Cont: The One Covid-19 Science and Medicine Thread Part 2

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The Don said:
Sure, but it's only because the US is testing. If no tests were done, no cases would be found. :rolleyes:

I worry about if and when the death rate starts climbing again.
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You mean more cases are found because more tests are conducted?

That would probably be putting causation on its head.
It's more likely that the rising number of tests is driven by the rising number of actual infections.

Why? Because the ratio "Tests conducted per confirmed case of COVID-19" has been going down in the USA, from already low levels:
https://ourworldindata.org/coronavi...~CHE~NLD&pickerMetric=location&pickerSort=asc

USA had a plateau high of near 22 tests conducted per confirmed case (which is decent) until third week of June, and since then that has dropped to under 15. That's hardly better than India. Canada, Germany, Switzerland, even the UK by contrast conduct 100 and more tests per confirmed case.
 
Rolfe said:
<...>

The virus has three modes of transmission.

  • Large (Flügge) droplets that are acted on by gravity and which can be avoided by staying 2 metres back
  • Fomite (touch) transmission where an inanimate object like a door handle transfers virus to another host (fomites become contaminated either by touch or by having droplets land on them)
  • Aerosol droplets that are small enough to remain suspended in the air for some time, probably around half an hour. These contain significantly fewer viral particles than Flügge droplets and so more need to be inhaled in order to acquire an infectious dose, on the other hand they're easier to inhale right into your lungs
<...>
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Hope you don't mind me using your post as a jumping-off point for a question I've had regarding surfaces. I have zero background in the whole virology thing so excuse the ignorance of the following.

Let's say we have an infected surface like a door handle used by several people. I touch the handle and get nasty stuff on my hands, but I don't touch anything else with that hand until I properly clean it (soap+water/sanitizer/whatever). I and others do this several times per day - touch an infected surface, but properly clean up before touching anything else.

Does the level of the virus go down each time it gets touched? Meaning, does it becomes 'less dangerous/infectious/whatever' as it gets touched by multiple people? And if so is that to any level which makes an appreciable difference? Or is it only time and/or direct cleaning which has an actual impact on that?
 
Joe Random said:
Hope you don't mind me using your post as a jumping-off point for a question I've had regarding surfaces. I have zero background in the whole virology thing so excuse the ignorance of the following.

Let's say we have an infected surface like a door handle used by several people. I touch the handle and get nasty stuff on my hands, but I don't touch anything else with that hand until I properly clean it (soap+water/sanitizer/whatever). I and others do this several times per day - touch an infected surface, but properly clean up before touching anything else.

Does the level of the virus go down each time it gets touched? Meaning, does it becomes 'less dangerous/infectious/whatever' as it gets touched by multiple people? And if so is that to any level which makes an appreciable difference? Or is it only time and/or direct cleaning which has an actual impact on that?
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Lots of factors to consider. The virus won’t survive for long on a surface, it won’t get absorbed through skin, if you wash your hands regularly you will kill the virus. There’s a slight risk of getting infected if an infected person sneezes on their hand touches the handle, then you touch the handle and touch your face in a way that the virus can get to your mucosal surface. In my opinion. Transmission is more likely from you sharing airspace, in other words you breathe in what they jus breathed out. Wear a mask if you’re positive, wash your hands and avoid crowded indoor places.


Sent from my iPhone using Tapatalk
 
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Rolfe said:
Yes there are people who should know better using the word "airborne". That doesn't make it right. It's scaremongering and it's playing into the hands of people who want to abandon lockdowns and even social distancing and believe the virus can't be stopped.

ETA: https://www.bbc.co.uk/news/world-53329946

This is nuts. Aerosol spread has been known about for months. I was writing emails about it to friends in musical circles in April. Now the WHO is saying it "can't be ruled out"!? I mean where have they been? And they're calling it airborne, which is disastrously wrong.

At least the professor who is quoted in the article gets the terminology right, but this shouldn't be allowed to continue. Aerosol and airborne are two completely different modes of transmission and they must be distinguished.

