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

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

We now have our first confirmed case of COVID-19 here in Indiana. It is a case study in how to do things right if you think you have, or have been exposed to, COVID-19.

The basic story is here. Whatever I may think of the person for having gone to an event at this time, they did things right in a way that should become the text book example of what to do if you have/have been exposed to COVID-19.

Note that they contacted the state health department as soon as they suspected. Working with them, they went to a hospital and parked away from everyone else. They contacted the hospital by phone, who had already been contacted by the state. This allowed them to have those responding take all appropriate precautions. They then took the person in via an entrance not normally used by the public, after putting them in clothing/gear to prevent spread. They was taken to an area of negative pressure for testing. Given that the case is mild at this time, they was taken out the same way and put in quarantine at home.

All of this allowed for: protection of the medical team/first responders involved; it allowed easy decontamination of the areas where this person went; it ensured that the chance of spread to anyone — especially other patients — was minimized.

Note that they did not go to a doc-in-the-box; they did not go to the ER directly; and, they minimized exposure to the public. This is how you do it.

Doing my normal bi-weekly shopping yesterday, I saw panic. People were wearing masks, which is in many respects idiotic. The one person I saw doing it right was from our SE Asian population and they were wearing a mask because they clearly were ill. I steered well clear of them. The others, well, not so much and not so well. Good luck finding disinfectants, hand sanitizer, etc. If you waited until now to begin preparing, well, sucks to be you. Failure to prepare is preparing to fail.

Again, wearing a mask if you are sick is a good idea. If not, you are mostly asking to be sick as few know how to put them on, how to wear them, and — most importantly — how to take them off without increasing your risk of infection. Masks, gloves, and other precautions require you to treat them as hazmat, not just throw them in the trash.

Again (and again) the best way to protect yourself here in the U.S. is to stay away from anyone obviously ill, and to wash your hands well and frequently, particularly after using the bathroom. In between washings, use hand sanitizer on a regular basis. Keep your booger hooks away from your face as much as possible. Don’t shake hands. For me, I like the idea of using the Vulcan salute instead.

Given that most people, especially those falling for politico-media fear mongering, have less sense than God gave a cherrystone clam, I would avoid crowds and as much as possible and avoid medical triage areas such as doc-in-the-boxes and ERs. Most people are not, unless educated by posts such as this one and actual medical statements, are going to flock to such places en masse which will increase the rate of exposure and the rate of infection.

If you think you have been exposed, or that you have COVID-19, do like this person. Call your state or local health agency and work with them so as to minimize the chance of exposing anyone, especially medical or other first responders.

Per my previous posts, if you are a first responder of any type, go to the highest level of precaution your department will allow — especially if responding to a report of someone ill. We can’t afford to have a dozen or more first responders quarantined for each incident as happened in Washington state (see previous posts).

With luck, planning, and people taking sensible precautions, the spread of COVID-19 can continue to be slowed until the weather gets better. There is a reason winter is worse for the flu, and the longer we can put off major spread the better. Also, keep in mind that the majority of cases are going to be mild, in keeping with a flu epidemic (which we have every year). There are a number of reasons it will not be as nasty and deadly here as in China (again, see previous posts). Panic will not help, and in fact will hurt. If you are older (60+) and have underlying health conditions, go to full, stringent, flu precautions as you are the most likely to have real problems with COVID-19. Right now, based on data from here in the U.S., 70+ with underlying health conditions is where we have the highest mortality.

It will be at least another 4- to 6-weeks before we have good data on COVID-19 here in the U.S. Data from China, Iran, etc., is both highly suspect (hint, the Chinese government and other governments have and are lying) and not directly applicable. Don’t panic.

Best thing you can do, other than washing your hands frequently, is to prepare for a possible quarantine. Make sure you have food, medicines, and other supplies to stay at home without leaving for at lest two weeks. This includes financial preparations where possible. Stock up prudently, in that what you buy should be what you normally would eat, drink, need. That way, if not needed, you simply fold it into your normal operations and move on while saving some money on food and such on the far end.

This is NOT Capt. Tripps, and while it will be a pain in the end, it is not something over which to panic. Unless you are in that specific demographic for it to be bad or fatal, you will get by. The major impact will be economic, though I suspect/hope it will change how we do business on several levels. We’ve slowly been trending towards remote work, and I expect that to become more the norm. I won’t object if handshaking becomes a thing of the past. For those smart and fast, there are some potentially fantastic business opportunities as we rightly move away from single-point failures in the supply chain.

Again, and again, and again: it is not a cause for panic. Be smart, be informed, and take media/politico reports with a tun of salt. Instead of a tun, maybe even a ton or two of salt.

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:

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