
Japanese woman confirmed as coronavirus case for second time - doppp
https://www.reuters.com/article/us-china-health-japan/japanese-woman-confirmed-as-coronavirus-case-for-second-time-weeks-after-initial-recovery-idUSKCN20L0BI
======
rosstex
Mayo Clinic assessment of the 2003 SARS coronavirus:

>A biphasic course has been described in many patients, with an initial
illness followed by improvement and then subsequent deterioration. This
worsening can present as recurrent fever 4 to 7 days after initial
defervescence, new chest infiltrates, respiratory failure, or watery diarrhea.
In a cohort of 75 patients in Hong Kong, 85% had recurrent symptoms after
initial improvement. The authors described a triphasic course with fever,
myalgia early in week 1, and recurrent fever, hypoxemia, diarrhea, and
shifting chest infiltrates in week 2. Twenty percent of patients progressed to
ARDS during the third week of the illness. Quantitative reverse-transcriptase
polymerase chain reaction (RT-PCR) of nasopharyngeal aspirate in 14 patients
with relapse showed peak viral loads occurred at day 10 after onset of
symptoms, suggesting that the late deterioration may be due to the host immune
response rather than to uncontrolled viral replication.

(Granted, the Japanese woman's symptoms disappeared for almost a month before
reappearing.)

[https://www.mayoclinicproceedings.org/article/S0025-6196(11)...](https://www.mayoclinicproceedings.org/article/S0025-6196\(11\)62689-X/pdf)

~~~
s_y_n_t_a_x
Similar to SARs and the 1918 Flu cause your own immune system to suffocate you
as it sends too many white blood cells to the infection.

It's called a cytokine storm.

This is why this virus is not only dangerous to the old and weak, a healthy
person's immune system becomes a liability in the following phases of
infection.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/)

[https://mmbr.asm.org/content/76/1/16](https://mmbr.asm.org/content/76/1/16)

[http://cytokinestorm.com/](http://cytokinestorm.com/)

~~~
knzhou
This just isn't true. The 1918 flu mortality rate had a peak for people in
their 20s (the so-called W shaped curve). But COVID-19's mortality rate is
much lower for the young, like most illnesses.

~~~
rjzzleep
To the other people commenting and saying it's not true here's a prelim study
on the CFR per age and gender[0]

    
    
         Confirmed Cases (%) | Deaths (%) | CFR
        Overall | 44,672 | 1,023|  2.3
        Age, years
         0–9 | 416 | (0.9) | − −
         10–19 | 549 (1.2) | 1 (0.1) | 0.2
         20–29 | 3,619 (8.1) | 7 (0.7) | 0.2
         30–39 | 7,600 (17.0) | 18 (1.8) | 0.2
         40–49 | 8,571 (19.2) | 38 (3.7) | 0.4
         50–59 | 10,008 (22.4) | 130 (12.7) | 1.3
         60–69 | 8,583 (19.2) | 309 (30.2) | 3.6
         70–79 | 3,918 (8.8) | 312 (30.5) | 8.0
         ≥80 | 1,408 (3.2) | 208 (20.3) | 14.8
        Sex
         Male | 22,981 (51.4) | 653 (63.8) | 2.8
         Female | 21,691 (48.6) | 370 (36.2) | 1.7
        Occupation
         Service industry | 3,449 (7.7) | 23 (2.2) | 0.7
         Farmer/laborer | 9,811 (22.0) | 139 (13.6) | 1.4
         Health worker | 1,716 (3.8) | 5 (0.5) | 0.3
         Retiree | 9,193 (20.6) | 472 (46.1) | 5.1
         Other/none | 20,503 (45.9) | 384 (37.5) | 1.9
        Province
         Hubei | 33,367 (74.7) | 979 (95.7) | 2.9
         Other | 11,305 (25.3) | 44 (4.3) | 0.4
        Wuhan-related exposure*
         Yes | 31,974 (85.8) | 853 (92.8) | 2.7
         No | 5,295 (14.2) | 66 (7.2) | 1.2
         Missing | 7,403 | 104 | 2.8
        Comorbid condition †
         Hypertension | 2,683 (12.8) | 161 (39.7) | 6.0
         Diabetes | 1,102 (5.3) | 80 (19.7) | 7.3
         Cardiovascular disease | 873 (4.2) | 92 (22.7) | 10.5
         Chronic respiratory disease | 511 (2.4) | 32 (7.9) | 6.3
         Cancer (any) | 107 (0.5) | 6 (1.5) | 5.6
         None | 15,536 (74.0) | 133 (32.8) | 0.9
         Missing | 23,690 (53.0) | 617 (60.3) | 2.6
        Case severity §
         Mild | 36,160 (80.9) − − − −
         Severe | 6,168 (13.8) − − − −
         Critical | 2,087 (4.7) | 1,023 (100) | 49.0
         Missing | 257 (0.6) − − − −
    
     

[0]
[https://drive.google.com/file/d/1CbsG_zfvOmTWK8rCzr7XM2vSfSV...](https://drive.google.com/file/d/1CbsG_zfvOmTWK8rCzr7XM2vSfSV7MpUM/view)

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aazaa
Two things stand out:

1\. This was a tour bus guide. Someone who had almost certainly come into
contact with people from different countries.

2\. She's not the first patient to relapse.

------
skokage
FTA: >"Japan has changed its strategy in combating the contagion, seeking to
slow its spread and minimize the number of deaths."

In my personal opinion living and working here, this society is very slow to
change and things that could greatly assist in slowing the spread, such as
adopting a Work From Home policy, will only occur once it's too late. Almost
no one is allowed to work from home here, even those with office/tech jobs
that can completely be done remotely with no issues. In addition, workers are
granted an incredibly small amount of days off, and most would rather get onto
their very crowded trains and commute into the office even when unwell as
opposed to taking one of their limited days off.

All that being said I'm not freaking out about it the way most people here
are, but I wish companies would react a bit faster and change their work
culture to accommodate the very easy things that could be done so people can
limit their interactions with others when something like this is occurring.
You can pretty much guarantee that one person with the virus getting onto a
sardine can train during their morning commute is going to infect several
other people in the process, and no amount of face masks the people here are
so fond of will do anything to keep an infection at bay.

