Coronavirus Epidemic Update 22: Spread Without Symptoms, Cruise Quarantine, Asymptomatic Testing

Coronavirus Epidemic Update 22: Spread Without Symptoms, Cruise Quarantine, Asymptomatic Testing

welcome to another MedCram lecture and
we can see here the numbers are increasing but slowly here on the world
ometer website seventy five thousand seven hundred and thirty total deaths
2128 recovered sixteen thousand if we look at the active cases in the close
cases you can see that the number of recovered has gone up slightly and seems
to be doing that on a daily basis if we look at the total worldwide cases you
can see here that they are dwindling overall but in looking at the cases that
are outside of china we can see that they continue to increase in terms of
the number of deaths unfortunately those continue to be increasing pretty much at
a linear rate want to update you on the situation with the Diamond Princess
cruise ship that’s docked outside of Japan there was a statement put out by
the CDC commending the Government of Japan for the fact that they quarantine
patients but there’s been a lot of international criticism of how Japan
actually handled this and there’s been an intervention and basically the
consensus if you read between the lines is that this did not work very well
there’s currently more than a hundred US citizens either on board the diamond
princess or in hospitals in Japan and they’ve been placed under the
restrictions and they’re saying that they will be required to wait 14 days
before coming home before they’re permitted to come on board flights
however if an individual does make it to the United States before that 14-day
period ends they will be subject to a mandatory quarantine until they
completed that 14-day period so the CDC is coming out with that statement and
they want to make sure that everyone’s aware that they are taking this
seriously I also want to quickly highlight a letter that was submitted to
the New England Journal of Medicine dated yesterday February 19 it was an
interesting look at about 18 patients nine men and nine women meeting 59 years
of age and what they did was they looked at viral loads in the upper respiratory
tract to see what they were based on when the symptoms began
and now these were people from Wuhan and all of them except for one were
symptomatic there was one person that was asymptomatic and we’ll talk about
that in just a second but you can see here the graphs of the
CT value which is basically the viral load and on the x-axis here is the
number of days since the onset of symptoms zero being here on the far left
and what you can basically see is that the viral load was quite high in the
very early days of the symptoms and then tapers off almost all of them being
undetectable here towards 14 days now please don’t confuse these days as the
incubation period this has nothing to do with the incubation period this has to
do with how long the symptoms last once you get the symptoms an incubation
period has to do with how long it is between infection and the onset of
symptoms the other thing to notice here at the bottom is may be difficult to see
but in terms of throat swabs versus nasal swabs there was a higher viral
count in the nasal swabs in general than there was in the throat swabs meaning
that this virus tends to potentially congregate in the upper Airways there
was one patient that was tested and was asymptomatic and they say here that the
viral load that was detected in the asymptomatic patient was similar to that
in the symptomatic patients which suggests that the transmission potential
of asymptomatic or minimally cyntha matic patients and this is confirming
what we had discussed earlier at the beginning of this outbreak that
potentially can be spread by asymptomatic individuals and we will put
a link in the description below to this article as well as the CDC article
another article that was submitted on the same day yesterday was a perspective
that was written by a number of physicians and epidemiologists on their
perspective of defining the epidemiology of kovat 19 and how more studies are
needed one of the interesting aspects that they mention here is they may need
to do testing in people that may not meet the current definitions which is
someone who has traveled from that particular area of China and has
symptoms and they say here a key point of these recommendations is that viral
testing should not be used only for clinical
CAIR I think that’s an interesting point if we really want to find out what the
scope is of the infection especially in China that there’s gonna have to be a
lot of people who are asymptomatic Lee tested to see whether or not they had
the virus at some point anyway I leave that perspective there for your
consideration in future updates we’ll plan on tackling the molecular biology
of corona virus and contrast that and compared to other viruses and that might
give us a little bit of information about what this virus likes to do please
join us at make cram comm for our course on the corona virus also multiple other
courses thanks for joining us

100 Replies to “Coronavirus Epidemic Update 22: Spread Without Symptoms, Cruise Quarantine, Asymptomatic Testing”

  1. Dr. Seheult, I have been wanting to know if blocking ACE2 receptors is a reasonable way of preventing the virus from infecting or decreasing symptoms? Since the virus binds to ACE2, I assume blocking it would stop or slow down its progress.

