Coronavirus - Health aspects

[michelek]

When we were building our RV I used a 3M full face mask with cartridge filters because of the very toxic cyanurate fumes. I did switch to a forced air system because I was worried the cartridges would become saturated but it was amazing the difference between having the mask on and taking it off. It filtered all chemicals and smells, and also was N95 (or better?).



The other nice thing is it covers the eyes. It is actually quite comfortable to wear, I had it on for hours when sanding. I bet you could be near 100% safe with this on. I would wear one if in China for sure. I paid about $180 for mine.

Very nice PPE Personal Protective Equipment

 

[NW-Bound]

Yesterday, at this time the number of confirmed patients in China was 9,600.

Just now, I see that it is 11,791.

And the two new hospitals with 2,600 beds being crash-built in Wuhan are not yet up.



PS. Another Web headline says "The Baltic Dry Index lost 99.95%". I don't understand this. Does that mean shipping companies don't even recover their fuel cost? Why even bother to haul anything for free?

 

[Teacher Terry]

Wow Bill that’s awful!

 

[Running_Man]

Yesterday, at this time the number of confirmed patients in China was 9,600.

Just now, I see that it is 11,791.

And the two new hospitals with 2,600 beds being crash-built in Wuhan are not yet up.



PS. Another Web headline says "The Baltic Dry Index lost 99.95%". I don't understand this. Does that mean shipping companies don't even recover their fuel cost? Why even bother to haul anything for free?

The Baltic dry Index fell from 2500 to 1000 from September to January 1st. In the month of January with the Corona virus it fell another 53% to 476.... Amazing drop of anticipation of shipping containers..........

 

[NW-Bound]

Regarding the low death rate reported by China despite the high number of patients, I see some info on Youtube from a man who is married to a Chinese doctor. It is said that if one looks at the reported deaths from flu in past years, one will see that the number is very low from China vs. from the US. Why? Is China better at treating flu than the US?

It is then explained that in China, if a patient has some existing conditions such as heart or lung disease, then dies with influenza, the cause of death on the certificate will not say influenza, but heart or lung disease. That is not the custom in the US, which will list the cause of death as complications brought on by the flu.

If that's how flu deaths have been classified, then it is likely deaths in China caused by the coronavirus are handled similarly. Hence, we see the number of deaths as only a few hundreds out of tens of thousand patients. The recovery number is also in the hundreds. I have been asking what happens to the rest? Are they still lingering on hospital beds? The answer may be that they died of "something else" not to be counted nor mentioned.

I was going to link to the Youtube video, but decided not to, because it contains some other controversial issues.

Thought I would mention the above, so that someone else may corroborate or dispute the classification of the cause of death as practiced in China and in the US.

 

[dixter]

for the corona virus china will list the cause of death as " drinking tainted poison snake blood"

 

[NW-Bound]

^^^ Very funny.

On the other hand, there's so far no death from coronavirus outside of China. That's something to ponder.

Maybe with good care, the chance to survive it is high. But if we allow too many people getting sick, hospitals only have so many ICU rooms. When you have patients laying out in the corridors, those patients will not have a fighting chance.

PS.

Number of confirmed cases in China: 11,791. Number of deaths: 259 (2.2%).

Number of confirmed cases outside of China: 157. Number of deaths: 0.

 

[tmm99]

If you want to see some solid data and transparency, here is an article published in the Lancet Medical Journal on Jan 29, 2020.

"Epidemiological and clinical characteristics of 99 cases of
2019 novel coronavirus pneumonia in Wuhan, China:
a descriptive study"


https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext

' In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020"

Age, years
Mean (SD) 55·5 (13·1)
Range 21–82
≤39 10 (10%)
40–49 22 (22%)
50–59 30 (30%)
60–69 22 (22%)
≥70 15 (15%)

Chronic medical illness 50 (51%)
Cardiovascular and cerebrovascular diseases 40 (40%)
Digestive system disease 11 (11%)
Endocrine system disease† 13 (13%)
Malignant tumour 1 (1%)
Nervous system disease 1 (1%)
Respiratory system disease 1 (1%)

Clinical outcome
Remained in hospital 57 (58%)
Discharged 31 (31%)
Died 11 (11%)

 

[Old Microbiologist]

I am a retired microbiologist that spent 40 years working on biothreat agents for diagnostics, pathogenesis, therapeutics and vaccine developments for aerosol exposures to very high threat organisms for military populations. This particular virus, like all zoonotic viruses are a threat because of their ability to spread quickly and to mutate once it jumps from its normal animal host to humans. The 2019-nCoV is not the species killer but it is of concern. So far it acts almost exactly like SARS and has a R0 of around 2.8 (a single case spreads to infect 2.8 people, meaning it almost triples itself) , a 14 day incubation and a death rate under 4%. This is not surprising as the analysis of its genome shows it is very close to SARS which has similar numbers.

