[Health] The Infectious Diseases Thread

[Unagi]

USA (#1 !) now has more confirmed cases than Italy and Spain combined (#2 & #3).

New York added approx. 8,500 new cases yesterday to their total, which is the total number of cases (8,500) in the entire state of California (who's in 3rd place).

[Jeff V]

She sounds mentally ill.

She sounds like she needs a hug.

From an infected person.

[Zaxxon]

USA (#1 !) now has more confirmed cases than Italy and Spain combined (#2 & #3).

Nobody has ever seen anything like it.

[soulbringer]

Well, I got exposed 2-3 days ago. Got the email from work that someone reported negative was actually positive. Ive been going over in my head the vast amount of exposures that probably occurred due to this mixup is astounding. I did have a low grade temp last night but otherwise feel fine. Hopefully this is gonna be nothing but im in isolation at home for the time being.

[AWS260]

Good luck! Fingers crossed for it being nothing.

[dbt1949]

It was reported on the news today that a state lawmaker has tested positive for coronavirus. He showed no symptoms.
Why was he getting tested then?

[LawBeefaroni]

I have a nursing assistant who is probably the most compassionate care giver I have worked with or managed.

Yesterday afternoon on his way home he stops for gas to fill up. He hears a lady shouting a couple tanks over from where he's at. Turns out she was yelling at him, "how dare you come out in public after taking care of sick people and risk me and my children's lives."

She proceeds to walk over and spit on him.

My nurse is the type of guy who would risk his health and well-being to care for a stranger, such as this lady. And she spat on him.

"Non-essential" and bitter about it. Her ass needs to be at home trying to remember what compound fractions are as her kids stick fig newtons on the walls.

[gameoverman]

If he's symptomatic now he's probably contagious now and didn't have it 4 weeks ago. Unless he just happens to have something else now.

My understanding has been that you could be asymptomatic and still be infected and still be spreading it. I also understand that it's in the realm of the possible that you could be exposed to it, fight it off briefly, then continue to be exposed to it and eventually get sick. I'm assuming the wife was tested because she was suspected to be sick with it. This means she could have been infected up to two weeks before that. That's where I'm getting the four weeks back he was exposed to the virus. And that's assuming he's not the one who gave it to her in the first place. I would not assume that she was only spreading it after she tested positive. I would not assume he only can spread it after he gets sick. He could indeed be sick with something else now, or something else plus this new virus. He shouldn't have gone to work after getting sick, but that's easy for me to say because I'm not the one who needs his paycheck.

[LawBeefaroni]

Yeah, but you start out asymptomatic and either stay that way or get symptoms within 3-14 days. Having symptoms now means you probably didn't have it 4 weeks ago.

[Kraken]

Well, I got exposed 2-3 days ago. Got the email from work that someone reported negative was actually positive. Ive been going over in my head the vast amount of exposures that probably occurred due to this mixup is astounding. I did have a low grade temp last night but otherwise feel fine. Hopefully this is gonna be nothing but im in isolation at home for the time being.

Good luck. Most of us -- likely on the order of 70% -- will get Covid eventually, and most of us will be fine. We just want to put "eventually" off as long as possible, or at least until after the caseload peaks...to the extent that we can do that. Some of us will inevitably get unlucky.

[Unagi]

Yeah, but you start out asymptomatic and either stay that way or get symptoms within 3-14 days. Having symptoms now means you probably didn't have it 4 weeks ago.

I think gameoverman is arguing you could 'host' this for well over 4 weeks, before you are even considered to 'have it and be asymptomatic'.

If you quarantined a person for 3 weeks, I believe the idea is that if they had it, they are now over it and no longer contagious.

How many weeks do you feel that 'really' is gameoverman? 8 ? 12? unlimited?

[Smoove_B]

Paging Dr. Smoove: on a scale of 1 - 10, how risky would it be if my gf came to stay with me during the quarantines? She lives in northern Florida and I'm in Charleston, both of which have cases but are certainly not current hotspots. In any case, we've both been working from home and self-isolating for the last few weeks. Florida just announced a 30 day stay-at-home order that goes into effect midnight tomorrow, so she was thinking about heading up before then.

