Coronavirus

[Swerd]

Debunking Coronavirus Myths vs. Truth | Emergency Physicians Monthly

Spreading facts among an outbreak of fears and rumors. https://youtu.be/x_C2Er74MDE Everyone's talking about - and wondering about - Coronavirus (COVID-19). Here are the answers to some common assertions, to better educate your patients, families, and colleagues. Coronavirus is a family of...

epmonthly.com

COVID-19 is a type of coronavirus, much like SARS and MERS but with a much lower fatality rate (≈3% vs. 10% vs. 35% respectively). COVID-19 is more highly transmissible, but not as deadly. You have higher rates of dying from influenza.

Remember that previous estimates of transmission and fatality rates assumed Covid-19 was a single type of virus. Now, two Covid-19 sub-types, S & L, are known to exist with differing rates of transmission and mortality. Those previous rate estimates were composite numbers. Unless they were estimated based on known numbers of patients with L and with S sub-types, they mean little.

 

[Irvrobinson]

A more comforting opinion from a GW ER professor. I'm not sure I believe it, but it's easier to read than the millions die scenarios:

I'm an emergency doctor. I expect to get coronavirus | CNN

James Phillips writes that as an emergency physician at an urban hospital in Washington, D.C., this is personal: "I will likely become infected in the next few months. It's just simple math that I have accepted." But there are ways to stop the virus from overwhelming the health care system.

www.cnn.com

 

[Irvrobinson]

Debunking Coronavirus Myths vs. Truth | Emergency Physicians Monthly

Spreading facts among an outbreak of fears and rumors. https://youtu.be/x_C2Er74MDE Everyone's talking about - and wondering about - Coronavirus (COVID-19). Here are the answers to some common assertions, to better educate your patients, families, and colleagues. Coronavirus is a family of...

epmonthly.com

The CDC is recommending people NOT wear N-95 respirators in public. It’s true that a properly fitted N-95 mask, sealed around the chin, mouth and nose can block about 95% of airborne particles from being inhaled. That’s probably going to cut down on COVID transmissions in controlled, limited healthcare encounters. But fitting and sealing the mask properly takes work. Breathing in and out through the thick N95 respirator is also work. Staff needs to take breaks and take the mask off frequently. Wearing a respirator for long periods of time, and frequently adjusting the respirator with one’s fingers, may well negate any protective effect

COVID-19 is a type of coronavirus, much like SARS and MERS but with a much lower fatality rate (≈3% vs. 10% vs. 35% respectively). COVID-19 is more highly transmissible, but not as deadly. You have higher rates of dying from influenza.

I use N95 masks when I work on automotive brakes or spread dusty dry fertilizer, and I can say first hand they make it noticeably more difficult to breath. They are worth it for brake work though; when I remove the mask I can see the black dust - which might contain asbestos - that it stopped me from breathing in.

 

[JerryLove]

A more comforting opinion from a GW ER professor. I'm not sure I believe it, but it's easier to read than the millions die scenarios:

I'm an emergency doctor. I expect to get coronavirus | CNN

James Phillips writes that as an emergency physician at an urban hospital in Washington, D.C., this is personal: "I will likely become infected in the next few months. It's just simple math that I have accepted." But there are ways to stop the virus from overwhelming the health care system.

www.cnn.com

There is nothing in there that suggests there won’t be millions dead.

indeed. He agrees it is a pandemic.

‘death rate is simple... number infected x mortality. The latter seems to be at least 2%. The former sets your order of magnitude.

 

[Swerd]

There is nothing in there that suggests there won’t be millions dead.

There is also nothing in there that suggests there will be millions dead.

 

[pewternhrata]

Of course there has to be a correlation to population density. I wonder how fast it could spread in the US vs China. It would have to be at a much slower rate.

 

[JerryLove]

There is also nothing in there that suggests there will be millions dead.

Actually there are at least three things.

the mortality in older patients is acknowledged.
The disease is acknowledged as a pandemic.
And contageion is viewed as unavoidable for the repeatedly exposed.

 

[Mr._Clark]

A more comforting opinion from a GW ER professor. I'm not sure I believe it, but it's easier to read than the millions die scenarios:

I'm an emergency doctor. I expect to get coronavirus | CNN

James Phillips writes that as an emergency physician at an urban hospital in Washington, D.C., this is personal: "I will likely become infected in the next few months. It's just simple math that I have accepted." But there are ways to stop the virus from overwhelming the health care system.

www.cnn.com

From the article:

"In addition, if our ambulances are busy transporting patients who are only worried or mildly ill, they will have slower response times to critically ill patients who truly need paramedic care. It is possible that people could die from health system disruption without ever having contracted the actual virus. An EMS delay of only a few minutes could mean that those having heart attacks, strokes, diabetic emergencies, opiate overdoses and trauma have a higher risk of death."

