Coronavirus - Health and preparedness aspects - II

[MissMolly]

https://www.cdc.gov/mmwr/volumes/69/wr/mm6909e1.htm?s_cid=mm6909e1_w

CDC Morbidity and Mortality Weekly Report

From the report:

“As of February 26, 12 travel-related COVID-19 cases had been diagnosed in the United States, in addition to three COVID-19 cases in patients with no travel history (including two cases in close household contacts) and 46 cases reported among repatriated U.S. citizens.§ Following confirmed diagnosis, the 12 patients with travel-related COVID-19 were isolated in the hospital if medically necessary, or at home once home care was deemed clinically sufficient.

Among the first 10 patients with travel-related confirmed COVID-19 reported in the United States, a total of 445 persons (range = 1–201 persons per case) who had close contact with one of the 10 patients on or after the date of the patient’s symptom onset were identified. Nineteen (4%) of the 445 contacts were members of a patient’s household, and five of these 19 contacts continued to have household exposure to the patient with confirmed COVID-19 during the patient’s isolation period; 104 (23%) were community members who spent at least 10 minutes within 6 feet of a patient with confirmed disease; 100 (22%) were community members who were exposed** to a patient in a health care setting; and 222 (50%) were health care personnel.”

The report follows the testing of those 445 contacts. It’s an interesting read.

This is all very encouraging where it sounds like you have to have had contact with an infected person to develop COVID-19. But then the report goes on to say:

Since February 28, an increasing number of newly diagnosed confirmed and presumptive COVID-19 cases have been in patients with neither a relevant travel history nor clear epidemiologic links to other confirmed COVID-19 patients.

So, we (or at least I) am right back to not knowing how much risk there really is.

 

[tmm99]

Whatever it is with Hopkin's map, 1,500 people have been added to Italy's infection stats since last night. That's a huge jump in numbers... It looks like its death numbers are being updated.

 

[ncbill]

Article in today's WSJ pointed out that the actual number of infected here in the U.S. is at least one and likely two orders of magnitude higher than the currently reported number.

I still expect to be exposed via air travel (domestic) over the next couple of weeks.

 

[JoeWras]

and scroll to the country list, you can click on specific countries to see the progression.

The Diamond Princess is its own country in this chart. That makes sense, it just caught me by surprise. I think in other charts I see it listed with the very sterile "International Conveyance."

This is all very encouraging where it sounds like you have to have had contact with an infected person to develop COVID-19. But then the report goes on to say:

Since February 28, an increasing number of newly diagnosed confirmed and presumptive COVID-19 cases have been in patients with neither a relevant travel history nor clear epidemiologic links to other confirmed COVID-19 patients.

So, we (or at least I) am right back to not knowing how much risk there really is.

So from a few family of sicker relatives who have been interviewed in NY, the family had very mild symptoms. Little to no fever and just a small cough. You can expect there are people out there who don't know they have it. If they use the self check out touch screen right before you, then you've been exposed.

 

[Sunny]

Why are folks panicking and stocking up on bottled water and toilet paper? Regular flu this season has knocked off over 18,000 of my fellow Americans.

If they are like most people and never thought about keeping supplies on hand for snowstorms, tornados, hurricanes, etc. maybe they looked at the lists of emergency preparedness that we have been told for decades we should have on hand and realized they didn't have enough stuff?

Or maybe just panic, probably both I suppose.

As for it is also flu season....this seems a lot different:

• Even dropping the mortality rate down to 1% instead of the 2.3% in China, it is 10x more deadly than the flu
• Last year of the 35 million estimated flu cases, "only" 1.4% were hospitalized.....Coronavirus seems to have a much higher percentage of hospilizations (https://www.cdc.gov/flu/about/burden/2018-2019.html , Study of 72,000 COVID-19 patients finds 2.3% death rate | CIDRAP)
• Early reports seem to be indicating those that have more severe reactions to covid-19 may be having permanent lung damage, and a higher percentage of people are having a moderate to severe reaction to this virus than the annual flu.
• Even if the rates somehow drop down to annual flu levels once all the counting is done, we don't really want another annual disease taking out and killing the infirm and old do we? It'd be good to stop it if possible.

