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My Visit to China: Could This Be A Reason Why Coronavirus Started There?

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Do You Think Unsanitary Conditions in China Make Ideal Breeding Grounds for Outbreaks Like the Coronavirus?

I've visited China and the wet markets where the coronavirus is believed to have started. With the conditions I saw it's not surprising that this is where the outbreak may have begun. You are reading page 4 of My Visit to China: Could This Be A Reason Why Coronavirus Started There?. If you want to start from the beginning Go to First Page.

SummitRN has 8 years experience as a BSN, RN and specializes in ICU + Infection Prevention.

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1 minute ago, juan de la cruz said:

I just didn't see that in the CDC recommendations. 

I'm certain that you noticed the recommendation from CDC for CONTACT + AIRBORNE precautions. 

Not to be rhetorical, but What do you think that the contact is for if not enteral? For fecal oral spread specifically, we have good epidemiology of SARS and MERS fecal oral spread and are detectable in feces. Coronaviruses appears to be longer lived on surfaces than influenza viruses. Luckily they do not appear as environmentally resilient as Norovirus. 

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juan de la cruz has 27 years experience as a MSN, RN, NP and specializes in APRN, Adult Critical Care.

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4 minutes ago, SummitRN said:

I'm certain that you noticed the recommendation from CDC for CONTACT + AIRBORNE precautions. 

Not to be rhetorical, but What do you think that the contact is for if not enteral? For fecal oral spread specifically, we have good epidemiology of SARS and MERS fecal oral spread and are detectable in feces. Coronaviruses appears to be longer lived on surfaces than influenza viruses. Luckily they do not appear as environmentally resilient as Norovirus. 

Contact does not mean enteric necessarily. Can you point to your source that the virus lives in the GI tract and not destroyed by GI juices?

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8 hours ago, Daisy4RN said:

Wow, are we medical professionals here. How are stating facts that wet markets have poor hygiene racist and xenophobic.  I think most of us know that different cultures have different practices and I dont see any problem pointing out the negative aspects of those in order to remain healthy. I have also traveled to parts of the world where I would not eat from these types of markets, that is not racist.

Most officials believe that the Coronavirus started in Wuhan since that is where the virus was identified, again not racist when that is what officials stated.

Geez, cant a guy just write an article about his personal experience and ask a question about hygiene. We healthcare professionals (as well as the general public) should care about this.

Yes, cultural practices. Early in my first tour of duty in a European country, I did not appreciate my first encounter with needing to pay to use a public restroom. I did not have the change. I was lucky that a sympathetic local took pity on my waterlogged appearing eyes, and paid for my relief. They explained to me. After this, I was careful to be ready to comply with this custom. 

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SummitRN has 8 years experience as a BSN, RN and specializes in ICU + Infection Prevention.

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44 minutes ago, juan de la cruz said:

Contact does not mean enteric necessarily. Can you point to your source that the virus lives in the GI tract and not destroyed by GI juices?

First reply I wrote was lost, but I threw this together... gotta sleep

replication in large and small bowel with implications for transmission

https://www.sciencedirect.com/science/article/abs/pii/S0016508503012150

This study demonstrates viral shedding in feces for SARS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323244/

SARS in bat feces as a potential source of persistence and spread to intermediate organisms.

https://www.ijidonline.com/article/S1201-9712(12)01061-2/fulltext

CDC rationale mentioning known fecal oral spread of SARS

https://www.cdc.gov/sars/guidance/i-infection/rationale.html

MERS and fecal oral spread in bats indicated by receptor type

https://www.ncbi.nlm.nih.gov/pubmed/28446791

 

SARS is hard to study because PRC did their very best to suppress information and outright lied. There were also not that many cases. MERS information is also limited by a small number of cases.

 

COVID 19 is unclear in so many respects because data is sparse and little time has passed to analyze what data PRC has allowed to be available. We have very few articles and a lot is speculative despite the larger number of cases.

This bulletin summarizes some knowledge:

https://www.sciencealert.com/latest-coronavirus-study-suggests-it-can-also-be-spread-through-poop

"Importantly, 2019-nCoV has been reported elsewhere in the feces of patients with atypical abdominal symptoms, similar to SARS which was also shed in urine, suggesting a fecal transmission route which is highly transmissible," William Keevil, a professor of environmental healthcare at the University of Southampton said in a comment to the UK's Science Media Centre.

 

We do know that there seems to be some wide variation in reproduction numbers, ie, so called "super spreaders" and fecal-oral in some patients who experience diarrhea (which isn't most) might be a good explanation for that. Time will tell...

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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There have been some flawed conclusions jumped to that could be explained by some degree of unreasoned thinking and justifiable but exaggerated beliefs, but I don't think it's racism or bigotry.

