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

  1. 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:

  2. Rec0veries vs conf!rmed inf3ction$ = 20%

    I don’t need to tell you what the inference is for the percentage of people who didn’t rec0ver……

  3. Wonderful work, can you please let us know your thoughts and the data on the possibility of this being a cold weather seasonal transmission disease or not? Indonesia is not reporting any cases, and Thailand is not progressing, but Singapore which is heavily air conditioned is potentially out of control. What are the relative flu virus rates in tropical hot countries vs temperate climates and does that have any relevance to this developing pandemic? Thanks!

  4. has there been anything stating how long it takes to recover for those who have recovered? Maybe I keep missing it if it has been said.

  5. I am more and more convinced that I stand a very high chance of having had it. I'm in Japan, on the trains every day, in contact with loads of people due to my job, had a fever and a cough as well as common cold symptoms. The cough is still lingering more than two weeks later. Went to the hospital twice for tests. Influenza A and B both were negative, lung scan thankfully clean. The hospital couldn't test for corona virus.

  6. Thank you for continuing this. I heard on NPR bat studies show transmission to humans in China. Is this from getting bit or eating?

  7. 3 week incubation period, asymptomatic transmission, indistinguishable from flu, no reliable diagnosing method, and infectious even after recovery … Folks, there's really nothing to worry about, seriously!

  8. Yet another interesting video, thank you. I found the study referred to particularly useful as it makes a strong argument for asymptomatic transmission, something that some commentators remain sceptical about.

  9. The way that it spreads it is difficult to see how this can be contained. influenza can't be contained even with a less robust transmissibility rate. the who seems to be confused. I watched the WHO press release video … mostly mindless babble. No one seems to have much of a clue … now its just wait-and-see.

  10. I’m in Daegu cases are increasing and someone died here today Mayor has told people to stay home population here is2.5 million

  11. So, if someone don't finish out their 14 day quarantine overseas, when they hit the States they gotta go into a full 14 day quarantine? That's good.

    Are they asking that the people "self quarantine at their homes?" Yeah… I don't see those people complying.

    They're not gonna go straight home and lock themselves up. They're gonna stop at a few different stores along the way to pick up supplies. And then during the "self quarantine," they'll sneak out to get a six-pack of their favorite brew and go back home….

  12. But the asymptomatic person is coughing less. So only as contagious if the virus spreads in breath aerosols, as opposed to droplets.

  13. I for one am thanking Japan for allowing that ship to dock in their country, and for the care, they offered peoples from around the world. Other countries have refused entrance to cruise ships! THANK YOU JAPAN😊🧡

  14. So sick of Americans demanding they be taken to the U.S.. Yeah we want you to spread it to everyone here. If you have it then self quarantine! Believe it or not, you're not special .

  15. Cod bless you all 🙏🙏🙏💜💜💜😭😭😭🇰🇭🇰🇭🇰🇭🙏🙏🙏🇨🇳🇨🇳🇨🇳🙏🙏🙏🇰🇭🇰🇭🇰🇭💜💜💜

  16. I think the sewage system on the diamond princess helped spread the virus. I've been on the ship a couple times and the toilet spewed sewer gasses into the room on several occasions. Very bad for spreading a virus that can be spread by aerosol. Add to that the crew which has zero experience in infection control and you've got a recipe for disaster

  17. I read in German Newspaper that one Japanese Doctor found and complaint that the situation in Diamond Princess was catastrophic in term of they didn't really separate the really sicks and the healthy groups as happened before to Chinese's tourists before outside of China. So he said, no need to wonder that they numbers of infected people will increase!

  18. Hi I am following your reports and appreciate the work you are putting into it. February 21st. Chinese health authorities released the info here in China that they have asymptomatic cases which test negative with PCR tests but get a positive result on testing the feces. Maybe you could look into that? Would be great to know more about that. Kind regards.

  19. So those Americans who choose to not come back with the others thought they would get out of quarantine, they thought wrong, No getting out of Quarantine if you where on the ship, I'm glad Japan stopped that from Happening. I'm sure more will come down with the sickness while in waiting.

