Coronavirus

[Padraig]

Yes - where does one obtain effective face masks, as opposed to the flimsy paper ones that only prevent an infected person infecting others, to some extent? I didn't see any of either type at either the local pharmacy or the supermarket yesterday.

I was impressed by a report suggesting that face masks were very effective in preventing or protecting us from/when touching the face. The reasons given were that we touch our faces an extraordinary number of times a day, that our hands would be major carriers of contamination and that infection gained entry via the mouth or nose.

[Bryn]

I have a few motorcycle facemasks (fabric) which are better than a scarf in cold weather. They would serve the "no face touching" purpose well but would be too darned hot once spring arrives properly.

[Serial_Apologist]

Like much else probably made in China where I suspect local demand now outstrips supply - just one more effect of the near total destruction of British manufacturing as capital shifted to China with its then lower wages and freedom from many of the annoying environmental issues.

Absolutely agree. A lady I was chatting to in Brixton Tescos told me she had been advised to turn up there at 8 am, as stocks had been exhausted every day after that time! I only saw one person wearing a face mask however, and she was emerging from the Tube station.

[eighthobstruction]

Absolutely agree. A lady I was chatting to in Brixton Tescos told me she had been advised to turn up there at 8 am, as stocks had been exhausted every day after that time! I only saw one person wearing a face mask however, and she was emerging from the Tube station.

....a generous blob of anti bacterial gel up each nostril and thats the nose sorted, then onlythe mouth to worry about S_A....

[Serial_Apologist]

....a generous blob of anti bacterial gel up each nostril and thats the nose sorted, then onlythe mouth to worry about S_A....

This particular mouth is a lot to worry about; it often seems to have a mind of its own!

[Serial_Apologist]

And so, Italy his now gone into mass self-imposed isolation.

This must be very worrying to Italians living over here. My next door neighbour, owner of the flat next door to me, rents it out to his young sister and her boyfriend while he now works in Milan, very near to the epicentre of the virus, commuting to and from the rest of his family - wife, two young children - halfway down the country each day. Coincidentally there are a number of Italians living elsewhere in our block, one of whom has today told me he had intended visiting his family in Venice in the next few days, and has now had to cancel his trip.

Meanwhile it was reported on the news just now that a laboratory in Liverpool has come up with a device capable of reading patient swabs to adduce all the bacterial constituents associated with Coronovirus in a few minutes, from which they intend producing specific antibiotic treatments believed to lessen the effects of the virus and shorten the duration of symptoms, which is some good news.

[Barbirollians]

And so, Italy his now gone into mass self-imposed isolation.

This must be very worrying to Italians living over here. My next door neighbour, owner of the flat next door to me, rents it out to his young sister and her boyfriend while he now works in Milan, very near to the epicentre of the virus, commuting to and from the rest of his family - wife, two young children - halfway down the country each day. Coincidentally there are a number of Italians living elsewhere in our block, one of whom has today told me he had intended visiting his family in Venice in the next few days, and has now had to cancel his trip.

Meanwhile it was reported on the news just now that a laboratory in Liverpool has come up with a device capable of reading patient swabs to adduce all the bacterial constituents associated with Coronovirus in a few minutes, from which they intend producing specific antibiotic treatments believed to lessen the effects of the virus and shorten the duration of symptoms, which is some good news.

I do not understand this - viruses rather than bacteria - do not respond to antibiotics. Though I see there is some suggestion that those dying may well be getting a bacterial superinfection.

[richardfinegold]

I do not understand this - viruses rather than bacteria - do not respond to antibiotics. Though I see there is some suggestion that those dying may well be getting a bacterial superinfection.

Antibiotics treat bacterial infections. Anti virals treat viral infections, and anti Fingal’s treat....

