Just the Facts, the Crown virus.

[SwampDonkey]

First case confirmed in New Brunswick, a woman travelling alone returning from France on a trip.

[DWyatt]

As of yesterday, the Governor closed all school effective 3/16 for 3 weeks. He also shut down all gatherings where 100 or more people were planned to be present. Gosh Darnit that was the woodworking show in Columbus this weekend! >:(

[DMcCoy]

Gov. Brown just closed all public schools K-12.  Warned parents to NOT let kids be babysat by someone over 60.  <24 hrs after giving a press conference(9am) leaving them open.  Concerned over kids infecting teachers.
It's the disease triangle, changing the environment is our only tool.  Getting people to co-operate...

[Magicman]

All of our state's colleges will take another week of "Spring Break" and then resume classes on the 23rd via online.

Some folks have enough TP, bottled water, and sanitizers for the rest of the year and beyond.

[YellowHammer]

Johns Hopkins Coronavirus Resource Center

The good things about some of the things we are stocking is that they are non perishable and they will be used at some point.  Can't ever have enough toilet paper and Pine Sol.

It will be interesting to see how it affects our business tomorrow.  We are making a few adjustments to hopefully reduce everyone's risk, including our own.

[Don P]

My sister wrote overnight, they should be halfway home by now from the holy land. The guides and staff that catered to them are now unemployed, they were the last tour, nothing else is entering. She said they did have the run of the sites and were very well treated and protected which was nice. She had stocked up before leaving so they will probably self quarantine and hole up for a bit. Won't know if it'll be more extensive until they land.

[Wood Shed]

No march madness, no spring training games, whoo! hoo! you teachers three weeks off with pay then it is Easter break, whoo! hoo!

Hopefully they will not close the trail heads here in AZ, if they do I am going home.  :embarassed:

[doc henderson]

I am spending about 3 hours a day making sure we are ready.  they are making efforts to slow it down.  if that does not work, we will all get it.  If that happens, we will see that the mortality is much lower than estimated.  otherwise healthy people may have little or no symptoms, so are not included in the group having it and survived unscathed.  so the flu shot is to slow the spread and keep hospitals open.  I feel most people get influenza each year but only a percentage get sick, and of those, the unwell are the ones who do poorly.  we will be ok!  by next year we will have this under control with rapid tests, vaccine and or anti-viral medications.  The well known corona viruses cause cold in kids, and I wonder if there is some cross protection and that is why we are not seeing kids getting it.  If so, Pediatricians are also prob. immune.  Just like drinking water in Mexico, if you are from there you are ok.  there are about 104 serotypes of strep, and after 10 or so, you are prob. immune to all 104.  My kids have never had antibiotics for strep, and are fine and I am sure they had strep and were not symptomatic enough for their "mean" pediatrician Dad to give antibiotics.  My retirement plan received by check for the whole year of funds yesterday.  We put it in while low. (DOW)  do not panic, and forge ahead!  IMHO

[sprucebunny]

Here is an article by a number cruncher guy.
Coronavirus: Why You Must Act Now - Tomas Pueyo - Medium

It suggests that stopping all travel Now and staying home will flatten the curve of infection. Also contains links to Twitter posts by a DR. in Italy that are pretty grim.

[doc henderson]

It may slow the spread, but if the infectivity does not taper in the spring, we will all get it eventually.  In the beginning the only patients we knew about were critically ill and there fore an exaggerated mortality rate.  If we all had it and the number of deaths stayed the same, then the rate of death would be tiny.  Even if you get the flu shot, you may still get the flu but not be as sick.  If we slow it down, we have time to develop and test drugs, immune therapies, immunizations, ect.  Lots of stuff being used in china, that have not shown any positive effects yet.  basically you develop adult respiratory distress syndrome.  we have been treating it and studying treatment of this for years.  So it might be better if we all got exposed, and some of get sick, and then be over it.  the trouble is half out hospital staff may be off work and then the ED would be unavailable to treat the sick.  we have been preparing for this since 9-11.  about 1/2 of our staff has been to FEMA and trained for potential disasters.