And if people are still saying things like "if this is confirmed" and "we may need to change the guidelines" at this stage, where have they been for the past four months? People have been writing about this for months and if anyone had any doubts at all then Skegit Valley (10th March) should have knocked them on the head.
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Your own link answers the "where have they been" question. It's called politics.

"In healthcare settings, if aerosol transmission poses a risk then we understand healthcare workers should really be wearing the best possible preventive equipment... and actually the World Health Organization said that one of the reasons they were not keen to talk about aerosol transmission of Covid-19 is because there's not a sufficient number of these kind of specialised masks for many parts of the world," he said.
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This is the same BS reason the CDC was claiming no asymptomatic spread, not enough tests and PPE. Finally in a news interview just this week Fauci was asked, "Why not just say there was asymptomatic spread but not enough tests and PPE and Fauci danced around the answer.


And said professor should know better. Sounds like they are making excuses. Droplet spread: generally droplets go about 3 feet from the source. Six feet apparently with highly infectious diseases. Three feet has been the standard here defining droplet spread.
This again is from your link:
But 239 scientists from 32 countries don't agree: they say there is also strong evidence to suggest the virus can also spread in the air: through much tinier particles that float around for hours after people talk, or breathe out.
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That's the bloody definition of AIRBORNE.

To claim aerosols aren't "airborne" particles is DOWNPLAYING the mechanism of spread using misleading and frankly ludicrous semantics.


I can't speak for the guidelines in the UK that do or do not need revising. I've complained since the beginning of this thread about the bad CDC guidelines here in the US, first claiming asymptomatic persons were not spreading the infection long after we had good evidence they were.

Then came the CDC admitting to asymptomatic spread. The CDC in the US and the WHO have only recently begun to consider said aerosols are spreading infection. We've had evidence for a while now that droplet spread isn't sufficient to account for all spread.

There is a reason more than 200 scientists have petitioned the WHO to revise its guidelines and it's not because they don't know the definition of airborne.
 
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Bob001 said:
Don't make me read something I can't understand anyway. Is the conclusion that people contract covid primarily by inhaling aerosols? If that's the case, why wouldn't masks over the nose be at least somewhat effective? Apparently medical workers who spend their time in close contact with covid patients but who wear surgical (not N95) masks are less likely to ge sick than the general population with ordinary social contact.

And if we need to not breathe through our noses, maybe swimmers nose clips would make more sense than plugs.
https://www.amazon.com/Speedo-75310...search-10&pf_rd_t=BROWSE&pf_rd_i=3418821&th=1
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The paper describes a gradient of numbers of virus particles from the nose down.

It means those people wearing their masks below their noses are putting others at risk.

From the paper:
These speculations describing the early pathogenesis of
SARS-CoV-2 upper and lower respiratory tract disease are
consistent with recent clinical observations. The data from
Wo¨ lfel et al. (2020) in COVID-19-positive subjects support the
concept of early infection in the upper respiratory tract (0–5 d)followed by subsequent aspiration and infection of the lower
lung. These authors focused on the oropharynx as a potential
site of the early virus propagation. As noted above, however, a
nasal-oropharyngeal axis also exists, which has two implications.
First, the nasal surfaces could seed the oropharynx for
infection. Second, it is likely that oropharyngeal secretions
reflect a mixture of local secretions admixed with a robust contribution
of nasal mucus and virus
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That is also consistent with early infection being a high risk of spread.

The problem trying to interpret this information meaning the nose is the only portal of entry, is that that conclusion, while maybe hinted at, is not supported by the data.

They are saying we looked at the the virus and we see it reproduces first in the nasopharynx cells then spreads to the cilia cells in the trachea.

What they aren't saying is there are no other places in the airway the virus can take hold.

If I were working in the hospital I might consider a nose plug under my mask but not in place of the mask.

Remember though, if you plug your nose you breathe harder in and out of your mouth. That condition was also not tested in this study.
 
lomiller said:
Covid-19 does infect dogs, cats, ferrets and hamsters. While cat-human transmission hasn’t been documented cat to cat and human to cat transmission has, so it’s reasonable to expect cat’s can infect humans as well. Cats also seem to remain largely asymptomatic while spreading the virus to each other. Animals do not seem to be a major factor in spreading the disease but they serve as a reservoir for the virus to cross back over into the human population.

