COVID-19

[enginist]

For those of us with compromised immune systems, which is almost all of us, an infection by the coronavirus could cause serious problems.  And according to an article in The Atlantic, it is likely that we'll all be infected.  The virus may replicate faster than our immune systems can respond, and inflammation of the lungs can spread to other organs.  It won't be much of a threat to the young and healthy, but it could raise the mortality rate for anyone with a chronic illness.  The most insidious thing about it is that an infected person may be asymptomatic and still be highly infectious.

[iolaire]

I’m worried about it.  I take the bus and metro to work so worry that that it will hit before I know to work from home.

[enginist]

I too am germophobic.  I think that we soon will see an upsurge in people wearing masks, especially in contamination zones, like buses and train cars.  On Amazon, the prices for an N95 mask are soaring.

[iolaire]

I did order a pair of paper 3M 8511 Respirator, N95, Cool Flow Valve on Sunday night from Amazon.  All the CDC instructions say to only wear a mask if infected which seems odd to me.  Smart coworkers say any of the N95 masks will work, even if its for drywall, welding ect...

[enginist]

Those are good masks, but two is not enough.  They must be disposed of after five days, or if you touch the front part with your fingers, or if someone on the bus coughs or sneezes in your direction.  You know how rude and thoughtless people can be.  Worse, they don't protect the eyes, a major transmission site.  I bought a pair of protective goggles to supplement my mask, which has replaceable filters.  Not cheap, but I'm expecting the worst.  The CDC has some good advice on mask reusability.  It also recommends washing hands over wearing masks.  I think that this is dubious advice.  I can see saving masks for the front-line health care workers, but you know that this won't happen.  Hoarding has already wiped out the supply, which was too low to begin with.  Every source I've read online says that droplets from a cough or sneeze can travel a maximum of six feet, which I don't agree with.  Particulates from a sneeze are expelled at a much greater velocity than those from a cough, so simple physics says they will travel farther.  Tiny virus particles, which are in the submicron range, travel farther than droplets.  I'd recommend a radius of 12 or 13 feet.  I know it isn't possible to keep your distance from everyone, but it is clearly the safest course of action.  Either that, or wear some sort of mask.

Anyway, here's a link to the CDC:

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

[Paul]

For those of us with compromised immune systems............an infection by the coronavirus could cause serious problems.

Not just those with a compromised immune system. In Britain we have had several cases of infection, but only one death. I was listening to the radio news on the day that was announced, and the news reader went to great pains to tell the listeners not to panic. He pointed out that the reason the patient died of coronavirus was because he had other serious, existing conditions. These were diabetes and the fact that he was on dialysis. "OK" I thought "That's me dead then!"

Was talking to a patient at the dialysis clinic, he had found out that the hospital the clinic is in, is the area's coronavirus test centre, so anyone suspected of having the disease will be walking the same corridors as us. His intention for today was to search the Internet to find a supplier of the plastic masks.

[enginist]

The claim that masks aren't helpful if you haven't been infected is a lot of nonsense.  According to a piece in The Guardian, wearing a mask if you're sick or not gives you five times more protection than no mask at all.  Even a loosely fitting surgical mask is better than nothing.  This is common sense.  If a mask is too expensive or otherwise unavailable, a scarf over the nose and mouth and a pair of sunglasses will give you at least a margin of safety.

Here's an article that gives the truth on masks.

https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?action=click&module=Opinion&pgtype=Homepage

And here's a short piece on homemade masks.

https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic

[Simon Dog]

...
the news reader went to great pains to tell the listeners not to panic. He pointed out that the reason the patient died of coronavirus was because he had other serious, existing conditions. These were diabetes and the fact that he was on dialysis. "

He was telling YOU to panic.

[Michael Murphy]

 The good news is that covid-19 has a calculated R value of around 2.8.
Measles has a R value of 13.  This is the expected number of people who will in infected by a individual patient. While this virus is spreadable it is not highly contagious. 

