(photo courtesy of pixabay.com)
(photo courtesy of pixabay)
Experts have been saying that the novel coronavirus is spread through close contact and physical touching. They also have downplayed transmission from asymptomatic individuals. Now evidence on the ground from Skagit County WA shows that airborne spread can occur from asymptomatic carriers to other individuals. A report in the Los Angeles Times from last night tells how, with no reported cases in the county, choir practice was assembled with half the normal cohort of singers on March 10. A few days later, an outbreak of COVID19 has felled two and laid 45 members low. The rest can be assumed to remain asymptomatic but be carriers of the virus.
These results confirm the indications from multiple scientific studies of the experience in China. A large proportion of cases have been attributed to asymptomatic or presymptomatic carriage and transmittal of virus from one person to another.
Now, due to a lack of testing, we have no idea who is a carrier and who has already recovered from asymptomatic or trivial symptoms of infection. If those who have recovered are recruited to the front lines, many of the shortages of protective equipment and personnel could be alleviated. Already, police in New York who have recovered from the illness are returning to work due to a lack of essential (even more so than medical) personnel.
As usual, data reported above are sourced from multiple news agencies– LA Times, Washington Post, NBC to name a few. Fox News has been left out of this conversation due to the lack of primary sources and a high level of cant which makes it difficult for realistic people to listen or watch.
(cartoon courtesy of pixabay)
(cartoon courtesy of pixabay)
(photo courtesy of pixabay)
Yesterday’s Washington Post carried an article telling the story of Birdie Shelton, a woman who returned rental cars for servicing to their central locations. In her job, she was exposed to secretions and excretions from people who had driven and ridden in cars that they had rented. In part, their motives were to prevent exposure through riding on public transportation. Her job, which she was forced to do by economic necessity, probably killed her.
The story was particularly affecting and effective because it was told by her partner, who dictated his recollections of her sudden illness and demise within days of its onset. These people, Indiana residents and members of the lower middle class, are helpless in the face of economic and epidemiological pressures that prevent them from taking time off when they are sick and massively expose them in the course of their work.
Never mind that she had multiple risk factors for severe disease. Never mind that she voluntarily chose this job. The rental car companies are responsible for their employee’s well-being.
First, the story shows how massive exposure can result in sudden, fatal symptoms. Second, this story shows why the capitalist system, without sufficient regulation and supervision, will be the death of us all (except the lucky 0.1%).
PS at the time the story was published, Birdie’s partner was also ill and confined to his home. He was unable to access her cell phone because she was too sick to give him the password. His electricity had been turned off (he got it back on, luckily). He was in danger because she had handled the finances for the two of them, and he was unable to find work. He will probably die too, because his exposure to her was of the same magnitude as her exposure to others.
(photo courtesy of pixabay)
An article in today’s New York Times demonstrates that the profit motive, manifested as industry consolidation, has handicapped preparations for today’s pandemic of novel coronavirus:
Government officials and executives at rival ventilator companies said they suspected that Covidien had acquired Newport to prevent it from building a cheaper product that would undermine Covidien’s profits from its existing ventilator business.
Back in April 2012, a small specialty manufacturer of ventilators (devices that inflate the lungs with oxygenated air to relieve shortness of breath due to weakened lung function) demonstrated a working model of a $3,000 ventilator that had been commissioned by the Centers for Disease Control (CDC) to fill the national stockpile. Projections that the US would need 70,000 ventilators in case of a flu pandemic (H1N1 had just passed through the world) alarmed experts at CDC, and they developed with Newport a contract to produce 40,000 of them, redesigned to be simpler and more portable.
Just as the demonstrator working models were rolled out, Newport was bought out by a larger generalist producer of medical equipment, Covidien, for $100 million. In May 2012, apparently fearing that the cheap ventilator would cut into its profits on selling larger, more complex ones, Covidien demanded more front money and a higher price for the new machine. The project fell apart, and no new ventilators that could be stockpiled for use in emergencies were produced.
