A Little Basic Science

One positive benefit from COVID-19 is that it reminds us of some basic science, such as the differences between a bacterium and a virus.

COVID-19 is a specific strain of virus.  The damage it does within someone's system can cause other/secondary infections, such as pneumonia.  Pneumonia is a bacterial infection.  So, what is the difference?

When we have a virus, we need to self-isolate, drink plenty of fluids, eat lightly and rest.  (It’s best to get an annual flu-shots early, especially if you are at high-risk). 

Typically, if you are not someone at risk (such as someone with weakened health – see below) your body’s defence system will most likely overwhelm the virus and you will be well again.  Antibiotics are no help at all against a virus. 

Virus

When you have a cold, for example, it is caused by a virus.  Many insist they need antibiotics when they feel sick, but they are not effective against viruses. 

Bacterium

On the other hand, if you have bronchitis or pneumonia, they are caused by a bacterial infection and maybe a result of first having a virus.  They do not typically respond to simple rest and fluids and may require antibiotics to fight off the disease.

Here is a great video to explain just some of the differences between the two and how differently they infect and grow within our bodies to make us sick.

https://www.youtube.com/watch?v=P_9DXEnEd-Q

Dr. Finch’s Lab:  Viruses vs. Bacteria | What's The Difference?

Most at Risk 

Statistics are still not reliable enough, but there are some common denominators with those who contract the virus and then develop a serious case and then die.  Those most at risk, include:

• ·       The aged (especially those older than 60 years)
• ·       Transplant patients
• ·       Chronically ill
• ·       Those with an auto-immune disease
• ·       HIV patients
• ·       High blood pressure
• ·       Lung diseases – COPD Asthma
• ·       Diabetes Mellitus
• ·       Those with other pre-existing conditions

It will take time to refine this list, but if someone is dealing with a serious or chronic condition, their system is already weak and so it makes sense. 

What has proven notable about COVID-19 is that children do not seem to be so vulnerable to the virus.  More data needs to be collected, verified and collated to substantiate this.

Those especially in the ‘firing line’

With that list in mind, it is obvious there are some individuals who are more vulnerable, not for the condition of their health, but because they are more likely to be exposed to those who have COVID-19. 

This is a key reason why protective medical gear must be available for these individuals, such as:

• ·       Health care workers
• ·       Public transportation workers
• ·       First Responders
• ·       Support and administrative staff in hospitals and clinics
• ·       Retail staff
• ·       Press

High-Risk Environments

If you feel unwell, stay home.  If you know you have been exposed to someone who is infected (or was in close contact with someone who has the virus) stay home (call the doctor, clinic or hospital emergency room and follow their directions. 

Being careful of where you go is most important, now.  Remember initial observations seem to indicate that someone can be infected, be spreading the virus to others and yet not show symptoms.  

Avoid, if at all possible, high-risk environments, such as:

• ·       Hospitals, clinics, doctor’s offices
• ·       Universities
• ·       Correction Facilities/Prisons
• ·       Aged Care facilities
• ·       Sports Events
• ·       Conferences
• ·       Large group gatherings
• ·       Government services centres 

Conclusion 

Keep in mind, initial statistics indicate that eighty-one per cent of those who contract the virus will have a mild to very mild form.  

If you suspect you have been exposed to COVID-19, stay home, call your health-care provider and follow their directions.  They will know the best strategy to follow.

REALISTIC MATHS AND COVID-19

 Key Points

• Statistics about COVID-19 or effective treatment are not yet stable
• Without everyone taking personal care up to 31% of the world's population could be infected
• Of those who contract COVID-19, the prognosis is good
• There is an immediate and increasing need for planning and triaging the management of those diagnosed as positive for the virus
• Present 'over-the-top' care is not sustainable 
• Limited or lack of resources in some countries can contribute to the world's infection rates
• It is critical that developed countries plan how to better manage/stretch medical resources, to review diagnostic and isolation protocols now to ensure those who require focused critical care can find it.

