Wuhan Coronavirus

[Trapper John]

Originally Posted by mugwump

It’s nice to know someone's looking ahead. Every time I’ve gotten involved in these things it’s been a panicky game of catch-up. Incredibly stupid.

On the good news front and in line with a proactive approach, Singapore looks Ike they may have beaten this back, at least for now. Community spread is fading and they’re barely keeping up with contact tracing, but barely is good enough.

Do you follow Prime Minister Lee? Amazing guy with amazing cooperation among the Singaporeans. He credits everything to the people—and good luck.

He never takes credit but he’s personally met with taxi drivers, HCWs, hospitality workers, finance groups...and he leaves behind actionable policy directives and a sense of optimism.

Taxi drivers know how to asses symptoms in their fares, exactly where to bring someone w symptoms, how to warn the hospital ER teams they’re coming, how to protect themselves and decontaminate their taxis...Same same with hotel workers, office workers, etc. Damn impressive.

Japan on the other hand is teetering. Fingers crossed.

I have not followed Lee, but based upon what you posted, maybe I should. It sounds as if he is a decentralized bottom-up leader type? That's why he is effective.

Taking a step back and looking at how this whole thing has evolved, clearly points out China's weaknesses and why China will ultimately fail. But I digress!

[Last hard class]

I watched "The Big Short" last night. The two young guys who made their money betting on bad things happening seems rather timely. Their philosophy was that people never believe bad things will happen so when it does the outcomes pays big.

Lose small, win big.

I have a few suppliers in China. All have been affected in some way. A couple have not gone back to work yet from the CNY . They were expected back on the 2nd. The others are on restrictions. Allowed out one day and not the next kind of thing. Saw some satellite images of china with much less smog than usual. If China is running below 70% normal capacity we are going to feel it by summer.

Macau casinos have been cleared to reopen. That's either a very good sign or a very foolish decision based on politics. Here's to it being option 1.

For the most part it seems like Americans think the world is not really connected. That a massive tragedy in China wont affect us here. For my own peace of mind I have purchased a few supplies just in case. Things that wont be available if actually needed (always knew that medical cross training we did the morning after a night of drinking would pay off ). Already seeing price gouging online. Hopefully the virus burns itself out this spring and my supplies will be expensed under Lose Small.




LHC

[InTheBlack]

Originally Posted by Last hard class

Lose small, win big.
...
my supplies will be expensed under Lose Small.

I remember when Bitcoin was $10. I would have bought some but could not figure out how to do the damn Wallet. I'd have a million now...

My supplies are an insurance expense.

Still not sure if I can use denatured alcohol for skin decon, or if I have to pay for liquor. OTOH Fed law allows individuals to distill IIRC 25 gallons a year for personal use. Where can I get a hobbyist still?

[mugwump]

Just a personal opinion, but I don’t think any mere mortal has the discipline, PPE, training, and wherewithal to avoid exposure if they’re going out in a pandemic. It's too infectious, with too many vectors. Osterholm at CIDRAP is describing it as “trying to stop the wind.”

Again, my opinion only, but talking of decontamination is ultimately pointless. Complete isolation may help you avoid the first wave, hopefully allowing time for vaccine production. But if you’re going out and about and hoping to decontaminate...good luck to you.

I know I’m repeating myself, but...

First order of business is to prepare for the most likely scenarios. There will be near total stoppage of the medicine supply chain. We’re pretty much there now, we're just not feeling it yet. Work on at least a 90 day supply of prescriptions while you can. You’ll not want to go out or possibly you’ll be placed under quarantine (food, water, entertainment, school lessons for prolonged social distancing). If you can, set aside a bit extra for those that didn’t prepare. Plan on home care for the sick, with otc meds and cleaning supplies. If you can swing it, get a stash of cash and and maybe some hard assets.

Chat with your neighbors and relations. If you/they have kids you have to consider parents going down, leaving helpless children in the home. Talk about mutual cooperation. It may increase your personal risk, but as ethical humans we have to take personal risks to protect our community (I know, I know, with this audience that’s teaching granny to suck eggs.) Phone trees for daily checks on each other. Alternate comms plan if the cells are temporarily down.

Decide if it’s worth risking exposure to aid old farts like me and my wife. Hint, it’s not. Families with kids, a different story.