Xenophobia is closer; Chinese wet markets are strange to westerners, it's a marketplace where unusual things occur, it's a bizarre bazaar.  But the risk perception of them isn't just explained by it being unfamiliar.

Wet markets are pathogenically high risk, but more so in terms of bacteria than viruses.  Bacteria love chunks of dead and dying cells, virus not so much.  It's the live animal markets that are the virus nurseries, which may often, but not always be co-housed with a wet market.  While viruses are happy to wait for their next host on a piece of meat, they're not necessarily significantly more happy than on other welcoming surfaces or modes of transmission.

The riskiness of these sanitation and cross-contamination practices are common enough that it's part of the dogma of a few religions, as is the idea that snakes are always up to no good.  This might be why we jumped to the conclusions that this originated in a wet market, and that a snake was the intermediate host, even though there's reasonable evidence to at least doubt both of these conclusions.  

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext

https://www.businessinsider.com/wuhan-coronavirus-may-not-have-originated-from-wet-market-2020-1

https://www.nature.com/articles/d41586-020-00180-8

 

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cynical-RN has 10 years experience as a BSN and specializes in ICU.

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4 hours ago, SummitRN said:

So you can whine that it is hypocrisy and cultural bias because some view western dog/cat snuggles as gross...  Viruses don't care about cultural sensitivities. Pandemic related zooinosis from dogs and cats is rare. Influenza Zooinosis from fowl and swine are not rare. Simple math governs chance. Coronavirus and Filovirus Zooinosis from Bush meat and wet markets is well demonstrated and Foodborne illness from poor butchery and food handling/storage is epidemiological knowledge going back well over a century.

The viruses don't give a crap about moral relativism or outrage. Viruses are simply replication machines that will reproduce, spread, and mutate between the species in which they are compatible. Viruses have no opinion about the resulting death and misery, only about genetic propagation before killing the host. 

I understand your misunderstanding. If western culture is so superior hygienically, why are most people's immune system so weak on this hemisphere? Perhaps natural inoculation is beneficial. Indeed, viruses do not give a crap about moral outrage and are replication machines, as such, those with excess protoplasm as a result of unhygienic, sedentary lifestyles should be among the first to lead by example. Obesity is a hygiene issue as well with favorable conditions for pathogens. Someone pointed out that in the not too distant future 1 in 2 Americans will be obese. This is a public health concern that will propagate infections, like the coronavirus. Your logic or lack thereof withstanding, simple math governs chance = the bigger the petri dish, the propensity of replication increases. Start the charity at home. 

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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Xenophobia and the racist stereotypes of “dirtiness”

"News of the coronavirus is amplifying a specific form of bigotry, called sinophobia — hostility against China, its people, people of Chinese descent, or Chinese culture.

“Historically, in both popular and scientific discourse, contagious disease has often been linked, in a blanket way, to population groups thought to be ‘outsiders,’” he said.

He points out that similar narratives were portrayed against Haitian immigrants in the early days of the HIV epidemic in America, as they were the only group singled out as “high risk” because of their nationality.

In trying to explain part of this dynamic, Chowkwanyun says, “In general, when there is a zeitgeist of racial backlash and xenophobia, it drips down into medical discourse. Given the tensions between the [US] and China now, it’s not surprising to see that happening with coronavirus.”

https://www.vox.com/2020/2/7/21126758/coronavirus-xenophobia-racism-china-asians

 

There are a variety of theories of where the virus came from and how humans were affected but there is no definitive link yet. There is some information, some correlation, but no causation. 

So someone has seen a small part of China on a short trip and saw a few foreign cultural practices and now has jumped to the unsupported conclusion that those practices caused Coronavirus. Nice. OP doesn't discuss the hygiene of stadium bathrooms, OP doesn't discuss the food practices of Tenessee where there is a law defending the rights of Tenesseans to eat roadkill https://www.chicagotribune.com/news/ct-xpm-1999-03-14-9903140236-story.html. We don't discuss Detroit, we don't discuss the sanitation on U.S. reservations.

Nope, China is dirty and disgusting based off a very limited and very targeted trip and thus there is no surprise dirty and disgusting Chinese are responsible for disease.

Leading with fear, xenophobia, and lightly veiled racism. 

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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I'm so sick of the interminable name-calling and cheap virtue-signalling.  What I took from the original post is that Gregg has been to China, seen some questionable food-handling practices (that are outlawed in many other countries) and thinks there may be some connection to the current coronavirus situation.  He hypothesized from his own personal observations, which is the start of any scientific study.

Nowhere did I see that he maligned anyone or made any statements or even hinted that he sees other races or cultures as inferior.  The article made no assertions as to who was the superior race, or had better overall health or longevity or any other comparison of peoples, races or cultures.

