As always, a reminder that I am not a medical doctor. I know a few, and they are all awesome! But I am not one. Nor am I a healthcare professional of any kind. These updates are my way of helping everyone sift through the riff-raff. My goal with these posts is to pass along relevant information from the medical community – direct from the source – with some translation into regular English.
A couple of notes before we begin
As of March 12th at 9pm:
Total cases: 1,215
— Travel-related: 125
— Close contact: 102
— Under investigation: 988
Total deaths: 36
States reporting cases: 43 (42 states and the District of Columbia)
That is a 300+ case jump in 24 hours. and 600+ up from 48 hours ago.
(Numbers pulled from other reliable resources) Total cases reported by other medical sites:
Johns Hopkins: 1,268
Government actions simplified
In the coming days, it wouldn’t surprise me to see more states issue “state of emergency” declarations. If your state or county issues a “State of Emergency” that doesn’t mean the situation is any more dire. It simply means the state or county governments are attempting to free up funding to address the problem.
If someone is told to quarantine, it doesn’t automatically mean that person is infected. There are have been multiple people who have self-quarantined out of “an abundance of caution” recently, a few have ended up not showing symptoms.
New from the CDC
The CDC introduced some warnings signs to look for in folks that may have contracted the virus. The original three included, fever, cough, and shortness of breath. Now, the CDC says other things to look for include a persistent pain or pressure in the chest, general confusion or extreme fatigue, bluish lips or face.
If you develop symptoms, the CDC recommends the following steos:
– Stay home and call your doctor
– Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep
other people from getting infected or exposed.
– If you are not sick enough to be hospitalized, you can recover at home. Follow CDC instructions for how to take care of yourself at home.
– Know when to get emergency help
– Get medical attention immediately if you have any of the emergency warning signs listed above.
The CDC also added a few links to their site this morning.
— Keeping workplaces, homes, schools, or commercial establishments safe
— CDC’s framework for mitigation
These pamphlets might be a good read for those trying to avoid contact and limit the transmission of the virus.
Other mitigation strategies the CDC recommends:
– Clean your hands often
– Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
– If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
– To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a
tissue or your sleeve to cover your hand or finger if you must touch something.
– Wash your hands after touching surfaces in public places.
– Avoid touching your face, nose, eyes, etc.
– Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches,
handles, desks, toilets, faucets, sinks & cell phones)
– Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings
with little air circulation if there are people in the crowd who are sick.
– Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.
From Johns Hopkins
Just in case you missed it, in a new research paper titled, “The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application” researchers from Johns Hopkins identified that the incubation period for Coronavirus is about five days.
The results of the research found that 5.1 days was the average time of incubation and around 97-percent of those who develop symptoms will do so within about 11 days. On top of that, researchers noted that only 101 out of every 10,000 cases will develop symptoms after 14 days.
That is why the quarantine protocol for so many places is 14 days. There is only a one-percent chance you have the virus if you don’t have symptoms after 14 days. The researchers noted that understanding the incubation period will help medical professionals prepare and react to the spread of the virus within the United States.
New Research
A new not-yet-peer-reviewed research paper titled, “Virtual Screening Based Prediction of Potential Drugs for COVID-19” looks as the genomic sequence of the Coronavirus responsible for COVID-19, as well as the experimentally-determined three dimensional structure of the Main protease. In the abstract, the authoss write, “The reported structure of the target Mpro was utilized in this study to identify potential drugs for COVID-19 using molecular docking based virtual screening. The results of this study confirm earlier preliminary reports based on studies of homologs that some of the drugs approved for treatment of other viral infections also have the potential for treatment of COVID-19.”
In the paper, the authors note that, “Saquinavir and Beclabuvir were identified as the best candidates for COVID-19 therapy based on virtual high throughput screening of clinically approved drugs and the structure of SARS-CoV-2 Mpro determined from X-ray diffraction data. The results of this study also rationalize the limited data regarding effectiveness of drugs for COVID-19 therapy, and provide information that can be utilized for choice of candidate drugs for in vitro studies and in vivo studies. ”
A different research papers, titled, “COVID-19: combining antiviral and anti-inflammatory treatments” looks to Artificial Intelligence to find a combination of drugs that may be effective against he virus.
What does this all mean? Is there a vaccine or drug to protect us?
No. Not yet. But this is a start.
It means that other researchers can now look at this information and run their own experiments and test to se if they can confirm or dispute the findings. But this is how science works and how treatments are developed. Piece by piece, step by step. It is usually a long process. That is why, despite what some politicians have said, there isn’t likely going to be a vaccine or treatment “by April.”