 

[tulak]

Will be visiting my seventy-six-year-old sister next week. She has Parkinson's which puts her at somewhat higher risk of infection.



There's only one case of CV near me and two near her, so I guess we'll still hug when we get together, but it's something I think about. If I lived in Seattle, I'd think more about it.



Imagine getting together with loved ones and just waving.

I’m starting to think about this for our upcoming trip to Europe in May. I’m traveling with DD so she can see the grandparents, all of which are in their 70’s. Before arriving, we will have spent a week traveling, most likely in Switzerland. Is it safe to visit them afterwards? Maybe we should get an airbnb and only wave at them from a distance?

Not sure what to do yet. I figure we still have time to figure it out. Worst case: we’ll facetime the grandparents and go to the beach instead.

 

[gromit]

A recent NBC News story had an expert show how he navigates some daily life situations. He carries a few paper towels in a pocket and always carries a pen. He uses his elbow or arm to open push doors. For credit card accept buttons, screen OKs, etc he uses the tip of the pen. For pumping gasoline he grabs the pump handle with a paper towel between his hand and the handle. He then tosses the towel when finished.

 

[JoeWras]

A recent NBC News story had an expert show how he navigates some daily life situations. He carries a few paper towels in a pocket and always carries a pen. He uses his elbow or arm to open push doors. For credit card accept buttons, screen OKs, etc he uses the tip of the pen. For pumping gasoline he grabs the pump handle with a paper towel between his hand and the handle. He then tosses the towel when finished.

That's good info. Glad to hear something sensible (and not just doom) coming from the media.

Shopping carts, touch screen accepts, pen writers, gas pumps, elevator buttons now all scare me.

I've been using a nitrile glove at the pharmacy for years now when signing their stupid "I don't need to talk to a pharmacist" screen. Really, a paper towel is probably enough.

 

[Nemo2]

https://www.scmp.com/news/china/sci...vel-twice-far-official-safe-distance-and-stay



Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds

The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres – further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.
The researchers also found that it can last for days on surfaces where respiratory droplets land, raising the risk of transmission if an unsuspecting person touches it and then rubs their face and hands.
The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.

China requires closed circuit television cameras to be installed on all long-distance buses, which provided valuable footage for researchers to reconstruct the spread of the virus on the bus, whose windows were all closed.

Hu Shixiong, the lead author of the study who works for the Hunan Provincial Centre for Diseases Control and Prevention, said the security camera footage showed patient “A” did not interact with others throughout the four-hour ride.
But by the time the bus stopped at the next city, the virus had already jumped from the carrier to seven other passengers.

These included not only people sitting relatively close to “patient zero”, but also a couple of victims six rows away from him – roughly 4.5 metres away.............//.......The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.

 

[gwraigty]

This may be helpful for people trying to stock up on prescriptions:

How To Boost Your Emergency Supply Of Prescription Medicines

But boosting your emergency supply of medicine is often challenging, even as insurers begin to ease their usually tight restrictions in light of COVID-19.

Most insurance companies have rigid schedules for authorizing refills.

...

Here's an alternative, Jacobson says: Reach out to your pharmacist to help intervene.

"They do it all the time," Jacobson says. "They're constantly talking to the primary care physician or any specialist on the nature of a prescription — the length of time," he says. Your primary care provider may also be able to help intervene with the insurance company.

Most insurers will relax their refill policies in cases of natural disasters like hurricanes or earthquakes. And that's just beginning to happen with the spread of the coronavirus.

 

[gwraigty]

As I suspected would happen by today, Ohio now has it's first confirmed cases of the coronavirus. 3 people in their 50s. 2 are a married couple who just got back from a cruise on the Nile River, and 1 person who came back from the AIPAC conference in DC. State of emergency has been declared and they're considering moving polling places out of nursing homes. They're all in Cuyahoga County, which is our neighboring county. DH's parents live in Cuyahoga County and DS works at a nursing home in Cuyahoga County.

