Are we high risk?

[Protimenow]

This virus will be around for a long time - until it mutates and becomes non-infectious to humans (IF it mutates - one report says that this new virus is a mutation from a different one that was less infectious) Perhaps the best way to solve this would be only have the elderly and those at risk stay at home, quarantined from everyone else. Let those who aren't at risk go about their daily lives.

Sure. some of them will die from it. Many others won't. Those that don't will have immunity (although we don't know if they'll stay immune until there's a vaccine).

The immune ones might be able to visit the vulnerable, being careful about washing hands, but it's possible that they may be able to transfer immunity to the vulnerable, protecting them from the virus.

This approach may actually make sense to some people -- let the virus burn itself out.

FWIW - if the young and healthy will eventually get it, and most will survive, with a small minority requiring hospitalization, and probably a smaller minority dying of it, why not get it done right away (assuming there are enough hospital beds), instead of spreading it out until there's a vaccine.

(This kind of remins me of the essay, 'Common Sense')

 

[LondonAndy]

The approach @Protimenow refers to is called "Herd immunity" and has been widely discussed, though only Sweden has really tried it as a national policy, and compared with other Scandinavian countries is doing worse at present. However, the same theory suggests that, post lockdowns, countries will eventually end up with the same sort of death rates anyway, depending on age profile of their populations and other factors such as population density and extent of international travel.

The "why not let everyone get it now" approach has the precise problem that Rich points out: hospital facilities are overwhelmed, as in parts of Italy and New York. Hence policies aimed at buying time to allow health services to prepare with, for example, more beds with ventilators. Though as knowledge of the virus has progressed those are looking to be almost part of the problem rather than a solution, with gentler methods of oxygenation proving more effective.

The problem with taking what might be termed a proportionate approach and allowing younger people to return to normal life is, at least here in the UK, our media and some 'left wing' organisations shouting that this means politicians are sacrificing the lives of some citizens for economic reasons, and that they don't care about the poor or indeed some ethnic groups who seem more at risk of death from Covid-19. BAME groups have been disproportionately affected, and whether it is genetics or socioeconomic conditions is the subject of research now. Darker skin tones evolved to protect the body from harmful UV rays from the sun, and with sunlight being an important source of Vitamin D this can mean in more temperate climates a lack of it, which seems to be important in defending us from Covid-19. But BAME populations may also be more in service jobs and coming into contact with more people.

So politicians have many factors to consider that may have bad consequences, if they get it wrong, for both their communities and their own electoral chances. I suspect that our own Prime Minister, having had a serious infection himself that seems from reports to have been genuinely life threatening, is particularly mindful of not wanting to do anything that risks horrible deaths and serious long term effects on some sufferers.

 

[rich01]

It's a balancing act with no right answer.

The 1st link I posted has a list of things you might take as a prophylactic. This was put together by a major medical school in Virginia (EVMS). It's mostly over-the-counter supplements you can take. It also has a list, with dosages, of supplements to take if you get the virus and are told to quarantine at home. These are primarily anti-virals. I also have elderberry syrup which is an anti-viral to take if I start to feel sick

Treatment is broken into 2 parts: 1st is anti-viral and 2nd is anti-inflammatory. Anti-virals are what one takes preventively and in early stages of covid-19 and anti-Inflammatory when you are sick enough to require hospitalization.

 

[rich01]

This is from the post I made last Wednesday:

I think that if we ever get real numbers, that close to 50% of people who died from covid-19 became infected in a medical facility such as a nursing home, assisted living home, other elder care facilities, VA homes, hospitals, doctor's offices, clinics, etc. My reasoning - most people that die from covid-19 are sick and elderly and this is where you find them. Asymptomatic health care workers could easily infect these patients.

I just came across this article in San Francisco Chronicle:

Nearly 50% of state’s COVID-19 deaths are residents, staff at nursing, care homes

Residents and staff in California skilled nursing and senior residential facilities account for nearly half of the state’s COVID-19 deaths, data shows.

The state departments of public health and social services released cumulative data on Friday revealing the extent to which the potentially deadly coronavirus has swept through congregate homes for the most vulnerable.

