REACH - 25. MOH's advisory to defer non-essential travel
18 Mar 2020 (Morning - 10pm) - extended to 11pm

REACH
[10:23 am, 18/03/2020] ☸️  Danny 心:
Dear contributors, welcome back! Our chat will be open until 10pm today.
📢 Topic: How are you affected by MOH's advisory to defer non-essential travel? What do you think of the precautionary measures to manage the spread of the virus? 📢
National Development Minister Lawrence Wong on Tuesday (Mar 17) urged Singaporeans to comply with the Ministry of Health's (MOH) advisory to defer non-essential travel, after the emergence of more imported COVID-19 cases involving Singapore residents who had returned from overseas.
Mr Wong said that Singapore is not planning to call for a lockdown to curb the virus' spread, but could consider "major circuit breakers" that potentially include measures like the temporary closure of schools and workplaces.
 https://www.channelnewsasia.com/news/singapore/covid19-please-dont-travel-lawrence-wong-singaporeans-12548496
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[2:06 pm, 18/03/2020] ☸️  Danny 心:
(1) I support the Government move to deter non-essential travel - that have the potential to bring in covid-19 virus --- that otherwise will have been prevented.
Statistics already show that large majority of confirmed cases in Singapore - are imported.

(2) 3 Strategies of fighting covid-19 :-
(a) Containment
(b) Border Control
(c) Prevent Community spreading

(3) The above 3 strategies are only effective --- at its weakest link.
If despite doing well in the above 3 strategies to combat the virus ---- non-essential travel will have make all the 3 strategies ineffective.
Non-essential travel (to Countries with high infection rate) - will have break the containment strategies - breach border control and start community spreading if not arrested early.

(4) I also support calibrated move to achieve the 3 strategies of fightnig the virus - instead of "complete lockdown" ---- that have a very big negative impact to our Economy.
Already the calibrated border control has caused quite a big damage to the Economy --- that cannot be helped to stop the virus at bay. A total lockdown will be devastating to the Economy --- until and unless the virus go out of control.

(5) China and S Korea have been effective in curbing the growth of the virus epidemic - and are now seeing rescinding trend.
Actually study need to be made why after a surge, will cause a drastic drop in infection. (Could it be immunity are build within the Community in China and SKorea?
Could it be the virus epidemic has run its full course in China and SKorea as the environment for the virus to survive no longer conducive?
Or could it be the treatment introduce - effective in curbing the spread of the virus?)
A detail study - can help the rest of the World --- find a solution to the virus spread and decline.

(6) With the China and SKorea precedent --- we are likely to see a similar trend happening with the rest of the World.
Namely Italy, Iran and Europe - which see a spike like China and SKorea.
To a lesser extent US and nearer afield Malaysia.
The lesson and study learn from China and SKorea --- may give humanity a clue how to fight the covid-19.

(7) Having say so, I support our Government measures of deterring non-essential travel overseas as well as the rest of the containment strategies adopted so far.
Singaporeans need to clench our teeth, hold tight while waiting for similar break and trend to happen for the rest of the World - like what China and SKorea are going through - for the covid-19 to reach its peak and then decline drastically.
Only then we and the whole World will be out of the wood.

Thomas
[2:10 pm, 18/03/2020] : I have a niece planning to go Taiwan for holiday at this time. Youngster ..🤦‍♂

[2:12 pm, 18/03/2020] ☸️  Danny 心:
Her parents not worried?
Also the confinement of 14 days not a deterrence to her?

Thomas
[2:14 pm, 18/03/2020] : Never think

[2:15 pm, 18/03/2020] ☸️  Danny 心:
Then talking to her and tell her the consequences will be better.

Thomas
[2:17 pm, 18/03/2020] : I think new ruling .. she will be stopped by TAIWAN side

[2:19 pm, 18/03/2020] ☸️  Danny 心:
Oh good.
At least save her family and the community at large.

Leonard
[2:22 pm, 18/03/2020] : They are shutting down the borders .. no foreigners can visit Taiwan
https://www.japantimes.co.jp/news/2020/03/18/asia-pacific/science-health-asia-pacific/taiwan-shuts-borders-coronavirus/#.XnG95yVGSEc

[2:25 pm, 18/03/2020] ☸️  Danny 心: Good for us.

