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How to cope with coronavirus

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Old Saturday 21st March 2020, 20:16   #101
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There's an unanswered question really nagging me now. Why do some infected people develop severe symptoms and require hospitalization, when most don't? Beyond the obvious elderly, chronically ill, and immunocompromised of course -- latest reports here suggest that ~40% of the ICU beds are filled with healthy people in their 20s to 50s. In the absence of those usual complications, what determines the severity of symptoms? It can't be previous immunity because there is none. All I read is "we don't know".

I've been wondering whether the level of initial exposure to the virus could be the key. Get a light dose, and your immune system has time to deal with it in the upper respiratory tract and you get over it. Get a massive dose, and it goes straight to your lungs and/or overwhelms the immune system, and does serious damage. Is this medically plausible?

I'm concerned because if this were true, people who contract a nice mild case that will build herd immunity would be at risk of coming home and (even pre- or asymptomatically) massively infecting anyone they live with, endangering their lives. If true, the mystery cases in the ICU would mainly be people who live with someone who will also turn out positive when tested -- not because the more severe case infected them, but the other way around. This would have serious implications for conduct at home (however impractical!), not just in public spaces. So is anyone studying this population of unexpectedly critical patients? What do they have in common, if not this?

I emphasize that this is just speculation on my part. Do we have biologists or doctors here?

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Old Saturday 21st March 2020, 20:46   #102
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I've been wondering whether the level of initial exposure to the virus could be the key. Get a light dose, and your immune system has time to deal with it in the upper respiratory tract and you get over it. Get a massive dose, and it goes straight to your lungs and/or overwhelms the immune system, and does serious damage. Is this medically plausible?
I´m not an expert in anything except rank foolishness, but your theory sounds plausible, and would explain the high percentage of healthcare workers among confirmed cases. Here, 25% are medical personnel. Whatever the "real" percentage of cases requiring hospitalisation among those infected, it doesn´t really matter. If the healthcare systems are overwhelmed with lots of patients all at once, our healthcare staff are the labour sector that are going to suffer most, just when we most need them.
I´m sure most of us here on BF know someone in the Health Service who is going out tomorrow (or doing a long shift this evening), with inadequate protection, exhausting hours, mayhem in the hospitals, and the prospect of empty supermarket shelves when they go off-shift and try to do some food shopping.
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Old Saturday 21st March 2020, 21:19   #103
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There's an unanswered question really nagging me now. Why do some infected people develop severe symptoms and require hospitalization, when most don't? Beyond the obvious elderly, chronically ill, and immunocompromised of course -- latest reports here suggest that ~40% of the ICU beds are filled with healthy people in their 20s to 50s. In the absence of those usual complications, what determines the severity of symptoms? It can't be previous immunity because there is none. All I read is "we don't know"...

I emphasize that this is just speculation on my part. Do we have biologists or doctor?
You may find this interesting reading about Cytokine Storms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294426/

https://www.sciencedaily.com/release...0227142250.htm

I am not medically qualified so can only speak generally and from personal experience of having exactly this phenomenona. An Immune Storm/Cytokines storm is an over reaction of the immune system where the body starts to attack itself a bit like a sudden and critically intense auto-immune disorder and the lungs and eventually (if not treated) the organs become flooded with fluids. I am autoimmune and perscribed Hydroxychloroquine as an anti-inflammatory. I have also twice been hospitalised for secondary acute respiratory distress as a result of a viral infections. Hydroxychloroquine is now being trialed (and has been for some time by China) as part of one of the possible treatment protocols for some critical end stage Coronavirus patients where Acute Respiratory Distress Syndrome is the clinical emergency. The drug had some success in the SARs outbreak.

The point is, although I do have an autoimmune condition, one doesn’t need to have an underlying autoimmune condition to experience a Cytokine Storm as a reaction to a viral respiratory infection. A healthy younger person (cf elderly) who has no other apparent underlying conditions can have a negative immune response to these types of viral respiratory infections too - I’ve absolutely no idea though how common or how rare it is or even if it’s evening happening with the novel coronavirus.