 

[Sunny]

https://www.scmp.com/news/china/sci...vel-twice-far-official-safe-distance-and-stay

Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds

That travel twice as far though was potentially using the air conditioning system on the bus though, according to the article.

And it makes sense in such a closed system as a bus it may even be how the vents are placed to how far it can travel. I wouldn’t think that 3.5 meter distance would apply in a wide open grocery store.

But who knows. I found out last night going to the store at 9pm was the least busiest I’ve ever seen it. Going forward, even after any potential virus/health concerns, I’ve found my new favorite time to go grocery shopping.

 

[W2R]

Louisiana got its first presumptive COVID-19 case today, too. This still needs to be confirmed by the CDC. The patient lives in my parish (=county), showed up at an ER with pneumonia, and has been hospitalized at the VA Hospital. No info as to age or sex or anything else, except that apparently the patient has not traveled.

So far Louisiana has only tested 11 patients so apparently this is one of them. And of course it has to be in MY parish. OK, now I don't feel so dumb for doing a little prepping last week.

I did notice that going to the gym today felt like risk-taking behavior. Nobody there is using gloves, masks, or hand sanitizer. I did notice one guy last week who wiped off the handles of a treadmill before using it, but nobody else has been doing a blessed thing. Last time I saw an old friend from years ago, in her 80's, who ran up to me to hug me and kiss me on the cheek (a common greeting here among friends). I turned my head away but overall it was kind of a difficult thing to handle.

 

[MRG]

I hadn't seen this article before.

https://www.bloomberg.com/news/arti...-says-high-blood-pressure-is-major-death-risk

While there’s been no published research yet explaining why, Chinese doctors working in Wuhan, the central Chinese city where the virus first emerged, have noticed that infected patients with that underlying illness are more likely to slip into severe distress and die.
Of a group of 170 patients who died in January in Wuhan -- the first wave of casualties caused by a pathogen that’s now raced around the world -- nearly half had hypertension.

 

[Sunny]

Louisiana got its first presumptive COVID-19 case today, too. The patient lives in my parish (=county) and has been hospitalized. This still needs to be confirmed by the CDC.

.... I did notice one guy last week who wiped off the handles of a treadmill before using it, but nobody else has been doing a blessed thing. ....

I’ve always wiped off the gym equipment before and after use. At my gym they have so many paper towel dispensers with sprays around I don’t know how people who do nothing at all just completely ignore wiping their grimy sweat off the piece of equipment they just used. Perhaps gym goers have a higher percentage of selfish people? But it has always struck me as odd.

Then again, we have always been different with germs. I don’t think we are germaphobes, just 2 people with medical backgrounds and infection control ingrained into our brains. We’ve used hand wipes for years before eating at restaurants, never put our silverware on those tables (wipe them with a wet cloth sometime to see why...), opened doors with sleeves, pushed buttons with elbows, etc. etc.

 

[OldConch]

https://www.scmp.com/news/china/sci...vel-twice-far-official-safe-distance-and-stay



Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds

"The scientists behind the research said their investigation also highlighted the importance of wearing face masks because of the length of time it can linger"

When we were in Hong Kong 3 weeks ago, almost 100% of people were wearing masks. Those who weren't appeared to be visitors. The number of new cases in HK appears to have peaked at just a little over 100 and there were no new cases today.

It's unfortunate IMO that masks are basically unavailable here in the U.S.

 

[zinger1457]

I’ve always wiped off the gym equipment before and after use. At my gym they have so many paper towel dispensers with sprays around I don’t know how people who do nothing at all just completely ignore wiping their grimy sweat off the piece of equipment they just used. Perhaps gym goers have a higher percentage of selfish people? But it has always struck me as odd.

Recently joined the local Planet Fitness gym and the first thing that struck me is that everyone seems to be very good about wiping the equipment off after use, that wasn't always the case in previous gyms I've used. They do have signs up all around the gym telling you to wipe the equipment off after use, and they also have the paper towel dispensers and spray disinfectant bottles all around the gym. I'm sure some of it is peer pressure, you can't but help see everyone else doing it, you would stick out like a sore thumb if you didn't. This was before the coronavirus scare hit so pretty sure it's common practice rather than tied to the scare.

