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The One Covid-19 Science and Medicine Thread

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Yes, obviously. What's your point?

Stop passing on word of mouth stuff that isn't validated. That's why I got interested in the JREF in the first place. I wanted to work on stopping bad medical beliefs from being passed on from person to person: vitamin C cures colds, homeopathy, the flu vaccine makes you sick, you can't get infected through your mouth.

Is this not the ISF? Or are we now just chit-chatting about whatever we heard somewhere?
 
But assuming a lockdown which has now gone on for quite a while, why are the new cases still so large? I contend that there are a LOT more people sharing air that shouldn't be still at this point

But I'm open to some unknown foodborne outbreaks

or maybe even a bunch of apartments sharing air between all the different units?

But given what I see of pictures and videos, it seems like still way way way too many people in close contact
I think it will be quite a while before the NY/NJ/CT “hotspot” can be fully understood.

It’s a very diverse place, and a lot of people were, and are, going to work every day. By subway. Social distancing, masks, etc certainly help. But it’s still a long way from testing everyone who wants/needs testing. And the turnaround is often still days, not minutes.

One snapshot: it took a long time for several of the ultra-orthodox Jewish communities to accept the need for social distancing. Before that acceptance, for example (IIRC), five rabbis in one such community in northern NJ died. Of Covid-19.

There’s a historical irony: this same tri-state area (plus Pennsylvania) bore the brunt of Hurricane Sandy, though far fewer deaths then.
 
....


I'll be interested to see what Germany comes up with, because I don't trust the LA numbers at all, which is probably why they didn't bother seeking peer review before publishing - they knew it was crap.

The LA numbers have not come out yet, only the Santa Clara County numbers that used a biased sample of 3300 subjects. LA used 1,000 random. But their pre-release info was "not as high as, but not a magnitude off either". Plus there is a 3rd test also by Stanford, done in San Jose. Numbers also due out Monday. I think it used the same instant system as LA.

What the serology test will show is that for every person WITH SYMPTOMS who tested positive by nasal swab, there were 20-50 for whom the disease came and went, without any serious signs or symptoms. Which means herd immunity is building faster than we thought. We can get a good guesstimate of when to stop the quarantines.

And maybe all those symptomless cases will give a better handle on the risk factors? Say, ventilation systems? Not the grocery store cart handles, the grocery store ventilation? NYC apartments? Ski resort lodges? Caloifronia has a low rate, nice weather too, and open windows?

Now people discuss whether serology means immunity. Seems to me it has to, or there would be no "recoveries", patients would just stay sick. Question actually is, how long does that immunity last? Or does recovery merely mean the cytokine storm is over? Active IgG is gone, but the fact that IgM is still there means nothing?
 
To add: it’s not high density living, or crowded subways, per se, that inevitably leads to a runaway epidemic. After all, Hong Kong beats New York City hands down in that regard (likely Tokyo, Seoul, Singapore, ... too).

An advantage HK has, over the Big Apple: they learned from SARS, because they had to. So no need to recommend face masks, for example (though they did); people wore them anyway.
 
I think it will be quite a while before the NY/NJ/CT “hotspot” can be fully understood.

It’s a very diverse place, and a lot of people were, and are, going to work every day. By subway. Social distancing, masks, etc certainly help. But it’s still a long way from testing everyone who wants/needs testing. And the turnaround is often still days, not minutes.

One snapshot: it took a long time for several of the ultra-orthodox Jewish communities to accept the need for social distancing. Before that acceptance, for example (IIRC), five rabbis in one such community in northern NJ died. Of Covid-19.

There’s a historical irony: this same tri-state area (plus Pennsylvania) bore the brunt of Hurricane Sandy, though far fewer deaths then.

NYC is also starting the biggest random serology testing. 2,000 people per day, 14,000 per week. Results in a week.
 
Dear SK,

You tend to over react to many posts. I only suggested that it was hypothetically conceivable skin possessed some inherent antimicrobial activities, or not, and only suggested to not be completely dismissive of the possibility. Obviously any such activities are not enough to consistently protect us. The reason to do handwashing, duh, but an evolutionary benefit, if true, before the development of soap.

Well surprise, skin is known to synthesize and display on its surface antibacterial peptides.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639779/

There is an enormous amount of RNase on the skin surface, although I don’t see how this could penetrate intact, infectious RNA viruses.

If you have studies that prove skin has no antiviral activities versus an inorganic surface I would like to read them. Honestly.
(bold is mine)

I did not dismiss it. I said we shouldn't be passing on unsupported assertions. You said:
... Skin has a variety of anti-microbials and I can imagine that some skin oils for example might help disrupt viral envelopes to some degree. Or not. I just don’t think it is established one way or another....
But remember you said it in support of Squeegee's post:
I have seen advice against gloves. The argument is that your skin's natural secretions can help the virus' lipids to break down, whereas rubber gloves just transmit it from place to place.