Let's Get Real 

Returning to the overall stats about COVID-19 as we know them today (see previous segment) it is important to be realistic and not panic.  

The disease may have been active as early as mid-November with no monitoring or collecting of observed behaviours of patients. 

Even today the accuracy of data is not complete (but is growing more stable) but does offer hope if we act now, take sensible, self-precautions and do not panic into a 'walking dead' mode of behaviour.

At this stage, the estimates are that COVID-19 may infect up to 30% of the world's population.  Of those infected the breakdown continues to offer hope and optimism.

• 81% - Mild Cases - of those infected will contract a mild case.  Without the diagnostic test, the infection could seem just 'the flu'. 
• 10% to 14% - Critical cases - of those infected are at risk to ultimately be infected with a serious form of the virus. 
• 7% - Death rate - out of this population of critical cases result in death.

Critical Care and Isolation

Not all hospitals are large enough to have an intensive care unit.  If they do, it is small with only a few beds because each bed represents the ultimate of care.  The beds are usually full as new patients are moved in and out.  

Typically, for each patient is assigned dedicated doctors, nurses, specialist practitioners, all responsible for identifying diagnostic and treatment requirements.

Additionally, these critical patients need heart monitors, respirators/ventilators to manage breathing, multitudes of tubes and other monitoring and testing devices, etc.  There are requirements for radiologists, lab technicians, respiratory and physical therapists, dietitians and those who maintained feeding tubes, change linens, etc. and practical nursing care.

Early Days 

These are the early days with COVID-19, so the ratio of health care providers, infrastructure and equipment is easy to provide (although the run on masks is already causing concern for those on the front line of caring for these highly infectious patients).  

Researchers do not have the full picture of COVID-19, so each infected patient is put in isolation (a room of their own).  All necessary safety protocols and procedures for a highly-contagious disease have to be in place, monitored and documented for future discovery.  

Fresh protective gear, masks, gloves and goggles need to be used for every visit with the patient.  Every time a health care provider leaves a patient's room, they must dispose of the contaminated gear.  Everything going into and taken from their room needs extra care and handling to ensure the virus does not spread and so no additional dangers are introduced.

With the need to isolate each patients for at least 14 days, consider the number of beds available within each treatment facility -- they are limited as cost utilisation initiatives have been shrinking our health care capacity for decades.

Current Procedures Won't Continue - They Can't 

Today, when someone arrives at their doctor's, a clinic or hospital emergency room who is suspected of being infected with this new virus, they are being given 'over-the-top' care.  Each infected person is sort of a 'guinea pig' to be observed and case notes taken and shared to help when the next person presents.  

Of great concern, many countries are totally unprepared for any of this and the health care infrastructure, even basic hygiene is missing.  Even the countries who take pride in their preparedness will be surprised should the virus not be contained quickly. 

Consider the Costs

Right now, with so few patients it is possible to lavish care on each individual’s diagnosis, treatment, support and confinement from the moment they are identified as being infected.  The costs per patient at this stage would be astronomical (and well worth it). 

However, as more cases are identified, the ‘quantity’ of care will, of necessity have to lower as fewer health care providers will be available per infected individual.  Also, supportive care tools, instruments and devices will be dramatically stretched.   We are in the time to prepare.

12 IMPORTANT REMINDERS ABOUT MASKS

There is a lot of commercial price gouging that has started when it comes to hand sanitisers and masks.  Well, I suppose you can’t blame businesses for responding to market demands.  But be wise. 

3M™ 8210V N95 Particulate Respirator

Remember:  Masks are urgently 
needed for health-care providers.  
If you are sick, however, you wear
one to protect those around you.    

Masks are urgently needed for health-care providers.  Currently many people are purchasing and hoarding masks, just in case they might need them.  But we MUST ensure they are available for those working with the infected.  