[enginist]

It's inaccurate to compare this to the measles, which is highly contagious but largely contained.  Most people have been vaccinated for measles. You're right that the R number is the reproduction rate, but your interpretation is way off.  Think of the R number as the ratio between each number in a series of numbers.  For example, if the R number were 2, the series would look like this: 1, 2, 4, 8, 16, 32... In other words, it increases at an exponential rate.  But nobody knows the R number for the coronavirus.  The World Health Organization estimates that it is between 1.4 and 2.5.  Which is not good news.  Anything over 1 means that the virus will spread rapidly, uncontained. 

Plus, the mortality rate is far higher than the flu's.  About 1 in 50 who get the virus will die, while approximately 1 in 1,000 people who get the flu will succumb to it.  We've had about 40,000 flu deaths in the U.S. this year.  Multiplying 40,000 by a factor of 20 gives us, in the U.S. alone, 800,000 probable deaths from the coronavirus.  Make it an even million.

[fifal9]

Plus, the mortality rate is far higher than the flu's.  About 1 in 50 who get the virus will die, while approximately 1 in 1,000 people who get the flu will succumb to it.  We've had about 40,000 flu deaths in the U.S. this year.  Multiplying 40,000 by a factor of 20 gives us, in the U.S. alone, 800,000 probable deaths from the coronavirus.  Make it an even million.

For what it's worth, I saw online https://wattsupwiththat.com/2020/02/15/amazing-but-hidden-news-about-coronavirus/ (not a particularly reputable source or anything) and guess it could be extrapolated (loosely) that if the USA is approx. 5 times the population as the US (66M vs 330M) and gets infected at the assumed 60% infection figure as being assumed for the UK, then maybe around 2 million deaths in the US.... not that I am worried or believe this will happen.

From the Telegraph:

Prof Neil Ferguson, professor of mathematical biology at Imperial College, has warned that the world is “in the early phases of a global pandemic”.

He said Britain is probably only picking up around one in three cases, focusing on those coming in to the country, when cases may have arrived – and gone undetected – before restrictions set in.

“Surveillance has started in hospitals across the UK of pneumonia cases, that will give us a proper picture,” he said.

“Our best estimate is that transmission in the UK will get going in the next few weeks; unless we are very lucky probably peaking 2 to 3 months after that,” he said. “If it truly establishes itself in terms of true person-to-person transmission it will behave like a flu pandemic, maybe up to 60 percent of the population being affected but most of those people having very mild symptoms.”

He suggested that 400,000 people in the UK could die from it in the next 12 months, based on estimates of a 1 per cent mortality rate and an infection rate of 60 percent of the population.

[PrimeTimer]

  Here's my 2 cents....fresh air and ventilation. No matter how cold/hot it is outdoors people might ought to consider stepping outdoors a few times a day and when indoors, leave a window cracked open about 1 inch. Of course, this may depend on the neighborhood you live in.

[Hereware]

OMG!!! where is the cure?

[MooseMom]

I received this from the Renal Support Network.  It doesn't really have any new info, but since it is targeted to renal patients, it is of interest.

https://www.rsnhope.org/rsn-blog/tips-to-avoid-catching-covid-19-coronavirus/

This is why and how COVID-19 is so lethal in certain populations, including ours:

https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/

[enginist]

The second link, MooseMom, describes in vivid detail just how horrible a death this could be.  If confined to the lungs, it would be like coughing to death or drowning in your own fluids.  In other cases, inflammation could spread throughout your body, causing your organs to fail one by one.  When you ultimately die of kidney failure, death would be a welcome relief. 

Meanwhile, here's an update on the latest strategy, called "Flattening the Curve," which comes to us from the CDC.  Despite its recent bungling and the spineless leadership of its director Robert Redfield, the CDC is still capable of doing good work.  In any case, we are asked as individuals to spread this approach to the virus far and wide.  It essentially means slowing down the rate of infection so that the health care system isn't overwhelmed.  It makes perfect sense to me, and there's a lot of good information in the link, the single best resource I have found so far.

https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellation?utm_source=digg

[UkrainianTracksuit]

Well, it's finally hit home. 

My husband just received a warning that he was at a conference where a person has tested positive. Keep in mind, it ended over 10 days ago, so it shows how long it can take to show symptoms. There were thousands of people there so I highly doubt he came in contact/got infected but even if had been he's been home all this time. So, yay!