Is this really a big problem, or is everyone making too big of a deal?
I’m not an expert, so I can’t answer that. However, as someone who works in the news world, I can say that I’ve never seen the world shut down like this for any other reason. For those who say, “the media is hyping this up for ratings and money! And to scare people!” I can only offer these graphics:
That is a look at the stock prices for a few of the larger national “local TV” companies. The parent companies of every single local TV station and national cable news organization is losing money.
The NBA, MLB, MLS, NHL, NASCAR, F1, Minor League this, amatuer-league that are shutting down. And losing money.
Entire countries are on lockdown.
There is a lot we don’t know about this virus. It is new. But it seems like a lot of the medical community – and now our President – thinks this is a big problem. This isn’t just national news making a big deal out of this.
And, I’ve got to say, when Johns Hopkins University, the Mayo Clinic, the CDC, HHS, WHO and other medical outlets start dedicating entire sections of websites to disseminating information, it makes my ears perk up. On top of that, scientists and researchers are dropping everything and teaming up to develop better more efficient tests. That, too, tells me this may be worth our attention.
The most important thing to take away: It may not make you very sick, but if you continue to live life as normal, you may pass it along to someone else who can’t handle it as well.
That is the biggest concern. And, personally, I think that is an area that a lot of people can’t wrap their head around. Sure, you may not feel that bad if you get it. And yeah the flu may make you feel worse. But if you pass this along – and it is very easy to pass it along – to another person who can’t handle it well, it may end very poorly for that next person.
This virus is new, and thus, no one has any immunity to it yet. It seems as though children can ‘handle’ the sickness better, but there is only anecdotal evidence of that, nothing that has been studied or verified by science. The only thing that has been verified by science is those who are older or those with a compromised immune system struggle to combat this sickness.
We need to all work together to help them.
The flu kills more people, Nick, relax
It does! But the common flu has been around longer and has a chance to “kill more people” at a much lower rate. This is a new virus for humans. And it hasn’t had enough time to infect as many people that the flu has infected during the last 12 months.
For example…
The flu infects about 1 billion people across the world and kills about 500,000, according to Johns Hopkins, per year. That means about 9500 people a week die from the flu.
The Coronavirus has infected about 120,000 people and killed about 4,000, according to Johns Hopkins, in about 10 weeks. That means about 400 people die per week from Coronavirus.
Big difference. However, there are only 10 weeks to pull data from with Coronavirus and 52 weeks to pull data from with the flu. So it is – ina way – an apples-to-oranges comparison.
The CDC breaks down the concerns really well here:
More cases of COVID-19 are likely to be identified in the United States in the coming days, including more instances of community spread. It’s likely that at some point, widespread transmission of COVID-19 in the United States will occur. Widespread transmission of COVID-19 would translate into large numbers of people needing medical care at the same time. Schools, childcare centers, and workplaces, may experience more absenteeism. Mass gatherings may be sparsely attended or postponed. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and sectors of the transportation industry may also be affected. Healthcare providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.
And that doesn’t happen because people will be “too sick” to work, but because it is so easily transmitted from one person to the next. And because the medical community can’t know how each person will react to the virus, it is best to quarantine those infected to ensure the rest of the population doesn’t get sick.
From the Mayo Clinic
From the Mayo Clinic website: “Dr. Gregory Poland, head of Mayo Clinic’s Vaccine Research Group, discusses who is at risk, how to stay protected from the virus, and, if there will be a coronavirus vaccine in the future.”
What is the coronavirus & who is at risk
The coronavirus can infect anyone. but it seems to be more potent for those who are older or those who have compromised immune systems.
The virus is like every other flu virus that can infect humans in many ways, but not every way. The main difference is it is in the same realm as the SARS and MERS viruses that affected Asia and the Middle east. Research done on the virus pulled from the first few patients to contract the disease showed a more than 80-percent match with SARS in some areas and an almost 95-percent match in others.
Researchers wrote in a recent scientific paper that SARS and Coronavirus are thus related. The authors even noted that the comparability would “[imply] the two belong to same species.”
And according to medical researchers, it was believed that those diseases and this new Coronavirus, came from bats.
But those same researchers noted there were a few things they didn’t know yet:
We don’t know the transmission routine of this virus among hosts yet. It seems the virus is becoming more transmissible between human-to-human. We should closely monitor if the virus continue evolving to become more virulent. Owing to shortage of specific treatment and considering the relatedness between SARS-CoV and 2019-nCoV, some drugs and pre-clinical vaccine against SARS-CoV probably can be applied to this virus.
