I’ve heard you mentioned Chinese people collapsing in hospital waiting lines a couple of times as anecdotal evidence of much larger carnage from 2019-ncov. Your conclusion(s) may be correct, but do caution against drawing conclusions specifically from these images/videos as such are common in China.
My wife has made many trips to China in recent years conducting primary research for a US Neurovascular company. She found that their public hospitals are chronically overrun, start with heavy amounts of red tape before one can be admitted and they have no fast lanes for stroke or heart-attack. As such, she was told many times that Chinese people collapsing/dying in hospital waiting lines is a daily occurrence.
I thought I remembered from some past reading, that N95 masks are minimally effective against viruses for healthy individuals. They are proven to be beneficial for limiting the impact of existing sick individuals by helping to block aerosol particles expelled via coughing and sneezing.
I decided to do a search on the size of viruses vs. the stated efficiency of N95 masks. Per the FDA, the N95 “respirator blocks at least 95 percent of very small (.03 micron) test particles”.
A search on the size of viruses gave me the following summary, “.004 to 0.1 microns in size, which is about 100 times smaller than bacteria”.
So, by my layman’s analysis, a virus is smaller than the N95’s capabilities, and this jives with what I remembered from reading I’d done in the past about what the N95 respirator can do. Again, as a layman, I can envision a scenario where some small particles could get snagged on filtering media, while others pass on by. Perhaps the N95 might be partially helpful that way? Perhaps doubling up and wearing two might be worth considering?
Chris mentioned the fever scans of incoming people from overseas at airports was good “kabuki theater” to soothe the masses, but was essentially pointless with contagious, asymptomatic individuals. I started to wonder if that’s what’s going on in China with the N95 respirators? Do officials understand that the masks help limit the damage that sick people can do, while keeping healthy people calm, because they believe they are protected (when the specs on the N95 suggest they are not)?
A couple of years ago, I purchased two CBRN certified face masks. These are protective face masks used by the military and healthcare to protect against Chemical, Biological, Radiological/Nuclear contamination (CBRN). They typically include an integrated full face mask to protect from eye contamination (something that might have killed a Chinese doctor who did not wear eye protection). These masks have a screw on filter(s) that include charcoal as a component, and are apparently more effective at stopping biological threats. They used to be $250 to $400 online depending on the features, but I’m sure that price is going up right now, and like N95 masks, supplies may be becoming limited.
Many of my friends and relatives have run out to buy N95 respirators, and have called or written me, because the are quite excited to be doing something proactive to protect themselves if we end up facing a pandemic. I’ve been uncomfortable about whether I should share this with them, mostly because I’m not a doctor or expert on the subject. I’d appreciate any information available from experts that might reside in the PP community. Thanks.
Chris,
Can you explain how an RO above 3.0 can cause a virus to “burn out”. I also don’t recall is you shared how long it would take to burn out? Finally, what could be the mechanism for taking off again?
@msnrochny,
I’m no expert by any means, but I too thought about the heavy duty breathing protection gear. I’ve read up about what went on with ebola and as I recall one problem with essentially “reusable” gear is that needs to be decontaminated after exposure to bad stuff. This is not a straight-forward task and the do-it-yourself decontaminator can easily expose themselves to the bad stuff on the outside of the mask. Disposable masks are easier to just dump in a plastic bag and get rid of–while wearing disposable gloves which go in the trash next.
But of course this probably applies to all clothing as well. So to be really safe we should probably all have disposable overalls, hoods, booties, etc.
Chris, Dr. Eric Feigl-Ding’s Twitter acct is now up (it appeared to be down last night); he’s posted this Coronavirus Data Map, seems to be updated at least daily: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
And just imagine if he infects just one person…and that person is asymptomatic and goes to the Superbowl in Miami. Boom, the numbers are staggering.
I’m not able to open/enlarge the map. Thanks! 
My great great grandfather died in the Spanish flew, having eleven children. I now, partly, understand how it has affected me and my family, in generations. Talking to elderly relatives I understand that my great great mother and children where tight, but a father figure was missing. It has affected us all, in generations. Just had to mention it.
My girlfriends niece is currently in a Bay Area Hospital, the nurse told her family there is a person in the ICU with a confirmed case of Corona Virus. Anecdotal reports of CV in another Bay Area Hospital, not confirmed.
