Talk:COVID-19/Archive 15

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Dangerous bias against the likelihood of transmission my contaminated surfaces, misrepresenting sources

This article has consistently had a dangerous bias against the possibility of transmission via contaminated surfaces, misrepresenting sources. For example, the conclusion to the most recent source clearly states "Two modes of transmission exist—direct and indirect. The direct mode includes transmission via aerosols, anal (feco-oral) secretions, tears, saliva, semen, and mother-to-child. Indirect modes include transmission via fomites [contaminated surfaces]. Several of these modes may be underestimated". The language of this study is less than perfect (direct and indirect modes as defined in the conclusion are not mutually inclusive and in fact the indirect mode requires the things listed as direct. It also contradicts the language used in other sources that assumes aerosols can be an indirect mode: https://www.nature.com/articles/s41598-020-69286-3), but other reliable sources (some of which appear to have been removed from the section) agree that there are multiple likely/possible modes of transmission. Instead this was simply misrepresented as "transmission by surfaces has not been conclusively demonstrated". This might be technically correct but it is not what the source says and it is extremely misleading and DANGEROUS to misrepresent the sources in this way, especially as the source does not say it has been "conclusively demonstrated" that surface transmission is rare either. Even the cases where close contact happened cannot generally rule out that they touched the same surface, so we really don't know how common each mode of transmission is. Mr G (talk) 21:35, 18 November 2020 (UTC)

Previously the sources linked were institutional such as WHO. This has been replaced by a single study, which was then grossly misrepresented. For future reference, and to avoid cherry picking, here is area few studies into transmission modes with more than one author:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454106/

https://www.nature.com/articles/s41598-020-69286-3

https://www.sciencedirect.com/science/article/pii/S0195670120300463

https://link.springer.com/article/10.1007%2Fs42399-020-00498-4

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30678-2/fulltext

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30514-2/fulltext (waning, this study has a sample size of ONE hospital ward which only found ONE positive swab due to hospital cleaning practices. very weak evidence. the above article relies on this)

One of the institutional sources that was removed is this one: https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions This one does say "there are no specific reports which have directly demonstrated fomite transmission." (July 2020) This is now out of date but even at the time it was misleading to state this alone because the same source also says there is

consistent evidence as to SARS-CoV-2 contamination of surfaces and the survival of the virus on certain surfaces. ... People who come into contact with potentially infectious surfaces often also have close contact with the infectious person, making the distinction between respiratory droplet and fomite transmission difficult to discern. However, fomite transmission is considered a likely mode of transmission for SARS-CoV-2, given consistent findings about environmental contamination in the vicinity of infected cases and the fact that other coronaviruses and respiratory viruses can transmit this way.

Secondly, the report is from July, and we now have at least one report of apparent surface transmission from SA Health in Australia. Mr G (talk) 00:29, 19 November 2020 (UTC)

There is one opinion piece in the Lancet that says "In my opinion, the chance of transmission through inanimate surfaces is very small", but other more reliable and more recent sources do not use this language and some even say that fomite transmission is "likely" (WHO) or "may be underestimated and, thus, risk the spread of virus" (Karia et al).Mr G (talk) 01:25, 19 November 2020 (UTC)

I don't see "bias". Secondly, your source states "Airborne transmission via aerosols formation is suspected to be the main mode of transmission." (bold for emphasis here) I've reverted your edit for now since you changed it to "may spread". Editing the article is fine as long as it's accurate. You don't need our permission but you might want to discuss the edit beforehand. MartinezMD (talk) 01:05, 19 November 2020 (UTC)

There is really no need to revert. You could just replace 'may spread" with "spread" in places if you think that is more accurate. I'll do it myself if you have no objections Mr G (talk) 01:14, 19 November 2020 (UTC)

The emphasis should remain on respiratory spread, as that is what the sources say. No objection to including surface spread. MartinezMD (talk) 01:18, 19 November 2020 (UTC)

OK, I think I have done so. The sources mostly emphasize close contact. See the quote from WHO above. Mr G (talk) 01:22, 19 November 2020 (UTC)

I have indented the quote from WHO to make it clear.Mr G (talk) 01:25, 19 November 2020 (UTC)

Given that quote, along with the fact that it can spread via direct touching of one person by another, I don't think we can say for certain that is spreads "primarily" via respiratory means. However, if you want to add that it is "suspected" to be transmitted primarily via respiratory means please do so. Mr G (talk) 01:31, 19 November 2020 (UTC)

Nevermind. I've gone ahead and added it for you. Mr G (talk) 01:41, 19 November 2020 (UTC)

I believe that it's considered settled that the primary method by which "close contact" transmits the virus is breathing on each other, not touching each other. Both are possible, but breathing is sufficient. WhatamIdoing (talk) 01:59, 19 November 2020 (UTC)

WHO says The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes

Another page from WHO: Current evidence suggests that the main way the virus spreads is by respiratory droplets among people who are in close contact with each other.

Canada says, on a page called "Main modes of transmission" that SARS-CoV-2, the virus that causes COVID-19, spreads from an infected person to others through respiratory droplets and aerosols created when an infected person coughs, sneezes, sings, shouts, or talks. Later, it says that the virus "may also" be transmitted by direct physical contact or fomites, but this sounds very much like a can't-rule-it-out line, not an equal partner in transmission.

All of this makes me think that we're pretty certain that it is primarily respiratory means. WhatamIdoing (talk) 04:40, 19 November 2020 (UTC)

"COVID-19 spreads via a number of means, primarily involving saliva and other bodily fluids and excretions." That is at best very confusing, at worst factually wrong, depending on what the reader defines as other bodily fluids. Most people would consider bodily fluids/excretions to be saliva, urine, blood, faeces, semen, vaginal fluids but it is ONLY saliva that is infectious. Saliva is the fluid that physiologically causes respiratory droplets and airborne particles, but that requires a lot of assumed knowledge. Remove that sentence. Can state anything like "via the respiratory route, via large and small particles" or the like. I think it is clearest to say 1. Respiratory route (this involves droplets and aerosols) 2. saliva and direct contact 3. fomites is considered possible but it is not the main way (CDC words) or theoretical, but considered possible (reviews on the matter). The SA government theory alluded to above has been retracted. --49.181.160.200 (talk) 11:58, 25 November 2020 (UTC)

I've significantly restored the WP:MEDRS sourcing and content of this section as it had gotten out of hand. In the lead especially we should stick to reliable secondary medical sources such as the WHO or CDC/ECDC. it seems we had slowly drifted away from those sources and the content had become confusing/incorrect/imprecise. Please review my edits and let's ensure we stick to WP:MEDRS for this crucial page. -- {{u|Gtoffoletto}}  ^talk 12:55, 6 December 2020 (UTC)

Infection fatality rate (IFR)

The section on IFR is grossly out of date. The best current estimates that I can find are those used by the MRC Biostatistics unit in Cambridge, UK Here:(In the section "Epidemic Summary", click on the tab labelled IFR), and reported by the BBC here.

