify language around use of masks

It would be helpful if references to masks could always indicate whether they mean medical masks or cloth masks, since the recommendations for use and their likely safety are different. This may be the latest WHO recommendation. Mary Mark Ockerbloom (talk) 14:19, 10 April 2020 (UTC)

Replacing a second 'cartoonish' GIF; also: a new combined graphic

20200409 Pandemic resurgence - effect of inadequate mitigation

Per the discussion above and at the Graphics Lab, I am planning to generate a GIF to replace the cartoonish File:Covid-19-curves-graphic2-stopthespread-v3.gif. I plan the new graphic to contrast curves for long-duration stay-at-home orders (successful mitigation), versus a resurgence after short-term orders (inadequate mitigation). Constructive suggestions welcomed here. —RCraig09 (talk) 22:13, 8 April 2020 (UTC)

Version with English-language captions is uploaded April 9. An "international" version, with icons and with minimal or no text, is planned. Suggestions welcome. —RCraig09 (talk) 18:30, 9 April 2020 (UTC)

General concept is based on a figure in: Anderson, Roy M.; Heesterbeek, Hans; Klinkenberg, Don; Hollingsworth, T Déirdre (March 21, 2020). "How will country-based mitigation measures influence the course of the COVID-19 epidemic?". The Lancet. 395 (10228): 931–934. doi:10.1016/S0140-6736(20)30567-5.

—RCraig09 (talk) 18:32, 9 April 2020 (UTC)

International version (no text) uploaded to File:20200410 Pandemic resurgence - effect of inadequate mitigation - International version.gif —RCraig09 (talk) 04:33, 10 April 2020 (UTC)

Update: I'm working on a combined "Flatten the curve, raise the line" graphic now. A combined graphic will save space in articles. —RCraig09 (talk) 16:33, 10 April 2020 (UTC)

CDC data on mortality data in USA

CDC provided report for USA, separate "All causes - Covid - Pneumonia - Covid Pneumonia". The link here provide for Week ending 2/1/2020 to 3/28/2020 https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm.

The CDC data is different (meaning lower) that what is getting reported by media. Since I am new to this page, do not want to direct start any edits. Request regular editors of this page, to review and advice if/how to present this. . Prodigyhk (talk) 19:33, 5 April 2020 (UTC)

thank you for post--Ozzie10aaaa (talk) 01:07, 11 April 2020 (UTC)

YouTube ([WP:RSMED]?)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

@RTG: I saw you reverted my deletion here. I was under the impression YouTube videos don't adhered to WP:RSMED, but you mention this is determined on a case-by-case basis. Can you please cite the relevant policy or guideline? Thank you. Moksha88 (talk) 04:38, 11 April 2020 (UTC)

@Moksha88:WP:RSMED tries to give an example of the spirit behind the guideline under Wikipedia:Identifying_reliable_sources_(medicine)#Biomedical_v._general_information but it isn't very specific. This source isn't trying to provide new information. It is simply a surgeon showing us with a diagram how the specific area of the lung works and how coronavirus damages it, in an almost mechanical sense. I suppose in this way it should be considered a secondary source because the surgeon is really relaying what he has read elsewhere rather than what he has discovered. He is indeed listed as head surgeon of (I can't remember what city in America) and he goes out of his way to show his credentials. Sadly, the closest I have found to describing the coronavirus effects in any publication has been, "it hurts" or, "this is not ordinary pneumonia/flu", which is insufficient and even frightening for those who may require this information. More to the problem is the manner which I have written it down. I was hoping someone might come along and make it easier to assimilate and provide a better, referenced source, like a medical journal giving us diagrams and details... But they are all so much more worried about the science of the spread of the disease. ~ R.T.G 14:09, 11 April 2020 (UTC)

For a general surgeon this information would be common knowledge, therefore secondary, not primary claims about something not published elsewhere. Hopefully someone might see this and provide a better encyclopaediac source and description of the same thing..? ~ R.T.G 14:13, 11 April 2020 (UTC)

YouTube videos are not good enough medical sources to support biomedical claims. For that we need WP:MEDRS sources. The YouTube video is a self-published source by a "weight-loss surgeon", who couldn't be considered a published expert in the field of virology, so it fails even WP:RS. --RexxS (talk) 16:18, 11 April 2020 (UTC)

I'd say it's a case-by-case question now. Youtube is used more and more by big news group. I've been accessing very officials press conferences on youtube. We also need to be mindful that there is basically 3 type of sources. Primary, Secondary and external resource. It's been talked again and again, but this is a new ongoing event and we are therefore basing way too much of our articles on primary sources. What I try to say is, we need to be careful, it's not because there is a youtube link at the end of a sentence that it is not verifiable and relevant. If that's the case, we should not delete the paragraph but rather provide a better source.

For this particular case, I don't really like the quality of the source. A non-expert doctor in front of a white board is meh. But the information conveyed about how the fluid get into the lungs, sounds credible to me and highly relevant, we should seek to source that part better, not delete it. Iluvalar (talk) 17:44, 11 April 2020 (UTC)

It's not about a medical claim. It's about relaying common medical knowledge. He isn't a "non expert" doctor. He is the head of a paediatric surgery unit in the USA. (EDIT:apologies, he isn't a paediatrician, he is a general surgeon, the article still lacks the description) He just isn't a specialist in virology. We already have videos from virologists on the article, telling us they are the non experts, that it is the medical ones who are experts this time. Anyone with a deeper understanding of the mechanics of the lung and a familiarity with SARS type diseases could probably piece together a reliable and relevant section with the same intention, to disseminate the mechanics of this disease in a non complex way to the wider audience. It's really important to do that if it can be done... a point by point "lay mans" description of the mechanics of the disease is absent not only from the article, but from the wider topic. The only sources I have found trying to relay that type of information for the layman was in two YouTube videos. It is only valid to discuss this because nothing else is apparent. If anyone is capable of finding such information, please help. I am happy to debate the pros and cons of YouTubery, there are many historical debates to go find and review, however, let's get something of this line onto the article, simple point by point description of how the virus causes disease. Beside, even Trumps sisters portrait is from a YouTube video on Wikipedia. Mary Poppins portrait on Wikipedia comes from a YouTube video. The element of importance is not at first the nature of YouTube, but the nature of the material. ~ R.T.G 19:16, 11 April 2020 (UTC)

Your assertion about the the mechanism of SARS-CoV-2 is obviously a biomedical claim. Biomedical claims need MEDRS sources, and the YouTube video isn't even a reliable source for any content in Wikipedia. For us to accept a self-published source as reliable, it has to be by an established expert on the subject matter, whose work in the relevant field has previously been published by reliable, independent publications. Doctor Vuong describes himself as "World's #1 Weight Loss Surgeon", and that ought to be waving a red flag at you already. He's no expert on virology, and his assertions about how SARS-CoV-2 damages the lungs has no more authority than if you or I were making them. If the only place you can find sources on a particular topic is YouTube videos, that ought to be telling you that it's not content that should be in an encyclopedia. Find the reliable sources first and then write the content. --RexxS (talk) 19:42, 11 April 2020 (UTC)

You are wrong about the virologists. Those study viruses. This is about pathology. Pathologists study disease. This doctor in particular studied for five years after becoming a medical doctor to become a general surgeon. He is a general expert on the on the mechanics in particular of the human body. Regardless. That is not what is relevant here The mechanics of the disease are a primary element of an encyclopaediac article about it. It is the heart of the value of the article and it is missing. ~ R.T.G 19:57, 11 April 2020 (UTC)

For anyone who thinks the medical aspect of this is a virologists expertise, please watch the first sixty seconds of this video, File:COVID19_in_numbers-_R0,_the_case_fatality_rate_and_why_we_need_to_flatten_the_curve.webm ~ R.T.G 19:59, 11 April 2020 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Question about move protection

Do you think we should restore the move protection that has just expired or should we wait to see if the disruption continues? Interstellarity (talk) 16:50, 9 April 2020 (UTC)

We should group them. One big vote for the month shouldn't hurt too much. Iluvalar (talk) 03:16, 10 April 2020 (UTC)

A bit of a consensus has developed here Wikipedia_talk:WikiProject_COVID-19#Highlighted_open_discussions Doc James (talk · contribs · email) 22:12, 11 April 2020 (UTC)

