Talk:COVID-19/Archive 4

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ACE Inhibitors MAY or MAY NOT be linked to more severe disease

Please understand that this virus enters cells through cell surface proteins (receptors) and that its tropism (ability to infect a given tissue) is closely linked to the expression of ACE2. Inhibitors of ACE2 are used for hypertension.

• This isn't helpful. The subject is more complicated than this oversimplification. Specious conclusions are also harmful. Do not stop taking ACE inhibitors: current advice 3/28/2020

The key thing to know is that patients on ACE2 have a compensatory upregulation of ACE2, which predicts better viral spread within the host and a poorer outcome. https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf In fact, patients with hypertension more aggressive disease and more deaths. The suggestion that ACE inhibitors may prevent disease is not theoretical - it is harmful and may kill people if users read this and mistakenly distribute their prescriptions to loved ones. I will repeat my assertion. There is no need to talk about ACE inhibitors as beneficial. You may kill additional people with this information. — Preceding unsigned comment added by 2605:E000:1C0E:12E:F9A3:FD34:4830:E82F (talk) 18:04, 23 March 2020 (UTC)

Thank you. The up regulation of ACE2 in the lungs of people on ACE inhibitors appears to explain findings such as Lancet study where there appears to be a high proportion of non-survivors with hypertension/diabetes/CHD. Note that relatively fewer non-survivor's had chronic lung disease. Worth keeping a eye out on this debate. Whispyhistory (talk) 04:50, 24 March 2020 (UTC)

These pieces seem very relevant: [1], [2], and [3]. TylerDurden8823 (talk) 05:09, 24 March 2020 (UTC)

Thanks... American Heart Association, the Heart Failure Society of America, and the American College of Cardiology; "The evidence does not indicate any increase in adverse outcomes from COVID-19 associated with these drugs," ... and this. Whispyhistory (talk) 07:09, 24 March 2020 (UTC)

• http://theconversation.com/what-we-know-about-ace-inhibitors-high-blood-pressure-and-covid-19-133970:

"ACE inhibitors do not appear to directly affect the action of ACE2. Nevertheless, they may have indirect effects that could lead to an increase in the number of ACE2 receptors. This has led to concerns that ACE inhibitors may facilitate COVID-19 disease, particularly as these drugs are used in older people with other health issues who we know are at risk of more severe respiratory complications.

However, the situation is not necessarily that simple. Previous work with the related condition SARS showed that reduced ACE2 (and with it, increased angiotensin II) was associated with severe lung injury. Based on this, ACE inhibitors and ARBs, by reducing angiotensin II, might actually be expected to be protective against severe lung problems. In an attempt to address these opposing theories, there is currently a clinical trial which is examining whether the ARB drug Losartan may have benefits in patients with COVID-19."

CT Diagnosis

I keep seeing appearance of misleading information on CT scans re diagnosis. I pulled up full-text of this article cited: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003341/ I actually don't see anything re specificity in the article, nor even a stats summary re radiography (please let me know if I just missed it). The cited article seems poorly crafted in the first place. While I was going to just edit/update with proper content in context, I am deleting this citation & related content since I can't find the substantiating info in the fulltext.Xris0 (talk) 14:49, 24 March 2020 (UTC)

Subsection - Prognosis

theres this sentence: "However, the time lag in death occurring can mean the mortality rate is underestimated."

The wording is bad imho, because "the time lag" mentioned is not clearly defined. actually this is the only occasion the word "lag" occurs in the article at all.

looking at source 138 it becomes understandable, that some graph (probably used in the WP article and based on the source article) should be viewed with the background knowledge that it shows mortality based on "death within 14 days after being diagnosed with Covid-19, and because of this the graph would show higher mortality if its scope would be extended to deaths occuring later than 14 days after diagnosis.

(The relevant passage in the source https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext

"Global mortality rates over time using a 14-day delay estimate are shown in the figure, with a curve that levels off to a rate of 5·7% (5·5–5·9), converging with the current WHO estimates. Estimates will increase if a longer delay between onset of illness and death is considered") - but this is not clear from the cited sentence in the article, it makes sense only if one reads the cited source.

i belive that because of this lack of clarity the wording in the WP article needs to be changed - either remove the unclarified statement from the WP article, or elaborate on it so it makes sense without further need to read the cited surce just to make sense of what is said in the WP article. 89.134.199.32 (talk) 10:02, 21 March 2020 (UTC).

perhaps this poorly introduced "the lag" could be linked to this article: https://en.wikipedia.org/wiki/Statistics#Inferential_statistics for readers seeking a better understanding of it. also consider rewriting the sentence: "However, the time lag in death occurring can mean the mortality rate is underestimated" to something like this: "the statistical result of percentage of deaths attributed to the Covid-19 infection is also dependant on the time frame taken into account - while some statistics count Covid-19 fatalities only if death occurs within 14 days of the diagnosis, looking at a longer time period would yield more casualties - however some of those may not be due to the virus but to other unrelated causes." 89.134.199.32 (talk) 10:14, 21 March 2020 (UTC).

That isn't the statistical point being made here—the "time lag" discussed in the Lancet article is that deaths are the result of illnesses contracted in the past, so the number of deaths should be considered as a fraction of the cases contracted 2 weeks (for example) ago rather than the cases confirmed on the day they are reported. —Nizolan ^{(talk · c.)} 11:36, 23 March 2020 (UTC)

I reworded this to "However, the fact that deaths are the result of cases contracted in the past can mean the current mortality rate is underestimated". —Nizolan ^{(talk · c.)} 14:45, 23 March 2020 (UTC)

thanks for taking a look at it. 89.134.199.32 (talk) 23:05, 24 March 2020 (UTC).

Forks focusing on early research

We now have multiple WP:FORKs focusing on early stage research: in vitro, trials that have started but not reported, small studies. These include COVID-19 drug development and COVID-19 drug repurposing research. WP:MEDRS discourages such focus on early stage research. I think these articles give a false impression of the significance of such research. Tables like the one at COVID-19_drug_repurposing_research#Research_progression are done in good faith, but are woefully ignorant of WP:MEDASSESS, WP:MEDANIMAL and WP:MEDPRI. They give a false impression of the research.

I know editors are keen to do something and to track information, but tables like COVID-19_drug_repurposing_research#Research_progression and lists like COVID-19_drug_development#Clinical_trials_in_progress:_2020 and COVID-19_vaccine#Preclinical_research of ongoing trials run counter to years of work developing WP:MEDRS. They are not useful. The severity and novelty of COVID-19 doesn't change that.

Do others agree? If so, what do we do about it? Bondegezou (talk) 10:53, 22 March 2020 (UTC)

This new editorial is also relevant about the dangers of early research, even that published in scientific journals. Bondegezou (talk) 11:00, 22 March 2020 (UTC)

Would WP:NOTNEWS apply in these cases? Yours, Wordreader (talk) 11:09, 22 March 2020 (UTC)

Yes, absolutely. However, while I could go on mass deletions and cite WP:NOTNEWS, but I suspect that would go badly. I think we need to build up consensus on applying WP:NOTNEWS and WP:MEDRS and ensure the full editing community accepts that. Bondegezou (talk) 11:48, 22 March 2020 (UTC)

It would be great if that could be done. WP:NOTNEWS is policy so already has consensus from the community. In situations like this (in which I tend to think Wikipedia fails badly) what we have is enthusiasts and a willingness to go along with them so as not to cause friction. Alexbrn (talk) 12:17, 22 March 2020 (UTC)

Well, I've cut one particularly NEWSy section here. Bondegezou (talk) 13:53, 22 March 2020 (UTC)

Given the easiness effect in explanation of science to the general public, and Scharrer+'s recommendation to "explicitly [highlight] topic complexity and controversiality" in order to reduce the easiness effect, I think that MEDRS could reasonably be updated on the condition that research - including its full "complexity and controversiality" - is distinguished from "knowledge". This doesn't mean allowing homeopathy and other nonsense, but it does mean allowing the meta-level knowledge about ongoing research. Scientists make mistakes, have hunches, make statistical analysis or interpretation errors, and other scientists generally come along and disagree with what they see as wrong/misleading results. That's the reality of science. Boud (talk) 14:35, 22 March 2020 (UTC)

Most news sources should be avoided as they cause confusion and are not WP:MEDRS. Those articles seem to be a lot of copy pasting of other content and are probably just a repetition. There are at least 3 sub pages on treatments/vaccines/drugs and it might be a bit too much.