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Thomas
[2:39 pm, 18/03/2020] : Finally told by her father. She is not going

[5:52 pm, 18/03/2020] ☸️  Danny 心:
1. Good to hear that.
2. Else if sick there - quarantine 14 days. Pay hospital fees. Cannot tour.
3. Come back Singapore quarantine another 14 days.
In total, confine 28 days. Tour ruin.
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[8:06 pm, 18/03/2020] ☸️  Danny 心:
Promising coronavirus treatment in the pipeline. If successful will be a significant medical breakthrough.
                                                                                                https://www.straitstimes.com/world/united-states/hundreds-of-scientists-scramble-to-find-a-coronavirus-treatment?cx_testId=20&cx_testVariant=cx_4&cx_artPos=1#cxrecs_s

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REACH
[9:18 pm, 18/03/2020] : https://www.channelnewsasia.com/news/singapore/coronavirus-47-new-cases-imported-travel-self-isolation-overseas-12551968

[9:19 pm, 18/03/2020] : Singaporeans advised to defer all travel abroad amid heightened risk of imported COVID-19 cases
https://www.channelnewsasia.com/news/singapore/covid19-singaporeans-defer-all-travel-abroad-imported-cases-12552706
[9:30 pm, 18/03/2020] +65 8637 0487: From Mar 21, all Singapore residents and visitors entering Singapore will be issued a 14-day stay-home notice.
https://cna.asia/2vARly0
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[9:41 pm, 18/03/2020] ☸️  Danny 心:
(1) Imported cases now form 90% of infection in Singapore - from Singaporeans, PR and Long-Term Pass Holders travelling abroad and come back to Singapore.

(2) Now our focus should be targeting on these group of people coming back from overseas - with compulsory quarantine and swab test kits to identify all suspected cases --- and not allow them to infect the Community --- that trigger community spreading in Singapore.

(3) Are these group of people supposed to stay at home for quarantine (that may infect their family members - & tantamount to community spreading) --- or should they be usher into dedicated quarantine center for thorough checkup and release after 14 days - so that they have no chance to infect their family members?

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[9:53 pm, 18/03/2020] ☸️  Danny 心: ---
(1) Note :- The family members of this stay at home or quarantine overseas returnees may not need to stay at home ---- but may be infected --- but start to infect others unknowingly.

(2) Only by ushering all these returnees into dedicated quarantine center --- will ensure their family members are not infected by them unknowingly -- and then start community spreading unknowingly.

(3) This is also an attempt to inconvenience those who travel abroad and come back --- so as to deter non-essential travels.
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[10:36 pm, 18/03/2020] ☸️  Danny 心:
(1) Summary of medical advancement in tackling covid-19 :-
- 49 treatment are being currently developed that attack the covid-19 virus directly in an attempt to kill the virus.
(This means if another new virus appear, the 49 treatment will not be useful)

- 1 treatment that will have a significant medical breakthrough - is not to attack the covid-19 virus directly, but to form a shield that wrap around the virus (irregardless of whether it is a covid-19 virus or other viruses) --- that infect human by fusing with the many combination of protein that are present in the human cells - so that these viruses can reproduce to overwhelm the human immunity system and then reproduce fast enough to infect others through cough or sneezing. By wrapping around the virus and not allowing virus to infuse themselves into Human cell protein, the virus cannot reproduce and will die naturally when attack by the Human immunity system.

- This is the 1st real virus treatment ever produced (in which bird flu virus, common flu, ebola, mers, hiv etc) --- can be prevented from infecting human.

- If this method of treatment prove to be successful in treating human from covid-19 --- then future virus can be treated for the 1st time in history --- according to the medical scientists.

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19 Mar 2020


[12:28 pm, 19/03/2020] ☸️  Danny 心:
1. This virus epidemic demonstrate the interconnected world we are in.
One-for-all. All-for-one.
One person get it, the whole country lockdown.
One country get it the whole world get infected.

‌2. This is the ripple water pool effect.

World will get infection twice.
Once when epicenter strike.
Second time when it ripple back from the world.

3. This predicted phenomenon is that after the second wave strike, the epidemic will start to slowdown and taper off like what China and SKorea are going through now.

4. Now the whole world is going through the second wave of infection and it has not reached its peak yet.


[1:36 pm, 19/03/2020] ☸️  Danny 心:
(1) When will the 2nd waves of infection reaches its peak and then begin to taper off?