I have 21 year old patient who was doing a year of University in Florence. He was sent home Thursday and upon landing was quizzed by Immigration officials. He mentioned that he has had a mild cough for a week. He was told to call his Physician. Upon doing so we directed him to the Hospital where Infectious Disease met him in a negative pressure room. He tested positive for “non novel Corona Virus” which is not Covid 19. He still has to quarantine for 14 days. His mother was almost hysterical and I had to spend 15 minutes with her today.
To date, 11 reported cases in Illinois. Eighteen thousand deaths this year nationally due to influenza. Somehow the Panic over this is unseemly.

[Dave2002]

He still has to quarantine for 14 days.

In "normal" times would that still be the procedure, or would he just go home and probably carry on as usual, unless he felt very ill? I did some quick calculations based on estimates.

1. 50 states in the US - so Illinois cases to date x 50 = 550. Now multply by 6 as we're about 2.y/12 way through the year, to get 3300.That estimate is around 1/6 the number of influenza deaths - an estimate (yours - though there seems to be wide variation) for the total US deaths in one year.

Assumption made here - which is wrong - is that all states have proportionately the same number of people.

another way....

2. 12.5 million people roughly in Illinois. 329 miillion people approx in the US. 329/12.5 * number of Illinois cases * year fraction
gives which gives about 26* 11* 6 approx 1750 estimated deaths - which is "better" than the previous estimate by a factor of around 2.
This is about one tenth (1/10) of the US wide estimated (again - your figure) annual deaths from influenza.

Another factor seems to be that really young people - school kids and similar - can get it, but only have very mild, if any, symptoms - and recover quickly - possibly without being diagnosed as having this disease. So the likelihood of it spreading could be high, because it would be propagated by the young without most of us being aware.

People over 70 have a sigificantly higher death rate from this disease, and males are affected more.

Would a fairer measure be to compare the death rate from Covid 19 with the death rate from flu before flu vaccines were commonplace? That would perhaps give even less incentive for us to be worried. However, it turns out that there is wide variation in cases each year, and it's not immediately obvious that annual deaths from flu have dropped since vaccinations became usual.

See https://healthvigil.com/flu-season-deaths-us-worlswide/

https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/

Of course I can't verify the accuracy of the links mentioned above.

The UK Government provides official annual data - https://www.gov.uk/government/statis...al-flu-reports - but I haven't found a summary of the trends over the last 50 (or even 30 years.

So should we just shrug off the issues relating to Covid 19? Accept that if our number is up that's bad luck, and get on with our lives (or not) as if nothing has happened? Experts in many countries appear to think not.

It might put things in a different perspective to look at deaths due to road traffic incidents - see https://en.wikipedia.org/wiki/List_o...ted_death_rate Perhaps for the US this is comparable to the expected rate from flu (not Covid 19) - though allowing for the wide annual variation. The US has a higher per capita death rate from road accidents than some European countries. The UK has a relatively low death rate from road traffic accidents compared with many countries.

[ardcarp]

Antibiotics treat bacterial infections. Anti virals treat viral infections

Is it possible that a bacterial infection could arise from (piggy-back on) the complications of a severe viral infection? If so, would an antibiotic be appropriate?

[BBMmk2]

I wouldn’t stand a chance against this virus!

China are loosening travel restrictions now, as day by day, the number of cases are reducing.

[Flay]

COVID-19 for most individuals causes mild to moderate illness, but in addition may result in pneumonia or severe acute respiratory infection.

The current national approach is to identify, isolate and contain. In England:
• individual patient advice is being provided by NHS 111
• public information and sampling are being managed by Public Health England (PHE)
• members of the public who may have COVID-19 and do not require urgent medical care are being asked to self-isolate until diagnosis is confirmed
• for confirmed cases isolation and treatment are being managed by national specialist treatment centres

Symptom onset is between 2-9 days after exposure with median of 5 days. This is from a very large Chinese cohort

The most common presentation was one week prodrome of muscle pain, malaise, cough, low grade fevers gradually leading to more severe trouble breathing in the second week of illness. It is an average of 8 days to development of breathlessness and average 9 days to onset of pneumonia/pneumonitis. It is not like Influenza, which has a classically sudden onset. Fever was not very prominent in several cases. The most consistent radiographic finding was bilateral interstitial/ground glass infiltrates (i.e. widespread lung infection).

