Keep Calm & Wash Your Hands
This isn't about Ocracoke, but it might get to us or our readers.
The Current consulted our scientific source (Sundae's sister's boyfriend), who shared this update that he wrote about Coronavirus. Seriously, this guy, Jeff Mahr, has a Ph.D in virology and immunology. He also got input from two friends, one wildlife biologist and the other a virus researcher at the Pasteur Institute.
Jeff explained that the virus is called SARS-CoV-2. The disease it causes is COVID-19.
Coronavirus Update – Feb 26 2020
Will it spread widely in the United States? It now looks like sustained community transmission of SARS-CoV-2 is happening in several countries, including South Korea, Italy, Japan, Iran and Singapore and I would be a bit surprised if it did not begin to spread in the United States. Many people who are infected have only mild symptoms, and typically those people do not seek medical care and therefore it is difficult to count them. The virus has a mean incubation period (time from initial infection to when symptoms appear) of ~6 days, but it can be as few as 2 and as many as ~14. It is strongly suspected that people who are in the incubation period can spread the virus and that leads to explosive increases in infections (like what happened in China) once it gets to a certain level.
How would I know if I was infected? Unfortunately, the symptoms of SARS CoV-2 are very similar to the flu, which is also going around. The most frequent symptoms of SARS CoV-2 infection are fever (>90% of cases), cough/upper airway congestion (~70%) & difficulty breathing (35%). Note that these numbers are based on three studies of Chinese patients in January. The virus is genetically very stable (very few mutations) and I expect these numbers will be the same in patients outside of China, but since it has only been a week since the virus has taken off in Italy and South Korea it is too early for studies on those patients to be published.
How serious is this virus? If you divide the number of infected people who have died by the total number of infections (as of Feb 26, 2020) you get 3.4%, meaning you would expect 3.4 out of every 100 infected people to die. Let’s avoid cutting a person into two fifths and say 34 people die out of every 1000 infections. This is called the case fatality rate and for comparison the flu virus in a bad year is at around 0.1%. So by that measure this virus would be 34x worse than seasonal flu in a bad year.
There are some issues with the case fatality rate for SARSCoV2 though.First, we don’t yet know enough about what’s going on in China to know if they are testing most/all of the infected people (remember, they are often symptomless). Most experts who I pay attention to expect that there are quite a few infected people in China with either no symptoms or so few symptoms that they haven’t been tested, and that would mean the overall case fatality rate is lower. Second, the fatality rate is very sensitive to which population of people you are talking about - for instance in the elderly and in people with underlying conditions (e.g. diabetes, heart failure) the fatality rate is much higher than 3.4%. Completely separate from the case fatality rate - 20% of patients experience severe respiratory distress and about half of those require assistance breathing. This is worse than the flu.
Can I be infected through Amazon? A student asked me if she could be infected from packages from China. The virus can survive for a while on surfaces, even when dried, but the particular surface (glass vs metal vs plastic vs cardboard) matters. The virus doesn’t turn into a gas and so doesn’t migrate through the air from a surface. If you touch a surface with the virus on it and then touch your eyes/mouth/nose, that is a known route of infection for this virus. Wash your hands after touching anything and this won’t happen. I’m not worried about getting infected from packages.
Masks? I am aware of one study of transmission of the virus among doctors in China in which they found that “N95” masks appeared to cut down on transmission somewhat. Your eyes are still exposed though and its likely you can be infected through your peepers (connected via sinuses to your airways). Masks might increase your risk if they cause you to get over-confident and relax your handwashing and/or personal space defense habits.
The. Most. Important. Thing. Proper hand washing: 20 seconds of vigorous rubbing with soap over all surfaces of your hands. Washing your hands for less time actually increases the transfer of microbes from your hands (based on a activity we do in Micro lab) Hand sanitizers (60-95% ethanol) also work against coronavirus (but not all viruses though – Hepatits A virus (a cause of food poisoning) is not sensitive to hand sanitizers). Moisturizers are not soap. Cleaning frequently touched surfaces with effective cleaning products is a great idea.
What to do
- Wash your hands frequently and correctly
- Avoid touching your face
- Avoid coming within 4-5 feet of other people (good luck with elevators, grocery store lines and your children)
- Pay particular attention to the elderly and anyone whose immune system or cardiovascular system might not be in tip top shape.
- Isolate yourself if you get a fever and call a doctor if you have any reason to suspect you have come into contact with someone who might have the virus. Right now that means anyone from the many countries in which there is an active outbreak of the virus (See the Johns Hopkins Coronavirus Global Case Map for the most current information on the outbreak).
Other questions I am being asked:
When will we have a vaccine? Maybe never. A lot of effort over many decades has failed to produce reliable vaccine for HIV - some viruses are just tricky. Having said that, I see published papers coming out that show some promising results in animal models.
Why did I read about ACE inhibitors and this virus? ACE inhibitors work against a protein on the surface of your lung cells. This virus uses that same protein to get inside your cells.
Was the virus created by the Chinese government? No. It is very clearly a bat virus that crossed into humans.
Is the word "coronavirus" on Lysol before December 2019 evidence of a conspiracy? No. There are at least 3 different human coronaviruses causing the common cold that we have known about since the 1960s plus the first SARS virus (2003) plus the MERS coronavirus (since ~2012) – those viruses are why coronavirus is on the Lysol cans.
Should I be scared? No. Fear disables our critical thinking and ability to think rationally, so access your inner Spock and go wash your hands.
Am I (Jeff) scared? Not scared, but I am thinking through the “what if” scenarios. I refuse to submit to a fear that I know is largely informed by apocalyptic movies, but I do have N95 masks and goggles for my family at the ready.
