Coronavirus: Covid-19

This is a document which discusses all related Coronovirus or Covid-19 issues.

Contents

1. Introduction

This document is about certain important aspects of the coronavirus.
The order of the issues discussed is rather haphazard. This wil be improved.

2. Corona virus spreading.

Infection by the coronavirus resembles what happens when there flows more water in a basket compared with the water that flows out: in that case the water level rises. If the reverse is the case: the level drops.
Compared with the coravirus this means when more persons are infected (in a certain period) than people detected with the virus, than the number of people (undetected) with the virus increases. This are the people (often unaware) that spread the virus. If the reverse is the case the number of people with the virus decreases. The assumption is that thereafter they go in quarantaine or in a hospital.
For a more technical discussion of how the coronavirus spreads study this document:
Coronavirus Covid-19 spreading
The conclusion of the document is that this is not so much a mathematical problem but a human related medical problem. People that have the virus should be traced as fast as possible and go into quarantaine. But there are also other solutions: close borders and international travel. People should ware mouth mask, keep distance, and contact tracing. But above all, the most complete drastic effects are the best: A country should first go to an almost complete shutdown before contact tracing can have any effect.
This implies all travelling between countries with and without covid-19 should be prohibited.
The only way to travel from a country with covid-19 to a country without covid 19 requires a quarantaine for approximate 14 days, because you have to be sure that you are virus free. The other way around is no problem. In that case the traveller puts him or herself at risk.

2.1 Who is in charge in General

There are certain international organizations who are involved with infectious deceases.
To mention some organizations: World Health Organization WHO, Center for Disease Control CDC and Docters without Frontiers.
This issue is important, because some organization should be incharge to monitor, supervise and clasify the outbreak of infectious diseases, specific to classify any outbreak and to inform its direct contributors of what is happening. This organization should also be in charge of a form of guidelines, such that every one follows the same rules and procedures.
The problem is that this did not happen with the outbreak of the Covid-19 pandemic.

One of the reasons of the lack of action could be that the organization in charge should be completely independent and should only consist of medical trained people: epidemiolgists and virologists.
It are those people who should give advice independant of political, etical, majority or religuous influences.

My impression is that from the outstart it was almost immediatly known, that for this virus there existed no medicine and no vaccin. If that is the case all the bells should ring and that did not happen.
Another issue is, that in this case, people can have the virus, have no symptons but can de infectious and spread the virus. This can have alarming results because it can spread rapidly all over the world.

My understanding is that the WHO is in sort of all sorts of health issues, all sorts of diseases including famine. The CDC is specific for infectious diseases and is IMO the most important company to take the lead.
In fact in each country you should have a CDC like organization who should be in charge for all infectious related diseases.
In Belgium there is a central oranization in charge for your medical record. This is the organization who should be incharge to control the track and trace app. See:
5.1 Tracing app - purpose - your medical record

3. What actions to take - how to prevent spreading.

My understanding is that the coronavirus only spreads by the mouth of infected people via particles (fluids) which contain the coronavirus.
I expect that there are two types that people can become infected:
  1. direct via fluids (particles) emitted by the mouth of infected people, maybe unaware.
  2. direct via mouth to mouth or skin of infected people.
  3. indirect by touching people which are infected via your hands and by touching your mouth.
  4. also by touching surfaces which are contaminated, via your hands and by touching your mouth.
The main problem of the coronavirus that people during a certain period, are not aware that they have the disease and maybe never get any symptons.
The main strategies to prevent spreading are (in random order):
  • Keep a safe distance
  • Wash your hands
  • Wear mouth protection. This is important because as mentioned above it is your mouth that spreads the disease, with the possibility that you are unaware.
  • Look for medical assistance when you don't feel well.
  • Keep yourself tested.
  • Use trace tracking when outside your house.
  • Stay at home as much as possible.
  • 4. Contact tracing, etical considerations.