It is, in fact, actually less of a problem than some "normal" influenzas which are far worse having a higher lethality. This SARS-like infection so far only seems to kill those at high risk such as the elderly and those with pre-conditions like diabetes. The main problem is infected individuals who are asymptomatic can be spreading the disease and a super-spreader can infect multiple people beyond the 2.8. Screening for temperature is missing these people hence the need to lock down all travel in and out of China. It may actually be too late as we are seeing it spreading into many other countries as 5 million left Wuhan before the lock down. This is the big problem. The problem with a disease like this which is not lethal is it is expensive to treat as it requires intensive medical care in containment facilities. This is why China is building 3 brand new from scratch 1,000 bed containment hospitals in under 2 weeks. I doubt this could happen anywhere else.

This is not the disease which will eradicate humanity. But, that disease is lurking out there somewhere in nature. If we were to see a strain of plague which was completely antibiotic resistant then you would see a completely different picture. That disease is very scary and I worked with it a lot. The normal wild strains have a time from infection to death (from cutaneous exposure) is under 12 hours which is actually too hot to spread very far. The respiratory TTD is 3 days so less virulent but lethality is greater at around 90%. So, a moderated strain that takes longer to kill would let someone coughing to spread it longer. Now that is scary and there are no vaccines available and we have been working on a vaccine for plague for over 100 years.

So, it is important to be able to identify these strains and develop the ability to contain any new disease before it spreads beyond the capacity to control. This is why this is an interesting disease to watch.

 

[Scratchy]

I am a retired microbiologist that spent 40 years working on biothreat agents for diagnostics, pathogenesis, therapeutics and vaccine developments for aerosol exposures to very high threat organisms for military populations. This particular virus, like all zoonotic viruses are a threat because of their ability to spread quickly and to mutate once it jumps from its normal animal host to humans. The 2019-nCoV is not the species killer but it is of concern. So far it acts almost exactly like SARS and has a R0 of around 2.8 (a single case spreads to infect 2.8 people, meaning it almost triples itself) , a 14 day incubation and a death rate under 4%. This is not surprising as the analysis of its genome shows it is very close to SARS which has similar numbers.

It is, in fact, actually less of a problem than some "normal" influenzas which are far worse having a higher lethality. This SARS-like infection so far only seems to kill those at high risk such as the elderly and those with pre-conditions like diabetes. The main problem is infected individuals who are asymptomatic can be spreading the disease and a super-spreader can infect multiple people beyond the 2.8. Screening for temperature is missing these people hence the need to lock down all travel in and out of China. It may actually be too late as we are seeing it spreading into many other countries as 5 million left Wuhan before the lock down. This is the big problem. The problem with a disease like this which is not lethal is it is expensive to treat as it requires intensive medical care in containment facilities. This is why China is building 3 brand new from scratch 1,000 bed containment hospitals in under 2 weeks. I doubt this could happen anywhere else.

This is not the disease which will eradicate humanity. But, that disease is lurking out there somewhere in nature. If we were to see a strain of plague which was completely antibiotic resistant then you would see a completely different picture. That disease is very scary and I worked with it a lot. The normal wild strains have a time from infection to death (from cutaneous exposure) is under 12 hours which is actually too hot to spread very far. The respiratory TTD is 3 days so less virulent but lethality is greater at around 90%. So, a moderated strain that takes longer to kill would let someone coughing to spread it longer. Now that is scary and there are no vaccines available and we have been working on a vaccine for plague for over 100 years.

So, it is important to be able to identify these strains and develop the ability to contain any new disease before it spreads beyond the capacity to control. This is why this is an interesting disease to watch.

Fascinating info.

Any advice at the individual/household level on how to protect and prepare ourselves if things were to take a bad turn?

 

[Old Microbiologist]

If you want to be completely safe then isolation is best. By that I mean limit contact with others to a bare minimum. If it gets bad then face masks are going to be necessary (good luck finding any now) to limit inhalation if you have to go out. I have seen some Chinese cutting brasieres in half to use as a face mask and that is a simple but effective idea. These masks typically sold commercially are not HEPA filtered masks and will only limit large droplets but most coughing produces large aerosols. N95 rated masks would be the minimum for controlling virus infections which behave as a gas as they are less than 0.2 microns in size. The really bad news is this coronavirus can live up to 28 days depending on temperature and humidity on surfaces or in the air.