Mortality rate

Covid-19-total-confirmed-cases-vs-total-confirmed-deaths

At least in the US, this medical issue has become politicized, resulting in alarmist statments from various groups, some calling it a very serious situation nessecitating what others see as draconian measures, while others claim the disease per se is not that big a deal and that, e.g., mortality rates are inflated by including all people who die with the disease in the category of people who die from the disease as well as by omitting mild cases (as indicated in our article). One source says that Italian statistics are " at about 0.25%" (https://www.uspoliticsandnews.com/study-two-thirds-of-italians-already-immune-to-it/) This source is a strongly biased one, so we can't use it, but can some-one dig into their statistics to see if there is a citable source that supports it (or not)? Kdammers (talk) 15:11, 8 April 2020 (UTC)

We have this graph. Doc James (talk · contribs · email) 17:03, 8 April 2020 (UTC)

I don't see how this addresses the issue. Kdammers (talk) 01:17, 9 April 2020 (UTC)

Kdammers - What exactly is the issue? Finding a reliable source that indicates a 0.25% Italian mortality rate? (If so, have you searched all the available databases to see if a reliable source exists?) Or are you saying that we should discuss the political controversies in more detail? Thank you.   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 04:30, 9 April 2020 (UTC)

Hi Kdammers, let me answer your question with another one : Would you rather 1) force 2,650 young people to play their favorite online video game at home for a week or two OR 2) kill yourself 1 elder of your community and let the 2,650 others free to do what they want (probably play their favorite online games) ? Would you take that same decision 100,000 time in a row ? Please leave your RL name and address as you answer as you might be part of the next generations history books :D. PS: I'm just a wikipedia editor, and my numbers could be off by an order of magnitude (maybe 2) but please take your decision now ! Iluvalar (talk) 06:12, 9 April 2020 (UTC)

Doc James and Marck D WorthenPsyD: I cited an article that says that death rates generally given are incorrectly high. I did not want to use that as a source on the artile page beause that secondary source is a politically biased one and also, as is common in the popular media, did not give sources per se. On the other hand, it did give data. So, I was saying that it would be nice if an editor could check out these "facts." This is not my area of expertise at all. Nonetheless, I did chance on supporting evidence that seems good for citing: https://bigthink.com/coronavirus/6-of-worlds-coronavirus-infections-detected?rebelltitem=2#rebelltitem2 ('The Daily Mail" also covers the same research.) Kdammers (talk) 02:10, 10 April 2020 (UTC)

@Kdammers: the problem is two-fold: first of all what do you mean by "death rate"? Are you trying to measure the number of deaths per day in a country, or per million population? or are you trying to measure the fraction of people infected who die per day? or the fraction of confirmed cases who die per day? All of these are very different metrics and we don't know how many people are infected, so the third one will remain unmeasurable until we can devise a way of determining who is or has been infected within a large population.

The second problem is that the death figures may be over-reported by including people who died with the condition, but possibly not as result of it; and the figures may be under-reported by excluding people who died from the condition because they did not die in hospital. We have no way of simply correcting for those effects, so whatever rates you read will only be an approximation of the true values. I recommend reading through https://ourworldindata.org/coronavirus for good discussions of these factors and for a variety of up-to-date figures. --RexxS (talk) 15:16, 10 April 2020 (UTC)

The death rates given are the deaths divided by cases. Yes some cases might not be symptomatic and thus not picked up. Some deaths might also not be picked up aswell with a fair bit of evidence of the later. The COVID19, that have been recorded the last couple of days represent 25% of typical US deaths. Doc James (talk · contribs · email) 22:15, 11 April 2020 (UTC)

Adding information on open-source data science projects to assess the risk of COVID-19 outcomes

I suggest adding the following paragraph to the end of the section Prognosis right below the last table and just above the subtitle Reinfection.

On April 4, 2020, an open-source software package was published on GitHub to allow the calculation and modeling of the case fatality rates by age by the wider data science community to accommodate the constantly arriving case-level data.

Debatable narrative (talk) 14:31, 11 April 2020 (UTC)

There's no evidence it is notable to the topic. In fact, it definitely isn't notable, sorry. ~ R.T.G 15:11, 11 April 2020 (UTC)

Dear RTG, thank you for your feedback.Debatable narrative (talk) 15:52, 11 April 2020 (UTC)

Agree does not belong on this page. Doc James (talk · contribs · email) 22:08, 11 April 2020 (UTC)

Dear Doc James, thank you for your input. Debatable narrative (talk) 22:20, 11 April 2020 (UTC)

Merge2Pandemic

There is a suggestion to merge the management of the NCOV disease into the management of the NCOV pandemic.--Geysirhead (talk) 07:53, 12 April 2020 (UTC)

Semi-protected edit request on 12 April 2020

I would like to have the Misinformation section modified to provide both grammar corrections, but also to provide sources to the topic of misinformation about COVID-19 from Vice News, Epoch Times, and Bloomberg. Polaris silvertree (talk) 11:28, 12 April 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Interstellarity (talk) 12:19, 12 April 2020 (UTC)

Bradykinin

@Docjames: Research into the disease mechanism found that while corona binds to ACE2 receptor of lung cells, Bradykinin isn't controlled anymore and leads to leaking bloodvessels in the lungs. Ad Huikeshoven (talk) 13:06, 12 April 2020 (UTC)

Lead formatting error

Can someone fix the formatting cock-up currently blaring out in red text at the end of the lead's first paragraph? I'd do it myself if I knew how. Thanks. PaleCloudedWhite (talk) 14:15, 12 April 2020 (UTC)

I see it's been fixed - must have been corrected at the template. PaleCloudedWhite (talk) 14:17, 12 April 2020 (UTC)

SWS sleep is an effective ancillary treatment for COVID-19

The duration of sleep, especially the slow-wave phase is a factor significantly affecting the form (mild or severe) of the course of acute respiratory viral infections, including COVID-19. See, for example, the review scientific and popular articles. And here's the brief description (not mine), with links to some scientific publications, that enough sleep helps to protect against COVID-19. Even the hypnotics is an effective ancillary treatment for COVID-19. Here's the preprint that analyses the impact of 27 selected risk factors on the outcome of COVID-19. From all treatment factors (factors, that we can manipulate) a statistically significant improvement was only when using hypnotics: “The use of hypnotics was significantly associated with favourable outcomes. Survival analysis also confirmed that patients receiving hypnotics had significantly better survival.” I suggest expanding and adding this information to the article, it could save a lot of people's life.--Sualohin (talk) 19:05, 12 April 2020 (UTC)

Read WP:MEDS. Your proposal would be speculative only at this stage. The report has not yet been peer-reviewed and uses regression analysis rather than blind randomization. Additionally, severe cases are (usually?) intubated and receive sedatives as part of their typical treatment, so I'm not sure what specific benefit this premature addition would give. MartinezMD (talk) 20:40, 12 April 2020 (UTC)

The first review https://doi.org/10.1146/annurev-psych-010213-115205 would generally be acceptable as MEDRS, but dates from 2015, when SARS-Cov-2 did not exist. I'm afraid that it would be WP:SYNTH to ascribe its conclusions as applying to COVID-19 in the absence of any up-to-date reviews. --RexxS (talk) 23:40, 12 April 2020 (UTC)

Community spread

I am requesting someone to either improve Community spread / Community transmission section or start an article on the topic. Thanks.Epiphyllumlover (talk) 01:18, 13 April 2020 (UTC)

Highlighted open discussions

• #RfC What image should we use

I disagree with "...but the virus is not considered airborne." It has been proven that it can be airborne. Making this edit, although not 100% wrong, is misleading. Yes, it doesn't qualify as airborne in all its variations, but through sneezing/coughing it does. Krakikoko (talk) 10:10, 13 April 2020 (UTC)

Newest publication: ten-fold (10x) increase in COVID-19 mortality observed among countries without BCG policy, versus thoroughly vaccinated countries.

https://www.urotoday.com/recent-abstracts/covid-19-and-genitourinary-cancers/120475-bcg-vaccination-policies-make-a-ten-times-difference-in-covid-19-incidence-mortality-new-study.html

BCG vaccination policies make a ten times difference in COVID-19 incidence, mortality: New study from UK and US, 2020 Apr 06. 94.21.121.60 (talk) 14:45, 7 April 2020 (UTC)

We need better sources than that. Countries that give BCG generally have much younger populations. Doc James (talk · contribs · email) 17:34, 8 April 2020 (UTC)

"Dr Hegarty claims that this result leads to a coronavirus death toll that could be up to 20 times less in countries with a BCG vaccine programme."

https://extra.ie/2020/04/08/news/irish-news/study-finds-bcg-vaccine-may-contribute-to-lower-covid-19-death-tolls --Gblaskovics (talk) 18:35, 8 April 2020 (UTC)

We need proper sources per WP:MEDRS. Doc James (talk · contribs · email) 19:20, 8 April 2020 (UTC)

I think its a generalization, but is true that prevention will be depending on the mask shape, materials, etc. Krakikoko (talk) 10:33, 13 April 2020 (UTC)

How is this project being managed

There are so many articles on this project Have listed the few that I found. Most of these articles, have redundant sections as these are covered in detailed manner in a different article. Is there a central page where all these articles are being listed ? Is there some method for editors of the different pages work together ?

