I’ve been monitoring the Coronavirus (SARS-CoV-2, which causes the condition COVID-19) situation…

Written by Nell Watson and reprinted here with permission.

Mar 05, 2020

Written by Nell Watson and reprinted here with permission.

I’ve been monitoring the Coronavirus (SARS-CoV-2, which causes the condition COVID-19) situation very closely for several weeks.

In the past few days, we seem to have entered a new phase, whereby there has been a rapid take-off in new cases in multiple nations. It now looks increasingly doubtful whether it can be successfully contained.

We are still learning about this new virus, but we know that it is easily transmissible, and potent. It can be transmitted easily through sneezes, touched objects, and fecal matter. It can potentially travel through the air for several meters, and linger on objects for days.

Each person who gets it will likely infect at least 2 or 3 others, meaning that the rate of transmission continues to grow, doubling at least every week or so. Between 20–70% of the population of most countries are likely to become infected.

However, the virus has a long incubation period, typically around 5 days, but possibly over 3 weeks. This makes it very difficult to contain, as people may appear healthy, and feel fine, and yet be shedding the virus (incubating or asymptomatic cases).

The death rate of infected people is somewhere in the region of 1–4%, but it might grow even higher as medical resources such as ICUs (Intensive Care Units) become full. Between 15–30% of people who get the virus will be in a serious or critical condition, requiring hospitalization: 8–10% need ICU machine respiration, the rest need concentrated oxygen treatment — and not just for a few days. The duration from the beginning of the disease until recovery is 3 to 6 weeks. The other 80% who don’t need to be hospitalized will take 2 weeks to recover on average.

The people most affected are older people (progressively more challenged with each decade of age), and smokers. Blessedly (thank heavens), children appear to be spared this (though there might be some lingering or latent effects, see below).

Edit: There are recent reports which suggest that young people in their teens and twenties are dying in Iran, which are difficult to confirm. I will update if it looks like the situation has changed.

There is no cure for the virus, although some medicines such as Plaquenil (hydroxychloroquine) and Aralen (chloroquine phosphate) have some evidence of being helpful in treating the infection. Tamiflu (oseltamivir phosphate), and some other meds (e.g. remdesivir, and Kaletra, a combination of the HIV drugs lopinavir and ritonavir) might be helpful also, where they are available.

There is some early speculation that some other HIV and Hepatitis C medicines including Indinavir, Tenofovir Alafenamide, Tenofovir Disoproxil and Dolutegravir, Boceprevir, and Telaprevir might also be useful.

There is no vaccine, and there may not be one for a long time. Although there are some promising candidates being tested, it is very uncertain if they will be safe enough to be released. Attempts at creating vaccines for SARS have backfired by causing autoimmune issues, and making reinfection more dangerous. Thus, we may not have a vaccine in the foreseeable.

Although most people who catch it are unlikely to die, you do not want to catch it if you can avoid it.

There may be potential lasting effects (which are *not* verified as yet). SARS-CoV-2’s cousin, SARS, has been implicated in damage to gonadal and brain tissue, and can cause lasting lung disabilities in some people. This new virus can act similarly — some people have already needed a lung transplant in order to live.

40% of recovered SARS patients had mental problems, 40% had chronic fatigue, unable to perform normal activities.

One should try hard not to get infected for three reasons:

* (1). It’s rather unpleasant, and might put your life on hold for weeks, potentially requiring hospitalization and risk of brain damage during long term intubation.

* (2). Anyone infected is very likely to spread it to others, such as family members and co-workers.

* (3). It might cause lasting effects which are not yet known, and reinfection may be more dangerous than a first infection.

The best way to avoid infection is to shelter in place, if it’s safe and feasible to do so.

This means to gradually put together a box of extra food and supplies at home, several weeks worth, so that you can comfortably stay at home for a long time if you need to; at least until the danger has lessened (i.e. drugs become available, it mutates to be less dangerous, or it burns itself out).

I’m linking some info on how to do this.

We should self-isolate as much as we reasonably can, for our sake, and for others, for the public good. That’s the only thing that can meaningfully reduce the rate of transmission, infecting less people, saving lives.

The more we keep our distance, and the earlier to choose to do this, the more lives can be saved, and less suffering to be endured by the sick. Many jobs today don’t require a physical presence to be effective, and can be done from home.

This might not be feasible for everyone — most of us cannot shut ourselves away from the world for long.

It is extremely important to wash your hands very often, and carefully. Hand sanitizer can help, if you absolutely cannot find water and soap nearby, but it’s usually only about as 30% as effective as soap and water. Or better still, wear disposable gloves.

You may choose to wear a face mask, to protect yourself and to protect other people, especially if you believe that people in your community may be infected. Ideally, one should use an N95 (FFP2) or N100 (FFP3) mask if you can find one.

These are more sophisticated than a standard surgical mask, which aren’t ideal for keeping viruses out as the filters are too big. However, surgical masks are still better at keeping viruses away than nothing, and might help remind you not to touch your face (something very important to remember!).

One should have spare masks at hand also, as germs can build up on the inside that eventually may be bad for your health.

Unfortunately, these masks are now very expensive, and hard to find. Especially because many of them were produced in Asia, where their need at the moment is perhaps even greater.

It’s also possible to improvise a mask using paper towels, if you get really stuck.

It’s important to be clean shaven (a soul patch might be Ok) — beards can disrupt the seal of a mask on the face.

It’s very important to sanitise one’s phone also — it’s like a third hand that we hardly ever wash. There are a few options:

* 1). You can wash it with soap and water if it is waterproof (IP67 or IP68).

* 2). You can use wet-wipes to clean it. Screen cleaning wipes (so long as they are wet with alcohol and haven’t dried out) should be reasonably effective. One may also apply isopropyl alcohol, or regular alcohol around ~70% ABV.

* 3). You can use a UV lamp to sterilize it. I would recommend using a dedicated sterilizer device for this such as PhoneSoap. I don’t recommend using an O³ (Ozone) generator, due to safety issues and uncertain effect.

* 4). You can also keep your phone in a ziplock bag if you need to use it in a contaminated environment (please dispose of the bag safely afterwards).

We should try not to travel long distances when it’s not essential to do so, and to avoid large crowds as much as possible. Try to keep your distance from other people, whether or not they appear sick, whoever they might be, or how they might look. Perhaps even from friends and family, for their benefit as much as yours. Anyone can have this virus in them and not know it.

This situation now appears unlikely resolve itself, or to go away any time soon. It is creating economic issues due to disrupted supply chains (China makes most of the world’s stuff, as well as producing raw materials). Many factories around the world are now halted due to lack of parts and materials.

Other issues going on such as droughts in Australia, wasted produce in China (locked down, unable to get to market), and the locust swarms eating crops in a belt between Western China and Ethiopia, compound these effects.

2020 will be a challenging, yet also survivable year. We will get through it together — as friends, as families, as communities.

If anyone has questions, I will try to suggest relevant info. Thank you.

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