(2) The following are the likely scenarios:-
a. When all countries in the world with many of their population get infected and develop some antibodies. The virus no longer can infect human.
This is the worst scenario.

b. Effective vaccine is found and the world population get vaccinated.

c. Effective treatment is developed and the virus is no longer fear by human.

d. Virus run out its full course and environment no longer support its growth.

[1:40 pm, 19/03/2020] ☸️  Danny 心:
The world is going through scenario 2a and people all over the world is going through a panic state.

[1:44 pm, 19/03/2020] ☸️  Danny 心:
Meanwhile medical scientists are scrambling to produce:-

b. Vaccines
c. Treatment

Both are showing promising development.

Both are undergoing trials and testing on animals and humans.

Hope to hear good news from the medical front soon.

Phyillis
[1:48 pm, 19/03/2020] : Do update us when you have the good news. Thank you Zen Beng. 🙏🏻

[1:49 pm, 19/03/2020] ☸️  Danny 心:
(1) Summary of medical advancement in tackling covid-19 :-
- 49 treatment are being currently developed that attack the covid-19 virus directly in an attempt to kill the virus.
(This means if another new virus appear, the 49 treatment will not be useful)

- 1 treatment that will have a significant medical breakthrough - is not to attack the covid-19 virus directly, but to form a shield that wrap around the virus (irregardless of whether it is a covid-19 virus or other viruses) --- that infect human by fusing with the many combination of protein that are present in the human cells - so that these viruses can reproduce to overwhelm the human immunity system and then reproduce fast enough to infect others through cough or sneezing. By wrapping around the virus and not allowing virus to infuse themselves into Human cell protein, the virus cannot reproduce and will die naturally when attack by the Human immunity system.

- This is the 1st real virus treatment ever produced (in which bird flu virus, common flu, ebola, mers, hiv etc) --- can be prevented from infecting human.

- If this method of treatment prove to be successful in treating human from covid-19 --- then future virus can be treated for the 1st time in history --- according to the medical scientists.

Sam
[1:51 pm, 19/03/2020] : Why your message so long? When I need to scroll down, I Sian Liao.

Rama
[1:51 pm, 19/03/2020] : Idiot

Phyllis
[1:51 pm, 19/03/2020] : Animation will be V V V V helpful

[1:52 pm, 19/03/2020] ☸️  Danny 心:
I not artist cannot draw well only can describe.

Phyllis
[1:54 pm, 19/03/2020] : Visual storyteller will be useful. Long and draggy text ready until pek chek.

Leonard
[1:55 pm, 19/03/2020] : Can use  some internet pictures and explain .. that will help ..

Sam
[1:55 pm, 19/03/2020] : Infographic
[1:55 pm, 19/03/2020] : Now people always talk about bite size info

Leonard
[1:56 pm, 19/03/2020] : Use cliksense or power BI also can

[1:56 pm, 19/03/2020] ☸️  Danny 心:
Simply put, there are no cure for viruses, even common flu.
Now there is one cure under trial that can treat virus.

Sam
[1:57 pm, 19/03/2020] : 🤭🤭well done

Phyllis
[1:57 pm, 19/03/2020] : Wah BREAK RECORD short and sweet I like!

Leonard
[1:58 pm, 19/03/2020] : @☸️  Danny 心Got O365 ?

[1:59 pm, 19/03/2020] ☸️  Danny 心:
Nope I don't have.

Leonard
[2:01 pm, 19/03/2020] : You can download this app PowerPoint on your phone

[2:02 pm, 19/03/2020] ☸️  Danny 心:
My phone no space.

Leonard
[2:03 pm, 19/03/2020] : Ok .. I thought the PowerPoint can help .. how about PC?
[2:03 pm, 19/03/2020] : What’s app can be used from PC also

[2:04 pm, 19/03/2020] ☸️  Danny 心:
I only got word and Excel no power point.

Leonard
[2:05 pm, 19/03/2020] : I see why not install it .. use the tool and you can put your thought and paste your ideas here ..

