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How to fight the coronavirus SARS-CoV-2 and its disease, Covid-19 [pdf]
- majos 7y agoJust to check the source, these are the same slides (same Drive doc) tweeted by the listed author on the slides [1], who is a neurobiology and bioengineering professor at Stanford. If you want an understandable, relatively short but info-dense writeup from a sober expert (there hasn’t been much of this on HN) this is nice. [1] https://mobile.twitter.com/michaelzlin?lang=en https://mobile.twitter.com/michaelzlin?lang=en
- raphlinus 7y agoI've added this to my list of resources for my blog audience, which I define as people who are curious about the science and have enough technical background to understand better than simplified popular explanations. My resource list is open source and takes issues and pull requests. [1] https://raphlinus.github.io/covid/2020/03/14/covid.html https://raphlinus.github.io/covid/2020/03/14/covid.html
- underbluewaters 7y agoI'd like to see more information on what to do if you are sick. Even younger people have gotten serious respiratory complications and it would be great to have information on how to care for yourself or your family short of heading to the hospital and contributing to the overwhelming of their staff.
- raphlinus 7y agoThe most authoritative source is (still) the WHO guidelines [1], though the audience for this is health care professionals, not patients. Your national and local public health departments may have more updated and tailored information. A popular article is "What Will You Do If You Start Coughing?" by James Hamblin [2], though this is heavier on public policy concerns than specific targeted advice. If anyone can find a really well-communicated set of advice on this, I'll gladly add it to my resource list. The need for such things is urgent, and I'm extremely frustrated about the poor quality and distribution of resources, which is why I'm putting time and energy into curating my own resource list. [1] https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts https://www.who.int/publications-detail/home-care-for-patien... [2] https://www.theatlantic.com/health/archive/2020/03/where-do-you-go-if-you-get-coronavirus/607759/ https://www.theatlantic.com/health/archive/2020/03/where-do-...
- Leary 7y agoBe careful with NSAIDs as they may exacerbate symptoms. [1] [1]: https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection https://www.theguardian.com/world/2020/mar/14/anti-inflammat...
- raphlinus 7y agoIs there an authoritative source for this other than the French public health authorities? I haven't seen references to it at all in epi Twitter.
- throwaway_pdp09 7y agoSeems you're putting twitter above a country's health authority. That seems odd. Not necessarily wrong, just odd.
- outworlder 7y agoNot necessarily wrong? I'm intrigued by the thought process.
- JamesBarney 7y agoHow do we know the doubling time? That seems like the biggest assumption that we're not sure about. I've seen 1 week, 5 days, and even recently 3 days.
- raphlinus 7y agoLook at the graphs on "our world in data": https://ourworldindata.org/coronavirus#trajectories-since-the-100th-confirmed-case https://ourworldindata.org/coronavirus#trajectories-since-th... Based on this, 3 days does indeed look like the doubling time. However, be careful when interpreting this data, as it conflates increases in testing coverage with actual viral spread. If you look at countries with excellent testing, such as South Korea, it was still in the 3 day range, though today they thankfully have transmission comparatively under control.
- JamesBarney 7y agoThanks for linking to that graph. That's a great resource! At 3 days that changes both how much we have to slow it down, and how quickly we need to start slowing it down. Not to mention that if it's 15 days from infection to diagnosis then that's 5 doubling times. So by the time we realize we didn't do enough it's way too late to avoid a complete catastrophe.
- raphlinus 7y agoI don't think 15 days is a good number for infection to diagnosis, though obviously it depends on how rapidly we can accurately diagnose cases. (In the subsection of the population without access to healthcare, it's a divide by zero error). I'm not qualified enough to provide an estimate myself, but happy to link to an authoritative review: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19 https://www.uptodate.com/contents/coronavirus-disease-2019-c... (see "Incubation period" for input on what you're looking for)
- JamesBarney 7y agoYou're right I misread PDF.
- Alex3917 7y ago> 95% don’t need to go to the hospital Including people who get at asymptomatically, maybe. Of people who get any symptoms, it's 15 - 20%. And even if you're not in that 15 - 20%, you may still have permanent or long lasting lung and heart damage. Stay inside; your grandparents were asked to go to war for several years, you're just being asked to spend a couple months playing video games.