Another issue is that immunity in Corona viruses tends to be relatively short-lived. 1-3 years is a reasonable expectation in which case eliminating it would require vaccinating every person on earth every year or two.
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To be a reservoir, these animals also have to spread it to each other (in addition to spreading it back to humans). One thing that happened so far with the H5N1 bird flu is people got it when closely exposed to infected poultry. And they spread it to family members. But it hasn't as yet taken off in human population because the virus needs another couple of genetic changes before it is well adapted to human cells. And it needs that adaptation in order to be an efficient reproducer of virus in numbers large enough to then spread more easily person to person.

This is the reverse, probably. Despite animals in close contact with the virus getting infected, they aren't producing large numbers of virus.

To get infected you need the susceptible host (us or animals), the dose has to be sufficient, and it needs a portal of entry. There are lots of pathogens that take a large dose of the microorganisms to start an infection. And there are some that take very few of the buggers to get a foothold.
 
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How timely (because they are discussing bad information from official medical sources). I just listened to a podcast on NPR's 'The Daily' which is from the NYT.

NYT Podcast, 07/09/20: A Missed Warning about Silent Corona Virus Infections. (Sorry, no transcript yet but this is so worth everyone's 32 minutes.)

At the end of January, long before the world understood that seemingly healthy people could spread the coronavirus, a doctor in Germany tried to sound the alarm. Today, we look at why that warning was unwelcome.
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Remember that ophthalmologist who tried to sound the warning in China but he was arrested?

How different are we from that? We don't arrest people but that doesn't mean we don't shut them up. This is a story about a German man who had a visitor from Wuhan at the end of Jan. That visitor did not feel ill until he was on the way home. When the man in Germany felt ill a few days later and went to the doctor, he was diagnosed as the first case of COVID 19 in Germany.

The doctor wrote a professional letter about the asymptomatic spread. Instead, the BMJ editors (I think it was the BMJ and the editors) argued against the asymptomatic spread and instead claimed the man from Wuhan actually did have symptoms. Thus they quashed the medical opinion of the doctor who made the diagnosis and replaced it with their own that the visitor had symptoms.

On today’s episode:

Matt Apuzzo, an investigative reporter for The New York Times based in Brussels.

Dr. Camilla Rothe, an infectious disease specialist at Munich University Hospital.
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They discuss the political reasons asymptomatic spread was denied at first. And that denial came from officials like the CDC in the US and the WHO. This has been a real eye-opener for me just how much political influence is playing on the public information these organizations are putting out. I rationalized that made sense when the WHO refused to upgrade the threat to an official pandemic. Now I see there was more to it than a simple formula for upgrading the threat.

Now these officials don't want to publicly admit there is some airborne spread. If they did that they would have to admit health care workers were not adequately protected even when they do have PPE. They would have to provide at least N95s for health care workers even though an N95 doesn't provide perfect protection either. But it is better than a surgical mask.


Guardian; Back in mid-April: Coronavirus is killing far more US health workers than official data suggests
The number of healthcare workers who have tested positive for the coronavirus is probably far higher than the reported tally of 9,200, and US officials say they have no comprehensive way to count those who lose their lives trying to save others.

The Centers for Disease Control and Prevention released the infection tally on Tuesday and said 27 health worker deaths have been recorded, based on a small number of test-result reports.

Officials stressed that the count was drawn from just 16% of the nation’s Covid-19 cases, so the true numbers of healthcare infections and deaths are certainly far higher.
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27 is bull ****. There are hundreds of health care worker deaths in the US alone. You can bet that 27 is the result of the CDC tamping down on the criteria needed to say a health care worker died of COVID 19 they got on the job.


Next the not airborne lie. And are we sure about this "kids aren't spreading it, open the schools" assertion?
 
