Coronavirus / Covid-19 and bad advice, fake news and dangerous scams

Nothing annoys me more than bad advice, especially if that advice can lead to misery and even death. The news is rife with false information but it's not all their fault, they just take information from source A and regurgitate it verbatim as if its fact even though in many cases it's not. Social media on the other hand should take the majority of blame because it allows anyone to perpetrate complete nonsense and some people even today believe what they read on social media. The prevalence of scammers on the other hand, promoting everything from life saving face masks to tablets claiming to cure the coronavirus, is to my mind something our government should tackle head on. 

Let's talk about the Coronavirus

This virus was apparently identified in China around the end of 2019, but there was clearly a period of time before that where people were being admitted to hospital and simply classed as viral phenomena. Even if people died in hospital ultimately of viral phenomena, this is not uncommon especially for the elderly. No one knows how long this particular virus was active BEFORE China identified it specifically but considering the population density it could be anywhere from a few weeks to a few months. Let's take the outside of a few months, which puts patient zero at somewhere in September 2019.

Once this virus strain was identified as something new it gained more focus, but with testing being a long winded and expensive process, and at most only 75% accurate, official numbers indicated a fairly slow pervasion in the community, this was of course not the case, but the long incubation period combined with only seriously ill patients being admitted skewed the figures enough that most people considered this to be just 'yet another SARS like virus'. 

By the time China realised this wasn't a common SARS like virus and instead could be transmitted far more effectively and even via asymptomatic people they reacted accordingly by isolating the epicentre. Unfortunately, by this time the virus had already been in circulation for months and was already spreading throughout the world. Once China had taken significant steps to reduce person to person transmission, other governments should have taken action at that point knowing that the virus was present globally. The W.H.O who is ultimately charged with managing pandemic's should have co-ordinated this action and in all fairness they did try.

Regardless, the current situation was not only unavoidable, but predictable and whilst our own Government could have acted sooner, and that could undoubtably have saved some lives it wouldn't have made a huge difference in the end without any effective treatment. Its clear that his strain of virus was spreadiong out of control in the general population for months before any action was taken, which explains the high incidence once organised testing was initiated. It is likely that the actual rate of proliferation is somewhat slower but until we have a valid reliable test for antibodies (not at time of writing) then we'll never know for sure.

This virus infects the airways, that's the nose, throat and lungs and will cause an immune response. This immune response will in most cases cause a rise in body temperature, mostly a mild rise. Only if the infection makes it way deep into the lungs will a cough develop. Since the majority of patients will contain the virus before it reaches deep into the lungs they will have mild symptoms but are still infectionus. There is increasing evidence that this virus is also able to affect the heart and brain to some degree, but at time of writing this wasn't clear or established. 

Stats

The media focuses negatively on the number of deaths daily from OR WITH Covid-19, but these stats cannot even be classed as stats because the information is nonsense. Determining a patients cause of death is in most cases quite involved and again in most cases there will be multiple causes and causes of those causes to consider, so the statistics are carefully worded as "of or with", something most people will miss if not attuned to it. The stats that the media constantly showreel are simply the number of people who died, who tested positive for the coronavirus. Many of those would have had only mild or no symptoms from the virus but died from some other underlying cause, many more would have been infected in hospital whilst being treated for something else, and even more will die in (or out) of hospital and not be tested. Give this reverlation I hope you can see that the number of patients who died "from or with" is simply a meaningless number. 

Transmission

This virus, like many is airborne, in that it can be transmitted between people simply by breathing air exhaled by an infected person, and recent data suggests that people are most infectious BEFORE showing any symptoms, if they show any at all. This virus, we know can persist in the air for up to 3 hours in the day, longer at night and of course as air is rarely still this gives it the ability to infect over significant distances. The news quotes a figure of two metres, which quite frankly is complete bullshit. This virus can easily be passed between people over much larger distances, and indoors it can persist in a room for hours after the infected person has left. Simply going into a shop where someone infected, symptomatic or not, has occupied in the last few hours can almost guarantee your exposure to virus particulate with a chance of becoming infected. 

This virus can survive on surfaces for days, and remain viable. This doesn't mean that an infected person is required to cough on a surface to transfer the virus, this means that an infected person simply being in a room and breathing will disperse virus particulate into the air, and some of that will ultimately become deposited on surfaces. If someone coughs into their hand and then touches a surface such as a door then this will also transfer the virus in much greater volume, but the effect is the same. Anyone coming into contact with an infected surface and then transferring that infection to their body through their eyes, nose, mouth has a risk of becoming infected. 

Students learning about infection control will sometimes use a dyed glycerol based goo placed on their fingertips to see how long it takes before they wipe it on their face, bags, desks, doors, phones and so on. It's surprising how much we touch things without being aware of it and trying not to do it takes training and practice. If you want to try this yourself for entertainment during isolation then just use some water based paint, dip your fingers in it and then see how many minutes it takes before you spread it all over something. 

This is what makes THIS virus significantly more successful than SARS & MERS

A quick note about surgical masks, which are currently being sold online for stupid money. This virus, as well as all viruses will pass right through a surgical mask as if it wasn't there. This is because surgical masks are not designed to stop viruses from entering, but instead designed solely to protect the patient from the surgeon transferring aspirated water from their airways into an incision. Some expensive masks with PP3 protection will work to stop the virus, but these masks are awkward to use and uncomfortable to wear and will only provide protection if eye protection is also worn. However, wearing a surgical mask for someone who has the virus will assist in preventing the infection of bystanders through directional aspiration, but the actual efficacy is variable as some masks simply redirect the flow of aspirate and do nothing to stop it.  