- yovagoyu 7y agoEhhh... there are more productive ways to spend your time than playing video games. I agree we should look out for the older generation though. For me, it's my parents (boomers, who fought no wars) I worry about, my grandparents (who fought) have passed already.
- Alex3917 7y agoI mean sure. If commit to spending even an hour a day on some sort of self-improvement activity, whether it's getting in shape or teaching yourself some new skill or whatever, you'll come out of this way better than you went in.
- patrickbeeson 7y agoI would encourage folks to go outside run, bike, hike, etc. There's plenty of healthy options that won't put you at risk from contracting the virus.
- pdonis 7y agoThe comparison of symptoms on slide 26 seems particularly useful.
- williamstein 7y agoEspecially interesting to me is the entry on "shortness of breath", which is common in COVID-19 but NO for both flu and cold.
- pdonis 7y agoYes, that seems like a good symptom to focus on for differential diagnosis.
- ones_and_zeros 7y agoI'm looking for information for those that provide patient care to covid patients. Infection rate, best practices, transmission to family (I live with a doctor providing care to covid patients...), etc. I've seen some anecdotes and single case reports that are concerning, but anything that is data driven like this will be helpful. Also, where is non denatured ethanol readily available?
- smichel17 7y agoYou can use diluted bleach (1:9 bleach:water) for cleaning surfaces. Source is WHO guidelines as linked by raphlinus downthread (hard for me to get a direct link to the comment due to the device I'm reading on, sorry).
- raphlinus 7y agoHere's a review that seems pretty comprehensive and careful with sources: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19 https://www.uptodate.com/contents/coronavirus-disease-2019-c...
- rwmurrayVT 7y agoEverclear is probably your best bet. It depends on where you live. Where I live your only bet is the local Naval Exchange. :(
- DoreenMichele 7y agoThe last slide is a hand sanitizer recipe. It's probably the most useful thing here.
- thotypous 7y agoUnfortunately, here in Brazil an old ban exists on selling ethanol, due to concerns of it causing accidents with fire and explosions. The only way for an ordinary person to acquire ethanol is in the form of - take a guess - hand sanitizers (or vehicular ethanol at gas stations, but it is inappropriate for that purpose). So currently hand sanitizers are completely out of stock and soap is the only alternative.
- deleted 7y ago[deleted]
- pengaru 7y agoYou can't get isopropanol/isopropyl/"rubbing" alcohol as sold in pharmacies usually near the hydrogen peroxide? You can mix this with aloe vera lotion in ~50:50 mix for a diy hand sanitizer.
- rebuilder 7y agoIf you can get your hands on near-pure ethanol.
- deleted 7y ago[deleted]
- devy 7y agoIt's disingenuous to compare COVID-19 death with traffic death in Dr. Lin's presentation. Here are the facts: - The 30k U.S. traffic death count is for the ENTIRE YEAR. The 3k death in Wuhun happened in a matter of weeks(6-8 weeks). - Given that U.S.'s inaction and squandered 2 months of lead time, we could see death count to be in the order of hundreds of thousands in U.S. alone.[1] This is NOT an estimate based on mathematical model, this is the estimate based on clinical data so far and virus's exponential growth rate. There isn't a national lock-down yet although some states are acting quickly, still 2 month late. - Mass majority of the vehicular deaths are preventable because most of them are due to human error. COVID-19 is NOT preventable RIGHT NOW. Vaccines are at least 1-1.5 years away, no matter how fast track you spin it. - Asymptomatic and family based clustering transmissions are making the lock-down less effective. - We will get through this nightmare pandemic outbreak. But the economic depression is real and ongoing. Nobody knows what the long term effect could be. [1]: https://www.businessinsider.com/presentation-us-hospitals-preparing-for-millions-of-hospitalizations-2020-3 https://www.businessinsider.com/presentation-us-hospitals-pr...
- natalyarostova 7y agoI didn’t get the impression he was comparing them. Just providing reference points. He’s pretty clear that this is bad.
- devy 7y agoThe closest outbreak to COVID-19 is probably the 1918 Spanish flu (forward-looking statement). And we are going to have 100% likelihood that this year's COVID-19 death count is going to surpass 30k people globally.
