COVID-19 8Mar20

The panic is off and running. Want to avoid getting it? Wash your hands, often and well. Consider sterilizing the things you use often as well, such as your keyboard, cell phone, tooth brush, etc. A single molecule/virus is unlikely to infect you: the key is to reduce the load of any microbe below that load needed for infection.

This virus has not acted normally, and now we have a better understanding of why. A friend kindly provided me with links to three studies that have shed new light on how COVID-19 infects people, and it is both fascinating and interesting. Fascinating from a biomolecular viewpoint and interesting in terms of some of the questions this news raises.

This paper outlines how the virus shares an ACE2 receptor with SARS. ACE2 expression explains some of the oddity of who it infects and why it has been more deadly in China. Short version is that ACE2 expression is small (to non-existent) in healthy lungs; but, as we grow older it starts to crop up. When you live with heavy air pollution (such as China) and if you are a heavy cigarette smoker, your lungs are damaged, increasing the expression. This paper gets into the smoking aspect.

The real kicker, however, is that COVID-19 has a mutated gene similar to Ebola and SARS that gives it up to 1,000 times the ability of SARS to bind with human cells. There is a lot of detail to be found in this article at the South China Morning Post.

The good news out of all of the above is that ACE2 inhibitors and a number of HIV drugs may work on COVID-19, or at least slow it down. It opens up several fronts on fighting the disease while effective and efficient vaccines are developed. How and why it developed the similar mutation to Ebola and HIV is a very interesting question. Another question is how much damage the virus does to the lungs, and if it is permanent as this article suggests.

Meantime, the fight is on continuing to throttle the rate of infection spread here in the U.S. So far, that strategy is working despite the CDC (hat tip to Insty) and others. The testing issue is major, as is CDC staffers hanging up on doctors who disagree with them and incidents like this that are far more frequent than is being reported (again, hat tip to Insty). The goal is to slow it down so that warmer weather will slow it further. Why?

As I noted in a previous post, unchecked it will overload the system, just as it has done in China and elsewhere. This report from Business Insider notes that hospitals have been warned to prepare for 4.8 million hospitalizations in a worst-case scenario. By the way, if you are looking for reasonably good and accurate coverage, keep the BI coronavirus search going, and also stay up with the South China Morning Post coronavirus coverage. Also, Instapundit runs frequent updates and collections of stories that are a good resource.

Failure to do things properly is partly the blame with what has happened in Washington State and elsewhere. Improper responses have caused dozens of first responders and health care professionals to have to be quarantined, taking them out of the fight for the time being. I say yet again, if you are a first responder or medical professional, go to the highest level of protocol that your agency will allow. You won’t do anyone any good in quarantine.

Slowing the spread prevents overloading the system. If you suspect you have COVID-19 or have been exposed, do like the person in Indianapolis discussed yesterday: call your state health department and work with them so that you can be dealt with in a way that minimizes the chance of spreading the virus to those helping you and to the general public.

Here in Indiana, IU Health has launched a free online screening process. I expect to see more efforts like this, as it will allow people to be screened efficiently and effectively while limiting exposure and spread.

The continued kicker is that based on anecdotal evidence, there seem to be a higher number of “superspreaders” who also appear to be spreading while asymptomatic. The latest (again from BI) is in NYC and there are 20 cases linked to him.

Again (and again), the best defense is to wash your hands frequently and well, and to use hand sanitizer when you can’t wash or between washings. Want to do more? Avoid unnecessary travel and avoid large gatherings (esp. since many cases have come from conferences and such, including CPAC). Work form home, telecommute, and use virtual meetings for as much as possible. Do not shake hands. If someone is visibly sick and/or not following good protocols (hand washing, covering mouth and nose when sneezing/coughing, etc.) avoid them by about ten feet if possible. If you are 70 plus and/or have health issues, stay home as much as possible. If you have to go out, follow the above stringently. Been at a crowded event? Wash, bathe, and wash your clothes. You don’t need to kill every germ, just enough to stay below the load level.