Also I agree that some of the tables and lists such as COVID-19_drug_repurposing_research#Research_progression look good at first sight but may be misleading. They might do more harm than good. I'll tag the author User:ProbablyAndrewKuznetsov who I think should be included in the discussion as he has put a lot of effort in those pages. More experienced editors will probably know how to handle this situation. To me it seems that most research should be handled on this page and on the drug's specific page. At least for now. --Gtoffoletto (talk) 14:40, 22 March 2020 (UTC)

Boud, I would oppose your suggestion. MEDRS has worked for years and is an established community consensus. All those issues have been considered in the past as part of the process to produce the current version. Now is not the time to change it. Bondegezou (talk) 14:44, 22 March 2020 (UTC)

Not currently sure what a good solution is, is there a way to keep the content while making sure to have disclaimers about the state of the research? I believe that removing it entirely is not going to help readers understand the state of 'COVID-19 Drug Repurposing Research', would modifications be sufficient? ProbablyAndrewKuznetsov (talk) 16:41, 22 March 2020 (UTC)

I think we should focus on MEDRS-compliant sources and on later stage research. There is plenty of literature: we can say many useful things. What is not useful is long lists of early stage research or links to ClinicalTrials.gov or links to news coverage. Adding disclaimers doesn't help if your content is fundamentally flawed. This just isn't territory Wikipedia can do well, and it's not what Wikipedia tries to do (as per WP:NOTNEWS). Make those changes and the articles will be shorter, so some merging may be appropriate.

Meanwhile, my earlier bold edit to the vaccine article on a WP:NOTNEWS basis has been reverted here. @BD2412: can I bring your attention to discussion here? Bondegezou (talk) 16:47, 22 March 2020 (UTC)

WP:NOTNEWS is intended to prevent the encyclopedia from being filled with things that seem important at the moment, but which will fail to be important in the long term. The extent to which entities set out to develop a COVID-19 vaccine will always be of historical significance. To remove that would be no more useful to the encyclopedia than claiming WP:NOTNEWS as a reason to remove accounts of early attempts at human flight preceding the Wright brothers effort (we have an entire article just on the efforts). Of course, we can always refine the presentation of the information. BD2412 T 17:12, 22 March 2020 (UTC)

Respectfully, Bondegezou, the COVID-19 pandemic is an unfolding current event for which the encyclopedia provides a public service of objective information. On Wikipedia are countless such articles that were or still are changing rapidly, such as last year's Mueller investigation (among many others), which had disputes and content or source changes almost hourly over a long time. COVID-19 drug development created yesterday is not a news article, but is rather the status of the emerging vaccine or therapeutic drug story as a reference for the public. Created just 2 weeks ago, the COVID-19 vaccine article has already had 157,000+ page views. MEDRS can be applied to these articles - such as yesterday's CDC update - but it is unrealistic to expect MEDRS-style journal review articles for such a short-term, rapidly changing health emergency. --Zefr (talk) 17:31, 22 March 2020 (UTC)

Yes, these pages are getting lots of hits, but they are not providing "a public service of objective information". Chunks of the articles described above are not good enough. A random scattering of unscientific news reports and misinterpreted early research is more likely to add to misinformation (see [4], for example). The scientific literature on COVID-19 has exploded and there's plenty to use: we can respect WP:MEDRS and say useful things. We don't need the citations to newspaper articles, university press releases, and clinical trial registries for starters.

We can deliver MEDRS-style articles. We can deliver a real public service. Bondegezou (talk) 19:57, 22 March 2020 (UTC)

In the weeks and months ahead better quality data and sources will emerge. As they emerge we can then replace the lower quality sources or outdated sources and with time the article will become more compliant with strict MEDRS standards. I do not agree with deleting information that is not strictly compliant with MEDRS, unless there is justification, e.g., it is inaccurate, fringe, discredited, outdated, etc. Most information is poor quality because this is a new disease.--Literaturegeek | T@1k? 20:16, 22 March 2020 (UTC)

Wikipedia has never included every scrap of information. We have policies coming out of our ears prohibiting that. That is the justification for chopping a lot of the material in the articles under discussion.

Nor is there any need to wait for "the weeks and months ahead" in which "better quality data and sources will emerge". We have good stuff now in good medical journals that is not being used, while articles fill up with citations to press releases or news stories. Why don't we do away with the lower quality sources now? Bondegezou (talk) 20:22, 22 March 2020 (UTC)

I agree here with Literaturegeek. The Ioannidis article is not a MEDRS source. It is an editorial opinion - probably correct - addressing the clinical response to COVID-19. Most editors here, myself included, are rigorous defenders of MEDRS. The articles in question in this discussion are about vaccine/drug development where cross-referenced news and government reports are the best collections of information that science editors can understand and convey accurately in the respective articles. --Zefr (talk) 20:21, 22 March 2020 (UTC)

You have just dismissed an editorial in European Journal of Clinical Investigation, a decent medical journal, and then you defended the likes of an article in TechCrunch (one of the examples used at COVID-19_vaccine#Preclinical_research). Generally speaking, does MEDRS prefer editorials in decent medical journals or news article in non-medical online news publishers? Bondegezou (talk) 20:53, 22 March 2020 (UTC)

Ioannidis's piece is fringe (and has been attacked as such[5]). As soon as we give up on WP:MEDRS we might as well all go home, because everything medical is then fucked. I am well aware however that many editors would be content to see Wikipedia sink to the level of the media in general. Alexbrn (talk) 21:06, 22 March 2020 (UTC)

Agreed on MEDRS, Alexbrn. How do we best push on MEDRS then? For example, as I understand it, BD2412 is arguing that COVID-19 vaccine does not even come under MEDRS at Talk:COVID-19_vaccine#Wikipedia_is_not_a_newspaper (this edit). Input would be welcome there. Bondegezou (talk) 21:23, 22 March 2020 (UTC)

That is a complete misrepresentation, to the point of constituting a WP:PERSONAL ATTACK, and you will be sanctioned if you continue. I have only contended that reporting in reliable sources regarding companies and entities that are undertaking vaccine development efforts should be included. If corporation X or national agency Y announces that it is working on a vaccine, that is not a biomedical claim falling under WP:MEDRS. If you try to "push on MEDRS" with respect to these things, you'll only end up breaking it and damaging your own credibility. BD2412 T 21:48, 22 March 2020 (UTC)

Agree with the above. WP:MEDRS-> relates to medical claims. Any reputable source can be used for the rest. (entities working on vaccine etc. However I believe it will be hard to keep track of any announcement. As the whole world is working on this. Some criteria for inclusion would probably help.--Gtoffoletto (talk) 21:58, 22 March 2020 (UTC)

Alexbrn, we are in the beginning of major pandemic and thousands of people are dying. These critically ill people do not have time for pedantic strict interpretations of MEDRS that could withhold information that could reduce the spread of the disease or treat it. These researchers, critically ill patients and doctors require information now. Society does not have time to wait for high quality doubled blinded randomised trials followed by meta-analyses and systematic reviews to emerge six months to one year from now. All we can do is aim to provide the best available, often preliminary experimental data, to the public and professionals who refer to Wikipedia as a starting point for information. People are dying. Yes, we must exclude information that is not important, outdated, obviously incorrect, discredited, etc and we can do that via consensus, not a problem lots of good medical editors on this page to do that.--Literaturegeek | T@1k? 22:31, 22 March 2020 (UTC)

This is an encyclopedia, meant to give a summary of accepted knowledge about topics. Wikipedia must not give medical advice, so it is absolutely not our job to include what (us amateur editors think) might "reduce the spread of the disease or treat it" based on our pick of any unreliable sources. The idea that it's our job to decide what "critically ill patients" or "doctors" need to know is arrogant and dangerous, if not deluded. Alexbrn (talk) 02:17, 23 March 2020 (UTC)

I never suggested we should instruct readers (researchers, healthcare professionals, the public) what to do. I never edit articles telling readers what to do on any subject matter. But the fact is desperate family members and doctors are searching out information online because this is a new illness. It is arrogant, dangerous and deluded to think that us editors should decide to withhold the best available emerging research because it fails a strict interpretation of MEDRS, a guideline that was never designed for an urgent pandemic global threat. I would expect members of the public reading our content would discuss any information found online with their doctor and ultimately be guided by their conclusions.--Literaturegeek | T@1k? 02:50, 23 March 2020 (UTC)

"Best available" according to whom? You? I'm not arguing for a "pedantic" application of MEDRS, but for basic observation of its core principles, as set out (for example) in its opening sentences. The idea that "critically ill patients" need our inexpert hot take on the research scene just shows how far through the looking glass we now are. Alexbrn (talk) 02:51, 23 March 2020 (UTC)

Not me, but consensus of editors, I have done very little editing of this article. Like I said we don’t have time to wait for those high quality sources to emerge summarising high quality data, people are dying. MEDRS compels us to use the best available sources which in rare cases (like this one) means primary sources, (which are not banned but discouraged by MEDRS).--Literaturegeek | T@1k? 02:55, 23 March 2020 (UTC)

I don't think anyone is advocating against using primary sources. It is clear that research is at an early stage for this. I think we all agree that we should strive to provide high quality of information while conforming to MEDRS as much as possible. I think we are losing a bit the aim of this discussion. It's not really clear what we are talking about anymore. Could we summarise the discussion with a clear support/oppose vote? Maybe User:Bondegezou should do it since he started the thread? --Gtoffoletto (talk) 10:45, 23 March 2020 (UTC)

agree w/ Gtoffoletto on all points --Ozzie10aaaa (talk) 13:10, 23 March 2020 (UTC)

The role of WikiJournals at this juncture

I've made a post that might be relevant over at WT:MED. T.Shafee(Evo&Evo)^talk 23:34, 24 March 2020 (UTC)

High quality review article on experimental treatments

• [6]

Doc James (talk · contribs · email) 00:06, 25 March 2020 (UTC)

Hey User: Doc James - back from MENA and in some downtime as all elective work stopped. If you need anything researched or graphics for this please point me in a useful direction. Ian Furst (talk) 01:46, 25 March 2020 (UTC)

User:Ian Furst a bunch of these need updating daily.[7] You will find them used in various pages. Doc James (talk · contribs · email) 01:50, 25 March 2020 (UTC)

OK - I've been watching the stats and didn't want to step on toes. I thought I saw theat the main graph is templated - are the country updates done at a particular time by a single person or group sourced? Ian Furst (talk) 01:54, 25 March 2020 (UTC) Disregard, I see it's the png version of the iframes that need updating in commons. On it. Ian Furst (talk) 02:05, 25 March 2020 (UTC)

May I upload this PDB file?