- majos 7y ago> This is NOT an estimate based on mathematical model, this is the estimate based on clinical data so far and virus's exponential growth rate. I’m not saying you’re wrong, but an exponential growth rate is a mathematical model. We’re extrapolating the current curve into the future, that’s a model.
- MaupitiBlue 7y agoWhy new diseases keep appearing in China https://m.youtube.com/watch?v=TPpoJGYlW54 https://m.youtube.com/watch?v=TPpoJGYlW54
- azinman2 7y agoI was expecting that to be some racist video, but it was actually very informative.
- mcsb4 7y agoThere seems to be a second virus in the west: DMTMW - dont mention the M word - M like mask. Purely looking at the data, the doubling of the infection rate in western countries is between 2-3 days. Looking at Asian countries: Japan: 8-9 days - many people wearing masks Thailand: 10+days - most people wearing masks China: negative values - all people wearing masks (not just in Wuhan) and handsanitizer everywhere Cost for masks: 0.2$/person per day. Let's hope that China can ramp up the mask and hand sanitizer production to supply the rest of the world asap, because the west doesn't have the capability.
- robbiep 7y agoMasks don’t help for catching the virus (materially) - better to wash hands. Masks do help with curbing transmission from infected, and are also needed for healthcare workers. Please don’t waste masks when you could get significantly better benefit by regularly washing your hands and not putting your fingers in your mouth
- fma 7y agoIf masks curb transmissions. And everyone wore masks. Wouldn't there be a benefit as a whole?
- csomar 7y agoPMs told that (masks are useless) to people so that doctors can have the masks. In reality masks are insanely effective if everyone wear them.
- fma 7y agoWhat does PMs mean? Also it doesn't make sense to me that "we should leave masks for doctors", as experts and media are saying. The masks sold in the grocery stores and pharmacies are surgical masks. Surgical masks prevent the wearer from spreading the virus... Doctors and nurses should have N95 masks, which prevent the wearer from obtaining the virus... I agree something is better than nothing, but if doctors and nurses are treating infected patients, surgical masks do nothing for them! In an ideal world, IMHO - we common folks wear surgical masks to contain the spread. Hospital staff wear N95 to prevent them from getting sick. The sooner we realize this fact - the sooner we can massively produce masks and get people to wear them when going out.
- blendo 7y agoFrom p28 of the slide deck: “Go outside - sunlight is the best disinfectant”
- fma 7y agoFWIW, Open Air Treatment was used to fight the 1918 flu pandemic. But I think culturally, we (Americans at least) love our HVAC. "A combination of fresh air, sunlight, scrupulous standards of hygiene, and reusable face masks appears to have substantially reduced deaths among some patients and infections among medical staff. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504358/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504358/
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- sn9 7y agoThis analysis seems largely correct but for one thing, the author assumes that people who contract the virus will develop immunity that lasts long enough to bend the exponential growth curve as herd immunity develops. (The curve will slow for other reasons as a sufficient number of people get infected such that there just aren't enough people who haven't been infected to be newly infected.) I didn't see a source for that --- it seemed like an assumption --- and everything I've read suggests that this is a major unknown at the moment. It's possible the author has a source that was not included. Either way, the author should either include the source or more explicitly take describe the epistemic status of that hypothesis and work through the consequences of it not being true.
- chme 7y ago> This analysis seems largely correct but for one thing, the author assumes that people who contract the virus will develop immunity that lasts long enough to bend the exponential growth curve as herd immunity develops. I am not a medical professional, but I would have assumed that the body develops a immunity because otherwise why would they search for a vaccine?
- sn9 7y agoI guess I was being overly broad. I'm not an immunologist or anything. I was thinking more of the kind of immunity one gets for something like chicken pox, where one childhood infection basically protects you for life, vs something like the seasonal flu which you can get again and again. Now I don't know if the reason you keep getting the flu is because it mutates more rapidly than the chicken pox virus and you still remain immune to the particular strain you got infected with or if that initial immunity weakens over time. Maybe someone better informed can chime in.
- mecit 7y agoHi, can anyone tell me, if taken Quercetin have negative effects for people who have under funktion of thyroid ?