I'd like to propose adding a paragraph immediately after the first paragraph of the IFR section as follows:

The fatality rate of Covid-19 varies greatly by the age of the patient, so that the average IFR of any population will vary by the demomgraphics of that population. The more useful measure is how the Infection Fatality Rate varies by age. The MRC Biostatistics Unit at the University of Cambridge currently (as of November 2020) uses the following estimates of IFR by age:

Estimated Infection Fatality Rate in England

Age	IFR
Overall	0.69%
0-4y	0.00051%
5-14y	0.0017%
15-24y	0.0034%
25-44y	0.027%
45-64y	0.37%
65-74y	2.3%
Over 75y	15%

Normally I would be WP:BOLD, and just add this text but as this is not peer-reviewed data, then I thought I should seek consensus here first. Hallucegenia (talk) 16:26, 4 December 2020 (UTC)

No response, which I have taken as WP:Consensus, so I have added the data above to the article. If anyone has any better up-to-date IFR figures from a peer-reviewed source, then please feel free to update these figures. Hallucegenia (talk) 20:33, 6 December 2020 (UTC)

I missed this at the time, but I have some concerns with both the source and the interpretation. Most notably, this does not appear to meet the criteria for WP:MEDRS, and thus would not be appropriate for inclusion in the article given the sources referenced. The sources are a primary source (and one I can't confirm has been peer reviewed), and an out of date news article (cites numbers from October, not those actually included in the article). While the estimate may be valid, we should not reference it until a secondary source which shows overall consensus can be cited. On this note, this section may require additional cleanup. I'll have to look back through the earlier discussion on the CEBM number, and those following it, as they all cite primary sources. Perhaps this is reasonable given the lower prominence, but I'd like to hear others weigh in.

As for the data you've added, is there a reason you chose the before-June estimate of IFR rather than the after-June estimate? I would understand the more recent IFR data and estimate (though it still shouldn't supersede the WHO and CDC values), but definitely not a new estimate of the old value. And on a final note, if we're going to use number like this, the error bars should be the ones cited, not merely the midpoint estimate. For the overall numbers here, that's 0.55-0.85% before June, and 0.4-0.67% after. Bakkster Man (talk) 14:26, 7 December 2020 (UTC)

There was a whole discussion about this on the talk page a month or so ago, but it looks like it got auto-archived without anyone doing anything. I just tried to get the data into the article somehow, in the hope that people better qualified than I would improve it rather than just reverting. I have now added instead the latest peer-reviewed estimates that I can find, but these date back to before July and so don't reflect the improvement in treatments since then. As far as I am concerned, Wikipedia cannot pretend to be a serious encyclopedia if it doesn't include the most important aspect of any disease, namely "If I or my family catch it, how likely is it to be fatal?" Hallucegenia (talk) 13:40, 9 December 2020 (UTC)

Hallucegenia I think regarding what a 'serious encyclopedia' should do, there's a very good reason behind the WP:MEDRS policy requiring secondary sources. Specifically, that it gets us information that's agreed upon as consensus, rather than thrashing back and forth between individual study's estimates each time one gets published. The issue being that a more recent study isn't necessarily more accurate or credible (particularly when we're looking at local studies to estimate global rates). Personal feelings alone don't override policy. A more substantial case would need to be made to consider this worthy of an exception to the secondary source requirement. While the second source you provided does appear an improvement over the first (in that it can be confirmed as peer reviewed), it still does not meet the threshold of MEDRS for inclusion without a strong case for an exception.

Looking back at the previous discussion, the path forward mentioned was to update the latest (September 10th) CDC planning scenario numbers (with the breakdown by age). I will get this added as a table to the article. I'll also look into this meta analysis by the WHO which would provide a best-case source in terms of policy, and see if it provides another value we can cite. On my first read through, much of the time is spent pointing out the variability in estimates between various studies. Bakkster Man (talk) 14:58, 9 December 2020 (UTC)

Update to the section has been made. We now have three WHO estimates over time, and the CDC planning scenario values. All solid secondary sources, and not out of line with the removed primary sourced information. The only remaining primary sources are the 'firm lower limits'. I'm somewhat more comfortable keeping these, given they're essentially just running worst case math assuming 100% infection (deaths divided by population).

Reading through the WHO meta analysis, it's going to be tough to summarize. Basically the big finding seemed to be that there was significant variation between studies and locations (seroprevalence of "0.00–25.00% across 133 Brazilian cities", and heterogeneity of IFR estimates of I^2 = 99.9%), making it tough to summarize here. The closest bet seems to be the following:

Across 51 locations, the median COVID-19 infection fatality rate was 0.27% (corrected 0.23%): the rate was 0.09% in locations with COVID-19 population mortality rates less than the global average (< 118 deaths/million), 0.20% in locations with 118–500 COVID-19 deaths/million people and 0.57% in locations with > 500 COVID-19 deaths/million people. In people < 70 years, infection fatality rates ranged from 0.00% to 0.31% with crude and corrected medians of 0.05%.

The overall population IFR here (0.00-1.63%) is less specific than the WHO estimate currently in the article (0.5-1.0%). The medians across high/low mortality countries might be useful, but it's definitely not going to be easy to summarize that value accurately. Bakkster Man (talk) 16:10, 9 December 2020 (UTC)

Merge Symptoms of COVID-19 into Coronavirus disease 2019?

Resolved

 – Content transcluded into other topics to resolve duplication. Merge proposal withdrawn as it appears the content may soon be expanded. - Wikmoz (talk) 22:11, 23 November 2020 (UTC)

We have three different summaries of COVID-19 signs and symptoms in the following topics:

• Coronavirus disease 2019 § Signs and symptoms
• COVID-19 pandemic § Signs and symptoms
• Symptoms of COVID-19

My initial thought was to consolidate and fine tune the best summary into Symptoms of COVID-19 and then transclude the first two paragraphs elsewhere. However, I think that we can actually merge the breakout back into Coronavirus disease 2019 § Signs and symptoms (as previously done with Mortality and Prognosis breakouts) and transclude from there to the pandemic topic. The bottom of the breakout (Complications and Longer-term effects) is already included in the main disease topic. So it would just be a matter of adding the bulleted symptoms list from the breakout and merging duplicate paragraphs that have slightly diverged. It would not substantially lengthen this topic. Thoughts? - Wikmoz (talk) 19:45, 16 November 2020 (UTC)

@Gtoffoletto, Tenryuu, Moxy, Bakkster Man, Ovinus Real, Sdkb, RealFakeKim, and Doc James: Inviting for comment since this is related to the content de-duplication effort being discussed in the COVID-19 pandemic thread. Traffic to the breakout is not insubstantial but still well below the reader and editor eyeballs on this topic and I think a majority of the traffic is coming from the 'Main article' links in this topic and the pandemic topic (can test if necessary). - Wikmoz (talk) 19:58, 16 November 2020 (UTC)

I feel like the content in the specific Symptoms of COVID-19 page should just be contained within the Coronavirus disease 2019 page. Do we really need a subpage at all? Signs and symptoms are exactly what someone looking for information on COVID-19 (the disease) is looking to find. Should be one of the major sections of the COVID-19 page and the subpage will necessarily be a complete duplication. I think the most logical solution would be to:

• delete the Symptoms of COVID-19 article
• include the best info into Coronavirus disease 2019
• remove Sign and symptoms from the COVID-19 pandemic article. It is just a duplication and the page is about the pandemic not the disease. See discussion here

Wikmoz I think this definitely a problem we need to solve. But I think we should start from the top (organising the main 3 pages) so I would invite you to join the discussion linked above. -- {{u|Gtoffoletto}}  ^talk 10:51, 18 November 2020 (UTC)

I think we're saying the same thing. I agree with all but the third bullet point on your list. I believe we should transclude a paragraph or two of 'Signs and symptoms' into the pandemic article with a 'Main article' hatnote directing users to the expanded content in Coronavirus disease 2019. - Wikmoz (talk) 21:17, 20 November 2020 (UTC)

John P. Sadowski (NIOSH), please see the above proposal. I believe this content still fits within the 'Signs and symptoms' section of this topic and we can merge back unique content without issue. - Wikmoz (talk) 21:23, 20 November 2020 (UTC)

