PlagueWatch 2020-23 - Coronavirus

[MChambers]

If you're really interested in the topic of pandemics and the like, I recommend reading David Quammen's book, Spillover. Among other things, it includes some descriptions of Chinese food markets and the potential for deadly viruses to originate in them. Also has some interesting, if scary, discussions of markets selling monkey meat and the like in Africa. Made me think that it's just a matter of time until we have a major pandemic.

Does this virus have the potential to be a big one? My inexpert sense is that it's pretty unlikely, but can't be ruled out. Let's see what the mortality rate is in another month.

Also, it sounds like there could be a vaccine in record time, but that would still be quite a few months: https://www.washingtonpost.com/scien...peed-openness/

[bundabergdevil]

If you're really interested in the topic of pandemics and the like, I recommend reading David Quammen's book, Spillover. Among other things, it includes some descriptions of Chinese food markets and the potential for deadly viruses to originate in them. Also has some interesting, if scary, discussions of markets selling monkey meat and the like in Africa. Made me think that it's just a matter of time until we have a major pandemic.

Does this virus have the potential to be a big one? My inexpert sense is that it's pretty unlikely, but can't be ruled out. Let's see what the mortality rate is in another month.

Also, it sounds like there could be a vaccine in record time, but that would still be quite a few months: https://www.washingtonpost.com/scien...peed-openness/

Thanks for the recommended reading. Regarding the food markets - lots of articles like the one below floating around about this. The description is not for the faint of heart and honestly sound worse than Sinclair’s descriptions of our system 100ish years ago in The Jungle.

https://nypost.com/2020/01/25/inside...e-coronavirus/

[chrishoke]

The possible Duke case turned out to be negative. https://ncdhhs.gov/news/press-releas...orth-carolina…

[devildeac]

The possible Duke case turned out to be negative. https://ncdhhs.gov/news/press-releas...orth-carolina…

Relief! Don't have to build my bomb shelter . My Infectious Disease colleague will be relieved and is likely still laughing at me.

[bundabergdevil]

WaPo with a satellite imagery click through of the geographical challenges presented by the virus.

https://www.washingtonpost.com/graph...g-coronavirus/

[freshmanjs]

My daughter is at the Yale Model UN Conference (hundreds of high school kids). They canceled today's events, including the awards ceremony. Apparently, there is a Chinese delegation and at least one of the kids has symptoms. Certainly good conditions for spreading a virus.

[Nick]

I would fight to stay alive as long as my loved ones wanted to fight with me. If they are all gone. I'm joining them.

If you can't fight with the ones you love, love the ones you fight with.

As for the coronavirus, I've spent some time looking through the interwebs ("Google, MD") trying to figure out how much of a threat this thing is, and my best guess is maybe a Spanish flu situation if it gets bad? I saw a chart posted with the age of the deceased patients and it was almost all 50+. Not apocalyptic--things still kept running despite the flu and WW1--but certainly the potential to be very bad (the Spanish flu killed 3-5% of the world's population). I'm in my 40s, and I had pneumonia a few years ago and would prefer to avoid something similar, so I ordered n95 masks and nitrile gloves today. Not because I expect to use them, but because I expect there will be a run on them if things get bad enough to where they are needed.

Overreaction? Appropriate reaction? Underreaction because I didn't stock up on food, water, and guns?

[OldPhiKap]

Putting aside wings made hot just to make them hot, I sense a pattern that vindaloo is the hottest “normal” meal.

Is there anything else that is just that bad-arse hot as a floor model?

[Kdogg]

If you can't fight with the ones you love, love the ones you fight with.

As for the coronavirus, I've spent some time looking through the interwebs ("Google, MD") trying to figure out how much of a threat this thing is, and my best guess is maybe a Spanish flu situation if it gets bad?

Let’s hope not. The death rate may be between 3-4% but that strain of H1N1 infected a third of the worlds population. Combined with the fact that demographics skew older now (at least in the developed world) it would not be pretty.

[bundabergdevil]

Putting aside wings made hot just to make them hot, I sense a pattern that vindaloo is the hottest “normal” meal.

Is there anything else that is just that bad-arse hot as a floor model?

Vindaloo - just hysteria or the end?

I think you’re looking for the thread next door!

[OldPhiKap]

Vindaloo - just hysteria or the end?

I think you’re looking for the thread next door!

Lol, yup. Never mind.

Although spicy food is good for health. . . .

[rsvman]

If you can't fight with the ones you love, love the ones you fight with.

As for the coronavirus, I've spent some time looking through the interwebs ("Google, MD") trying to figure out how much of a threat this thing is, and my best guess is maybe a Spanish flu situation if it gets bad? I saw a chart posted with the age of the deceased patients and it was almost all 50+. Not apocalyptic--things still kept running despite the flu and WW1--but certainly the potential to be very bad (the Spanish flu killed 3-5% of the world's population). I'm in my 40s, and I had pneumonia a few years ago and would prefer to avoid something similar, so I ordered n95 masks and nitrile gloves today. Not because I expect to use them, but because I expect there will be a run on them if things get bad enough to where they are needed.

Overreaction? Appropriate reaction? Underreaction because I didn't stock up on food, water, and guns?

Just FYI, N95 masks come in multiple different shapes and have to be professionally fitted if you really want them to provide N95-level protection. Also, you can't have any facial hair at all, which means you would have to be clean shaven (shaved?) daily. At our hospital, we have at least 5 different styles of N95 mask, and we are required to go through about a 20-minute test of them to prove they actually fit properly.