Furthermore, wearing a mask and imagining it is protecting you from someone who may be infected with COVID-19 is a mistake.  There are many reasons for this.  Here are just twelve reminders:

1.   Most masks are not made of material woven tightly enough to filter out viruses as viruses are electron-microscope small. 

2.   When you are sick and need to venture out, the masks that afford the most protection for those around you must be at least an N95 or N100 mask. – but better to just stay home.

3.   If you wear a mask, it needs to cover the mouth and nose and be uninterruptedly tight around this area.  (For more protection wear wraparound glasses, because your eyes are vulnerable, too)

4.   Most masks are hot to wear.  They trap moisture inside and outside the longer they are worn.  This makes an ideal environment inside the mask for viruses and bacteria trapped inside to multiply as outside they catch and hold contamination. 

5.   Because masks are uncomfortable and hot, people tend to naturally move the mask around on their face (consciously or unconsciously).  They may even pull it away from their face, to let their face breathe or to simply get a breath of fresh air themselves.

6.   Masks may remind us to not touch our faces, eyes or mouth but typically we touch the outside or edges of a mask if we wear one.    

7.   The surfaces of the mask (inside and outside) collect more ‘stuff’ the longer they are worn.  The minute the mask is off it feels so good it is easy to touch your face, eyes or mouth.

8.   Masks typically aren’t made for multiple wearings and can’t be washed.  Therefore, just having one mask is not going to help.  You need to change the masks often depending on how long you’ve worn it and how contaminated the areas are you travelled through.

9.   Most remove or move the masks by the ‘face’ of the mask, again where the outside surface is contaminated.  Resist the temptation.

10.                     To remove a mask properly, remove it by the elastic around the ears.  Do not touch the inside or outside surface of the mask.

11.                     Remember, if you are unwell, it is primarily contaminated by your own breathing.  Disposed of the mask carefully by ensuring the more contaminated area is turned inside.  Throw the mask into a plastic bag (preferably one that is a (zip) sealable bag.  This protects others from the contamination.

12.                     Remember this virus lives longer than most bugs do outside the body.  When an infected person has coughed, sneezed or flushed the toilet, the virus is circulating in droplets in the air.  They lurk on surfaces to be picked up by another who touches their mouth, eyes or breathes the aerated virus. 

We are living in a time when our phones can keep us in contact with others, amuse and educate us.  We can order breakfast, lunch and dinner, access the news and pertinent information anytime.  Even with all the power in your phone, sometimes it is good to put it aside and rest.  It is a novel idea. 

6 Rules for Handwashing Success

If you have children, you would have taught them the importance of washing their hands well and thoroughly.  If not, you were taught how to wash your hands -- once upon a time.  

Here are the six basic rules to follow as washing your hands will prove to be one of your best weapon to protect yourself against COVID-19.

1.   Wash your hands often.

2.   Wash your hands with soap – don't just run them under the water arbitrarily. 

3.   Rub the soap on the backs and palms of the hands. 

4.   Wash each finger and between the fingers carefully - you may need to use a nail brush if you've gotten anything under them.

5.   Rinse the soap off completely.

6.   Use a paper towel (NO AIR DRYERS) or fresh hand towel or to use your OWN towel to dry them thoroughly.

12 Rules to Live by to Thwart COVID-19

1.   If you are sick, stay home.  Do not soldier on.  Self-quarantine for 14 days.  Work from home, if possible.  If you have workers, it is time to consider letting them work from home, too.

2.   Call the doctor, clinic or emergency room.  Don't just show up because critically vulnerable individuals may be there. Self-quarantine works well, but your doctor will know best.  (NOTE:  One key symptom is an unusually high fever.)

3.     Don't struggle to get to the supermarket or chemist for one more thing.  Use a delivery service or ask a friend to drop by what you need.  Tell them to leave it at the door and ring the bell, phone or send a text.  Don’t feel obligated to thank them in person – they will thank you for protecting them.  