Again (and again), COVID-19 is NOT Capt. Tripps. So, stop the panic and freakout. It is worse than the flu to certain populations, surprisingly mild in some ways outside of those populations, and right now the mortality numbers here in the U.S. are well below that of flu, which kills between 12,000-61,000 people in the U.S. each year. And, note that thanks to the early travel restrictions, the U.S. has the lowest per capita infection rate of any country with more than 100 cases by a significant margin. So, again, please stop the panic. You can safely ignore most of the media coverage, especially if it focuses on the political angle. So far, such reporting (and the politics) have almost 180 degrees from reality.

Your response to this, ultimately, is as important — if not more important — than the government response. You have the power to protect yourself. You have the power to avoid spreading it. You have the ability to think, plan, and prepare if a general quarantine is put in place for your area.

Think.

Yes, it’s hard and the media is stoking the panic for all it’s worth. All the more reason to stop, think, learn, and do what is right for you and for your fellow citizens.

So, wash those hands, cover your nose and mouth when sneezing or coughing, and don’t go running into an area crowded with already compromised people if you think you have it (i.e. a doc-in-the-box, ER, etc.). Think, then act. Use an online screening process, call your state health department, or similar step and then do what they tell you to do.

Final quick note: bureaucracies are not fast and responsive, particularly when they have mission bloat. That said, for all that some elements of the CDC (and WHO and others) are fucking up by the numbers, there are good people in all them who are having to fight their own administrations (not The Administration) to try to get things done. My hat is off to them, and if there is any way I can help them I’m glad to do it. I have a fond but faint hope that one good to come out of this is that some long-overdue reforms of the CDC and FDA may finally happen. It’s time to have the experts in charge again, not political administrators. Both need to be lean, mean, and flexible — something they are far from being now.

As always:

Use the interactive graphic to keep track of things. Is COVID19 an epidemic? Yes. Is it a Pandemic? Not according to WHO, but most everyone else is saying yes, it is. Is there need for panic? No. Should you be paying attention? Yes. Hell yes. Should you be preparing? Yes, better late than never.

Want to avoid catching COVID19 here in the U.S.? Wash your flippin hands frequently, wash them thoroughly every time you use the bathroom, then follow with hand sanitizer after every washing, use hand sanitizer liberally when you can’t wash on a regular basis. Cover your mouth and nose when you sneeze, and stay away from those who don’t. Also, keep your bugger hooks out of/away from your eyes, nose, and mouth. Do NOT shake hands with anyone, and avoid touching or being touched by strangers. Or your strange friends.

Avoid travel if at all possible. Right now, there is no way I’m going to a trade show, major convention, etc. If you can telecommute, get that set up now. If you have to travel, use lots of hand sanitizer and go to full flu protocols. If you have to use a public restroom, take full precautions including using paper towels and such to handle faucets, doors,etc.  Believe it or not, this was highly recommended before now, and major grocery chains have long told employees to use those practices to avoid getting or spreading colds, flu, etc.  Not many actually do it, but…  

If you own a business, make sure your employees know the above protocols. Have someone who refuses to wash their hands or otherwise follow the protocols? Talk to them, write them up, and if necessary fire them as they now pose a risk of infection to you and your customers. Extreme? Yes, but while the CDC and others are working to slow it down, odds are it is already here and could hit hard and fast. Prepare for the worst and hope for the best.

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

Heh

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 6Mar20

COVID-19 5Mar20

COVID-19 4Mar20

COVID-19 3Mar20

COVID-19 What Am I Doing?

COVID-19 2Mar20

COVID-19 1Mar20

COVID-19 29Feb20

Quick Additional Thoughts On The Bureaucracy

Panic Is Off And Running

COVID-19 28Feb20 Reasons To Hope, Reasons To Fear

COVID-19 A Plea To The Politicians (And Media)

COVID-19 27Feb20

COVID-19 Breaking A Chain?

COVID-19 26Feb20

COVID19 The Situation In China Gets Even Weirder

COVID19 25Feb20

COVID19 24Feb20 Raising DEFCON

COVID19 23Feb20

COVID19 22Feb20

COVID19 21Feb20: Just Look At The Blooms Dear

COVID19 Update 20Feb20

COVID19 Update

Update & Quick Thoughts On Preparedness

Expansion On A Theme

Well Maybe I Was Wrong

Some Quick Thoughts On Coronavirus 2019-nCoV

Why Should You Be Prepared?