Protein Data Bank published a "colouring book" (Line drawing) for coronavirus 2019 (Sars cov2). (link: [8]https://pdb101.rcsb.org/learn/coloring-books/coloring-coronavirus). May I recolour and upload this file (through Wikimedia commons)? Would it flouth copyright policies?

Also is it okay to upload any PDB structures as wikimedia commons images?

RIT RAJARSHI (talk) 15:43, 24 March 2020 (UTC)

@RIT RAJARSHI: All of Goodsell's Molecule of the Month items are under CC BY 4 (link to statement). This is technically not part of that series, however I've found Goodsell to be very on-board with wikimedia movement, so would likely response if asked by email or on twitter. T.Shafee(Evo&Evo)^talk 00:11, 25 March 2020 (UTC)

Thank you. 2409:4060:8C:9130:99FF:3445:EF8E:D7CD (talk) 05:51, 25 March 2020 (UTC)

Anonymised cell phone movement profiles are not private data

Hi ☺ the data, which Deutsche Telekom shared with Robert-Koch-Institut RKI, is not private data, but anonymised movement data only. The source used is wrong in that aspect. Respectable German-language source which explicates on the data protection measures and details is here. The same data is habitually used to optimise public transport, it is all done in compliance with one of the most privacy-strict legal systems globally; there even is a Deutsche Telekom subsidary solely dedicated to mining this movement data, they're called Motionlogic. Please remove the misleading adjective "private" and replace it with the fact-adequate one "anonymised". Thank you. --92.195.220.14 (talk) 17:01, 21 March 2020 (UTC)

Not doneDone with changes It is non-trivial to anonymise location data because people generally travel between their home and workplace (etc) and this data constitutes a unique identifier. As such movement data should be considered private, not anonymised, until convincingly referenced otherwise. The article you reference says that the data is grouped into cohorts of 30. This does not constitute anonymity because it would be straightforward to correlate a list of 30 homes and 30 workplaces with (e.g.) tax data to generate a list of the 30 people's names. User:GKFX^talk 16:16, 22 March 2020 (UTC)

IMO that's largely irrelevant. We need to be guided by what sources say. The problem here is we're using TRT World which IMO is questionable given the often fraught relationship between Turkey and Germany nowadays and the possibility this is in biased in the direction of making Germans companies and institutions look bad. Nil Einne (talk) 08:31, 23 March 2020 (UTC)

We should of course follow what sources say. However describing location data as "anonymous" is an WP:EXTRAORDINARY claim for the reasons described above so unless the source clearly justifies that word I do not believe it should be repeated. The description of the anonymization given by the Heise article, via Google Translate is:

A data set contains data from around 30 users. So the data is obviously not broken down into individual devices, but into groups of 30 people. However, individual people or people infected with the corona virus are not tracked. The anonymized location data of all users are passed on. The measures for anonymization are coordinated with the data protection authorities and in accordance with data protection.

There are other, more apt descriptions of the treatment of the data, based on the source. For example, "aggregated phone location data" would be an accurate replacement for the current text "private cellphone data". In terms of picking a more reliable source than TRT, why not switch to (or add) the Heise article? User:GKFX^talk 16:26, 23 March 2020 (UTC)

I think you misunderstand. I'm not suggesting we say anything about anonymous. I'm saying we cannot say this was sharing private data if the only source is TRT. Probably the info should just be removed if the only source is TRT. There's no reason we should be digging the bottom of the source barrel for an article like this one. Maybe if this was the Germany article, it would be more acceptable to mention something which no one but TRT has noticed, but not for this article. If the Heise article supports the claim of sharing private data, then it can be added and maybe it will be acceptable. Since I don't understand German, I can't comment on that part. And I emphasise again, our personal views of whether the data is anonymous or private is irrelevant. What matters is what the sources are saying. Nil Einne (talk) 05:42, 24 March 2020 (UTC)

Okay I see, many thanks. I have used my suggested phrasing ("aggregated phone location data") and replaced TRT with the Heise article as a source. FWIW, the Heise article says roughly the same things as the TRT article, but the Heise article has more detail and different spin regarding privacy. Ultimately, both of the words "private" and "anonymized" are subjective so I have used neither. User:GKFX^talk 16:40, 25 March 2020 (UTC)

Anosmia

(merged from section: "Smell") ENTUK just published this on loss of smell (anosmia) and COVID-19. Whispyhistory (talk) 14:48, 21 March 2020 (UTC)

Hello. Should anosmia be added to the symptoms? See: Kate Ng (21 March 2020). "Coronavirus: New symptom of virus could be loss of taste and smell, top UK doctor says". The Independent. Retrieved 21 March 2020. 83.228.162.170 (talk) 18:59, 21 March 2020 (UTC).

That would require a medical-standard reliable source, see WP:MEDRS for policy. In short not a newspaper. User:GKFX^talk 16:18, 22 March 2020 (UTC)

The New York Times is reporting the same. Given the urgency of the situation, I'd say we should be on the lookout for MEDRS-compliant sources to avoid any unnecessary delay. Would this an acceptable source for any kind of statement about anosmia: https://www.entnet.org/content/coronavirus-disease-2019-resources —Granger (talk · contribs) 02:49, 23 March 2020 (UTC)

I added anosmia to the symptoms section citing Mx. Granger's source and one from the UK. User:GKFX^talk 17:09, 25 March 2020 (UTC)

Prognosis- COVID 19 in pregnancy

The statement "Pregnant women are at particular risk for severe infection" is misleading and is not consistent with what is stated in the article that it is linked to. This should probably read something like, "Pregnant women MAY be at increased risk based off of similarity to MERS and SARS, but there is no evidence that has demonstrated this in COVID 19". what do you think? This seems misleading to me. — Preceding unsigned comment added by 204.195.147.127 (talk) 17:58, 25 March 2020 (UTC)

I reviewed the sources and agree with you. Thank you for bringing this up. Moksha88 (talk) 19:11, 25 March 2020 (UTC)

Title

I thought Wikipedia went with the common name. I have never before seen the designation "Coronavirus disease 2019" except with "Covid-19." Why aren't we using Covid-19 (which is a shortened form), which is commonly used? 37.99.32.93 (talk) 16:15, 21 March 2020 (UTC)

A Google Scholar search yields 1320 hits for "Coronavirus disease 2019", but 13,300 for "COVID-19". References to "Coronavirus disease 2019" are nearly always followed by "(COVID-19)". I would favour moving to "COVID-19". Bondegezou (talk) 16:36, 21 March 2020 (UTC)

I agree that "Coronavirus disease 2019" is an awkward name and that no one actually uses it except to preface the name "COVID-19". There would also be no ambiguity in using "COVID-19". A month ago this was discussed, but a lot has changed in a month. Should a new move request be made? Prinsgezinde (talk) 17:19, 21 March 2020 (UTC)

Wikipedia tends very strongly to discourage abreviations in article titles. Just look at Severe acute respiratory syndrome, which has been that way for 15 years. Since, there is also an ongoing discussion for a 1 month moratorium on moves Talk:2019–20_coronavirus_pandemic#Proposal:_Move_moratorium — it would be better to take this up there. A new request is likely to be Speedy-closed without properly discussing things first. It seems that even in this discussion it isn't clear what the suggestion is, whether it be "Covid-19", "COVID-19", "Coronavirus disease 2019 (COVID-19)", Coronavirus disease (COVID-19)", "2019 Coronavirus disease", "2019 Coronavirus disease (Covid-19)", or "2019 Coronavirus disease (COVID-19)". Carl Fredrik ^talk 18:02, 21 March 2020 (UTC)

To say "Wikipedia tends very strongly to discourage abbreviations in article titles", and use SARS as a chief example, is balderdash. It's in the Manual of Style to use acronyms "...in a page name if the subject is known primarily by its abbreviation and that abbreviation is primarily associated with the subject... In general, if readers somewhat familiar with the subject are likely to only recognise the name by its acronym, then the acronym should be used as a title." The SARS article is titled "Severe acute respiratory syndrome" to disambiguate between the disease, the virus that causes it (SARS-CoV), the virus that causes COVID-19 (SARS-CoV-2), and the many other things that happen to be abbreviated "SARS". Contrast this with HIV, and HIV/AIDS, which are known primarily by the acronyms and the acronyms are unambiguously referring to the virus and disease. There are lots of articles with acronyms in the title: NASA, UNESCO, UNICEF, CT scan, Laser, Radar, Lidar, Sonar... COVID-19 is unambiguous, in the popular lexicon, and commonly used by official sources such as the WHO, CDC, Health Canada, etc.

