Things I've been wondering about COVID-19

03 March 2020, 06:49 PM

jon-nyc

I'll grow this list over time I'm sure, but for now...

1). In China men were more likely to be victims than women. Was that for some biological reason? Or cultural reason (say they spent more time in crowds or smoked more or something). Will that result obtain here and in other countries?

2) Kids are usually asymptomatic or have very mild symptoms. Does this make it less likely for them to spread the disease, since they aren't coughing and sneezing as much? Or is it a wash because they lick their hands and touch everything? What's the R0 for the 10 and under crowd?

3) China saw much higher death rates in people with certain co-morbidities. Some of those co-morbidities are present in a much higher percentage of the population here than in China. For example, the biggest co-morbidity risk factor was cardiovascular disease - the fatality rate among those patients was over 10%. But only 20% of Chinese adults have cardiovascular disease, here it's almost half. Will that be reflected in the CFR? That could make it materially higher. (that could also be a possible explanation for differential CFRs between men and women)

03 March 2020, 06:54 PM

jon-nyc

quote:
But only 20% of Chinese adults have cardiovascular disease, here it's almost half. Will that be reflected in the CFR? That could make it materially higher.

This seems like it could be really significant but I've seen no reporting on it, or even anyone asking the question.

If the fatality rate is 10.5% among those with cardiovascular disease and half of American adults have cardiovascular disease, does that push our CFR closer to 5% than 2%?

Let's hope not.

03 March 2020, 07:29 PM

jodi

Good questions.

03 March 2020, 07:39 PM

ShiroKuro

Somewhere... NYTs maybe, wrote about the higher susceptibility in men than women...

03 March 2020, 07:44 PM

ShiroKuro

BTW here's something I don't get, and that is, if transmission is not airborne but rather by droplets (which is what I've read), then how are people contagious before they are symptomatic? If they're not coughing, what are the "sloughing" off? And how could we get better at avoiding that? (besides hand washing and not touching our faces)

Another question: what's the latest on soap and water vs. hand sanitizer? I seem to remember that a while back I concluded (based on things I'd read) that soap and water was actually better than hand sanitizer, and that's why I never really got in the habit of buying it. (That, and I am very good about washing my hands regularly). But is hand sanitizer now considered to be better??

03 March 2020, 08:08 PM

ShiroKuro

quote:
1). In China men were more likely to be victims than women. Was that for some biological reason? Or cultural reason (say they spent more time in crowds or smoked more or something). Will that result obtain here and in other countries?

here's the article about this from the NYT (which I will now go and read...)

https://www.nytimes.com/2020/0...logy&pgtype=Homepage

04 March 2020, 01:18 PM

ShiroKuro

ETA: here are two more questions:

I saw a Japanese news article about a Japanese pharmaceutical that is working on developing a treatment for COVID-19, they are saying they think it will be ready in 9 months. (i.e. not just a medicine to treat symptoms, but something that will aid in healing or cure, in the way that tamiflu does with the flu)

So, isn't the coronavirus one of the viruses that causes the common cold? Why should we expect a medicine that can treat COVID-19 when we've never been able the common cold?? What am I missing?

The other question is... so, the flu vaccine is said to give partial immunity even when it's not perfectly matched to the particular flu in a given year.... So, if coronavirus is the same as the types of viruses that cause colds, then if someone had already had and gotten over a cold that year (assuming it was a coronavirus and not a rhinovirus), would that give them some partial immunity or resistance to COVID-19? Is this the right way to think about it?

04 March 2020, 09:20 PM

wtg

Emergency med doc in NYC talks about the state of testing.

https://news.google.com/articl...S&gl=US&ceid=US%3Aen

We really have no clue how many cases are out there.

04 March 2020, 09:26 PM

Piano*Dad

I think the Chinese men syndrome will wind up being primarily behaviorally driven. Men smoke at much higher rates in China.

04 March 2020, 09:59 PM

Daniel

quote:
Originally posted by ShiroKuro:
ETA: here are two more questions:

I saw a Japanese news article about a Japanese pharmaceutical that is working on developing a treatment for COVID-19, they are saying they think it will be ready in 9 months. (i.e. not just a medicine to treat symptoms, but something that will aid in healing or cure, in the way that tamiflu does with the flu)

So, isn't the one of the viruses that causes the common cold? Why should we expect a medicine that can treat COVID-19 when we've never been able the common cold?? What am I missing?

The other question is... so, the flu vaccine is said to give partial immunity even when it's not perfectly matched to the particular flu in a given year.... So, if coronavirus is the same as the types of viruses that cause colds, then if someone had already had and gotten over a cold that year (assuming it was a coronavirus and not a rhinovirus), would that give them some partial immunity or resistance to COVID-19? Is this the right way to think about it?