Hand washing is the most beneficial way to control infections. These dumb antibacterial lotions are ridiculously ineffective and I have argued against them for a very long time to no avail. Do not count on them to work. Physical hand washing is the best way to limit this kind of infection with scrubbing under the fingernails. Also, train yourself to not put your fingers into the nose, mouth and eyes. Most people do this unconsciously very frequently so it is a bad habit which is difficult to control but is also the highest risk of getting infected.

Stay away from obviously infected people and if they are coughing hold your breath until you can get away from them. Avoid places like hospitals and doctors offices. Don't fly at all. Airplanes do not filter the air at all which is recirculated so everyone rebreathes already breathed air. The TSA security checkpoints are already identified as being heavily contaminated areas much worse than anywhere else. The air in aircraft will, by its very nature, contain small particles so is a very high risk. Why they didn't mandate putting in filtration after 9/11 baffles me. Office buildings pose the same risk.

Avoid large crowds. If you don't have contact with people at all you will be safe. The more contact you have the higher the risk.

Because the incubation can be up to 14 days in an epidemic this is the time it takes to see if control mechanisms are working. One thing people need to do is stay at home if sick so they don't infect others. Sadly, in the US this is not a very good way to handle this kind of problem. In France, as an example, they have ordered all sick people to stay at home and call for medical assistance. They come to you at your home in full PPE and evaluate you on site thus limiting risk of exposure to others. But, in the US we don't have that kind of healthcare system and a call to 911 will cost you perhaps thousands of dollars but is free in countries that have national health plans. This is one serious problem with US healthcare in this kind of situation where it becomes a national emergency. There is no system in place to handle the volume necessary or to figure out who is going to pay for it.

Much of my career was devoted to disinfection and sterilization procedures. Many things can kill organisms and each organism is different. The key component is contact time with a disinfectant. Common household bleach works the best but I recommend at a minimum 10 minutes contact time. A typical household sprayer works well. The bleach solution must be made fresh every 24 hours and a 1:10 dilution works fine. It kills anthrax spores as well which are very hardy but takes the full 10 minutes to work.

 

[Scratchy]

If you want to be completely safe then isolation is best. By that I mean limit contact with others to a bare minimum. If it gets bad then face masks are going to be necessary (good luck finding any now) to limit inhalation if you have to go out. I have seen some Chinese cutting brasieres in half to use as a face mask and that is a simple but effective idea. These masks typically sold commercially are not HEPA filtered masks and will only limit large droplets but most coughing produces large aerosols. N95 rated masks would be the minimum for controlling virus infections which behave as a gas as they are less than 0.2 microns in size. The really bad news is this coronavirus can live up to 28 days depending on temperature and humidity on surfaces or in the air.

Hand washing is the most beneficial way to control infections. These dumb antibacterial lotions are ridiculously ineffective and I have argued against them for a very long time to no avail. Do not count on them to work. Physical hand washing is the best way to limit this kind of infection with scrubbing under the fingernails. Also, train yourself to not put your fingers into the nose, mouth and eyes. Most people do this unconsciously very frequently so it is a bad habit which is difficult to control but is also the highest risk of getting infected.

Stay away from obviously infected people and if they are coughing hold your breath until you can get away from them. Avoid places like hospitals and doctors offices. Don't fly at all. Airplanes do not filter the air at all which is recirculated so everyone rebreathes already breathed air. The TSA security checkpoints are already identified as being heavily contaminated areas much worse than anywhere else. The air in aircraft will, by its very nature, contain small particles so is a very high risk. Why they didn't mandate putting in filtration after 9/11 baffles me. Office buildings pose the same risk.

Avoid large crowds. If you don't have contact with people at all you will be safe. The more contact you have the higher the risk.

Because the incubation can be up to 14 days in an epidemic this is the time it takes to see if control mechanisms are working. One thing people need to do is stay at home if sick so they don't infect others. Sadly, in the US this is not a very good way to handle this kind of problem. In France, as an example, they have ordered all sick people to stay at home and call for medical assistance. They come to you at your home in full PPE and evaluate you on site thus limiting risk of exposure to others. But, in the US we don't have that kind of healthcare system and a call to 911 will cost you perhaps thousands of dollars but is free in countries that have national health plans. This is one serious problem with US healthcare in this kind of situation where it becomes a national emergency. There is no system in place to handle the volume necessary or to figure out who is going to pay for it.