The Symptoms of COVID-19 article needs to be expanded, not condensed into a section of another article. It's a high-impact topic, but the article currently lacks important details such as prevalence and mechanisms of each symptom. My intent in breaking it out as a separate article was to encourage these expansions, and I was going to highlight it along with a couple other articles at WT:COVID once I circle back to working on COVID content. So I don't support a merge. John P. Sadowski (NIOSH) (talk) 23:04, 20 November 2020 (UTC)

@John P. Sadowski (NIOSH): It is a high impact topic. But the COVID-19 article is the place to discuss signs and symptoms thoroughly. The only reason why you won't find some info like prevalence and mechanisms of each symptom is because we don't know those things very precisely yet. That's also why the specific article (which mostly contains duplicate info) is not being expanded. I would merge. — Preceding unsigned comment added by gtoffoletto (talk • contribs)

@Wikmoz: yes I think we are going in the same direction. But we need to be clear: the pandemic article is about the pandemic. I think the most we can have is one single new section (called maybe "Cause") that includes a very brief description of the disease, transmission methods, and main symptoms with a clear link to the underlying page. Nothing more than this or we are just duplicating information. -- {{u|Gtoffoletto}}  ^talk 12:56, 22 November 2020 (UTC)

The COVID-19 article is too long for a thorough discussion of any topic, it needs to remain written in summary style. Plenty has been written on prevalence and mechanisms, and a thorough discussion would include all viewpoints. There isn't room for this in the main article, so merging would actively prevent expansion from happening. John P. Sadowski (NIOSH) (talk) 19:40, 22 November 2020 (UTC)

I think that it's valuable to offer "one-stop shopping" for readers (assuming that any will read something so long), but I agree with Gtoffoletto that we should be focusing the articles to put "the disease" mostly in one page and "the event" mostly on another page. A brief, link-heavy section in the "event" article sounds like a good way to go about that: enough information about the disease that you can make sense of the rest of the page, but short, light on details, and general enough that it won't need to be updated regularly. WhatamIdoing (talk) 19:56, 22 November 2020 (UTC)

I see what you're saying. I don't have a strong opinion on this so long as we can use transclusions to avoid duplicating content. In this case though, I think we can still merge and expend the content within the main disease topic. The content will be seen by many more editors and may actually stand a better chance of further development. Can section hatnote it to request editor attention. If it gets too long we can re-split. Would that work or would you still prefer to keep it separate? - Wikmoz (talk) 23:12, 22 November 2020 (UTC)

In my experience, a section in a long article is less likely to get high-quality expansion because there's pressure to keep it short. We have WP:SUMMARY for a reason: the summary is higher visibility and has the most important points of a topic, while the full article is a place for details that are important but can't make it into a summary of a few paragraphs. If people do add material to the main article, it can be shifted easily to the subarticle. Transcluding ledes is fine, I'll take a look at the article's lede and try to make it suitable for this purpose. John P. Sadowski (NIOSH) (talk) 23:45, 22 November 2020 (UTC)

Sounds fair. We can transclude the two or three paragraph lede into the main disease topic. - Wikmoz (talk) 00:08, 23 November 2020 (UTC)

There is currently too much information on this page. I think it all comes down to how we handle the general content duplication discussion. At the moment I think John P. Sadowski (NIOSH) made a good argument that we shouldn't merge but summarise and link to the Signs and symptoms article. Once we have cleaned up this page (there are many other sections that are much more problematic) and we see how long Signs and Symptoms ends up being we can figure out what to do (I have my doubts Signs & Symptoms will be that long if we stick to MEDRS compliant sourcing. There isn't much we know for sure.). -- {{u|Gtoffoletto}}  ^talk 14:47, 23 November 2020 (UTC)

Support for not merge Thanks to all of you who have put in effort on these articles; I was recently looking at pageview data on Symptoms of Covid-19, you'll notice there's been a spike in traffic, in line with rising cases. My sense is there's a lot of information on the covid-19 article, almost an overload. I agree with John P. Sadowski (NIOSH) and others to not merge. Shameran81 (talk) 00:21, 23 November 2020 (UTC)

Generalise result for other sections

Should we adopt a similar approach for other sections covered by subarticles? I think the "transclusion of the lead into the main article and deep dive in the sub article" makes sense in all cases to avoid duplication of content and out of date content.

@Wikmoz, John P. Sadowski (NIOSH), Shameran81, and WhatamIdoing: thoughts? We could adopt it as a general guideline in {{Current_COVID-19_Project_Consensus}} -- {{u|Gtoffoletto}}  ^talk 00:09, 25 November 2020 (UTC)

It certainly solves the duplication of content issue from an editorial perspective. Eliminates the risk of dated and contradictory information. I previously did this for vaccine content and I think the solution works well for signs and symptoms. I just did the same for prognosis since there were just two paragraphs. Lengthier sections will require greater attention to ensure the best content survives but in general, I'm a fan of transclusion. - Wikmoz (talk) 01:48, 25 November 2020 (UTC)

I agree with Wikmoz when it comes to using transclusion. That being said, should we set limits on it? Transcluding only text and references shouldn't cause PEIS issues like graphs and tables do, but they should definitely be handled with care. —Tenryuu 🐲 ( 💬 • 📝 ) 02:35, 25 November 2020 (UTC)

I agree with both. That's why I think we need clear guidelines. For example. I think the guideline should be clear that only the lead of the sub article should be transcluded. The lead is where we summarise the most important info on the topic. If some info is missing then the solution is to just edit the lead of the underlying article and NOT adding other sentences from elsewhere in the sub-article. Should we try to write down an Item for the Consensus Template? -- {{u|Gtoffoletto}}  ^talk 09:41, 25 November 2020 (UTC)

How about:

To avoid duplication: when a section within a general article is covered by a specific sub-article on that topic the guideline is to transclude the lead of the specific sub-article into the general article with a link to read more

I would something like this to the consensus template for general reference. -- {{u|Gtoffoletto}}  ^talk 19:47, 26 November 2020 (UTC) @Wikmoz, John P. Sadowski (NIOSH), Tenryuu, and WhatamIdoing: should we add this to the consensus template? -- {{u|Gtoffoletto}}  ^talk 02:03, 7 December 2020 (UTC)

I don't think that this should be added to the consensus template at this time. WhatamIdoing (talk) 02:11, 10 December 2020 (UTC)

Semi-protected edit request on 10 December 2020

In the second sentence of the third paragraph, change "he" to they in order to be less gender specific Mattyice21 (talk) 02:44, 10 December 2020 (UTC)

done. MartinezMD (talk) 03:02, 10 December 2020 (UTC)

Deterioration of lead

I haven't monitored this page as closely as COVID-19 pandemic, and checking back in on it, I'm disappointed to see that the lead was substantially better a month or two ago than it is now. Seriously, who thought it was a good idea to remove a link to COVID-19 pandemic? (No, the hatnote isn't sufficient, since those are supposed to be disambiguatory, not informative.) The descriptions have also lost their conciseness and jargon such as "fomites" has been needlessly added. I'm not sure who's responsible and haven't checked, but someone competent needs to start paying attention, and I urge those less competent to self-reflect enough to realize that their contributions are not helping. It shouldn't be such a struggle to keep this page on an upward rather than downward path. {{u|Sdkb}} ^talk 22:16, 6 December 2020 (UTC)

This is exactly why we need to avoid duplication across articles. Editor attention needs to be guided to the right areas. This is the main page we have on the disease. The lead should be perfect. We don't have enough editors to deal with constantly duplicated but slightly different leads and content. -- {{u|Gtoffoletto}}  ^talk 02:07, 7 December 2020 (UTC)

Sdkb, would you mind posting a diff of the current version against one that you think is better? The last time someone posted something like this, there were very few changes, and the perceived problem was in a transcluded section from a different one. WhatamIdoing (talk) 02:15, 10 December 2020 (UTC)