Well, I don't think so myself. I don't think the coronavirus causes the common cold. I also think they try to find a vaccine, asap, not necessarily a cure.

04 March 2020, 10:07 PM

ShiroKuro

Daniel, I maybe wasn’t clear enough. I don’t mean that I think COVID-19 a the same as the common cold.

But as I understand it, Coronavirus is a type of virus, of which the current problematic one, COVID-19, is one variant. The common cold is caused by wither rhinoviruses or Coronaviruses, so it seems like there should be some similarities to those and COVID-19.

Anyway I’m probably not thinking about it the right way. But the reason I was asking is b/c there’s a Japanese company saying they’re working on a treatment, not a vaccine. It’s not out the realm of possibility I suppose, tamiflu is a treatment for flu, so...

04 March 2020, 10:19 PM

wtg

quote:
Originally posted by ShiroKuro:
ETA: here are two more questions:

I saw a Japanese news article about a Japanese pharmaceutical that is working on developing a treatment for COVID-19, they are saying they think it will be ready in 9 months. (i.e. not just a medicine to treat symptoms, but something that will aid in healing or cure, in the way that tamiflu does with the flu)

So, isn't the coronavirus one of the viruses that causes the common cold? Why should we expect a medicine that can treat COVID-19 when we've never been able the common cold?? What am I missing?

The other question is... so, the flu vaccine is said to give partial immunity even when it's not perfectly matched to the particular flu in a given year.... So, if coronavirus is the same as the types of viruses that cause colds, then if someone had already had and gotten over a cold that year (assuming it was a coronavirus and not a rhinovirus), would that give them some partial immunity or resistance to COVID-19? Is this the right way to think about it?

Poaching a good explanation:

quote:

Partial immunity happens when a person's immune response to a pathogen (or vaccine) is enough to prevent severe infection or mortality, but they can still become ill. In the case of partial immunity to influenza, the immunity of the person depends on the antigenic relatedness between two (or more) influenza viruses. There are two types of influenza virus that cause epidemics: A and B. These two types are further broken up into different strains, and they are constantly evolving.

The flu vaccine in any given year is tailored to give immunity to only a few strains or variants of the two types (A and B) of flu. To other strains only partial immunity will be conferred, and little or no immunity to others. The thing is is that the dominant strains vary from year to year and the vaccine has to be prepared many months ahead of the flu season so the vaccine is made using a predicted estimate of what is coming. For example trivalent flu vaccines are formulated to protect against three flu viruses, and quadrivalent flu vaccines protect against four flu viruses. You get full immunity for the "main" strains that year yet only partial for closely related strains.

I don’t think that having a cold confers any kind of immunity to covid-19. They may both be in the same class of viruses, but they are different beasts immunologically speaking.

04 March 2020, 10:27 PM

jon-nyc

quote:
Originally posted by wtg:
Emergency med doc in NYC talks about the state of testing.

https://news.google.com/articl...S&gl=US&ceid=US%3Aen

We really have no clue how many cases are out there.

Yeah, I said a few days ago that once we get our testing capability up to China or SK standards our case count will go vertical.

Seriously, the FDA and CDC really screwed the pooch on this one.

05 March 2020, 09:20 AM

ShiroKuro

quote:
They may both be in the same class of viruses, but they are different beasts immunologically speaking

This is the part I don't understand, why, if something is the same type of virus, there's not some immunological overlap. Because that's what we have with the flu, right? Different variants of the same class of virus, with a flu shot, you get an immunological boost even if the shot isn't perfectly matched to the variant...

In any case, I started out this line of questioning thinking about how it seems pretty farfetched to claim that a pharma company will have treatment and/or vaccine ready in less than a year, given that no one has ever figured out how to deal with the common cold.... But, maybe, one point is that, the common cold is multiple types, and they're just working on COVID-19.

Anyway, lots of unknowns. The only thing we know is, we gotta keep washing our hands. :P

05 March 2020, 09:34 AM

wtg

Some more technical info: https://www.ncbi.nlm.nih.gov/books/NBK7782/

About the "common cold" (rhinovirus vs coronavirus):

quote:
The epidemiology of coronavirus colds has been little studied. Waves of infection pass through communities during the winter months, and often cause small outbreaks in families, schools, etc. (Fig. 60-2). Immunity does not persist, and subjects may be re-infected, sometimes within a year. The pattern thus differs from that of rhinovirus infections, which peak in the fall and spring and generally elicit long-lasting immunity. About one in five colds is due to coronaviruses.

I think we have to be careful in trying to apply layperson logic to these puppies. What seems like a group of "similar" viruses to us may be viewed very differently by a microbiolgist...

Calling piqaboo....or maybe Martin?...I think he was here this morning...they might be able to shed more light on the subject...