This article was moved from "2019-nCoV acute respiratory disease" to the current title on Feb. 19. "COVID-19" was put forward as the new title at that time, but "Coronavirus disease 2019" was the compromise at the time because "COVID-19" was not clearly the common name. Well, a lot has happened in the last month, and it seems quite clear that COVID-19 has become the most common name now. It's just a matter of time before an overwhelming tide of people question why this isn't titled "COVID-19". CplDHicks2 (talk) 05:27, 26 March 2020 (UTC)

Reproduction Life Cycle of this virus.

Wikimedia commons contain several images of coronavirus reproduction; the following one (with detailed text) seems to be very helpful. File:Coronavirus replication.png I plea to add this diagram to COVID-19 article, preferably with large preview. The image has been used in several other COVID-19 and SARS-Cov-2 articles viz https://id.wikipedia.org/wiki/SARS-CoV-2 (which language), Hindi , https://ban.wikipedia.org/wiki/Coronavirus_2019-nCov (which language?) , https://ca.wikipedia.org/wiki/Pand%C3%A8mia_per_coronavirus_de_2019-2020 (which language?), etc. I pray wikipedia community to kindly add the image to English wikipedia too.

Regards. RIT RAJARSHI (talk) 16:47, 25 March 2020 (UTC)

The diagram is already in the coronavirus article. It does not belong here, and we must be careful with such diagrams because not all coronaviruses have the exactly the same replication cycle. Graham Beards (talk) 13:44, 26 March 2020 (UTC)

Discussion on cartoonishness of graphics used in this article

 You are invited to join the discussion at Talk:Social distancing#Cartoonishness of graphics. Sdkb (talk) 18:29, 24 March 2020 (UTC)

thank you for post--Ozzie10aaaa (talk) 16:02, 26 March 2020 (UTC)

Origin

So short story : I was looking for sources that would confirm the Wuhan origin. How strong those sources are etc. Because as I understand it, the more the virus is detected across the globe, the least plausible the origin at Wuhan become, I looped back here because that's what this article was saying. But as I read our own sources, it says "origin unknown". So I just aligned our text with our sources. I'm happy with this, I will keep searching for a good scientific origin source for a while, but i'm not expecting any.

This being said, I think we can't deny the common belief that the first case happened in January at Wuhan. I can't bother searching sources to make it NPOV. So tomorrow I will neutralize my own POV with an OR. If someone have sources for the origin at Wuhan, please do not hesitate. Iluvalar (talk) 23:28, 23 March 2020 (UTC) EDIT "We do not know the exact source of the current outbreak of coronavirus disease 2019", CDC [9]. Iluvalar (talk) 23:32, 23 March 2020 (UTC)

"Because as I understand it, the more the virus is detected across the globe, the least plausible the origin at Wuhan become" ...according to what source? This doesn't make sense. "We do not know the exact source of the current outbreak of coronavirus disease 2019"' ...the CDC is referring to the animal origin, not the location of initial outbreak. The location of origin is Wuhan, China. I haven't seen any legitimate source state otherwise. - Wikmoz (talk) 01:09, 24 March 2020 (UTC)

Why doesn't it make sens ? We can assume that miraculously the virus became super mutant and both acquired extreme deadliness and growth at the same time. That would be 2 super mutation at once... or we can suppose that it's only super deadly with a normal growth rate and just reassess the amount of people contaminated before Wuhan to explain the whole situation we face. To me, each new cases we find with this unnatural growth rate is just another nail in the coffin of the Wuhan origin scenario. Do you have that source that state that the origin of the virus (not the first case) is from Wuhan ? The source we do have in the article right now say "unknown". Iluvalar (talk) 02:38, 24 March 2020 (UTC)

Iluvalar - The Wikipedia "2019–20 coronavirus pandemic" article gives the first case as occurring on 1 December 2019 in Wuhan:

"The earliest person with symptoms was soon traced back to 1 December 2019, someone who did not have visible connections with the later wet market's cluster.[217][218]"

• 217. Cohen, Jon (January 2020). "Wuhan seafood market may not be source of novel virus spreading globally". Science. doi:10.1126/science.abb0611. Article link = [10]
• 218. Wang, C.; Horby, P. W.; Hayden, F. G.; Gao, G. F. (February 2020). "A novel coronavirus outbreak of global health concern". Lancet. 395 (10223): 470–473. doi:10.1016/S0140-6736(20)30185-9. PMID 31986257. Free to read. Article link = [11]

This particular coronavirus certainly spreads like wildfire and is at least 10 x deadlier than the flu, maybe more, but far less so than the MERS outbreak in Saudi Arabia in 2012. That death rate was about 36%. YIKES! Yours, Wordreader (talk) 04:21, 24 March 2020 (UTC)

• "Lucey says if the new data are accurate, the first human infections must have occurred in November 2019—if not earlier—" from first source you gave "Wuhan seafood market may not be source of novel virus spreading globally"
• I don't see a mention of the first case in the lancet. Hmmm, I only see "Cluster of cases of pneumonia of unknow origin" in the timelime image only, am I missing something ?

Iluvalar (talk) 05:12, 24 March 2020 (UTC)

I was one of the early advocates for removing "Wuhan" from the original title of the outbreak article, "2019-20 Wuhan coronavirus outbreak," and started the discussion that got the topic renamed. According to the cited Lancet article, while patient zero may not have been associated with the wet market, there's no indication that he wasn't a Wuhan resident. And yes, based on genetic analysis, this started in Wuhan, China and spread around the world. - Wikmoz (talk) 05:22, 24 March 2020 (UTC)

This is a very impressive graph Wikmoz, I didn't know there was all this data available on the internet like that. It's great ! But how the first hypothetical case was set by this graph ? We have enough source here alone to explain how the origin could be guessed there in january, but was there more information that we don't have to confirm this graph decision.

I'm going deep in genetic, more then comfortable, but is there any sure way to know which mutation came first ? I see for example a case in Washington with "divergence 9". A common ancestor could easily exist between our hypothetical point 0 and this one. As I understand it with this data only. Correct me if i'm wrong. Iluvalar (talk) 17:21, 24 March 2020 (UTC)

EDIT: This is a 3 day old source "The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir." -- CDC [[12]] This doesn't look to me like someone who point directly Wuhan at all. Iluvalar (talk) 17:45, 24 March 2020 (UTC)

I've seen "unknown", "Wuhan," and "Wuhan pneumonia" in infoboxes. The first reported cases have been Wuhan. Reliable sources have said this including UptoDate, and the situation summaries/reports of the CDC and WHO. Yes, some have gotten sick from the seafood market and some haven't but that's not a reason to put "unknown." Most of the problem is poor use of epidemiological terminology. I believe that it's best to change "Origin" to "First Reported: Wuhan", "Emerged in Wuhan", or something similar because "first reported" isn't technically "origin." One more thing to point out, "origin" denotes "source" or "reservoir" which isn't the same as where it came from. COVID-19 (SARS-CoV-2) origins is a batcoronavirus. To say where the virus came from, the term "endemic" is appropriate, however, there hasn't been enough research into that. -DustyGoliath 18:14, 24 March 2020 (UTC)

I stand corrected, I will avoid the word "origin" as it mean 3-4 things in this case. I'm looking for the first human to human transmission. I agree with you on this point, more research needed. But I see enough people, governments included, who point to wuhan for the first infected. I'd like to include that POV. Iluvalar (talk) 19:09, 24 March 2020 (UTC)

Found one ! [13]. "Other experts cast doubt on the hypothesis that the new virus could have been circulating in Europe before the end of 2019." ::That's what I was looking for. Iluvalar (talk) 19:17, 26 March 2020 (UTC)

out of subject ?

Just another Scientist (talk) 07:15, 24 March 2020 (UTC)"The virus remained viable in aerosols throughout the time of the experiment (3 h).[43]" This statement is pertinently not true for real life conditions. The article first of all showed decay, and it was performed without considering UV light exposure and dispersion of aerosols. This is a nice lab-experiment, but cannot be extrapolated to the situation in real life because it was conducted in a so-called Goldberg drum. The problem of which many "scientific" experiments suffer.

Transmission / Prevention

Transmission Rate – Number of a newly infected person from a single person. The transmissibility rate is how fast or rapid disease spreads from one person to another. This represents the average number of people infected by a single person.

