COVID-19 IV: SG Circuit Breaker EXTENDED TILL 1ST JUNE: 451 New Cases, 1 SG/PR (19 May)

[13177]

4 hours ago, Tohto said:

That is near my running route near the PCN. My recent run during CB all do late night run. Think about it I also scare.

 

Punggol Field death: 20-year-old man arrested, to be charged with murder

https://www.channelnewsasia.com/news/singapore/punggol-field-murder-suspect-arrested-police-12738942

Murderer is a 20 year old man? What is his motive siah? 😓

[13177]

7 hours ago, Chongster said:

looks like we are on course to reopen come 1 June.  the dorm situation also doesnt appear to stress the hospitals. 

Think it is guaranteed to reopen from 2 Jun la. Locals new cases have been doing very good?! 🙄

[Weez911]

As of 16 May 2020, 12pm, the Ministry of Health (MOH) has confirmed and verified an additional 465 cases of COVID-19 infection in Singapore. The lower number of cases today is partly due to fewer tests being processed as one testing laboratory is reviewing its processes following an earlier apparatus calibration issue, and will need time to ramp up its testing capacity. 

There is still an unlinked local case today. *scratch head*

[Dafansu]

5 hours ago, Tohto said:

That is near my running route near the PCN. My recent run during CB all do late night run. Think about it I also scare.

 

Punggol Field death: 20-year-old man arrested, to be charged with murder

https://www.channelnewsasia.com/news/singapore/punggol-field-murder-suspect-arrested-police-12738942

I run along this route also, can be very quiet after 8pm and the bushes and newly planted trees along the street doesn't help as the area is rather isolated

[13177]

3 minutes ago, Dafansu said:

I run along this route also, can be very quiet after 8pm and the bushes and newly planted trees along the street doesn't help as the area is rather isolated

If the place is near some empty land and bto construction site, usually would be quiet. Maybe it is still better to run along PCN.

[RadX]

5 hours ago, Jellandross said:

What it means by positive but not infectious ah? 

18 Covid-19 patients discharged after being deemed not infectious despite still testing positive

https://www.straitstimes.com/singapore/18-discharged-from-dresort-community-isolation-care-after-being-cleared-of-coronavirus-moh

Also alludes to the high discharge stats.  Apparently once they cross the 23 days incubation, safe to discharge

[1fast1]

11 minutes ago, RadX said:

Also alludes to the high discharge stats.  Apparently once they cross the 23 days incubation, safe to discharge

To me, this smacks of a tacit admission that they can't cope with the ever increasing demands of space to house these people.

Our policy had previously always been to await two negative swabs to ensure the viral loads in the parts of the body most likely to transmit the disease (nose and mouth) have decreased to undetectable levels. Is it a perfect marker for non-infectiousness? Probably not. But it's still a damn sight better than sending a patient with a positive PCR out of the hospital or isolation facility.

(And here I'm not even talking about other potential portals for shedding - like through stool, which could well persist for longer).

Even if you assume an additional 7 days is enough to further reduce loads to "safe levels" (whatever those might be), you're still basically dependent on the patients being fully compliant with staying at home for the 7 days. How in the heck can you trust in this sort of half-baked measure, especially given the measure-defying champions we've seen to date (and I still see mask-free "champions" every damn day).

And I have no idea how they're going to prevent transmission to others in the home - eventually *someone* in the home will have to go out for groceries or something and that can spread the infection beyond the house.

If they're gonna go down this road, why the hell don't they just start sending everyone in the CIFs who's reasonably well and ambulant and has minimal or no risk factors for severity home immediately for home-isolation? That'll actually not only free up resources, but may actually increase compliance. I am willing to bet that there are people reluctant to come forward to get tested for mild URTI symptoms because they do not want to subject themselves to the hassle of hospitalisation and/or a CIF. And why should they, if this is what we're doing with them in the end?

The news report also mentioned this:

The committee found that although the patients were shedding dead viral components - which were detectable through polymerase chain reaction (PCR) tests - the components were no longer transmissible and infective to others.