I forget exactly which date I used for comparison. The lead here doesn't use any excerpts, so it should all be traceable in the history. {{u|Sdkb}} ^talk 01:07, 11 December 2020 (UTC)

Lead update

Similar to how the COVID pandemic lead update discussion is ongoing, we have to update the lead as vaccines have started being distributed, and a patient in UK has been discharged after being injected. GeraldWL 03:26, 10 December 2020 (UTC)

I had a go at removing outdated information from the ==Research== section. There was a lot of "As of April, there were 20 clinical trials" or "Research is just starting on [now-approved] drug". There is a lot more to be done. Simply removing the seriously outdated content would be helpful at this stage. WhatamIdoing (talk) 18:00, 10 December 2020 (UTC)

WhatamIdoing, these are consequences of managing a current event article. There certainly are many mess to clean up. GeraldWL 01:40, 11 December 2020 (UTC)

COVID-19 Clinical Research Coalition

I'm removing this:

The COVID-19 Clinical Research Coalition has goals to 1) facilitate rapid reviews of clinical trial proposals by ethics committees and national regulatory agencies, 2) fast-track approvals for the candidate therapeutic compounds, 3) ensure standardised and rapid analysis of emerging efficacy and safety data and 4) facilitate sharing of clinical trial outcomes before publication.

from COVID-19#Research, because I don't think it really fits in this article. It probably fits in another one; maybe someone can find it a new home? WhatamIdoing (talk) 04:00, 11 December 2020 (UTC)

Two medication sections...

There's so more work that needs to be done in de-duping treatment content. We should not have two different medication sections:

• Coronavirus disease 2019 § Medications
• Treatment and management of COVID-19 § Medications

Can someone help consolidate into Treatment and management of COVID-19?

It looks like there may be more content that needs to be moved from Research but approved medications seems like the higher priority. - Wikmoz (talk) 06:05, 12 December 2020 (UTC)

IMO we should have two different sections on medications for these two different articles. IMO this article's section should be more general (e.g., "Remdesivir exists but might not work") and the other should be more detailed ("Remdesivir was approved for use in adults and adolescents aged twelve years and older with body weight at least 40 kilograms (88 lb) who require hospitalization"). WhatamIdoing (talk) 16:48, 14 December 2020 (UTC)

Studies showing benefits of Vitamin D in prevention and treatment of Covid

I propose that the recommendation in the next section based on markedly better hospital outcomes for COVID patients who were not vitamin D deficient be incorporated into the article.

COVID-19

Vitamin D and COVID 19: The Evidence for Prevention and Treatment of Coronavirus (SARS CoV 2)

https://www.youtube.com/watch?v=ha2mLz-Xdpg

Premiered Dec 10, 2020

Professor Roger Seheult, MD explains the important role Vitamin D may have in the prevention and treatment of COVID-19. Dr. Seheult illustrates how Vitamin D works, summarizes the best available data and clinical trials on vitamin D, and discusses vitamin D dosage recommendations.

Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com

He is an Associate Professor at the University of California, Riverside School of Medicine and Assistant Prof. at Loma Linda University School of Medicine

Dr. Seheult is Quadruple Board Certified: Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine

Interviewer: Kyle Allred, Producer and Co-Founder of MedCram.com

REFERENCES:

The National Human Activity Pattern Survey (NHAPS)... (J. of Exposure Analysis and Environmental Epidemiology) | https://www.researchgate.net/publicat...

Aging decreases the capacity of human skin to produce vitamin D3 (The J. of Clinical Investigation) | https://pubmed.ncbi.nlm.nih.gov/2997282/

Racial differences in the relationship between vitamin D... (Osteoporosis Int.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Decreased bioavailability of vitamin D in obesity (The American J of Clinical Nutrition) | https://academic.oup.com/ajcn/article...

Vitamin D Insufficiency and Deficiency and Mortality from Respiratory Diseases ... (Nutrients) | https://www.mdpi.com/2072-6643/12/8/2488

Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis... (BMJ) | https://www.bmj.com/content/356/bmj.i...

Randomized trial of vitamin D supplementation to prevent seasonal influenza A... (The American J.of Clinical Nutrition) | https://pubmed.ncbi.nlm.nih.gov/20219...

Vitamin D and SARS-CoV-2 infection... (Irish J. of Medical Science) | https://link.springer.com/article/10....

Factors associated with COVID-19-related death... (Nature) | https://www.nature.com/articles/s4158...

Editorial: low population mortality from COVID-19 ... (Alimentary Pharm. & Therap.) | https://pubmed.ncbi.nlm.nih.gov/32311...

The role of vitamin D in the prevention of coronavirus ... (Aging Clinical & Experimental Research) | https://www.ncbi.nlm.nih.gov/pmc/arti...

25-Hydroxyvitamin D Concentrations Are Lower in Patients with ... SARS-CoV-2 (Nutrients) | https://www.mdpi.com/2072-6643/12/5/1359

Vitamin D deficiency in COVID-19: Mixing up cause and consequence (Metabolism) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Low plasma 25(OH) vitamin D level... increased risk of COVID-19... (The FEBS J.) | https://pubmed.ncbi.nlm.nih.gov/32700...

The link between vitamin D deficiency and Covid-19... | https://www.medrxiv.org/content/10.11...

SARS-CoV-2 positivity rates... with circulating 25-hydroxyvitamin D levels (PLOS One) | https://journals.plos.org/plosone/art...

Vitamin D status and outcomes for... COVID-19 (Postgrad Medical J.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Vitamin D Deficiency and Outcome of COVID-19... (Nutrients) | https://www.mdpi.com/2072-6643/12/9/2757

“Effect of calcifediol treatment...” (The J. of Steroid Bio. and Molec. Bio.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Vitamin D and survival in COVID-19 patients... (The J. of Steroid Bio. and Molec. Bio.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Effect of Vitamin D3 ... vs Placebo on Hospital Length of Stay...: A Multicenter, Double-blind, Randomized Controlled Trial | https://www.medrxiv.org/content/10.11...

Short term, high-dose vitamin D... for COVID-19 disease: a randomized, placebo-controlled, study [SHADE study] (Postgraduate Medical Journal) | https://pmj.bmj.com/content/early/202...

Association of Vitamin D Status... With COVID-19 Test Results (JAMA Network Open) | https://jamanetwork.com/journals/jama...

Vitamin D Fortification of Fluid Milk ... A Review (Nutrients) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients... (Scientific Reports from the Journal Nature) | https://www.nature.com/articles/s4159... — Preceding unsigned comment added by Ocdctx (talk • contribs) 00:35, 14 December 2020 (UTC)

Your links are mostly broken or incomplete, you've made no edit proposal, and it looks like these are primary studies. Read WP:MEDRS and make a specific proposal, otherwise this is just spam. MartinezMD (talk) 00:45, 14 December 2020 (UTC)

Vitamin D is discussed in the medications section here... Treatment and management of COVID-19 § Medications. MartinezMD, I'm hoping to merge these sections in the near future and transclude in part or in full into this topic. Hoping you or someone else can check to see if anything insufficiently sourced made it past editors in that section of the other topic. - Wikmoz (talk) 05:27, 14 December 2020 (UTC)

I see three secondary sources in that section. The strongest one is the following meta-analysis in Critical Reviews in Food Science and Nutrition (which I haven't heard of before, and I'm not sure how their review process works, so I'm hesitant to call this a slam dunk source):

Vitamin D deficiency was not associated with a higher chance of infection by COVID-19 (OR = 1.35; 95% CI = 0.80–1.88), but we identified that severe cases of COVID-19 present 64% (OR = 1.64; 95% CI = 1.30–2.09) more vitamin D deficiency compared with mild cases. A vitamin D concentration insufficiency increased hospitalization (OR = 1.81, 95% CI = 1.41–2.21) and mortality from COVID-19 (OR = 1.82, 95% CI = 1.06–2.58). We observed a positive association between vitamin D deficiency and the severity of the disease... However, there is no support for supplementation among groups with normal blood vitamin D values with the aim of prevention, prophylaxis or reducing the severity of the disease.