• WHO's estimated (on Jan. 23) Transmission Rate to be between 1.4 and 2.5.
• Other studies have estimated a Ro between 3.6 and 4.0, and between 2.24 to 3.58.

Prevention Measures:-

1. Wash your Hands often after coming from outside.
2. Cover your face with the mask.
3. Carry Sanitizer with you while going outside.
4. Use sanitizer having at least 60% alcohol.
5. Social Distancing is most important to protect you against Coronavirus covid-19.

Rajnahar51 (talk) 08:14, 24 March 2020 (UTC)

https://www.technologyreview.com/s/615399/coronavirus-neural-network-can-help-spot-covid-19-in-chest-x-ray-pneumonia/?utm_medium=tr_social&utm_campaign=site_visitor.unpaid.engagement&utm_source=Twitter#Echobox=1585072267

https://radiopaedia.org/articles/covid-19-3?lang=us

https://radiomd.com/audio-player/nmhpeer/item/41866-examining-the-connection-between-covid-19-and-pneumonia?sf119428101=1

https://www.gatesfoundation.org/TheOptimist/Articles/coronavirus-mark-suzman-therapeutics

Referente COVID-19 + PNEUMONIA Ana Gauna (talk) 21:15, 26 March 2020 (UTC)

Close-range aerosol transmission exists

• The WHO, CDC, and the Chinese Center for Disease Control ALL use language that explicitly describes the existence of close-range aerosol transmission. As a reminder, Wikipedia states an airborne disease is any disease that is caused by pathogens that can be transmitted through the air by both small, dry particles, and as larger liquid droplets [14].
  • The WHO states, "COVID-19 appears to spread most easily through close contact with an infected person. When someone who has COVID-19 coughs or sneezes, small droplets are released and, if you are too close, you can breathe in the virus" [1,5]
  • The CDC describes SARS-CoV-2 transmission as primarily by droplets from coughs or sneezes, which "land in the mouths or noses of people who are nearby or possibly inhaled into the lungs" [1,6]
  • It is my opinion that this page is citing public facing documents from the CDC and WHO. The various less cited documents aimed at healthcare workers, also from the CDC and WHO, contradict the public facing statements with respect to the airborne nature (WHO: you can breathe in the virus, CDC: possibly inhaled). It is my opinion that this kind of public facing "happy talk" messaging is a disservice to public health. Given emerging evidence that asymptomatic and pre-symptomatic people can aerosolize the virus in unventilated areas by talking loudly or singing [2], there are implications for offices and places of worship.
• The Chinese Center for Disease Control and Prevention says that COVID-19 transmission occurs primarily by respiratory droplets and close contact, with the "possibility of aerosol transmission in a relatively closed environment for a long time exposure to high concentrations of aerosols." [1]
• A recent non-peer-reviewed report from Germany supports aerosol transmission of COVID-19 at close range because of the high viral density in the back of the throat and sputum (not just the lungs) [1,3]
• another recent non-peer-reviewed article demonstrates that COVID-19 aerosols can be present in healthcare settings [1, 4]
• Inhalation of very small particles near the source may be an important mode of transmission. Larger droplet transmission is probably much less important [1]
• In unventilated areas, singing and shouting can produce aerosolized version of the virus, according to a senior Korean infectious disease authority with 30 years of experience, who went through SARS, MERS, Swine flu, etc. When members of a Korean religious group met in closed quarters, the singing and shouting produced small droplets that, combined with air movement, dried up the droplets into an aerosolized version. This authority is saying that coughing and sneezing are not the only means of creating droplets, and droplets can be produced through the normal behaviors of non-symptomatic and pre-symptomatic people [2]

Some national health authorities recommend healthy people wear masks

• The public in Korea is encouraged to wear masks. The government literally provides the needed materials to sewing clubs to make the appropriate masks [7].
• A key factor pushing authorities to advise against masks is supply, not science [8]. In addition, there are rumors circulating that people will feel too confident with masks, and so they shouldn't hear the truth that masks help. Wikipedia should be spreading scientifically backed facts, not harmful rumors.
• PLEASE BE FAIR TO ASIAN CULTURES AND REFERENCE THE HEALTH AUTHORITIES IN PARTS OF CHINA [8], HONG KONG [9], AND SOUTH KOREA [11] THAT ENCOURAGE MASK WEARING TO REDUCE BOTH OUTGOING AND INCOMING INFECTION. THESE ARE COUNTRIES THAT HAVE OBJECTIVELY DONE THE BEST AT REDUCING THE INTRA-COUNTRY SPREAD OF COVID19. WEARING A MASK IS A CIVIC DUTY IN MUCH OF ASIA SINCE THE 1918 PANDEMIC [10]. #MASKS4ALL
• Here is a list of over 41 papers that support the case that masks reduce disease transmission [13].

Asymptomatic spreaders exist, and may be super-spreaders

• The CDC Director now says: "you have individuals that may not have any symptoms that can contribute to transmission, and we have learned that in fact they do contribute to transmission." [12]
• This article hedges and states "spread may be possible before symptoms appear", and "Preliminary evidence suggests asymptomatic cases may contribute to the spread of the disease", which is outdated after this revelation by the CDC Director.

[1] http://www.cidrap.umn.edu/news-perspective/2020/03/commentary-covid-19-transmission-messages-should-hinge-science This CIDRAP article here has full citations to the primary sources and is put together by Dr. Brosseau, a national expert on respiratory protection and infectious diseases and professor (retired), University of Illinois at Chicago. CIDRAP is in a top 10 public health school, the University of Minnesota.

[2] https://www.youtube.com/watch?v=gAk7aX5hksU&feature=youtu.be This is the interview with a senior Korean infectious disease expert who describes what Korea has learned after dealing with SARS, MERS, Swine flu, COVID-19, and how COVID-19 can be aerosolized by talking loudly and singing.

[3] https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf

[4] https://www.biorxiv.org/content/10.1101/2020.03.08.982637v1

[5] https://iris.wpro.who.int/bitstream/handle/10665.1/14482/COVID-19-022020.pdf

[6] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Ftransmission.html

[7] https://www.youtube.com/watch?v=VN1DfpALj5Y

[8] https://www.sciencemag.org/news/2020/03/would-everyone-wearing-face-masks-help-us-slow-pandemic

[9] https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30134-X/fulltext

[10] https://qz.com/299003/a-quick-history-of-why-asians-wear-surgical-masks-in-public/

[11] https://www.medscape.com/viewarticle/927723

[12] https://www.npr.org/sections/health-shots/2020/03/31/824155179/cdc-director-on-models-for-the-months-to-come-this-virus-is-going-to-be-with-us

[13] https://docs.google.com/document/u/0/d/1HLrm0pqBN_5bdyysOeoOBX4pt4oFDBhsC_jpblXpNtQ/mobilebasic?fbclid=IwAR1c-_QzUKkdlrftHmYXt7dQIsY2a_lEC7t1ct2ETiE4Qq2FYXJ9_TKfCrk

[14] https://en.wikipedia.org/wiki/Airborne_disease

Zoombyflip (talk) 22:13, 26 March 2020 (UTC)

WHO handrub formulas

The hydrogen peroxide in the WHO formulations for alcohol-based hand sanitizers is explicitly stated not to contribute to the antiseptic effect; it's to combat bacterial spores in the alcohol. I changed that.

The instructions, dating from 2009 in this source, were intended for healthcare use in remote areas, not as a homemade substitute. That's why the instructions are for producing one to fifty liters at a time. I didn't add that, but I changed "suggested" to "provides" because "suggested" made it sound like WHO has provided these instructions in response to COVID-19, which is not the case. Some news organizations have used the WHO guidelines to counteract improper recipes for homemade hand sanitizer, but that's not their purpose.

I don't like the statement, in general, but I left it, because some editors might think it's better than having people trust a recipe that doesn't work. This one will, if the proper materials are used and the procedure is followed. There are also flammability and toxicity hazards associated with handling ethanol or isopropanol. Roches (talk) 01:56, 27 March 2020 (UTC)

Hub for Open Source projects, related to Coronavirus prevention with Softwares and Data Analysis

Actually there is a fragmentation on the net, happening due to an huge number of projects, all related to the prevention of virus diffusion among the population.

To concentrate the efforts, and also have a single source of information, for software development purposes, there's a project on GitHub where there are different sources, useful for data analysis and software development. — Preceding unsigned comment added by Skunder738 (talk • contribs) 11:13, 27 March 2020 (UTC)

Removal of an outdated reference

The CDC page on symptoms of COVID-19 archived in January is still being used as a reference in the article. This page consists only of incubation period reported based on MERS, and just three symptoms of COVID-19, based on what we knew of COVID-19 in January. I think we should replace older citations like this one and add more recent, high quality citations in its place.--Netha (talk) 10:38, 27 March 2020 (UTC)

which specific ref did you have in mind--Ozzie10aaaa (talk) 23:10, 27 March 2020 (UTC)

That page was last updated March 20th 2020.[14]

So no need to change it. Doc James (talk · contribs · email) 20:14, 28 March 2020 (UTC)

Source point origin of this outbreak.