Unless viral cultures (to rule out viable virus) were done in all these cases, I don't see how the committee can possibly have the confidence to state to a certainty that those are "dead viral components". And viral culture is not generally done for viruses like this - it's too dangerous and you need specialised containment laboratories. So I think this is a foolhardy comment if it's not backed up by hard evidence in every case or at least a sufficiently large sample to give an adequate degree of statistical confidence.

Now, there have been studies that used viral cultures to follow-up patients, and one such study published in Nature showed that live virus could no longer be isolated 8 days after symptom onset (even though PCRs remained positive at that stage and beyond). This *suggests* that infectiousness may be blunted beyond 8 days post-symptom onset. But that's one study of just 9 patients, so the statistical power is lacking. I am not aware of any more good data on this (but I could've missed something out there).

In any case, they should've been more circumspect about stating that those are "dead" viral components because that was not established (to the best of my knowledge) in the Singapore cases being discharged early. If an inference was being made based on extant literature, then that should've been made clear. The phrasing is very poor indeed.

By the way, viral cultures also have limitations - they are nowhere close to perfect proxies for natural acquisition of infection by humans. I suspect that cell-line cultures of viruses can either over- or under-estimate infectiousness "in the real world". So it's not very sound to dismiss a positive PCR result outright (as being non-infectious) even with a negative viral culture result because the positive PCR doesn't really just show "dead" and "static" viral components - it is highly indicative of continuing viral replication. This premise has been further strengthened by the same Nature paper that showed sequence divergence of the amplified virus from a patient (that sequence divergence is because the RNA-dependent RNA polymerase of the virus is highly unreliable and makes errors - think of it as very short term "evolution").

The TL;DR non-technical summary: I am alarmed by the new policy. I took it as an article of faith that they were being exceedingly careful in awaiting 2 negative swabs before sending the patient out of a healthcare or isolation facility, but that faith has been shaken with this new revelation.

 

[RadX]

5 minutes ago, Turboflat4 said:

To me, this smacks of a tacit admission that they can't cope with the ever increasing demands of space to house these people.

Our policy had previously always been to await two negative swabs to ensure the viral loads in the parts of the body most likely to transmit the disease (nose and mouth) have decreased to undetectable levels. Is it a perfect marker for non-infectiousness? Probably not. But it's still a damn sight better than sending a patient with a positive PCR out of the hospital or isolation facility.

(And here I'm not even talking about other potential portals for shedding - like through stool, which could well persist for longer).

Even if you assume an additional 7 days is enough to further reduce loads to "safe levels" (whatever those might be), you're still basically dependent on the patients being fully compliant with staying at home for the 7 days. How in the heck can you trust in this sort of half-baked measure, especially given the measure-defying champions we've seen to date (and I still see mask-free "champions" every damn day).

And I have no idea how they're going to prevent transmission to others in the home - eventually *someone* in the home will have to go out for groceries or something and that can spread the infection beyond the house.

If they're gonna go down this road, why the hell don't they just start sending everyone in the CIFs who's reasonably well and ambulant and has minimal or no risk factors for severity home immediately for home-isolation? That'll actually not only free up resources, but may actually increase compliance. I am willing to bet that there are people reluctant to come forward to get tested for mild URTI symptoms because they do not want to subject themselves to the hassle of hospitalisation and/or a CIF. And why should they, if this is what we're doing with them in the end?

The news report also mentioned this:

 

 

Unless viral cultures (to rule out viable virus) were done in all these cases, I don't see how the committee can possibly have the confidence to state to a certainty that those are "dead viral components". And viral culture is not generally done for viruses like this - it's too dangerous and you need specialised containment laboratories. So I think this is a foolhardy comment if it's not backed up by hard evidence in every case or at least a sufficiently large sample to give an adequate degree of statistical confidence.

Now, there have been studies that used viral cultures to follow-up patients, and one such study published in Nature showed that live virus could no longer be isolated 8 days after symptom onset (even though PCRs remained positive at that stage and beyond). This *suggests* that infectiousness may be blunted beyond 8 days post-symptom onset. But that's one study of just 9 patients, so the statistical power is lacking. I am not aware of any more good data on this (but I could've missed something out there).

In any case, they should've been more circumspect about stating that those are "dead" viral components because that was not established (to the best of my knowledge) in the Singapore cases being discharged early. If an inference was being made based on extant literature, then that should've been made clear. The phrasing is very poor indeed.