Your question makes me uncomfortable, mainly because what you're proposing involves risk and I am wired to avoid risk. That being said, it sounds like you have both been following protocol, however the risk is that one of you is asymptomatic and that you'd give it to the other one upon your re-connection. However, the mental health benefits to this arrangement likely outweigh the low risk it involves. I think if you've both been following protocol (i.e. working from home, minimal contact with outside world, etc...) then this is likely an acceptable risk to take. To paraphrase Janet, also not a doctor.

[gameoverman]

Yeah, but you start out asymptomatic and either stay that way or get symptoms within 3-14 days. Having symptoms now means you probably didn't have it 4 weeks ago.

I think gameoverman is arguing you could 'host' this for well over 4 weeks, before you are even considered to 'have it and be asymptomatic'.

If you quarantined a person for 3 weeks, I believe the idea is that if they had it, they are now over it and no longer contagious.

How many weeks do you feel that 'really' is gameoverman? 8 ? 12? unlimited?

What I'm arguing is more like this: If I get exposed to it, I can be a carrier and spreader even though I myself don't get sick from it. Then, two weeks later, I come into close proximity to someone who is infected and maybe they are sick(as in sneezing/coughing). This second time I'm exposed results in me getting sick two weeks later. So you can see how for four weeks I've been a carrier and spreading it, even though I myself have only been sick this past week or two.

Thinking the danger at work with him starts after he knows his wife is positive with it and he himself is sick makes no sense to me. That's because the risk didn't start with his wife's positive result or him getting sick. Those two things come at the end of the trail of the spreading virus, not at the start. The start was back when the wife or husband was first exposed and that was weeks ago.

How long do you have to be quarantined to be no longer contagious? My understanding of that issue is that only two things will stop this virus from spreading, and therefore stop infected people from being contagious- a vaccine or herd immunity. As long as we have neither it IS spreading, the most we can do is flatten the curve but not stop it entirely.

[Alefroth]

What I'm arguing is more like this: If I get exposed to it, I can be a carrier and spreader even though I myself don't get sick from it. Then, two weeks later, I come into close proximity to someone who is infected and maybe they are sick(as in sneezing/coughing). This second time I'm exposed results in me getting sick two weeks later.

Are you sure that's how it works?

the most we can do is flatten the curve but not stop it entirely.

Which is exactly what everyone is saying.

[Anonymous Bosch]

Coronavirus breakthrough: Doctor featured on Netflix's Pandemic finds COVID-19 'cure'

With the total number of cases worldwide now closing in on 900,000, scientists the world over are scrambling to identify vaccines and other treatments. Dr Jacob Glanville, CEO of Distribute Bio, has revealed he and his team have adopted a pioneering approach which offered the potential for dramatic results. He tweeted: "After 9 weeks we have generated extremely potent picomolar antibodies that block known #neutralizing #ACE2 #epitopes, blocking the novel #coronavirus from infecting human cells."

Speaking to New Zealand Radio's Checkpoint programme, he added: "I'm happy to report that my team has successfully taken five antibodies that back in 2002 were determined to bind and neutralise, block and stop the SARS virus.

"We've evolved them in our laboratory, so now they very vigorously block and stop the SARS-CoV-2 [COVID-19] virus as well."

The antibodies would make suitable medicines once they had gone through a process of human testing, Dr Glanville explained.

Describing the new virus was a "cousin" of SARS, which emerged in the far east in 2003, he added: "What we've done is we've created hundreds of millions of versions of those antibodies, we've mutated them a bit, and in that pool of mutated versions, we found versions that cross them over.

"So now we know they bind on the same spot as the new virus, COVID-19.

"It binds the spot that the virus uses to gain entry into your cells. It blocks that.

"At this point we know it binds the same spot extremely tightly with high affinity."

Military scientists work with the virus itself, Dr Glanville stressed, as he did not want either COVID-19 or SARS in his lab.