• National_responses_to_the_2019–20_coronavirus_pandemic
• Criticism_of_response_to_the_2019–20_coronavirus_pandemic
• 2019–20_coronavirus_pandemic_in_mainland_China
• Misinformation_related_to_the_2019–20_coronavirus_pandemic
• 2019–20_coronavirus_pandemic
• COVID-19_testing
• Severe_acute_respiratory_syndrome_coronavirus_2
• 2019–20_coronavirus_pandemic
• Coronavirus_disease_2019

If you know of any other articles, please add to the list here.

Prodigyhk (talk) 03:56, 7 April 2020 (UTC)

Hello, Prodigyhk,

There are over 700 COVID-19 related articles and several hundred templates. It's not being "managed" but you can find more information on the subject by joining WikiProject COVID-19. They have lists of articles and several task forces you could participate in. Check it out. Liz ^{Read! Talk!} 04:51, 7 April 2020 (UTC)

I had wondered about all the COVID-19/Coronavirus articles too. So thank you Prodigyhk for asking a good question and Liz for the prompt, helpful answer. :0)   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 11:02, 7 April 2020 (UTC)

Liz thanks for pointing me to the project page. With almost entire world in lock down, it seems our entire motley band of WP editors are full steam generating multiple pages and articles :D Prodigyhk (talk) 16:59, 7 April 2020 (UTC)

And I think it’s fine to have a variety of articles. For example, often it takes a little while to get really familiar with an aspect of the topic, and then at a certain point, you might find yourself doing brief, succinct, and really first-rate treatments of such. And with a variety of articles, we can get into the economic, the social, different workplace responses, etc. FriendlyRiverOtter (talk) 01:46, 10 April 2020 (UTC)

Maybe he/she meant to add the Use of Masks as an effective Prevention mechanism, regardless of discrepancies between countries measures and health organizations recommendations. BUT, this is controversial, because it could lead to all people buying essential PPE, leaving many (if not all) health workers unarmed in this war (this answers OC question). Krakikoko (talk) 11:15, 13 April 2020 (UTC)

0.06% have died

Not seeing that in this source.[1] Doc James (talk · contribs · email) 02:27, 13 April 2020 (UTC)

Yeah. Big screw up here. First the primary source had 0.15%. Then the source disappeared, or went to another link. Then it was 0.06%. In German. The original primary source was translated at several places, including reddit, and other places. [2] The internet never forgets. People take the 14% as that herd immunity is pending. But e.g. Germany as a whole has a lot lower fatality rate than 0.06%.Jmv2009 (talk) 19:30, 13 April 2020 (UTC)

Asymptomatic case rate

User:Waddie96 I've seen reports in the popular press that 50% of cases from Iceland are asymptomatic but when I review the stats from DeCode the numbers don't appear to support that (roughly 60 of 6000 asymptomatic people test were positive). I see you've commented on on the South Korean reports at 78% asymptomatic? I'm wondering everyone's opinion - for countries that are testing only symptomatic people does this mean that the true case rate is roughly 2-3x diagnosed? E.g. (diagnosed rate)/0.5 or 0.78 ?? Ian Furst (talk) 16:31, 13 April 2020 (UTC)

Infections commonly have a percentage of people who are asymptomatic at some point, typically beginning ("I dont feel sick yet") or late ("I feel fine now" but still contagious), but to be a carrier without symptoms at any point is much less common (see Typhoid Mary as an example). Unless you survey and then test an entire population, you won't truly know. I find numbers this high dubious but what's the solution? I would wait for secondary sources and preferably something conforming to WP:MEDRS MartinezMD (talk) 17:32, 13 April 2020 (UTC)

See this gov't ofIceland update which states that of the 1616 positives in the country, 1474 were symptomatic and 142 asymptomatic. Despite more testing on asymptomatic individuals. Yet, the president of DeCode is widely quoted as saying 50% of cases are asymptomatic. My thought is that he merged the asymptomatic with minimally symptomatic cases, otherwise it does not make much sense to me. Ian Furst (talk) 19:05, 13 April 2020 (UTC)

Agree it is currently unknown what percentage of people are truly asymptomatic. Best to wait for proper sources per User:MartinezMD. Doc James (talk · contribs · email) 19:29, 13 April 2020 (UTC)

Asymptomatic cases can be important because A) they can possibly they spread the disease and B) they may become immune. I think ~50% asymptomatic is a good number. Jmv2009 (talk) 19:35, 13 April 2020 (UTC)

What we as editors think is not important. The question is what do high quality sources say. Doc James (talk · contribs · email) 19:42, 13 April 2020 (UTC)

That's just my opinion atm, but I want to point out that a normal human being get a cold every 7-10 years in mean. We all have ILI symptoms regularly right ? Unless we assume that this coronavirus mutated to be particularly bad at infecting people, we should expect a lot if infected people with mild to no symptom at all who goes undetected. Opinion set aside, I'd say credible sources at the moment vary wildly still, from 7x more then confirmed case to 20% of the world population already had it. Iluvalar (talk) 20:52, 13 April 2020 (UTC)

The main issue is that there is a big difference between truly asymptomatic and mildly symptomatic as far as being aware of having an illness and being able to get quarantined to avoid spreading it. I'm not sure these reports recognize the difference. That's why I have suggested waiting for the secondary/medically-reliable reports. MartinezMD (talk) 21:48, 13 April 2020 (UTC)

Currently listed under signs and symptoms referencing a BMJ article that reported on Chinese data from Apr 1 of 166 cases. Agreed this is too little, nor is it normally considered a RS. But the Iceland data is from the gov't and a relatively large sample so, imo, it would meet RS. I'd be in favor of replacing the BMJ reference with the Icelandic data and updating as it progresses. Ian Furst (talk) 00:30, 14 April 2020 (UTC)

March 11 JAMA article mentioning high-flow canula and non-invasive ventilator

Care for Critically Ill Patients With COVID-19, JAMA Insights, March 11, 2020.

@Ian Furst: @MartinezMD: this JAMA article was very preliminary, basically just mentioning and nothing else, and it’s now a full month old. Maybe we include it simply because the news media has hit the point again and again, what happens if we run out of ventilators? And at least this is talking about some kind of alternative.

But can’t we find something more recent? FriendlyRiverOtter (talk) 03:32, 14 April 2020 (UTC)

Semi-protected edit request on 14 April 2020

Under the heading Management, add the following subheading and text:

Home isolation for mild cases Self-isolation at home (also called quarantine) is recommended for mild symptoms such low fever, cough without shortness of breath or mental status changes such as confusion or fainting. The affected person should be otherwise generally healthy; that is, not having chronic illnesses such as heart failure, asthma, chronic obstructive pulmonary disease (COPD) or kidney failure. This person should be isolated in one room within the house. There should be no close contact with others. Symptomatic care of cough and fever using over the counter medicines and home remedies is recommended. Health care professionals should be contacted by telephone in case of worsening such as shortness of breath or delirium. Home-based quarantine is an effective strategy in reducing spread and the load on health care facilities. PrimaryHealth (talk) 04:28, 14 April 2020 (UTC)

 Not done @PrimaryHealth: Wikipedia is not an instructional manual, and we don't give medical advice, so your text would need to be re-written. More importantly, all content that is added to Wikipedia should be supported by a reliable source, and your suggested text doesn't mention the sources you used to write it. Please take a look at WP:Identifying reliable sources for some guidance on the sources to use. --RexxS (talk) 19:09, 14 April 2020 (UTC)

Text

User:Magnovvig has added the following text a couple of times:

"On 9 April it came to light that some doctors were reviewing the recommendations to use the "highly invasive" procedure which "require the patient to be rendered unconscious" which in the opinion of NHS consultants at the University Hospitals Birmingham were "being used too early and may cause more harm than good... less invasive forms of oxygen treatment through face masks or nasal cannulas work better for patients"."