If what I think is going to happen, happens, a bunch of us will fall ill but the majority will come through just fine. If you prepare and it doesn’t hit, you’ll have some supplies you probably should have around anyway. And if you talk about neighborhood cooperation, maybe you’ll build some additional goodwill within your community. We need that now, big time. You’ll have lost nothing and maybe gained in the long run.

And get that flu shot, even this late. It may be 30% effective but that’s 30% fewer people stressing the healthcare system. Those poor guys are totally slammed with flu cases right now and we have to do all we can to help keep the icu beds free.

[doctom54]

Originally Posted by mugwump

......Again, my opinion only, but talking of decontamination is ultimately pointless. Complete isolation may help you avoid the first wave, hopefully allowing time for vaccine production. But if you’re going out and about and hoping to decontaminate...good luck to you.

1918-1919 Pandemic

Worst affected was Western Samoa, formerly German Samoa, which had been occupied by New Zealand in 1914. 90% of the population was infected; 30% of adult men, 22% of adult women, and 10% of children died.

Samoa was very remote in 1919 and they were affected also!

[doctom54]

Originally Posted by mugwump

And get that flu shot, even this late. It may be 30% effective but that’s 30% fewer people stressing the healthcare system. Those poor guys are totally slammed with flu cases right now and we have to do all we can to help keep the icu beds free.

Yes. Yes. yes.

[mugwump]

Originally Posted by doctom54

1918-1919 Pandemic

Worst affected was Western Samoa, formerly German Samoa, which had been occupied by New Zealand in 1914. 90% of the population was infected; 30% of adult men, 22% of adult women, and 10% of children died.

Samoa was very remote in 1919 and they were affected also!

Every ship was a plane back then.

No place to hide, yes. That’s why you plan to be sick. And hopefully never use it.

[EricV]

Sigh... Went to my local Board of Supervisors meeting last night. Suggested that the five member Emergency Management Team which is missing three members be filled out. Suggested that the township get a web page dedicated to the situation. Give advice on hand washing, hygiene, etc.

Got the vacant, dull eyed stare of open mouth air breathers. One guy in the audience with a Chinese wife proclaimed, in so many words, it's a nothing burger.

If it all blows over, I'll happily look the fool. If it doesn't, I guess I'll be a "Hero of the People!!"

Meanwhile, I believe there are 5400 people in voluntary lock down in California...

[T-Rock]

Not sure how reliable twitter is but it appears Qom, Iran, may be under quarantine:

https://mobile.twitter.com/babaktagh...392162818?s=21

https://www.google.com/amp/s/www.alj...125104907.html

Edited to add:
Looks like a British Columbian who visited Iran tested positive:
https://www.google.com/amp/s/beta.ct...1_4821112.html

[InTheBlack]

I previously linked to this paper. I'd like to know more about the CD8+ T cell issue. Maybe the MD's here can read the citation & interpret?

https://www.frontiersin.org/articles...018.00343/full

Back to the Future: Lessons Learned From the 1918 Influenza Pandemic
Kirsty R. Short 1,2, Katherine Kedzierska3* and Carolien E. van de Sand
2018

>
MEDICAL INTERVENTIONS, THERAPIES AND VACCINES: THEN AND NOW
snip

Unfortunately, antibodies elicited by seasonal
influenza vaccines do not provide protection in the case of an
antigenically distinct influenza virus of a novel subtype, such
as A/H5N1 or A/H7N9 (De Jong et al., 2000). Furthermore,
current inactivated seasonal influenza vaccines may even prevent
the induction of cross-reactive CD8+ T cell responses, which
are our primary protection in case of a pandemic outbreak
and may therefore prove to be a double-edged sword (Bodewes
et al., 2009a,b, 2011b,c).

[Ret10Echo]

From LiveScience dot com

Coronavirus 'spike' protein just mapped, leading way to vaccine
By Yasemin Saplakoglu



Stephen Morse, a professor at Columbia University's Mailman School of Public Health who was also not a part of the study agrees. The spike protein "would be the likely choice for rapid development of vaccine antigens" and treatments, he told Live Science in an email. Knowing the structure would be "very helpful in developing vaccines and antibodies with good activity," as would producing higher quantities of these proteins, he added.