He said: "The next step is we send the antibodies to the military, and they will directly put those on the virus and show that it blocks its ability to infect cells.

"The other nice thing about it is you want the stamp of approval of a government military to independently test your work.

"This is one of the foundations of good science."

Dr Glanville added: "Antibodies are attractive because you can give them to a patient right when they're in the hospital like an antiviral.

"You can also give them to doctors, you could give them to the elderly people to prevent them from getting sick."

Other scientists around the world are also working on developing antibodies, Dr Glanville said, while emphasising his belief that he and his team had a head-start.

He explained: "Part of the reason we think we're moving pretty fast is that instead of starting from scratch discovering an antibody, we went to these existing antibodies that were already extremely well characterised against SARS. And we've adapted them. So we're piggybacking on two years of research.

"It's sort of like a short-term vaccine, except it works immediately."

"A vaccine could take six to eight weeks to take effect, where this will take effect within 20 minutes. You could give it to a patient who's sick, experiencing COVID-19, then within 20 minutes of receiving the shot, their body is flooded with those antibodies."

Unlike a vaccine, antibodies would only offer short-term protection, perhaps between eight and 10 weeks, Dr Glanville stressed, but nevertheless if it worked it would have the potential to relieve pressure on health services significantly.

And crucially, treatments could theoretically be available by the autumn.

[Kasey Chang]

I have a nursing assistant who is probably the most compassionate care giver I have worked with or managed.

Yesterday afternoon on his way home he stops for gas to fill up. He hears a lady shouting a couple tanks over from where he's at. Turns out she was yelling at him, "how dare you come out in public after taking care of sick people and risk me and my children's lives."

She proceeds to walk over and spit on him.

My nurse is the type of guy who would risk his health and well-being to care for a stranger, such as this lady. And she spat on him.

Ask her if she'd like to deliver food and other "essentials" to his house or know of some people who would.

People are behaving irrationally. It's understandable, but not acceptable.

[gameoverman]

Are you sure that's how it works?

Which is exactly what everyone is saying.

Unagi asked how long I thought a person needed to be in quarantine before they wouldn't be able to spread it. That's why I brought up the 'flatten the curve' thing. We are all asked to shelter in place, sick or not, why? Because symptomatic or not, sick or not, we might be infected and spreading it. So we isolate. However, once the curve is flattened this all doesn't just go away. So there is no magical 'X weeks in quarantine and you're safe' ending to this. Vaccine or herd immunity, that's when it ends.

As to how sure I am about how it all works, I'm only going by what I see happening in the world. This virus traveled rapidly around the world. That didn't happen because the virus can only be spread under very specific and limited circumstances. It happened because this virus is easy to spread. Is that scientific? No. The science will come later, after all this is over and scientists have ALL the data and the time to process it. Right now I'm comfortable going with what seems self evident to me. If it can move from China to the wife of one of your co-workers, it can move from the wife to the co-worker, and from the co-worker to you, all before anyone gets tested or sick.

[Kraken]

It's a very successful virus, no doubt. That gives me some confidence that it won't mutate into a more virulent form. Why would it? It's already spreading optimally and under almost no selection pressure, at least until we start throwing medicines at it.

[Alefroth]

As to how sure I am about how it all works, I'm only going by what I see happening in the world.

I'm talking about your hypothetical of getting exposed a second time and then getting symptoms. Just because you didn't have symptoms the first time doesn't mean you didn't create antibodies does it? I don't know the answer, I was just asking if you did.

[stessier]

Are you sure that's how it works?

Which is exactly what everyone is saying.

Unagi asked how long I thought a person needed to be in quarantine before they wouldn't be able to spread it. That's why I brought up the 'flatten the curve' thing. We are all asked to shelter in place, sick or not, why? Because symptomatic or not, sick or not, we might be infected and spreading it. So we isolate. However, once the curve is flattened this all doesn't just go away. So there is no magical 'X weeks in quarantine and you're safe' ending to this. Vaccine or herd immunity, that's when it ends.