How true that is I don't know.
If you don't know if it is true or not, look into it before passing unsupported speculation on.

You implied Squeegee's post contained a valid hypothesis, fine, I said prove it. Prove it is a valid hypothesis, don't just assert it without any source. Take the time to look into it before posting it where you know people will run with it.

OK, good, here is something valid we can actually discuss. It does not support the assertion anything on our hands kills enveloped viruses. But it's a start to find out if that is the case or not.

The majority of that paper is about inflammatory reactions on the skin, not like the macrophages in the lung that actually attack microorganisms.

Skin Immune Landscape: Inside and Outside the Organism
In fact, the skin surface is cohabited by microorganisms recognized as skin microbiota that live in complete harmony with the immune sentinels and contribute to the epithelial barrier reinforcement. However, under stress, the symbiotic relationship changes into a dysbiotic one resulting in skin disorders. Hence, the skin microbiota may have either positive or negative influence on the immune system. This review aims at providing basic background information on the cutaneous immune system from major cellular and molecular players and the impact of its microbiota on the well-coordinated immune responses in host defense....

...Moreover, the skin forms a complex and dynamic ecosystem colonized by about 1012 microorganisms including bacteria, fungi, and viruses known as skin microbiota.
The article is clear that any immune response against a microbial assault requires it to be triggered.

This article supports the assertion the immune response has to be triggered. It isn't like our skin contains natural disinfectants:
The Dynamics of the Skin’s Immune System
In the event of an insult, the skin-resident immune cells are crucial not only for prevention of infection but also for tissue reconstruction. Deregulation of immune responses often leads to impaired healing and poor tissue restoration and function. In this review, we will discuss the defensive components of the skin and focus on the function of skin-resident immune cells in homeostasis and their role in wound healing.

Given the enveloped coronaviruses aren't likely to upset the skin biome unless that is the virus' target cell (like HSV and HPV) we need to look further.


I didn't have good luck looking for coronavirus on hands, too many articles on hand washing show up. But I did find some related articles:

Survival of influenza virus on hands and fomites in community and laboratory settings.

H1N1 doesn't survive long on hands but the exact time isn't in the abstract. However:

Fomite-mediated transmission as a sufficient pathway: a comparative analysis across three viral pathogens
We developed and analyzed a compartmental model that explicitly accounts for fomite transmission by including pathogen transfer between hands and surfaces. We consider two sub-types of fomite-mediated transmission: direct fomite (e.g., shedding onto fomites) and hand-fomite (e.g., shedding onto hands and then contacting fomites). We use this model to examine three pathogens with distinct environmental characteristics (influenza, rhinovirus, and norovirus) in four venue types. To parameterize the model for each pathogen we conducted a thorough literature search....

Conclusions
Fomite-mediated transmission is an important pathway for the three pathogens examined. The effectiveness of environmental interventions differs significantly both by pathogen and venue. While fomite-based interventions may be able to lower ℛ0 for fomites below 1 and interrupt transmission, rhinovirus and norovirus are so infectious (ℛ0>>1) that single environmental interventions are unlikely to interrupt fomite transmission for these pathogens.

This suggests it is the viability of the microorganisms on hands is related to the pathogen more than the skin surface.

To find out if coronavirus is more easily transferred by a gloved hand than an ungloved hand is a moot point if they both can become contaminated and transfer the virus. If you add the fact skin oils can act as a transfer medium....

But if someone wants to investigate the glove vs hands claim, have at it.


So are we chit-chatting or are we discussing evidence based information?
 
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But assuming a lockdown which has now gone on for quite a while, why are the new cases still so large? I contend that there are a LOT more people sharing air that shouldn't be still at this point

But I'm open to some unknown foodborne outbreaks

or maybe even a bunch of apartments sharing air between all the different units?

But given what I see of pictures and videos, it seems like still way way way too many people in close contact

You won't likely see a foodborne outbreak because it would be a contaminated surface of the food rather than a broader contamination.

But we don't know for sure. Some pathogens have been a contaminate of things like green onions after getting into the rinse water.
 
This article does a great job of explaining the value of serologic tests. It also is one of the rare pieces that describes the problem with the Stanford study. It's a really good article. The guy understands statistics.

https://finance.yahoo.com/news/fastest-way-end-lockdowns-004102410.html

Cuomo said they are going to do a very broad serological survey all over the state to estimate how widespread the virus is. He said it would take a week. I am excited to see the results of the survey.

He also noted there are many versions of the test by different companies and they weren't interchangeable. That creates a problem.
 
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To add: it’s not high density living, or crowded subways, per se, that inevitably leads to a runaway epidemic. After all, Hong Kong beats New York City hands down in that regard (likely Tokyo, Seoul, Singapore, ... too).