OK, China, but how & where? A report I read said the drain and waste and vent system (DWV), in a high rise building was source point because of plumbing code violation. The International Assoc. Plumbing Mechanical Officials, (I.A.P.M.O.) has a report that was done with the WHO. My interest here is to cite the actual source point, not the stigmatic identity of origin. If the consensus is best facts reviewed, then we can include this info. here. A good reason to know actual source point is to prevent such arrangement that creates the possibility of a repeat in the future. The credo of the Plumbers is to "Protect the health and safety of the nation" May I add the world.. I have some documents I could share, I am involved in this as a professional. This is only create facts clarity and add to resolve, not to cause problems. — Preceding unsigned comment added by Greg Chick (talk • contribs) 20:25, 26 March 2020 (UTC)

Unknown from what I understand. Refs required. Doc James (talk · contribs · email) 20:15, 28 March 2020 (UTC)

illogical sentence about masks

This starts by talking about infected and possibly infected people and then talks about protecting them from infection:

Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask when exposed to an individual or location of a suspected infection... --Espoo (talk) 14:47, 26 March 2020 (UTC)

WP:SOFIXIT. I would change an individual or location of a suspected infection to simply people or a location people frequent.--Literaturegeek | T@1k? 14:51, 26 March 2020 (UTC)

Most of my time on WP is spent on copyediting, but here it was and is impossible to know what is meant. Your proposal doesn't fix the illogical use of "exposed" when referring to those who are already infected. --Espoo (talk) 16:33, 26 March 2020 (UTC)

I have fixed it, thank you for bringing it to the attention of the community. :-)--Literaturegeek | T@1k? 17:17, 26 March 2020 (UTC)

Would be good to brake that into separate sentences. Doc James (talk · contribs · email) 20:16, 28 March 2020 (UTC)

Prognosis picture

added a new chart in the gallery but image 4 is blocking out image 1 for some reason. anyone? Ian Furst (talk) 13:19, 26 March 2020 (UTC)

User:Ian Furst to what do you refer? Can you provide a dif of your edit. Doc James (talk · contribs · email) 20:45, 28 March 2020 (UTC)

User:Doc James already fixed. Also - Our World in Data has a bunch of new charts up. Let me know any you want to add and have updated daily. Ian Furst (talk) 21:03, 28 March 2020 (UTC)

Transmission

This was accurate so restored it "Respiratory droplets may be produced during breathing but the virus is not considered airborne."

Doc James (talk · contribs · email) 03:38, 29 March 2020 (UTC)

WHO makes this clear that it is not generally airborne.[15]

Also consensus is here Talk:2019–20_coronavirus_pandemic#Highlighted_open_discussions Doc James (talk · contribs · email) 03:40, 29 March 2020 (UTC)

References

Regular exercise, good sleep and probiotics

This study "2019 Novel coronavirus infection and gastrointestinal tract" has:

Currently, there is no direct clinical evidence that the modulation of gut microbiota plays the therapeutic role in the treatment of COVID‐19, but we speculate that targeting gut microbiota may be a new therapeutic option or at least an adjuvant therapeutic choice. In early February, the guidance (version 5) established by the China's National Health Commission and National Administration of Traditional Chinese Medicine9 recommended that in the treatment of patients with severe COVID‐19 infection, probiotics may be used to maintain the balance of intestinal microecology and prevent secondary bacterial infection, which shows that the Chinese government and first‐line medical staffs accept the importance of the role of gut microbiota in COVID‐19 infection.

Huge efforts from the Chinese government and accelerated related research have been done over this period. Although no specific antiviral treatment has been recommended to date, we speculate that probiotics may modulate the gut microbiota to alter the gastrointestinal symptoms favorably and may also protect the respiratory system. Further studies may focus on this point

This news article "Stockpile on sleep, not supermarket staples to protect from COVID-19" says:

UniSA sleep and fatigue researcher, Dr. Raymond Matthews says prioritizing sleep will help protect you from COVID-19 by boosting your immune system.

This news article "Coronavirus: What you need to know to prepare for a covid-19 pandemic" says:

It is being claimed all kinds of things can protect you from the covid-19 virus, from vitamins to garlic. There is no evidence to support most of these claims. However, there is evidence that moderate exercise, adequate sleep and a healthy diet help keep your immune system in shape generally.

This news article "Strengthening immune health can help protect against COVID-19" has:

A balanced, nutritious diet, regular exercise and getting enough sleep can go a long way to optimizing the immune system to fight off infection, whether it's the flu or something more serious.

People can also make changes that enhance immune system function. For example, eating a low-carbohydrate diet with plenty of different-colored fruits and vegetables helps supply the immune system with the antioxidants and anti-inflammatory phytonutrients it needs to fight infection.

A high-fiber diet, including grains and yogurt, can strengthen the gut microbiome -- or so-called "good bacteria" in the digestive tract -- and bolster immune defenses.

I suggest adding information on the relevance of regular exercise, good sleep and probiotics to the article in one form or another.
I think many would consider this information important because they might consider these measures some of the most basic ones most people can implement without any or much cost especially until better treatments are available, as prophylaxis and at locations where there is no somewhat COVID-19-specific treatment available.

---

Furthermore I think it would be important to include information about whether an anti-inflammatory diet or supplementation can be useful for COVID-19 and when if possible yet. It seems it can aggravate Covid-19: "anti-inflammatory drugs are known to be a risk for those with infectious illnesses because they tend to diminish the response of the body’s immune system".

Moreover I think now might be a good time to add information about probiotics against proinflammatory cytokines to the cytokine release syndrome § Management article/section as this information likely can't be added here. I don't know if there are good reviews so I suggest to at least write that it's being researched. Relevant studies include "Effect of probiotics Lactobacillus and Bifidobacterium on gut-derived lipopolysaccharides and inflammatory cytokines". It should probably also include information on some other things like green tea. Some of it could also go into the sepsis article. Those articles are linked to from this article.

Also see section #"Potential interventions for novel coronavirus in China: A systematic review" - Information on additional compounds being researched and nutrition / nutritional supplementation.

If you have more relevant news articles or studies, please link them here.

--Prototyperspective (talk) 12:29, 26 March 2020 (UTC)

Other things that might be relevant but aren't addressed in the article are stress, indoor air and weather/climate.

More links/content that might be useful:

From Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series:

Sputum and throat swab specimens collected from all patients at admission were tested by real time polymerase chain reaction for SARS-Cov-2 RNA within three hours. [...] Patients also received treatment with probiotics in most cases. Quinolones and second generation beta lactams (oral and intravenous) were administered if fever lasted for more than seven days or C reactive protein levels were 30 mg/L or more (normal range 0-8 mg/L). Patients suspected of being infected with SARS-Cov-2 were discharged from hospital once the results of two real time reverse transcription polymerase chain reaction tests taken 24 hours apart were negative for SARS-Cov-2 antigens.

From Management of corona virus disease-19 (COVID-19): the Zhejiang experience:

Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as Lactobacillus and Bifidobacterium. Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation.

From Machine learning-based CT radiomics model for predicting hospital stay in patients with pneumonia associated with SARS-CoV-2 infection: A multicenter study:

Most patients received antiviral treatment with interferon inhalation, lopinavir and ritonavir, combined with probiotics. Patients were discharged once the results of two real-time fluorescence polymerase-chain-reaction tests taken 24 hours apart were negative for SARS-CoV-2 antigens

Of course it's clear that as of right now there is no definite scientific rationale of using probiotics to help protect, prevent or treat COVID-19 specifically. Furthermore they might possibly be less relevant as prophylaxis than when antibiotics are used concurrently.

And the recommendations of: Physical distancing and other transmission reduction measures - coronavirus (COVID-19) including:

Stay healthy with good nutrition, regular exercise, sensible drinking, sleeping well, and if you are a smoker, quitting.

--Prototyperspective (talk) 12:36, 27 March 2020 (UTC)

NYT article on exercise and immunity:

“So, it is safe to exercise, despite concerns about coronavirus,” he concludes. Exercise, in fact, will probably lessen the risk of an infection, he says.

There are caveats, though. If you have not been exercising, now might not be the ideal moment to start an extremely ambitious and tiring new workout routine. In the 2005 studies with mice and influenza, a separate group of animals that ran strenuously for weeks developed somewhat more severe and longer-lasting symptoms than the mice that ran moderately before their infections, although the differences were slight.

“It is fair to say that a large increase in exercise intensity and/or duration, especially in people new to exercise, might have transient negative effects on the immune system,” says Jeffrey Woods, a professor of kinesiology and community health at the University of Illinois in Urbana-Champaign, who studies exercise and immunity and led the mouse study.

From this editorial in Nature (also note the "(anti-sera or pegylated IFNα)"):

During the incubation and non-severe stages, a specific adaptive immune response is required to eliminate the virus and to preclude disease progression to severe stages. Therefore, strategies to boost immune responses (anti-sera or pegylated IFNα) at this stage are certainly important. For the development of an endogenous protective immune response at the incubation and non-severe stages, the host should be in good general health and an appropriate genetic background (e.g. HLA) that elicits specific antiviral immunity.

