germs

How did Ernest Hemingway describe going bankrupt — ‘gradually, and then suddenly’

How Fear Can Spread Like a Virus

TV medical dramas gives their masks to hospitals to help fight the coronavirus

There were no new cases of the novel coronavirus in the past 24 hours in Hubei province, China, including the city of Wuhan, where COVID-19 was first discovered, per a post on the local health department’s website Wednesday.

99% of Those Who Died From Virus Had Other Illness, Italy Says

[social distancing] will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced. [Imperial College COVID-19 Response Team | PDF]

Antiviral drugs that had held promise as a potential treatment for the coronavirus did not work in one of the first major studies in seriously ill patients, researchers from China reported on Wednesday. “No benefit was observed,” the researchers wrote in The New England Journal of Medicine. The study tested Kaletra, a combination of two antiviral medicines, lopinavir and ritonavir, that are normally used to treat H.I.V.

Recovery depends on the strength of the immune system

The better we get at interventions to identify and isolate specific people with the virus, the less we should need to rely on interventions that isolate the entire population. […] South Korea and Singapore have been successfully addressing their coronavirus epidemics with less extensive social-distancing measures than are currently seen in Italy, France, and parts of the U.S., in part because of their effective testing and surveillance regimes. The Financial Times reports today on the town of Vò, Italy, which successfully stopped its local outbreak though a strategy that involved widespread testing of the population and isolation of those who tested positive, even as the rest of Northern Italy did not fare so well. […]

It is also possible that effective antiviral treatments to treat the sick will be available much sooner than a vaccine that protects the healthy. This is partly because ongoing trials are testing whether already existing antiviral drugs, approved and on the market to fight other viruses, can reduce the severity of COVID-19 and save lives.

{ NY mag | Continue reading }

Evidence is starting to emerge that temperature and humidity do make a difference in the ability of the virus to infect large numbers. […]

Some Southeast Asian nations with close business and tourism links to China have seen surprisingly few cases, even if you assume their less developed public health systems are missing infections. Thailand, Indonesia and the Philippines have each seen fewer cases than Estonia, Slovenia or Iceland, despite a combined population more than 100 times as large. […] In extreme cold and very hot and wet conditions the virus is “largely absent,” the researchers from Spain, Portugal and Finland wrote, meaning that people in tropical and polar climates are unlikely to see local transmission of cases. […]

Another pre-print study by four Beijing-based researchers uploaded to the arXiv server last week comes to a similar conclusion after analyzing the infection rates in 100 Chinese cities. […]

Both studies are still just computer models, and neither has been through peer review. On top of that, even a reduced rate of infection will only slow, rather than halt the spread of this pandemic.

{ Bloomberg | Continue reading }

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eight children persistently tested positive on rectal swabs even after nasopharyngeal testing was negative

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Don’t touch your face. It’s exactly what will make you sick.

– To protect yourself, sanitize your hands immediately before eating and immediately after touching things touched by others to avoid getting viruses.

– To protect others, use clean hands to touch others’ things or when handling things to others.

– Sanitize objects given to you and only pass objects that have passed your own cleanliness test to others. For example, I have my hand sanitizer bottle open and ready to clean my credit card immediately after I get them back from cashiers, before I put it back in my wallet.

– Sanitize smooth surfaces you are going to touch directly with your hands (e.g. tables and chair edges, places where you set down your phone and computer). Use paper towels to turn off faucets and open bathroom doors.

– To keep the number of times I have to sanitize, I keep track of whether clean objects and hands stay clean. As long as my hands or my objects have not encountered unknown/dirty things after their last cleaning, they don’t need to be recleaned. This is why I suggest immediate sanitation of hands after touching things of unknown cleanliness, so you can resume using your clean things without worry.

– Sanitization can be done by soap and water (hands) or hand sanitizer (hands or objects) or windex (objects)

– Finally, if your hands are clean, you can touch your face.

[…]

– I’d suggest not eating prepared salads or sandwiches. There may be no evidence that these are risky, but I prefer my foods cooked anyway.

– Don’t share food, obviously.

– Go outside – sunlight is the best disinfectant.

[…]

– 50% of people with virus have no symptoms but will
become immune just like most infected people

– 95% don’t need to go to the hospital

{ Michael Lin, | Continue reading }

We need to stop picturing that ubiquitous “flatten the curve” chart and start imagining a roller coaster. […]

No one knows for sure how long social distancing will have to last to reduce the spread to near zero. But if South Korea and China are appropriate exemplars, we’ll need to stay apart now for at least eight weeks, and maybe more. China locked down Wuhan and other cities in Hubei province on Jan. 23. Today, provincial officials are reporting few or no new cases of the virus. Just a few days ago, they closed the last of their 16 makeshift emergency hospitals. Consequently, restrictions are easing. Schools and offices are slowly opening. People are beginning to go out and see other people. […]

A likely scenario is that there will be subsequent waves of the disease. […] The next round of social distancing will be activated more rapidly, because officials — and the public — will be more prepared. It should also be shorter, because we can assume that most of the people who were initially infected are likely to be immune next time around. But it will still disrupt people’s lives and the economy. We will still have canceled conferences and sporting events. People will not frequent restaurants and will not travel. The service industry will be severely curtailed. And it’s going to happen again and again.

