Wednesday, March 18, 2020

5th Update: What I Learned About the Coronovirus From a Webinar Hosted by Advisor Perspectives (3/18/2020)


ALL POSTS PRIOR TO 2021 HAVE NOT BEEN REVIEWED NOR APPROVED BY ANY FIRM OR INSTITUTION, AND REFLECT ONLY THE PERSONAL VIEWS OF THE AUTHOR.
Wednesday, March 18, 2020 - Update #5 - on the Coronavirus itself

Dear Clients, Students, Colleagues, Family and Friends:

I listened today to a webinar hosted by Advisor Perspectives, with Julie Parsonnet, a professor of medicine from Stanford University, who provided some insights on the Coronovirus.

I'm not a physician, of course. And different viewpoints may exist, within the medical community.

Nevertheless, here is a summary of the webinar content, which I hope better informs you.

Most people who are infected have no symptoms.

The virus stays in the upper respiratory tract. But 20% get significant symptoms. And a subset of these become very severe cases. There are effects of the virus on not just the lungs, but the heart.

This virus spreads very, very easily. There is some evidence that those infected may be transmitting the disease for longer than 2 weeks after they become infected (for those who have little or no symptoms). 

The older you are, the higher the mortality rate. Those who are over 80 are “massively at risk” – 15 times greater risk - as their immune system responses are generally lower. The increased risk appears at the age of 50, and over (and perhaps the age of 40).

Those who have hypertension, obesity, underlying lung diseases, asthma, heart conditions, are at greater risk. Anyone with a depressed immune system, as well. (But the greatest risk is for over the age of 80.)

Italy has a high mortality rate, due to the high average age of their population. (A lot of Italians, percentage-wide, are over the age of 60.) Italy did not “close down” quickly, leading to an overwhelming of the health care system in Italy.

Should you receive packages?

A paper in the New England Journal of Medicine that was published on March 17th indicated that the virus remains on cardboard for up to 24 hours, and on glass and stainless steel for 2-3 days or longer.

So, it is essential to clean those surfaces.

If you receive a delivery of an item shipped 72 hours (or longer) before, don’t worry about becoming infected.

[Note: Thus far, experts have said there isn’t any reason to believe the coronavirus can be spread through food. But, the packages the food is shipped in may be able to spread the coronavirus. Also, eat the food while it is hot … when food is at room temperature, bacteria growth accelerates.]

How to stop the spread.

If everyone stayed at home, this pandemic would die out. Social distancing, in the ideal world, is the best means to contain this disease. But, some people have to deliver food, render medical care, deliver mail, etc.

Hand-washing with soap and water (works better than hand sanitizers) and not touching your face are important. If you go out, having gloves on will help you to not touch your face and provide a barrier. Does not matter, really, what types of gloves.

Closing schools may be a mistake, in communities where there is not an outbreak. It is believed that children rarely get sick from the disease, and they may not be very good “vectors” of the disease.

Dentists are at very high risk, and most dentist offices in areas that have confirmed cases have shut down except for emergency.

Having food delivered is better than going to the market. But, wash the food (such as fruit), upon receipt, as many persons may have handled it. Or wash the outside of cans.

Masks are not very effective, as long as social distancing. A little protection may exist, but not a lot.

However, if you live in a household with someone who is infected, the infected person should wear a mask.

Health care providers need masks, as well – and there are not enough of them. Training for health care providers on the Coronavirus is being delayed, due to shortage of masks.

There are still not enough tests in the U.S.

Health experts would like have enough tests to be able to test people without symptoms, as a means of trying to further limit community infection. 

The big obstacle to having enough tests is the reduced supply of reagents (chemicals needed to run the tests), and sampling equipment (such as nose swabs).

We don’t have an antibody test yet, to show us who have been exposed. If that is developed, and if those who have had the disease won’t get the virus again, then those persons could return into the workplace. We don’t know how close we are to having an antibody test.

We should have much better testing in about two weeks, which will help screen those who are arriving from traveling abroad, etc.

The potential overwhelming of health care systems is the reason everyone needs to act to reduce the spread of the disease.

Physicians and hospitals in some areas of Washington State and California are already running out of equipment, gowns, and gloves, and other shortages have occurred in other areas.

One of the problems is that there are very few “negative pressure” rooms in hospitals, which makes it difficult to quarantine infected patients. Huge strains on our health care system are very probable.

Health care experts expect that those who have had the virus will develop some form of protective immunity to it, similar to other viruses. But this is not certain at this time. And how much protective immunity exists may vary by person.

Are There Treatments to Reduce the Mortality Rate?

There are indications that a drug, Remdesivir, may have benefits for those who have severe symptoms. Another new drug in China may have significant benefits 

Other medications, already on the market, may have benefits in decreasing the severity and duration of the illness.

But more research is needed.

When Will a Vaccine Be Ready?

Any vaccine under development will be fast-tracked. There are vaccines in clinical trials already, in humans (Phase I trials for safety). Realistic, it will be 12-18 months before a vaccine is ready, although hope exists that this might be a bit less (but not a great deal less). It will not be in the next few months.

The current flu shot does not provide protection against this COVID-19 Coronavirus. But it does prevent against the seasonal flu, and people are encouraged to get the vaccine – which will help to reduce the strain on the health care system.

How Long Will Self-Isolation Last?

China may be a model. China has started to re-open stores and factories, after 2-3 months of closures. But we don’t know if there will a significant increase in the number of infections, in China, as a result of these re-openings. China is clearly several weeks ahead of us, or even a couple of months ahead of us, in having the disease spread and then in addressing the disease, so watching what goes on there will provide lessons for Americans.

It may take a month, or several months, before it is safe to go back to work, for most persons, according to the speaker.

For example, if a test is available to discern those who have already been infected, and if those who have been infected develop protective immunity that prevents them from being re-infected, then those persons will be able to get “back to the office or factory” sooner.

Also, as the weather heats up, and we have higher humidity, the virus may become harder to spread, and easier to contain. But health experts don’t know this, for certain, yet.

More Diseases to Come?

This particular virus came from a bat, that invested another wild animal that is prized for herbal medicines in China. China has now banned wild animal markets. This may help us reduce the risk of new viruses emerging, but it will not completely stop the emergence of new viruses completely.

[Where can I go to get more information?]

There are many resources available. 

The most authoritative one might be from the Centers for Disease Control: https://www.cdc.gov/coronavirus/2019-nCoV/index.html

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