As to how sure I am about how it all works, I'm only going by what I see happening in the world. This virus traveled rapidly around the world. That didn't happen because the virus can only be spread under very specific and limited circumstances. It happened because this virus is easy to spread. Is that scientific? No. The science will come later, after all this is over and scientists have ALL the data and the time to process it. Right now I'm comfortable going with what seems self evident to me. If it can move from China to the wife of one of your co-workers, it can move from the wife to the co-worker, and from the co-worker to you, all before anyone gets tested or sick.

No one is questioning that it can spread before symptoms. But your timelines are just boogiemen. "Get sick, fight it off, then get it and you can be spreading it the whole time." Why stop at a month? Why not say someone got it in November and is still spreading it? You're just making up random facts because they feel good to you. It's nonsense.

[Kasey Chang]

Hooligans taking advantage of COVID-19 to grab whatever they want.

They go into a store and grab what they want. If confronted, they simply say they have coronavirus, and nobody dares to touch them.

https://www.nbcbayarea.com/investigatio ... y/2265713/

It's gotten bad enough that Walgreen has agreed to issue hazard pay for all employees.

[msteelers]

My wife works for a vet's office, which is deemed essential and is staying open during the shutdown. One of her co-workers came down with a fever last week. She managed to get tested for the coronavirus, and has been staying home ever since. Apparently, her results came back "inconclusive" because there wasn't enough of a sample. And, supposedly they won't retest her.

Management is saying that if she is fever free over the weekend that they will let her come back to work on Monday. I'm not sure how I feel about that. Are people still able to spread the virus once the fever goes away? Do we know yet at what point you are no longer contagious?

[Unagi]

two weeks at home seems to be the standard amount being used to 'clear' someone of suspected infection, from what I've been following.

Not one weekend. I guess it would depend on how they feel about their original 'suspected infection', but if they felt like testing her, then I would say: 2 weeks.

[gameoverman]

As to how sure I am about how it all works, I'm only going by what I see happening in the world.

I'm talking about your hypothetical of getting exposed a second time and then getting symptoms. Just because you didn't have symptoms the first time doesn't mean you didn't create antibodies does it? I don't know the answer, I was just asking if you did.

That idea comes from my experience with the common cold and the flu, two other viruses that get passed around. I've been in plenty of situations where I had to be around someone who is sick, like a family member, so I know for a fact I was exposed to the virus. But I didn't get sick. Then, a week or so later, I'm around another person who is sick and in the days after that now I'm sick. Whether I got sick from the initial exposure or the second one, it amounts to the same thing- it took awhile for me to get sick from it.

Also, I've heard medical personnel say they need protective gear because they are constantly exposed to infected people. This tells me that it's not a situation where your first exposure is the first and last time to worry, it tells me each exposure is a risk.

[dbt1949]

I thought the cold came from bacteria.

[Unagi]

I thought the cold came from bacteria.

[LawBeefaroni]

My wife works for a vet's office, which is deemed essential and is staying open during the shutdown. One of her co-workers came down with a fever last week. She managed to get tested for the coronavirus, and has been staying home ever since. Apparently, her results came back "inconclusive" because there wasn't enough of a sample. And, supposedly they won't retest her.

Management is saying that if she is fever free over the weekend that they will let her come back to work on Monday. I'm not sure how I feel about that. Are people still able to spread the virus once the fever goes away? Do we know yet at what point you are no longer contagious?

72 hours symptom free is the current guideline. As far as I know there is no definitive answer on how long people can shed the virus after being symptom free but 72 hours is what most hospitals are using for return to work for untested or inconclusive tests.

[msteelers]

My wife works for a vet's office, which is deemed essential and is staying open during the shutdown. One of her co-workers came down with a fever last week. She managed to get tested for the coronavirus, and has been staying home ever since. Apparently, her results came back "inconclusive" because there wasn't enough of a sample. And, supposedly they won't retest her.