[Hilltop366]

Canadian researchers isolate cause of COVID-19

Progress perhaps?
https://www.thestar.com/news/gta/2020/03/12/sunnybrook-researchers-isolate-covid-19-coronavirus.html

[doc henderson]

regarding testing.  we all have the viral swabs.  must not have a wooden stick handle.  the kits are retained by KDHE, but more labs are getting the kits after being evaluated for quality.  Flu testing is cheap since it is prevalent and been around.  we do a pcr test to include 20 viruses including 3 corona viruses (not the new (novel) virus and this test costs over a thousand dollars.  when everyone is testing + for influenza and we often run out of test kits in a busy year (2017)  and then we just treat based on symptoms.  the thing to remember is there is not treatment specific for corona, so the test is to help know who needs to be quarantined.  We treat the patients with ARDS with support up to and including, a ventilator.  so early testing is for public health folks and not for treatment per se.  If we tested everyone for the covid 18 novel virus, we would at least know what % get sick, and of those the mortality rate.  It can take years to develop a rapid test.  the flu swab takes 20 minutes.  out multi antigen test takes 2 hours and cost over a thousand dollars, and does not cross react with the covid 19 virus.  The world has moved quickly on this out break (pandemic).

[kantuckid]

Great thread on crown virus, thanks Doc and others!

Another forum I visit has some political polarization that this one has avoided, thanks!
One of the newspapers I read (Lexington, KY Herald-leader) has many purely hateful comments towards certain political persons today. I also read the NYT's and expect such from them but some events, like a pandemic?, shouldn't that be immune I would hope? Enough on that for sure, I hope definitely hope I didn't offend anyone by this.

We did our first at home grocery visit yesterday, 3/12/2020 while I was doing an out of town dental appt.. The dental appt. was very normal excepting to be asked if I'd visited Wuhan, China the medial folks act normal. My student dentist and I agreed that we had to break the habit of rubbing our eyes with our hands. The lady who took me to my dental chair set-up in the student lab, Chair #74 BTW!, happened to be the Dental Assistant supervisor and said the only thing she noticed different of recent was that people were stealing the masks and surgical gloves from all the dispensers when nobody was looking!

Early in the day 3/12/2020 the first (small grocery visit where we mostly buy coffee) was normal shelves. Our later, 8p.m. Walmart visit was like the pics above! Empty shelves!!!
Given that we are a 50 mile RT from a serious grocery store it's a problem to find many staples gone, as in zero on the shelf. No TP, no beans, no water, no dairy, no pasta, no canned stuff and the list goes on... We saw many young adult males, obviously sent by their wives, pushing carts filled to the brim with huge amounts of everything known to man! I'm saying grocery orders easily in the $300 range. Also lots of order pickers for the pick up business.  We re-visited the Kroger store for a few items to see that over the time I'd been to my dental visit in another city that they had been hit hard too!
Have we gone zonkers?
Our guv did the similar school closing thing. As a retied educator we had to question the idea to keep the school cafeterias open so the kids can eat? When you live in a mostly rural state exactly how do the brainy leaders think those kids are gonna get to that food miles from home? 

Why close the court system? Can't the numbers be kept mostly small?
I see the girly clubs are open and most food places.
I got an email from Red Lobster telling me how they're keeping it clean. Give me a break! as I'd hoped it was clean there to begin with. Some of this mentality is purely stupid?

I love sports like many people. It seems to me they might have been able to play basketball to a handfull of family members and kept playing? That was the original plan here in KY to allow 4  family per player for the state tournament but it's suspended for now. Maybe I'm wrong but other than the crowds why stop it all?

[doc henderson]

so they isolated the actual virus.  definite help, but will still take years to break it apart.  should be the start of treatment and testing advance.  they are talking about getting plasma from people who test positive and survive (the vast majority) and use the antibodies they produced in response (hyper immune globulins)  but remember the ARDS is an inflammatory response so enhancing the immune response could in theory make the condition worse.  this is why we use steroids in asthma to quell the immune response (allergy, fighting a virus) and decrease the asthma (over reaction) symptoms.  a lot of stuff reported as helping the ARDS in China has been disproven for years in the world scientific community.

[Jeff]

This topic some how inadvertently got quarantined.   Feel free to roam on.

[Ljohnsaw]

I asked a question of Doc while this thread was temporarily off line.  So I will ask it again here so all can see your response:

The Canadians just isolated the virus for further research.  How is that different from the DNA sequencing that was performed back in January?  Didn't they have to isolate the virus to get that?  I was just assuming they had it and were working with it since then trying to come up with some vaccines.