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Skeptic Ginger said:
How timely (because they are discussing bad information from official medical sources). I just listened to a podcast on NPR's 'The Daily' which is from the NYT.
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This's a good podcast. Would be great to get some inside views how these facts were looked at by the different country's health departments. WHO is very afraid to do anything that might impact international trade and travel. Intrinsic bias.
NYT Podcast, 07/09/20: A Missed Warning about Silent Corona Virus Infections. (Sorry, no transcript yet but this is so worth everyone's 32 minutes.)

Remember that ophthalmologist who tried to sound the warning in China but he was arrested?

How different are we from that? We don't arrest people but that doesn't mean we don't shut them up. This is a story about a German man who had a visitor from Wuhan at the end of Jan. That visitor did not feel ill until he was on the way home.
Click to expand...

The Doc tried, but not able, to contact the woman after she returned to Wuhan and so was only able to go by the observations of her work while in Germany where she exhibited no signs of any illness to others.

After returning to Wuhan and getting sick she retrospectively related that she had woken up feeling under the weather and attributed it to jet lag. She took a 999 (Chinese cold tablet containing mostly acetaminophen) and went back to bed. She felt fine the rest of her time there.

So that got published in Science by the other researchers and they also requested NEJM pull the original letter as flawed. NEJM did not and considered the squabble largely semantics.

But this does show the ambiguity of discriminating common aches and pains from "symptoms." People oh so love having binaries. Either you have this symptom or or you don't. When you combine this with the political issues involved it's really messy.
 
Rolfe said:
As far as I know cats have not been shown to be a significant driver of this epidemic in any meaningful way. As you say, nobody has been shown to have caught it from a cat and cats are not themselves seriously ill if they catch it.
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Thanks for that.


"Here Mr Twinkles....come to daddy Mr Twinkles..."
 

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From Scientific American:

Mounting Evidence Suggests Coronavirus Is Airborne—but Health Advice Has Not Caught Up
(July 8, 2020)

After months of denying the importance of aerosol transmission of SARS-CoV-2, the World Health Organization is reconsidering its stance​
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In Lidia Morawska’s home city of Brisbane on Australia’s east coast, roadside signs broadcast a simple message: ‘Wash hands, save lives.’ She has no problem with that: “Hand washing is always a good measure,” says the aerosol scientist, who works at the Queensland University of Technology. But the sign might be outdated.

Converging lines of evidence indicate that SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, can pass from person to person in tiny droplets called aerosols that waft through the air and accumulate over time. After months of debate about whether people can transmit the virus through exhaled air, there is growing concern among scientists about this transmission route.

This week, Morawska and aerosol scientist Donald Milton at the University of Maryland, College Park, supported by an international group of 237 other clinicians, infectious-disease physicians, epidemiologists, engineers and aerosol scientists, published a commentary in the journal Clinical Infectious Diseases that urges the medical community and public-health authorities to acknowledge the potential for airborne transmission. They also call for preventive measures to reduce this type of risk.

. . .

But this conclusion is not popular with some experts because it goes against decades of thinking about respiratory infections. Since the 1930s, public-health researchers and officials have generally discounted the importance of aerosols — droplets less than 5 micrometres in diameter — in respiratory diseases such as influenza. Instead, the dominant view is that respiratory viruses are transmitted by the larger droplets or through contact with droplets that fall on surfaces or are transferred by people’s hands. When SARS-CoV-2 emerged at the end of 2019, the assumption was that it spread in the same way as other respiratory viruses and that airborne transmission was not important.
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marting said:
This's a good podcast. Would be great to get some inside views how these facts were looked at by the different country's health departments. WHO is very afraid to do anything that might impact international trade and travel. Intrinsic bias.


The Doc tried, but not able, to contact the woman after she returned to Wuhan and so was only able to go by the observations of her work while in Germany where she exhibited no signs of any illness to others.

After returning to Wuhan and getting sick she retrospectively related that she had woken up feeling under the weather and attributed it to jet lag. She took a 999 (Chinese cold tablet containing mostly acetaminophen) and went back to bed. She felt fine the rest of her time there.