Management is saying that if she is fever free over the weekend that they will let her come back to work on Monday. I'm not sure how I feel about that. Are people still able to spread the virus once the fever goes away? Do we know yet at what point you are no longer contagious?

72 hours symptom free is the current guideline. As far as I know there is no definitive answer on how long people can shed the virus after being symptom free but 72 hours is what most hospitals are using for return to work for untested or inconclusive tests.

Thanks!

[Unagi]

Why are people being self quarantined for 2 weeks? Or am I making that up?

[Z-Corn]

Because the TP is better at home?

[gilraen]

Why are people being self quarantined for 2 weeks? Or am I making that up?

You self-quarantine for 2 weeks when you aren't sure whether or not you are infected, since it takes up to 2 weeks for symptoms to appear (in theory, anyway).

Once you *know* (whether you guessed based on symptoms or you were tested), then you need to be symptom-free for 72 hours to be considered recovered enough to no longer be contagious.

[Smoove_B]

The tricky part is that for some people the fever comes and goes. So it's critical to be monitoring temperature and to make sure you have 72 hours without any fever symptoms. When in doubt, exercise caution because we're still learning.

[Blackhawk]

As to how sure I am about how it all works, I'm only going by what I see happening in the world.

I'm talking about your hypothetical of getting exposed a second time and then getting symptoms. Just because you didn't have symptoms the first time doesn't mean you didn't create antibodies does it? I don't know the answer, I was just asking if you did.

That idea comes from my experience with the common cold and the flu, two other viruses that get passed around. I've been in plenty of situations where I had to be around someone who is sick, like a family member, so I know for a fact I was exposed to the virus. But I didn't get sick. Then, a week or so later, I'm around another person who is sick and in the days after that now I'm sick. Whether I got sick from the initial exposure or the second one, it amounts to the same thing- it took awhile for me to get sick from it.

Also, I've heard medical personnel say they need protective gear because they are constantly exposed to infected people. This tells me that it's not a situation where your first exposure is the first and last time to worry, it tells me each exposure is a risk.

Each exposure represents a risk that you'll get sick, but that doesn't mean you'll get sick repeatedly. If you get it and are asymptomatic, you won't get it the second time. Your body fought it off the first time, and the second exposure won't gain a foothold. If you get it and have symptoms, again, your body fights it off and then you don't keep getting it. In your example (and we've all had that), you just managed to either not get it the first time by luck and got it later, or it was something you weren't susceptible to the first time, and the second person actually had something else with similar symptoms.

Once you've had it, you're clear. The only 'spread' risk at that point is if you get it on your hands and touch something else.

[Unagi]

So... there is some discussion of the virus being able to be present in a person's mucus, even if they are now immune to it. From what I've read.

For instance - there was a dog in China that tested 'positive', but only because his owner had it so bad that the virus was in the dog's mucus. The dog didn't 'have the virus', in the classic sense.... and they didn't feel that dogs (or cats) could really be a transmitting vector, but this data was found.

[Isgrimnur]

So that's how it is in their country...

[Isgrimnur]

CNN

[malchior]

COVID-19 death toll potentially higher, even much higher than official tally in some places.

This was theorized and even modeled to some extent but new data is emerging. Effectively, if you count all deaths then mortality rate is much higher than the official COVID-19 tally. Sometimes this is because they aren't testing the dead or they ascribe them to other causes. However, the stats show that sometimes the mortality rate in areas was 900% higher than baseline. 10 deaths per 100,000 when ordinarily it'd be 1 per.

[stessier]

CNN

Doesn't that graph show it's between 2&3 days, not 5? Unless it's because the graph has started to turn over and level out?

[Isgrimnur]

¯\_(ツ)_/¯

[Max Peck]

CNN

Doesn't that graph show it's between 2&3 days, not 5? Unless it's because the graph has started to turn over and level out?

You need to compare the slope of the line, which varies over time, to the reference angles. If you go to the Johns Hopkins COVID-19 dashboard, you can look at the last 5 days totals and see that they have roughly doubled over the last 5 days.