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





Coronavirus (COVID-19) Update: March 5, 2020

6 03 2020

COVID-19 NOW TESTING POSITIVE IN THE HOUSTON AREA

My thoughts for a blog post in the morning always change by the evening.  Today I learned that three individuals who traveled to Egypt together, that the two in Harris County [Houston] who live in an unincorporated northwest area of Harris County, have had positive tests for COVID-19 and the one in Fort Bend County (which is southwest of downtown Houston in a suburb called Stafford) was presumptively positive.  One of the Harris County travelers was a professor from Rice University.  She had come into limited contact with an employee on February 24-25.  Fourteen Rice doctoral students, faculty and staff have been in self-quarantine away from campus.  None of those individuals have reported symptoms.  Potential contacts of the man from Stafford are being notified and being asked to self-quarantine for 14 days.   The only callers coming into the screening line in Stafford being referred for testing were those who were sick enough to go to a hospital and who had either come into contact with someone confirmed to have coronavirus or who had also traveled to China, Iran, Italy, Japan or South Korea.   People in area didn’t seem rattled by the news. 

The University of Houston announced that it requires students or staff returning from travel to countries under a CDC Level 2 or Level 3 travel warning related to coronavirus to self-quarantine for a period of 14 days away from campus.  Two faculty members and four students from the University of Houston are under a 14-day self-quarantine after returning from Italy and South Korea.

The Houston Health Department laboratory is now conducting COVID-19 testing for specimens collected by medical providers from patients who meet CDC COVID-19 testing criteria.

As a follow-up to my post about how companies planned to profit off Americans to come up with the test kits (and in the future a vaccine), companies we already pay upfront to subsidize their research with our tax dollars, a bright light came from sunny California from Governor Gavin Newsom:  BREAKING: we have ordered health insurance companies to waive ALL out-of-pocket costs for preventive coronavirus testing. Let’s hope other states will follow suit.

On Monday, March 2, 2020, San Antonio Mayor Ron Nirenberg declared a public health emergency Monday after the federal government released a woman from quarantine who tested positive for COVID-19.  The woman was among the 91 Americans evacuated from Wuhan and was placed in federal 14-day quarantine at Joint Base San Antonio-Lackland.  She tested negative twice for COVID-19 and was released on Saturday under the guidance from the CDC.  After the woman’s release, the CDC received the results of another test that showed a weakly positive confirmation of the virus that causes COVID-19.  Nirenberg said, “As mayor of this city, I find it totally unacceptable that CDC would release a patient prior to receiving all test results and potentially expose the public to this harm.”  According to the press release, the woman arrived at the Holiday Inn Express Airport at 3 p.m.  The woman also visited North Star Mall, where she browsed stores including Dillard’s, Talbot’s and Swarovski and ate at the food court.  They transported her to Texas Center for Infectious Disease at 2 a.m.  Local officials are tracking 16 people from the mall and three at the hotel who they believe had contact with her.  The city health department has recommended deep cleanings “with disinfectants” to both the hotel and mall.  Nirenberg said, “We simply cannot have a screw-up like this from our federal partners.  While the CDC is encouraging everyone to wash their hands and prevent the spread of the virus, as we would during the season, I would encourage the federal administration to not wash its hands of the responsibility to protect the public.” 

Bexar County Judge Nelson Wolff said that 235 people were still under quarantine at Lackland. They came from the Diamond Princess cruise ship which was quarantined last month off the coast of Japan.  Those evacuees were scheduled to be released Monday but local officials have requested a third round of testing before giving them the all clear. 

Eleven of those individuals had tested positive prior to this gross error and were still being monitored at Lackland. 

I caught some video of a news correspondent who was in Seattle.  It looks like a ghost town; it is creepy.  My husband said that when he went to the gym today (and he goes at the same time every night after work) he noticed more people had dropped off.  On Monday it wasn’t as crowded (like one-third of the people were not there) but he didn’t give it much thought, but as the week went on, it became less and less. 

Meanwhile, China has discovered that the coronavirus has mutated at least once into two strains.  One type, called type L, accounted for about 70% of the cases in China and is much more aggressive than the other strain, called type S, which is milder and is the source of about 30% of cases.  Type L was more common in the early stages of the outbreak in Wuhan, but began to decrease after early January 2020.  They believe human intervention may have placed more severe selective pressure on the type L, which might be more aggressive and spread more quickly.  But type S, which is evolutionally older and less aggressive, might have increased in relative frequency due to the relatively weaker selective pressure per the scientists.   “The researchers said the S type is thought to be the ancestral strain and that the findings ‘strongly support an urgent need for further immediate, comprehensive studies that combine genomic data, epidemiological data, and chart records of the clinical symptoms of patients with coronavirus disease 2019.”   It goes on to say “the genomes studied were only sourced from China, so it is unclear what strains are most common in other countries or if there have been further mutations.” 

The Trump administration said today they will not have the number of kits available as VP Pence stated in his press conference yesterday (stop promising things until you know that this is true).  The stock market does not like uncertainty as one could see by the drop after the gains yesterday.