The Telegraph is not an appropriate source for medical content. Doc James (talk · contribs · email) 19:21, 14 April 2020 (UTC)

References

Removal and subsequent reinsertion of Total Cases/Deaths/Recovered

Statistics on total cases, deaths and recovered were removed from the lead earlier today by Sam1370. They have been reinserted. Certainly, there will be crossover information between this article and that of the pandemic. This cannot always be avoided, nor should it be as is the case here. These statistics are relevant. If there is disagreement, let's discuss it before removing it.Veritycheck✔️ (talk) 15:52, 13 April 2020 (UTC)

@Veritycheck: Huh? I'm not sure what you're talking about. I think it was yesterday or the day before that I made the total cases, deaths, and recovered an excerpt from the article 2019-20 coronavirus pandemic because the sections we had here and there were nearly identical. Can you check the history again to make sure you don't have the wrong person? sam1370 (talk) 16:33, 13 April 2020 (UTC)

@Veritycheck: You can see my excerption in the revision here: https://en.wikipedia.org/w/index.php?title=Coronavirus_disease_2019&oldid=950424905 sam1370 (talk) 16:38, 13 April 2020 (UTC)

I believe somebody removed the excerpt tags in the original article. sam1370 (talk) 16:42, 13 April 2020 (UTC)

Yes, the tags were removed. I have put them back, with comments so that people realize the importance of them. I re-edited the main article, undoing your edit. sam1370 (talk) 17:06, 13 April 2020 (UTC)

You have removed the statistics from the lead with your latest revert. I have put them back again. Would you like to discuss why you do not want Total Cases/Deaths/Recovered in the lead? - Other editors' opinions might be useful here. Veritycheck✔️ (talk) 18:00, 13 April 2020 (UTC)

@Veritycheck: Okay, not to be rude, but if you have been comprehending what I have been telling you on this talk page and my edit summaries, you would know that I am not trying to remove the statistics from the lead, I am attempting to excerpt them from the 2019-20 coronavirus pandemic article. I do not know why the section tags keep getting moved on the main article -- they get pushed to the end and end up not encompassing anything. I will keep your edit until I can find a long-term solution. Was the original wording in my reply confusing? sam1370 (talk) 18:41, 13 April 2020 (UTC)

Okay, I see what is happening here. Whenever the visual editor is used, the section tags get moved to the end. I will try to find out why this is happening. sam1370 (talk) 18:48, 13 April 2020 (UTC)

They were working based on an "excerpt". These are too complicated to keep functional it appears so lets just not use them. Doc James (talk · contribs · email) 19:47, 13 April 2020 (UTC)

Disagree. A consensus was already reached on this. Please respect it or repopen before deleting. Veritycheck✔️ (talk) 19:55, 13 April 2020 (UTC)

@Doc James: I see you have attempted to fix it now. Let's hope it stays. Veritycheck✔️ (talk) 19:58, 13 April 2020 (UTC)

We are discussing completely different things User:Veritycheck... Doc James (talk · contribs · email) 20:13, 13 April 2020 (UTC)

It might be more helpful if you state what you are discussing then if it is, in deed, not the inclusion of the statistics mentioned in the section heading. Veritycheck✔️ (talk) 20:19, 13 April 2020 (UTC)

@Veritycheck: What the other editors in this thread have been discussing is not whether to include those metrics, but how to include them. Sam1370 has been trying to include them by taking the figures from 2019-20 coronavirus pandemic, so that they only need to be updated in one place. That is called "an excerpt" from the other article. Do you now understand what the other editors have been trying to explain to you?

Unfortunately, it appears that anyone using the visual editor in that other article messes up the placement of the tags that define where the figures are to be taken from, and defeats the process of excerpting. So, for the moment, they have restored the previous system where the articles remain unconnected and the metrics have to be updated individually in each article. Hope that makes it clear to you what has been happening. --RexxS (talk) 00:16, 14 April 2020 (UTC)

@RexxS: Yes, that seems to be the case. What initially created confusion here were edit summaries stating the removal of the statistics due to duplication. In fact, the edits that were introduced eliminated all the data. It seems this was not done intentionally and perhaps the editors were unaware they had removed the statistics as subsequent edit summaries now would suggest. WP:FAITH Veritycheck✔️ (talk) 00:44, 14 April 2020 (UTC)

@Veritycheck: I still think you do not understand what we have been saying. My original edit summary did not say the removal of the statistics, it stated the excerption of them: "Excerpted nearly identical section to main pandemic article". Other than the slight grammatical error "to" instead of "from", the meaning is fairly clear. Even if you were still confused after that, my later edit stated "revert -- it was an excerpt from the pandemic page but the tags got removed. I have fixed the problem", which should have cleared up any misconceptions.

The edits that were introduced did not initially eliminate all the data. Indeed, they kept them in, until the Wikipedia visual editor was used on the 2019-20 coronavirus pandemic article, which moved the <section begin="intro-cases" /> and <section end="intro-cases" /> tags to the end, where they were put right next to each other, not encompassing anything, thus making the excerpt included in the COVID-19 page not actually excerpt anything. Indeed, I have stated multiple times in the talk section that this was intended to be an excerption, not a removal of the data, but you continue to say here that this was a good faith removal. sam1370 (talk) 04:46, 14 April 2020 (UTC)

Again, apologies if I seem rude here, I am simply attempting to help you understand, and explain my own confusion at your lack of understanding. sam1370 (talk) 20:08, 14 April 2020 (UTC)

neurological damage

• https://onlinelibrary.wiley.com/doi/10.1111/cns.13372
• https://jamanetwork.com/journals/jamaneurology/fullarticle/2764549
• https://www.psychologytoday.com/intl/blog/the-new-brain/202004/neurological-implications-covid-19-raise-concerns and especially the articles it refers and links to

--Espoo (talk) 20:00, 12 April 2020 (UTC)

What specifically do you propose adding? How would you write it clearly and concisely? (I might be misunderstanding the intent of your post. If so, just let me know. Thanks!   - Mark D Worthen PsyD (talk) (I'm a man—traditional male pronouns are fine.) 21:48, 12 April 2020 (UTC)

Have you looked at these links? I don't understand your question. The important information in these reliable sources linked to directly or indirectly above is completely missing from the article. So i obviously propose adding a summary of this information. I don't have time to do this now myself, but have at least started the process. See also the links in this article: https://elemental.medium.com/coronavirus-might-attack-the-brain-too-21ea92a39c04 --Espoo (talk) 22:13, 14 April 2020 (UTC)

Shouldn't this be renamed to COVID-19?

The official name is "COVID-19", it is also the common name. Sure, that name was derived from the term "coronavirus disease 2019" but that is not the actual name of the disease.----Pontificalibus

You're technically right, but common usage tends to confuse COVID-19 (the disease, this article) with 2019-nCoV (the virus), which is covered at the article using the official name Severe acute respiratory syndrome coronavirus 2. It's not a big deal, and redirects take care of searches on any term, but I don't see any harm in keeping our articles titles as unambiguous as possible for now. --RexxS (talk) 15:31, 10 April 2020 (UTC)

We see the same at chronic obstructive pulmonary disease were the common name is in fact COPD. We tend to use the full name and than the abbreviation as we do here already. Doc James (talk · contribs · email) 19:47, 10 April 2020 (UTC)

Agree, COVID is an acronym, not the full name.--Pestilence Unchained (talk) 06:54, 11 April 2020 (UTC)

Even as an editor, I am still WP:SURPRISEed by the title when arriving at this article. I think Coronavirus disease 2019 (COVID-19) would be best, though COVID-19 would be an improvement. The German-, Spanish-, Dutch-, and Italian-language articles are "COVID-19" (though not the French), but I think that both the full name with the abbreviation in parentheses would be least WP:SURPRISEing of all. WP:PARENDIS describes how parenthetical expressions should be used for disambiguation (somewhat applicable here), and I think that in this case my suggested title is least ambiguous of all, though I'm not invoking a formal Move Request. —RCraig09 (talk) 16:27, 12 April 2020 (UTC)

We do not generally put both the name and abbreviation as the name of the article.