I prefer to look at the bright side of things: There's a good chance I will die from something other than COVID-19 (that's just an attempt at black humor, it's not a poke at you or the article).

On a more serious note, at my age, from a purely actuarial standpoint my odds of dying in any given year are roughly 1%. I find myself wondering if an additional 2% (or whatever the odds really are) risk of dying from COVID-19 really makes that much difference. I'd prefer to avoid the increased odds if possible, but it seems a bit academic at times.

 

[Gmoney]

for some reason it’s sparing children from dying from it and they don’t know why m

 

[KEW]

This morning, I read that paper more carefully. If you open that link, click on the PDF icon and you'll open the full text of this paper. It's too large to attach here. Here are the take home messages:

• The paper refers to the SARS-Cov-2 virus. It's the same as what the World Health Organization now calls COVID-19. Don't be confused by the different names.
  
  
• The authors' major point is that SARS-Cov-2 is really two different strains of related viruses. They named them L and S. As a result, all prior analyses of this epidemic must be re-evaluated because of the differences between L and S types. This could explain some of the confused reports about virulence and mortality during January and February.
  
  
• The S type has been around longer and is less aggressive. It's less contagious, or replicates slower, than the L type. However, the L type has not been the predominant virus strain since January 2020. To answer why, the authors suggest this possible explanation:
  
  "… since January 2020, the Chinese central and local governments have taken rapid and comprehensive prevention and control measures. These human intervention efforts might have caused severe selective pressure against the L type, which might be more aggressive and spread more quickly. The S type, on the other hand, might have experienced weaker selective pressure by human intervention, leading to an increase in its relative abundance among the SARS-CoV-2 viruses."
  
  
• As a result, we now face the less aggressive S type Covid-19 virus. That's a good thing, not a reason for panic.

Thanks for the factual information on this important topic!
It is reassuring that the more aggressive one is not the dominant one!

 

[GO-NAD!]

I use N95 masks when I work on automotive brakes or spread dusty dry fertilizer, and I can say first hand they make it noticeably more difficult to breath. They are worth it for brake work though; when I remove the mask I can see the black dust - which might contain asbestos - that it stopped me from breathing in.

I use one when I'm using woodworking power tools - sawing, routing, planing, sanding, etc. I can't imagine wearing one around town. That would drive me batty.

 

[Swerd]

I wonder if I should take the bait and respond to this. It's obvious to me that these comments are so vague that they can be read in a large number of different ways. Overall, they're meaningless.

Or – in the spirit of pouring cold water on posts that can inflame unwarranted fears of disease & death – should I respond?

Actually there are at least three things.

the mortality in older patients is acknowledged.

You cannot speak of Covid-19s mortality in older patients without comparing it to known mortalities of other infectious viral diseases such as influenza, viral pneumonia, etc. In the case of influenza, get mortality data for each season's flu, not a composite average of all seasons. They do vary significantly.

The disease is acknowledged as a pandemic.

Saying it's a pandemic is meaningless. How does that add anything to your claim of "millions dead"? Influenza is a known pandemic each season. It kills plenty of people each year. Yet, there is no widespread fear & loathing for the seasonal flu.

And contageion is viewed as unavoidable for the repeatedly exposed.

So is the common cold, so is Ebola, and so is the plague. So what?

All three points sound alarming, but add up to very little, or nothing. Why say them at all?

I feel compelled to point out that Trump has taken pains to make light of the Covid-19 pandemic. I emphatically do not agree with him on this matter, nor on any other matters. He seems to be more concerned over Wall Street & loan interest rates than he is about rates of disease transmission or mortality rates. His responses, and those of his flunkies, are primarily aimed at public relations, not fighting a public health threat.

I do however believe there is great harm in over-reacting because of the widespread fear of Covid-19. That's why I want to keep politics out of this. And that's why I want to stick with "just the facts".

 

[AcuDefTechGuy]

for some reason it’s sparing children from dying from it and they don’t know why m

Children are probably healthier than most older adults.

I wonder if any healthy athletes have died from this Coronavirus?

 

[KEW]

I wonder if I should take the bait and respond to this. It's obvious to me that these comments are so vague that they can be read in a large number of different ways. Overall, they're meaningless.