Having said all that, most respiratory viruses, including coronaviruses, are spread through what we call "large droplets," not "droplet nuclei." Large droplets generally fall out of the air within about 5-6 feet of where they are expelled. They are also too large to go all the way into your lungs, so infection starts in the nose. You can protect yourself from large droplets with regular surgical masks, which are essentially the same thing as any quality dust mask that you can buy at Home Depot or your local smaller hardware store.

N95s are for protecting against diseases that are not only spread through the air, but are shed in droplet nuclei, which are extremely small, can remain in the air for a long time and even travel through duct work into neighboring rooms, and can be inhaled all the way down into the alveoli of the lungs.

[BLPOG]

Thanks for the recommended reading. Regarding the food markets - lots of articles like the one below floating around about this. The description is not for the faint of heart and honestly sound worse than Sinclair’s descriptions of our system 100ish years ago in The Jungle.

https://nypost.com/2020/01/25/inside...e-coronavirus/

This point is a bit afield, and I'm not sure whether it makes the comparison better or worse, but Sinclair fabricated The Jungle. I don't mean "it's a work of fiction." I mean that it's a fabrication (with respect to the food industry work and safety aspects for which it is remembered and had greatest contemporary impact). It really bothers me that it's remembered by most as a kind of exposé.

[bundabergdevil]

This point is a bit afield, and I'm not sure whether it makes the comparison better or worse, but Sinclair fabricated The Jungle. I don't mean "it's a work of fiction." I mean that it's a fabrication (with respect to the food industry work and safety aspects for which it is remembered and had greatest contemporary impact). It really bothers me that it's remembered by most as a kind of exposé.

It was a work of fiction but did shine a light on pretty awful conditions and helped catalyze changes in the industry and how we thought about our food system at that time. Is that a debated point? I know the popular idea that Sinclair went “undercover” to research the book is contested.

Not sure exactly what your point is. My main idea was - the industrialization of food in our country was messy so the description of China - a bigger, more complex country industrializing and serving world markets - doesn’t surprise me in the least.

[BLPOG]

It was a work of fiction but did shine a light on pretty awful conditions and helped catalyze changes in the industry and how we thought about our food system at that time. Is that a debated point? I know the popular idea that Sinclair went “undercover” to research the book is contested.

Not sure exactly what your point is. My main idea was - the industrialization of food in our country was messy so the description of China - a bigger, more complex country industrializing and serving world markets - doesn’t surprise me in the least.

My point was that the horrors he described - things like workers falling into machinery and being sold as part of the end product, were false. They weren't part of "discoveries" he made while undercover. The understanding of the book at the time, and now, is centered around that sort of thing, and perpetuates a myth regarding actual conditions and standards at the time. I try to discourage people from holding false beliefs.

The subsequent regulations that passed as a result of public clamor were essentially written by the meat packing industry (and they had already been trying to get some of these regulations put in place; the whole thing is a great example of regulatory capture, so you might want to update your belief about it catalyzing changes in the industry, as opposed to creating barriers to it). Sinclair himself remarked on that. His hope was that the book would spur people to socialism and nationalization of industry, not create some sort of public health-related regulatory structure - but people were much more alarmed by his fantastic descriptions of what was going into their food than they were interested in fomenting a workers' revolution.

[Troublemaker]

One of the major concerns right now is that people with the virus can still spread it before showing symptoms, at least according to China's health minister: https://www.cnn.com/2020/01/26/healt...als/index.html

"This is a game changer," said Dr. William Schaffner, a longtime adviser to the US Centers for Disease Control and Prevention. It's much harder to contain a virus -- to track down a patient's contacts and quarantine them immediately -- if the patient was spreading the disease for days or weeks before they even realized they had it.

"It means the infection is much more contagious than we originally thought," said Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. "This is worse than we anticipated."

[Troublemaker]

I should note though that until a patient dies under western care (none that I'm aware of at the time of this post), the asymptomatic spread and estimated R-0 of around 2.5 is probably much more of a problem for China. I fear they will lose many, many lives over there.

[weezie]

There is some really incendiary stuff swirling around the webs. We're not supposed to troll here but yikes, people do get up to some weird theorizing at their laptops. Or, yes their small screens.

[budwom]

Aside from the obvious concern, it is interesting to watch what the Chinese do about all this. They have (previously) been embarking on some truly Orwellian control freak stuff, such as the Social Credit Score, in which behavior the authorities don't like can result in travel restrictions, school restrictions, dog confiscations (what?), job loss, etc.

Few societies can control as much as the Chinese can, but the coronavirus may or may not recognize their authority in this matter.

[rsvman]

One of the major concerns right now is that people with the virus can still spread it before showing symptoms, at least according to China's health minister: https://www.cnn.com/2020/01/26/healt...als/index.html

"This is a game changer," said Dr. William Schaffner, a longtime adviser to the US Centers for Disease Control and Prevention. It's much harder to contain a virus -- to track down a patient's contacts and quarantine them immediately -- if the patient was spreading the disease for days or weeks before they even realized they had it.

"It means the infection is much more contagious than we originally thought," said Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. "This is worse than we anticipated."

Bill Schaffner is a friend of mine. I did my Peds ID training at Vanderbilt. Yes, I'm name dropping. He's a big deal in the adult ID world, especially in the realm of public health. He's also a genuinely nice guy.