  2. Please subscribe to get notified about new MedCram videos.
    Visit us at for clear explanations of antibiotics, abdominal pain, pneumonia, cough etc.
    Quick links to our other videos on Coronavirus (COVID-19):
    – Coronavirus Epidemic Update 21: Antibodies, Case Fatality, Clinical Recommendations, 2nd Infections?:
    – Coronavirus Epidemic Update 20: Misinformation Spread, Infection Severity, Cruise Ship, Origins:
    – Coronavirus Epidemic Update 19: Treatment and Medication Clinical Trials:
    – Coronavirus Epidemic Update 18: Cellphone Tracking, Increase in Hospitalizations, More Sleep Tips:
    – Coronavirus Epidemic Update 17: Spike in Confirmed Cases, Fighting Infections with Sleep (COVID-19):
    – Coronavirus Epidemic Update 16: Strengthening Your Immune Response to Viral Infections (COVID-19):
    – Coronavirus Epidemic Update 15: Underreporting, Prevention, 24 Day Incubation? (COVID19):
    – Coronavirus Epidemic Update 14: Hospital spread of infection, WHO allowed in China, N-95 masks:
    – Coronavirus Epidemic Update 13: Li Wenliang, nCoV vs Influenza, Dip in Daily Cases, Spread to Canada:
    – Coronavirus Epidemic Update 12: Unsupported Theories, Pneumonia, ACE2 & nCoV:
    – Coronavirus Epidemic Update 11: Antiviral Drugs, Treatment Trials for nCoV (Remdesivir, Chloroquine):
    – Coronavirus Epidemic Update 10: New Studies, Transmission, Spread from Wuhan, Prevention (2019-nCoV):
    – Coronavirus Epidemic Update 9: Fecal-Oral Transmission, Recovery vs Death Rate:
    – Coronavirus Outbreak Update 8: Travel Ban, Spread Outside of China, Quarantine, & MRSA:
    – Coronavirus Epidemic Update 7: Global Health Emergency Declared, Viral Shedding:
    – Coronavirus Outbreak Update 6: Asymptomatic Transmission & Incubation Period:
    – Coronavirus Update 5: Mortality Rate vs SARS / Influenza:
    – How Coronavirus Kills: Acute Respiratory Distress Syndrome (ARDS) & Treatment:
    – Coronavirus Update 3: Spread, Quarantine, Projections, & Vaccine:
    – Coronavirus Symptoms, Diagnosis, Treatment:
    – Coronavirus Outbreak – Transmission & Updates:

  3. Doctor, are you okay? I am hearing lower energy and today's video is shorter. Maybe you had to film in a place where you must be quiet? Please take care of yourself! You are important to many people.

  4. …the 'S' has now hit the "F' in South Korea. I wouldn't be the least surprised if South Korea is like Wuhan within weeks from now.
    So, where will the next 'super-spreader' outbreak also make itself apparent? And WHEN will the ditherers at the WHO finally decide to declare this as the growing pandemic it is?

  5. At this rate we'll have negative numbers next week from China… Great!… open the borders everyone, back to work, now you can use your car 150 million people, back to normal.

  6. I've been following Covid-19 since January and have watched so many vlogs – I love yours the best because it's evidence-based AND, most importantly, your delivery is CALM & MEASURED which I need!! I watch another evidence-based vlog which is also good, but his demeanor & delivery of information is more alarming to me and freaks me out… makes me run right over to Amazon and buy (more) alcohol and canned goods. Thank you for your work!! 🙂

  7. Was the Govt of US willing to pay for treatment of the US patients in japan, if not they have no say in it.

    When 1000s of dollars are needed to treat a patient, you can't blame another country unless you are offering to help

  8. Look at South Korea people in a church have had exposure. China is lying with there numbers also look at Japan. Its starting more spread. Start preparing USA stock up on food and supplies

  9. Hundreds of millions of people don't wash their hands when outside. This is evidenced by the vile smell of banknotes when sprayed with water. I know as I have experimented with that, and the odour is many orders of magnitude worse than that of both toilets and urinals combined. Banknotes and coins circulate uncontrollably. This will translate into a pandemic without resistance.

