10 ms·
I think everybody should carefully read the short section that says "Does the amount of exposure affect the severity?". Some people are looking at antibody stu
by hristov 6y ago
I think everybody should carefully read the short section that says "Does the amount of exposure affect the severity?".
Some people are looking at antibody studies that show that large parts of the population are somehow affected and then doing back of the napkin math and deciding that this is really not worse than the flu in terms of death rate. They are further encouraged by the fact that people that die tend to be older and with pre-existing conditions. Then they say we should open everything up and get everything "back to normal", and sometimes they add that this is just a way to winnow out the old and the weak.
As problematic as the latter statement is, the above thinking is actually dangerously optimistic. Experience shows us that in specific situations with prolonged/repeated exposure, the death rates are much higher. Also young and healthy people may get seriously sick and die due to high level of exposure.
This has already been happening in hospitals that did not have sufficient protective equipment/procedures.
If we open everything up and get into a situation where the virus is all over the place we can get into a horrible spiral of increased exposure and increased death rates etc.
- Bnshsysjab 6y agoAs someone who hasn’t followed, and I understand I’m asking a random internet user this and not a scientist, but what is the definition of ‘prolonged exposure?’ Are people who contract the disease less likely to die that someone who is in close contact for a prolonged period of time? How long is that period? 15 minutes? Two hours?
- bdamm 6y agoTo wit; if my wife gets sick and I care for her, does that mean I am experiencing "prolonged exposure"?
- tomrod 6y agoYes.
- code_duck 6y agoBeing around a positive person continually for several days at home would mean a lot more exposure than many people would get when encountering others in public.
- nradov 6y agoMaybe? No one knows for sure. We can't directly measure the dose of virions each person receives. There is a huge variations in contagiousness between patients based on factors that are still unclear. Proper use of PPE by caregivers can also have a huge impact.
- seppin 6y agoYes. Separate as much as possible, don't share a bathroom at all.
- greggman3 6y agoI my experience most houses and apartments in Japan, and SF only have 1 bathroom.
- sjg007 6y agoIt’s dose. So you get a higher dose the longer you are exposed. A smaller dose infected less cells are initially infected and maybe you get less sick. Higher dose may mean you get more sick.
- beamatronic 6y agoDoes it not logically follow that if the dose can be precisely controlled, it could help your body start developing antibodies sooner?
- skybrian 6y agoThat's the idea behind "variolation", which was used before there were vaccines. It's risky, since you might get infected anyway, or perhaps the dose isn't enough to work. Making strong guarantees that people will become immune and won't be infected is part of what makes coming up with a vaccine hard. It's apparently pretty easy and quick to come up with vaccine candidates.
- zajio1am 6y agoWith variolation it was not lower dose, but different (mild) strain (cowpox), which offers cross-immunity to smallpox.
- InDemoVeritas 6y agoIt was a controlled infection with Smallpox, by scraping the skin with pus or scab powder from an infected person. Cowpox is what makes the smallpox vaccine.
- zajio1am 6y agoYou are right.
- deleted 6y ago[deleted]
- nisa 6y agoNot a scientist, I can only attempt to retell what virologist Prof. Christian Drosten from Charité Berlin told in in his podcast[1]: It's not really clear at the moment but it could be due amount of dose (more virus particles, faster replication) and where the virus makes contact with the body (if you are unlucky you are breathing a high dose directly into your lungs i.e. coughing patients in a hospital) - your immune system does not know the virus and it takes a while until it's able to fight it off and if the virus is directly in the lungs or you've got a high dose it has less time to do so. If you have it only in the throat it takes a lot of time, like multiple days until it goes into the lungs (if at all, this is also not clear when and when not this happens) and he suspected that in this time period you already have a better immune response. Besides that (not from the podcast) I've read that the virus can induce inflammation that can can cause blood clots and other nasty things - so you may die from stroke or heart problems and not pneunomia. There was also a paper that hypothesized that the virus can either replicate in the throat and go the lungs but it's probably also possible for the virus to use the nervous system to reach the brain via the olfactory bulb. China did isolate ill patients from their families and it was hypothesized that sharing a bed/room with a sick person is a bad idea because the virus is in high doses in the air. So you can read that you should keep fresh air flowing in and possible avoid too much direct contact. 1: https://www.ndr.de/nachrichten/info/podcast4684.html https://www.ndr.de/nachrichten/info/podcast4684.html (only in german)
- kpennell 6y ago60+ NYC MTA employees have died from Covid. Are we thinking that this happened because they had high viral loads?
- deleted 6y ago[deleted]
- slimed 6y agoSomething like 0.2% of NYC residents have passed away from the virus. As of 2018 the MTA had 50k employees. 60 out of 50,000 is 0.12%.