The CDC still does not have its correct number of cases.  Even though it says their numbers are updated at noon every day (and these were the noon March 5, 2020 totals), they don’t even say these numbers on air.  These numbers aren’t even the ones they publicly said on Monday and it was now Thursday.  Heavy sigh.  They say the numbers that are accurate (which is more than double their number on their web site).   

This is incorrect information — BTW

And here are the stats I post at the end of every blog:  

In the United States there are now 215 cases confirmed by lab tests and sadly 14 deaths.   Deepest sympathies to the family and friends of these individuals. This is as of 12:30 a.m. March 6, 2020.

Of hopeful note, Mainland China only saw an increase of 143 cases between yesterday and today, perhaps a sign that things are getting under control there.  Switzerland has reported its first death from the virus as did the United Kingdom. 

All the countries on the chart below had increases from the day before with the exception of these countries who did not have tests showing positive results (doesn’t mean there aren’t more people infected):  Afghanistan, Andorra, Argentina, Armenia, Belarus, Brazil, Cambodia, Croatia, Denmark, Dominican Republic, Egypt, Estonia, French Guiana, Gibraltar, Hong Kong, Indonesia, Iraq, Ireland, Japan, Jordan, Latvia, Liechtenstein, Lithuania, Luxembourg, Macau, Malaysia, Mexico, Monaco, Morocco, Nepal, Nigeria, Pakistan, Poland, Qatar, Republic of Macedonia, Senegal, Sri Lanka, Tunisia, Ukraine, Vietnam.

The only new country on the list tonight is the West Bank and Gaza. 





Coronavirus (COVID-19) March 3

3 03 2020

People are panicking.  Today I went to pick up a few things at Walmart.  The hand sanitizer I expected to be gone; however, I didn’t expect to see all the Clorox and Lysol wipes to be sold out.  I looked at the man who was looking for an alternative.  I said, “People are panicking needlessly.”  I told him and wrote down for him my alternatives that will work just as well.  Also, all the alcohol was gone (not the kind you drink but the kind you use to sterilize things).  I saw that as I was getting antibiotic cream because we were out of that. I didn’t see anything else that might have disappeared from the shelves but I’m sure there probably is.  I had a specific agenda of things to get (you know, like yogurt, hornet spray, things like that). 


Last night I saw someone post something on the mayor’s FB page and said that their loved one tested positive for coronavirus but they told her she didn’t have the China coronavirus and accused the mayor of the city of a conspiracy.  I decided to reply to him.  I said the common cold is a coronavirus (of course I’m wondering how their loved one was tested to begin with since kits are not readily available but I didn’t say that), but the one in China is a specific coronavirus called COVID-19.  Coronaviruses included SARS and MERS, too, but it also included the common cold so stop freaking out.  What they told them at the hospital was accurate and it wasn’t some kind of conspiracy. 

My favorite infectious disease physician, Dr. Matt McCarthy, of NY-Presbyterian Hospital in New York City (who I believe has finally gotten that 1 person in NYC diagnosed that he was speaking of the other day that he said they all believed had the virus but was having problems with the testing process).  His comments on television today: “Before I came here this morning, I was in the emergency room seeing patients.  I STILL do not have a rapid diagnostic test available to me.”  The host of the show asked, “That’s easy to do.  Is it hard to manufacture?”  Dr. McCarthy replied, “It’s easy to do for some countries.  What happened in the United States is the CDC created a test, sent out to 50 states, then said, “Hold up.  Don’t use it.  Let us fix it.”  It’s now March.  We hear that it’s coming very soon, but I’m here to tell you right now at one of the busiest hospitals in the country, I don’t have it at my fingertips.  I still have to call the Department of Health.  I still have to make my case—plea—to test people.  This is NOT GOOD.” 


You could tell how frustrated he is.  And I’m certain he is talking about rapid testing like South Korea has with their drive-through process and also now China. 

Jeremy Konydyk is a senior policy fellow at the Center for Global Development. His research focuses on humanitarian response, USAID policy reform, and global outbreak preparedness.  Today he said his frustrations were 1) We have NOT had a disciplined, well-organized federal response; testing is the perfect example of that; there is a critical bottleneck that didn’t need to exist.  2) The fact that they didn’t solve this much earlier. 3) They don’t have any organization and focus that they need.  He hopes that with some of the reshuffling over the last week that it will start to move in that direction. 

As far as the charts below, cases confirmed remained stable in Afghanistan, Armenia, Azerbaijan, Belarus, Brazil, Cambodia, Croatia, Denmark, Dominican Republic, Ecuador, Egypt, Estonia, Finland, Georgia, Greece, Ireland, Israel, Lebanon, Lithuania, Luxembourg, Macau, Malaysia, Mexico, Monaco, Oman, Nepal, New Zealand, Pakistan, Philippines, Romania, San Marino, Sweden, and the UAE. 

Sadly, new to the list are Andorra, Indonesia, Jordan, Nigeria, Portugal, and Senegal.  