 

[Protimenow]

The State of New York is actively trying to eliminate this problem from its nursing homes. The Governor has instructed these facilities to frequently test all health care workers at least twice a week (or, perhaps, every three days), and to test patients for COVID-19. If any patient is positive, the patient must be put into an area that is designed to adequately care for the patient. If the facility is unable to provide that patient with appropriate care, the State deparment of health must be notified - the patient will be transferred to one of the many facilities that is equipped to care for that patient.

Failure pf a facility to follow these rules will result in cancellation of the facilities' license.

Governor Cuomo isn't kidding about the State's insistence on reducing the spread of the virus inside these facilities.

(I'm waiting for a similar rule in prisons - all prisoners should be tested regularly, and those with posiitive results should be moved to an area where others have positive results, quarantined, and if they get sick, moved where they can get appropriate care. But this is a bigger problem).

 

[rich01]

Florida supposedly had one of the best plans for nursing homes and other care facilities, but they are getting hit hard like many other states. From Orlando Sentinel.

But as the state starts to reopen, coronavirus cases in Central Florida’s nursing homes and assisted-living facilities continue to climb, fueling concerns that asymptomatic staffers — including hospice and home-health clinicians — may be spreading the virus from one facility to another.

By Friday, cases at three of Central Florida’s hardest-hit nursing homes — in Osceola County, west Altamonte in Seminole, and Volusia — accounted for 115 of the 182 cases in the region. Among them, 22 staffers tested positive for the virus.

Across the state, the virus has killed 656 patients at nursing homes and assisted living facilities, including 22 at a facility near St. Petersburg and 16 at a Broward facility, state data shows. That means these facilities account for almost 40% of the state’s confirmed deaths from COVID-19.

I doubt if twice a week testing will make much difference. One infected staff person could easily infect 10 or more people in a day or two, especially if asymptomatic and they are somewhat careless about following protocols.

New York has had 5,300 people living in nursing homes die from the virus, compared to Florida at 656. A big part of the problem in NY was from Cuomo's policy in March which required nursing homes to accept Covid-19 positive patients. His new policy reverses that and prohibits nursing homes from accepting positive patients.

Again, just thinking out loud here on the forum, I don't see the nursing home problem being solved without major reform, which probably won't happen. I would require people to work 12 hour days and be onsite for 4 days straight. I test them before they can start their 4 day shift. If I could, I would retest them every day but that may not be possible. I bet there are blood tests that would be good indicators of infection. Maybe everyone has to have a daily blood sample taken. The point is, I would need to be sure every day that no one on staff is contagious. Anything less than that is worthless and just for show. I would also want to test patients as often as possible, especially if it is easy to administer and not painful to patients.

I would also have at least 4 inspections a day to make sure everything has been properly sanitized and that staff are up to date and following procedures properly.

And the state needs to have a health professional inspect every facility every day. Instead of having police worry about social distancing, maybe some of them have the background to perform inspections. States need to reallocate their resources and provide nursing homes and other care facilities with inspections and counseling.

 

[LondonAndy]

Sad but interesting stats from Florida. Here in the UK some wonderful care home staff have decided to leave their families and live at the care homes, often in temporary facilities, to avoid this risk of bringing the virus in.

 

[Keithl]

Unfortunately here in the US the lack of leadership will make this a rough go. I get it, the economy must reopen. We wasted the lock down period on arguing over is it too much and when to reopen. Then states buckled and started reopening once people became desensitized to the aftermath and death. We have a government that want no part in this and is in denial stating it will go away. The way to should have been done is like many other countries. You lock down, get your health care system ramped up, come up with plans for testing and tracing and then you reopen with restrictions. Simple leadership explain the hardship and sacrifices we all will make would have gone a long way. Now you have people in open defiance of science and logic because they have politicized this. Every state should have made masks in public mandatory and this would be easier now even with the early reopening. Some common sense regulation s and restrictions would allow reopening and yes there will be more cases and death, but it would have been manageable and minimized compared to what is about to happen.