    In the context of this article to track and to trace are synomyms. Contact tracing has a certain ethical aspect:
    1. Suppose I'm coronavirus positif, do I want to maintain this information secret?
    2. Suppose I was in close contact with a person who is coronavirus positif. Do I want to know that?
    Specific the answer on the second question is Yes. Yes I want to know when I was in contact with some who has the disease. Specific this is a reason for me to take a test, because I want to know (now) if I'm positif. Related to the first question I also would like that all the persons which I possible could have infected become informed, so that these people can take the necessary actions i.e. become tested ( and go in to quarantaine).

    The point is: I want that and I don't think of any reason why most people don't want that.
    In fact contact tracing should become enforced in order to eradicate the disease as afast as possible.

    Contact tracing has two aspects:

    1. Which is the source of an infection
    2. Which are the people that are infected.
    However in a more general contact tracing means: to identify all the people that you met within a certain distance within a certain period. There are two methods to do that: Absolute and Relative.
    1. An absolute positioning system uses the absolute positions of the people tracked. That means on the earth surface the longitude and latitude.
      Generaly speaking only your positions is known. The (absolute) position tracked is not known.
    2. A relative system is a system that measures the distance between you and the person tracked. To do that you need some form of radar system, that only measures distance.

    5. Tracing app

    A Tracing app is an application on your IPhine used to track/trace other IPhines.
    Part of this application is in theory completely user independent.
    One of the first questions to answer when you want to develop an app is: What is you app supposed to do in a broader context and how are we going to test app.
    Let us start with the second part. The first part is discussed in:
    5.1 Tracing app - purpose - your medical record

    The test scenario can consists of:
    1. Consider a group of pupils on a schoolyard. For example 100. When you use this app in context with the corona virus the pupils are not ill.
    2. Consider a group of teachers on a schoolyard. For example 10. When you use this app in context with the corona virus the teachers are ill.
    The experiment involves that the pupils play on the schoolyard and that the teachers walk through the schoolyard. The purpose of app is that each teacher in some way or another monitors each person and calculates the closest distance of each person. There exist a maximum distance which has to be monitored.

    Already here you can see that the application is user (application) independent, because the appliction should monitor all 110 participants, independent if the user is a pupil or a teacher.

    To identify the closest distance identifies two events: An entry point and an exit point.

    The result of the test should indicate that always two IPhines should demonstrate the same minimum distance event.

    5.1 Tracing app - purpose - your medical record

    The tracing app has three purposes:
    1. Two indentify the closest distance between two persons (IPhines).
    2. Two identify which persons (IPhines) were in close contact which a certain person (IPhine) during a certain period.
    3. To update your medical record.
    Specific the second purpose almost imposes a common database which contains all the data of all the minimum distance events. The third reason is almost the most important reason: to update your medical record
    That is why all data collected falls under a doctor secrecy agreement.
    That is why in some sense the most important aspect of the app is to show your personel health information and your record about all the events when you came in contact withsome showing only date and time.
    That is why the app should also have the capability to add more contacts.
    That is why the app when your IPhine is off, should stop collecting data.

    It should be emphasized that the organization in charge is the same as the organization that handles all your medical records. This is in fact your own personal doctor. It is this person in fact which informs that you have been in close contact which some one who has the virus and who is in charge that you get tested.
    when the result is positif, he will inform you and is incharge that you have to go into a hospital. At the same he sends you a request to ask for more technical information about the persons you were in close contact.
    The reason is because this whole process is very personal and very penetrating. To receive information of this sort can olso raise other physical or social issues, which each have to be treated, primarily in a safe and private environment.

    It should also be mentioned that in this whole process no social media or any big data companies are involved. If these companies want to endorse this whole process there are many ways to donate money privately.