(The reason for the high numbers of healthcare workers being infected is because they are working in the frontline with highly infectious patients and, as is becoming blindingly apparent, have inadequate personal protection equipment)
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Old Saturday 21st March 2020, 21:37   #104
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Anyone know if there's a plume of infective virus particles downwind of an infected person, like there's a plume of smoke downwind of a smoker breathing out their smoke?
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Old Saturday 21st March 2020, 21:44   #105
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I started looking into mortality rates a few days ago, found it a bit morbid, them a bit boring, then got busy with more important things.

But haven't really seen the science/analysis done elsewhere. And I believe it is relevant, if dealt with in the right place, and sensitively.

I started looking at the known mortality rates from known cases (think it was c40,000 cases analysed in China at that point), and compared to how it would be in the UK, then seeing what could happen in the different age groups. Aim was to then compare to what the known mortalities would be in those age groups in an average year to compare, but never got that far ...

The 0.2% mortality figures I assumed could be for individuals in an age group with underlying health issues, including that weren't known about. However that could include overreaction of immune system as mentioned above.
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Old Saturday 21st March 2020, 22:27   #106
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Anyone know if there's a plume of infective virus particles downwind of an infected person, like there's a plume of smoke downwind of a smoker breathing out their smoke?
Interesting question. If there is such a plume (and why wouldn't there be?), the "6-foot" rule would presumably still apply?
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Old Saturday 21st March 2020, 22:49   #107
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Interesting question. If there is such a plume (and why wouldn't there be?), the "6-foot" rule would presumably still apply?
I suspect it wouldn't work well - you could be a metre away upwind and perfectly safe, but given that in some conditions a smoker is easy to smell up to 20-30 metres (or more) downwind, would the same apply to a virus plume? How much virus does one need to breathe in to get infected?
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Old Saturday 21st March 2020, 22:54   #108
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I suspect it wouldn't work well - you could be a metre away upwind and perfectly safe, but given that in some conditions a smoker is easy to smell up to 20-30 metres (or more) downwind, would the same apply to a virus plume? How much virus does one need to breathe in to get infected?
c10 getting into your system I recall quoted as an average starting point for infection a month or two back.
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Old Saturday 21st March 2020, 23:11   #109
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c10 getting into your system I recall quoted as an average starting point for infection a month or two back.
considering that an infection releases hundreds of thousands if not millions . . .
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Old Saturday 21st March 2020, 23:17   #110
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I suspect it wouldn't work well - you could be a metre away upwind and perfectly safe, but given that in some conditions a smoker is easy to smell up to 20-30 metres (or more) downwind, would the same apply to a virus plume? How much virus does one need to breathe in to get infected?
Fair point. What would be useful to know is what effect (if any) the "quality" of the air stream has on the viability of the virus--for example moist air fresh from the lungs vs what happens to be blowing in the general environment. You'd think there'd be data on this somewhere. . ..
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Old Sunday 22nd March 2020, 10:23   #111
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Fair point. What would be useful to know is what effect (if any) the "quality" of the air stream has on the viability of the virus--for example moist air fresh from the lungs vs what happens to be blowing in the general environment. You'd think there'd be data on this somewhere. . ..
Likely is for some viruses; probably not yet for this one?
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Old Sunday 22nd March 2020, 19:45   #112
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I suspect it wouldn't work well - you could be a metre away upwind and perfectly safe, but given that in some conditions a smoker is easy to smell up to 20-30 metres (or more) downwind, would the same apply to a virus plume? How much virus does one need to breathe in to get infected?
I'd say no.

The virus is carried in droplets of moisture which would be heavier than the smoke expelled by a smoker hence the 2m guideline?

I must admit though that as a lifelong, non smoker, I had wondered myself.

I saw a shop worker today, wearing gloves. As the virus is spread by touching your face, whether or not the virus is on hands or gloves is irrelevant if you touch your face!
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Old Sunday 22nd March 2020, 20:01   #113
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didn’t want to put this on the ‘impact on birding’ but it’s another example of some people’s interpretation of ‘social distancing’

https://www.theargus.co.uk/news/1832...t-meet-people/

What is it about ‘avoid crowded places’ you don’t get!

