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Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!


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3 hours ago, teef said:

i never realized how much i touch my face until recently.

 

This is shocking to me, considering you spend your days 6" from other's mouths.........you of all people should have self-awareness in these trying times.

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26 minutes ago, SlimShady'sGhost said:

 

probably 100 times a day 

 

if not more 

 

i'm so hyper aware of it now.

Just now, Seasons1992 said:

 

This is shocking to me, considering you spend your days 6" from other's mouths.........you of all people should have self-awareness in these trying times.

during treatment time it's not an issue because i'm constantly changing gloves and and had washing, so i never do it.  it's during my paper work time i catch myself doing it.  i'm a fidgety person, so i'm constantly tapping, touching, kicking something.  apparently my face is a big part of that.

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This may not be the place to put this, but after the humor above: there is so much bull#### about Covid19 going around that I feel the need to share some actual straight info with my homies here especially since I'm getting requests in PM.  Questions will be answered with references or to the best of my ability***.  Bullcrap Youtube videos starting out "Cathedral of Misogyny" will be shot into space.  Political conspiracy theories, whinging about how "media panic" is the problem and it's really just flu will follow out the airlock.  There's a thread in PPP for that.  Further humor in decent taste is welcome.

 

Its. An. Illness.  It doesn't care about your politics or your religious beliefs.  It will follow well-understood patterns of spread, and can be contained by well-known strategies.

 

There is substantive evidence that "community transmission" of Covid19 is taking place in Washington State, with an initial case of someone who flew back from Wuhan in mid-January before the shutdown of the city. (Trevor Bedford is professor at Fred Hutch virology institute and knows his *****).  Anyone want to bet the rent that if there's community spread in Snohomish, Washington originating from travel mid-December to mid-January, there is not already community spread elsewhere in the country?  I don't.  (Yes, there are caveats here, but do we really want to bet the low probabilities vs an emerging epidemic, or do we want to test and find out?)

 

Why don't we know that there's community transmission underway all over the country?  Until this week, testing was 100% focused on returning travel from known infected places because the "case definition" included these.  Seriously.  If you hadn't traveled but had symptoms, you couldn't be tested (except apparently by a bunch of rogue Fred Hutch researchers who had already collected flu samples, apparently).  Meanwhile, places we once scorned as 2nd rate like Taiwan "get it": "Furthermore, they proactively sought out patients with severe respiratory symptoms based on records in the national health insurance (something which all developed countries can deploy with relative ease, with the notable exception of the US [my note: but we could still do it, just harder])."  Meanwhile, In US, people in hospital with severe respiratory symptoms who tested negative for flu were NOT being tested for Covid19.  Even a nurse who became ill with respiratory symptoms AFTER CARING FOR A KNOWN COVID19 PATIENT in CA struggled to get tested - and this is a critical test, because if a HCP falls ill caring for a patient, it's a Red Alert that the infection control protocol needs revision.  That nurse shoulda been first in line for a test.

The second reason is maths - if one is dealing with a disease where the vast majority of those infected have a mild form easily mistaken for seasonal flu, community spread will easily pass unnoticed until enough people get sick that a cluster of cases with severe illness show up at the hospital in need of treatment AND ARE TESTED.  That can take ~a month and has an element of chance (one of the sick people has a relative in a nursing home and visits regularly vs. the sick person lives in a town of 30,000 college students who might all get sick, but are at low risk to become severely ill). 

Why do we care about containing this disease if 80% of those who contract it have only mild symptoms, another 15% have a severe flu-like illness requiring treatment for weeks, and only 5% become severely ill and require artificial ventilation?  Again, maths: If too many people fall ill at once, it pushes the healthcare system to failure point.  Covid19 infected people who need the highest level of care won't be able to get it because equipment, beds, and skilled HCP will simply not be available.  (This is one reason why the initial fatality rate in Wuhan was so high, 5.8% - they ran out of equipment and beds to care for the most seriously ill).  People who need care for other reasons will not be able to get high-quality care: be sure to schedule your heart attack or your child's meningitis accordingly.

 

Why should we worry about the disease - it seems it's already declining in China and never took off in Taiwan as predicted?  It's declining in China because they got to grips with the problem.  China instituted a very aggressive and effective set of disease control strategies.  From this reddit which is an accurate bullet-point summary of an international WHO team that visited China:

"One of the important reasons for containing the outbreak is that China is interviewing all infected people nationwide about their contact persons and then tests those. There are 1,800 teams in Wuhan to do this, each with at least 5 people. But the effort outside of Wuhan is also big. In Shenzhen, for example, the infected named 2,842 contact persons, all of whom were found, testing is now completed for 2,240, and 2.8% of those had contracted the virus. In Sichuan province, 25,493 contact persons were named, 25,347 (99%) were found, 23,178 have already been examined and 0.9% of them were infected. In the province of Guangdong, 9,939 contacts were named, all found, 7,765 are already examined and 4.8% of them were infected."    Likewise, Taiwan was very proactive in implementing effective disease control strategies in a matter-of-fact way that did not cause public panic.