He has been advised to watch for fever and monitor how he feels. No need to self-quarantine yet. He's strong and healthy so naturally we aren't concerned about him...  but me!

[iolaire]

He has been advised to watch for fever and monitor how he feels. No need to self-quarantine yet. He's strong and healthy so naturally we aren't concerned about him...  but me!

Can you use that story to start sliding in warnings about your needs into discussions at your workplace? 

My work came out with a formal FAQ that in part stated if you feel you need to stay home because of health concerns you need a doctors note, I think my managers are ok with me at home, but I might need to get that at some point.

[MooseMom]

UT, are you doing anything special to protect yourself?  Are you avoiding crowds, etc?  Do you feel it is necessary just yet?

Iolaire, I have found that all you need to do is say "transplant patient", and people aren't going to question you!  LOL!  You were dealt the kidney card, so play it when you need to.  I don't think you'll have any problem getting a doctor's note!

I don't want to bother my tx coordinator will questions of this nature, so I'll ask you all to tell me what you would do...

1.  I have labs tomorrow, and the waiting room is the same as for patients waiting to see other PCPs who have their offices in the came suite.  If it were you, would you still go?  I think I will; labs are important, but I have seen lots of Purell around in the past, so I'll make good use of it.

2.  I have my annual eye exam in 2 weeks.  I have no eye health problems, so it's just my regular check up.  Should I go, or should I postpone it indefinitely?  What would you all do?

I live a generally quiet life here at home at the end of the cul-de-sac, so I figured that self-isolation would not be a big problem.  But then I started thinking of all of the one-off things I need to attend to outside of my moose-bubble!

[enginist]

I'd get my labs done, but the waiting room is a petri dish, so I'd wear a mask in there, even if I had to improvise.  I'd also wear gloves--Latex or winter gloves--at all times.  When I go to the store or go out running I wear thin leather gloves that I spray with alcohol when I get home.  Handwashing, of course, is never omitted.  I'd cancel the eye test as unnecessary.  An eye test is too up close and personal, and you don't know who was examined before you.

On second thought, I'd cancel the blood test too, unless your numbers are unstable.  A waiting room full of vulnerable people is like a large public area but in concentrated form.  To ensure your maximum safety, assume that a random number of patients--even if it's only one--will be sick and not know it yet.

[UkrainianTracksuit]

Iolaire, yes, I have contacted my boss and let him know of the situation. As well, I've made note that since this "could potentially" be a case of community transmission, I'd prefer to work from home. I noted that in the case that I am living with someone who has "potentially been exposed" to the virus I would not want to "get my colleagues ill" it is only right for me avoid them. Used both sides of the card.

Do you have to use special software (or whatever) to be able to work from home or do you have a laptop specifically for work? I know that's a discussion going on.

MooseMom, at the moment, I am kind of confused on what to do. My husband suggested I stay at a hotel and he at home (keep in mind, he hasn't been told to social distance yet). But, in the case that he is asymptomatic, it would mean I've been exposed and would share the virus with other people, though I am not sick at all. I DO have a cough that scares people but that's from a breathing tube incident.

I just don't freaking understand why a convention/conference would have went ahead especially with attendees from '132 countries' as they say on the website during a global public health crisis. Top politicians attended too, so probably, it was more a case of investments trump sanity.

In general, I am just hand sanitizing the heck out of everything, like I do anyway, especially on shopping trolleys or doors. But most definitely, I second guess going around anything crowded. Staying out of the airport is definitely on my list.

As for your questions:
1. Yes, transplant labs are important, so I would go. If the people waiting for their PCPs are following instructions, if they are infected, they'll know to call directly, rather than sit in a waiting room. As usual, sanitize and common sense.
2. Kinda conflicted on the eye exam appointment and I am in the same shoes. I go on Friday but I have eye issues. To be honest, I have caught the flu once visiting the eye doctor as well as the dentist. A side of me says to go because you don't know the next time you'll be able to get in if many people cancel and the risk is generally low. On the other hand, it isn't a really necessary outing, especially with a close proximity to people.