[T-Rock]

I can't read Chinese but it looks like Beijing is having some issues:

https://mobile.twitter.com/jennifera...40909882896386

[JJ_BPK]

Originally Posted by T-Rock

I can't read Chinese but it looks like Beijing is having some issues

One of the comments had an interesting side link

Pathogen cross-transmission via building sanitary plumbing systems in a full scale pilot test-rig, Michael Gormley, Thomas J. Aspray, David A. Kelly, Cristina Rodriguez-Gil, Published: February 10, 2017

Abstract

The WHO Consensus Document on the epidemiology of the SARS epidemic in 2003, included a report on a concentrated outbreak in one Hong Kong housing block which was considered a ‘super-spreading event’. The WHO report conjectured that the sanitary plumbing system was one transmission route for the virus.

Empty U-traps allowed the aerosolised virus to enter households from the sewerage system. No biological evidence was presented. This research reports evidence that pathogens can be aerosolised and transported on airstreams within sanitary plumbing systems and enter buildings via empty U-traps.

A sanitary plumbing system was built, representing two floors of a building, with simulated toilet flushes on the lower floor and a sterile chamber with extractor fan on the floor above. Cultures of a model organism, Pseudomonas putida at 106–109 cfu ml-1 in 0·85% NaCl were flushed into the system in volumes of 6 to 20 litres to represent single or multiple toilet flushes. Air and surface samples were cultured on agar plates and assessed qualitatively and semi-quantitatively. Flushing from a toilet into a sanitary plumbing system generated enough turbulence to aerosolise pathogens. Typical sanitary plumbing system airflows (between 20–30 ls-1) were sufficient to carry aerosolised pathogens between different floors of a building.

Empty U-traps allowed aerosolised pathogens to enter the chamber, encouraging cross-transmission. All parts of the system were found to be contaminated post-flush.

Empty U-traps have been observed in many buildings and a risk assessment indicates the potential for high risk cross-transmission under defect conditions in buildings with high pathogen loading such as hospitals. Under defective conditions (which are not uncommon) aerosolised pathogens can be carried on the airflows within sanitary plumbing systems. Our findings show that greater consideration should be given to this mode of pathogen transmission.



https://journals.plos.org/plosone/ar...l.pone.0171556

Aerosolised Pathogens in the sewer systems. Scary..

[mugwump]

Originally Posted by JJ_BPK

One of the comments had an interesting side link



Aerosolised Pathogens in the sewer systems. Scary..

Yeah, this was established to be a real thing and caused documented SARS transmission. Chinese plumbing traps are shallow to decrease space between floors; a 30- story Chinese apt. building is significantly shorter than a 30 story American one.

When it's running, tap water needs boiling (fecal contamination), plumbing is a disease vector, all exits are welded shut, and really bad smells are coming from the apartment next door. Millions are in that boat.

ETA: There's a lot of speculation that tap water might be a significant vector in China. Nobody drinks tap water there, but they do use it to wash dishes, brush teeth, etc. It's generally perceived to be undrinkable due to the carcinogens produced by the ridiculously high levels of chlorination needed (high chlorine+organic material=carcinogenic compounds) but plenty of foreign nationals I know have gotten raging cases of the trots from stumbling to the sink and gulping tap water after an obligatory drunkfest. So, poopie is in the water during the best of times.

Recent research shows the virus is shed from the respiratory system in the first half of the infection and then shifts to the gut for the last half. Fecal transmission.

[T-Rock]

Well, JJ PPK, thanks for sharing that post - and that explains why it's spreading so fast in Iran (as well as other countries), and has the potential to spread exponentially (hopefully not) to us here in the US of A (sincerely hope it doesn't). Nevertheless, don't shake the left hand of a Muslim (Sunni or Shia), because their hands are permanently dusted with shit particles and are probably infested with the SARSCoV2 from those in Qom, and the surrounding cities - Studies have shown not only is this thing airborne, it's also spread via the fecal route, seriously. Lol.
https://www.google.com/amp/s/fortune...nsmission/amp/

One study that I've read shows that by September 2020, ( https://www.medrxiv.org/content/10.1...VgdiEesYBsnER8 )
This Virus will be totally global with an RO of nearly 6.6 and that won't fair well for our healthcare system here in the USA. The hospital where I work has only 4 (true) airborne isolation rooms. It could be disastrous for our hospital & staff considering the infection rate is nearly 30% among health care workers. If we were to have more than 4 cases in our Hospital we would be toast. Let's hope the draconian isolation measures other countries have taken will work. Hopefully the Virus will end up being nothing but its best to be prepared, right?