Harlan Krumholz

You're going to have evidence from a Cochrane review with case control studies and cohort studies, what we call low-quality evidence.

We're going to hear about rapid reviews of evidence.

We're going to look at model reproduction numbers, epidemiology of infection and case fatality rates, and all about how to do randomised trials and what's needed in things like hand-watching.

The whole array of evidence, which...

is interesting and helps us think about this important public health issue right now, coronavirus.

Well, not only that, what's really interesting, and this is important, in pandemics, there's a real need to make this stuff available rapidly and to make it open access so people can actually use it and read it and interpret it in what is a fast-moving emerging infection.

Well, I know a little bit, but we could do with some expert help on this aspect.

But we're talking about a group of viruses that is out there already.

And the corona is that sort of corona that exists around the sun where you see these proteins that exist on the surface and give you this corona effect.

And they are viruses that affect issues like the common cold are coronaviruses.

But then you get these very serious ones, the new outbreaks that come from animals.

And we've had SARS, the severe acute respiratory syndrome.

And we've had this MERS, the Middle Eastern respiratory syndromes, which have been outbreaks of coronavirus.

And then this one, this new one, coronavirus-19, which has emerged, we think, in Wuhan in China, where it's come from animals to humans, and then it gets into humans from direct transmission between individuals.

There's a lot of words in there and a lot of thoughts, but what he's saying is, let's just summarise, he's saying this can enter through the lungs, can enter through the guts, you get this initial viral response where you have mild symptoms, but not everybody, but some people will have the immune system goes into an ovary reaction, you get this cytokine storm, and they're the people you really worry about because they can end up on intensive care units and require ventilation, and this thing called, he said, ARDS, which is Acute Respiratory Distress Syndrome,

But beyond that, there's also this issue with the ACE2 receptors, which causes you to have hypertension, and you can also have heart problems, which can then lead to some of the deaths if that happens.

Well, I think that's interesting because I think as you describe what you're describing, what we've heard, this could be any viral infection, very similar to influenza.

But there is this issue that the case report reports on days two, three, a sort of subjective fever.

And when he presented to the emergency services, his fever was only 37.2 at that point.

And actually, although they tested him for coronavirus, nobody really thought about it.