Much of my career was devoted to disinfection and sterilization procedures. Many things can kill organisms and each organism is different. The key component is contact time with a disinfectant. Common household bleach works the best but I recommend at a minimum 10 minutes contact time. A typical household sprayer works well. The bleach solution must be made fresh every 24 hours and a 1:10 dilution works fine. It kills anthrax spores as well which are very hardy but takes the full 10 minutes to work.

Fantastic info. Thank you!

 

[Bongleur]

The really bad news is this coronavirus can live up to 28 days depending on temperature and humidity on surfaces or in the air.

Hand washing is the most beneficial way to control infections. These dumb antibacterial lotions are ridiculously ineffective and I have argued against them for a very long time to no avail.

What about the 1.3% BAC (benzylammonium chloride) handwash products? One has some sort of claimed technology to "ionize" it, to break down cell wall structure for penetration. Also claimed to stay active on the skin for several hours.

You can buy 2% BAC disinfectant in the janitorial supply aisle of big box hardware stores.

 

[Bongleur]

Since this is in the HEALTH section, can we limit posts to that and put the financial implications & chatter somewhere else?

 

[Bongleur]

Masks & full face respirators are not very effective without a good facial seal. That means clean shaven. No five o-clock shadow, let alone beards.

Also they make you work 25% harder to breath, worse when not at rest. So you might have a heart attack if you are not in good shape.

 

[Old Microbiologist]

https://www.biorxiv.org/content/10.1101/2020.01.26.919985v1

This article was brought to my attention this morning about the putative receptor for 2019-nCoV being ACE2 and that in this small study Chinese have 5 times more ACE2 receptors. I can't accept it being anything but suggestive given such a small sample size and caution must be applied to rapidly done papers. They can provide good data but only if validated in other labs using larger sample populations. But, it does serve to remind us that different genetic populations may respond differently. When performing clinical trials for new drugs the target population must be clearly defined and tested thoroughly which can be extremely expensive and takes years. Any candidate vaccine will get released on an emergency basis using only animal data with only human safety trials which will be limited. However, I wouldn't get any hopes too high as they have been working on a SARS and MERS vaccine for over a decade now with zero candidates that made it through the 2 animal testing requirements.

It is extremely early to establish "hard" data and generally this becomes clear years after an epidemic once all variables are sorted out and analyzed. The Chinese have been very forthright in providing hard data which is very different than happened with SARS. The consequence for those in the government that hid the SARS data was a permanent ending with a bullet to the head after a quick trial. It is, after all a communist country. This also makes compliance with control measures a lot easier. In the US it is like herding cats.

 

[Old Microbiologist]

Regarding hand washing. There is an excellent review of all the various methods here:https://www.ncbi.nlm.nih.gov/books/NBK144041/

IMHO nothing beats good hand washing with a good soap. This is in part because some of the disinfectants actually cause the organisms to adapt and become more resistant. If you want to be certain then scrub thoroughly and rinse with 70% alcohol. 10% bleach would be better but it eats your skin.

Regarding masks, none except gas masks and even those with HEPA filtration down to 0.1 microns are only 99.9% are very effective. But, it is better than nothing and as I said the particles will be large so more or less easily contained.

I worked with aerosol exposures of high consequence (meaning 100% fatal with zero treatment available) and wore 3 suits and a Partial pressure air respirator running through 3 filtrations which also removed toxic gasses. I was spraying monkeys for inhalation exposure with up to 1 trillion organisms inside a ABSL-3 negative pressure lab inside a glove box which was itself a BSL-4 certified chamber. Even so if a mask is 99.9% effective that means up to 100,000 organisms could still potentially get through hence the multiple layers. We performed head to toe bleach spraying with 15 minute wait times in an antechamber removing one suit each time. Getting in and out of the lab was a painstaking ordeal. You also can't sit because the batteries and blower/filtration units are in the way which weigh 20 pounds. So, you are performing high threat work with dangerous animals (all my monkeys were Herpes B positive which is 100% fatal in humans and they are vicious and try and bite all the time). So, this work is not for the faint of heart. I will say that in my lab we had zero workers infected by aerosol. I also decontaminated the entire suite after every experiment using plasma peroxide.

 

[Old Microbiologist]

There is a good review of handwashing methods here:https://www.ncbi.nlm.nih.gov/books/NBK144041/

I use gloves and good (5 minute scrub with plain soap).

 

[GoodLife59]

Coronavirus Risk?

I’ve been trying to get to the root cause of the concern. Seems to be rooted in concern by health officials in multiple countries and the UN about what to fully expect. How far, wide and fast will it spread. From what I can find risk seems to be greater for the elderly, young children and people in an immuno-compromised state. That’s not surprising and definitely not good that folks are getting sick and some are not surviving. Meanwhile our typical US flu season has resulted in 10,000 deaths and 180,000 hospitalizations to date. This has had no impact on the market. I’m staying the course.

