OG doc. AMA on COVID-19

Hey Doc thanks for the thread. I heard a person that has contracted Coronavirus has red around their eyes, kind of like allergies maybe? Is that true? Thanks again.

Actually are there any physical traits that you’re seeing in a corona virus patient? 

mataleo1 - 
jcblass - 
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.


I get your points and they are completely valid. But neither you nor I should be making these decisions. It worries me to see calls for "extreme and total isolation" or "a full stop to isolation procedures" without any kind of experience.

Nobody knows for sure, but some know more than others. We've got pretty smart people in this country who do this for a living and I defer to them on how strict isolation should be, how long it should last, and where it should be done.


I am not suggesting I should be making the decisions, I am simply giving my thoughts. Although I have poured through a lot of data and read many statistical models.

I have been down the middle with my thoughts on this. I understand the virus is very contagious which is dangerous especially to those vulnerable to the virus, (old and sick). However, I keep seeing people looking at the NYC numbers and then projecting those kind of percentages onto the rest of the country to get to their dooms day number. I am saying each location is different and the simple fact that NYC is under fire (at the moment) doesn't mean the entire country is going to be enveloped. Now, I am not suggesting you believe that but many people do.

The circumstances are not the same everywhere. China has a population of 1.3 billion, it killed under 4k (even if you times tht x 10 because they 'lie' then its 40k).

Thailand has experienced 4 deaths...

Other countries under 40....it's not something that catches fire and totally annihilates a country, its regional and we know where it settles, densely populated places, particularly with an older/unhealthy demographic.

Let's keep most the travel restrictions in place for the time being, keep the ban on large events, keep the border closed, isolate the old and the sick, not punish anyone if they don't feel comfortable going to work, but slowly start opening up commerce while making sure everyone is practicing safe practices. Maybe that means restaurants only seat every other table, parties under 4...for a month or so.

However, at this rate the economic fallout is going to be dire. Despite only have 11 deaths, the entire city of Los Angeles is entirely shut down. The Magic Castle, a staple of Hollywood, just laid-off 189 of 199 employees, they are on the brink of failure. This can't continue.

jcblass -
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.

Lombardy has the most resources. It is the most prosperous region in Italy.

used2wrestle - 
jcblass -
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.

Lombardy has the most resources. It is the most prosperous region in Italy.


Well it had a dreadful population of sick old people because 98.5% of the deaths were people 78 or older with a minimum of 2 serious pre-existing conditions...

I don't think you will find those numbers in too many places. It was a major contributor. I read that the virus took the area by surprise and they had no response for it...once it gets a foothold in an area that old and sick, it will be a struggle. I agree 100% with that.

Meanwhile in Japan, 45 deaths, Thailand 4 deaths, Canada 30 deaths...

jcblass - 
mataleo1 - 
jcblass - 
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.


I get your points and they are completely valid. But neither you nor I should be making these decisions. It worries me to see calls for "extreme and total isolation" or "a full stop to isolation procedures" without any kind of experience.

Nobody knows for sure, but some know more than others. We've got pretty smart people in this country who do this for a living and I defer to them on how strict isolation should be, how long it should last, and where it should be done.


I am not suggesting I should be making the decisions, I am simply giving my thoughts. Although I have poured through a lot of data and read many statistical models.

I have been down the middle with my thoughts on this. I understand the virus is very contagious which is dangerous especially to those vulnerable to the virus, (old and sick). However, I keep seeing people looking at the NYC numbers and then projecting those kind of percentages onto the rest of the country to get to their dooms day number. I am saying each location is different and the simple fact that NYC is under fire (at the moment) doesn't mean the entire country is going to be enveloped. Now, I am not suggesting you believe that but many people do.

The circumstances are not the same everywhere. China has a population of 1.3 billion, it killed under 4k (even if you times tht x 10 because they 'lie' then its 40k).

Thailand has experienced 4 deaths...

Other countries under 40....it's not something that catches fire and totally annihilates a country, its regional and we know where it settles, densely populated places, particularly with an older/unhealthy demographic.

Let's keep most the travel restrictions in place for the time being, keep the ban on large events, keep the border closed, isolate the old and the sick, not punish anyone if they don't feel comfortable going to work, but slowly start opening up commerce while making sure everyone is practicing safe practices. Maybe that means restaurants only seat every other table, parties under 4...for a month or so.