- tomrod 6y agoI suspect this would be facted on operators (trains, bus, etc.) versus support/construction/maintenance staff.
- cameldrv 6y agoYes, but they're workers. People generally retire at 65, and in the MTA, I believe you can get a full pension at 55. The population that pushes up the mortality numbers are 70+, and they're not driving a bus or a train anymore.
- asdf123wtf 6y agoAge is relevant here. I don't recall the numbers, but I read that a disproportionate amount of younger people who have died from covid-19 or had sever cases, were healthcare workers. And the theory was that viral load plays a part. The Chinese doctor who blew the whistle on covid-19 died from it, and I believe he was an otherwise healthy 30-something.
- zajio1am 6y agoAnother explanation is high long-term stress related to handling the pandemic in hospitals, as stress has negative effect on immune system.
- 6y ago
- mfer 6y agoStrokes, kidney disease, and other problems are happening to people who get this. Looking at death rate alone doesn’t tell of all the consequences
- nradov 6y agoAnd how many strokes, kidney disease, and other problems were caused by other respiratory system viruses before COVID-19? We don't know because we've never really looked.
- nisa 6y agofor SARS-Cov (the first one from 2003) there is some data and it's not pretty :/
- pfdietz 6y agoThere is data showing that flu vaccination reduces the chance of heart attack. The effect is about as strong as giving up smoking.
- arcticfox 6y agoHoly cow. I admit I've been lazy about flu shots but COVID has opened my eyes. That's one more fact that's going to send me to the clinic yearly.
- nyhc99 6y agoI read that there was visible lung tissue damage forming the characteristic broken glass pattern on CT scans of 58% of the infected but asymptomatic carriers on the Diamond Princess cruise. That to me adds a sobering footnote to the process of developing herd immunity. Most of us won't die, but do we walk away with long-term impairment of our lungs and possibly other organs?
- nisa 6y agoThis was also confirmed by a physician from Innsbruck, Austria that looked after healthy young adults that were divers and got the virus - all of them had only mild symptoms but most lost the fitness to dive anymore and lack lung function. https://www.sportschau.de/weitere/allgemein/corona-lungen-schaeden-taucher-100.html https://www.sportschau.de/weitere/allgemein/corona-lungen-sc... (I did not found an english link)
- nerdponx 6y agoI've also been wondering if this is a factor in the high death rates of people who've already been hospitalized, or in their rapid/unexpected deterioration. In a quarantine unit there must be a large amount of the virus all over everything.
- pfdietz 6y agoIt is my understanding with some viruses that one doesn't become infected with a single virus particle, but rather with a population. That's because the viruses mutate enough that no single virus has all the machinery necessary for replication. Only when a cell gets hit a few times to get all the parts does replication kick in. I don't think the mutation rate of this particular virus is very high, though, so this situation doesn't seem as likely here.
- akiselev 6y agoDo you have a source for that first paragraph? My understanding is that viruses don't have replication machinery at all - it's one of the defining features of viruses. Their host cells are essentially tricked into producing copies of the virus.
- pfdietz 6y agoI mean, working genes for all the various parts of the virus. Of course it is hijacking the cell's machinery.
- scentoni 6y agoThat is incorrect. The virus particles are mostly identical. The reason the dose matters is because each individual particle doesn't have a 100% chance of infecting an individual. That is partly due to the https://en.wikipedia.org/wiki/Innate_immune_system https://en.wikipedia.org/wiki/Innate_immune_system
- snissn 6y ago> Some people are looking at antibody studies that show that large parts of the population are somehow affected and then doing back of the napkin math and deciding that this is really not worse than the flu in terms of death rate. i feel like a lot of people are ignoring that a ton of people have relocated outside of NYC. i don't think the 25% antibody positive study in nyc is accounting for that
- epistasis 6y agoAlready 0.2% of NYC has died of COVID19. That's completely consistent with the very initial, very dire infection fatality rates of 0.6%-1.0%. (Which is different than the case fatality rate.) When you combine this 10x increase of the IFR along with the 5x-8x increase in suspected attack rate of flu, one would have to quite ignorant of reality, and perhaps an unknowing tool of others, to somehow look at the NYC study and think that it supports the silly "flu" conflation. (And for that matter, flu kills a ton of people every year, are we going to add another flu to the world without fighting back at all? What sort of wimpy, defeatist person looks at the world that way?)
- paypalcust83 6y agoDouble the official NY COVID deaths figure because excess deaths at home weren't counted.