  10. Has China changed the definitions again?
    I don't trust the official numbers. The party has control over what information is releases. Not that I want a po li ti cal discussion. Numbers reported can be kept low artificially or a lot of cases fly under the radar for a lot of different reasons.

  11. Seems to me if the virus hangs out in the nasal cavity using a neti pot regularly might help control the viral load and lower its impact.

  12. It's amazing the difference in presentation between yourself and another vloger I was listening to. He's advocating us all to live in the woods to get away from this Pandemic, which maybe a bit extreme… Thank you for your calm and measured approach. Martin from London UK.

  13. 9 deaths in IRAN
    south korea had 31 cases yesterday and today 104.. most from the church and from ONE lady.. r045 if she did in fact infect 45 people at the church

  14. I wonder if any of the bureaucrats will be held accountable for murder? or will it just be some low level person? Or will they get off like CEO's that poison 10's of thousands(See DuPont) and all they have to do is pay a fine(bribe) to government?

  15. 14 day quarantine is not sufficient! It should be 30 days with an added 30 days to be totally clear! The room ventilation system must be highly filtered as an air furnace filter placed over the air coming into the rooms. Plastic over doors will help but the Covid19 can stick on plastic.

  16. The reason I suspect this virus as being designed is that it meets the criteria of what governments might want to achieve if they did something evil like this. Biggest problems in society include the shape of our age graph – too many old people dragging on the economy – and overpopulation. Guess what, this thing is almost harmless to kids and totally deadly to those of old age. Asymptomatic spread, aerosol spread, the period it can last on surfaces, so many other reasons to think that this is a designed virus. This is exactly what you'd build if you were pure evil and decided to take some action with these problems. Obviously, the evidence is much more important than pure guesswork, but this thing sure checks all the boxes.

  17. It seems like a large % of total cases and new cases outside China appear to be on the cruise ship(s). The idea of being on a cruise ship or a plane which is so contained just seems like an almost perfect scenario for the disease to spread

  18. How can cases be reported/counted when 100's of millions of people are under strict quarantine and not aloud to drive their cars… HOW can you trust this numbers?

    I'm surprised the doc does not see this, but I guess its about keeping people "calm"… They'll be "calm" when dead.

  19. I wish you had seen the Today show. Some "doctor" was saying you had to be within feet to get it from someone and lied straight to our faces as if it were nothing. I tuned him out so I cant tell you what else he said. You and Dr. Cambell are my go to source for info.

  20. I'm sorry I don't believe the numbers of the dead. They have had their crematoriums running night and day. They have brought in 20 more mobile cremation unites. We aren't getting the true numbers.

  21. This is a no win situation. If you have to go to work you'll be around tons of people who have been around tons of people, if you have kids in school, they'll be in an enclosed classroom full of kids with families that have been who knows where or visited by who knows who. If you have to go to the doctor, dentist, or hospital, therapist, etc.there's no way to know who they were around right before you. If you go to the grocery store, you're around a bunch of people, if you go to a mall you're breathing recirculated air from thousands of people, if you get on a plane, train or bus, or go to church regularly, who knows who was in there that could've been infected or if you're sitting right next to an infected person. All of the people you come in contact with everyday could be infected or could've just been around someone who's infected and doesn't know it. Everything you buy, your groceries, your grocery bag, etc could've been touched by someone who's sick. A cashier touches thousands of items, credit cards, and worse yet, cash daily, then they touch your groceries and grocery bags. The door handle in a public place could have the virus on it if someone is sick and doesn't know it and just touched it right before you. Your own friends and family are around different people all the time, then they hang out with you. You go eat out and who knows if the person who prepared or served your food, or that you're sitting next to in a restaurant is sick. There's nothing we can do but hope we don't get it, unless you go live in the mountains totally isolated for the rest of your life, might as well be dead then. In other words, there's no way to prevent a virus from spreading to the public once it's out there.