However, the NICE source seems to contradict this slightly:

There is no evidence to support taking vitamin D supplements to specifically prevent or treat COVID‑19. However, all people should continue to follow UK Government advice on daily vitamin D supplementation to maintain bone and muscle health during the COVID‑19 pandemic.

And the BML meta-analysis from 2017 of general respiratory infection protection, which is not COVID specific and the conclusion was :

Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.

Combined, these seem to suggest less that Vitamin D is a treatment for COVID-19, and rather that (per the first source in particular) Vitamin D deficiency may be a risk factor for COVID-19 (amongst all the other health risks of deficiency). Personally, I think we should trim that section to primarily these three sources, focusing on the deficiency link and noting there is no COVID-specific recommendation for supplements from an authoritative source. Other sources that expand on these discussions (Mayo Clinic link, for instance) would be welcome. I might take a stab at this later, thanks for mentioning it. Bakkster Man (talk) 17:01, 14 December 2020 (UTC)

Authors of Nature study recommend vitamin D supplements for populations at risk for COVID-19

I propose that the following recommendation and the findings on which it is based be incorporated into the article.

Vitamin D deficiency markedly increases the chance of having severe disease after infection with SARS Cov-2. The intensity of inflammatory response is also higher in vitamin D deficient COVID-19 patients. This all translates to increase morbidity and mortality in COVID-19 patients who are deficient in vitamin D. Keeping the current COVID-19 pandemic in view authors recommend administration of vitamin D supplements to population at risk for COVID-19.

https://www.nature.com/articles/s41598-020-77093-

Article

Open Access

Published: 19 November 2020

Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers

Anshul Jain1, Rachna Chaurasia2, Narendra Singh Sengar3, Mayank Singh4, Sachin Mahor5 & Sumit Narain4

Scientific Reports volume 10, Article number: 20191 (2020) — Preceding unsigned comment added by Ocdctx (talk • contribs) 01:02, 14 December 2020 (UTC)

Your link is broken and more importantly, that is a primary study. Again, read WP:MEDRS. The article needs secondary studies, see WP:PSTS. MartinezMD (talk) 01:22, 14 December 2020 (UTC)

Ocdctx, the last time I looked at this question, the advice was that if you should be taking Vitamin D anyway, then you should take Vitamin D during the pandemic, but if you didn't need supplemental Vitamin D anyway, then you should not take it now. Has the overall situation changed? WhatamIdoing (talk) 16:50, 14 December 2020 (UTC)

See above talk section. I agree, the secondary sources seem to indicate that the correlation is with Vitamin D deficiency. Those secondary sources (including meta-analysis) are what should be included here, not individual studies. Bakkster Man (talk) 18:17, 14 December 2020 (UTC)

There is a difference between direct evidence of help wrt Covid19, as discussed in secondary sources, and the advice given by government or healthcare, which might err on the precautionary side. This is especially true for a safe, cheap and convenient proposal to pop a wee pill every day. The UK is giving 'at risk groups' a supply of vitamin D, and the government advice notes that "It is likely that many of us have been indoors more than usual this spring and summer, and some of us have been shielding, so we might not have been making enough vitamin D from sunlight. So, it’s even more important this year to take a vitamin D supplement as we go into the winter months." This aspect is probably more relevant to the articles discussing our reaction to the pandemic (staying indoors, shielding, government statements) rather than the disease itself. -- Colin°^Talk 17:40, 14 December 2020 (UTC)

Paragraph about strains, serotypes, and Cluster 5

Hello. I am surprised to see that this article doesn't talk much about strains, and doesn't talk at all about serotypes and Cluster 5. I'm thinking about adding this paragraph to the end of the virology heading.

SARS-CoV-2 has at least six main strains as of August 2020. The main strains are L, S, V, G, GR, and GH. Strain L was the first strain, discovered in Wuhan in December 2019. As of August 2020, strain G (and related strains GR and GH) are the most widespread. Strains L and V are gradually disappearing. In addition, there are some infrequent mutations. Cluster 5 was a rare but virulent strain that was discovered in mink farms and mink farmers in Denmark. Denmark engaged in a mink euthanasia campaign, and is believed to have eradicated Cluster 5. The number of SARS-CoV-2 serotypes is currently unknown.

Source for the strains is ScienceDaily.com. It says it got its material from "Daniele Mercatelli, Federico M. Giorgi. Geographic and Genomic Distribution of SARS-CoV-2 Mutations. Frontiers in Microbiology, 2020; 11 DOI: 10.3389/fmicb.2020.01800". I don't know if that's a "preprint" or not, how does one tell?

A serotype is in my opinion very important data to include in an article about a pandemic. A strain is any change at all to the genetics, whereas a serotype is a change to the genetics that changes the antibody needed to fight/kill the pathogen. The number of serotypes is very important from a vaccination perspective. It's the difference between the disease being easy to vaccinate (measles - 1 serotype), versus having to change vaccines every year (flu - medium # of serotypes), versus the disease being impractical to vaccinate (rhinovirus aka common cold - high # of serotypes). I suspect the # of serotypes for COVID is 1, but I googled hard, and I couldn't find an article that explicitly stated this. Nevertheless, I believe it important to include a sentence on serotypes in this article. Maybe it will inspire somebody to find an article and specify the #.

Any objections? If comments are positive, I'll go ahead and add this, and you guys can edit the details once it's in the article. Thanks. –Novem Linguae (talk) 17:24, 15 December 2020 (UTC)

I'd suggest any updates of this manner would be better added to the Severe acute respiratory syndrome coronavirus 2 article, listed as the main article for the section you reference. Bakkster Man (talk) 17:29, 15 December 2020 (UTC)

Should "one in five infected individuals do not develop" be rephrased to "one in five infected individuals does not develop" ?

Apokrif (talk) 13:34, 19 December 2020 (UTC)

Warning. Technical explanation incoming. So this is a verb conjugation question. What is the correct conjugation for the verb "to do"? Depends on whether the subject of the sentence is singular or plural. How do we find the subject? We need to cross out all the stuff that isn't a noun. "One in five" is a phrase functioning like an adjective here. It answers the question "how many?", cross it out. "Infected" is definitely an adjective, cross it out. So we're left with the sentence "individuals do/does not develop". When stated that way, it becomes clear that "individuals do not develop" is the correct conjugation. Hope that helps. –Novem Linguae (talk) 13:56, 19 December 2020 (UTC)

Thanks, but actually, the subject is the whole phrase "one in five infected individuals", which is (looks) singular. In French (my first language) one would definitively use a singular verb form in this context. Perhaps in English one rather uses a plural verb form (because, in this context, "one" in five persons actually means several millon people) but: [1] [2] (less clear-cut). Apokrif (talk) 02:13, 20 December 2020 (UTC)

The Cambridge Grammar of the English Language has this to say:

In [One in a hundred students take/takes drugs], however, the head is plural, but the verb can be singular as well as plural.