By the way, viral cultures also have limitations - they are nowhere close to perfect proxies for natural acquisition of infection by humans. I suspect that cell-line cultures of viruses can either over- or under-estimate infectiousness "in the real world". So it's not very sound to dismiss a positive PCR result outright (as being non-infectious) even with a negative viral culture result because the positive PCR doesn't really just show "dead" and "static" viral components - it is highly indicative of continuing viral replication. This premise has been further strengthened by the same Nature paper that showed sequence divergence of the amplified virus from a patient (that sequence divergence is because the RNA-dependent RNA polymerase of the virus is highly unreliable and makes errors - think of it as very short term "evolution").

The TL;DR non-technical summary: I am alarmed by the new policy. I took it as an article of faith that they were being exceedingly careful in awaiting 2 negative swabs before sending the patient out of a healthcare or isolation facility, but that faith has been shaken with this new revelation.

 

Yup! I was flabbergasted at the least to hear of this coming out.

[Dafansu]

7 hours ago, 13177 said:

If the place is near some empty land and bto construction site, usually would be quiet. Maybe it is still better to run along PCN.

The resident was staying nearby, most likely he need to access this route towards the waterway PCN. The PCN along punggol waterway can be rather quiet also depending on the timing. Those extreme end facing coney island will need to avoid after 9pm plus. 

[Fitvip]

8 hours ago, Dafansu said:

I run along this route also, can be very quiet after 8pm and the bushes and newly planted trees along the street doesn't help as the area is rather isolated

There is a bus stop, and the resident at Blk 227A could hear his call for help and could see him from the window. That means that location is not that isolated. 

[Mockngbrd]

https://www.channelnewsasia.com/news/singapore/covid19-patient-hospital-dresort-coronavirus-ncid-12738530

[inlinesix]

11 hours ago, Wt_know said:

covid is very scary ...

recovered liao ... still positive

got asymtomatic patient ... walk here and there 

tio corona liao ... may result permanent damage not just to lungs but also to other organs

very worried ...  

Recovered still positive because virus has not been fully shredded.

Reduced blood O2 of course will other organs la.

[Playtime]

7 hours ago, Turboflat4 said:

To me, this smacks of a tacit admission that they can't cope with the ever increasing demands of space to house these people.

Our policy had previously always been to await two negative swabs to ensure the viral loads in the parts of the body most likely to transmit the disease (nose and mouth) have decreased to undetectable levels. Is it a perfect marker for non-infectiousness? Probably not. But it's still a damn sight better than sending a patient with a positive PCR out of the hospital or isolation facility.

buildings are being repurposed .... lets see if the NIMBY comes when they find out

[RH1667]

Real test of how safe the 18 discharged infected patient will be to ask anyone from the task force to sit down face to face with them and have a coffee. If the minister dare to do it, then I think we can be assured that they are really safe for the rest of the community. 

[Wt_know]

amdk gotta love the curry rice for 4-weeks ... sibei song ah!

Edited May 17, 2020 by Wt_know

[Weez911]

26 minutes ago, RH1667 said:

Real test of how safe the 18 discharged infected patient will be to ask anyone from the task force to sit down face to face with them and have a coffee. If the minister dare to do it, then I think we can be assured that they are really safe for the rest of the community. 

Share the same cup of coffee too! If they drink from the same cup, then I'm happy for these 18. Otherwise, I won't go near them within a 1km radius! Ask them to wear an unremovable headwear pls, like Sun Wukong.

[Icedbs]

11 hours ago, Yewheng said:

I believe government and doctor would had done a study on these 18 people who had been isolated for super long and found that they do not spread the virus at all. So should be okay la.. 

I am not sure if I am comfortable with any conclusion from the same people who said there were no evidence of the virus being airborne and hence there is no need for mask at the beginning.

Not trying to be sarcastic, but I think there are still a lot of unknowns about this virus for me to be confident of their "group studies".

[Mustank]

11 hours ago, 13177 said:

Think it is guaranteed to reopen from 2 Jun la. Locals new cases have been doing very good?! 🙄

Just confine bangla caN already