However, at this rate the economic fallout is going to be dire. Despite only have 11 deaths, the entire city of Los Angeles is entirely shut down. The Magic Castle, a staple of Hollywood, just laid-off 189 of 199 employees, they are on the brink of failure. This can't continue.

Of course, this is a discussion forum and I appreciate your input.

I also agree with several of your points. NYC is hit hard while other cities may not be hit much. And I didn't suggest all regions should be treated the same. Canada has started to implement restrictions on travel between provinces (or at least forced quarantine if you do). That may be better in some areas than a complete shutdown. And, yes, I fully acknowledge the risks (financial, medical, social) of a shutdown. I remember the statistic from the movie "The big short", i.e. that every 1% rise in unemployment caused 40k deaths. This stat is very disputed but it definitely means there are massive risks on a shutdown.

1 Like

Balls Mahoney - 

Actually are there any physical traits that you’re seeing in a corona virus patient? 


I've seen very few COVID positive patients (my call ended when the storm started). My colleagues have not mentioned anything particular, except weird respiratory symptoms and signs. They feel sometimes ok while blood oxygenation is way down. Some breathe at 50/minute which is really fast.

1 Like

jcblass -
used2wrestle - 
jcblass -
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.

Lombardy has the most resources. It is the most prosperous region in Italy.


Well it had a dreadful population of sick old people because 98.5% of the deaths were people 78 or older with a minimum of 2 serious pre-existing conditions...

I don't think you will find those numbers in too many places. It was a major contributor. I read that the virus took the area by surprise and they had no response for it...once it gets a foothold in an area that old and sick, it will be a struggle. I agree 100% with that.

Meanwhile in Japan, 45 deaths, Thailand 4 deaths, Canada 30 deaths...

They didnt look at all the patients but I would assume it would probably not change much if they continued to examine more cases


 


The Rome-based institute has examined medical records of about 18% of the country’s coronavirus fatalities, finding that just three victims, or 0.8% of the total, had no previous pathology. Almost half of the victims suffered from at least three prior illnesses and about a fourth had either one or two previous conditions.

jcblass - 
mataleo1 - 
jcblass - 
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.


I get your points and they are completely valid. But neither you nor I should be making these decisions. It worries me to see calls for "extreme and total isolation" or "a full stop to isolation procedures" without any kind of experience.

Nobody knows for sure, but some know more than others. We've got pretty smart people in this country who do this for a living and I defer to them on how strict isolation should be, how long it should last, and where it should be done.


I am not suggesting I should be making the decisions, I am simply giving my thoughts. Although I have poured through a lot of data and read many statistical models.

I have been down the middle with my thoughts on this. I understand the virus is very contagious which is dangerous especially to those vulnerable to the virus, (old and sick). However, I keep seeing people looking at the NYC numbers and then projecting those kind of percentages onto the rest of the country to get to their dooms day number. I am saying each location is different and the simple fact that NYC is under fire (at the moment) doesn't mean the entire country is going to be enveloped. Now, I am not suggesting you believe that but many people do.

The circumstances are not the same everywhere. China has a population of 1.3 billion, it killed under 4k (even if you times tht x 10 because they 'lie' then its 40k).

Thailand has experienced 4 deaths...

Other countries under 40....it's not something that catches fire and totally annihilates a country, its regional and we know where it settles, densely populated places, particularly with an older/unhealthy demographic.

Let's keep most the travel restrictions in place for the time being, keep the ban on large events, keep the border closed, isolate the old and the sick, not punish anyone if they don't feel comfortable going to work, but slowly start opening up commerce while making sure everyone is practicing safe practices. Maybe that means restaurants only seat every other table, parties under 4...for a month or so.

However, at this rate the economic fallout is going to be dire. Despite only have 11 deaths, the entire city of Los Angeles is entirely shut down. The Magic Castle, a staple of Hollywood, just laid-off 189 of 199 employees, they are on the brink of failure. This can't continue.

Very reasonable.

mataleo1 -
Balls Mahoney - 

Actually are there any physical traits that you’re seeing in a corona virus patient? 


I've seen very few COVID positive patients (my call ended when the storm started). My colleagues have not mentioned anything particular, except weird respiratory symptoms and signs. They feel sometimes ok while blood oxygenation is way down. Some breathe at 50/minute which is really fast.

Thank you

jcblass -
mataleo1 - 
jcblass - 
mataleo1 - 
jcblass - 
Stache - That Oxford model is interesting but, like they ask at the end of the article, how do you explain the explosion in cases in Italy, Spain, NYC, etc?