    5.2 Tracing App - Example: COVIDSafe

    COVIDSafe is a contract trace and tracking system implemented by the Australian Government.
    For more information see:
    https://theconversation.com/covidsafe-tracking-app-reviewed-the-government-delivers-on-data-security-but-other-issues-remain-137249
    The problem with this document it that it does not give much technical detail. That means its working is a guess.
    A much better document is this issued by "Australian Government - Departmenth of Health" https://www.health.gov.au/resources/apps-and-tools/covidsafe-app/covidsafe-help#how-the-app-works
    The document contains the following 5 paragraphs:
    1. Technical support

    2. How the app works

      • Technical aspects

        Here we read:
        The app will perform digital handshakes with all other contact apps in Bluetooth range.
        The app records Bluetooth signal strength to allow approximation of distance.
        The app will poll every minute for new connections and to record the duration of existing connections
    3. Close contacts

      • How does the app know a 'close contact' has occurred?

        Here we read:
        When 2 (or more) app users come into close proximity their phones exchange Bluetooth signals and make a series of ‘digital handshakes’.
        The app records the encrypted reference code, time and proximity of 2 users, through the strength of the Bluetooth signals. This allows the approximate distance between the users and the duration the contact occurred to be determined once the data is uploaded to the highly secure information storage system.
        The proximity for a close contact is approximately 1.5 metres, for a period of 15 minutes or more.
    4. Privacy

    5. Why we need this app

    6. How COVIDSafe relates to other coronavirus apps

    My understanding of how COVIDSafe works (in general) is as follows:
    1. First you have to install COVIDSafe. Installation means (part of) that you have to enter your IPhine telephone number in the database of COVIDSafe.
    2. After installation and the app is activated Bluetooth will try to make contact with other IPhines, specific which IPhine which also have COVIDSafe installed.
    3. When that is the case certain data is exchanged between the two IPhines including telephone numbers of both IPhines and distance.
    4. Next a record is added to the database of COVIDSafe (called contact log) containing the same data.
    5. When the user of the IPhine is declared coronavirus positif the contact log is transmitted to the central computer of the health authorities
    6. Next the health authorities will contact the people in the contact log to inform them that there is a possiblity that they are infected.
    This more or less explains how COVIDSafe works. Privacy considerations are not discussed.
    However there are certain considerations.

    6. Tracing app - additional request

    What makes 'tracing app' development difficult is that there are many additional requests:

    7. Lockdown Exit strategies

    One of the strategies to prevent spreading is: Stay at home as much as possible.
    This means prevent travelling as much as possible.
    Lockdown means to implement all the strategies as mentioned in:
    3. What actions to take - how to prevent spreading. In

    The question this what is your strategy to go back to normal? But even more important is the question when.?
    The general answer is: a certain region can go back to normal, and lift certain or all the actions imposed, when there are no new corona cases detected in a period of 2 weeks.
    However that may be not always the case. Two specific situations are:

    1. The prediction is that this will never happen, because the number of new cases is constant.
    2. Not all the actions are implemented
    Most probably both situations are the case.
    When that is the case first all actions should be implemented, before you can lift certain actions.
    In many european countries in most cases the 'Trace app' is not implemented and or not all people use the 'Trace app'.
    In many european countries mouth protection is not used.
    The problem is when you lift the actions too soon This will have deadly consequences and people will be reluctant to go back to more stifter actions.


    Reflection 1 - TV information and Journal articles.

    1. The dutch CDC related organization informed during a period of one month as follow:
      The general public is not advised to wear a mouth piece because there are no mouth pieces.

      Sometimes you can also read the following information:
      To wear a mouth piece makes sense but it is not important to wear a mouth piece because there are no mouth pieces.

      Even an international magazine wrote something like: People in china used mouth pieces often with good effects, but there exists no scientific evidence. As such:

      This type of advice is not very wise. In fact all 'medical consultants' should have adviced, to use a mouth piece. Specific when it became known, that infected people can be unaware that they can infect other people.
      At the same time they should also have adviced to make more mouth protection.

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