COVID-19

COVID-19 Masks and Spread

It is now clear that this deadly virus is spread mostly by aerosol transmission. That means places like bars and restaurants are the most dangerous especially because you sit there without a mask for a prolonged period of time. Due to their indoor location and minimal air circulation it has been shown that even someone several tables away can infect you.

If you are in a high risk group you must avoid these exposures until we have found a vaccine or good treatment. I think, based on the ongoing studies, that we will have something by December and can hope that things will go back to normal by early 2021.

Even if you are not in a high risk group, about 1/200 to 1/400 healthy young adults can die of the disease. If we are not prudent then, in a city of 500,000 young adults (that is a small city in the US), if 1/2 the people get the disease, 2-3 thousand young adults can die!

Wearing masks and social distancing works. I have been driving cross country in an RV to get back to Las Vegas and avoiding contact. But in Florida it looked like no one was wearing a mask anywhere. We are now in Kansas and everyone was wearing one; in Colorado it is a state mandate like Nevada. That is the way to stop the spread.

You know, heroes come in many forms. Most people consider the military heroes who protect us from terrorists and risk their lives. But you can be a hero by wearing a mask to protect your fellow Americans. Refusing to wear one is a cowardly act, not an act of freedom. Not protecting your fellow Americans places you in the same category as those terrorists and murderers our President feels he needs to keep out of this country.

The no mask attitude of this country has resulted in an explosion and now schools are in limbo for the fall - for no good reason.

In a recent study (Nature 2020 Jun 8) A multinational team of social scientists modeled data on the effects of large-scale anticontagion policies in six countries. The team estimates that these measures already have prevented 285 million cases in China, 38 million in South Korea, 49 million in Italy, 54 million in Iran, 45 million in France, and 60 million in the U.S. — a total of 530 million cases prevented or delayed, thus far. If COVID-19–related mortality is 0.5% (a conservative estimate), such measures have prevented 2.65 million deaths. We need to continue this!

In another study, JAMA Intern Med 2020 Jul 1, researchers have found that there have been an excess of 120,000 deaths between March 1 and May 20 of this year; likely all due to COVID.

Wear a mask!!

The New Coronavirus - not a time for panic!

The New Coronavirus - my take

Family member have been calling me concerned about the COVID-19 virus and what will happen. I think the press has "enjoyed" the publicity and people are genuinely frightened. I have been asked questions such as "should I start stocking up on food and water", or "should I travel by plane?" etc

First, there is of course, reason to be concerned about this contagious infection. But it will not cause the chaos people are fearing.

About The Virus

Like two other recent Corona Virus infections (SARS and MERS), this virus seems to affect lung cells more than those in the throat and nose (like a cold). It can lead to lung failure and death BUT the death rate (from a recent study of 72,000 patients in China) is only 2.3%. And the majority of deaths occurred in the elderly, immunosuppressed and chronically ill. In patients over 80 the rate was 15% and 70-79 was 8%.

Think about it - if I told you there was a contagious virus that killed 1% of its victims and was even more deadly in elderly and ill (5-15%) I am sure you would be concerned. Would you get vaccinated for it if possible - I would think yes. Especially if you knew there were over 45 million worldwide cases last year. Well why didn't you get the flu vaccine, because those are influenza statistics?And unlike COVID-19 influenza has the ability to mutate and become immune to vaccines. In 1918 this virus had a 20% fatality rate. Much scarier!

It seems inevitable that COVID will reach the USA. And we will take gargantuan measures to prevent transmission (as we would if we did not have a flu vaccine!). This may disrupt schools, sporting events, gatherings and transportation. It may overwhelm our medical facilities. There is no reason to think it will affect our food sources, shipping, police, fire etc - remember only a small percentage get seriously ill. But the CDC and government will stop large gatherings and movement from affected areas to help prevent spread.

So a little about the disease itself. Probably about 2-5% of infected individuals will have no symptoms at all. Are they contagious - maybe; we do not know yet. The incubation is 2-14 days, and more severe cases have fever, cough and shortness of breath, which can lead to respiratory failure in a small percentage. Once you have had COVID infection you are probably immune; certainly in the short term. Again we do not know how long antibodies last.

How is it spread? Certainly by respiratory droplets in the air; like the cold virus, measles, chicken pox etc. Wearing a mask probably helps prevent a sick person from spreading the disease as all the droplets from coughs get caught. But unless you wear a medical respirator designed to filter the air, masks do not appear to prevent you from catching it. It does not seem as infectious as some respiratory illnesses (like chicken pox and measles); it is thought you need to be in relatively close contact (6-10 feet). Of course this is so new that these are only based on current observations.

How about air travel? All airplanes have fine HEPA filters that remove viruses from the air. So again it is close contact that is the issue. If you have an air vent above you on a flight turn it on to form a cone of fresh air around you. The air coming out of that is filtered and sterile.

Can you get it from a surface or through the skin? Currently we do not believe if can penetrate intact skin. And probably does not survive long on dry surfaces. But this is still unknown.

Another question is how long a person is contagious after being sick. With MERS and SARS this could be 2 weeks. With another recent virus, ZIKA, intact particles could be found months after infection. Another question. 

Finally, when can we expect treatment? Several studies of an antiviral drug developed for SARS are now underway and we should have results in a month; and then can come to market if successful as soon as May. With new DNA and genetic technology there are already 2 vaccines in preliminary testing that could become available as soon as this summer.

What about travel? Check the CDC site; the most recent advisory:

• CDC has issued the following travel guidance related to COVID-19:

• China — Level 3, Avoid Nonessential Travel — updated February 22;

• South Korea — Level 3, Avoid Nonessential Travel — updated February 24;

• Japan — Level 2, Practice Enhanced Precautions — updated February 22;

• Iran — Level 2, Practice Enhanced Precautions — issued February 23;

• Italy — Level 2, Practice Enhanced Precautions — issued February 23;

• Hong Kong — Level 1, Practice Usual Precautions — issued February 19.

• CDC also recommends that all travelers reconsider cruise ship voyages into or within Asia at this time.

In summary - it is not time for panic. The death rate is quite low and might even be lower in the US and Canada with our most advanced medical care. Vaccines and anti-virals will be developed; probably before the end of the year. It will come to the US and will create disruptions, but not Armageddon!