A specific set of circumstances tailor made to spread the virus. Circumstances not at all inline with the rest of the country, i.e., old sick population, Italy. Densely populated, international hub with public transport and people living on top of one another, NYC...

It's not the same in Toledo Ohio, or Ft. Walton Beach Florida. Hell even Los Angeles is managing just fine, a couple deaths every other day, if that.

True, but these are only hypotheses. Why do you explain that Rome wasn't as hardly hit as Milano? Rome's population is more densely populated, is older, and receives more tourists.

Other small towns were hit hard.


I would imagine Rome might have more resources, the people more wealthy and in better health than Lombardy, or there is something about this virus, we haven't quite figured out, that makes it pray on some people more than others. However, generally speaking, these outbreaks have been regional and afflicted the elderly and immune compromised. That one variable has been stable throughout and mainly why I think a good % of the country can get back to work in the next week or two.

Obviously, if it is a regional hot spot you don't, but we can start relaxing some of this.


I get your points and they are completely valid. But neither you nor I should be making these decisions. It worries me to see calls for "extreme and total isolation" or "a full stop to isolation procedures" without any kind of experience.

Nobody knows for sure, but some know more than others. We've got pretty smart people in this country who do this for a living and I defer to them on how strict isolation should be, how long it should last, and where it should be done.


I am not suggesting I should be making the decisions, I am simply giving my thoughts. Although I have poured through a lot of data and read many statistical models.

I have been down the middle with my thoughts on this. I understand the virus is very contagious which is dangerous especially to those vulnerable to the virus, (old and sick). However, I keep seeing people looking at the NYC numbers and then projecting those kind of percentages onto the rest of the country to get to their dooms day number. I am saying each location is different and the simple fact that NYC is under fire (at the moment) doesn't mean the entire country is going to be enveloped. Now, I am not suggesting you believe that but many people do.

The circumstances are not the same everywhere. China has a population of 1.3 billion, it killed under 4k (even if you times tht x 10 because they 'lie' then its 40k).

Thailand has experienced 4 deaths...

Other countries under 40....it's not something that catches fire and totally annihilates a country, its regional and we know where it settles, densely populated places, particularly with an older/unhealthy demographic.

Let's keep most the travel restrictions in place for the time being, keep the ban on large events, keep the border closed, isolate the old and the sick, not punish anyone if they don't feel comfortable going to work, but slowly start opening up commerce while making sure everyone is practicing safe practices. Maybe that means restaurants only seat every other table, parties under 4...for a month or so.

However, at this rate the economic fallout is going to be dire. Despite only have 11 deaths, the entire city of Los Angeles is entirely shut down. The Magic Castle, a staple of Hollywood, just laid-off 189 of 199 employees, they are on the brink of failure. This can't continue.

amen

Thanks for your answers docs.

 

This video, from Italy,  I found to be a tough watch.  At one point a Dr says, with tears in her eyes, its a disaster.  A tsunami!

 

That is the thing that is very odd.  Tsunamis in several places.  China, Italy, Spain and France.  And yet elsewhere not yet tsunami's.  Its puzzling.  

 

 

Trust -
mataleo1 - 
Mountain Medic - 

Hey docs- we are getting information on how long it might survive on cardboard and stainless steel.

 

Any thoughts on waterbourne , watershed viability/transmission?

 

Not trying to be a conspiracy guy, I'm just a rafter and spring run off is coming....

 


There are a few studies, the most famous one being that published in NEJM: https://www.nejm.org/doi/10.1056/NEJMc2004973

aerosols: 3h
Copper: 4h
Cardboard: 24h
Plastic: 2-3d
Steel: 2-3d

Will check for waterbourne, read conflicting data.

 

I would love to know the explanation behind this.  Why do these different surface materials affect a virus differently?  What is happening at the virus/surface level?  



aerosols tend to dry up quickly because of their large surface to volume ratio. the virus needs the polar nature of water in order for its proteins to fold into the correct 3 dimensnional shape to infect your cells


copper: some metals cause a chemical reaction on their surface that microbes arent very good at dealing with. its called the oligodynamic effect


cardboard tends to be absorbent and dries out quicker than plastic or steel surfaces. drying viruses out generally inactivates them

1 Like

How powerful of a UV light would be required to inactivate the virus in one pass?   What I'm imagining is a baseball hat with a UV light underneath the brim so that its essentially making a face shield out of UV light, thereby inactivating any droplets or aerosols that pass through that light before reaching your face.

