Covid-19 Discussions & Development

Some Chinese autopsies of Covid-19 victims showed that they had both Covid pneumonia and bacterial pneumonia. Obviously, having two types of pneumonia could be deadly ! There is no vaccine for Covid-19, and unlikely to be one available this year. But there are two vaccines for bacterial pneumonia. Prevnar 13 that protects against 13 strains (and typically provokes a stronger immune response) and Pneumovax 23 that protects against 23 strains of bacteria. Due to the different ways the two vaccines work, one can take Prevnar 13 first and Pneumovax 23 three months later. Do the opposite order, and you have to wait a year to get Prevnar 13. Up until 2019, both vaccines were recommended for people 65 and older or with special circumstances. It will depend upon your physician, but potential exposure to Covid in later middle age may qualify as a special circumstance. Insurance may, or may not, pay for these vaccinations. We know that the impact of Covid is heavily age dependent. See my...

- Bacteria and viruses are removed by friction. Simply running soapy water over your hands is not enough, All areas need to rubbed a bit. That includes wrists and the webs between fingers. Your fingers have four sides - rub all four sides. - Covid-19 (corona) viruses have a lipid coating. That is, they are covered by fat. Soap binds with fat (that is what makes it soap). Use enough soap when washing your hands to make them, and the viruses, soapy. - The fingertips, under the nails and the "fingerprint" area are the greatest risk areas to transfer germs to your mouth or nose. For me, the side of my right hand is the greatest risk for transfer to my eyes. Pay special attention to them. I clasp my fingers inside each other (fingertips to base of finger) and just rub & wiggle them in soapy water. I wiggle my thumbnail into the palm of the opposite hand to get that thumbnail and thumb tip. This gets the high priority areas. - Your thumbs are a fingers too. Don't forg...

A major tool currently used in controlling the spread of the virus outside China is contact tracing. This is trying to find people that have become infected by a known case of Covid-19. This standard can also be used to help define "high risk" behavior if Covid-19 becomes an epidemic in your area. 1) Being within two meters (6 feet 6 inches) of an infected person for 15 minutes. 2) Being in the same office (defined as large open space) for two hours. 2b) Airplanes, because of their airflow of outside air, are defined as within 3 rows 3) Contact with secretions of infected person (this includes sneezes) Anyone who is known to meet any of these criteria is then "traced" as potentially infected. This may be useful information in case Covid-19 becomes widespread. As of February 15th, no data (that I am aware of) has been released on how long the virus is viable on a surface. Given the behavior of other corona viruses (the four that cause 25% of common colds...

There will come a time, perhaps this Spring or next Winter, when the number of cases will overwhelm the current system of containment, quarantine and contact tracing. The next step - in addition to finding and isolating the potentially infected - is changing society, and our individual behaviors, so that each infected person infects - on average - less than one new person. The epidemic will die out when we do this. This is what China is doing today with significant success. Without protective gear (such as masks) and changes in behavior, one person with Covid-19 will infect between 2.0 and 2.5 people in Chinese society. (Different societies have slightly different contagion rates (known as R0 )). Reduce contagion by over 60%, to an R0 to less than 1.0, and the epidemic dies out. Individually, LOTS of hand washing and training to NOT touch your eyes, nose and mouth. Alcohol wipes on things you touch (cell phones !!) and touch them differently (elevator buttons with your knuckle, t...

I just read (2/23/2020) a series of tweets by an MD that claims he is in charge of virology testing at Brigham & Women’s Hospital, a Harvard Medical School teaching hospital in Boston. He appears legit to me. There are @ 100 labs in the US capable of testing for Covid (including his) but only 3 are currently doing so. (Another source claims 4). Ten days ago the CDC called back Covid testing supplies and will not share why. Nor when improved supplies will become available. Currently only travelers from China, those in quarantine or contacts with known cases are being tested by CDC for Covid. This means that cases from other countries and transmission within the USA are being missed. He is concerned that community based Covid contagion may be in the US today but is simply not being tested, quarantined or contact traced. I am concerned too. If 100 labs start testing in a few days, hundreds or thousands of Covid cases may quickly appear in the USA. 2/25/2020 Update - CDC sa...

I reviewed the Chinese CDC paper on Covid demographics.  http://weekly. chinacdc.cn/en/article/id/ e53946e2-c6c4-41e9-9a9b- fea8db1a8f51  The most striking observation is the effects of age on Covid infection and mortality: 1) The younger you are, the less likely you are to get sick with Covid. Ages 0 to 19 were just 2.1% of the cases (even there, 10-19 had 32% more cases than 0-9). 2) Among those infected, the death rate climbed dramatically with age. 0-19 had 2.1% of infections but only one death out of 923 (2.1% of 923 is 19.4 so mortality in sick children is @ 5% of average mortality based on just a single death). Looking at the Chinese age pyramid, 0-19 is about 23% of the population. So, roughly, children get sick @ 1/11th as much as average. If sick, children die @ 1/20th as much (inferring from just one death) This youth effect is still strong at 20-29. @ 12% of population, 8.1% of cases and 7 of 923 deaths. In my age group (of particular interest...