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posted by Fnord666 on Tuesday March 24 2020, @04:54AM   Printer-friendly
from the lock-em-down dept.

Politicians won't admit it yet, but it's time to prepare—physically and psychologically—for a sudden stop to all life outside your home.

[...] Whether you are reading this in your living room in Vancouver, office in London, or on a subway in New York City, you need to think hard, and fast, about two crucial questions: Where, and with whom, do you want to spend the next six to 12 weeks of your life, hunkered down for the epidemic duration? And what can you do to make that place as safe as possible for yourself and those around you?

Your time to answer those questions is very short—a few days, at most. Airports will close, trains will shut down, gasoline supplies may dwindle, and roadblocks may be set up. Nations are closing their borders, and as the numbers of sick rise, towns, suburbs, even entire counties will try to shut the virus out by blocking travel. Wherever you decide to settle down this week is likely to be the place in which you will be stuck for the duration of your epidemic.

To appreciate what lies ahead for the United States, Canada, Mexico, and the United Kingdom, pay heed to Italy, France, and Germany. The United States, for example, is currently tracking exactly where Italy was about 10 days ago. France and Germany, which track two to five days ahead of the United States, are now revving up measures akin to those taken by Italy, including lockdowns on movement and social activity. In a matter of days, the United States will follow suit.

[...] Once tough location decisions have been made, the household must be readied for a long siege. While panic-buying has led to stockpiles of toilet paper and hand sanitizer, getting through eight months of confinement with others will require a great deal more, both physically and psychologically. This is especially true for households that span generations.

Long-term confinement that includes children undergoing remote schooling and adults trying to work requires designated spaces for each individual, a powerful Internet signal and Wi-Fi router, and a great deal of shared patience. Everybody in the household must understand how the coronavirus is spread, and what steps each should follow to eliminate their personal risk of passing infection to others in the home.

The virus is transmitted by droplets and fomites[*]—it isn't like measles, capable of drifting about in the air for hours. It dehydrates quickly if not inside water, mucus, or fomite droplets. The size of the droplets may be far below what the human eye can see, but they are gravity-sensitive, and will fall from an individual's mouth down, eventually, to the nearest lower surface—table, desk, floor. You do not need to clean upward.

However, a newly published study, backed by the National Institutes of Health, found that the virus survives in "aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel." This means an uncleaned surface can pose a risk to members of the household for a very long time—a doorknob, tabletop, kitchen counter or stainless steel utensil.

[*] Wikipedia entry on fomites:

any inanimate object that, when contaminated with or exposed to infectious agents (such as pathogenic bacteria, viruses or fungi), can transfer disease to a new host.

[...] In addition to objects in hospital settings, other common fomites for humans are cups, spoons, pencils, bath faucet handles, toilet flush levers, door knobs, light switches, handrails, elevator buttons, television remote controls, pens, touch screens, common-use phones, keyboards, and computer mice, coffeepot handles, countertops, and any other items that may be frequently touched by different people and infrequently cleaned.

Researchers have discovered that smooth (non-porous) surfaces like door knobs transmit bacteria and viruses better than porous materials like paper money because porous, especially fibrous, materials absorb and trap the contagion, making it harder to contract through simple touch. Nonetheless, fomites may include soiled clothes, towels, linens, handkerchiefs, and surgical dressings


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  • (Score: 3, Informative) by HiThere on Tuesday March 24 2020, @06:55PM (17 children)

    by HiThere (866) on Tuesday March 24 2020, @06:55PM (#975143) Journal

    Testing is important, but with good tests you still need a way to treat it after you detect it.

    FWIW, I'm told that during the initial stages it destroys some of the cells in the lungs...not at random, but a particular variety. And that's why the lungs stop being good at breathing. By the time you notice, it's already done a *LOT* of damage, and I don't know whether it's something that the body *can* recover from.

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  • (Score: 2) by krishnoid on Tuesday March 24 2020, @07:06PM (15 children)

    by krishnoid (1156) on Tuesday March 24 2020, @07:06PM (#975150)

    Do you have a citation for that? That would be really +1,Interesting if that's the case.