Bobby Tan
[2:05 pm, 19/03/2020] : Powerful is always together with excel and word de

Leonard
[2:05 pm, 19/03/2020] : PowerPoint .. not powerful .. oops .
[2:06 pm, 19/03/2020] : It’s good to learn a new tool

[2:08 pm, 19/03/2020] : https://www.facebook.com/592308557475467/posts/3098041253568839/?d=n

[2:09 pm, 19/03/2020] ☸️  Danny 心:
Any way very simple to understand.

1. Virus use receptor to connect to human cell with the right protein mix to survive and reproduce.

2. The new treatment target this virus not to kill it but wrap around it so that its receptor cannot fuse with human cell.

3. Virus with no protein nutrition cannot survive and reproduce.

4. Human white blood cells kill it off.

Jonathan Lim
[2:10 pm, 19/03/2020] : Interesting

[2:11 pm, 19/03/2020] ☸️  Danny 心:
Perhaps you can help me to draw it out in PowerPoint and show it here.

Jonathan Lim
[2:12 pm, 19/03/2020] : Drawing nt gd😅
[2:12 pm, 19/03/2020] : But like that point form easier to read & understand

[2:13 pm, 19/03/2020] ☸️  Danny 心:
Me too I don't draw well. Can only describe.

Jonathan Lim
[2:15 pm, 19/03/2020] : Put in picture form easier to understand
[2:15 pm, 19/03/2020] : Like PowerPoint
[2:22 pm, 19/03/2020] : Or try to break down your points or share link also can

[2:29 pm, 19/03/2020] ☸️  Danny 心:
1. Reason why many treatment try to kill virus fail - because virus mutate quickly to survive when it cannot get protein nutrition.

2. The cure no longer effective after virus mutate and become a new virus.

3. The new treatment don't kill the virus directly but wrap around it and deprive it of nutrition.

4. Thus the virus don't mutate and it die off naturally or kill by human white blood cells.

[2:30 pm, 19/03/2020] ☸️  Danny 心:
Thus the 1st real cure of virus emerge.

[2:32 pm, 19/03/2020] : Danny pls correct me if I'm wrong: Virus penetrates human cell at a bonding site, like key opening a lock. The new treatment isolates virus, like air trapped in a bubble, so virus cannot open the "lock".

[3:16 pm, 19/03/2020] ☸️  Danny 心:
Sounds right.

Lam Kwok Leong
[3:08 pm, 19/03/2020] : Sone misconceptions here. As fast as virus mutates, there are at most 3 strains identified for covid-19. Viruses are not technically living beings, they don’t eat, and so can’t be starved of nutrients.
They reproduce by infiltrating a healthy cell, hijack the production machinery and “print” many copies of itself until the host cell explodes into many copies of the original virus.
Almost all anti-viral drugs seek to inhibit part of this virus lifecycle (eg blocking infiltration or makes them photocopy themselves wrongly)
Anti-virals have been around for decades.

[3:18 pm, 19/03/2020] ☸️  Danny 心:
Your explanation is more technical and medically right.
[3:21 pm, 19/03/2020] ☸️  Danny 心:
Mine is a layman explaination.

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[6:51 pm, 19/03/2020] ☸️  Danny 心:
Found the medical article with promising medical breakthrough that can cure covid-19 ---

18 Mar 2020
NEW YORK (NYTIMES) - Working at a breakneck pace, a team of hundreds of scientists has identified 50 drugs that may be effective treatments for people infected with the coronavirus.

Many scientists are seeking drugs that attack the virus itself. But the Quantitative Biosciences Institute Coronavirus Research Group, based at the University of California, San Francisco, is testing an unusual new approach.

The researchers are looking for drugs that shield proteins in our own cells that the coronavirus depends on to thrive and reproduce.

Many of the candidate drugs are already approved to treat diseases such as cancer that would seem to have nothing to do with Covid-19, the illness caused by the coronavirus.

Scientists at the Mount Sinai Hospital in New York and Pasteur Institute in Paris have already begun to test the drugs against the coronavirus growing in their labs. The far-flung research group is preparing to release its findings at the end of the week.

There is no antiviral drug proven to be effective against the virus. When people get infected, the best that doctors can offer is supportive care - ensuring the patient is getting enough oxygen, managing fever and using a ventilator to push air into the lungs, if needed - to give the immune system time to fight the infection.