{ NY Times | Continue reading }

Countermeasures in Wuhan and elsewhere have already reduced the local R0 of COVID-19, with research suggesting the R0 was reduced all the way down to 0.32 in Wuhan in early February after extensive testing and containment measures. In Italy, which implemented aggressive countermeasures fairly late into their local epidemic, preliminary analysis suggests the R0 was reduced from 3 in late February to 1.7 in early March and the number of new cases has dramatically slowed down.

According to an analysis published in the Lancet, approximately 95% of the Wuhan population remained uninfected by the virus at the end of January, after the peak of their crisis, as a result of aggressive countermeasures. These data on their own indicate that herd immunity is not an inevitable outcome, nor is the possibility that up to 80% of the UK population will be infected within the next year.

{ Unherd | Continue reading }

Israeli Nobel Laureate Michael Levitt said most people are naturally immune, and that since the infection rate in China is slowing down, “the end of the pandemic is near.” […]

“The rate of infection of the virus in the Hubei province increased by 30% each day — that is a scary statistic. […] Had the growth continued at that rate, the whole world would have become infected within 90 days. […] In exponential growth models, you assume that new people can be infected every day, because you keep meeting new people. But, if you consider your own social circle, you basically meet the same people every day. You can meet new people on public transportation, for example; but even on the bus, after some time most passengers will either be infected or immune.”

[…]

The Diamond Princess cruise ship represented the worst-case scenario in terms of disease spread, as the close confines of the ship offered optimal conditions for the virus to be passed among those aboard. “Those are extremely comfortable conditions for the virus and still, only 20% were infected. It is a lot, but pretty similar to the infection rate of the common flu,” Levitt said. Based on those figures, his conclusion was that most people are simply naturally immune.

However, that doesn’t mean Levitt is dismissive of the precautions being put in place by governments around the world.

{ Jerusalem Post | Continue reading }

Researchers found that the novel coronavirus could be detected on

Copper for up to four hours
Cardboard for up to 24 hours
Plastic and stainless steel for up to two to three days.

Also, the coronavirus could linger in aerosols — the suspension of tiny particles or droplets in the air — for up to three hours.

{ NIH | Continue reading }

more:

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

Coronavirus COVID-19 Global Cases

COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv

Was his help inshored in the Stork and Pelican against bungelars, flu and third risk parties?

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We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts. We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go. As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population. […]

The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc). Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients). By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.) […]

[T]he doubling time will start to slow once a sizable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population.

{ Liz Specht | Continue reading }

The median incubation period was estimated to be 5.1 days, and 97.5% of those who develop symptoms will do so within 11.5 days of infection.

{ Annals of Internal Medicine | Continue reading }

related { How the drug industry got its way on the coronavirus }

photo { President Xi Jinping of China, right, was briefed at the Huoshenshan Hospital in Wuhan on Tuesday. The hospital was built in a matter of days in February to treat coronavirus victims. | NY Times }

Prepare for self-quarantine

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Most estimates suggest 80% of COVID-19 cases are mild and feel roughly like a flu. Estimates I have seen suggest that roughly 10-15% of cases will be more significant and may necessitate hospital visits (see also) with 1-3% potentially needing an ICU. The concern of many governments is the peak number of cases that occur in a given moment. […]

The reported death rate has hovered around 2% but may in reality be 0.2% to 1% depending on country and healthcare system. Many estimates tend to indicate an overall expected mortality rate of ~0.5% globally. The current existing fatality rate is biased upwards by Wuhan cases dominating the mix (which are closer to a 3-4% death rate and make up most cases). It is possible the virus is being undertested for in China / rest of world driving the real death rate down (as many more people are infected than is reported). […]

R0 value: The spread rate of the virus seems to be well over 2 and likely ~3. This means for every person infected at least 2 to 3 more get the disease.

{ EladGil | Continue reading }

Experts think there may be many people with no symptoms at all, or such mild ones that they never bother to seek medical attention. Because those cases have not been counted, it’s not possible now to know the real proportion of mild versus severe cases. […]

After viral infections, people generally develop antibodies in their blood that will fight off the virus and protect them from contracting it again. It’s reasonable to assume that people who have had the new coronavirus will become immune to it.

But it is not known how long that immunity will last. With other coronaviruses, which cause the common cold, immunity can wane.

{ NY Times | Continue reading }

The best estimates so far suggest that Covid-19 kills about 1% of people it infects. That number may go up somewhat or fall significantly; either way it could add up to a dreadful toll.