Or – in the spirit of pouring cold water on posts that can inflame unwarranted fears of disease & death – should I respond?
You cannot speak of Covid-19s mortality in older patients without comparing it to known mortalities of other infectious viral diseases such as influenza, viral pneumonia, etc. In the case of influenza, get mortality data for each season's flu, not a composite average of all seasons. They do vary significantly.
Saying it's a pandemic is meaningless. How does that add anything to your claim of "millions dead"? Influenza is a known pandemic each season. It kills plenty of people each year. Yet, there is no widespread fear & loathing for the seasonal flu.
So is the common cold, so is Ebola, and so is the plague. So what?

All three points sound alarming, but add up to very little, or nothing. Why say them at all?

I feel compelled to point out that Trump has taken pains to make light of the Covid-19 pandemic. I emphatically do not agree with him on this matter, nor on any other matters. He seems to be more concerned over Wall Street & loan interest rates than he is rates of disease transmission or mortality rates. His responses, and those of his flunkies, are primarily aimed at public relations, not fighting a public health threat.

I do however believe there is great harm in over-reacting because of the widespread fear of Covid-19. That's why I want to keep politics out of this. And that's why I want to stick with "just the facts".

I worry that the biggest take-away from this virus after all of the hype will be a "boy who cried wolf" phenomena where a later more potent virus that is more lethal will not get the caution it deserves after this one. That is not to make light of the hundreds or likely thousands who will die in North America, but now that I know more and knowing my immediate family is in good health, I am not so worried as I would be with a different virus that could actually have millions of casualties!!

Understand that it is still early in the game, and I may be proven wrong, but based on the current info, It seems like this is not the virus that will wipe out 10+% of the population!

 

[snakeeyes]

Well if anyone is following the events in Seattle, the city and county officials are recommending companies allow employees to telecommute who can. So that’s what I’m doing. Went from 2 days telecommuting to all 5 days for now at least.

 

[Swerd]

I worry that the biggest take-away from this virus after all of the hype will be a "boy who cried wolf" phenomena where a later more potent virus that is more lethal will not get the caution it deserves after this one. That is not to make light of the hundreds or likely thousands who will die in North America, but now that I know more and knowing my immediate family is in good health, I am not so worried as I would be with a different virus that could actually have millions of casualties!!

Understand that it is still early in the game, and I may be proven wrong, but based on the current info, It seems like this is not the virus that will wipe out 10+% of the population!

A good point. The less aggressive Covid-19 type S virus may be the dominant form for the present. But it is probably not the last sub-type we'll see. More mutations should be expected, as this newly emerged virus adapts to human hosts world wide. But, as always, natural selection will be at work. Any advantages offered by new mutations will be favored, but only in combination with the selective pressures created by medical & public health efforts from the human hosts of the infectious virus.

By selective pressures or evolutionary pressure I mean something specific.

In the lab, if someone is studying the function of a particular gene in bacteria, they alter that gene to see what happens to the bacteria when it can't work. What if that mutated gene makes the bacterial grow slowly or not at all? Would you be able to find it growing among many other bacteria that didn't have the mutation? You physically attach that mutated gene to another gene that creates resistance to an antibiotic such as penicillin. When you grow the bacteria on nutrient plates containing penicillin, only the ones with the penicillin resistance gene can grow. Among them will be the interesting mutations of the gene you're interested in studying. That's only one commonly used selection method. There are many others.

We can't do that with humans, but we can still talk about selective pressures. The efforts at containing contagious viral diseases by public health measures such as quarantine, or by medical interventions, can affect whether new mutations thrive or fail. That also qualifies as selective pressure.

 

[Swerd]

Well if anyone is following the events in Seattle, the city and county officials are recommending companies allow employees to telecommute who can. So that’s what I’m doing. Went from 2 days telecommuting to all 5 days for now at least.

A Brave New World version of Ferris Bueller's Day Off … but probably not as much fun.

 

[Irvrobinson]

Well if anyone is following the events in Seattle, the city and county officials are recommending companies allow employees to telecommute who can. So that’s what I’m doing. Went from 2 days telecommuting to all 5 days for now at least.

Look on the bright side, traffic in the Seattle area must be much lighter than usual, so air quality will be up.

 

[snakeeyes]

Look on the bright side, traffic in the Seattle area must be much lighter than usual, so air quality will be up.

Ya as long as you aren’t trying to go to a Costco location. LOL

 

[Irvrobinson]

Ya as long as you aren’t trying to go to a Costco location. LOL

I hear you. There are no reported cases in my state, but we were in Costco yesterday and lots of people were buying several cases of bottled water and toilet paper. You would think this virus was a diarrhea bomb and not a respiratory illness. I suspect if Costco sold oxygen concentration machines those would sell like ice in hell too.