This is a slow motion film of a sneeze

https://www.smithsonianmag.com/smart...get-180960257/
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Old Sunday 22nd March 2020, 21:43   #114
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One very useful article:
https://medium.com/@noahhaber/flatte...y-9aa8cf92d652

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Flatten the Curve of Armchair Epidemiology
Noah Haber

Mar 19 · 3 min read

Vet your sources or more people will be deluded


written by Noah Haber, ScD (@noahhaber), Mollie Wood, PhD (@anecdatally), and James Heathers, PhD (@jamesheathers), none of whom are infectious disease epidemiologists

Everyone has seen messages telling you we must “act today or people will die,” COVID-19 is basically just the flu, and/or that “flattening the curve is a deadly delusion.” These often have numbers, charts, citations, retroactively edited titles (“taksies backsies”), and data “science.”

Unfortunately, all of the above are signs of DKE-19, a highly contagious illness threatening the response against COVID-19. We must act today to flatten the curve of armchair epidemiology, or we will all be in peril.

What is DKE-19?

Dunning-Kruger Effect (DKE) is a phenomenon where people lack the ability to understand their lack of ability. While strains of DKE typically circulate seasonally, a new and more virulent strain called DKE-19 is now reaching pandemic proportions.

When you’re done reading this article, this is what you’ll take away:

DKE-19 is coming to you.
It’s coming at an exponential speed: gradually, then suddenly, then suddenlier.
When it does, your feeds will be overwhelmed.
Exhausted fact checkers will break down. Some will die of sadness.
The only way to prevent this is social media distancing. Not tomorrow. Today.
That means vetting sources BEFORE you share, starting now.


What are the symptoms?

Signs of DKE-19 generally appear 3–5 days after learning that the word “epidemiology” is not the study of skin diseases. Symptoms vary, but include extreme claims, making charts, and publishing on Medium. Although most cases are mild or even entirely asymptomatic, the recent outbreak indicates that severe DKE-19 primarily affects men ages 24–36 working in tech, for reasons unknown to scientists who are unaccountably also men.

How is the infection spread?

DKE-19 is in the same family of misinformation viruses as the one that caused the b00m3R-FB outbreak in 2016. It is transmitted person-to-person through a variety of means, including listening to/repeating bullshit while on the toilet (“feco-aural transmission”), and sharing dirty tweedles.

Transmission most often occurs through casual digital contact from asymptomatic individuals. This strain tends to be hidden in well-intended partial truths, making population detection more difficult. DKE-19 can hide in viral reservoirs throughout the internet. Once infection takes hold, DKE-19 is exceedingly difficult to treat. Several cases of second-hand craniofacial injury have been reported, related to collisions between desks and actual experts’ heads.

It will only get worse

Recent lockdowns to contain COVID-19 have resulted in Bay Area tech employees having vastly more time on their thumbs. We expect that exponential growth of bullshit takes are likely to grow exponentialer until the heat death of the universe and/or last Tuesday.

Are you at risk?

We have combined the collective expertise of three people with PhDs to create a machine learning model which predicts the spread of DKE-19-related misinformation. We believe this to be the best, most accurate infectious disease model published on Medium as of the time of this writing.

Things you can do to flatten the curve


Wash your phone for at least 20 seconds fully immersed in soapy water
6 ft of social media distancing
If take appears hot/feverish, seek expert help
Check the qualifications of authors BEFORE sharing
Listen to people who know what they are talking about
Push for better social media infrastructure that can slow the spread of DKE-19 and future strains

Only you can help #flattenthecurve of DKE-19

Thanks to Dan Larremore (@DanLarremore) and Megan Sass (@Megan_Sass) for helping edit.

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Old Sunday 22nd March 2020, 22:46   #115
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I'd say no.

The virus is carried in droplets of moisture which would be heavier than the smoke expelled by a smoker hence the 2m guideline?

I must admit though that as a lifelong, non smoker, I had wondered myself.