    • (Score: 3, Informative) by HiThere on Tuesday March 24 2020, @07:16PM (3 children)

      by HiThere (866) on Tuesday March 24 2020, @07:16PM (#975154) Journal

      As I said "I'm told". I was told this by a web source. Search for "closing the barn doors after the horse is in another state" in https://blogs.sciencemag.org/pipeline/archives/2020/03/24/the-latest-coronavirus-clinical-trials [sciencemag.org]

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      • (Score: 2) by Reziac on Wednesday March 25 2020, @03:26AM (2 children)

        by Reziac (2489) on Wednesday March 25 2020, @03:26AM (#975316) Homepage

        I read something about lingering kidney damage, too.

        Would not be surprised to learn of lingering cardiac damage, given that inflammation of the heart has been reported, and apparently is one of the major causes of actual death.

        [too lazy to dig up cites]

        • (Score: 2) by HiThere on Wednesday March 25 2020, @03:00PM (1 child)

          by HiThere (866) on Wednesday March 25 2020, @03:00PM (#975478) Journal

          IIRC, the kidney damage was due to one of the drugs being testes for viral suppression. But you may be referring to a different report.

          The drugs that I've heard of in sufficient detail *all* had side effects sufficient that you should have medical evaluation of which was worse and how much to take. And since they're all (except the arthritis drug) unusual, most doctors won't have the experience to judge, and will just "go by the book", if you're lucky, or by feel if you're not.

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          • (Score: 3, Interesting) by Reziac on Wednesday March 25 2020, @05:11PM

            by Reziac (2489) on Wednesday March 25 2020, @05:11PM (#975541) Homepage

            No, this was reported as broad-spectrum damage BY the virus in patients who had died (in China, IIRC). Then again, who knows how accurate any report is at this point.

            I read a personal anecdote from an infected doctor who noted that a specific type of OTC asthma inhaler did wonders for him and his also-sick wife, and cited reasons (helped unclog mucous plugs). That sounds like a reasonable and tolerably safe course to attempt in anyone to the can't-breathe stage, actually.

    • (Score: 2) by janrinok on Tuesday March 24 2020, @07:43PM

      by janrinok (52) Subscriber Badge on Tuesday March 24 2020, @07:43PM (#975164) Journal

      There was a comment and , I think, a cite on a previous COVID story on SN - but I'm still looking for it.

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    • (Score: 2) by quietus on Wednesday March 25 2020, @07:48PM (9 children)

      by quietus (6328) on Wednesday March 25 2020, @07:48PM (#975585) Journal

      Parent is correct. Here in Belgium, nearly half of ICU capacity is taken by people between 30 and 50: they'll come out with severe lung damage.

      • (Score: 0) by Anonymous Coward on Wednesday March 25 2020, @09:10PM (8 children)

        by Anonymous Coward on Wednesday March 25 2020, @09:10PM (#975604)

        Would you have references for that statement?

        • (Score: 0) by Anonymous Coward on Wednesday March 25 2020, @11:12PM

          by Anonymous Coward on Wednesday March 25 2020, @11:12PM (#975628)

          I notice a lot of scare propaganda is going out aimed at younger people, because they aren't panicking on command.

        • (Score: 2) by quietus on Thursday March 26 2020, @11:26AM (6 children)

          by quietus (6328) on Thursday March 26 2020, @11:26AM (#975809) Journal

          There were 2 interviews with critical care doctors, in the early days of social distancing, but they've been removed from my public broadcasters' website. I cannot find references to it in recent videos either.
          If you look at Figure 3, page 5, here [europa.eu] though, you'll see that while the hospitalisation rate for these groups is lower, the number of hospitalisations is relatively high.

          • (Score: 0) by Anonymous Coward on Thursday March 26 2020, @12:42PM (5 children)

            by Anonymous Coward on Thursday March 26 2020, @12:42PM (#975830)

            So I'll take it your statement that "Here in Belgium, nearly half of ICU capacity is taken by people between 30 and 50: they'll come out with severe lung damage." was bullshit.