--Prototyperspective (talk) 11:42, 28 March 2020 (UTC)

Immunomodulation

The immune system and its functioning can be altered in various ways. These may include regular exercise, good sleep and probiotics. They also include immunostimulants and immunosuppressive drugs. Whether and if so which kind of modulation would be useful to what extent when depends on the individual person or rather his/her immune system. In some complications arise from an overreaction of the immune system after infection while others would benefit from stimulating their immune system.

I suspect that some immunomodulary interventions might also be useful for basically everyone if done appropriately (varies per individual) at the right time and that this includes regular, moderate exercise or fitness-promoting activities. But I haven't researched this much and don't have a scientific review that shows this to be valid for SARS-CoV-2. Note that if you run a triathlon you shouldn't expect the be more immune to viruses like SARS-CoV-2 hours afterwards (quite the opposite actually). Here are some relevant reviews:

Is Regular Exercise a Friend or Foe of the Aging Immune System? A Systematic Review:

Overall, in healthy older adults, regular, particularly aerobic, exercise appears to be a friend of the immune system, helping to offset diminished adaptive responses and chronic inflammation. The possibility exists that particularly strenuous exercise may cause acute immunologic changes, such as diminished NK cell activity, which could predispose to infection in certain individuals. However, given the possible benefits of regular exercise on the immune system and the many definite benefits on other systems, the evidence presented here should not dissuade practitioners from suggesting regular exercise to otherwise healthy older adults.

Potential impact of physical activity and sport on the immune system--a brief review:

Acute responses to exercise depend on the intensity and duration of the required activity relative to the individual's fitness level. Moderate endurance exercise causes either no change or an enhancement of such indices as total leucocyte count, granulocyte, monocyte, lymphocyte and natural killer cell count, total T cell count, helper:suppressor cell ratio, cell proliferation in response to mitogens, serum immunoglobulin levels, and in vitro immunoglobulin production. However, exhausting exercise tends to produce adverse changes in these same indices

But these reviews and their studies mostly aren't investigating more longer-term effects of exercise.

Some further information:

How to boost your immune system, Harvard Medical School

To answer the question how this and smoking in particular related to immunity: they have an effect on the immune system and smoking may make people more likely to develop serious complications from it. Smoking may suppress the immune system: "Similar increases in immunoglobulin levels (IgA and IgG) in mucosal secretions (saliva) were noted after cessation of smoking. [...] We suggest that these findings may provide further insight into the association of smoking with an increased incidence of certain malignant diseases and respiratory infections." from here and "Many of the adverse and beneficial effects of smoking might result from the ability of cigarette smoke to suppress the immune system." from here. But the damage to lung cells that's making smokers more likely to develop serious complications probably isn't mostly related to immune system function so the section's title should be probably be more broad than it was previously if this gets readded.
It would be better if it was more broad anyways if some of the other things named here get mentioned there as well. For example it could be named something like "Immunomodulation and personal preventive approaches".
Note that most available research seems to be investigating medical treatments for patients with serious complications, not preparatory / preventive measures or complementary treatments or treatments for mild patients.

Also relevant (can't read the full article as it's paywalled):

Include ‘Natural Killer’ Cells in the Covid-19 Arsenal on immunotherapy.

--Prototyperspective (talk) 12:49, 3 April 2020 (UTC)

---

We need to stick with WP:MEDRS Doc James (talk · contribs · email) 19:08, 27 March 2020 (UTC)

Agree and I have seen/read that page. But I don't understand / agree with the removal which removed almost all of the section's content.

I'd agree that those aren't optimal sources but it seems they should be just good enough.

WP:MEDRS has:

Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; [...] and guidelines or position statements from national or international expert bodies

The removed sources were:

• FDA/Michael Felberbaum, FDA spokesman: could be considered to be statements by a national expert body; the problem is that the source could have been better and that it's not on their website in some more official way (at least I haven't found it there); instead of removing one could have the text say that this is what a FDA spokesman said in an interview.
• Guidelines by the National Health Committee of the People's Republic of China and National Administration of Traditional Chinese Medicine: the former is a national expert body and hence it falls under "guidelines by a national expert body"; the problem is that the text in the source is Chinese so I added a 2nd source (a study) which doesn't meet WP:MEDRS. Maybe somebody has a translation of it.
• The remaining 3 sources, which all confirm the same statement, aren't review articles but case series which is clarified explicitly in the text. They are basically ground reports by experts about what they're doing and the text only said that they're using probiotics and nothing more. I also added a better-source-needed-note there.

It's okay if it can't be added because it isn't very clearly meeting the WP:MEDRS requirements. But I think it could be included. Maybe somebody else can comment on this?

--Prototyperspective (talk) 21:38, 28 March 2020 (UTC)

The source is Bloomberg not the FDA. Unable to verify any of this.[16] We should stick with EN language sources. Doc James (talk · contribs · email) 21:22, 31 March 2020 (UTC)

The bigger question is how does this relate to immunity "The FDA states that people with underlying health issues also include people who smoke and/or vape tobacco or nicotine-containing products and that they may have increased risk for serious complications from the disease." Doc James (talk · contribs · email) 21:25, 31 March 2020 (UTC)

That's clarified in that link and is explained by the context that this sentence was added to the article: the link had "Vaping may leave users with underlying health conditions at higher risk of serious complications if they contract the respiratory disease caused by the novel coronavirus, the Food and Drug Administration said." and "'E-cigarettes can damage lung cells,' Felberbaum said."

I've added a subsection to this section that explains how it relates to immunity.

--Prototyperspective (talk) 12:49, 3 April 2020 (UTC)

Okay and were does it comment on vapings effects on immunity? Doc James (talk · contribs · email) 00:55, 5 April 2020 (UTC)

Well that's a good point and it's also why the section name should have been more broad. In the section above only usual smoking is addressed. Here's a study on potential effects on the immune system, it says:

We show a significant increase in cytotoxicity caused by the vaping process itself. Importantly, exposure of macrophages to ECVC induced many of the same cellular and functional changes in AM function seen in cigarette smokers and patients with COPD. While further research is needed to fully understand the effects of e-cigarette exposure in humans in vivo, we suggest continued caution against the widely held opinion that e-cigarettes are safe.

And here an article by the AAAS says:

Her analysis of nasal samples from cigarette smokers, e-cigarette users, and non-smokers for a panel of 600 different genes related to immune response found 53 genes suppressed in cigarette smokers. Those same genes were suppressed in e-cigarette users, along with 305 other suppressed genes, Jaspers said.
Animal studies also found that alternative tobacco products without nicotine produced similar or stronger effects than products that include nicotine.
Judith Zelikoff of NYU Langone Medical Center studied pre- and post-natal exposure to mice of commercially available e-cigarette vapors and aerosols with and without nicotine, finding changes to frontal cortex gene expression associated with mental health and activity issues, some of which are associated with schizophrenia, she said. While nicotine and non-nicotine products both produced changes, e-cigarette products without nicotine resulted in even more gene expression changes than products with nicotine, Zelikoff said.
[...]
Jaspers followed up her nasal sample analysis with lab studies of immune cells commonly present in nasal mucosa. The cells, which were exposed to different flavors of liquids added to e-cigarettes, repeatedly showed the most significant immune suppressive effects came from strongly cinnamon-flavored liquids.
Jaspers clarified that while U.S. Food and Drug Administration may classify flavoring agents as “generally recognized as safe” for oral consumption, the agents may not show the same results when the products are inhaled.

Haven't researched this much and I don't think there's a review that addresses it. But the relevance to COVID-19 probably mostly stems from induced damage to lung cells which would make smokers and people vaporizing more likely to develop more serious complications. And again for that the section title wasn't appropriate / broad enough.