4.     Wash your hands OFTEN, with soap, not disinfectant wipes.  And wash them the right way (see the segment on handwashing in this blog).

5.     If you can’t find any place to wash your hands properly, use disinfectant wipes with a liquid-based on 70% isopropyl alcohol - but do not rely on them over soap and water.  When you get to a place you can wash your hands with soap, be sure to wash your hands properly.

6.     Do not touch anything you don’t have to.  This includes handshaking and hugging for now.  Think before you touch anything!

7.     Carry a fresh handkerchief or supply of ‘Kleenex’ tissues with you at all times.  Use them to ‘touch’ things like ATM buttons, escalator handrails, doorknobs, etc., and then throw them away.

8.     If you must travel and take public transportation and someone is sputtering and coughing near you, move to another carriage or get off and catch the next one.  Try to avoid crowded carriages/buses - just avoid crowds as much as possible.

9.     Get at least seven hours of solid sleep.  It seems to be one of the great preventative keys.

10. Eat well.  If you don’t feel well enough to eat, perhaps try some protein shakes or fruit juices.  But you need your strength.

11. Do not underestimate the need to drink fluids.  If you’re as bad at this as I am, keep a couple of litre-(or quart-)bottles in the fridge and monitor it that way.  (Most people find cold water easier to drink and more refreshing than straight from the tap but just be sure to drink the equivalent of seven or eight (8oz) glasses per day).

12. Try to minimise coffee or other caffeinated drinks (I love them too, but they dehydrate you).  Fluids help flush out the bad stuff so water is best.

One COVID-19 Curiosity and One Myth from Space

The Myth from Space

Around 5 February 2020, an image from a space satellite showed a bright red spot to the west of Wuhan China.  In the need for an explanation, a conspiracy arose when a reporter posted what he said this image proved.  

He reported that crematoriums in China were overwhelmed with dead bodies from the virus.  To cover up the magnitude of the situation, they were, not only misreporting the number of people dying from COVID-19, but supposedly the officials were burning large numbers of unidentified bodies en masse outside the city.  

The red glow would have been damning, had it not been for deeper investigation that shows the story is another example of 'fake news' (which always seem to have a political tinge).  

A News Vacuum is Always Filled by Gossip

However, it is the reluctance of China, to accurately share the truth in a timely fashion that has opened this "Pandemics Box" of disease and death, globally.  We can only hope and pray the growing seriousness of the situation motivates increasing accuracy and openness.

The Curiosity from Space

China has long been recognised as the world's heaviest polluter and there are some scientists puzzling with another discovery.  An air-quality, monitoring satellite showed a lack of a 'normal' red glow indicating a dramatic decrease of nitrogen dioxide over China.  

For those of us who forgot most of our basic chemistry, nitrogen dioxide (NO2) is the gas released into the air from burning fossil fuels in cars, trucks, buses and power plants. 

Health Effects of NO2

When nitrogen dioxide mixes with the air we breathe, and especially when there is a high concentration of NO2 over time (such as there typically is in China), it irritates airways in our respiratory systems.  

Even limited exposure can aggravate breathing for those who have respiratory diseases, especially asthma.  It can lead to coughing, wheezing and/or difficulty breathing.  It results in many urgent trips to the emergency room and hospital admissions to help manage the symptoms. 

NO2 has been suspected of causing the rise in asthma and the increasing vulnerability of normal individuals to other respiratory infections.  

NO2 reacts with other chemicals in the air and forms particulate matter (like dust) and ozone.  Both have been proven to be harmful when inhaled and cause additional damage and weakness to the respiratory system.

Final Concern

This strange lack of NO2 leaves us with a curious mystery.  Not that the lack of typical levels of pollution was a result of practically closing down China  -- but how vulnerable the lungs of the Chinese people must be.  To COVID-19 virus it must have seemed a rather welcoming environment for a newly mutated virus to luxuriate in!