An advantage HK has, over the Big Apple: they learned from SARS, because they had to. So no need to recommend face masks, for example (though they did); people wore them anyway.

Yeah, I noticed early on that so many photos from SE Asia showed universal mask use and lots of gloves, too.

Perhaps more importantly, as you say, a cultural understanding and acceptance of what these things are, how, and when to use them.
 
Cuomo said they are going to do a very broad serological survey all over the state to estimate how widespread the virus is. He said it would take a week. I am excited to see the results of the survey.

Me too! We are going to know a lot more in the next few weeks.

He also noted there are many versions of the test by different companies and they weren't interchangeable. That creates a problem.

Yep. OTOH, we will get a lot of info on which tests actually produce results consistent with what they stated during their emergency approvals as well as the few that have gone through the full FDA process.

I expect a lot more clarity in a few weeks.

One thing that knaws at me is the differences which are quite large. For 75% of the choir group to become symptomatic and all the ones tested were PCR positive and yet 10x more asymptomatic v symptomatic elsewhere seems irreconcilable.

This need to be understood.
 
The photos and video always show a ground-level view, often with a telephoto lens. This tends to crowd very distant things together in the images, making the beaches look a lot more crowded than they actually are. When they switch to the drone or aerial shot, the actual distancing is quite evident.

But yes, from a side view the shots of people for example on the boardwalk does show that many of them are not maintaining their distances. I think for couples and small families that's ok, but I'd often see converging groups of people which are a no-no.
Here is a photo from this afternoon in Florida. I understand what telephoto lenses do, but I still think we see people that are too close. Also, I can't find a single mask on anyone.
 

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Here is a photo from this afternoon in Florida. I understand what telephoto lenses do, but I still think we see people that are too close. Also, I can't find a single mask on anyone.

I suspect that the beach and outside in general is a pretty low risk place with or w/o masks. Lots of dilution and air movement. Much better than being in a grocery line for 10 minutes even with masks.
 
Me too! We are going to know a lot more in the next few weeks.



Yep. OTOH, we will get a lot of info on which tests actually produce results consistent with what they stated during their emergency approvals as well as the few that have gone through the full FDA process.

I expect a lot more clarity in a few weeks.

One thing that knaws at me is the differences which are quite large. For 75% of the choir group to become symptomatic and all the ones tested were PCR positive and yet 10x more asymptomatic v symptomatic elsewhere seems irreconcilable.

This need to be understood.
Good point. Do we know if any of the symptomatic persons had such mild symptoms were they not looking for them they would have ignored them?

I'm more skeptical of the results of the 200 random people though. That's the number that seems way off.

We still don't know the actual specificity of these tests (false positives).
 
I suspect that the beach and outside in general is a pretty low risk place with or w/o masks. Lots of dilution and air movement. Much better than being in a grocery line for 10 minutes even with masks.
Does that mean it's ok to include this level of risk along with standing in grocery aisles?

I see an argument for curbside pickup only at stores more than I see a "people crowding beaches and parks is fine" one.

YMMV.
 
Noteworthy from New Zealand:

We've been carrying out community testing over the last four days, concentrating on areas near existing clusters and ~1600 tests haven't found a single case. If there were ten or more times the number of infections as official cases, someone would have shown up. Small numbers, but in a small population and the equivalent of USA testing 120,000 people randomly.

That's very good news for us, and with Aussie starting community testing today or tomorrow, we might be able to keep this end of the world safe.

Feel free to come down from the end of the month, but you'll be spending the first 14 days locked own in quarantine.
 
Ummm, if serology tests are showing up the fact that many people actually have the disease without symptoms, vs the 90% of people with symptom who are negative for the nasal swab test, does that put the lie to the statement that asymptomatic people can spread the disease?

Maybe I need to draw a picture, big blocks, little blocks, arrows,.... Venn diagram maybe?
 
Ummm, if serology tests ...

...results are reliable and peer-reviewed, they will be worth discussing.

In the meantime, I have a non-peer-reviewed geology paper that shows some amazingly profitable gold mines just waiting to be dug up, so PM me anytime if you're interested.
 
According to a NY Times article, runners can drag exhaled droplets up to 30 feet behind them and even walkers can drag exhaled droplets up to 15 feet behind them.

https://www.nytimes.com/2020/04/15/well/move/running-social-distancing.html

Runners are also exhaling deeply and strongly.

While there is dilution from distance, recent research has show normal breathing produces some droplets and aerosols. Talking produces about 10x more. And loud talking 100x more. Seems pretty obvious that people singing and runners would produce even more. So it's probably good advice to keep a good distance outside from joggers and people shouting.

Baseball isn't going to be the same for a while.
 
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