It is Chronic obstructive pulmonary disease not Chronic obstructive pulmonary disease (COPD) Doc James (talk · contribs · email) 03:03, 15 April 2020 (UTC)

A lot of hidden comments . . . like ancient DNA!

And a little of this goes a long way. The < ! - - opens the hidden comment (without the spaces), and - - > closes it (again, without the spaces).

And we’re just going overboard. It’s like we’re writing some parts of the article twice. I really urge that we start going the other way and paring back on these comments.

from Transmission

< ! - - Quote: "The main way the disease spreads is through respiratory droplets expelled by someone who is coughing." - - >

This is a better use, since it gives a quote (would be better still if we gave source and date!).

FriendlyRiverOtter (talk) 01:57, 10 April 2020 (UTC)

————————-

< ! - - Quote: "We are still learning how it spreads" - - > (spaces added)

This is kind of obvious. So, even if it were attributed to a person or orgazination, with a date, we don’t need it gumming up the works as a hidden comment and making it more difficult to edit as new information becomes available. FriendlyRiverOtter (talk) 17:59, 10 April 2020 (UTC)

The hidden comments were dense in the lead, but not anywhere else. I deleted most of the these. We will see if anyone squawks. --{{u|Mark viking}} {Talk} 18:31, 10 April 2020 (UTC)

I have restored them. This text is so incredibly controversial that having the hidden comments helps other editors. Plus if the references we are using change their wording it is easier to pick up when our content is out of date. I guess the could move them to "quote=" inside the reference but that is less clear as the same reference might be used in different spots. Doc James (talk · contribs · email) 19:38, 10 April 2020 (UTC)

Thanks for your note. So the justification is that the level of controversy makes including these hidden comments in the source not only acceptable, but recommended. I can understand that and will not delete them. But their purpose was unclear to us and presumably to other editors before your comment here. It would be better to annotate these with, say, quote from X: , so other editors can indeed know they are for verification and from which ref they came. --{{u|Mark viking}} {Talk} 20:43, 10 April 2020 (UTC)

I just don’t get this thick underbrush. For example in the Transmission section, it had said:

“Though the virus is not generally airborne,[6][57] The National Academy of Science has suggested that bioaerosol transmission may be possible and air collectors positioned in the hallway outside of people's rooms yielded samples positive for viral RNA.”

Why did we have a capitalized “The” smack dab in the middle of the sentence? I’ll tell you why, because we had some many hidden comments between the two parts of the sentence that it was a very easy mistake to make. I fixed it with:

https://en.wikipedia.org/w/index.php?title=Coronavirus_disease_2019&diff=next&oldid=950071042

But I’m wondering, what else are we paying a cost for? To me, we can and should use these hidden comments a lot more sparingly. FriendlyRiverOtter (talk) 03:24, 11 April 2020 (UTC)

Not sure what the cost is? Doc James (talk · contribs · email) 22:11, 11 April 2020 (UTC)

That it’s harder to edit. We already have a long article with a lot of references on a changeable and changing topic. FriendlyRiverOtter (talk) 04:32, 13 April 2020 (UTC)

Sure but this bit specifically has been very controversial and very extensively discussed. Doc James (talk · contribs · email) 19:41, 13 April 2020 (UTC)

And we seem to be wanting to lock the article in place, as if we were locking in an article on a baseball season when the season is only a quarter of the way in. FriendlyRiverOtter (talk) 20:15, 13 April 2020 (UTC)

No we are wanting high quality sources to be accurately reflected especially in the lead. If and when those sources change so should we. Doc James (talk · contribs · email) 03:04, 15 April 2020 (UTC)

Auranofin study preprint

I'm unhappy with this edit by Wikinium, which makes claims for the effectiveness of auranofin based on a news source. I tracked the source of the news source to a preprint of an in vitro study - that's really no better and not a MEDRS source. Nevertheless, as an example of ongoing testing of already approved drugs, it is interesting, so I've tried to rephrase it to ensure the reader sees the preliminary nature of any findings and cited the preprint instead of the news source. I'm still not sure that the current text is justified, so I'm seeking further opinions on whether it should simply be deleted? --RexxS (talk) 23:12, 15 April 2020 (UTC)

Okay - question answered. Thanks, James. Cheers --RexxS (talk) 23:19, 15 April 2020 (UTC)

As am I and I have trimmed it. These are not treatments. This is early stage research. Doc James (talk · contribs · email) 23:21, 15 April 2020 (UTC)

I explained in the text that it was undergoing studies and trials. Not that it was a direct or available treatment. The treatment section should include more than just current treatments. It should also include information on what drugs/medicines/etc are being explored as possible future treatments. Completely purging would be a bit aggressive, but I do agree that it should be worded in such a way that doesn't give people a false impression that it's in any way being used or offered to COVID-19 patients. Wikinium (talk) 00:37, 16 April 2020 (UTC)

Would anyone like to see the addition of a section near Medications that specifically talks about ongoing research? No matter how early stage they are, they should be documented. The section currently talks about research being ongoing, but doesn't elaborate on what current drugs/treatments/etc are currently being explored. Doc James did make an edit on the Auranofin page that's toned down. Perhaps that could be used verbatim as a start for this new section? I came to this article specifically to get a refresher on all in-progress research and was surprised to see it's not documented in or near the treatments section, which is where I would most expect to see it. Wikinium (talk) 00:49, 16 April 2020 (UTC)

We already have that section Coronavirus_disease_2019#Research I am not sure if this one of 100s of substances is notable yet. We should wait until it is covered by a secondary source. Doc James (talk · contribs · email) 00:54, 16 April 2020 (UTC)

Relative Prognosis

People have no way to estimate the risks of the pandemic, until the relative prognosis is provided. The triangle illustration above in the article section must be provided in relative terms, relating the risks of this virus relative to influenza or the total of all common viruses so that the change in the pre-existing total risk burden is known. Then the change in our choices/actions can be measured so we know if they are appropriate or need further adjustment. Each and every individual needs this information to make personal choices and it's appropriate for us to share it in our social networks. — Preceding unsigned comment added by Rtdrury (talk • contribs) 13:59, 16 April 2020 (UTC)

And as soon as the information is stated in a reliable source, we'll be able to report it. --RexxS (talk) 17:09, 16 April 2020 (UTC)

coagulopaty, thromboprophylaxis and use of heparin

Hi, from the first description on Italian newspapers (here and here), I have searched online and discovered this publication by J. Thachil regarding the presence of micro-thrombosis and the use of heparin. I leave it here if more expert users want to take a look in the next days. have a nice wiki!--Alexmar983 (talk) 01:18, 13 April 2020 (UTC)

The use of heparin was reported on many more local newspapers (here or here) and finally approved by the Italian Medicines Agency. Regards.--Alexmar983 (talk) 10:25, 14 April 2020 (UTC)

Adding some more info on effects on cardiovascular system in the article now [3] --Gtoffoletto (talk) 22:12, 15 April 2020 (UTC)

Glad to see it is still there. I am more focused on the "gray areas" of socio-political aspects so I would never touch this page directly.--Alexmar983 (talk) 23:49, 18 April 2020 (UTC)

Semi-protected edit request on 17 April 2020

Hello, it is stated that COVID-19 was discovered in December 2019. For the sake of accuracy, would we be able to make a statement closer to the WHO's first-ever situation report of this finding? https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4

The first point in the summary states: "On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China."

Stressing that the date is known but the disease itself was unknown at the time is more accurate. The current article uses the word "discover" which implies far more understanding than was actually the case in December.