Keeping Alert

Coronavirus And Practical Preparedness

COVID19 22Feb20

Not going to get into too much detail this morning, but do recommend keeping an eye on the region pictured.

REPEATING: If you have not implemented the steps I discussed in this post, I strongly urge you to do so now. Use the interactive graphic to keep track of things. Is COVID19 an epidemic? Yes. Is it a Pandemic? Not Yet. Is there need for panic? No. Should you be paying attention? Yes. Hell yes. Depending on how a couple of parameters go in the next few days, I am considering raising my personal DEFCON from Sit Up to Really?!? Much depends on what we see outside of China in that time. At this time, I still see the major impacts as economic.

Want to avoid catching COVID19 here in the U.S.? Wash your flippin hands frequently, wash them thoroughly every time you use the bathroom, then follow with hand sanitizer after every washing, use hand sanitizer liberally when you can’t wash on a regular basis. Cover your mouth and nose when you sneeze, and stay away from those who don’t. Also, keep your bugger hooks out of/away from your eyes, nose, and mouth. In other words, standard flu protocols and fairly standard basic personal hygiene.

More soon.

Other COVID19/COVID-19/2019-nCoV articles:

COVID19 21Feb20: Just Look At The Blooms Dear

COVID19 Update 20Feb20

COVID19 Update

Update & Quick Thoughts On Preparedness

Expansion On A Theme

Well Maybe I Was Wrong

Some Quick Thoughts On Coronavirus 2019-nCoV

Why Should You Be Prepared?

Keeping Alert

Coronavirus And Practical Preparedness

COVID19 21Feb20: Just Look At The Blooms Dear

I had originally intended to do a starter post on the economic cascade effects that have started. However, I think we are entering a very interesting period where the data will tell us how things are going to go. To determine that, watch the blooms.

The bloom of infections is starting to drop in China, at least as far as we can tell. Again, don’t trust any official figures from the Chinese government as they lie, and have lied from the start. That drop, however, appears to be confirmed by at least some non-government sources in China.

They key to this bloom is that it will grow again once the draconian measures in place are eased. They will have to be eased for economic reasons if nothing else. Once they are, the bloom will grow. How large and how fast it grows, and how fast it stops growing, will tell us a lot.

The blooms are growing, however, in countries around China. This is not, repeat not, unexpected. What we are looking at now is how large and how fast those blooms grow, and if they can be contained to limited areas. If they can, good news. If not, bad news.

There are smaller blooms starting elsewhere, such as the U.S. However, keep in mind that a good part of that bloom are Citizens who have been repatriated from infectious areas, including those known to be infected. That there will be more, many more perhaps, is a given. The efforts so far are on slowing it down, not keeping it out altogether as that is impossible at this point. I do wish they had implemented travel restrictions and quarantines sooner. If wishes were horses…

My own estimate right now is that we could see some massive blooms in SE Asia, all the way down towards Australia and New Zealand. Australia is the one to watch, as it is the closest first world enclave to China. They have enacted a “proper” response based off of very modern public health and public hygiene systems.

If those systems have indeed provided an adequate response, the first place we will truly see it is in Australia. If not, again, the first place we will see it is in Australia. The lessons learned from Australia can be applied to either improve the existing plans and protocols, or to make changes with enough time to prevent a complete disaster. We hope.

Given that there appear to be a number of “superspreaders” with this virus; that it can be transmitted while asymptomatic; that it can be transmitted by multiple vectors; and that we really don’t have good data yet on transmission values (or death), well, much is in up in the air.

Add in that in multiple countries there were people who were allowed in who spread it asymptomatic, and that no effort to find everyone they came in contact with will be 100 percent effective… Those are the new blooms to pay close attention to. Again, if things continue to work well in the U.S. and other first world countries, we should be relatively okay. The slow-down of the spread buys time to develop vaccines, effective treatments, and even more effective protocols for containment.

