Expanded title: COVID-19, 4 March update: implications of community spread
If I had a different primary care physician, I would want Dr. John Campbell to be that person. I've known hundreds of physicians first hand, i.e. under clinical conditions requiring mutual physician interaction. I've seen all kinds of bedside manner or what passed for same. I've seen M.D.s with varying level of compassion, ranging from none to social justice warriors. This is to introduce to you, if you don't already know, Dr. John Campbell, primary physician, NHS, UK has been producing daily youtube videos about COVID-19. Please heed what he says. I am not an infectious disease expert. I have personally treated patients with cerebral tuberculosis, viral encephalitis/non-herpetic, lymphocytic meningitis, etc. My level of knowledge has not kept apace of pharmaceutical and technological advancement. These achievements remarkably have occurred in only the 6 years I retired from my dual specialty practice.
Why am I writing this? For the same reason I am glad that I am a physician who helps people, people with pain, grief (another type of pain), sudden loss, news of grim tiding. I am no physician to anyone here. If I give information, it is information which I feel is reliable. For comparison, I would immediately refuse to evaluate medical information published in a for profit Press. If I do give opinions, they will be clearly labelled as such. [For those of you in the legal profession, you may notice the foregoing to be an informed consent explanation]
[video:https://www.youtube.com/watch?v=5Tlmfss3Piw]
From his video, a sheet specifically about North Korea
South Korea has community spread. 60% of confirmed cases have no identifiable patient zero. This means the arrival of COVID-19 is not a matter of IF but of WHEN.
I my opinion, unsupported by any but my personal experience with infectious disease (although admittedly limited and somewhat outdated) and my experience in epidemics / epidemiology. I have studied epidemiology in med school (a class to which I attended only twice during 8 weeks--but, I passed somehow.) I have also been victim of a few flu epidemics but never a rip-roaring pandemic like the 1970's swine flu. I didn't have any complications as my symptoms were only of a mild cold (what we medical types call Upper Respiratory Infections--URI).
However, many of my patients unfortunately availed themselves of a swine flu vaccine, specific to that strain allegedly. This result, as mentioned elsewhere, in more cases of Guillain-Barre, regional neuropathy, mononeuropathy and encephalopathy than from all cause in the remainder of my 30+ year career.
So, what I am attempting to do here, is present medical information in a manner understandable to people in general. I won't prescribe treatments even though I might discuss some.
Key messages, from D. Campbell and others:
Stock up but don't panic
Social isolation
Self-quarantine when in doubt
Wash hands--that means soap, water and 20 seconds' rubbing.
Added after expanded title posted
The original title failed to give an adequate discussion of the meaning of community spread. Community spread means that the current strain is now endemic. This enbdemia may however be temporary, e.g., seasonal. Hopefully like other influenzal strains, the virus will not thrive in warmer weather.
But containment is impossible. The only policy workable is delay. Delay until tests become rapid. Delay until tests become reliable. Delay until tests are widely available--not merely on "clinical suspicion". Clinical suspicion is about as good as betting on horse races, although in medicine there are a lesser number of horses in a given race. Carrying over an Obama-Era rule, the FDA could not allow states to perform certain testing. The result is a federal backlog of tests being released, partly due to bureaucratic inertia.
One of the better things Commander Cheeto has done is to allow states to develop and utilize their own testing. Drive-in/drive-out testing with immediate knowledge of results is available in South Korea and other countries. Why isn't it available here?
My theory is that Obomba in his desire for total governmental control of knowledge, limited testing issuance, reading, and reporting to one, readily edited source: the FDA. Obomba has politicized every single branch of government he could, in a deliberate fashion.
Comments
the advice here in Germany that shocked me the most
was the advice for people, who have flue symptoms (those who could carry the virus but don't know yet, if they carry it), the advice was to NOT GO TO THEIR doctors and sit in their waiting rooms. They were asked to call in, so that doctors would be forced to make a decision about testing or not testing without having seen the potential corona virus carrying patient.
I guess they will change advices as time passes.
It think the video was helpful and pretty precise in answering questions that popped up in my mind. Self-isolation as a family member or at the work place is almost impossible.
https://www.euronews.com/live
Situation in the UK and perhaps elsewhere
Testing is valuable provided it is dispensed with progressively less stringent reasons needed to so. These are called "indications" for testing.
Dr. Campbell Has Done Heroic Work... Too Bad He Isn't the
head of the WHO or CDC...
“Tactics without strategy is the noise before defeat.” ~ Sun Tzu
Refusal to test = artificially low numbers
Thanks for sharing the video. I've seen several of his videos. I also have been following the videos of another guy who mainly does economy/investment videos, and since this pandemic definitely affects the economy, he's covering covid19. He also has medical related degree or two and enjoys reading the scientific papers. He's good at dumbing it down for the rest of us.
In this video from 3 days ago he explains the exponential spread as well as the fact that the genetic makeup of the 1st known case in the US (WA state) matches that of the 2nd case in WA state SIX WEEKS LATER. Also, higher numbers reflect more testing. Our numbers are low because we aren't testing. Listen to one US doctor reveal that he was begging for patients to be tested, and being denied.
Case
Case
Case
Cluster
BOOM!
[video:https://youtu.be/CNQB-Q67DpE]
Shit is about to hit the fan. Maybe those doomsday preppers were on to something even if they didn't know what it was. Our meds are going to stop coming into the country soon, along with all the useless junk we consume. Even the stuff we make in the US will likely stop being produced when places have to stop production for a month or two. (Amazon has ordered their Seattle employees to work from home through the end of the month. Those are not production or warehouse folks. Those are executives.)
The guy from the video estimates, based on data for other strains of corona virus, that covid19 remains infectious on steel up to 9 days, and that the incubation period is up to 27 days, not 14.
Excellent comment
My suspicion is that the infectivity rate, R naught or R0, is much lower than 2.6 would imply. Think of the hundreds of people any person in an urban or semi urban environment comes into contact with daily. Consider a maximum 2 week infectivity duration, even though it may be longer as you write. Consider the thousands of contacts by an infected individual has haphazardly, causally every single day. Consider also, even allowing for a 3 week incubation period, the numbers of cases reported is artificially low, because testing is withheld, the U.S. should NOW--not in 3 more weeks--be seeing thousands of cases. Our ICUs are not overflowing--yet. They probably will be. As better case ascertainment develops, due to improved testing procedures, we will probably find that although a single person may infect 2.6 people during the course of his/her illness, why aren't more contacts from the hundreds being afflicted. Several reasons suggest themselves. Social isolation is one such reason. But the vast majority of the population is only now waking up to the growing.
If the death rate from COVID-19 is 1%, then it certainly is worse than ordinary influenza strains. But in reality, when the dust settles, we will find a much lower mortality.
Figures from this year's flu season (excluding COVID-19 cases) are 24,000,000 infected; 16,000 dead. That's a lot of deaths. But look at the figures another way. This year's "flu" has a mortality of 0.06% if we use these numbers.
I'm not a health professional
But learned something useful from one and I believe A Ed will correct if I'm wrong. You can mix bleach with water in a spray bottle, proportion 1 part bleach to 20 parts water, a 5% solution to make an antibacterial spray if you can't find the wipes. BUT the solution loses potentcy after 10 days, so make a small amount at a time.
Just did my 1st of the month shopping and learned that antiseptic wipes and hand sanitizer are sold out. I was told no hand sanitizer anywhere (in the world). Maybe the recipe will be useful to some people.
You are correct
Bleach, diluted for safe topical use, is an excellent disinfectant. It kills viruses, bacteria, fungi, and mycoplasma (think Tuberculosis)