If the research effort succeeds, it will be a significant scientific achievement: an antiviral identified in just months to treat a virus that no one knew existed until January.
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[8:45 pm, 19/03/2020] ☸️  Danny 心:
Dr Krogan and his colleagues set about finding proteins in human cells that the coronavirus uses to grow.

Normally, such a project might take two years. But the working group, which includes 22 laboratories, completed it in a few weeks.

"You have 30 scientists on a Zoom call - it's the most exhausting, amazing thing," Dr Krogan said, referring to a teleconferencing service.

Viruses reproduce by injecting their genes inside a human cell. The cell's own gene-reading machinery then manufactures viral proteins, which latch onto cellular proteins to create new viruses. They eventually escape the cell and infect others.

In 2011, Dr Krogan and his colleagues developed a way to find all the human proteins that viruses use to manipulate our cells - a "map", as Dr Krogan calls it. They created their first map for HIV.

That virus has 18 genes, each of which encodes a protein. The scientists eventually found that HIV interacts, in one way or another, with 435 proteins in a human cell.

Dr Krogan and his colleagues went on to make similar maps for viruses such as Ebola and dengue.

Each pathogen hijacks its host cell by manipulating a different combination of proteins. Once scientists have a map, they can use it to search for new treatments.

In February, the research group synthesised genes from the coronavirus and injected them into cells. They uncovered more than 400 human proteins that the virus seems to rely on.

The flu-like symptoms observed in infected people are the result of the coronavirus attacking cells in the respiratory tract. The new map shows that the virus' proteins travel throughout the human cell, engaging even with proteins that do not seem to have anything to do with making new viruses.

One of the viral proteins, for example, latches onto BRD2, a human protein that tends to our DNA, switching genes on and off. Experts on proteins are now using the map to figure out why the coronavirus needs these molecules.

Dr Kevan Shokat, a chemist at UCSF, is poring through 20,000 drugs approved by the Food and Drug Administration for signs that they may interact with the proteins on the map created by Dr Krogan's lab.

Dr Shokat and his colleagues have found 50 promising candidates. The protein BRD2, for example, can be targeted by a drug called JQ1. Researchers originally discovered JQ1 as a potential treatment for several types of cancer.

On Thursday, Dr Shokat and his colleagues filled a box with the first 10 drugs on the list and shipped them overnight to New York to be tested against the living coronavirus.

The drugs arrived at the lab of Dr Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at Mount Sinai Hospital. Dr Garcia-Sastre recently began growing the coronavirus in monkey cells.

Over the weekend, the team at the institute began treating infected cells with the drugs to see if any stop the viruses.

"We have started experiments, but it will take us a week to get the first data here," Dr Garcia-Sastre said on Tuesday.

The researchers in San Francisco also sent the batch of drugs to the Pasteur Institute in Paris, where investigators also have begun testing them against coronaviruses.

If promising drugs are found, investigators plan to try them in an animal infected with the coronavirus - perhaps ferrets, because they're known to get Sars, an illness closely related to Covid-19.

Even if some of these drugs are effective treatments, scientists will still need to make sure they are safe for treating Covid-19. It may turn out, for example, that the dose needed to clear the virus from the body might also lead to dangerous side effects.

This collaboration is far from the only effort to find an antiviral drug effective against the coronavirus. One of the most closely watched efforts involves an antiviral called remdesivir.

In past studies on animals, remdesivir blocked a number of viruses. The drug works by preventing viruses from building new genes.

In February, a team of researchers found that remdesivir could eliminate the coronavirus from infected cells. Since then, five clinical trials have begun to see if the drug will be safe and effective against Covid-19 in people.

Other researchers have taken startling new approaches. On Saturday, Stanford University researchers reported using gene-editing technology CRISPR to destroy coronavirus genes in infected cells.

As the Bay Area went into lockdown on Monday, Dr Krogan and his colleagues were finishing their map. They are now preparing a report to post online by the end of the week, while also submitting it to a journal for publication.

Their paper will include a list of drugs that the researchers consider prime candidates to treat people ill with the coronavirus.

"Whoever is capable of trying them, please try them," Dr Krogan said.
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[9:01 pm, 19/03/2020] ☸️  Danny 心:
China reports no new domestic COVID-19 cases for first time 19 Mar 2020, but 34 imported.

China has achieved a miracle today.

Even Wuhan - the epicentre has 0 case.

Thus covid-19 can be defeated.
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