~~~
qiqitori
Could be that my (IT) company is an outlier, but we've been told that we
should work remote and only come to the office if we absolutely must. And if
we do go to work, we are to avoid riding the trains during rush hour. Business
trips are all canceled.

Well that's the company I'm employed by, but the company I'm currently
deployed at (until today) is an automotive company and they don't seem ready
to allow much remote work to take place.

~~~
dvfjsdhgfv
> my (IT) company

IT as in Information Technology or Italy?

------
lbeltrame
From this report from the NHK
([https://www3.nhk.or.jp/nhkworld/en/news/20200227_12/](https://www3.nhk.or.jp/nhkworld/en/news/20200227_12/))
it shows that she was discharged very quickly after being diagnosed. Compared
to the other cases we've seen, IMO this points to a mistake when testing, as
the people in the comments have discussed.

------
Grue3
The virus seems to be spreading much slower in Japan than in Korea or Italy.
Despite having infections quite early, the number of cases is still
surprisingly low, with linear growth instead of exponential. Maybe some
cultural factors like self-isolation and not touching each other are at play
here.

~~~
Benmcdonald__
Japan is the most hygiene and clean country. Bowing instead of handshakes
would help too. Also public touching is uncommon

------
throwaway122378
Time to panic?

Edit: lots of downvotes but that was a serious question.

~~~
woutr_be
I've been living through it in Hong Kong for the past month, and this is just
my personal view. Time to panic? Absolutely not, but do take proper
precautions. Wash your hands more often, try to avoid touching your face after
you've been out in public. Don't go to areas where there are usually a lot of
tourists.

I've seen the panic mentality here in Hong Kong, and there's no real
difference between the people who panicked, and the people who didn't.
Panicking just makes it worse for everyone else.

~~~
sudhirkhanger
>try to avoid touching your face after you've been out in public. What does it
actually do? Is face or mouth more susceptible to contracting virus?

~~~
woutr_be
Not a doctor, but from what I've read, it's mostly transmitted through
droplets, from coughing or sneezing. Especially when you use public transport,
someone already infected might have sneezed or coughed, and then it's
transmitted to you by you rubbing your eyes or mouth. I heard it's very low
risk, but other than close contact with someone already infected, it's just
another way.

------
blackrock
What has been the efficacy of antibiotics on this virus?

Normally if you get sick, and it develops into bronchitis, the doctor just
prescribes you some antibiotics, the ZPack. Has that not helped in this
situation?

~~~
s_y_n_t_a_x
Antibiotics don't work for viral infections, only bacterial infections.

------
vackosar
Cov19 likely contains HIV like mutation making it more infectious and maybe
harder to build immunity to
[https://www.scmp.com/news/china/society/article/3052495/coro...](https://www.scmp.com/news/china/society/article/3052495/coronavirus-
far-more-likely-sars-bond-human-cells-scientists-say)

------
sigmaprimus
There is so much about this disease that is still unknown, the mere thought
that it might lie dormant then flare up again like some sort of herpes
infection(the mention bi-phasic but it could be much worse) is terrifying.

One possible positive if there is such a thing is that if "Wuhan Fever"
becomes a pandemic that kills off a large enough portion of the global
population maybe it will solve the global warming crisis or at the least slow
it down.

~~~
JamesBarney
The upside of your family dying in that car wreck is you'll save on your
health insurance each month.

~~~
sigmaprimus
Good point, but I would think even the current travel restrictions being
imposed by various countries must result is a reduction of greenhouse gas
production.

I would also imagine that there may be a reduction in holiday travel plans
just out of fear of being quarantined.

Not to mention the effect a global recession would have on CO2 production.

~~~
Fjolsvith
And, with global demand for oil dropping, gas will get cheaper!

