Coronavirus (COVID-19) Update: New info about the virus

11 03 2020

NEW STUDY BY NEW ENGLAND JOURNAL OF MEDICINE

This warrants its own blog post.  Here is a warning.  This is going to flip everything you have heard about this COVID-19 virus.  This was a study that was published by the New England Journal of Medicine on February 28.  These are the take-aways from that report.

The WHO has updated the death rate on Wednesday to 3.4%. 

The study from the NEJOM looked at 1,099 COVID-19 patients.  The majority of non-severe cases (60%) are teens and adults between 15 to 49 years old which could suggest this group is spared the worst.  In the public, this is what we have been told up until I read this today.  The truth is severe cases were slightly more prevalent in the younger demographic.  Of the 163 severe cases reported in the study, 41% were young adults ages 15-49; 31% were ages 50-64; and 27% were ages 65 and up. 

According to the Chinese CDC, after looking at 72,000 patients, millennials and Gen Z are also just as likely as the older groups to contract the virus.  Risk should be factored by underlying medical conditions.  So, what are the risks?

This is where it gets a little graphic.  “The novel coronavirus tears apart the lungs” but, according to the American College of Cardiology, they state the condition that is most connected with the worst outcomes are heart issues.  Examples would be high blood pressure, acute cardiac injury, arrhythmias, hypotension, and tachycardia as well as atherosclerosis.  They are not sure exactly why other than the heart and lungs are interconnected.   One study in China of 150 patients from Wuhan, China, they found that patients with cardiovascular disease had a significantly increased risk of death when they are infected.  Dr. Erin Michos, cardiologist of Women’s Cardiovascular Health at Johns Hopkins Medicine in Baltimore said a lot of people are walking around unaware of plaques in their arteries or that they have hypertension.  The CDC said 108 million Americans have hypertension but at least 11 million have no idea they have it.   Diabetes is often associated with cardiovascular problems and it is in the high-risk category.     

Next issue is chronic respiratory illness (like cystic fibrosis, COPD, asthma or reactive airway disease or allergies and people with lung damage linked to smoking).  There is a long incubation period which ranges from 2 to 14 days. 

A new study in the Lancet has found that coronavirus patients SHED THE VIRUS (which means they are still contagious) FOR (sit down for this) BETWEEN 8 TO 37 DAYS.  Thirty-seven days!!!!!!!??????  Oh, I’m screwed.  I take immunosuppressants and I can’t be around anyone who has gotten a vaccine with live virus because they shed the virus, too.  Back in 1997 when they were giving the oral polio solution, I had to get my son the inactivated polio injection so that I didn’t have to go away until he was done shedding polio virus.  There were cases with my disease where people got polio by being around people who got the live virus.  Now that is the standard of care (the IPV versus OPV). 

So why is this a problem.  Here is what I envision:  Person A is exposed to someone with COVID-19 or maybe they think they are coming down with symptoms and their doctor asks them to stay in their home for 2 weeks.  Let’s say they get the very mildest form of this.  They call their doctor and say, “I got a scratchy throat but that was it.”  Doctor says, “Well, if you didn’t have any other symptoms than that then maybe it was just allergies but stay in your home for the 14 days just to be on the safe side.”  Person A goes out in public on day 15.  From day 15 until possibly 37 days they are shedding virus wherever they go and people start getting sick. 

Dr. Enid Neptune, a pulmonologist at Johns Hopkins Medicine, said that with any chronic respiratory illness, she would advise her patients to come up with a plan of protection with their doctors which might include knowing which nearby hospitals employ respiratory specialists. 

Cancer patients and immunocompromised individuals are also at risk.  Dr. J. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society in Atlanta said this in an interview: “Patients who have had cancer treatment in the past may also remain immunologically compromised even though they appear to have recovered.” 

The Chinese CDC recorded 44,600 confirmed cases with children involved, but only 400 involved kids under 9 years old and none died.  The question is postulated are children less likely to be infected or that they just didn’t get sick?  Dr. John Williams, Chief of the Division of Pediatric Infectious Disease at the University of Pittsburgh Medical Center thinks the latter is true.  Once testing begins to include more mildly symptomatic patients, outpatients in clinics, and doctors’ offices, they’ll find a lot more kids who are positive (as well as the adults). 

China also has suggested that the virus can spread BEFORE symptoms present, but there is no evidence for these claims so far although Raina MacIntyre, a professor of global biosecurity at University of New South Wales, Australia, said that young people could have the virus without displaying any symptoms. 

HOW LONG CAN THE VIRUS LAST ON SURFACES

Dr. Robert Redfield, director of the CDC said this:  On copper and steel, it’s about 2 hours.  On other surfaces like cardboard and plastic it is longer and so we are looking into this.  The Journal of Hospital Infection found that coronaviruses may persist on surfaces for up to 9 days.  Best thing you can do after handling a package would be to wash your hands. 

WHAT ARE THE SYMPTOMS

According to the Lancet’s January 24th edition:

COMMON SYMPTOMS

Fever

Dry cough

Fatigue or muscle pain

Breathing difficulties

LESS COMMON SYMPTOMS

Coughing up mucus or blood

Headaches

Diarrhea

Kidney failure


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