 

[ncbill]

Regarding hand washing. There is an excellent review of all the various methods here:https://www.ncbi.nlm.nih.gov/books/NBK144041/

IMHO nothing beats good hand washing with a good soap. This is in part because some of the disinfectants actually cause the organisms to adapt and become more resistant. If you want to be certain then scrub thoroughly and rinse with 70% alcohol. 10% bleach would be better but it eats your skin.

Regarding masks, none except gas masks and even those with HEPA filtration down to 0.1 microns are only 99.9% are very effective. But, it is better than nothing and as I said the particles will be large so more or less easily contained.

I worked with aerosol exposures of high consequence (meaning 100% fatal with zero treatment available) and wore 3 suits and a Partial pressure air respirator running through 3 filtrations which also removed toxic gasses. I was spraying monkeys for inhalation exposure with up to 1 trillion organisms inside a ABSL-3 negative pressure lab inside a glove box which was itself a BSL-4 certified chamber. Even so if a mask is 99.9% effective that means up to 100,000 organisms could still potentially get through hence the multiple layers. We performed head to toe bleach spraying with 15 minute wait times in an antechamber removing one suit each time. Getting in and out of the lab was a painstaking ordeal. You also can't sit because the batteries and blower/filtration units are in the way which weigh 20 pounds. So, you are performing high threat work with dangerous animals (all my monkeys were Herpes B positive which is 100% fatal in humans and they are vicious and try and bite all the time). So, this work is not for the faint of heart. I will say that in my lab we had zero workers infected by aerosol. I also decontaminated the entire suite after every experiment using plasma peroxide.

Ummm...like these escaped monkeys now roaming across Florida?

https://www.dailystar.co.uk/news/world-news/herpes-infected-monkeys-spreading-across-21407566

 

[EveryLady]

There is speculation the smoking that is so prevalent in China has over time resulted in damage to the lungs that in the elderly leave them even more susceptible to a severe course of disease. More elderly men than women in China smoke with that a possible reason for the statistics that (at least early on) showed more deaths among men.

The disease was so mild in one of the Germans that he was ill only over the weekend then reported to work on Monday. That sounds positive but then it's not clear to me whether he would have been fully recovered and no longer infectious?

Yesterday the disease course for the Washington State man was released (sorry cannot now find the link). Now recovered, he was only mildly sick for several days before pneumonia finally appeared on X-rays.

 

[audreyh1]

There is speculation the smoking that is so prevalent in China have over time resulted in damage to the lungs that in the elderly leave them even more susceptible to a severe course of disease. More elderly men than women in China smoke with that a possible reason for the statistics that (at least early on) showed more deaths among men.

The disease was so mild in one of the Germans that he was ill only over the weekend then reported to work on Monday. That sounds positive but then it's not clear to me whether he would have been fully recovered and no longer infectious?

Yesterday the disease course for the Washington State man was released (sorry cannot now find the link). Now recovered, he was only mildly sick for several days before pneumonia finally appeared on X-rays.

I think they figured out the German man still had the active virus even though he had already recovered.

 

[Another Reader]

For the conspiracy theorists out there, there is zerohedge's take on this, which is that this is a weaponized virus developed in a Wuhan laboratory by a scientist that specializes in bats and the corona virus. They named the scientist and published his contact information, for which they got kicked off Twitter.

https://www.zerohedge.com/health/man-behind-global-coronavirus-pandemic

In Boston, the head of the Chemistry and Chemical Biology department at Harvard University was recently arrested for lying about his work for the Chinese, per this article in the Boston Globe. Another researcher at a different institution was also arrested.

https://boston.cbslocal.com/2020/01...nqing-ye-zaosong-zheng/#.XjSfzJ5z39J.facebook

The timing of the arrests is interesting...

My take is that we really do not know what is going on here and we probably won't for awhile.

 

[braumeister]

For the conspiracy theorists out there, there is zerohedge's take on this, which is that this is a weaponized virus developed in a Wuhan laboratory by a scientist that specializes in bats and the corona virus.

And more good news regarding this:

The 100-year-old maker of Reynolds Wrap went public on Friday ... Reynolds Consumer Products, whose shares rose nearly 10% on Friday, is counting on budget-conscious, home-cooking millennials to drive sales of its products.

Time to buy the stock, since we're all going to be wearing the hats.

 

[Gumby]

Apparently, some are already well supplied. So you may not see the anticipated pickup in demand.