[doc henderson]

thanks Jeff.  I think everyone is doing a good job of sticking to the facts. or being open to them.  early on they found enough genetic material to deem it a novel virus;  now they have isolated the specific virus so they can begin development and testing of new more rapid testing, and work on treatment modalities, like anti-virals, and vaccines.  so as an example, they are considering plasma from a prev. infected individual.  like getting a transfusion of their serum, hopefully containing antibodies that can stop the virus from attaching to antigens, which is how it can enter certain cells.  i.e. prev. only animal cells, and or predilection to antigens more prev. in certain tissues or ethnicities.  they may now be able to develop these in a lab, and not take from another animal.  They can test to see if it is stopped by antibodies to other corona viruses, and maybe that's why kids are not getting it, or at least not getting sick, as they get the normal corona viruses every winter.  viruses are packets of genetic material with proteins that can attach to certain specific antigens.  like a key fitting a lock.  the antigens for 3 known corona viruses we have been checking in the pcr panel, do not cross react with the novel (new) virus.  so when they say it can "live" in the air for 3 hours, or on plastic surfaces for 3 days, they should be saying remain "viable"  meaning able to cause infection.  it can only reproduce by invading a host cell via attaching to a cell membrane and incorporating its genetic material (dna/rna).  so to isolate it was hard as it has to be grown in other living cells like fibroblast cultures (living cell).  If you watch crime shows, they can take a swab of goop, isolate the dna/rna, then multiply it by making copies and then test it.  but never had the intact viral packet.  many cancers are caused by viral interference in our cells dna, like human papilloma virus.

[doc henderson]

this may seem really bad, but just like R&D for military equipment we now use everyday in civilian lives,  this surge of research may find the cure to cancer , or at least help develop anti viral medications that we currently have only a few.  think HIV.  also we have Tamiflu for influenza, but it barely works.  makes you a little less sick and shortens the course of illness from 6 to about 5.5 days.  so for all the suffering, it may advance what we know about viral disease.  

[doc henderson]

brief disclaimer.  I am giving info that most internal medicine and pediatric docs would know.  the world experts all work in big government or university labs.  this is rapidly changing and a new virus.  if you look back, we have had many pandemics, and have never been so prepared to contain it. I am also translating it from scientific to real person language just like I would do for my patients.  Dealing with the sick puts me and my other staff at a higher risk of getting this virus.  I am sleeping very well, and more worried about 500 panicked people shoeing up at the same time.

Pandemic - Wikipedia

[DMcCoy]

doc Henderson
So I have another question which might seem dumb but I would like to know.

2 cases of infection;
1) A person  inhales 1 coronavirus  their body mobilizes to fight.

2)  A person inhales 100 coronavirus and their body mobilizes to fight as well.

So my question if I can ask it correctly.  Does it make a difference?  
I understand that infected can be looked at as 'yes' or 'no', but it also seems that the viral load at the time of initial infection might have something to do with the ultimate outcome.
Thanks,
Dave

[Wood Shed]

This is for anyone who did not get to walmart before the shelves in the TP isle went bare.





Oh sure!  Good luck finding corn cobs now.

[RichTired]

We are sure going to miss the ole Sears catalog. So much better than the corn cobs...



 

[Sedgehammer]

@doc henderson Your thoughts on kids, pediatricians and related. That would also tie in with this is mostly affecting the elderly, since they don't have and aren't around little kids all that much typically. Leastwise here in the states anyways.

[Nebraska]

Just as a fun exercise I calculated the world infection rate as of an hour ago off of the Johns Hopkins site. It came out to .000359% of the world's population  using confirmed cases. I added a 20x  factor to account for unconfirmed cases(just pulled that number out of the air)

Based on the today's number of confirmed cases in the US the rate of infection for us is roughly 000004 % (1300÷330,000,000) with no consideration of unconfirmed cases.  I would have to ask my actuary son but I'm pretty confident it's more dangerous to drive to the box store to get the toilet paper at the moment. Yeah it's going to get higher but even at 20x it's still pretty low.
 Deep breaths be prepared, be aware, don't let this run your world. Go make some sawdust it's theraputic.

[SwampDonkey]

Yeah, but it's 8% in Italy. Wait until exponential growth kicks in. Give it a couple weeks.  2¹, 2², 2³, 2⁴, 2⁵, 2⁶ no big numbers yet, but when we hit 2¹⁰ and onward it gets your attention. ;) Cutting firewood is pretty safe right now. Except there is too much snow and more falling. :D