 

You could also wear sunscreen and sunglasses if there was concern over the UV light.  Or there could be a plastic face shield with some kins of protective coating(like what they use for low-e windows) and then the light shines down in front of the shield.  So the plastic just protects you from the UV light but the light is still whats making the virus killing barrier. Wouldn't be too hard to rig something up with a battery powered light just taped to a hat.

 

You could also make bracelets with UV lights directed out towards your hands to automatically sanitize anything that you reach for before you touch it.

 

Or you could have a backpack with a uv lamp extended above your head and pointed down over you, surrounding you in a bubble of virus inactivating light.

 

Elon could probably refine these designs nicely and crank these out. I'll just take a modest royalty for inventing the idea 

1 Like

turducken -

How powerful of a UV light would be required to inactivate the virus in one pass?   What I'm imagining is a baseball hat with a UV light underneath the brim so that its essentially making a face shield out of UV light, thereby inactivating any droplets or aerosols that pass through that light before reaching your face.


 


You could also wear sunscreen and sunglasses if there was concern over the UV light.  Or there could be a plastic face shield with some kins of protective coating(like what they use for low-e windows) and then the light shines down in front of the shield.  So the plastic just protects you from the UV light but the light is still whats making the virus killing barrier. Wouldn't be too hard to rig something up with a battery powered light just taped to a hat.


 


You could also make bracelets with UV lights directed out towards your hands to automatically sanitize anything that you reach for before you touch it.


 


Or you could have a backpack with a uv lamp extended above your head and pointed down over you, surrounding you in a bubble of virus inactivating light.


 


Elon could probably refine these designs nicely and crank these out. I'll just take a modest royalty for inventing the idea 

I know of at least one large flight service that is taking aircraft out of service for 24hrs after transporting Corona patients and putting the UV light systems in them for decon. That's going to be completely unsustainable if this really ramps up.


 


 

gregbrady -
Trust -
mataleo1 - 
Mountain Medic - 

Hey docs- we are getting information on how long it might survive on cardboard and stainless steel.

 

Any thoughts on waterbourne , watershed viability/transmission?

 

Not trying to be a conspiracy guy, I'm just a rafter and spring run off is coming....

 


There are a few studies, the most famous one being that published in NEJM: https://www.nejm.org/doi/10.1056/NEJMc2004973

aerosols: 3h
Copper: 4h
Cardboard: 24h
Plastic: 2-3d
Steel: 2-3d

Will check for waterbourne, read conflicting data.

 

I would love to know the explanation behind this.  Why do these different surface materials affect a virus differently?  What is happening at the virus/surface level?  



aerosols tend to dry up quickly because of their large surface to volume ratio. the virus needs the polar nature of water in order for its proteins to fold into the correct 3 dimensnional shape to infect your cells


copper: some metals cause a chemical reaction on their surface that microbes arent very good at dealing with. its called the oligodynamic effect


cardboard tends to be absorbent and dries out quicker than plastic or steel surfaces. drying viruses out generally inactivates them

Appreciate you guys.

1 Like

Any truth to blood type playing a role in how your body responds? Rogan mentioned it on a podcast the other day. 

DY2 -

Thanks for your answers docs.


 


This video, from Italy,  I found to be a tough watch.  At one point a Dr says, with tears in her eyes, its a disaster.  A tsunami!


 


That is the thing that is very odd.  Tsunamis in several places.  China, Italy, Spain and France.  And yet elsewhere not yet tsunami's.  Its puzzling.  


 



 

Some perspective, it takes very little fora tsunami. Hospitals are not built for surges.


 


As an example, the Boston Marathon bomber event was 200 people across four of the top hospitals in the country. The fact that it worked was hailed as a huge success of an extremely hard problem.


 


Corona virus would bff much bigger

Non N00B -

Any truth to blood type playing a role in how your body responds? Rogan mentioned it on a podcast the other day. 

I have seen this mentioned anecdotally a number of places, but I don’t believe this has been proven

Just received a reminder from our state board of medical examiners that physicians should not prescribe themselves or their family hydroxychloroquine, chloroquine or azithromycin- which I assume means that some physicians have been doing that which is highly disappointing (essentially hoarding medications)

1 Like