  20. So on a quaranteened ship with a few thousand people people get 60-80 infected a day, but in a country with 1 billion people only 1.5k get infected a day?

  21. Why is there no detailed case info for the Diamond Princess cruise ship? It is a large test sample, observed under an explicit prevention protocol.

  22. My understanding is that the Chinese authorities are conducting mandatory asymptomatic PCR tests for every single person in Wuhan.

    I think that's what we need. I suspect that at least 60% of the population will test positive. In any case we definitely need to know this.

  23. Any possibility that the use of an N95 mask may actually increase possibility of acute disease from SARS-cov-2 virus as it may alter the modality of infection?..I E. Aerosolized particles in the LRT?..thoughts???

  24. A thirty year old woman in Vancouver Canada has tested positive after returning from a trip to Iran . She did not travel to any other countries other then Iran , sometime after she got back to Vancouver she felt ill , went to a hospital and tested positive for Coronavirus. This virus is spreading quickly .

  25. I think this influenza virus has been over exaggerated. Remember the Ebola virus, it was headline news for months. Our behavior is part of our own human reaction. Here today, gone tomorrow.

  26. South Korea's infected patients are drastically increasing from yesterday, would this trend indicate Korea turning into 2nd Wuhan?

  27. I live in British Columbia Canada they call it Metro Vancouver we're just recorded R6 case of covid 19 or Coronavirus whichever you want to call it the lady was from Iran in her thirties I would like to know if and how bad it could get here she's been on where I live for about a week not too sure what I should be looking for

  28. If you looked what happend on a ship what supposed to be a controled situation. I am pretty sure China has not stoped or slowed the virus.

  29. Can you please talk about testing, why so many people are testing negative on multiple test to be tested positive at some point?

  30. Stay away from all airports and avoid flying for the next six months.
    Anyone infected on an aeroplane will infect the entire cabin! You all breathe the same air over and over and over!

  31. I’m getting really worried (in New Zealand), people say the second wave of the virus will be worth, I do not know what media to trust now. do you think the second wave of the virus will happen and will it be worse? (Some comments in coronavirus videos are also kinda scaring me)

  32. Thank you doctor for the information, i'm from indonesia, and from the 112 specimen collected, 110 tests came back negative from covid19 , 2 still waiting, but the majority from the 110 were positive of h1n1. What makes indonesia has 0 confirmed case so far. Is it possible that most people here have no symptoms and don't get checked?

  33. Zhejiang Hisun's antiviral drug has gotten Chinese approval, but there's almost no reporting on it. Please find out more for us. Thanks for your videos.

  34. Something i don’t hear anyone correlating with the virus is that it is hitting hardest in areas and provinces where air quality consistently suffers from dangerously unhealthy levels…when AQI is near 300 …it is damaging and weakening respiratory systems and often results in flu like symptoms…so those populations would likely have increased risks of vulnerability and weakened body defenses.

  35. Doctors at least must calculate the Age of the Wuhan corona virus spreading to give alarms worldwide on every President of every Nation ! Because if Doctors calculates from 7 months to more than 2 years then the whole world have it if since then the corona virus evolved and became lethal on the first kill on January !!! How many months from first contacting the Baby common wuhan virus till it become svery deadly ??

  36. I`m still taking precautions. Ended up spending more money than I wanted for my daughter and myself, (the money was for other plans) but better safe than never.

  37. How can a vaccine be developed while the corona virus changes itself continuously? In other words, the virus from the first patient is totally different from the current one. May need a brand new biotechnology to handle this case.

  38. Update 21,2.20
    Contracted the disease, 76,821
    Still infected

    Thanks for your updates 😉

  39. Med Cram – is there any truth to what I just heard? That the virus attacks organs, like the heart, after you’re declared recovered and you can drop dead quickly?

  40. There is a series on Netflix from a TV show in 2016, called "Containment". I STRONGLY advise you all to watch it, if you can. And there was also a documentary that was made for Netflix last year and was released on Netflix on January 26th, 2020 named "PANDEMIC". I actually saw an interview on one of the news stations the other day with a doctor that was a part of this documentary. This will all scare the crap out of you, but it may also help you to start preparing for what is surely coming our way.