            Looking at the pdf you provided, we have a bathtub curve where on average, 12% of *diagnosed* patients 30-50 end up in hospital (not ICU). Typical bathtub curve, elderly and babies are higher.

            15% of cases hospitalised develop severe illness, 12% of those die (~2%). 2% of hospitalised cases, not total infected.

            Comparing to the CDC numbers on the seasonal flu at https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm [cdc.gov] , when 59000 died of the flu this year out of 710000 hospitalisations, that gives a mortality rate of ~8% of hospitalised cases for the flu. That is interesting: Are admission guidelines to the hospital lower for Covid-19 cases in Europe, or admission guidelines higher in the US for flu?

            • (Score: 0) by Anonymous Coward on Thursday March 26 2020, @01:00PM (4 children)

              by Anonymous Coward on Thursday March 26 2020, @01:00PM (#975840)

              Here I made a mistake. It was 12% of hospitalised cases dying, not 12% of severe illness.
              Still, while mortality is higher than the seasonal flu, how does it compare the 2009 H1N1 pandemic? I couldn't immediately find the data on that.

              • (Score: 2) by quietus on Thursday March 26 2020, @03:01PM (3 children)

                by quietus (6328) on Thursday March 26 2020, @03:01PM (#975902) Journal

                I haven't searched for that, either. However, my feeling is that focusing on mortality might be the wrong way to look at this. Here's the initial article [www.vrt.be] I mentioned earlier. While it doesn't say anything about my [hopefully, probably, bullshit] claim of nearly half of beds being occupied by 30-50 year olds, it says something about the damage being done, once you need hospitalization, even at that age.

                The article is from the English language edition of the national public broadcaster; 2 days later that same medic had to give a calm-down interview [www.vrt.be] (in Dutch), because of all the calls his hospital was getting.

                • (Score: 0) by Anonymous Coward on Thursday March 26 2020, @03:28PM (2 children)

                  by Anonymous Coward on Thursday March 26 2020, @03:28PM (#975917)

                  It shows three CT scans: A healthy 64 year old woman, then a sick person with data cut out, and finally a 54 year old sick person. All the images show is that 1) There were healthy people that were scanned and 2) There were sick people that were scanned.

                  The article makes no mention of incidence rates and comorbidities. In deference to the doctor, I'm sure he said more but the author of the article cut it down to sound bytes. I'll put this in the "scare propaganda aimed at younger adults" category.

                  The flemish article seems to indicate that all this ER doctor is stating now is that "If you can't orally express a coherent thought, you have to do it in bits and pieces, then you may well be one of the people with lung damage".

                  The rest of the article says that "Most patients instead have minor symptoms, and should thus stay away from overloaded emergency facilities" and another primary care doctor said he had it and didn't have fever so: "Everybody says that it is paired with a high fever and a heavy flu feeling. That does not seem to be the case with many people. The image is that fever is listed almost as an obligate state, but that surely isn't always the case".

                  • (Score: 2) by quietus on Thursday March 26 2020, @04:41PM (1 child)

                    by quietus (6328) on Thursday March 26 2020, @04:41PM (#975967) Journal

                    Troll. That's not at all what that image shows.

                    • (Score: 0) by Anonymous Coward on Thursday March 26 2020, @05:40PM

                      by Anonymous Coward on Thursday March 26 2020, @05:40PM (#975989)

                      So please tell us what it is supposed to show. I looked at the link you provided. Perhaps also tell me where in the images it shows that "Here in Belgium, nearly half of ICU capacity is taken by people between 30 and 50: they'll come out with severe lung damage."?

  • (Score: 0) by Anonymous Coward on Tuesday March 24 2020, @08:29PM

    by Anonymous Coward on Tuesday March 24 2020, @08:29PM (#975179)

    Testing is still important even without a treatment plan because if you can determine with high enough confidence who is infectious, then you can do a much more limited quarantine. Realistically, an antibodies test (to determine who has already gotten it and is now immune) is important, too, as well as the full isolation long enough to get the case count down to a manageable number.