Bottom line: the disease is genuinely declining in China, but it's not because it's a "paper tiger" just seasonally going away as a threat, it's because China is taking proactive and effective disease control strategies and has tested and implemented the most effective disease treatments nationwide.  The overall death rate in China is now <1%, but that's not because the disease isn't significantly more serious than flu - by reliable accounts, it is - it's because China is now pursuing aggressive disease testing to keep outbreaks within the limits the health care system can treat, and has done a lot of work testing and developing more effective disease treatment protocols that are now implemented nationwide.  China can now produce 1.6 million test kits for the novel coronavirus per week that delivers a result on the same day.  Across the country, anyone who goes to the doctor with a fever is screened for the virus.

 

We can do this.  But we aren't.  You want to keep your Grandma or Gramps or heart disease suffering, immunocompromised friend or loved one alive, call your Congresscritters and Senators and ask why China can produce 1.6 million test kits a day and proactively test everyone with fever to determine the scope of the disease, while we're still worrying about where ya traveled recently and we aren't testing.  Demand that we drive response to this disease with science and proven epidemiology not political appointees. 

 

***ability and disclaimer.  I have a doctorate in biochemistry and spent a decade doing research at a major med school and a decade in pharma R&D including work on vaccines.  I am neither a virologist nor an epidemiologist by training, I believe my training and background enable me to "get" both.  Substantive correction and contribution by trained virologists and infectious disease specialists welcome.

 

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5 minutes ago, Hapless Bills Fan said:

 

 

***ability and disclaimer.  I have a doctorate in biochemistry and spent a decade doing research at a major med school and a decade in pharma R&D including work on vaccines.  I am neither a virologist nor an epidemiologist by training, I believe my training and background enable me to "get" both.  Substantive correction and contribution by trained virologists and infectious disease specialists welcome.

 

This immunocompromised fellow gots to know "where did you stay last night?"

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Symptoms (from WHO report linked above):

Based on 55924 laboratory confirmed cases, typical signs and symptoms include:fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%). People with COVID-19 generally develop signs and symptoms,including mild respiratory symptoms and fever, on an average of 5-6 days after infection (mean incubation period 5-6 days, range 1-14 days)

 

Myalgia = muscle pain

Arthralgia = joint pain

Hemoptysis = spitting up blood (you got to be pretty sick for this)

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Prognosis (from WHO report linked above and in case you're too lazy to scroll up, here)

Most people infected with COVID-19 virus have mild disease and recover. Approximately 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory failure, septic shock, and/or multiple organ dysfunction/failure). Asymptomatic infectionhas been reported, but the majority of the relatively rarecases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.

Note that as contact tracing and follow-up improved, the earlier notes about asymptomatic cases and asymptomatic transmission changed - most people who tested positive without symptoms eventually did develop some symptoms (this is actually good news, from an epidemiology viewpoint). 

Mean incubation period 5-6 days, range 1-14 days

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If any of you want practical advice, here you go. 

 

This is based on the following.  The highest rate of transmission appears to be by close contact (among family members of an infected person).  The virus doesn't seem to linger in the air as some do.  However, it does appear to live on hard surfaces longer than, say, flu virus.  It's killed by alcohol-based hand sanitizer, but soap and hot water is best.  A number of different disinfectant products work so don't worry about some special product.  0.1% bleach or hydrogen peroxide should work.

 

Train yourself and your loved ones just never ever touch your face unless you've just washed your hands or you're in a space you control and keep clean.  If you absolutely must scratch your nose out in public, go wash your hands and then scratch it by proxy, through a Kleenex. 

 

Basically any time you're in public, act like you've got dog**** on your hands and you want to clean it off before you smear it all over yourself or your personal belongings.  Come back from a meeting to your cubby, sanitize your hands before you sit down at your keyboard and type.  If you're in one of those modern shared office spaces where you wheel your little cart over to an unoccupied desk, keep some disinfectant wipes around and swab the place (leave stuff wet for a minute).  If you can, sanitize your hands after you unlock your car but before you start touching everything (dashboard etc).  Come home, wash your hands right away then grab a disinfectant wipe and wipe down the faucet handles, bathroom doorknob, door to the house, keys.  Use the tip of a key or a pen to push crosswalk or elevator buttons. 

 

Out in public, think: "I've got dog**** on my hands"  Clean the dog**** off your hands before you get it all over your workspace, car, and home not to mention your face.

 

Gross, but it's a way of thinking about it that drives the point home.
 

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