 

[GenXguy]

That's a wonderful site with a great interface, but today, for the first time, it's reporting "No Data" for many of the stats. Maybe it's a temporary glitch, but I expect that at some point, it will only be able display estimated numbers.

I've had that happen once in a while on that site.

Here's another one:

https://covid19info.live/

 

[JoeWras]

It's unfortunate IMO that masks are basically unavailable here in the U.S.

Hoarding 101. This is what your friendly neighbor does to you.

A week ago before this got too hot, wipes were already in short supply. As I detailed earlier, I saw one gentleman take 8 tubes of wipes. He just cut off 7 families from having at least 1 tube.

 

[socca]

...I don’t know how people who do nothing at all just completely ignore wiping their grimy sweat off the piece of equipment they just used. Perhaps gym goers have a higher percentage of selfish people?

I don't bother wiping off a piece of equipment at the gym before using it. These days, I simply assume that the equipment is contaminated and concentrate on keeping my hands away from my orifices. So far, so good.

I'm willing to start wiping down gym equipment after I use it if this provides emotional comfort to other gym-goers. However, IMO as a practical matter one good cough by a coronavirus carrier onto a complex piece of gym equipment renders the equipment hopelessly contaminated. Maybe coronavirus transmission probability is reduced somewhat after a good wiping - who knows?

 

[TromboneAl]

Last time I saw an old friend from years ago, in her 80's, who ran up to me to hug me and kiss me on the cheek (a common greeting here among friends). I turned my head away but overall it was kind of a difficult thing to handle.

Yes, it's difficult (impossible?). I've vowed that I'm going to try to avoid shaking hands no matter how awkward it seems.

I wrote this to my sister, related to our upcoming visit (I have to go to her area for my basal cell facelift):

I'm a little worried about COVID and you, Gail, given your age and PD—are we going to hug anyway​

Maybe we should take showers then dress and hug?

 

[Dtail]

Not sure if there is a Bath and Body Works near you, but we have been able to pick up 40 1 oz bottles so far and they seem to have a decent supply.
It contains 68% alcohol which is comparable to the 70% alcohol in Purell.

 

[W2R]

Yes, it's difficult (impossible?). I've vowed that I'm going to try to avoid shaking hands no matter how awkward it seems.

I wrote this to my sister, related to our upcoming visit (I have to go to her area for my basal cell facelift):

I'm a little worried about COVID and you, Gail, given your age and PD—are we going to hug anyway​

Maybe we should take showers then dress and hug?

Wonderful idea to contact her first!!! That way both of you can think about it, and if you decide not to hug, neither will feel slighted.

As for me, I'd love to just stay home for a few months starting right this minute so that I don't have to deal with such things. But then, I am such an introvert that I have to be careful to not succumb to the temptation to become a recluse. My guess is that such behavior patterns would be overly enticing, and wouldn't be mentally healthy for me.

 

[JoeWras]

I don't bother wiping off a piece of equipment at the gym before using it. These days, I simply assume that the equipment is contaminated and concentrate on keeping my hands away from my orifices. So far, so good.

I'm willing to start wiping down gym equipment after I use it if this provides emotional comfort to other gym-goers. However, IMO as a practical matter one good cough by a coronavirus carrier onto a complex piece of gym equipment renders the equipment hopelessly contaminated. Maybe coronavirus transmission probability is reduced somewhat after a good wiping - who knows?

If your equipment gets a lot of skin contact, I'd wipe it. It was about 15 years ago that there were all those MRSA outbreaks in gyms. Now, MRSA is a bacteria and can invade through a small scratch. I don't think this virus works this way, so your "orifice avoidance" plan is good. Still, best to avoid getting anything right now so you can stay away from health care facilities.

 

[TromboneAl]

I am such an introvert that I have to be careful to not succumb to the temptation to become a recluse. My guess is that such behavior patterns would be overly enticing, and wouldn't be mentally healthy for me.

I don't want to be an enabler, but I'm okay with my tendency to be a recluse. I've given up trying to fight it.

Waking up knowing there's nowhere I need to be that day: priceless.