  22. @MedCram: Excellent episode. Thank you for presenting an overview of the CDC’s nasal v oral swab article & source link. Info that’s good to know! 📊📚

  23. Very good informative channel. Guys, don't be gullible. Stop watching videos from people who want to make money by scaring the s… out of you. It's good to be critical about mainstream news, but don't forget to be critical about all anonymous people with no credentials who will use fear to get more views/more money. Playing with other people's fears, aka the business of the end of the world, is a very profitable business.

  24. Lock the next county down, or, we will see an explosion globally. I'm not a doctor, but I can understand basic virus spread.

  25. Thank you! I'm still not sure how it's possible for someone to have a viral load that is at the same level as most of the infected and still not be symptomatic. Reminds me of Typhoid Mary. How can one be infected but not ill? What is different in that immune response? Thank you so much for the videos.

  26. 1 month quarantine and everyone has to have independent air heap filtered no skin contact food served only in sterilized food plastic packs NO plates or cutlery

  27. Thank-you!
    Am wondering how two people died in Iran because of COVID-19 at time they had not travelled abroad or even outside of Qom province prior to their deaths.

  28. Thank you for your work. I agree with the other post on your calm delivery of info. And in a way most can understand. I’ve learned other things on the side things you talked about….
    like sleeping. Thanks again!!

  29. Keep in mind that Ct values, which are data from an in vitro test that detects only a tiny fragment of the nucleotide sequence (100 to 200 nucleotides, typically) of the entire Coronavirus genome, which is about 26,000 nucleotides in total. So a positive result does not prove that live virus is present; I would have preferred to see culture results or a separate experiment in which the Ct results are correlated with live virus culture results.

  30. What if you get packages from China? I'm sure many people order online from there.
    What's the risk of virus attaching itself to packages ??

  31. You can add one, possibly two, zeros to that death toll. CPP sent 40 industrial incinerators to Wuhan. The world will never have an accurate picture of all the details of this outbreak. The outbreak is not as lethal as the CPP. Good luck.

  32. It looks like their is a gag order on reporting the truth about this virus. From what I am reading about the spread of this virus; it must be spreading off hard surfaces that have been exposed; like vents,and also anything that was touched by a person The ships and most apartments with offices and hotels have a central heating system with air conditioning. I would get some of the bio filters and put them at the exits of all vents leading into rooms and on the main system. I would also put these in cabs with ozone machines running between customers. If you are an uber driver; it might be a good idea to get a plastic guard between you and the customers. I would also get a bio filter and put it in your system. Get out of the car in between customers and run an ozone machine off a battery; if you don't have electricity. This will keep you and the other customers safer. I would also get alcohol and spray between customers. The mats and door handles and seats. Hope this helps to keep you safe. God Bless and stay safe everyone.

  33. While you are at it again spreading US Gov lies and propaganda, Try throwing a little truth in there.
    Like the fact that no animal deaths have been mentioned but 12 industrial FURNACES were moved to Wuhan yesterday FOR THE BURNING OF ANIMAL CARCASSES AND MEDICAL GARMENTS or at least that's the story.

  34. Would there be enough test kits for testing for SARS-CoV-2?
    They are so stretched in China with the number of cases and isn't it better for them to focus their resources on looking after their patients.

  35. Thank you for making these videos. They have been very informative. Would you be willing to make a video discussing why the virus seems to disproportionately affect adults? Why are we not seeing children affected by the virus?

  36. Thank you doctor for some true facts. What should we do to prevent catching this ?
    Also how do I find out if it's in our community ?

  37. If it's mostly in the nose, wouldn't that mean it was breathed in? You can't tell me everyone infected has been sneezed on, or was just touching a contaminated surfaces if that's the case. Correct me if I'm wrong, but the nose doesn't seem like the best moist place available to multiply if the virus has a choice on where to do it's thing.