Once again, the profit motive has over-ruled the altruistic motive in the boardroom. We can see that capitalism without regulation and oversight is deadly to the human race. Communism, with its totalitarian tendencies and its use of unrealistically high expectations to prod superhuman efforts from motivated “commies”, would be even worse. Don’t tell that to our Commander in Cheat: he’s too busy preening in front of his bathroom mirror. Time and time again, projects that use our motives for the common good to spur low-profit production have been derailed by Tea Partiers crying “communism!” to tar socialist policies with the unwarranted slur of totalitarianism. When will these red-baiters learn that we are all in this together?
(image courtesy of pixabay and TheDigitalArtist)
Research on COVID-19 revealed viruses contaminating all surfaces in hospital rooms before cleaning that was removed by using 5000 ppm of sodium dichloroisocyanurate for “high-touch areas” and 1000 ppm on floors. Areas where viruses were recovered included the blades of exhaust fans and toilet seats. Recovery from exhaust fans showed that air is contaminated with droplets from exhaling (breathing out), coughing, and sneezing. The size of these droplets varies from visible to extremely tiny, small enough so that only one or a few viruses could fit within a single particle. Smaller particles can float in the air for long periods of time. From the experience with measles transmission, we know that air remaining in a room for as long as two hours after a patient has left can contain infectious virus. Whether SARS-COV-2 is as efficient as measles is unknown but considered unlikely.
Implications are that low-level infectiousness of ambient (remaining) air in areas through which patients have passed is entirely possible. How long these infectious particles persist is unknown, but experts downplay the risks of transmission through the air after the larger droplets have settled out.
There is a significant risk of low-level exposure for susceptible individuals who pass through areas in which infectious patients have been breathing. Whether this low-level exposure might lead to mild or inapparent disease is unknown. I think that there is substantial risk for mild exposure, which might actually be a good thing, since patients with asymptomatic infection are likely to obtain immunity which might be sufficient to prevent later severe disease.
(image courtesy of pixabay and TheDigitalArtist)
A German study of nine patients with COVID-19 published on March 5 on a pre-print server looked at cell culture to determine infectiousness before and during illness. Seven of the nine had only upper respiratory (sore throat and runny nose) symptoms and two had mild lower respiratory (cough) symptoms. All showed infectious virus shedding on days one through five of illness; after day eight, no infectious virus appeared. Although virus was detected in the feces, it was not infectious and could not have transmitted disease. Antibodies were found in the blood serum after about one week of illness.
While this study has not yet been peer-reviewed, it looks solid and I believe it can be depended upon to guide our decision-making.
“Conclusions: the present study shows that COVID-19 can often present as a common-cold type illness.” This small but thorough study indicates that everyone who says this virus presents as pneumonia is wrong. Most symptomatic patients only have upper respiratory symptoms (URI) and are infectious, with high levels of viral shedding, very early and possibly even before symptoms appear.
Apparently, this virus has swept the world because of its nearly unique features. First, it is highly infectious early in the illness, even 24 hours before symptoms appear. Second, most patients have mild or even trivial symptoms that might be ignored if there is not adequate support for sick leave and isolation. Third, it is antigenically different enough from previous coronaviruses that no-one in the world has pre-existing immunity.
The problem is that a small percentage of patients who fall ill develop pneumonia, respiratory distress, and low blood oxygen (deoxygenation). These patients represent the real burden of illness for the health system because they require hospitalization, intubation, and artificial respiration, that is they will need those ventilators that the Commander in Cheat thinks are unnecessary. Anywhere from five to twenty percent of patients fall into this latter group, and they will overwhelm the medical care system if “stay at home” orders are not followed.
The issue of gastrointestinal illness appears to be confined to a tiny percentage of patients and feces are unlikely to pass on the virus.
The level of exposure related to seriousness of illness has not been settled. If this virus is like most others, small exposures are likely to lead to mild illness and massive exposures may result in death from pneumonia and “cytokine storm” (massive over-reaction of the immune system to the virus).
As the pandemic spreads I am learning exponentially more about the SARS-COV2 problem and I am deeply concerned that people are not taking it seriously enough. I had an inkling that something was seriously wrong when I heard the first reports, and it seems that my instincts were correct. This virus will infect most of the world. It will have a massive effect on our economy that will last for years. It is too late to prevent major disruption of our lives. Universal testing is essential to limit the damage.
Conrad Theodore Seitz 