While I am not raising my alert level yet, I am strongly recommending not traveling to anywhere in SE Asia other than Australia or New Zealand. This does include Japan, South Korea, Indonesia, Malaysia, etc. Have plans for the Olympics in Japan? Cancel and see if you can get refunds. Business absolutely requires working in/with those areas? Telecommute.

Oh, some quick thoughts on a couple of areas.

First, there is a large possibility that it may be more deadly in China because of the massive (and sometimes deadly) air pollution in major cities and/or regions; smoking habits on top of said air pollution; nutrition and basic health; and, public hygiene/sanitation. Again, time will tell.

Second, I really would love for someone to check the grey water systems on the Diamond Princess. Given the increasing number of reports that one mode of transmission is via fecal matter, I think tests on white, grey, and black systems could tell us a lot. Given the level of response over there, am not going to bet that such tests will be run.

Side note is that a number of the systems and such pushed by the so-called Green New Deal types could be almost tailor-made to encourage epidemics and/or pandemics. Again, good reason to check those recycling systems on the Diamond Princess. Sadly, these days I’m not as inclined to consider such “oops” as poor planning, but rather as intentional.

Third, there is some hope that better sanitation systems and practices can help contain the outbreak to some degree. The better the systems, and the more people follow good to excellent hygiene, the better.

Fourth, pray that it does not get a foothold in Africa, particularly south of the Sahara. If it does, it will have a second natural reservoir in which it can lie dormant, mutate, and/or otherwise come forth on a regular basis to plague the world.

If you have not implemented the steps I discussed in this post, I strongly urge you to do so now. Use the interactive graphic to keep track of things. Is COVID19 an epidemic? Yes. Is it a Pandemic? Not Yet. Is there need for panic? No. Should you be paying attention? Yes. Hell yes. Depending on how a couple of parameters go in the next few days, I am considering raising my personal DEFCON from Sit Up to Really?!? Much depends on what we see outside of China in that time. At this time, I still see the major impacts as economic.

Want to avoid catching COVID19 here in the U.S.? Wash your flippin hands frequently, wash them thoroughly every time you use the bathroom, then follow with hand sanitizer after every washing, use hand sanitizer liberally when you can’t wash on a regular basis. Cover your mouth and nose when you sneeze, and stay away from those who don’t. Also, keep your bugger hooks out of/away from your eyes, nose, and mouth. In other words, standard flu protocols and fairly standard basic personal hygiene.

More soon.

Other COVID19/COVID-19/2019-nCoV articles:

COVID19 Update 20Feb20

COVID19 Update

Update & Quick Thoughts On Preparedness

Expansion On A Theme

Well Maybe I Was Wrong

Some Quick Thoughts On Coronavirus 2019-nCoV

Why Should You Be Prepared?

Keeping Alert

Coronavirus And Practical Preparedness

Keeping Alert

There is a difference between being alert and in a panic, a distinction that is lost (or deliberately ignored) by those of our “betters” sniffing in disdain and saying the current nCoV outbreak is nothing to worry about and it will fizzle out like SARS. Such people are, for the most part, educated idiots without much of a clue. The rest of us do not, yet, have a true clue but we know that and acknowledge it.

Yesterday, there was briefly some hope that this would be like SARS: deadly, contagious (particularly in non-first-world areas), and brief. This hope was very short lived. Note that the chart(s) are part of the link I provided yesterday to keep up on things.

Here’s a good post on part of the poor response to the outbreak by all levels of the Chinese government. Here’s another take by a medical professional.

In the “closing the barn door” department, we have this, this, this, and this. In the department of “Duh” we have this. I think SF activating it’s EOC is both prudent and interesting. This is a neat fact: an AI system issued an alert for the virus a week before WHO, CDC, et. al. For the record, I think we should have shut down air/sea with China already, and that the evacuation of Americans in Wuhan directly to CONUS without quarantine offshore is a mistake.

That’s all I have time for this morning, hope to get back into some of the background, and some discussion on practical preparedness in the days ahead. Stay safe.