  41. I was reading on the Chinese outbreak site that people were showing no virus in the nasal and throat testing but still showed it in the fecal tests. Is it possible the virus is hiding internally and they are releasing people when they still have the disease? Maybe we should testing fecal samples before we give the all clear.

  42. Dr. Seheult, In an earlier video you showed the composition of the annual flu vaccination, which included strands of the H1N1 strain. I was wondering if any evidence has surfaced that shows that people who had their flu shot this year didn't catch the COVID19 when exposed or if they were positive, that their symptoms were less severe?

  43. When everyone around me is dying and the molatov cocktails are a flying….at least I will still tune in to solace in the smooth sounds and re-assuring voice of Dr. Seheult. 😑

  44. A very good and informative presentation.. Thanks , doctor. I have been following your lectures for the last few weeks. .Now that you have mentioned the sampling of swabs from the throat and the nasal cavity. I anticpated you elaborating a little on the sieve-like plate called the CRIBRIFORM PLATE in the Upper nasal cavity. The ramifications of of the 1st cranial nerve,( Olfactory Nerve) pass through the perforated openings in this sieve-like membraneous plate., which innervate the smell receptors in the nasal mucosa. Anatomically, it separates the brain, the cerebral spinal fluid from the ambient atmosphere in the nasal cavity , which also communicates the adjacent sinuses . What happens if this sieve-like plate is blocked by mucus plug or nasal congestion. THE CENTRAL Nervous System ( CNS ) " breathes " through this perforated plate., communicating with the extracranial atmosphere. Besides, this perforated plate facilitates lymphatic drainage. This calls to mind the " BLOOD-BRAIN BARRIER" and the components 1. Neuroimmune System 2. The Neuro-GUT Axis. Perhaps, you might want to enlighten us on these , in your tutorial lectures.

    To control corona virus spread globally, no stone should be left unturned.
    Since sampling tests from the nasal cavity may give us a clue. we should not omit sampling these
    SARS Variant hordes in the upper nasal cavity and the sinus cavities

  45. The hospital in my home town is getting 700 people who are infected with the Corona Virus, the news says they know what they are doing but the doctors at work say they don't

  46. What is really worrying is aerosol transmission. So maybe all these people we were making fun off at the airport wearing masks were on to something!

  47. El virus ya esta en Europa. ¡¡¡Sálvese quien pueda!!! Italia sera separada de la Unión Europea por el coronavirus. China deberá ser denunciada por atentar contar la salud mundial. Lo dije antes y lo digo ahora: China debe de ser puesta en cuarentena y todos los asiáticos que están por el mundo deben de ser deportados a sus países de origen para evitar contagios en otros continentes, antes de que sea demasiado tarde.


  49. This tiny 'warrior' virus surprises me every day. Hence, I wouldn't be at all surprised if we later come to find out that dogs, same as children and young adults, are asymptomatic carriers, silently passing it all around. People need to simply wake up…between floods, fires, hurricanes, earthquakes and on an on, Nature attempts to wake us up to the insane damage we cause…but very few listen. My overall sense is that the spiritual/natural world is in a full blown clash with the material (it started a few years ago and humans just stick their heads further into the ground.) We can all keep pretending that this is not happening, but that will only result in a mass, self-inflicted suicide. But….whatever…humans historically have had a way of 'working' at killing themselves (and others) on a daily basis. Here's another 'war' for us to chomp on.

  50. I disagree with your prediction. If 80% of the world's population get this – I think we will see deaths at a much higher rate than the predicted 2% My reason is – if 20% of those infected need hospital treatment – how many will get it? How many hospital beds available? NHS staff to adequately care for them? equipment needed? It can take a month's recovery time. If this is worldwide – will this create medical shortages? How much is imported? What economic impact will this create?
    The burning question is – what measures and risk assessments have been done to address these things? Are we prepared? Are we even doing anything to prepare?

  51. Man made coronavirus straight from the biochemical warfare labs. This is being spread on purpose to kill off as many people as possible.

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