I hope this request is clear and appropriate. Thank you in advance. Jennifer T. Coen (talk) 10:19, 17 April 2020 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. Given the level of activity in these articles at this point, an edit request can really only be completed for clear, uncontroversial maintenance (spelling errors and the like). ‑‑ElHef (Meep?) 14:58, 17 April 2020 (UTC)

No need to address any further. I don't see the use of the word "discover" in the article (there are a lot of edits and it may have been present previously). Lead currently says "The disease was first identified in December 2019 in Wuhan..." so I think that's appropriate. MartinezMD (talk) 16:33, 17 April 2020 (UTC)

Agree I agree, it should be removed. It's quite an extraordinary claim, so until there's some more evidence, I think it can be removed (especially since, well, you can always add it back with more sources later). Better to be a paragraph short than to publicise and perpetuate false information. ItsPugle (talk) 04:15, 19 April 2020 (UTC)

Flattening the curve = seeking herd immunity

https://www.dailymail.co.uk/news/article-8229009/Britain-faces-TEN-waves-coronavirus-population-achieves-herd-immunity.html https://www.abc.net.au/news/2020-03-27/coronavirus-options-to-end-lockdown-explained/12090270 https://www.medrxiv.org/content/10.1101/2020.03.30.20048009v1.full.pdf They appears correct that Flattening the curve = seeking herd immunity. Does everybody agree? There are two options, bring the reproduction number down from 5 to around unity, which will everybody get immune at some point (e.g. get the number of infections and deaths up from e.g. 3% (Dutch number) to >60% never mind that it takes forever, or just below unity, that the virus just gets suppressed more and move over time. Jmv2009 (talk) 16:38, 17 April 2020 (UTC)

@Jmv2009: I don't agree. "Flattening the curve" is a strategy whose purpose is to limit the rate of hospital admissions to a level that does not overwhelm the system. Achieving herd immunity will require either a vaccine, or (on Dutch numbers) over twenty times the number of infections (and twenty times the number of consequential deaths). That assumes that immunity lasts and the virus does not mutate significantly. --RexxS (talk) 17:42, 17 April 2020 (UTC)

Flattening the curve is NOT herd immunity, it is reducing transmission rates. This can be achieved by many methods, including social distancing as is being demonstrated currently. Herd immunity is another concept, but can eventually play a role. MartinezMD (talk) 17:45, 17 April 2020 (UTC)

There is now 3 things that is called "Flattening". The new plan proposed by the US government for instance is same as herd immunity yes. BTW, I only saw WHO say that 100% of the population is vulnerable. I expect 45% of the population had already immunity before the outbreak. I'm waiting for a source that goes that way, more data is needed. Iluvalar (talk) 18:36, 17 April 2020 (UTC)

Reducing transmission rates is one thing, but EXACTLY to what level. Reproduction number of unity, or just below unity? Makes a huge difference. See below. Jmv2009 (talk) 06:10, 18 April 2020 (UTC)

Flattening the curve is only one thing - reducing the rate of new infections, a mathematical projection. How that is achieved however, is a varied matter. MartinezMD (talk) 18:51, 17 April 2020 (UTC)

I agree but I believe most people confuse the plateau of cases that happen when you test most of the cases with the actual flattening. Also the new US plan is to flatten in the opposite direction now. The plan is to reduce the mitigation in such a way that the health care system can handle it. Which is the same plan with other country. The vaccine won't be here in time. Iluvalar (talk) 19:00, 17 April 2020 (UTC)

It seems we kind of agree. If it only takes an epsilon of extra restrictions to drive the number of cases exponentially to zero with respect to having it escalate exponentially to overwhelming the health care system, it doesn't make sense to ONLY mitigate in such a way that the health care can handle it. If you are ONLY mitigating in such a way that the health care system can handle it (continually adjusting on the instability), you ARE steering towards some level of herd immunity. Also see https://www.rivm.nl/en/novel-coronavirus-covid-19/what-are-we-doing-in-the-netherlands-in-response-to-the-coronavirus, which says "Moreover, it is very likely that the virus would simply start spreading again once the lockdown is over", implying that we need immunity. Jmv2009 (talk) 06:07, 18 April 2020 (UTC)

https://pagetwo.completecolorado.com/2020/04/17/dierenbach-flatten-the-curve-may-now-be-long-term-lockdown/ Another article about how flatten the curve is not the proper view anymore. Jmv2009 (talk) 18:25, 18 April 2020 (UTC)

As has been stated above, these two things are totally unrelated. - Wikmoz (talk) 01:37, 20 April 2020 (UTC)

Other Treatments

A medical team involving Dr Cheng from Shanghai has used intravenous administration of high dose sodium ascorbate, up to 50g per treatment, with a 100% success rate. It is combined with other essential nutrients such as zinc to improve efficacy. This is a well established treatment for acute respiratory disorders, and has 70 years of clinical evidence. This is a treatment used widely in China for covid-19. I am not going to insert it in the main article, simply seeking an explanation on it not appearing. I understand it cannot be patented, and therefore would not be profitable for the pharmaceutical industry. Is it wikipedia policy for editors to be neutral, or has this changed? Thank you. (NZ Tech)

Subsequently discovered a very brief mention of it in this article: https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research however it ideally needs to be mentioned by name in the main article "Medications" section. It's probably a concern for the pharmaceutical industry to have a cheap treatment available that makes most of their patented drugs obsolete. It seems to be buried in a large list of pharmaceuticals in the other article. As stated in Event 201, "use the flood method" to drown out any information you don't want becoming widely known. Well played. (NZ Tech) — Preceding unsigned comment added by 27.252.162.72 (talk • contribs)

Do you have a medically reliable source for this statement suggesting this miracle cure is somehow being kept from the public? MartinezMD (talk) 07:05, 19 April 2020 (UTC)

I've reverted the latest contribution and blocked the IP for disruptive fringe-pushing. Boing! said Zebedee (talk) 11:46, 20 April 2020 (UTC)

Herd immunity

The following paragraph was added to Prevention with a single reference:

With societies apparently being able to control the growth rate of the infections by social distancing, a couple of variants appear. One could keep the infection rate at a high level such that the possibly expanded health care system would be able to keep up with, building up immunity as fast as possible, but accepting the associated death rate if no effective treatment is available. Opening up as much as the health care systems and eventually the built up immunity allows for. One could also accomplish a lower than unity reproduction number temporarily, working towards a much lower infection rate, and wait for an extended period for the development of a vaccine. At low infection rates and extended testing, one could try to trace and isolate infected people. This is what is referred to as "crushing the curve". (citation)

I haven't heard any reputable medical sources endorse herd immunity as a good idea without factoring in vaccination. There's a great discussion of the idea in this article.

Should the paragraph be removed? - Wikmoz (talk) 03:19, 19 April 2020 (UTC)

————

The citation:

April 2020, Rachael Rettner-Senior Writer 03. "Instead of just flattening the COVID-19 curve, can we 'crush' it?". livescience.com. Retrieved 2020-04-18.{{cite web}}: CS1 maint: numeric names: authors list (link)

Only seems to support the last three sentences in that paragraph. So, patial Yes, I favor removing the other part. As always, we go with what our references say, no more, no less. FriendlyRiverOtter (talk) 04:34, 19 April 2020 (UTC)

The entry does not accurately reflect what the source is saying. Secondly the source is an opinion piece reporting an an editorial in New England Journal that requires unrealistic factors to make true including "Make millions of diagnostic tests available. Not everyone needs to be tested, but everyone with symptoms does. The nation needs to gear up to perform millions of diagnostic tests in the next 2 weeks." I've removed it pending further discussion here. MartinezMD (talk) 05:02, 19 April 2020 (UTC)

Saying home directly kills people via financial impact. Progressively reopening is, therefore, saving lives. Besides, I don't see why we wouldn't mention the option of not preventing at all. A slow reopening is definitively an option. Iluvalar (talk) 05:28, 19 April 2020 (UTC)

A suggestion supporting survival of the fittest is not in that article, and I doubt you'll find any credible sources suggesting it.MartinezMD (talk) 06:35, 19 April 2020 (UTC)

Here the three options are laid out by Dutch politicians and scientific advisors:

[4][5] Three options: 1) Maximally control the virus, and build up immunity. Roughly corresponds to having a flat infection rate curve. 2) Let virus run it's course. 3) Lock-down: Suppress the virus. Don't build up immunity. Roughly corresponds to having a crushed infection rate curve. Not advocating, just showing options. Can imagine that particularly hard hit municipalities which are close to herd immunity will choose differently. Jmv2009 (talk) 11:47, 19 April 2020 (UTC)

He's not suggesting letting it run it's course. He specifically says "And that, of course, is a scenario we must prevent at all cost." That is not crushing the infection rate; that is letting the infection rate reach maximum, increasing the height of the curve, so that it's over faster. MartinezMD (talk) 15:35, 19 April 2020 (UTC)

This particular source, yes. But COULD it be done ? yes ! Does governments consider the option ? Yes ! That's why I'm a bit confused. This being said, I won't do an edit war far that line in that section. Iluvalar (talk) 16:52, 19 April 2020 (UTC)