  38. Why am getting videos, i am not even subscribed to this channel. getting daily updates is annoying andthis guy just does it for views clicks and money, well i have adblock so a!.

  39. Cases in China are decreasing as they manage to get better control of …. the viral spread of … 'information'. (my thought)

  40. “Total worldwide cases are dwindling overall.” There is no research that shows that is the case. You appear to have based that comment strictly on information from the Chinese Government. The virus spreads extremely easily. Quarantines in Wuhan and on the Diamond Princess failed. Just what do you think will happen when those people in Wuhan who have avoided the virus thus far come out of their homes again?

  41. 2/20/2020 @ 2pm EST for 2 minutes take a break and pray, meditate or just send positive thought to those affected by this situation!

  42. China numbers not decreasing— they have been locked in their homes, not even allowed to go for food – so they are not going to the hospitals either—-so I don’t believe the numbers. CA USA has 5100 under self quarantine as of Feb 14 2020 … google it.

  43. A comparison of accuracy of tests from upper airways vs lower airways would be interesting … given the reports of false negatives.

  44. What if during the quarantine period in the ship, they get the virus….like it's airborne (in ship its congested) so in case the person gets the virus on 12th day of his quarantine, and he leaves the ship on his 14th day??…..he might test positive after a few more days but by then a whole lot would be infected

  45. Hey doc ,great updates .english is my 4th language im based in london . I see news in french or arabic or amazing which is berber .this is great ,thank you .☮

  46. Thank you for this important information. I cannot believe they allowed the cruise ship to basically become a mini Wuhan. Where was the thought process on this one! My friend in Ireland canceled the family’s vacation to Japan for the Olympic Games. My family has canceled a family reunion in Hawaii and I have canceled a cruise to Vietnam. When the markets finally get honest we will see huge consequences to this misleading time. 🙏 Stay safe and be well.

  47. Dear Doc, Thank you for clear concise factual lectures that are easy to follow. At a time like this, we need precisely the type of information your lectures provide. It is all much appreciated. Regards

  48. The history or pandemic viruses have Herald a lot from China. Do you think it will be as bad as the Spanish H1N1? That was around 2 years and summer made little affect.

  49. As a mechanic with degrees in pharmacy I always viewed engineers as the most disgusting vermin but pandemics have shown me the truth. Nothing shows the stupidity of the schools of lower learning than the words that come out of a doctor's mouth. If you said anything they did not allow you to say your ass would not be a doctor tomorrow, that is a fact demonstrated daily in the past. So many people thank you and praise you but honestly, let me be frank you are a brain dead idiot just like every other death dealer in a lab coat. If it happens that you don't have MRSA on your lab jacket it is only because you don't deal with people and have figured out a way to scam the people without touching them. Doctors and pharmacists kill more people than the death angel does, those are facts and you wouldn't dare debate me on those numbers because you know it is the truth. Why not risk your license and tell the truth hooker? Be sure of one thing, you will meet me in person in a day very near today and I'm going to question you with real questions and you are going to answer me honestly and then we will decide, make up your mind today Doc, do you stand with us the people or those of the practice? Remember the unbelieving and FEARFUL will have their part in the lake of fire which burns with brimstone and your parts will be destroyed forever, forget hell, you'll simply have the memories of you forgotten and never be mentioned again, but in the meantime we will take an in depth look at what you did when the crunch time came.

  50. I enjoy your videos and content! Thanks for sharing correct information with the audience. I am a retired RN and I am learning a lot! I realize that the content is more geared toward your peers ( MD etc.) However the majority of people watching your videos can understand. 😃👍🏽🦠🧬

  51. Your figures for China are wrong , your basing your math on communist Chinese gov stats , do you really believe them cause I don’t

  52. South korea the infection more than doubled in one day, 51 to 104 today. Super spreader there infected more than 20 people so far. Plus they have had deaths

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