The carelessness of others by them no wearing masks or keeping social distance basically mean i will frequently stores less and buy less as I will not put myself in those situations. Some stores like Costco require masks, good for them. The odds I will visit a restaurant or fast food place until there is a cure or vaccine is zero becasue of all the carelessness of others. We have limited our grocery store visits we double mask ( a reusable one covered by a disposable one) and I wear gloves in the store (more to remind me not to touch my face). Over the last 7 weeks we do mostly deliveries or contactless pickup. I will error on the side of caution to minimize our risk. Yes life is full of risks, but taking needless risk is something I am not willing to do. All these steps once you do them really are not a big deal.

 

[LondonAndy]

I am no expert in masks, though have had for some time a couple of the "N95" rated ones to hand if needed, but haven't done so yet, relying on social distancing and home deliveries etc. Here in the UK the benefit of masks has been the subject of much debate, suggesting that their benefit is more in preventing an infected wearer from spreading the disease to others, but that the mask itself becomes a risk as it gets moist from our breath, and also when you take it off, both in terms of potentially touching your face with infected hands, and what you do with the mask, eg putting it on a work surface and therefore spreading the virus on that. However, I note that mask wearing is prevalent in many Asian countries, which have done rather better than much of the West in minimizing the infection rate.

I wonder, therefore, if you would be better off wearing the disposable mask under the re-usable one? And I would certainly wear a mask in places where social distance cannot be maintained, such as on public transport.

 

[Keithl]

Wearing masks is all bout knowing how to wear them, take them off and understanding the benefit of each type. True the mask is really to protect everyone form the mask wearer should they be infected. And yes, many of the mask people are wearing are weak at what they block, but some protection is better than none. There are several articles on what materials work better than others. 600 thread count sheets and pillow cases are decent when doubled over. Using a nylon stocking over your mask adds additional protection (but that look is where I draw the line as not me). I have purchased 2 dozen 3 layer masks that we reuse. Once it has been used we take it off for at least 3 days before touching it again, if we need to otherwise it gets washed. We wear the disposable mask either over or under the reusable mask. As with nitrile gloves there is a proper way to take them off to avoid infecting yourself. I watch many people how they handle their masks and most are uneducated on how to deal with their mask or glove. Being a long term germaphobe many of these steps come natural to me on how to handle potentially germ/virus/bacteria full items.

Also social distancing is a bit of a myth, I wear a mask everywhere when out, the virus just not just fall out at 6 feet, there are measured scenarios where it travels further. My wife and I keep several disposable and reusable masks as well as nitrile gloves in each car so that if we are in a situation where we need to mask up we can if we did not bring some for the situation.

Some info on the various level f mask protection:

https://cdn.vivarep.com/contrib/va/documents/al_lib_44.2015112134294585.pdf

Other mask info:

Someone reverse-engineered N95 face masks: Here’s how to make your own

Making a new mask? Some fabrics might filter as well as N95 masks (and you probably have them at home)

 

[rich01]

The amount of viral load one is exposed to is critical. If exposed to a small load, you have a much better possibility of your body being able to fight off the virus. Even though wearing a mask isn't foolproof, it helps limit the viral load a person is exposed to. The goal is to try to prevent people from having critical viral infections.

What I don't understand is why employees in big box stores are not required by the company to wear a mask. It would protect the customers and I would think that, if nothing else, would be good for business.

For those in areas where there is a Walmart, you might want to check out their delivery/pickup. Only pickup is available where I live, but Walmart has really got the process down. You order online and select a day/time from those available. You get an email when order is ready and you use the app to say you are on the way. When you arrive, they check to see who you are and then load groceries into the vehicle. They always wear a mask and maintain social distancing. I have also used Food Lion and it is good, but not quite as good as Walmart. I'm sure other grocers are good as well.

 

[pellicle]

The amount of viral load one is exposed to is critical

my understanding is that viral load refers to the amount of virus found in in your plasma. This directly relates to how well your immune system is destroying the virus VS how effectively your body is making the viruses.