So far, there have been very few concurrent or subsequent bacterial infections, unlike Influenza where secondary bacterial infections are common and a large source of additional morbidity and mortality. (Therefore COVID-19 in itself is more dangerous. Antibiotics rarely have a place).

Tamiflu does not work. Newer antivirals are being tried/trialled, but don't hold your breath.

Patients with underlying cardiopulmonary disease seem to progress with variable rates to acute respiratory distress syndrome and acute respiratory failure requiring BiPAP then intubation. There may be a component of cardiomyopathy from direct viral infection as well.

Patients can shed RNA from 1-4 weeks after symptom resolution, but it is unknown if the presence of RNA equals presence of infectious virus. For now, COVID-19 patients are “cleared” of isolation once they have 2 consecutive negative RNA tests collected more than 24 hours apart.

If you have any suspicion that you may be infected, please phone NHS 111. Do NOT go to your GP or A&E

[Flay]

Question for oboists: should virus mutate, would it be Metamorphoses after Covid?

Sorry, couldn't resist.

[LMcD]

I did venture an exchange of pecks on the cheek with a friend whom I see on Thursday mornings. She's 90 and past worrying, and gave me the confidence to proceed with our customary weekly greeting.
Has anybody else put 'coronavirus' into an anagram solver, by the way?

[Cockney Sparrow]

COVID-19 for most individuals causes mild to moderate illness, but in addition may result in pneumonia or severe acute respiratory infection.

The current national approach is to identify, isolate and contain. In England:
• individual patient advice is being provided by NHS 111
• public information and sampling are being managed by Public Health England (PHE)
• members of the public who may have COVID-19 and do not require urgent medical care are being asked to self-isolate until diagnosis is confirmed
• for confirmed cases isolation and treatment are being managed by national specialist treatment centres

Symptom onset is between 2-9 days after exposure with median of 5 days. This is from a very large Chinese cohort

The most common presentation was one week prodrome of muscle pain, malaise, cough, low grade fevers gradually leading to more severe trouble breathing in the second week of illness. It is an average of 8 days to development of breathlessness and average 9 days to onset of pneumonia/pneumonitis. It is not like Influenza, which has a classically sudden onset. Fever was not very prominent in several cases. The most consistent radiographic finding was bilateral interstitial/ground glass infiltrates (i.e. widespread lung infection).

So far, there have been very few concurrent or subsequent bacterial infections, unlike Influenza where secondary bacterial infections are common and a large source of additional morbidity and mortality. (Therefore COVID-19 in itself is more dangerous. Antibiotics rarely have a place).

Tamiflu does not work. Newer antivirals are being tried/trialled, but don't hold your breath.

Patients with underlying cardiopulmonary disease seem to progress with variable rates to acute respiratory distress syndrome and acute respiratory failure requiring BiPAP then intubation. There may be a component of cardiomyopathy from direct viral infection as well.

Patients can shed RNA from 1-4 weeks after symptom resolution, but it is unknown if the presence of RNA equals presence of infectious virus. For now, COVID-19 patients are “cleared” of isolation once they have 2 consecutive negative RNA tests collected more than 24 hours apart.

If you have any suspicion that you may be infected, please phone NHS 111. Do NOT go to your GP or A&E

Thanks Flay. Can you say your part in this insight - was all that from NHS England? Perhaps you could indicate your area of expertise? I'm not being conentious, I'd just like to know - it all seems eminently authoritative and correct...

There was a reference, probably upthread, to something posted on Slipped Disc - this reference confirms the author, an American virologist:

https://www.snopes.com/fact-check/zinc-lozenges-coronavirus/