Editorialised to include the example sentence. It seems it could be either, though in this case, I find "do" to be more phonically pleasing than "does". —Tenryuu 🐲 ( 💬 • 📝 ) (🎁 Wishlist! 🎁) 02:33, 20 December 2020 (UTC)

English grammar rules are a mess and you can see from the web links that people disagree. I think the best explanation is whether you are thinking about (and in turn, want the reader to think about) an imaginary tiny sample set of five people with a single case (who develops symptoms, say), or are thinking generally about a huge population group and a select subset that is large regardless of whether the first number is one or two. You might be more tempted to think of the single case when the overall study size was small anyway (e.g. a classroom) or when that one is extraordinarily rare (one in 17 million). If you write whatever sounds right to your ear, the reader will know what you mean, and only pedants might complain. -- Colin°^Talk 15:08, 21 December 2020 (UTC)

References

N501Y strand prevalent in London

In the Virology section, variants of the virus are discussed. (Arguably this belongs in Severe acute respiratory syndrome coronavirus 2, but e.g. Cluster 5 is covered in this disease article, not in that virus article.)

The variant N501Y, now prevalent in London, allegedly no more lethal but significantly more contagious than former strands, appears not to be mentioned in Wikipedia at all. Of course, a good source would be needed.--Nø (talk) 10:16, 20 December 2020 (UTC)

I agree that the variants (particularly when they only affect virulence, not the course of the disease itself) should primarily be discussed in Severe acute respiratory syndrome coronavirus 2 (all notable variants) or COVID-19 pandemic (variants which produced major actions, like travel bans). In general, I think this article should link to one of those sections as the main article, with a short recap or transclude. Bakkster Man (talk) 14:14, 21 December 2020 (UTC)

PS. It's now covered, under the horrible but correct name VOC-202012/01.--Nø (talk) 16:09, 22 December 2020 (UTC)

Sourcing and notability

I posted the results of a "natural experiment" in South Korea that found that recent spread of COVID-19 had occurred in a restaurant from a host to a 16-year old victim, at a distance of 20' apart, and during a maximum 5-minute exposure at that distance. A good-faith editor removed my edit as representing only a single example and therefore not sufficiently significant and perhaps conclusionary. In fact, the P.R.C. CDC had noted the likely insufficiency of a six-foot distance as early as late January, 2020. I'll add those cites. South Korea found an early instance of a superspreader who was a member of a large congregation of a denomination, denialists that preached that illness had causation in "sin." Historical superspreaders have their own Wikipedia articles, of course, including Gaëtan Dugas and Mary Mallon being among the most famous. The editor had deleted my well-sourced and notable details, as emanating from only a single instance, and therefore not worthy of mention. Another editor deleted partial documentation of a study that determined that the presence of a frequent residual fragment of Western European Neanderthal DNA made such victims of COVID-19 much more susceptible to highly negative outcomes of infection, produced more likely hospitalizations, fatalities, and markedly constrained the success of conventional inpatient treatment producing significantly more negative responses and outcomes despite intense treatment. In removing my text the editor removed the international collaborative context, especially the work of Svante Pääbo (a Swedish/Estonian scientist who could succeed his father in receiving the Nobel prize) in the development of the hypothesis and its confirmation, that good faith editor terming it "fluff." Activist (talk) 23:51, 17 December 2020 (UTC)

Some of this is related to WP:MEDRS, and a preference for secondary sources. Particularly with the high visibility and in-development nature of COVID, most articles have been running a very tight ship around items with only primary sources (especially with only a single primary source). IMO, the most applicable piece of this guideline comes from the WP:MEDPRI section:

If conclusions are worth mentioning (such as large randomized clinical trials with surprising results), they should be described appropriately as from a single study... If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed.

While I could see a case made that the case studies of greater distances of infection than 6' depending on airflow (see also: [3]), it does need to be placed in the proper context and lower prominence than the recommendations of various public health organizations. The simplest solution for all of this, however, would be to find a reliable secondary source showing consensus on the topic. I expect a secondary source stating that transmission >6' is possible but rare can be found, I think it's less likely we'll find one on the Neanderthal finding. Bakkster Man (talk) 17:59, 18 December 2020 (UTC)

Transmission >6 feet is not common, but it's not exactly rare, either. Time and other circumstances (e.g., masks, airflow) matter. It is not difficult to find sources about this, and it is not necessary to rely on news reports about a single event to discuss the fact that physical distance is not a guarantee. WhatamIdoing (talk) 03:39, 23 December 2020 (UTC)

Needless jargon

Someone seems to keep changing sentences like The virus may also spread via contaminated surfaces to The virus may also spread via fomites (contaminated surfaces). MOS:JARGON is pretty clear about this: Do not introduce new and specialized words simply to teach them to the reader when more common alternatives will do. I'm going to change back to plain English and I urge whoever is doing this to familiarize themselves with the MOS advice on this. {{u|Sdkb}} ^talk 23:08, 17 December 2020 (UTC)

Sdkb, it's TechnoHippie, if I remember. He once suggested that this article be simply put to make it ESL-friendly. I opposed this and removed it, but someone reverted it, and I don't really wanna care about this article at the time. Support the removal though. GeraldWL 14:04, 19 December 2020 (UTC)

Hmm. In MOS:JARGON, the sentence before the one quoted is Avoid excessive wikilinking (linking within Wikipedia) as a substitute for parenthetic explanations such as the one in this sentence. Which seems to me to encourage the use of parenthetical "simple" descriptions. I don't have an opinion on their use or disuse in this article. But I did want to point out that the policy is not particularly clear on this issue. –Novem Linguae (talk) 07:02, 22 December 2020 (UTC)

This means that we shouldn't use fomite by itself (with a wl instead of a parenthetical definition), but neither option does this. I'd suggest the relevant guidance here is Do not introduce new and specialized words simply to teach them to the reader when more common alternatives will do. MY read would be that we should add a parenthetical explanation for the word 'fomite' if we're directly quoting a source which uses that word, and otherwise the more common alternative of contaminated surfaces (with the wl to the article people can read more) is most appropriate. Bakkster Man (talk) 14:19, 22 December 2020 (UTC)

Bakkster Man, INFO: By "wl" you mean "wikilink"? GeraldWL 14:41, 22 December 2020 (UTC)

Yes, I mean wl (wikilink) ;) Bakkster Man (talk) 14:58, 22 December 2020 (UTC)

My understanding of the MOS here is to avoid gratuitous teaching of specialist terms ("simply to teach") but doesn't of course rule out intentional teaching of specialist terms (i.e. teaching words and using the "correct" idiomatic word as any professional writer might when discussing a topic). A suggestion here, for words you suspect the reader is less likely to know (and fomite certainly fits) is whether you need to use it again or whether they might unavoidably encounter that term when dealing with this subject in other literature [where we would do the reader no favours by avoiding teaching the word or inventing novel non-idiomatic terms instead, which believe me, does happen]. And as noted, also if you need to quote someone. I would certainly expect to read about fomites at Transmission of COVID-19#Objects and surfaces where the word is introduced and repeatedly used. Here, it was only used in the lead and in fact the body makes no mention of this at all. Hmm. -- Colin°^Talk 14:46, 22 December 2020 (UTC)

This is a very good correction, and a great guideline on when the specialist term is worth using. Bakkster Man (talk) 14:58, 22 December 2020 (UTC)

I'm still very opposed to adding "fomites (contaminated surfaces)." The current "contaminated surfaces" seems to be fine. The previous attempts to make the article Simple English level (i.e. adding "(no symptoms)" after "asymptomatic" is ridiculous: even though jargon terms must be simplified where possible, it doesn't mean common-sensical words like "a-symptom-atic" should be extended to a term so long, I don't think it would even help. I would stress to other editors that this is the English Wikipedia, not Simple English Wikipedia, and the simplification of certain words is much more restricted as this edition isn't fully targeted towards the ESLs. In most cases, wikilinks help: those who don't understand the word can just click the link and read that article's lead. Considering this is a medical article and the edition this article's at, even "fomites" and "asymptomatic," I think is already fine.

