Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
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Dr. Fauci says there's no chance COVID-19 disappears on its own. "Fauci is most concerned that the United States will be put to the test this fall and winter by a second wave of COVID-19 if the country does not blunt the infection rate by the summer. “Shame on us if we don't have enough tests by the time this so-called return might occur in the fall and winter,” he says, advising that the U.S. needs to make sure we not only have an adequate supply of tests available before a second wave hits, but also a system for getting those tests to the people who most need them. “I don't think there's a chance that this virus is just going to disappear,” he says. “It's going to be around, and if given the opportunity, it will resurge.” As such, Fauci says the U.S. should also focus this summer on properly reinforcing the nation’s health care system, ensuring the availability of hospital beds, ventilators, and personal protective equipment for health care workers. He also stressed the importance of continuing to social distance everywhere until the case counts start to fall in cities and states. The U.S. witnessed about 20,000 to 30,000 new cases every day in the month of April, suggesting the country is stuck in its peak."
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/
Stuck at its peak. That's not a place we want to be. Stay home.
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Cardiac disease indeed makes for worst COVID-19 outcomes. "Our study confirmed previous observations suggesting that underlying cardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized with Covid-19. Our results did not confirm previous concerns regarding a potential harmful association of ACE inhibitors or ARBs with in-hospital death in this clinical context."
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2007621
Coronary artery disease doubled mortality risks; heart failure and COPD tripled it. This is not just a "disease of the old" - it's a disease for anyone in the risk categories.
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Speaking of risks, the Lancet documents COVID-19 and obesity. "However, as the pandemic hit the Johns Hopkins Hospital in late March, 2020, younger patients began to be admitted to our ICU, many of whom were also obese. An informal survey of colleagues directing ICUs at other hospitals around the country yielded similar findings. At this time, news editorials were noting obesity as an underappreciated risk factor for COVID-19. This risk is particularly relevant in the USA because the prevalence of obesity is around 40%, versus a prevalence of 6·2% in China, 20% in Italy, and 24% in Spain. Obesity can restrict ventilation by impeding diaphragm excursion, impairs immune responses to viral infection, is pro-inflammatory, and induces diabetes and oxidant stress to adversely affect cardiovascular function. We conclude that in populations with a high prevalence of obesity, COVID-19 will affect younger populations more than previously reported. Public messaging to younger adults, reducing the threshold for virus testing in obese individuals, and maintaining greater vigilance for this at-risk population should reduce the prevalence of severe COVID-19 disease."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31024-2/fulltext
The higher the BMI, the more likely COVID-19 will affect you regardless of age.
Consider the stat in there. 40% of the United States is obese.
That in turn means that 40% of the population is at greater risk of negative outcomes for COVID-19 and more likely to need hospital care.
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New York City reports fifteen cases of multi-system inflammatory syndrome in kids infected with SARS-CoV-2. "A pediatric multi-system inflammatory syndrome, recently reported by authorities in the United Kingdom, is also being observed among children and young adults in New York City and elsewhere in the United States. Clinical features vary, depending on the affected organ system, but have been noted to include features of Kawasaki disease or features of shock; however, the full spectrum of disease is not yet known. Persistent fever and elevated inflammatory markers (CRP, troponin, etc.) have been seen among affected patients. Patients with this syndrome who have been admitted to pediatric intensive care units (PICUs) have required cardiac and/or respiratory support."
Source: https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatory-syndrome.pdf
For children who do contract COVID-19, there may be unforeseen complications. Much of our clinical data is still rooted in China's early experiences; now that data is becoming available from the US, we're seeing the disease behave differently here. Different population, different environment, and different outcomes. America is a third-world nation when it comes to healthcare, so it's no surprise we're seeing more variable outcomes.
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New, peer-reviewed evidence from Science Direct of a case of COVID-19 in France in December, 2019. "The COVID-19 epidemic is believed to have started in late January 2020 in France. We report here a case of a patient hospitalized in December 2019 in our intensive care, of our hospital in the north of Paris, for hemoptysis with no etiological diagnosis and for which RT-PCR was performed retrospectively on the stored respiratory sample which confirmed the diagnosis of COVID-19 infection. Based on this result, it appears that the COVID-19 epidemic started much earlier."
Source: https://www.sciencedirect.com/science/article/pii/S0924857920301643
Hopefully they have genomic data for this case to help trace down which strain of SARS-CoV-2 this was. December 2019 was when China was experiencing its heaviest outbreaks beginning.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home.
2. Wear gloves and a mask when out of your home.
3. Stay home as much as possible.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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Common misinformation debunked!
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered, nor that it escaped a lab somewhere.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/