The COVID-19 Science and Medicine Question Thread

[Tigashrk]

This is not going away till they have a vaccine or definitive treatments. Thank you china!

 

[Roccus7]

Roccus, is it possible to stop the spread of this virus by locking down, or are we only slowing down the spread ?

Great question, something that has been on everyone's mind as of late. If you truly could lock it down, then yes, it would stop it from spreading from the lock down area. However that ship has long left the dock so the realistic answer to that question is no, a lock down at this late stage with the mobile population that we have in 2020 will not stop its spread.

A general lock down slows the spread of the virus. With less person to person contact, there are less chances per day for it to spread so it's rate of spread will be slowed down. And maybe, IF there are things like a seasonal nature and the virus will loose it's steam in the summer like some predict, there will be less infections during a particular outbreak because of the slowing of the rate of infection pushing a large number of uninfected folks into the "Safety Zone" of summer.

Regardless, why is slow better? It's "flattening the curve" which some folks have misunderstood. Flattening the curves doesn't lower the number of infections, it just slows down the rate. The graph below shows this concept. The total number of cases is the area under each curve and they are the same total number. You want to flatten the curve so you don't exceed you ability to care for patients. In this example they also brought more resources to bear to raise the critical line.

 

[cany]

Dom do you think its wise to open everything back up here now in NY

 

[Capt13]

... good question !

 

[Roccus7]

Dom do you think its wise to open everything back up here now in NY

From an epidemiological perspective, HELL NO!!! Not until we know and do the following. You just can't wave a magic wand at say, "All is forgiven, go back to where you were 3 months ago!"

1. Run enough testing using the serological, antibody test to get a good idea as to how many people have been infected.
   
   
2. Have enough science to understand if the antibodies detected above are protective against a reinfection or not. This is still a point of debate and regrettably, there aren't enough good, reliable testing data of provide an answer.
   
   
3. Setting a new "normal" for society, e.g. wearing masks, social distancing, etc.
   
   
4. Having a well disciplined and thought out rolling out strategy. Live concerts w/Mosh Pits would definitely be a no-no for a considerable time.
   
   
5. Having measures in place that monitor infections during the roll back, with the ability to immediately stop them if outbreaks pop up.

Now as I've said before, we're all cognizant of the huge Economic hit the entire world is taking at this moment. Should that impact be weighed against the current situation and be allowed to cut some corners? This is a huge question. Folks seeing their hard earned small businesses tank will probably have a very different opinion than folks who lost a loved one and weren't even able to say goodbye. This is not a scientific question, it's a social one and will be a subject of debate for a long time, and belongs on the other Coronavirus thread...

 

[Roccus7]

For those of you interested in Virology 201, here's a good video showing the mechanism of a Corona Virus infection.

 

[movetheboat]

Dom..can you get infected thru a wound? I cut my finger the other day and have it covered.

 

[Roccus7]

Dom..can you get infected thru a wound? I cut my finger the other day and have it covered.

Nope, it's evolved to invade the mucosal cells of the airways.

 

[Capt13]

I read 19% percent of cases had GI issues, diarrhea. If that's the case, how did the original infection start if it invades "the mucosal cells of the airways?"

 

[cany]

From an epidemiological perspective, HELL NO!!! Not until we know and do the following. You just can't wave a magic wand at say, "All is forgiven, go back to where you were 3 months ago!"

1. Run enough testing using the serological, antibody test to get a good idea as to how many people have been infected.
   
   
2. Have enough science to understand if the antibodies detected above are protective against a reinfection or not. This is still a point of debate and regrettably, there aren't enough good, reliable testing data of provide an answer.
   
   
3. Setting a new "normal" for society, e.g. wearing masks, social distancing, etc.
   
   
4. Having a well disciplined and thought out rolling out strategy. Live concerts w/Mosh Pits would definitely be a no-no for a considerable time.
   
   
5. Having measures in place that monitor infections during the roll back, with the ability to immediately stop them if outbreaks pop up.

Now as I've said before, we're all cognizant of the huge Economic hit the entire world is taking at this moment. Should that impact be weighed against the current situation and be allowed to cut some corners? This is a huge question. Folks seeing their hard earned small businesses tank will probably have a very different opinion than folks who lost a loved one and weren't even able to say goodbye. This is not a scientific question, it's a social one and will be a subject of debate for a long time, and belongs on the other Coronavirus thread...

Thank you Sir

 

[Dx life Rx fishing]

Any thoughts on the news that a group at the Jenner Institute at Oxford Univeristy seems to think it's possible that with emergency approvals a vaccine could be available in september ?

They seem to have a head start with an earlier coronavirus last year.

 

[Roccus7]

Any thoughts on the news that a group at the Jenner Institute at Oxford Univeristy seems to think it's possible that with emergency approvals a vaccine could be available in september

They seem to have a head start with an earlier coronavirus last year.

Possible yes. Not enough data to comment regarding probability. Even they aren't saying it's a sure thing...