 

[Keithl]

I think their reference to viral load is how much of the virus you are exposed to. In tight spaces with poor air movement if you are around someone with the virus you may recover a large number of virus particles for a longer time, this would be harder for your immune system to beat down. Also if it gets into your lungs vs. maybe staying in your sinus that may have an impact on how sick you get and how your body can fight it. Thinks of it a snatch vs. Flamethrower, tia ea match to something and you you can squash it with a cup of water, take a flamethrower to soothing you need more to stop that and may be overwhelmed by the fire.

 

[pellicle]

I think their reference to viral load is how much of the virus you are exposed to. In tight spaces with poor air movement if you are around someone with the virus

Blood pressure is a term with a meaning too

https://en.wikipedia.org/wiki/Viral_load
Its inappropriate to just twist it to mean something else

 

[rich01]

my understanding is that viral load refers to the amount of virus found in in your plasma. This directly relates to how well your immune system is destroying the virus VS how effectively your body is making the viruses.

infectious dose

 

[dornole]

This article explains the concept of infectious dose well.

The Risks - Know Them - Avoid Them

 

[Protimenow]

This may already be slightly off target (but refers to an earlier post). In California - or perhaps just Los Angeles) our Governor (or Mayor) acknowledged that health care workers are often sleeping in their cars (or elsewhere away from their homes) so that they don't bring the virus home.

Ths state (or city) contracted with hotels to provide free, or low-cost housing for these health workers so that they have a comfortable place to stay - a room with a bed, a bathroom - instead of the uncomfortable ways that they may otherwise be sleeping - and this is the least that they deserve for the risks that they take and the sacrifices that they're making during this time.

 

[jcgtok17]

My Dad passed away 10th January 2020 of lung failure in hospital in Florida. He fell ill on 18th Dec 2019 aboard a Panamanian cruise which departed from Ft. Lauderdale. Family members are still insisting it was COVID-19 related, but the timing is more than a bit off (his illness being so early). As Dad has not been interned yet I'm tempted to try and get a test done post mortem as un-resolved I'll be hearing about it for the rest of my days.

Dornole's note made me think it is possible he was "patient zero" but unlikely as to my knowledge none of the ICU staff were infected (and no family were). How to make a tough situation tougher for sure. Dad was 76 and still working. Issues, like we call accumulate, but I has him pegged for 85. Treasure every interaction.

 

[rich01]

My Dad passed away 10th January 2020 of lung failure in hospital in Florida. He fell ill on 18th Dec 2019 aboard a Panamanian cruise which departed from Ft. Lauderdale. Family members are still insisting it was COVID-19 related, but the timing is more than a bit off (his illness being so early). As Dad has not been interned yet I'm tempted to try and get a test done post mortem as un-resolved I'll be hearing about it for the rest of my days.

Dornole's note made me think it is possible he was "patient zero" but unlikely as to my knowledge none of the ICU staff were infected (and no family were). How to make a tough situation tougher for sure. Dad was 76 and still working. Issues, like we call accumulate, but I has him pegged for 85. Treasure every interaction.

This was in France. It appears their 1st case was a month earlier than they originally thought, occuring in mid-December.

But Professor Yves Cohen, the head of the intensive care unit at a Paris suburban hospital, made a surprising discovery when his team checked old test samples of patients with pneumonia in December and January. Out of 24 patients, one patient's sample from Dec. 27 twice tested positive for COVID-19 -- Amirouche Hammar’s.

https://abcnews.go.com/International/man-france-countrys-earliest-covid-19-case/story?id=70536861

 

[Protimenow]

I'm not sure if an autopsy would be able to show much -- the virus probably wouldn't be detectable this long after death. While it may put some minds at rest, the cause (if it WAS COVID-19 that killed your father) may never be resolved. Unless there's some mention of COVID-19 positive or negative - if that's even possible - you or your family may ALWAYS wonder if he got the virus.

He probably wouldn't be Patient 0, because he would most likely have gotten the virus (if he had it) from someone else on the ship or at one of the ports. Without seeing a passenger and crew manifest, the source will probably never be found.