Coronavirus - worldwide spread and control

People with respiratory illnesses, diabetes and heart disease are at higher risk for complications/severity according to doctors that I've been following.

 

Agreed, those are two different things. I haven't yet come across any studies reporting how premorbid asthma or other respiratory illness affects outcome of Covid 19, though.

You'd think you would see a difference between the more and less severe cases, with premorbid respiratory disease showing up in a higher proportion of the more severe cases, but I haven't seen that reported yet. For example, in another Wuhan study (here https://jamanetwork.com/journals/jama/fullarticle/2761044)

Maybe when we have more data on Covid 19 patients with asthma, we'll know if it follows the same pattern as influenza.

 

It could be that having diabetes is also somewhat associated with other cardiovascular diseases that do increase the risk.

 

Table 1 in this study from the New England Journal of Medicine shows data for patients with various co-morbidities including COPD (but not asthma). It does list diabetes, @Barry .

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

The numbers are very small for COPD, in that there were only 12 patients with COPD in the sample of 1099. But those 12 patients were split evenly between the much larger non-severe group (n=926) and severe group (n=173), i.e. 6 COPD patients in each group. So the trend is in the expected direction.

Looks like we’ll need much larger datasets to be able to really see how people with asthma fare.

 

A hand sanitizer mule That's gotta hurt

 

The risk from diabetes is that blood sugars go wonky when you are ill. The liver releases stuff so you have plenty of sugar to fight infection. Then there is the problem of not feeling like eating and so on. All this can lead to an accumulation of ketones which is a medical emergency.

So the risk from diabetes is complications of that, not the virus as such (though being ill could give the virus more opportunity to cause damage.)

The advice is to measure blood sugar and ketones regularly.

 

In other news, people are having to learn to live without loo roll:

 

I would like to know what happens if you eat the virus... ie is ingesting it going to infect you or does the virus itself have to hit some part of the respiratory system? So if droplets of virus land on your food & then you eat, will you be infected or does it need to be breathed in? or touch the nose/eyes?

 

Ars Technica has a decent guide with answers to many common coronavirus questions. They say it will be updated regularly. It is US-centric, however.

Don’t Panic: The comprehensive Ars Technica guide to the coronavirus
https://arstechnica.com/science/202...ensive-ars-technica-guide-to-the-coronavirus/

 

My question is why was it found in feces? Is that in only serious cases with organ failure/death?
Did the virus appear in feces because the GI tract is colonized or is it cross-contamination from hands?
Or lab error or contamination of bedpans or?

I don't know.

Maybe best to eat with silverware and not hands. Wash fruits and vegetables in a chlorine bath (1:10 bleach for 10 minutes will kill it).

Eat canned food.

 

I was thinking more of the lasagne & salad that neighbour just brought me & which I ate & then thought... err should I have eaten that? They are kind enough to do a meal for me every sunday eve - whatever they're having they make an extra portion for me. I suppose if any of them are inadvertently incubating it then there is a good chance I have it now. In the last couple of yrs I've been scooping the meals from them onto another plate because of not wanting to touch the plate - they have historically had 3 teenagers in the house so quite a lot of colds etc. But it's just the 2 of them now so a bit less risky.

 

Incidentally I just wanted to take this opportunity to thank @Jonathan Edwards for his very sound advice on this thread a few wks ago - about getting in supplies before the panic buying started, the hand washing/not touching face etc. Having been fortunate enough to be able to follow the thread & read it, everything is now in place to give me the best chance of avoiding infection & managing fine through any shortages etc.
I did share the advice with my friends as you said I could. Only one of them took any notice, but as stores in our town have completely run out of toilet roll & various tinned goods are getting low & everyone is freaking out, she & I are able to relax a bit. So a huge thank you, as always, for all your wisdom & advice.

And indeed to everyone else for the wealth of information & support on this thread (& the other one too), I feel massively less panicky about it all having good information, than I would if I were just left to sus it all out alone as a total science/health layman.

 

According to TV news, they are now trying a drug normally used to treat rheumatoid arthritis on patients. They didn't say what the rationale was, but I suspect it's the idea that part of the problem is an overly aggressive immune response in lung tissue.

It seems that it will be impossible to prevent the spread of this virus. The only thing that can be done is to reduce the speed at which it spreads.

 

I like this graph a lot.

Something like this should be like a global campaign to move the narrative away from "80% mild, only 2% die" to "reduce the strain on the health care system".

https://twitter.com/user/status/1236721200291655680

 

The skin is a barrier to the virus which is why you can't be infected by having particles on your hand. The mucous membranes, the mouth, the nose and the eye are much easier to pass through so that is the usual entry point.