London — In the global scramble for a COVID-19 vaccine, a select number of human trials are now under way, but it's scientists from England's University of Oxford who appear most confident that they're onto a cure. Professor Sarah Gilbert heads the Oxford team behind the potential vaccine being developed in partnership with the Jenner Institute. She's said it has an "80% chance" of success, and it could be available for wide use by the public as soon as September.

 

[Roccus7]

I read 19% percent of cases had GI issues, diarrhea. If that's the case, how did the original infection start if it invades "the mucosal cells of the airways?"

Good question, no definitive answer yet regarding a direct viral caue. My inclination is that it's a general reaction of the insult of a body from the infection. Your body pumps out all sorts of chemicals due in response of an infection, many of which that can impact the GI system. One notable group is histamines which in high concentration can over stimulate the smooth musculature of your GI tract, which means diarrhea. In cases of true flu, there can be GI issues via the same mechanisms. There is a GI flu too, but with that flu the only symptoms are GI without the aches and coughing, sneezing and breathing issues of seasonal flu.

Only study I could find is outlined below. Interesting thing is that the major digestive symptom was reported to be loss of appetite at 85%. If I think about it, this symptom seems to be a No Chit Sherlock kind of moment. I love to eat, but when I'm sick as a dog, eating is way down on my list of things to do. AAMOF, from a personal perspective, I find the "Hey I'm hungry today, it's been a while" moment as a notable milestone in my recovery path from any sickness that knocks me for a loop. About 1/3 of the patients with GI symptoms report having diarrhea.

I'll keep my eyes open to see if this topic gets updated.


Digestive symptoms in 50.5% of patients

The expert group behind this new study — the findings of which appear in The American Journal of Gastroenterology — analyzed data from 204 people who received medical care for COVID-19 between January 18 and February 28, 2020.

The patients had an average age of 52.9 years, and of the total, 107 were male and 97 female.

When they presented to a hospital, 103 of the 204 people — or 50.5% — were experiencing digestive symptoms.
The main digestive symptoms among the study cohort were a lack of appetite, in 81 individuals, and diarrhea, in 35.
Other symptoms included vomiting, in four individuals, and abdominal pain, in two.

The study authors also note that six of the patients with COVID-19 had no respiratory symptoms but did experience digestive symptoms.

Moreover, the digestive symptoms among the larger group grew more severe as the severity of COVID-19 increased, the researchers report.

Given these findings, the authors advise that “the index of suspicion may need to be raised earlier in at risk patients presenting with digestive symptoms,” rather than waiting for respiratory symptoms to emerge.

“However,” they caution, “further large sample studies are needed to confirm these findings.”

In the study paper — the first author of which is Dr. Lei Pan, from Binzhou Medical University Hospital, in China — the investigators emphasize that:

“With the evolution of the pandemic and the accumulation of case data, we are now able to describe the initial clinical presentations and chief complaint of patients with COVID-19; our experience is revealing, in that digestive symptoms are very common.”

 

[Capt13]

Thank you R7. Still not sure how I got it (if it was c19, I haven't been tested yet) ...... put me on the list. Severe diarrhea and no appetite for days, high fever, severe chills. Major abdominal cramping, minor nausea. Aha moment was the moment I finally was hungry.

 

[Roccus7]

Thank you R7. Still not sure how I got it (if it was c19, I haven't been tested yet) ...... put me on the list. Severe diarrhea and no appetite for days, high fever, severe chills. Major abdominal cramping, minor nausea. Aha moment was the moment I finally was hungry.

You're not alone in wanting to get your "Over the phone" diagnosis confirmed or rejected. Admiral and I had wicked lung disease back in late Feb/early March. She's convinced it was COVID-19, I'm around 50/50. I've been reaching out to my old gang to see if and when they can spot me some antibody tests, but they're really not there yet, at least in a version I could run in the kitchen.

I keep "selling" the point that we're a matched set, in that mirror images of our progression of sickness and the occurrence and intensity of most of the major symptoms, like coughing fits of an intensity never before experienced by either one of us. IMPO, any test that says one of us had it and one didn't is faulty, only 100% concurrence between our results would prove to me that the test was accurate. I would not be surprised with a negative result for both of us, she would immediately argue that the test was no good and I'd have to remind her of something from our personal history, the story of a Christmas party back we hosted in the late 80s.

We were trying for a second child and faced by the potential that she could be pregnant, although not "late" yet. I strapped on my home scientist gear and gave her a urine sample cup and grabbed one for myself. Why me? Very simple, I was going to push the sensitivity of the pregnancy test which I co-developed well beyond the "normal" point and wanted to see if I pushed it too far. As long as my urine stayed negative, the results would be valid.

I ran each of us 3 times and all three of my tests were dead negative, but her results were interesting, only something somebody intimately involved with the test could discern. They weren't blatantly positive, but they weren't dead negative like mine. "Hon, I'd just limit yourself to 1 drink tonight. Not saying you're pregnant, but you sure ain't negative." It's known that many early pregnancies are lost, as many as 25%, without a woman even knowing or thinking they're pregnant.