The difference in death-rate between Coronavirus and SARS/MERS
A recent paper, published last week, by Zunyou Wu and Jennifer M. McGoogan, highlight the difference.
A total of 8096 SARS cases and 774 deaths across 29 countries were reported for an overall CFR of 9.6%. MERS is still not contained and is thus far responsible for 2494 confirmed cases and 858 deaths across 27 countries for a CFR of 34.4%. Despite much higher CFRs for SARS and MERS, COVID-19 has led to more total deaths due to the large number of cases. As of the end of February 18, 2020, China has reported 72,528 confirmed cases (98.9% of the global total) and 1870 deaths (99.8% of the global total). This translates to a current crude CFR of 2.6%.
You can read the whole article here: https://jamanetwork.com/journals/jama/fullarticle/2762130
So, Coronavirus is 1/3rd as deadly as SARS. And Coronavirus is 1/13th as deadly as MERS. And, as one medical researcher put it on CNN the other day, as it evolves in the future, it is statistically more likely to become less deadly. Because the viruses that mutated to become more deadly will stay within the hosts that are dead, rather than continue to be passed along.
What does Coronavirus do to people
The coronavirus is very contagious. And only causes symptoms of a fever and cough for most people. That may be the biggest concern for people. It seems innocuous until it is deadly. And it spreads quickly within an infected community.
Here is a snippet from a research paper from Ying Liu, Albert A Gayle, Annelies Wilder-Smith, and Joacim Rocklöv in the Journal of Travel Medicine:
[transmission] estimates for SARS have been reported to range between 2 and 5, which is within the range of the mean [transmission] for COVID-19 found in this review. Due to similarities of both pathogen and region of exposure, this is expected. On the other hand, despite the heightened public awareness and impressively strong interventional response, the COVID-19 is already more widespread than SARS, indicating it may be more transmissible
For the medical community, they are also focused on identifying the symptoms and how to resolve them.
Currently, the medical community says symptoms are fever and cough, “which frequently lead to lower respiratory tract disease with poor clinical outcomes” for people who are older or have pre-existing health conditions. And diagnosis can only be made based on the symptoms, the history of exposure, as well as chest imaging.
That means if you have a runny nose and headache, it is less likely to be coronavirus. If you have a stuffy nose and clogged up sinuses, it is less likely to be coronavirus.
And if you have not been to China or been exposed to someone who has been to China is it unlikely you have Coronavirus.
WHO finds dogs can’t spread COVID-19
The World Health Organization recently found that dogs cannot transmit the virus. Right now, the medical research community thinks – like SARS – it started in bats and, perhaps, civets. But there was a paper that noted that other animals could be transmitters – but only if infected by another animal.
Yushun Wan, Jian Shang, Rachel Graham, Ralph S. Baric, and Fang Li wrote in the Journal of Virology:
Pigs, ferrets, cats and non-human primates contain largely favorable 2019-nCoV-contacting residues in their ACE2, and hence may serve as animal models or intermediate hosts for 2019-nCoV
But until an animal has been in contact with another animal with the Coronavirus, it is not going to carry the virus.
There is new research from the World Health Organization showing here is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus.
Are facemasks a good idea
This is straight from the CDC:
CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).
Things to do right now
Now that this is a pandemic, you might think things have changed, but actually, that does not change – in any way – what you need to be doing now.
Right now, simply keep tabs on the news with Coronavirus. Continue to wash your hands – like you would do to combat the spread of the common cold or flu – and avoid touching your face. If you know someone who has traveled to out of this country or to a place with widespread infections, monitor them for symptoms. And try to no be within six feet of people who are infected.
And again, since the death-rate of Coronavirus is around two- to three-percent, this virus isn’t as deadly as SARS or MERS to the general population. But, since there are about 1300 cases and 33 deaths, it means gt the mortality rate in the United States is higher than the average. Since the average two-percent would leave only 26 deaths.
But the biggest concern is for those with compromised immune systems and people over 60.
The other thing to do is to keep this potential outbreak in perspective. While, yes it is dangerous to those infected, and yes there is the potential that it could spread to the United States, at this time the best thing to do is remain calm and do what you would normally do to fight against the regular flu. Plus limiting contact with others to suppress the spread of the virus.
And, as a reminder, the regular flu is still out there, too. And it has sent 21,000,000 people to the doctor and – according to the CDC – is responsible for up to 46,000 deaths. So protect yourself from the regular flu, too.