I have a daughter at University of Washington which has a large number of Chinese students
she received this notice about three suspected cases two of which are still awaiting test results from students who had been living in Campus housing (Dorms) and are now moved to private housing while they await results
Very Unsettling to say the least. She’s already in mask and eye protection mode but I’m considering pulling her out of school if one of those cases gets confirmed. Fortunately she is not on campus housing but that won’t matter much if this takes off.
Note , they did not broadly notify the student body!
she only got the warning from a friend who got it from friend who got it from the mother of a student in a dorm.
universities strike my as likely epicenters if this gets a foothold here. particularly as the timing was unfortunately around the winter break when students may have returned to China as well as the obvious high density of student living and association.
mm
Thanks for the info. Also my understanding is that the State Department has chartered a flight from Wuhan to bring diplomats and US citizens on Tuesday (tomorrow). They are flying them to San Francisco SFO. Seems like a quick way to spread the virus IMHO.
Jeff, that’s interesting considering that the two confirmed cases of 2019-nCoV were located in Orange and LA counties. Hmmm…maybe we’re not getting timely, accurate reports?? sarc Per Nancy’s post, more potential cases are coming in tomorrow via a flight from Wuhan to SFX. (Thanks for the “heads-up”, Nancy!)
The alert layperson will need to rely on informal information resources embedded in local hospitals, medical offices, etc. as it appears that state health departments are reporting/underreporting limited information about suspected and confirmed cases primarily at the state or county level, to ensure patient confidentiality (and avoid local panic?).
Hi Phil,
The short answer is that I think you mis-read the passage. This is Chris’s comment from the ALERT:
If a virus is ‘too lethal’ and kills above a certain threshold, it will burn itself out quickly. The 3% CFR of this coronavirus is in the ‘sweet spot’ for doing a lot of damage.I think he was referring to the case fatality rate, not R0. This generally means that the more lethal a pathogen is, the more likely the host will die before being able to pass on the pathogen (likening to a lower R0). A longer answer is that all epidemics will burn themselves out eventually, as the people become immune to the disease. An R0 basically determines how quickly this happens. A higher R0 is more like a conflagration, with a very large and very quick outbreak, as the pathogen spreads like wildfire among susceptible people until there's nothing left to burn. A lower R0 leads to a slower spreading brushfire that keeps creeping along. A final thing is that, while R0 is most commonly used, it has limited utility (meaning it's only useful in times like this where there is a fully susceptible population and no control measures). More accurately, epidemics are described by R in the simplified equation R = R0 - x, where x=the cumulative effect of reducing transmission, either through immune individuals or the implementation of control measures. While an R0 is a static, constant, number for a pathogen, public health measures are designed to increase "x" which will reduce R. When R<1.0 then the outbreak dies out.
In December, I traveled to LA for Christmas with my mom. After a week after I got home (first week of January), I came exceedingly close to getting sick for the first time since the swine flu ('08?). When I could feel the virus trying to take over, I did all my usual preventatives and got a mammoth night’s sleep. I was definitely off for another 5-6 days, but I nipped it in the bud before I had to take to bed and ride it out.
Sore throat (bad!), fatigue, cough (still lingering a couple weeks later).
A woman I am dating also got it, but she had been burning the candle at both ends with a home renovation and was worn down and got knocked on her behind for 4-5 days. Her throat and lungs became so raw from cough that when she gargled salt water, the water came out light pink (at the worst of it). Concurrently, my son’s mother and my son (3 years old) both had sinus/chest/flu bouts – his lasted a 5-6 days and required antibiotics when he developed a sinus infection, and his mother (as indomitable a human as I know) near about ended up in the ER with throat pain and lung tightness.
Yesterday, the woman I’m dating reminded me of all this. It had slipped my mind (I had semi-major surgery about 10 days ago and am in the process of moving; my 2020 is crowded, noisy and intense so far). She and I wondered if we’d had an early meetup with CoV. I live on Maui (air travel crossroads, LOTS of Chinese tourists), and had been to LA (while there I visited the gym twice, a perfect place to swap coronaviruses with strangers) in the timeframe we now know the virus was active.
Just posting this for anecdotal purposes. Probably wasn’t CoV. Wouldn’t mind if it was, since I (and my fam and ladyfriend) would have immunity to the next wave.