--Prototyperspective (talk) 09:31, 5 April 2020 (UTC)

Neither of those comment on COVID19 as it did not exist yet... So references need to be BOTH about this disease and the topic in question. We do not do original research here. Doc James (talk · contribs · email) 16:34, 5 April 2020 (UTC)

References

Reference of dubious character must be removed

Used as a reference this paragraph in Terminology

In February 2020, the World Health Organization advised the public to not refer to Coronavirus as the "Chinese virus" or "Wuhan virus".[206][207][208][209] Even more controversial terms, such as "Wuflu" and "Kung Flu", also emerged in the United States during this period (outside the community of medical professionals) as offensive ways of describing COVID-19. These terms are linked to Wuhan, where the virus was first detected, or China in general, via portmanteau with terms from traditional Chinese Martial Arts, Wushu and Kung Fu. Use of these terms (popularized in social media and alt-right sources) not only downplays the seriousness of the deadly disease, but also misinforms by suggesting it is a strain of influenza (when it is not a flu), while simultaneously mocking Chinese culture. It also implies that the pandemic is China's aggressive gift to the world, when actually thousands of Chinese suffered and died from COVID-19, especially in Wuhan.[210][211]

The Reference if from a non-credible source and: https://www.youtube.com/watch?v=xho1OL8n7zM&feature=youtu.be&fbclid=IwAR0YUhbVzS4gp_aYAKPZKk-LBuM356QKR1IsTOg4bvdQ4Z3C8WzbnRBSQiE

This reference is from Salon magazine, a politically motivated, non-scientific, non-credible source: Any reference that calls the President "racist" is certainly not credible, it totally politically motivated and needs to be removed from this article. This is so bad the Wiki could actually be sued for it, Salon certainly should. Remove this reference or else remove yout own good name. The reference itself is racist, bigoted, prejudicial, myoptic, and not credible. 99.42.89.21 (talk) 06:10, 29 March 2020 (UTC)

No, any reference that calls the President racist is not automatically disqualified on that alone. That's nonsense. TylerDurden8823 (talk) 06:43, 29 March 2020 (UTC)

"Corona"

The usage of "Corona" is under discussion, see Talk:Corona (disambiguation)#Requested move 29 March 2020. Crouch, Swale (talk) 21:07, 29 March 2020 (UTC)

A posture of defensive hypersensitivity is not encyclopedic

"Kung Flu" isn't accurate, because of its inclusion of the word "flu", but it's not offensive (because nothing that people choose to take offense at can be presumed, without cited evidence, to have been coined for the purpose of being offensive just because people DO choose to be offended by it). "Kung Flu" doesn't mock Chinese culture. (And where exists the culture that does NOT deserve to be mocked, anyway? Respecting ways of doing things without sufficient reason, just because your parents and grand-parents in a chain gong back centuries respected those ways of doing things, is not an objectively justifiable way to think.) It is inevitable that some words sound like other words. "Shanghai" (which became a verb amongst English-speaking sailors) sounds like "Shang-hijack". That is an objectively observable fact which in no way can be considered equivalent to a statement that Chinese names or words deserve disparaging. Words sound like other words. The coining of "Kung Flu" was inevitable, although it'd be more accurate if reserved for an actual flu. In an ENCYCLOPEDIA, the assertion that a pun is coined in an effort to be offensive or an effort to mock people of a certain culture must be supported by either logical argument or a citation, for instance polls taken wherein punsters are asked for their motives. There is no such logic or citation here and the assumption that "Kung Flu" was coined to mock or offend is unsupportable. It was coined because the "Fu" in "Kung Fu" resembles the word "flu", and because either a skilled Kung Fu practitioner or a flu can inflict a powerful physical defeat upon you. That is the ONLY reason for the phrase "Kung Flu" to exist. No racism or mockery AT ALL, UNLESS you quote the published source wherein someone confesses "I wanted to be racist against Chinese, so I coined the phrase 'Kung Flu'."204.155.230.3 (talk) 16:11, 2 April 2020 (UTC)Christopher L. Simpson

We should follow what reliable sources say, not our personal opinions. Bondegezou (talk) 17:12, 2 April 2020 (UTC)

"Potential interventions for novel coronavirus in China: A systematic review" - Information on additional compounds being researched and nutrition / nutritional supplementation

Should information about (from) this study be included in the article? The article already informs about many potential treatments named in the review. But it doesn't inform about nutritional interventions or compounds like Mucroporin‐M1 for instance. I think this should be added to the section Research. From the study:

In this review, we summarize all the potential interventions for COVID‐19 infection according to previous treatments of SARS and MERS. We have found that the general treatments are very important to enhance host immune response against RNA viral infection. The immune response has often been shown to be weakened by inadequate nutrition in many model systems as well as in human studies. However, the nutritional status of the host, until recently, has not been considered as a contributing factor to the emergence of viral infectious diseases. Therefore, we propose to verify the nutritional status of COVID‐19 infected patients before the administration of general treatments. In addition, we also found coronavirus‐specific treatments and antiviral treatments were very useful for the treatment of SARS and MERS. They should also be considered as potential treatments for COVID‐19 infection. The other compounds should also be chosen as alternative options for the treatment as well as new drug designs.
[...]
Therefore, we suggest that all the potential interventions be implemented to control the emerging COVID‐19 if the infection is uncontrollable.

At a minimum it should inform about treatments for SARS and MERS being researched as potential treatments and that nutrition and/or nutritional supplementation are relevant to management of the disease. I'm pretty sure it would be good if it shortly named which and summarized why.

Furthermore I couldn't find a link to COVID-19 drug development in the article - it probably should be added somehow.

--Prototyperspective (talk) 23:54, 24 March 2020 (UTC)

Relevant: Coronavirus Treatment: New York Treats COVID-19 With Massive Doses of Vitamin C and from here:

“There is some reason to hypothesize that some vitamins and supplements could reduce the risk and severity of COVID-19 because of benefits seen for other viral or respiratory disease,” Dr. Walter Willett, a professor at the Harvard T. H. Chan School of Public Health, told USA TODAY.

--Prototyperspective (talk) 11:57, 26 March 2020 (UTC)

Maybe these links are useful somehow:

Vitamin D Supplementation Could Prevent and Treat Influenza, Coronavirus, and Pneumonia Infections, preprint.

From "A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence":

Studies have shown that vitamin C may prevent the susceptibility of lower respiratory tract infection under certain conditions[69], while COVID-19 may cause lower respiratory tract infection. Therefore, a moderate amount of vitamin C supplementation may be a way to prevent COVID-19.In addition,the decrease in vitamin D and vitamin E levels in cattle could lead to the infection of bovine coronavirus[70]. This suggests that proper supplementation of vitamin D and vitamin E may enhance our resistance to SARS-CoV-2. Patients with primary basic diseases, especially those with chronic diseases such as hypertension, diabetes, coronary heart disease and tumor,are more susceptible to SARS-CoV-2and their risk of poor prognosis will increase significantly after infection, because they have low systemic immunity as a result of the disease itself and treatments[71]. Therefore, it is particularly important to enhance self-resistance. The main way to boost personal immunity is to maintain personal hygiene, a healthy lifestyle and adequate nutritional intake[72, 73].

And another preprint: "Susceptibility Analysis of COVID-19 in Smokers Based on ACE2"

There's also "Former CDC Chief Dr. Tom Frieden: Coronavirus infection risk may be reduced by Vitamin D" and "Vitamin D: Deficiency May Increase Coronavirus Infection Risk".

Furthermore there is good evidence that healthy vitamin D levels can protect against respiratory infections and improve immune system function. Maybe a note about that and possibly similar things could be added somewhere in the article somehow while making clear that there's no conclusive research on COVID-19 in specific.

More info relevant to the above can be found in the talk page section #Regular exercise, good sleep and probiotics.

--Prototyperspective (talk) 23:25, 27 March 2020 (UTC)

Relevant preprint: Vitamin B12 May Inhibit RNA-Dependent-RNA Polymerase Activity of nsp12 from the COVID-19 Virus

--Prototyperspective (talk) 11:41, 28 March 2020 (UTC)

From here:

Apart from immunomodulators, metformin, atorvastatin, fibrates, as well as nutritional supplements may help in treating acute respiratory distress syndrome (ARDS) by boosting immunity. However, evidence of efficacy in SARS-CoV or MERS-CoV is poorly reported.[24]

Zinc is reported to have antiviral effect,[24] and it inhibits CoV RNA polymerase activity and thus hampers replication in cell culture experiments.[25] As cytokine storm is a pathognomonic feature of COVID-19, inhibition of these pro-inflammatory cytokines may theoretically prove useful (e.g., inhibition of IL-6 by tocilizumab).[24]

From here:

POTENTIAL INTERVENTIONS

[...]

Therapeutics of COVID‐19 primarily include symptomatic treatments and antiviral therapies. Early supportive interventions are critical for treating mild patients including nutrient supplements, oxygen therapy, Chinese herbal medicine, and antibacterial therapy. Patients infected with COVID‐19 are mostly middle aged and elderly generally with low resistance to infection.

--Prototyperspective (talk) 12:48, 3 April 2020 (UTC)

From the preprint "A prospect on the use of antiviral drugs to control local outbreaks of COVID-19":

In addition, in all tested scenarios, the model highlights the benefits of the administration of an antiviral drug in addition to quarantine, isolation and contact tracing. The resulting control measure, could be an effective strategy to control local and re-emerging outbreaks of COVID-19.

This content is here in case it's useful for somebody seeking to add content on this topic to the article. Only very few of those links may meet WP:MEDRS: mostly because most of them aren't reviews or statements by an inter/national expert body.

--Prototyperspective (talk) 09:14, 5 April 2020 (UTC)

See WP:MEDRS Doc James (talk · contribs · email) 20:18, 28 March 2020 (UTC)

Thanks, I do know of this policy. I'm not suggesting that info from all the links I've added here to be included in the article. Note that most available research seems to be investigating medical treatments for patients with serious complications, not preparatory / preventive measures or complementary treatments or treatments for mild patients.

I added some content to the other talk-page section that's relevant to here and vice-versa.

--Prototyperspective (talk) 12:48, 3 April 2020 (UTC)