I used to be an ESL person too, and I learn through watching films and reading books. I would memorize some of the words said, then when I'm out I'll look or ask for that term's definition. I would search for a sentence example, and boom a new word's in my dictionary. In fact, I think it's how nearly all people learn new vocabularies. Just because we must make articles slightly universal, doesn't mean all terms must be simplified to an extent one consider "simple"-- Wikipedia articles with an appropriate amount of new terms can help one's knowledge of English. GeraldWL 15:11, 22 December 2020 (UTC)

I'm not clear who you are arguing "very opposed". Indeed, I can't see anyone thinking the lead of this article should say "fomites" at all. -- Colin°^Talk 16:05, 22 December 2020 (UTC)

For the record, as a reader with scientific background but not in the relevant area, and one who didn't know the term "fomite": I think "contaminated surfaces" wikilinked to "fomite" makes sense, but "fomite (contaminated surface)" would too. As long as the technical term is not used again in the article, teaching it in the lead seems a bit too preachy; I'd go with the first solution (which is the status right now, anyway).--Nø (talk) 16:22, 22 December 2020 (UTC)

Nø, I prefer option 1, since it saves space. Why do links exist if not for clarification/to give context? GeraldWL 16:26, 22 December 2020 (UTC)

Gerald Waldo Luis I suppose what you mean is "fomite" wikilinked to "fomite", which is an option I didn't mention at all (so we could call it option 3), because I don't think it makes sense. For the average reader (me - always! ;-) ), it is more cumbersome than "contaminated surfaces" wikilinked to "fomite", even if marginally shorter. There is no need to use the more technical term, when "contaminated surfaces", as far as I can see, is fully understood and accurate, to the expert and the lay reader alike - and, as mentioned, when the term is so marginal to this article, as it stands, that it is never used again.--Nø (talk) 16:41, 22 December 2020 (UTC)

Nø, I'm talking between your option 1 and 2, in which I prefer "contaminated surfaces" linked to "fomite." It's much more space efficient. However if you were to give the option 3, I'll choose 3. GeraldWL 16:45, 22 December 2020 (UTC)

Great; we almost agree then!--Nø (talk) 16:49, 22 December 2020 (UTC)

Gerald Waldo Luis unfortunately, option 3 is the one that seems most discouraged by the manual of style. I agree with Nø that options 1 and 2 are both fine, with option 1 preferred for articles which do not use the word 'fomite' elsewhere in the article. Bakkster Man (talk) 16:53, 22 December 2020 (UTC)

Wrt relying on the wikilink alone to explain jargon (writing "fomite" alone), I think the reason MOS discourages that is that we'd like the article to be largely accessible in itself. Imagine someone (Alexa, even) was reading it out and said "fomite". I do appreciate that being able to click/hover/press the linked words is great for looking up unfamiliar stuff, but this isn't some city or brand name you can't recall, and it isn't the sort of word anyone could guess enough of the meaning in order to get by. -- Colin°^Talk 17:01, 22 December 2020 (UTC)

Oh right, I remember this. My reasoning for looking the other way at the time is given the prevalence of the disease worldwide, it seemed like an appropriate time to lightly ignore some MoS conventions if laypeople were going to Google up the disease (sadly Simple does not appear high on search engines). I don't have any strong feelings either way, but I think the issue arose from what the common person should know. Compared to "asymptomatic", "fomite" is a very technical term that many people not in the field would not understand. Given how ledes are the most read section of articles and many readers don't go past that, I don't see the need to use "fomite" unless the lede mentions the concept more than once or twice. —Tenryuu 🐲 ( 💬 • 📝 ) 🎄Happy Holidays!⛄ 19:14, 22 December 2020 (UTC)

Dump any mention or link to "fomite" or we will have readers scrubbing only their "fomite surfaces". Charles Juvon (talk) 21:58, 28 December 2020 (UTC)

My wife spelled FOMITES playing Boggle the other day. I didn't see it myself. That doesn't have any bearing on whether the article should mention the word, but I thought I'd share it anyway :-). -- Colin°^Talk 22:07, 28 December 2020 (UTC)

The existing Possible earlier cases in History

Please add the following to the History#Possible earlier cases section after the existing text there

However conclusions from the study were questioned because such antibody tests can show up a lot of false positives, and at the time in the area there also wasn't a dramatic uptick in pneumonia-like cases corresponding to the study's ratio of positives.

Explanation:

The section is based on a single reference, a news report by the site "Lovin malta", which is reporting on another news report by 112 Ukraine, which is affiliated with Viktor Medvedchuk. There are more credible sites reporting on this.

If you read about it in Live Science they include commentary:

But it's hard to imagine that a substantial fraction of the population was infected with SARS-CoV-2 in September in Italy without a dramatic uptick in pneumonia-like cases then. For instance, in Spain, far less than 10% of the population tested positive for antibodies to SARS-CoV-2 in the summer, despite the fact that 28,000 people had died from COVID-19 up to that point, according to a survey published in August in the journal The Lancet.

"I would be very cautious," about these findings, said Dr. George Rutherford, professor of epidemiology and biostatistics at the University of California, San Francisco, who was also not a part of the study. The results "have to be confirmed with different antibody tests," that look for the prevalence of antibodies that target other parts of the coronavirus.

His previous experience has shown that such antibody tests for the coronavirus' RBD can create a lot of false positives, Rutherford told Live Science. And because this is "such an unexpected finding," it should be confirmed with other antibody tests such as those that look for antibodies against another one of the coronavirus' proteins, an outer coat called a "nucleocapsid," which is also unique to the novel coronavirus, he said.

So it only makes sense to mention that as well.

--176.72.77.137 (talk) 08:52, 17 December 2020 (UTC)

References

You can change the wording. Can someone at least comment? --176.72.77.137 (talk) 00:17, 23 December 2020 (UTC)

 Not done: Request has been rendered moot by the removal of the 'Possible earlier cases' section. Sdrqaz (talk) 20:40, 29 December 2020 (UTC)

spelling error

I spotted a double "such as such as" in the article. — Preceding unsigned comment added by 82.197.217.12 (talk • contribs)

Fixed. thank you. MartinezMD (talk) 11:24, 31 December 2020 (UTC)

Remdesivir subsection - Proposed reordering

I was just reading the subsection Medications on Remdesivir and found that it did not flow well. I think the subsection would benefit from a reordering of the sentences, with attention to the chronology, and with some slight adjustment to the wording. The current 3rd paragraph could be used to open the subsection. It would also benefit from being inverted, and a brief description of what Remdesivir is, such as: "a broad-spectrum antiviral medication". The first sentence would then read as:

 On 1 May 2020, Remdesivir, a broad-spectrum antiviral medication, was given an emergency use authorization (EUA) for people hospitalized with severe COVID-19 by the United States Food and Drug Administration (FDA). 

Then it would flow into the next sentence refering 28 August 2020 with the word "By" leading in:

 By 28 August 2020, the FDA broadened the EUA for remdesivir to include all hospitalized patients with suspected or laboratory-confirmed COVID-19, irrespective of the severity of their disease.

Then the sentence starting: "In Australia and the European Union" could be tagged on the end as this might benefit from a chronological context as 3 of the 4 sources for this sentence are dated August 2020. The next sentence of the 2nd paragraph would read:

 The same month, remdesivir (Veklury) was indicated in Australia and the European Union for the treatment of COVID-19 in adults and adolescents aged twelve years and older with body weight at least 40 kilograms (88 lb) with pneumonia requiring supplemental oxygen.