VIVA – Sager
From the New England Journal of Medicine a few days ago:
SARS-CoV mutated over the 2002–2004 epidemic to better bind to its cellular receptor and to optimize replication in human cells, enhancing virulence.7 Adaptation readily occurs because coronaviruses have error-prone RNA-dependent RNA polymerases, making mutations and recombination events frequent. By contrast, MERS-CoV has not mutated substantially to enhance human infectivity since it was detected in 2012.8
It is likely that 2019-nCoV will behave more like SARS-CoV and further adapt to the human host, with enhanced binding to hACE2. Consequently, it will be important to obtain as many temporally and geographically unrelated clinical isolates as possible to assess the degree to which the virus is mutating and to assess whether these mutations indicate adaptation to the human host.
Furthermore, if 2019-nCoV is similar to SARS-CoV, the virus will spread systemically.9 Obtaining patient samples at autopsy will help elucidate the pathogenesis of the infection and modify therapeutic interventions rationally. It will also help validate results obtained from experimental infections of laboratory animals.
A second key question is identification of the zoonotic origin of the virus. Given its close similarity to bat coronaviruses, it is likely that bats are the primary reservoir for the virus. SARS-CoV was transmitted to humans from exotic animals in wet markets, whereas MERS-CoV is transmitted from camels to humans.10 In both cases, the ancestral hosts were probably bats. Whether 2019-nCoV is transmitted directly from bats or by means of intermediate hosts is important to understand and will help define zoonotic transmission patterns.
(Was it not the mutated form of the Spanish Flu that did the deadliest work? - me)
Sager, I’ve read that immunity from corona viruses only lasts for a few months once you already had it, so you can get it, be ok, then a few months later get it again. I read that on the internet, so who knows if it’s true, but be careful.
This is important, a little complicated, but not too much. Different sorts of viruses get transmitted in different ways. The avian flu viruses are real pains in the butt because they "aerosolize." That's essentially being shed as a pure virus particle that can be breathed out into the air. These are very small particles, but not all the way as small as individual virus particles. Here's some data on avian transmission:I decided to do a search on the size of viruses vs. the stated efficiency of N95 masks. Per the FDA, the N95 “respirator blocks at least 95 percent of very small (.03 micron) test particles”.
A search on the size of viruses gave me the following summary, “.004 to 0.1 microns in size, which is about 100 times smaller than bacteria”.
Poultry-to-human avian influenza (AI) virus transmission can occur from 3 types of exposure: fomite-contact transmission, including contact with contaminated surfaces; droplet transmission, in which large (>5 μm) particles contact a person’s conjunctiva or respiratory mucosa; and droplet nuclei transmission (or aerosol transmission), in which a person inhales small (<5 μm) particles suspended in the air. (Source)Corona viruses, on the other hand, are not known to have the aerosolization feature. With the one caveat that it's always possible that the 2019-ncov is different, other known and studied cornaviruses spread mainly by droplets (>5 um).
When person-to-person spread has occurred with MERS and SARS, it is thought to have happened mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. Spread of SARS and MERS between people has generally occurred between close contacts. (Source - CDC)Bottom line: N95 masks are perfectly useful for protection against other coronaviruses, and I would expect that to be true here as well. (Of course, we'll keep a close eye on it all in case that proves untrue). Also: No mask is worth the effort if worn improperly! Might as well not have it. This means a snug fit where you are not breathing 'around' the mask.
I didn’t go out to search for this, but just stumbled upon it after my post above. This is from a CDC Pandemic influenza planning document, showing the varying effects of R0 on an epidemic curve.
Is there even the remotest possibility that this virus was somehow designed? I don’t ‘believe’ this theory but am open to the possibility…if it is possible.
The timing is very suspicious. The U.S. government has created proxy wars all over the Middle East, mainly to control oil, which enables them to maintain the reserve status of the dollar. Without that, I don’t know how a U.S total currency collapse can be avoided.
Through the belt and road initiative, China will have the upper hand and will be the dominant currency. So far they have been striking China, everywhere but through it’s heart. Is this pandemic an attempt to go for its jugular?
Again, a question rather than a statement.
Sparky1, I am about as close as you can get to the source of this information. When a nurse of 2 year old,with cancer, tells the family that corona virus is in the hospital, I think it’s safe to assume the worst