References

1. euronews - 'Debunked:  This image doesn't show 'extent of corpse burning in Wuhan', 13 February 2020.

2. US Environmental Protection Agency (EPA), 'What is Nitrogen Dioxide?'

3. Foxnews, 'Over China coronavirus coincides with a plummet in nitrogen dioxide', 1 March 2020.

Self-Quarantine and Testing

Key Points

1. Avoid crowds
2. Self-quarantine if in high risk
3. Don't be careless or cavalier 
4. Diagnostic tests not always available

It is important to be circumspect in your daily activities during this time because there continue to be unknowns about how COVID-19 is spread.  Common-sense actions, such as avoiding crowds and closed spaces (such as public transportation) is advised.  

Australia and other nations are postponing or cancelling religious and sporting events where many people gather.  The danger comes when one person who is unaware they are infectious (can spread the disease) could unknowingly begin a chain of infection for those they come in contact with during these events.

High-Risk Individuals

Those, especially at high-risk, should self-quarantine where possible.  They include: 

• The elderly
• Those with chronic respiratory disease (COPD, emphysema, asthma)
• Individuals with diabetes
• Anyone with suppressed immunity (such as from a transplant or undergoing cancer treatment).  

Keep in mind, those who are infected could be infecting others 14 (or more) days before showing symptoms themselves.  Because the symptoms initially seem like the flu, someone infected with COVID-19 virus could be tempted to just go about their daily routines.  

NOTE:  There are controversy and no hard data yet to know if, after someone is diagnosed and recovers or is proven to be free of the virus, if they can be re-infected.  

Diagnostic Tests

Additional challenges come from there being no standard diagnostic test, yet.  There are 'test kits' but: 

• Many countries do not have any of them, 
• There are not enough of them
• Some have already proven to be faulty
• Facilities that need them may not have them when a patient presents themselves

Finally, the test kits take time and have not proven to be as accurate as a CT scan.  However, CT scans are not available everywhere a patient may present with symptoms, especially in undeveloped countries, they are very expensive, time-consuming.  This is another area where solid research and statistics will help.

Necessity of Standard, Cumulative Global Statistics

The world seems to be in a 'blame someone mode'.  We must get real about the developments and implications of COVID-19 for our day-to-day lives. 

A roadblock is uncovering the facts during this time.  I've been following the various sources and reports about COVID-19 since mid-January and offer here some overview stats to consider as offering hope.

Stats of Progress of COVID-19

Estimates from the progress of the virus to date indicate that: 

• 30% - Global infection - (up to, not more than) of the world population could be infected as it progresses.  
• 81% - Mild Cases - of those infected, will contract a mild case.  Without the diagnostic test, the infection could seem just 'the flu'.  
• 10% to 14% - Critical cases - of those infected are at risk to ultimately be infected with a serious form of the virus.  
• 7% - Death rate - out of this population of critical cases result in death.
• 
  

As the disease develops, some countries continue to work independently (believing they know best how to manage the disease).  Some are not forthcoming of the existence of the virus for political or commercial reasons.  


However, sharing information now is critical so the health providers the world relies upon are forewarned and forearmed.  Having and organising a complete picture of observations of symptoms and behaviours and accurate statistics would be invaluable.  

Reporting Bodies

There are credible reporting bodies collaborating and sharing information as it is available, but no ONE source for the global developments.  Some good resources are: 

• The Centres for Disease Control and Prevention (CDC)
• 
  
• Johns Hopkins Research Centre
• 
  
• The Lancet in the UK
• 
  
• The World Health Organisation

Global Reporting Metrics

A global standard for metrics has not been established for COVID-19, yet.  There are some benefits in that it is early days with this virus and some unexpected general observation may prove to be worthy to monitor.  

Conclusion

Certainly, the memory of the 'Spanish Flu of 1918' has faded so far in the background and the health-arrogance and carelessness of the world means we were not ready for COVID-19.  But we will be!