I saw a shop worker today, wearing gloves. As the virus is spread by touching your face, whether or not the virus is on hands or gloves is irrelevant if you touch your face!
Thanks; tho' I'm not convinced - fog droplets may be 'heavy', but they don't drop out of the air, and I'd suspect are often larger than virus particles.


Gloves won't stop you from touching your face, but they do act as a visible reminder - you see a gloved hand coming up, and "oh yes, gloves, why have I got them on? Ah yes, Stop!!! Mustn't touch!!" Works for me, until the itch in one's face becomes intolerable
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Old Sunday 22nd March 2020, 22:58   #116
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On the plus side, no government is going to be caught this way again.
I'd expect massive effort to ensure that future virus outbreaks are detected early and dealt with swiftly.
Fortunately the knowledge of microbiology is now sufficiently in hand that such capability is within reach.
With luck, the end of Montezuma's revenge as a collateral benefit.
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Old Sunday 22nd March 2020, 23:03   #117
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On the plus side, no government is going to be caught this way again.
I'd like to think that would be so, but....money hungry politicians and stupid people with short memories. I'm not betting on it.
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Old Monday 23rd March 2020, 00:00   #118
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cheering news

Among the essential business which may remains open, in New York, are off licenses, known here as liquor stores. I applaud New York Governor Andrew Cuomo for understanding what are truly essentials.
Since there is a limit to the number of persons allowed in a shop, ordering for pickup or delivery is mandated by many shops.

Happy bird watching,
Arthur Pinewood
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Old Monday 23rd March 2020, 00:14   #119
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I applaud New York Governor Andrew Cuomo for understanding what are truly essentials.
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Old Monday 23rd March 2020, 02:00   #120
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An Immune Storm/Cytokines storm is an over reaction of the immune system where the body starts to attack itself a bit like a sudden and critically intense auto-immune disorder and the lungs and eventually (if not treated) the organs become flooded with fluids. I am autoimmune and perscribed Hydroxychloroquine as an anti-inflammatory.

Hydroxychloroquine is now being trialed (and has been for some time by China) as part of one of the possible treatment protocols for some critical end stage Coronavirus patients where Acute Respiratory Distress Syndrome is the clinical emergency. The drug had some success in the SARs outbreak.
Dr Andrew Fauci just talking on CNN about Hydroxychloroquine fact checking Trump - contrary to Trump’s confusing comments earlier in the week claiming he would soon make this drug widely available. Dr Fauci saying exactly as I said in another thread, Hydroxychloroquine is already widely available for the treatment of malaria and autoimmune disease, and doesn’t need extensive safety trials just Fed approval for off-label use for the treatment of c-19. It’s not a proven treatment yet but as said above, it had some success in China in slowing/inhibiting the effects of coronavirus in critical patients and in vitro tests (in test tubes) in the States.


etudiant - The Chinese doctor that ‘discovered’ what became known as Covid-19, recognised it as a novel sars-like coronavirus very quickly but the Chinese authorities initially tried to shut him down (he later died) https://www.bbc.co.uk/news/world-asia-china-51364382. That withstanding, I would think it’s very difficult to detect the extent of a virus outbreak ‘very early’ if carriers are asymptomatic. It’s been suggested that one of the reasons the outbreak is so bad in Italy is that it might have been circling around in the community for sometime before people became symptomatic.

I applaud Andrew Cuomo for many things he has done for the people of NYC, in particular supporting the needs of homeless people!
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Old Monday 23rd March 2020, 02:44   #121
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Dr Andrew Fauci just talking on CNN about Hydroxychloroquine fact checking Trump - contrary to Trump’s confusing comments earlier in the week claiming he would soon make this drug widely available. Dr Fauci saying exactly as I said in another thread, Hydroxychloroquine is already widely available for the treatment of malaria and autoimmune disease, and doesn’t need extensive safety trials just Fed approval for off-label use for the treatment of c-19. It’s not a proven treatment yet but as said above, it had some success in China in slowing/inhibiting the effects of coronavirus in critical patients and in vitro tests (in test tubes) in the States.


etudiant - The Chinese doctor that ‘discovered’ what became known as Covid-19, recognised it as a novel sars-like coronavirus very quickly but the Chinese authorities initially tried to shut him down (he later died) https://www.bbc.co.uk/news/world-asia-china-51364382. That withstanding, I would think it’s very difficult to detect the extent of a virus outbreak ‘very early’ if carriers are asymptomatic. It’s been suggested that one of the reasons the outbreak is so bad in Italy is that it might have been circling around in the community for sometime before people became symptomatic.