In the middle of the party, The Admiral sashays up to me and says, "Well YOUR test is NG, I'm spotting." "Hey, I told you the results were sketchy, especially as far as I pushed it I still wouldn't go crazy with the drinking." The next morning, "Hon, did your 'friend" come to visit?" "No, run me again". Once again an "interesting", but not definitive result either way. This continued for another day until the fourth day when just as I added the reagent that develops color the whole thing lit up as extremely pregnant result.

My comment, "Yeah, like MY test doesn't work!"

 

[Roccus7]

Last time I'll post this, unless there's a definitive uptick or downtrend in Maine's COVID-19 situation. Data pretty convincing that we're on a plateau...

 

[Roccus7]

A huge "Hmmmmm" moment this morning. Many, including myself, have thought that deaths from COVID-19 may have been overstated. This blurb from today's NY Times from CDC reports suggests that the number is UNDERSTATED!! Now, there's no way to know if the "Death Gap" reported below is directly due to a COVID-19 infection or did "Charlie" die of a heart attack due to an ambulance not getting to him in time because they were all out on Coronavirus calls.

Regardless, the data are quite compelling...

Total deaths in seven states that have been hard hit by the coronavirus pandemic are nearly 50 percent higher than normal for the five weeks from March 8 through April 11, according to new death statistics from the Centers for Disease Control and Prevention. That is 9,000 more deaths than were reported as of April 11 in official counts of deaths from the coronavirus.

The new data is partial and most likely undercounts the recent death toll significantly. But it still illustrates how the coronavirus is causing a surge in deaths in the places it has struck, probably killing more people than the reported statistics capture. These increases belie arguments that the virus is only killing people who would have died anyway from other causes. Instead, the virus has brought a pattern of deaths unlike anything seen in recent years.

If you look at the provisional deaths from all causes, death counts in New York, New Jersey, Michigan, Massachusetts, Illinois, Maryland and Colorado have spiked far above their normal levels for the period. In New York City, the home of the biggest outbreak, the number of deaths over this period is more than three times the normal number. (Recent data suggests it could have reached six times higher than normal.)

How reported coronavirus deaths compare with deaths above normal
Numbers are from March 8 to April 11, 2020.

AREA	PCT. OF NORMAL	EXCESS DEATHS	−	REPORTED COVID-19 DEATHS	=	GAP
New York City	325%	11,900	−	10,261	=	1,700
New Jersey	172%	5,200	−	2,183	=	3,000
New York (excluding N.Y.C.)	142%	4,200	−	2,425	=	1,700
Michigan	121%	2,000	−	1,391	=	600
Massachusetts	120%	1,200	−	686	=	500
Colorado	116%	600	−	274	=	300
Maryland	115%	700	−	207	=	500
Illinois	113%	1,400	−	682	=	700

In New Jersey, deaths have been 172 percent of the normal number so far — more than 5,000 additional deaths, compared with an average count from the past five years. In Michigan, the partial death count is 121 percent of the count in a normal year, the equivalent of nearly 2,000 more deaths.

 

[Roccus7]

Ah the difference between data from and well-conducted trial and, "Good Feelings and Hunches"...

The F.D.A. plans to announce the emergency use of a virus treatment after a trial showed shortened recovery time.

The F.D.A. plans to announce as early as Wednesday an emergency use authorization for remdesivir, an experimental antiviral drug that is being tested in treating patients with Covid-19, the disease caused by the coronavirus, according to a senior administration official.

Ahead of the announcement President Trump and Dr. Anthony S. Fauci, the federal government’s leading infectious diseases scientist, on Wednesday hailed early trial results of the drug, holding out hope that it could help stem the rising death toll.

Meeting with reporters at the White House, Dr. Fauci cautioned that the results of the study overseen by his agency, the National Institute of Allergy and Infectious Disease, still need to be properly peer reviewed but expressed optimism that it could make a difference in speeding up the recovery of some patients infected with the virus.

 

[pequa1]

I think if I was in ICU with crappy prospects for life, I would be rooting for remdesivir even if it caused an ear to fall off.

 

[Roccus7]

Thank you R7. Still not sure how I got it (if it was c19, I haven't been tested yet) ...... put me on the list. Severe diarrhea and no appetite for days, high fever, severe chills. Major abdominal cramping, minor nausea. Aha moment was the moment I finally was hungry.

I just found out that Quest Diagnostics is offering a new COVID-19 serological (Antibody) test, one that you can order for yourself. The current test is a product of some of my "kids" back at work. AAMOF I was emailing one today to get the skinny and he was saying how things were a major fire drill there and, "Now I know the pain you went through. I find myself saying, "WTF would Dom do in this situation?'" It's so good to see the children growing up...

If you're interested in getting tested you can go on the Quest Diagnostics website and sign up. You will be asked a bunch of questions which are aimed to see if you have or could have an active infection going on right now, since this test will NOT tell you if you're currently infected. The charge is "reasonable", cost me $130 for the test, including the blood draw.