If 60% of the world’s population is ultimately infected, as suggested by Gabriel Leung, chair of public health medicine at Hong Kong University, a 1% fatality rate would kill almost 50 million people — similar to the 1918 Spanish flu. If that falls to 0.1%, it could still be roughly 10 times more fatal than the 2009 H1N1 influenza outbreak, which killed several hundred thousand in its first year. […]

The most severe period of initial infection could soon be fading. Respiratory diseases flourish in the cold season and taper off as the weather warms up. That should cause infection rates to slow in the northern hemisphere, while continuing at a lower level in tropical regions and spiking in temperate parts of the southern hemisphere where winter will be setting in. When a new year rolls around, the bulk of the disease will shift back to the northern hemisphere, to begin the cycle again.

Subsequent Covid-19 seasons probably won’t be as serious. Those who survive viruses should be immune from reinfection (though there have been reports of people being diagnosed with Covid-19 for a second time), and as the share of survivors in the population rises, it gets harder for a disease to spread. […]

In a best-case scenario, it’s even possible that vaccines may be available in not much more than a year.

{ Bloomberg | Continue reading }

The only path to flattening the curve for COVID-19 is community-wide isolation: the more people stay home, the fewer people will catch the disease. The fewer people who catch the disease, the better hospitals can help those who do. […]

Get a flu shot, if you haven’t already, and stock up supplies at home so that you can stay home for two or three weeks, going out as little as possible. […] Here’s a handy, one-page guide on what you need.

{ Scientific American | Continue reading }

related { CoronaCoin: crypto developers seize on coronavirus for new, morbid token }

You live and you learn

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The “hygiene hypothesis” […] suggests that people in developed countries are growing up way too clean because of a variety of trends, including the use of hand sanitizers and detergents, and spending too little time around animals.

As a result, children don’t tend to be exposed to as many bacteria and other microorganisms, and maybe that deprives their immune system of the chance to be trained to recognize microbial friend from foe.

That may make the immune system more likely to misfire and overreact in a way that leads to allergies, eczema and asthma, Hesselmar says. […]

In their latest research, the researchers took a look at how people wash their dishes. […] In families who said they mostly wash dishes by hand, significantly fewer children had eczema, and somewhat fewer had either asthma or hay fever, compared to kids from families who let machines wash their dishes.

{ NPR | Continue reading }

photo { Daria Zhemkova photographed by Mario Kroes }

Maître d’: Ah, good afternoon, sir; and how are we today? Mr Creosote: Better.

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Far more attention has been paid to the microbes in our feces than the microbes in our food. […]

We characterized the microbiota of three different dietary patterns in order to estimate: the average total amount of daily microbes ingested via food and beverages, and their composition in three daily meal plans representing three different dietary patterns.

The three dietary patterns analyzed were: (1) the Average American (AMERICAN): focused on convenience foods, (2) USDA recommended (USDA): emphasizing fruits and vegetables, lean meat, dairy, and whole grains, and (3) Vegan (VEGAN): excluding all animal products. […]

Based on plate counts, the USDA meal plan had the highest total amount of microbes, followed by the VEGAN meal plan.

{ PeerJ | Continue reading }

‘I only hope that we never lose sight of one thing — that it all started with a mouse.’ –Walt Disney

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“There’s as much biodiversity in the soils of Central Park as we found in the soil… from the Arctic to Antarctica” […] almost 170,000 different kinds of microbes. […] The team also found 2,000 species of microbes that are apparently unique to Central Park.

{ NPR | Continue reading }

‘All stable processes we shall predict. All unstable processes we shall control.’ —Von Neumann

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Few human possessions are so universally owned as mobile phones. There are almost as many mobile phones as there are humans on the planet. More people worldwide own mobile phones than have access to working toilets. These devices not only help individuals share information with each other, they are increasingly being used to help individuals gather information about themselves. Smartphones — mobile phones with built in applications and internet access — have rapidly become one of the world’s most sophisticated self-tracking tools. Self-trackers and those engaged in the “quantified self” movement are using smartphones to collect large volumes of data about their health, their environment, and the interaction between the two. Continuous tracking is now obtainable for personal health indicators including physical activity, brain activity, mood dynamics, numerous physiologic metrics and demographic data. Similarly, smartphones are empowering individuals to measure and map, at a relatively low cost, environmental data on air quality, water quality, temperature, humidity, noise levels, and more.

Mobile phones can provide another source of information to their owners: sample data on their personal microbiome. The personal microbiome, here defined as the collection of microbes associated with an individual’s personal effects (i.e., possessions regularly worn or carried on one’s person), likely varies uniquely from person to person. Research has shown there can be significant interpersonal variation in human microbiota, including for those microbes found on the skin. We hypothesize that this variation can be detected not just in the human microbiome, but also on the phone microbiome.

{ Meadow/Altrichter/Green | Continue reading }

O Lord what a row you’re making like the jersey lily easy

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This research project focused on the potential spread of bacteria when blowing out candles on a birthday cake. […] We tested whether salivating before blowing out the candles over icing would affect the outcome. To simulate a realistic party atmosphere, this procedure included consuming a slice of fresh pizza prior to blowing on the candles. We determined that a higher level of bacteria was transferred with this procedure than the previous testing. These results led us to conclude that bacteria expelled from the mouth can, in fact, contaminate birthday cakes and other potential food samples.”

{ via Improbable | Continue reading }

photo { Maurizio Di Iorio }