[iolaire]

Do you have to use special software (or whatever) to be able to work from home or do you have a laptop specifically for work? I know that's a discussion going on.

I'm at a not small company (3k-5k employees) so for the past many years the setup has been a VPN client that authenticates via my phone, that's on my home computer, then I remote desktop (RDP) in to my windows work computer with that connection going over the VPN and use my desktop computer directly via RDP.

Today in my office they told everyone to pickup Chromebooks, which I did, the instructions are the same, but it feels like they might require the Chromebook over desktop computers.  Its probably much safer enterprise security wise to move everyone to the Chromebook.  The Chromebook was not customized or locked down, just a raw in the box little laptop.  People with company laptops just work directly on their laptop and access the entire local work network from the laptop and VPN, my VPN connection doesn't allow that only RDP.

[enginist]

Requiring a note from a doctor sounds like grammar school.  Isolation is needed for everyone--everyone, everywhere--not only those with underlying conditions. 

For any of you who like to geek out on numbers and graphs, this article, which is long and detailed but highly illuminating, could keep you  entertained for a couple of hours. 

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

The takeaway is that the virus is here.  It's hidden and it's growing exponentially.  A total lockdown is required.  All nonessential exposure to humanity must cease.  Not tomorrow but today.  Time to go into hermit mode, into self-imposed exile. 

[UkrainianTracksuit]

I'm at a not small company (3k-5k employees) so for the past many years the setup has been a VPN client that authenticates via my phone, that's on my home computer, then I remote desktop (RDP) in to my windows work computer with that connection going over the VPN and use my desktop computer directly via RDP.

Today in my office they told everyone to pickup Chromebooks, which I did, the instructions are the same, but it feels like they might require the Chromebook over desktop computers.  Its probably much safer enterprise security wise to move everyone to the Chromebook.  The Chromebook was not customized or locked down, just a raw in the box little laptop.  People with company laptops just work directly on their laptop and access the entire local work network from the laptop and VPN, my VPN connection doesn't allow that only RDP.

Ah, okay, at a "larger" company I would fully expect for them to have more advanced systems or a sort of contingency plan. I work for a much smaller operation so the person in HR is working with the ownership to come up with something. We rely on a lot of evidence, data and reports so it can easily be done at home and we already have virtual conferencing software. Once thing is definitely for sure is that I will not be personally meeting with clients.

As for my husband, it was later revealed that the man at the convention that tested positive "was not contagious" at the time. Still, all attendees have to still monitor for symptoms. No fever or anything out of the ordinary for him. Besides, well, some sadness that ice hockey is cancelled...

I went to my eye appointment and it was pretty much the most perfect scenario. First appointment of the day, no one else in the office and I could smell the antiseptic scent on the machines. They did call ahead of time to say if I had any cold/flu symptoms to cancel. As well, I will keep my dental appointment because I specifically see one dentist (very knowledgeable about medications/pre-existing conditions and teeth) and he cancelled on me twice. They wear masks, visors and gloves around me anyway.

Besides all that, my primary care provider told me that as of yesterday, I really need to self-isolate. It's bad enough to be a tx patient and immune-compromised, but she assumed I'd have to be shipped off to tx hospital because few want to even deal with a pancreatic transplant in such a precarious scenario. I'm going to go crazy.

[iolaire]

Requiring a note from a doctor sounds like grammar school.  Isolation is needed for everyone--everyone, everywhere--not only those with underlying conditions.

Last night they sent an email say people like me could work from home. Which was good because they reached out to my manager something this week saying I need a note.  Any what received two week approval for at home work and by then end of that everyone will be home. Our schools are closed on Monday and within three weeks out CEO expects everyone should be working from home.  My wife is depressed that her source of dvds, our library, is closed as of tomorrow.

UT sorry your company is slow to accommodate you. Do your best to keeps some distance from coworkers. 

[iolaire]

In the DC, Maryland, and Virginia area schools are closed for the rest of the month and things are becoming real for more people.

This article is a good read on the various interpretations of social distancing that we need to do. It’s also interesting the different viewpoints from the three experts.
https://www.theatlantic.com/family/archive/2020/03/coronavirus-what-does-social-distancing-mean/607927/?utm_source=feed