I applaud Andrew Cuomo for many things he has done for the people of NYC, in particular supporting the needs of homeless people!
It's a replay of the several parts that were "aired" last week. The whole thing can be watched here: https://edition.cnn.com/videos/healt...rus-town-hall/
It's definitely very worth while watching (I've watched/listened to it probably 3 times already).

I feel like I should stay away from all coronavirus threads because I feel it affects me in a wrong way, but I thought adding the link could be useful for someone else.
Cheers
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Old Monday 23rd March 2020, 05:15   #122
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Among the essential business which may remains open, in New York, are off licenses, known here as liquor stores. I applaud New York Governor Andrew Cuomo for understanding what are truly essentials.
Since there is a limit to the number of persons allowed in a shop, ordering for pickup or delivery is mandated by many shops.

Happy bird watching,
Arthur Pinewood
Don't your supermarkets sell booze?

For our American cousins, 'off licence', colloquial name for a booze outlet which had a licence to sell alcohol for consumption 'off' the premises. Many old pubs used to have them in the UK when I was young, a small room usually, with a counter which was seperate to any bar area.
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Old Monday 23rd March 2020, 09:27   #123
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Don't your supermarkets sell booze?
Hello Andy,

The Sale of alcoholic beverages is governed by each state, and sometime by county. There are "dry" counties" in some Southern states. A suburb of Chicago, Evanston, bans the sale of all alcoholic beverages. California permits the sale of alcoholic beverages in supermarkets but many states permit the sale of liquor in state owned monopolies. alone. As I recall, only weak beer is sold in Minnesota supermarkets but strong beer and liquor are sold in state licensed shops.
In New York state, beer is sold in supermarkets but wine and spirits are sold in licensed establishments, known as "liquor stores." Such stores are often known by the euphemism, "package stores," in other states.

Stay safe,
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Old Monday 23rd March 2020, 17:10   #124
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You may find this interesting reading about Cytokine Storms
I've read about that but thanks for that reminder, though it just begs the further question why some people will experience dangerous cytokine storms and others won't. Are there that many people out there with preexisting autoimmune tendencies? (One does hear a lot of alleged intolerances these days, but in most cases I've assumed that was psychosomatic.)

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Anyone know if there's a plume of infective virus particles downwind of an infected person, like there's a plume of smoke downwind of a smoker breathing out their smoke?
Google "coronavirus" and "aerosols". There seems to be debate about how long droplets containing virus remain suspended. I was surprised that the recommended distance is only 6ft/2m, but like most things I suppose that's meant to substantially reduce risk rather than totally eliminate it.

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Very funny, but people are getting a lot of bad and confusing information and it's understandable to need to try to sort it out. More importantly, the really vital questions here are not technical matters of epidemiology, but of public policy, in which everyone can and should have a voice.
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Old Monday 23rd March 2020, 17:59   #125
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More importantly, the really vital questions here are not technical matters of epidemiology, but of public policy, in which everyone can and should have a voice.
Really?

I was on an aeroplane recently, in bad weather, leading to a couple of goes at getting on the deck. Afterwards, as we trekked through the airport to find our bags, I overheard Miss Chav of Chavsville, Essex, whining nasally that the pilot had never asked the passengers whether they thought another shot at getting in before diverting was a good idea.

Exactly right, he didn't. Aviation is a professional business, not a democracy, and so ought to be countering a viral epidemic.

Everybody's voice can say "please make this go away by the quickest means" but that should be the limit of everyone having a voice in public policy at the moment. Indeed, one wonders whether elected politicians should have a voice in it.

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