We need to make a distinction between enumerating in principle available policy options, and picking one. Mentioning a policy option does not mean that you don't want to prevent it from happening. Mentioning an policy option doesn't necessarily mean you advocate for it. Jmv2009 (talk) 16:56, 19 April 2020 (UTC)

I'm not looking for an edit war either. Perhaps it isn't clear to me what exactly you want to add to the article. In any of the medical disease articles, you can discuss doing nothing and letting nature take its course. That is not a usual inclusion to the article. Most discussions of this type I can think of about treatment are usually admonitions if nothing is done ("if you don't do X, Y will happen"). That concept seems to be already covered by the infection curve exceeding treatment capacity and the entire point of trying to flatten it. MartinezMD (talk) 17:15, 19 April 2020 (UTC)

There are three options here, right? 1) Do nothing 2) Crush curve, don't build immunity, wait for vaccine 3) Flatten infection rate to horizontal, build immunity a.s.a.p. limited by health care system. Despite this being a medical article, this is a political choice. Jmv2009 (talk) 18:03, 19 April 2020 (UTC)

Yes, you can always choose to do nothing in any disease. But what who is advocating that? The politician in the source above says that must not be one of the options. This has to carry appropriate weight and be reliably sourced. I can come up with other theoretical options too. MartinezMD (talk) 18:27, 19 April 2020 (UTC)

Well, Trump was saying "the cure can not be worse that the disease", just a few weeks ago, and still appears to be advocating for it. Rutte and Boris Johnson were saying building up immunity was important, and RIVM still appears to promote it as the policy according to the sources. And others are de-facto for crushing the curve, which appears to have become the main policy now. Even unpopular choices and not chosen options can be notable. I don't think we should only show one policy here, especially policies which may be an unaffordable luxury in many jurisdictions.

What's unaffordable is the prospect of something like a ten-fold increase over the current total in the number of deaths before herd immunity is achieved without use of a vaccine. That's based on a SWAG of infections = 40 x confirmed cases. If the multiplier is lower, then the death toll is proportionately higher. YMMV. --RexxS (talk) 18:56, 19 April 2020 (UTC)

Aboriginals, Africans, Inuit, war zones, refugees. Only in situations with a lot of control do you achieve reproduction numbers at or below unity. Ah, and Germany perhaps. Jmv2009 (talk) 19:15, 19 April 2020 (UTC)

China obviously, and as far as I can judge, Italy's curve straightened 2 weeks ago. I don't know if they said anything about it. And that sounds like USA's reopening plans too. Iluvalar (talk) 20:03, 19 April 2020 (UTC)

@Jmv2009: point very well taken that some countries may not be able to afford the kind of economic phasedown which major industrial economies have engaged in. In fact, two weeks ago I added this reference to our article about Coronavirus and Nigeria:

Lagos lockdown over coronavirus: 'How will my children survive?', BBC, 31 March 2020.

And since I’m all in favor of breadth of coverage, I think we can have some coverage in our article here. As always, we go with our references, no more, no less. FriendlyRiverOtter (talk) 22:47, 19 April 2020 (UTC)

Ok, let's do this. Just like any article, if we want an inclusion, it needs reliable sourcing. The section that I agreed with the other editors was not supported by the source. I don't/can't object if the source is credible and supports an inclusion. But for now, I don't see that. MartinezMD (talk) 03:10, 20 April 2020 (UTC)

So we are not only looking for recommended options anymore. By the way, not wanting to claim how good any of the options would work either. Just want to enumerate. Option 1 was do nothing scenario. Option 2 was to suppress, with the goal for the health care system to be able to deal with it, but build immunity. This was the narrative of flattening the (infection rate curve) curve we were all trying to be sold. Option 3 is to crush the curve, with the goal of avoiding deaths. Different goals, different options.

Why wouldn't e.g. [6] or [7] wouldn't qualify? This is more a political discussion/decision than a medical. Please specify what you are looking for specifically, if anything is missing.

Because he isn't discussing doing nothing as an option and it seems to be undue weight. I'd be interested to see what other editors think on the matter as well so it isn't just us. MartinezMD (talk) 17:45, 20 April 2020 (UTC)

References

Text

"In the absence of confirmed antiviral drugs or vaccinations, as of March 15, 2020 Traditional Chinese Medicine (TCM) has been used in conjunction with conventional medicine in the treatment of over 85% of total confirmed SARS-CoV-2 infected patients."

All sorts of alt med and traditional medications are being used without evidence. Do not think this is due weight. Doc James (talk · contribs · email) 22:03, 20 April 2020 (UTC)

References

antiviral?

"Several existing antiviral medications are being evaluated for treatment of COVID-19,[175] including … chloroquine …" Is cloroquine really a virostatic? --JonValkenberg (talk) 14:35, 20 April 2020 (UTC)

The evidence also looks poor for chloroquine, but yes there are claims it has antiviral properties. Doc James (talk · contribs · email) 22:03, 20 April 2020 (UTC)

I saw a CNN tv report that a study of some 300 found it to be ineffective against the disease. Not good. Should be a RS out there on this. 50.111.14.1 (talk) 19:16, 21 April 2020 (UTC)

Semi-protected edit request on 23 April 2020

I would like to add a few links of various sources to the page. They all are articles on prevention many of which would help fulfill the current descriptions of Covid-19 prevention. This is how I would like to contribute to this pandemic. All of the articles I would like to add links of are public and non-political. WHOdaily (talk) 14:12, 23 April 2020 (UTC)

I suggest that you list your proposed sources here. Bondegezou (talk)

 Not done: this is not the right page to request additional user rights. You may reopen this request with the specific changes to be made and someone will add them for you, or if you have an account, you can wait until you are autoconfirmed and edit the page yourself. JTP ^{(talk • contribs)} 16:01, 23 April 2020 (UTC)

References

Add "Mask Usage" in Prevention

I strongly suggest that "mask use" (or similar term) should be added to the Prevention part of the article, where it also states "Hand washing, quarantine, social distancing", because: "The virus is mainly spread between people during close contact,[a] often via small droplets produced during coughing,[b] sneezing, or talking."

Several countries around the world are using it as an effective prevention mechanism. In some Asian countries, masks have been used regularly for years by people to protect themselves against pathogens (also air polution, but this is not the only reason).

It also has been proven that this virus attaches to airborne particules that are released from the respiratory tract and it can survive suspended in air for hours, depending on the setting (an elevator for example, where air rarely gets renewed). In the SARS outbreakof 2003, it was deduced that the use of an elevator was an important cause of vertical transmission in a building.

Considering the last paragraph, I also suggest an edit to "...often via small droplets..." in the main article: To add "airborne particles" also as a possible mechanism of infection.

I would prefer to be over cautious than not, and therefore advice everyone the same: use a mask to prevent infection.

If citations of studies and links to information here are needed, I will find and add them to this edit request. Krakikoko (talk) 10:03, 13 April 2020 (UTC)

I think we need to, as per WP:BALANCE, acknowledge that there is an ongoing debate about the value of general mask wearing.

That said, this new BMJ paper arguing for is useful to cite. (COI declaration: I know the first author and they cite a paper by my Dad.) Bondegezou (talk) 12:46, 13 April 2020 (UTC)

Only a preprint, but there's this new evidence review too. Bondegezou (talk) 14:28, 13 April 2020 (UTC)

Didn’t the WHO come forth recommending the use of masks? I know before they were dismissing mask use by the general public. OyMosby (talk) 06:38, 14 April 2020 (UTC)

This is the latest from WHO on masks, as far as I know. Their public-facing website summarises here. WHO, as far as I can see, recommends only wearing a mask if you are coughing/sneezing or looking after someone with COVID-19. However, p. 2 of that first document is more ambivalent (e.g., "In some countries masks are worn in accordance with local customs or in accordance with advice by national authorities in the context of COVID-19. In these situations, best practices should be followed about how to wear, remove, and dispose of them, and for hand hygiene after removal.") and offers pros and cons for policymakers, and advice on what to do if you decide that your policy will be to recommend public wearing of masks ("Whatever approach is taken, it is important to develop a strong communication strategy to explain to the population the circumstances, criteria, and reasons for decisions. The population should receive clear instructions on what masks to wear, when and how (see mask management section), and on the importance of continuing to strictly follow all other IPC measures (e.g., hand hygiene, physical distancing, and others).").