If the virus is swallowed the stomach acid will kill it, at least that happens in most respiratory viruses, this one may be different but there does not seem to be gut involvement.

This coronavirus easily latches onto lung cells to infect and replicate. There is no runny nose so I wonder if the virus can't latch onto nose tissue easily so the immune response of plentiful mucus is not stimulated there, we'll find out.

This is not a new type of virus just a new variety of a known one so it's actions are likely to be similar to other coronaviruses and other respiratory viruses. If you think about risk factors for the cold as coronavirus is a common cause of cold-like disease, you won't be far wrong for this one.

The only difference is this one is more virulent so we really want to avoid it.

Sorry, I didn't realise there was another page of responses when I answered this, oops.

Rinsing salads may be a wise thing to do, but only in the sense that is is good practice normally. Things like E.coli 0157 and salmonella have been transferred in salads because of contaminated water used to wash them and fruit may have traces of pesticides remaining.

We do not know what this virus will become or how it will affect us - people can catch TB by sitting next to an infected person on a bus but family members can live with a patient for years with no harm come to them - so you can't predict individual outcomes.

Since none of us have any immunity to this new bug we will all probably get it at some point over the years. Our goal is to keep free of it while hospitals are under stress because lots of people are sick at the same time.

All we can do is take reasonable precautions. It is impossible to keep all virus out without living in a sterile bubble but things like washing hands and not touching the face, avoiding people who are ill and so on will increase our chances of keeping it at bay. The point where our ME means we cannot do any more, well it is not necessary to worry too much. Like everything, we get 99% of protection from simple things so it is a balance. Not worth crashing for that extra 1% if you see what I mean.

 

Like others, I am grateful to Jonathan Edwards for the advice on buying some stuff in advance. I have a shopping bag full of tins I can eat cold if my carers are affected.

One thing I have not seen mentioned that may be important for us is to have a bag packed in case we have to go to hospital. If my husband takes bad I will never be able to get things together for him.

For each of us, we have a carrier bag with nightwear, a list of medication and things like eye drops which are essential but not likely to be available on the ward and some of my supplements like Coenzyme Q10 and magnesium. Also some money including enough for a taxi home.

It occurs to me it would be a good thing to keep handy anyway.

 

Latest from UK, and Boris Johnson after the Cobra meeting:

no change to any policies. No shutting down of any events or crowds. I think I saw somewhere that the UK is now where Italy was, 2 weeks ago. Italy started putting things into lockdown relatively quickly and still look how big it’s gotten. UK cases have already passed the number cases in countries like Singapore, despite Singapore being very close to China and having more cases earlier on. We are at a point where cases are increasing very rapidly over the past few days, but yet nothing much to do, according to our PM.

I’ve already stopped my boyfriend from seeing me for the past week because I’m so afraid of him going in and out of London at rush hour, I know how packed the tube gets at rush hour.

 

Just finished placing 2 significant orders with sainsbury's, almost entirely canned and dried food, 2 orders so I don't kill any delivery drivers when they try and lift it up the stairs.

I have not come close to the stocks I used to maintain here when I was more severe, probably after this lot I will have under half what I used to, but even buying it on tick I can't really afford/justify buying more.

Food just costs so much to build up stocks of these days, especially when I've been deliberately running them down for years - thinking it was no longer necessary to keep more than a few weeks worth in.

I 'may' have overbought toilet roll, but an extra 36 rolls isn't on the scale I have seen mentioned here, and it's not as if they go off rapidly.

ETA - I still haven't made any decisions on water yet, mainly because of how much I need (I drink at least 4 liters, usually 6-7 liters, a day) and the sheer weight and volume of it. If the mains water goes off then I have a significant issue just with drinking water let alone all the other things water is useful for. I do almost always have at least 6 liters of tap in the fridge, which at a push would cover me for 2-3 days if the supply is temporarily disrupted (there's normally 9 liters in the fridge, it goes down to 6 only until a bottle is refilled), but any longer and .....

I can buy food for months, I'll have 2-4 weeks worth if there is no power, but water, can't see an easy, or practical, solution to that one

 

This is why the spread has to be slowed as early as possible. The more rapidly the number of infected cases ramps up, the more people there will be at any one time not yet recovered.

 

Amazing, isn't it? Medical staff dying of the virus and, as yet, we have not heard of any outbreaks of mass hysteria. There must clearly be a hidden problem. Perhaps we should send them some of our experts to advise.