All other places have increased their numbers.  The United States, now at 103 diagnosed cases, will see a huge jump in numbers once the test kits become more readily available but remember that is because of better diagnostics not necessarily that it is spreading.  In the meantime, wash your hands well, keep your hands away from your face and mouth, use a paper towel or your shirt sleeve or tissue to open door handles – take simple precautions; don’t panic; don’t freak-out. 

The map & charts were updated 12:36 a.m. Eastern Time on March 3.





Twelve Hours

19 01 2012

Twelve Hours…half the number of episodes of the series “24”.  Or in geekdom terms, the amount of time it takes to watch all three extended-edition versions of The Lord of the Rings trilogy with appropriate bathroom and snack breaks if one hurries.  At 4:00 a.m. I was thinking about shadows in the Mines of Moria. At 3:55 p.m., a phone call delivered to me the light of Elendil.

Already it has been a week since my friend was buried, and the day was similarly splendid in terms of weather.  A good start to any day.  I believe that to create change, you have to be proactive, so I was off to see a counselor. There is wisdom in the balance of body-mind-spirit; my triangle in the last year has looked more scalene than equilateral. Thomas Merton said, “Happiness is not a matter of intensity but of balance, order, rhythm and harmony.”

At 3:55 p.m., I received an unexpected phone call from my nephrologist. Phone calls taken between 3:50 and 4:10 p.m. with 936 area codes usually are bus drivers telling me Patrick is having a seizure somewhere along the drive home.  After a few seconds to readjust that this phone call is about me and not Patrick, I said something to the effect that I wasn’t expecting him to call (before my appointment) so this must be very bad news. I am looking at my clock thinking, “Oh crap, and Patrick is going to be walking off the bus any minute.” I put my elbows on the kitchen counter, closed my eyes and took a deep breath. On the contrary, he says. My labs came back normal and my creatinine was going way down as was my urine protein. (Can I get a “Frack yeah?”) I asked, “So is it that “minimal change disease” thing? “Minimal change disease…sort of.”

“Good God,” I think to myself. “I have yet another “disease variant.” Honestly, if I’m going to have all these “disease variants”, I DEMAND a really sexy superhero costume with a cool name.  Biohazard doesn’t have the same ring to it as say DV Girl!

To make a long story short, this is the second best possible news.

Our game plan is this: I stop taking nonsteroidal anti-inflammatory medication. We do an allergy re-challenge of Ultram for my pain (to take if I’m desperate) and hope it doesn’t increase my intracranial pressure due to my pseudotumor cerebri issue like it did before, which after 5 years has been under decent control.  I will continue losartan to keep the protein in my urine down. I do NOT have to take immunosuppressive medications. I go back to see him in March (birthday month!).

Just 12 hours after my post I got answers I was not expecting for another 16 days, 12 hours, 30 minutes give or take a few minutes, but who’s counting?  Which begs the next question:  Is the internet God?

–Hilda  





Shadows to Shade

18 01 2012

I’m scared.

There. I actually wrote the words down; I wasn’t sure if I could. Many know I’m grieving right now, but few know how scared I am. Not a panic that I feel when I try to sing in public; not my posttraumatic stress disorder panic and anxiety related to certain medical procedures that remind me of an assault that occurred in my 20’s and/or my recent hospitalization for whatever happened to my arm that resulted in that horrible infection I had. This is…..something else.

I’ve been in denial about it for several months, believing from head to toe that if I thought it was NOT true, it would turn out not to BE true–the power of positive thinking. Names have great power; I did not want this to have any power.

When I found out last Monday that my friend, Diane, died, it snapped me back to semi-reality and I accepted that my test results on Friday would come back positive (as my doctor had informed me they would), but the question of what it was and to what degree still lurked in the shadows.

Shadows remind me of my childhood in our tenement in Brooklyn where this spine-chillingly vicious dog lived that would lurch out and try to bite me every time I went up the stairs. Shadows were the bad things that were about to happen to me in the rooms of my home most of my so-called childhood. Wondering, when I was age 4-5, if the wife could survive the beating from her husband in the shadows under the neighbor’s door. Shadows are the terrors that torment you, the face you see in every person after you’ve been told at age 9 that your stepfather may show up one day and try to kill you. Shadows of the life you would never have had when your mother tells you she wished she had aborted you (and meant it). Shadows are the abandonment you feel at age 14 when she tells you to leave and take only what you have bought with your own money with you. And the shadows that stretched from her grave to crush my heart one last time when my sisters found their baby pictures while going through her stuff, confirming that when she laughed in my face when she said she threw mine out, that I guess she really did. The only evidence of my existence that I was in her life are in those pictures I happened to be in with my sisters. Thrown away into the shadows of garbage she felt I was.

I was about 14 months old here; the earliest picture that exists of me now. My sister, Eva, holding my hand. I was a cute baby!

After all I’ve been through and all I’ve seen, to say I’m scared now seems illogical. The tests did come back positive, but there seemed to be more questions now after the kidney biopsy than answers. A lot of blood work was drawn after that visit–more shadows.  Yet, there is a difference.  There is trust, great trust, in those caring for me that is helping to keep the shadows in their place.

On February 3, I hope we will be able to modpodge some of the puzzle.  Names have great power, even names things are not. Until then, I remain in….shade.