Whether the current coronavirus situation is due to dietary and food-handling practices, or something that escaped from a lab, or some other whole different thing remains to be seen.  I think civil discourse is not promoted by jumping to call each other "racist" at the least provocation.

 

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cynical-RN has 10 years experience as a BSN and specializes in ICU.

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5 hours ago, TriciaJ said:

I'm so sick of the interminable name-calling and cheap virtue-signalling.  What I took from the original post is that Gregg has been to China, seen some questionable food-handling practices (that are outlawed in many other countries) and thinks there may be some connection to the current coronavirus situation.  He hypothesized from his own personal observations, which is the start of any scientific study.

Nowhere did I see that he maligned anyone or made any statements or even hinted that he sees other races or cultures as inferior.  The article made no assertions as to who was the superior race, or had better overall health or longevity or any other comparison of peoples, races or cultures.

Whether the current coronavirus situation is due to dietary and food-handling practices, or something that escaped from a lab, or some other whole different thing remains to be seen.  I think civil discourse is not promoted by jumping to call each other "racist" at the least provocation.

 

Contrary to popular misunderstanding, bigotry in the form of racism and xenophobia is usually implicit rather than explicit. Furthermore, it is typically subtle, covert, and intangible. Gone are the days of public lynching and KKK rallies, but what's in popular existence is articles filled with intellectual laziness, stereotypes, and bigoted innuendos. Read between the lines. It is the subtle nature of racism that fuels systemic maligning of disenfranchised demographics, silence from fence-sitters, and blind support of bigots from otherwise rational people. In the history of opression, propaganda usually precedes carnage.

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SummitRN has 8 years experience as a BSN, RN and specializes in ICU + Infection Prevention.

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15 minutes ago, cynical-RN said:

Contrary to popular misunderstanding, bigotry in the form of racism and xenophobia is usually implicit rather than explicit. Furthermore, it is typically subtle, covert, and intangible. Gone are the days of public lynching and KKK rallies, but what's in popular existence is articles filled with intellectual laziness, stereotypes, and bigoted innuendos. Read between the lines. It is the subtle nature of racism that fuels systemic maligning of disenfranchised demographics, silence from fence-sitters, and blind support of bigots from otherwise rational people. In the history of opression, propaganda usually precedes carnage.

Yes yes... witches are hiding everywhere... it must be rooted out... we must hunt for it... we could call it a witch-hunt even! That's catchy, eh?

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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Making statements deriding someone's race is an attempt to show one's racial superiority.  Jumping on every pretext to call someone racist is showing one's moral superiority.  Both behaviours are flip sides of the same coin and equally repugnant.

Looking for "subtle" "implied" "innuendo" everywhere is just plain creepy.  It is a form of witch-hunting.  It's what got people sent to Siberia.  It got this country McCarthyism.  There have been times and places throughout history where people were hypervigilant for every nuance and opportunity to sell out their neighbours.

We need to measure our own worth by how we treat others, not how we call each other out. 

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cynical-RN has 10 years experience as a BSN and specializes in ICU.

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24 minutes ago, TriciaJ said:

Making statements deriding someone's race is an attempt to show one's racial superiority.  Jumping on every pretext to call someone racist is showing one's moral superiority.  Both behaviours are flip sides of the same coin and equally repugnant.

Looking for "subtle" "implied" "innuendo" everywhere is just plain creepy.  It is a form of witch-hunting.  It's what got people sent to Siberia.  It got this country McCarthyism.  There have been times and places throughout history where people were hypervigilant for every nuance and opportunity to sell out their neighbours.

We need to measure our own worth by how we treat others, not how we call each other out. 

There are several articles on this site about coronavirus and the logistics that are relevant for its spread/containment. Why is this the only one that has generated rightful rebuke? It is because it is filled with subjective biases that do not form proper logic. Correlation is not an indication of causation, let alone sprinkling sanctimonious platitudes and responses feigned as nuanced discourse. You are making a quantum leap that is quite disingenuous. Just because most people eat ice cream in the summer, and most murders occur in the summer, it would be improper to conclude that ice cream causes increased murders. The priggish author went to Beijing and Shanghai, then makes conclusions about Wuhang in a country of 2 billion people. It is akin to a foreigner visiting Flint, Michigan and observing impurities in tap water, then concluding that intellectual disabilities in America are a result of poor drainage systems. IF a=b, and b=c, then a must be c is the foundation of illogical fallacies. Again, why do you think that this article out the several written (written by more qualified authors) on AN elicited the response it has? Perhaps it is because it has inflammatory language and unsubstantiated anecdotes improperly generalized to a bigger population.

Speaking of McCarthyism, here's a poignant quote from a man who endured the worst of McCarthyism's fear-mongering propaganda based on meaningless innuendos and platitudes: “History will have to record that the greatest tragedy of this period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people.” ― Martin Luther King Jr.

Edited by cynical-RN

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