There is ongoing debate within public health circles I know about the pros and cons. The BMJ paper and preprint above are examples of a pro-mask stance. I'll see if I can find for balance some anti-mask papers. Bondegezou (talk) 09:48, 14 April 2020 (UTC)

This is now a CDC recommendation, which was weeks in the making. I've added it to the section. They've bent over backwards to encourage the use of non-medical face coverings to prevent exacerbating the shortage but the medical goal is the same... limiting spread by pre/asymptomatic individuals. I've linked to the topic dedicated to this discussion. - Wikmoz (talk) 03:10, 17 April 2020 (UTC)

We have "Face masks and respiratory hygiene" as a section. Doc James (talk · contribs · email) 05:29, 24 April 2020 (UTC)

What do people use instead of worldmeter?

Just wondering since apparently there are problems with it. Lizbethcoffee (talk) 23:05, 25 April 2020 (UTC)

@Lizbethcoffee: Personally, I use Our world in data. It's not guaranteed free of glitches (I don't believe the UK tested 73,000 people with 28,000 tests today, for example) but there's a lot of data there and you can download and use it freely. --RexxS (talk) 23:30, 25 April 2020 (UTC)

This is a very nice site! Cheers. Lizbethcoffee (talk) 00:50, 26 April 2020 (UTC)

See also Wikipedia:WikiProject COVID-19/Sources.--Moxy 🍁 23:42, 25 April 2020 (UTC)

"In experimental settings, the virus may survive on surfaces for up to 72 hours"

Is this statement contradicted by this not very explicit paper? Apokrif (talk) 09:59, 25 April 2020 (UTC)

The statement is ambiguous.

If you read it as "the virus may survive on surfaces for up to 72 hours (and perhaps longer)", then the paper (a primary study) doesn't contradict it.

If you read it as "the virus may survive on surfaces for up to 72 hours (but no longer)", then the paper does contradict it.

Whichever way you read it, a single primary study on its own isn't strong enough for us to draw conclusions from. --RexxS (talk) 19:19, 25 April 2020 (UTC)

Should we change it to: the virus may survive on surfaces for up to 72 hours and potentially longer depending on the material and environment -- {{u|Gtoffoletto}}  ^talk 01:18, 26 April 2020 (UTC)

You could if you wanted to. It might even be worth adding "... and temperature, and probably relative humidity" for the pedants. --RexxS (talk) 01:25, 26 April 2020 (UTC)

Thumbnail image

When I mouse over coronavirus disease 2019 the thumbnail image is a gray plate saying "2 to 14 days". Could a more helpful thumbnail be put up? Maybe a picture of someone suffering the condition. buidhe 20:06, 19 April 2020 (UTC)

Not sure to what you refer? Doc James (talk · contribs · email) 21:44, 19 April 2020 (UTC)

I'd guess it's about "page previews" feature - thumbnail showing on mouse hover. At present, I don't see a gray plate, but File:Symptoms_of_coronavirus_disease_2019_3.0.svg, cropped a little at the top. – attomir (talk | contribs) 17:01, 20 April 2020 (UTC)

It was a very uninformative grey plate at the time of the message. Case closed I guess. Iluvalar (talk) 17:08, 21 April 2020 (UTC)

Maybe fill out a phabricator ticket. Doc James (talk · contribs · email) 03:26, 26 April 2020 (UTC)

Unsecure reports

Conflicting reports about Covid-19 and Smoking

articles that state that smoking may offer a benefit

• A: A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications (Preprint, French study, cites C)
• B: French researchers to test nicotine patches on coronavirus patients (Guardian, 22 April 2020, cites A)
• C: Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19 (Preprint, Review)

articles that state that smoking makes it worse

• D: Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease (Chinese study)
• E: Smoking increases your coronavirus risk. There’s never been a better time to quit (cites D)
• F: COVID-19 and smoking: A systematic review of the evidence (editorial)

--VietnamSongAgainstCoronaRocks2 (talk) 10:57, 23 April 2020 (UTC)

We should stay away from the popular press and pre prints. Doc James (talk · contribs · email) 05:32, 24 April 2020 (UTC)

Possible background immunity

@Doc James: As you're a M.D. there's an interesting news report from a German study. (Not even a pre-print though only an interview with Christian Drosten about the findings of an unnamed colleague of him at the Charité. He says that they found in old samples (pre-Covid-19) that 34% of the "patients" had some immunity against Sars-CoV-2:"Die Forscher hätten bei Untersuchungen von Abwehrzellen in Proben aus der Zeit vor der Pandemie gesehen, dass bei 34 Prozent der Patienten reaktive T-Zellen vorlagen, die bestimmte Teile des neuen Coronavirus sozusagen erkannten." That would mean that perhaps old infections or more likely infections of the recent past (with common-cold coronaviruses?) could help against the new coronavirus and that would also explain why children are more immune than adults since children have had more of these infections in the recent past. Here's the link to the article in German Milde oder symptomlose Corona-Verläufe könnten nach Ansicht des Berliner Virologen Christian Drosten mit früheren Infektionen mit Erkältungs-Coronaviren zusammenhängen.. — Preceding unsigned comment added by VietnamSongAgainstCoronaRocks2 (talk • contribs)

I say we wait for sources that fit WP:MEDRS. Doc James (talk · contribs · email) 23:18, 24 April 2020 (UTC)

With 34% immunity and 20% already infected, it would make a lot of sens that a virus with an R0 of 2.2-2.5 would start to flatten. But, as Doc james say, this have to stay in talk page until we get confirmation. PS. I believe the most popular models so far must not like these numbers, many of them must be spitting non-sens. And it probably explain why we suddenly raise our source standards a little. Iluvalar (talk) 03:53, 25 April 2020 (UTC)

I am not sure of the veracity of the 34% claim. It is unclear how accurate the test is. How big a population this applies to and if the presence of antibodies gives immunity. Doc James (talk · contribs · email) 03:30, 26 April 2020 (UTC)

It says that 34% of some unidentified sample had reactive T-cells that recognised "some part of the new virus, as it were". Drosten also cautioned against over-interpretation and emphasised that you mustn't conclude that one-third of the population is immune. He also points out that alternative explanations for mild or asymptomatic cases exist, such as people catching fewer viruses or being in better physical health to begin with.

It all goes to show the value of reading the whole source rather than just picking up on a news source's headline. I'm sorry to keep banging on about this, and I know we all want some good news, but working from stories in newspapers (online or in print) isn't how we develop medical content for an encyclopedia. --RexxS (talk) 04:24, 26 April 2020 (UTC)

Virus survival on surfaces: potential new data

Search for "Stability of SARS-CoV-2 in different environmental conditions Chin"

Disclaimer and some comments: https://www.reddit.com/r/COVID19/comments/fprsyy/stability_of_sarscov2_in_different_environmental/

Search for "Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents Kampt"

Disclaimer and some comments: https://www.reddit.com/r/COVID19/comments/f8bpur/persistence_of_coronaviruses_on_inanimate/

French illustration:

https://6-28.mastodon.xyz/media_attachments/files/012/539/938/original/ccfce06b79793ee6.png

• 6J => 6 days
• some objects, from last to upwards
  • surgery mask (exterior)
  • glass, ceramic
  • platic
  • stainless steel

--Tuxayo (talk) 02:32, 26 April 2020 (UTC)

Please see WP:MEDRS with respect to sourcing. Doc James (talk · contribs · email) 06:34, 26 April 2020 (UTC)

History section is confusing and incomplete

I find this statement incomplete: "the spread of infection was almost entirely driven by human-to-human transmission". It lacks precision on the geographical delimitation of the initial spread. It can be misinterpeted like "humans at some place in the planet were infected and then it spread to other places" which is very vague for a history section. I propose that we delimit the location of known early infections to the Asian continent and China, thus providing a detailed description directly related to history of the disease, in my opinion.--Forich (talk) 02:26, 23 April 2020 (UTC)

Is there scientific evidence of that ? Iluvalar (talk) 16:20, 25 April 2020 (UTC)

"In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China" Huang et al (2020) on The Lancet's (15 February 2020 - Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China). Notice that the entry's history section lacks mention of Wuhan, hence my observation of incompleteness. --Forich (talk) 10:10, 26 April 2020 (UTC)