- lostlogin 6y agoThere are some interesting stories on this. A lot of deaths are occurring that are outside of the 'normal' and not accounted for by deaths attributed to covid alone: https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav... https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
- djsumdog 6y ago
- flatline 6y agoAssuming it’s about as bad as the flu, fine, but we have herd immunity to the flu via vaccines and antibodies, plus people with the flu are symptomatic relatively quickly. Infect the entire US population with covid-19 and you lose ca. 0.5% of the population in one swoop, or about 1.5 million people. Just like the flu, but not, and the full consequences of the infection won’t really start showing up for a couple weeks.
- jliptzin 6y agoIt would be way more than that as most would not be able to seek medical attention
- AuryGlenz 6y agoIn a good year the flu vaccine is 50% effective, and that’s pretty rare (though getting better). That’s not enough for herd immunity, and flu viruses mutate enough where we also don’t get it from naturally formed antibodies.
- jnbiche 6y agoI can't agree with this enough. People are failing to account for viral load. I think that's part of what may be happening in areas like N. Italy and NY where the health system gets overloaded and the death tolls are high. People are getting such high initial inocula that they get really, really sick.
- pnako 6y agoLike most people I'm 1) not a specialist at all and 2) still have an opinion. One thing I'm looking at is the excess mortality in a country like Sweden, which had an outbreak (in the top 25 countries by cases) but has not done any lockdown. https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ It's flat.
- djsumdog 6y agoI've heard that, but then this article says: > In practice, however, this strategy, which was rejected in the United Kingdom, is leading to a much higher death rate in Sweden than in other Nordic countries. and they cite a CNN source. But then I look at this data plotted on a log chart and it appears they're leveling out: https://covidly.com/graph?country=Sweden#growth https://covidly.com/graph?country=Sweden#growth I think it's way too early to make any inferences about which method is working better. There is a lot of noise in all the data.
- kenjackson 6y agoThe IHME model has been really interesting for Sweden. While Sweden is saying they have it under control the growth rate of their expected deaths is rising faster than any country. It was projected at about 10k by Aug 4 just a couple of weeks ago, but it is now over 17k expected to die in Sweden. Although they seem to be more OK as a country if their senior citizens die.
- gnopgnip 6y agoFlat depends on your perspective. The death rate per capita is higher than anywhere in Asia, despite many of those countries being denser
- aaron695 6y agoSorry but this sounds like junk science. Nurses and doctors work in close proximity to people who are sick. So 50 cm compared to 2 meters. This is why their viral load would be more. Given a default R of 2 to 2.5 what model are you implying makes this worse in terms of viral load given a reduced R? How would this work? This bit need explaining because it sounds like you are implying with a R of 2 to 2.5 then the average person might get a higher viral load than if R was .9 lets say.
- gvjddbnvdrbv 6y agoLets say you have 20 people im a room and one of them has a mild. Now you have up to 20 mild cases. If 20 people spend a day in a room and 10 of them have mild cases maybe you now have 10 mild and up to 10 severe cases. In order to be in a situation with many mild or pre-symptomatic cases in the same room the disease must spread fast through society.
- aaron695 6y agoI don't think a room would have 10 people with mild cases. So this needs to be modelled realistically. I think there's a small chance one person in the room has it for R0 = 2.5 compared with a not quite as small chance one person in the room has it for a lesser R. Also I also don't think being in a room with multiple people effects load. I think it's distance. A cough from a person within 50cm is far far worse than 2 people breathing. So this is my junk science claim, this needs to be backed with numbers. It's not logical R effects load exposure to me, where is this evidence from? Else this is dangerous information, exactly the same as saying it's just the flu.
- shadowprofile77 6y agoYour mention of prolonged/repeated exposure being "much deadlier for all age groups would possibly include health workers? You know, those who tested positive and likely had to face a much greater number of exposure vectors than any typical civilian in the general population. Well, even among them, the mortality rate is shown to be quite far from "much higher". In one recent major Italian analysis of its health workers: sitting at 0.4% if one includes elderly doctors as well, and at no more than 0.1% if clinical workers above 60 are excluded. For medical workers under 30, the mortality rate at zero, out of close to 2000 who tested positive. This in general out of nearly 17,000 Italian medical staff that were almost certainly often living and working under severe immune-compromising strain and frequently becoming exposed to patients with Covid... Yet... Well, the numbers show what they show. There is indeed dangerous optimism with aspects of COVID among some people. But masturbatory pessimism also exists, and it seems to be endemic in comments here among people who keep ignoring steadily more evidence of a virus that's not showing itself to be near as deadly as it seemed just a month or so ago.. Also, yes, young people do die of Covid as well, but at such an exceptionally low rate that they're extreme outliers that grab plenty of media attention. Repeatedly focusing on how you "might" die of the virus even if you're young is an absurd exercise in ignoring proper risk perspective for the sake of cheap fear-mongering points. Link: look at the table: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_16-aprile-2020.pdf#page=13 https://www.epicentro.iss.it/coronavirus/bollettino/Bolletti...