So that got published in Science by the other researchers and they also requested NEJM pull the original letter as flawed. NEJM did not and considered the squabble largely semantics.

But this does show the ambiguity of discriminating common aches and pains from "symptoms." People oh so love having binaries. Either you have this symptom or or you don't. When you combine this with the political issues involved it's really messy.
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Thanks for the details. By the time I wanted to post about it, I didn't recall the details and didn't want to listen to it again to get those bits right in my post.
 
novaphile said:
Will 113 cases in a single school help to up-play it?

https://www.abc.net.au/news/2020-07...-covid19-cluster-melbourne-truganina/12437584
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Missouri summer camp virus outbreak raises safety questions

An overnight summer camp in rural southwestern Missouri has seen scores of campers, counselors and staff infected with the coronavirus, the local health department revealed this week, raising questions about the ability to keep kids safe at what is a rite of childhood for many.

Missouri is one of several states to report outbreaks at summer camps. The Kanakuk camp near Branson ended up sending its teenage campers home. On Friday, the local health department announced 49 positive cases of the COVID-19 virus at the camp. By Monday, the number had jumped to 82.

...

Missouri’s outbreak at a camp operated by Christian-based Kanakuk Kamp has done little to change the way that state is handling summer camps, which essentially calls for camp operators to consult with their local public health agency to craft plans to keep kids and staff safe. Camps must report any positive cases to the state.

Dr. Randall Williams, director of the Missouri Department of Health, said Monday that his agency had no plans to shut down summer camps in the wake of the Missouri outbreak.

“We think school is incredibly important to kids. We also think camps are important,” Williams said.

In fact, the camp plans to reopen later this summer once test results from all staffers are returned and show it’s safe to do so, Williams said.
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Kanakuk orients towards suburban churches with a large youth ministry. It's more of a dorm-style vacation lodge. These kids don't do real camping, they are indoors half the day. Every evening is basically a 4 hour long service, everyone seated in rows, lots of choral singing, basically the worst things you can do.
 
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Skeptic Ginger said:
To be a reservoir, these animals also have to spread it to each other (in addition to spreading it back to humans). One thing that happened so far with the H5N1 bird flu is people got it when closely exposed to infected poultry. And they spread it to family members. But it hasn't as yet taken off in human population because the virus needs another couple of genetic changes before it is well adapted to human cells. And it needs that adaptation in order to be an efficient reproducer of virus in numbers large enough to then spread more easily person to person.

This is the reverse, probably. Despite animals in close contact with the virus getting infected, they aren't producing large numbers of virus.

To get infected you need the susceptible host (us or animals), the dose has to be sufficient, and it needs a portal of entry. There are lots of pathogens that take a large dose of the microorganisms to start an infection. And there are some that take very few of the buggers to get a foothold.
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Cats have been show to spread it to each other and do shed infectious viruses in relatively large amounts of the virus when they are infected. Minks are susceptible as well had are suspected to have passed the virus back to humans after being infected.

While the chances of getting COVID-19 this way is low, it doesn’t need to be common for it to be a viable way to jump back into human populations should we be luck enough to eliminate the virus in humans. (Don’t abandon your cat due to COVID-19 you are a much greater risk to infect it that it is to infect you) I’m strictly speaking to the suggestion we could easily eliminate this virus altogether because it has no animal repository. On the contrary, in its current form it seems to jump species relatively easily.
 
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lomiller said:
Cats have been show to spread it to each other and do shed infectious viruses in relatively large amounts of the virus when they are infected. Minks are susceptible as well had are suspected to have passed the virus back to humans after being infected.

While the chances of getting COVID-19 this way is low, it doesn’t need to be common for it to be a viable way to jump back into human populations should we be luck enough to eliminate the virus in humans. (Don’t abandon your cat due to COVID-19 you are a much greater risk to infect it that it is to infect you) I’m strictly speaking to the suggestion we could easily eliminate this virus altogether because it has no animal repository. On the contrary, in its current form it seems to jump species relatively easily.
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I see they are culling all the minks when COVID hits a mink farm.
 
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