The 3rd paragraph could start "Remdesivir was approved for medical use in the United States in October 2020 but should be combine with the sentence starting "As of late October 2020, Remdesivir was the only drug..." as these sentences say more or less the same thing. The third paragraph could look something like:

 As of late October 2020, Remdesivir was the only treatment for COVID-19 approved by the U.S. Food and Drug Administration (FDA) for medical use in the United States. It is indicated for use in adults and adolescents aged twelve years and older with body weight at least 40 kilograms (88 lb) for the treatment of COVID-19 requiring hospitalization.

The reworked subsection would close with the last remaining sentence, only preceded by the word "In":

 In late November 2020, the World Health Organization (WHO) made a conditional recommendation against treatment with remdesivir for hospitalized patients, regardless of severity (based on data from the Solidarity Trial).

I've moved the text around in most of the above, but they largely say the same thing. I am hoping that this proposed order might flow better, and better reflect how things developed chronologically speaking. I look forward to hearing what you think of this. SpookiePuppy (talk) 00:27, 12 December 2020 (UTC)

SpookiePuppy, that section was a mess because I had just evicted a bunch of content from the ==Research== section. I appreciate your help in cleaning it up. WhatamIdoing (talk) 16:46, 14 December 2020 (UTC)

Thanks WhatamIdoing, that all makes more sense now. I should just point out that I haven't actually made any changes to the Remdesivir subsection yet. I think the last paragraph of what I wrote above was ambiguous, even misleading, particularly ("I've moved the text around in most of the above"), as it might have made it sound like I'd already made those changes in the article, when in fact I was proposing the changes here for the first time! I'm more than happy to make all the edits and swap things around as per the above as and when we get some sort of consensus here. SpookiePuppy (talk) 01:13, 16 December 2020 (UTC)

 Done (...the reordering of the remdesivir section as per above). Apologies if this appears a too drastic change. SpookiePuppy (talk) 03:29, 3 January 2021 (UTC)

Note news

See https://www.reuters.com/article/us-health-coronavirus-novavax-executives/novavax-bosses-cash-out-for-46-million-with-covid-19-vaccine-trials-still-under-way-idUSKBN29G1A2 .

— Preceding unsigned comment added by 190.145.37.2 (talk) 14:40, 11 January 2021 (UTC)

Lacking pre-incubation details

There a big gap here between transmission abundant details and incubation (=the first days of the progression). I can't find any texts regarding passage through airways, landing sites, spike engagement with ACE2, cell penetration, etc. and timelines thereto (minute-by-minute, hour-by-hour). I wouldn't mind even more granular timings (seconds).

Everything I've learned so far about that has been in scattered bits and pieces in articles here and there, and I'm really puzzled^*.

I came here to get a sketch and some better sources, and find neither. Somebody who knows something about that subset of the etiology and knows their way around the literature, formal and informal, might want to fill that in. Thank you. _____

^*I'm surprised to not even find a one-minute youTube video on this very interesting topic. Just about everything else under the sun is covered. JohndanR (talk) 22:58, 12 January 2021 (UTC)

The opener is racist

The first case was identified in Wuhan, China, in December 2019. It has since spread worldwide, leading to an ongoing pandemic.

This suggest the virus is from Wuhan and started in December 2019. This is not confirmed. Please reword this segment.

172.98.159.139 (talk) 16:47, 8 January 2021 (UTC)

 Not done That's the accepted sequence of events. It's not "racist". Viruses don't know about "race". Alexbrn (talk) 16:49, 8 January 2021 (UTC)

You cannot present a conjecture as a fact. No one knows where the virus is from. This is fact.

172.98.159.139 (talk) 18:48, 8 January 2021 (UTC)

It's conjecture to state that something was first identified in a location? —Tenryuu 🐲 ( 💬 • 📝 ) 18:49, 8 January 2021 (UTC)

It is confirmed that the virus was first identified in Wuhan. That could change, perhaps with serum sampling from other locations, but this is how it currently stands. This is a non-issue. MartinezMD (talk) 19:32, 8 January 2021 (UTC)

Identification does not mean origin. 172.98.159.139 (talk) 17:42, 11 January 2021 (UTC)

You have made your point and it has been rejected. Move on. If in the future researchers find the virus originated elsewhere, that should be mentioned. Even if that happens, however, the fact that the first case was identified in Wuhan remains exactly that: a fact. Jeppiz (talk) 18:02, 11 January 2021 (UTC)

The lede doesn't mention the 'origin' of the virus, only the identification of the first case. You're reading your own presumption into that language, which isn't something that can be addressed by rewording the page. Bakkster Man (talk) 19:18, 11 January 2021 (UTC)

this sentence in the lede It has since spread worldwide, leading to an ongoing pandemic. suggests the virus originated in Wuhan. This is racist. Please edit the lede. Thank you. 172.98.159.139 (talk) 22:10, 11 January 2021 (UTC)

What alternative wording would you suggest? HiLo48 (talk) 22:28, 11 January 2021 (UTC)

Get rid of the word since in the sentence It has since spread worldwide, leading to an ongoing pandemic. in the lede. Thanks. 172.98.159.139 (talk) 22:37, 12 January 2021 (UTC)

But that's what happened. HiLo48 (talk) 23:06, 12 January 2021 (UTC)

Please walk us through your logic process as to how saying a pandemic has occurred since the virus has been first identified somewhere is racist. —Tenryuu 🐲 ( 💬 • 📝 ) 02:34, 13 January 2021 (UTC)

The wording spread since suggests the first identification is the origin. This is not true. You should not use the word since. 204.197.178.34 (talk) 17:47, 13 January 2021 (UTC)

There is nothing wrong with the wording. MartinezMD (talk) 18:22, 13 January 2021 (UTC)

Semi-protected edit request on 8 January 2021

Change the Duration from 5 days to 10 months+...to just short to long term. Also to added references beside the duration section.

Because most people can recovered in 1 to 2 weeks. But are there some people which can have longer effects like lingering or symptoms which comes and go. 80.233.48.106 (talk) 18:43, 8 January 2021 (UTC)

We should list it as something like "typically 1-2 weeks (add ref) with a minority of cases lasting longer (link to Long COVID and a ref)" MartinezMD (talk) 19:43, 8 January 2021 (UTC)

Not sure about this... people who get hospitalised have much longer durations. And they are a significant percentage. The current indication is probably more precise (without the "typically") -- {{u|Gtoffoletto}}  ^talk 18:48, 13 January 2021 (UTC)

References

"B11K" listed at Redirects for discussion

A discussion is taking place to address the redirect B11K. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 January 16#B11K until a consensus is reached, and readers of this page are welcome to contribute to the discussion. _signed, Rosguill ^talk 18:11, 16 January 2021 (UTC)

RfC about the selection of accepted medications for COVID-19

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

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Does Wikipedia have legal exposure for failing to include Ivermectin as a treatment option? Ivermectin has USFDA approval and has the same USNIH rating as other medications that Wikipedia considers acceptable for COVID-19.--Vrtlsclpl (talk) 01:53, 19 January 2021 (UTC)

No. Wikipedia's legal exposure comes from copyright, and slander/libel, to name a few. I've never heard any argument that Wikipedia failing to mention something in an article opens us up to liability. Please stop pushing this Ivermectin POV. Experienced editors are telling you that this is not supported enough by medical reliable sources to deserve WP:WEIGHT in the main COVID-19 articles. It is already covered in Ivermectin#COVID-19 and Misinformation related to the COVID-19 pandemic#Ivermectin. And please remove the RFC tag. –Novem Linguae (talk) 06:42, 19 January 2021 (UTC)

• Close RfC and sanction the filer. Not an admissible RfC question, and makes no sense in any case. Vrtlsclpl's crusade to push ivermectin has now wasted enough community time. Alexbrn (talk) 06:45, 19 January 2021 (UTC)

  Agree. GeraldWL 06:59, 19 January 2021 (UTC)

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