Protection from Infection

IF you actually want complete protection from infection then this is quite hard to achieve. You would need to remain at home and not come into contact with ANYONE who has been outside of the home. This is called isolation. You could not have deliveries come to the door and you could not even have the windows open on a warm spring day. You need to consider EVERYONE outside of your home as being infected even if they possibly aren't. This sort of isolation is hard to achieve in real terms and is unlikely to be practical for most, which leaves options to limit risk. 

The best defence to this virus is understanding the vectors of infection, which having read the above I hope you now do. For clarity I'm going to highlight a few scenario's below. 

Going out to get exercise

This is probably the most stupid suggestion of all. Leaving your home to 'exercise' raises the risk of infection significantly because you will be out with other people 'exercising' some of whom will be infected, exhaling virus particulate in the billions and those will waft around in the air around them as they walk or run and some will inevitably walk through that breathing it in. Have you ever seen anyone smoking or vaping? You will have noticed how the smoke wafts around them and travels distances, and that you can often smell the smoke or vape from a fair distance away? This is no different for the virus which will waft around in micro-droplets of water. 

Shopping for food

This is a necessity for most, but this is also the most likely route to infection if you are isolating. The footfall in a supermarket means that infected people are virtually guaranteed to be there, breathing out virus particulate as they move, depositing it on everything they touch. AVOID going to supermarkets are all costs. Order your food online, and then take precautions when it arrives. DO NOT open the door to the delivery person, they won't be offended I promise you. Place a cardboard box outside before they arrive and ask them to put the goods into the box. When they've gone, leave it for at least 15 minutes and then go out and collect your shopping, bringing it indoors and placing it on a specific surface, perhaps a counter top. Have an anti-bacterial spray ready along with a cloth. Remove items one at a time, spray with the antibacterial, wide down and then place in the fridge, freezer or cupboard. Repeat for all items. Take the empty box and store it outside if possible, then take the antibacterial spray and wipe down all doors and door knobs and surfaces used to bring the box of shopping into your home. Again wash your hands one more time. I know this sounds excessive, and to be honest it is for most people, but if you want to significantly reduce the chance of infection then this will. 

How do you know if you're infected

This virus spreads so successfully because it can infect someone and they can show no symptoms at all, or they can have a very severe reaction leading ultimately to death. This makes diagnosing this specific virus very hard to do visually or symptomatically. The testing kits (at time of writing) are only 75% percent accurate, much less for lower virual load, so instead consider yourself as being infected regardless of whether you are or not. Take the same precautions you would if you were infected and watch out for the key symptoms which are Fever and cough. If you have a fever and a cough there is a chance its Coronavirus, but do not go to the hospital. If you find you're having trouble breathing, and the media doesn't make clear what that means so let me be specific; if you need to breath faster than you would normally at rest then this can be an indicator and you should call 111 and take their advice. 

Herd Immunity

There was some mention of herd immunity in the press at the outset of the pandemic, and this is not clearly understood by many so I'll do my best to explain it here. Essentially, herd immunity relies on the fact that once a person has had the virus and recovered they are not able to become reinfected. This being the case (and it is assumed to be the case at time of writing) then as more people catch and recover from the virus, they will no longer be able to act as carriers and infect further people. Since this virus can only survive for a maximum of 3 days in the wild, the number of susceptible people encountering it will become less and less, meaning the infection rate will dramatically reduce. Another way of thinking of this is that in an office, if there are 10 people working there, 8 of whom have had the virus and recovered, then the chances of the remaining two catching the virus from other office workers is zero. Likewise, the 8 remaining office workers can no longer infect anyone with this virus. Herd immunity what prevents most viruses from becoming pandemics, the gradual immunity attained by communities to the pathogen. This ONLY applies if the antibodies you produce to the virus are able to recognise all future strains of this virus, at the time of writing its not clear if this is the case. 

The NHS

Firstly, our government has given the NHS immunity from any legal action during this period. This means that if someone dies or is seriously injured during this crisis the patient or their family have no legal recource. This I think more than anything else highlights that the NHS is unable to cope and function safely during this crisis, and that alone should be enough of an incentive to NOT BECOME INFECTED. If you do, you are more likely to die from it simply because the NHS doesn't have the resources, budget, medications or specialists to treat you. 

Tracking, Monitoring and New Regulation

The new regulations rushed through parliement recently give the government and of course the police new powers to do pretty much whatever they want. Warrants no longer need to be approved, GDPR is suspended and is in free fall and tech companies are being used to track people using their mobile phones. This new regulation lasts at least 6 months, but the government can amend it at any time of course. The gov.uk website has some "what you can and can't do" available HERE. Some may argue that this sort of government imposed house arrest is unlawful, and others may argue is proportionate, personally I think its too early to call it one way or the other. 

The Cure

This I think is probably the most misunderstood. People demand a cure be found but actually that's simply not possible. Take for example if you will, a bacterial disease. Researches can grow it in a series of dishes, throw a range of drugs at it and see what stops it growing and kills it. This virus however is not alive, its not bacteria, its a virus and a virus is nothing more than some genertic materia wrapped in a protien shell. It can't be 'killed' with any drug because its not alive. A Virus is chemically attracted to a cell in your body, it then injects its tiny chain of genetic material into your cell and that material instructs the cell to make copies. The disease is NOT the virus, its your own cells responding to the viruses genetic material, producting copies and then ultimately dispursing those copies. To treat a viral infection for which you have no immunity, you have to interrupt or hinder its progress by preventing it from doing its work and this is significantly more complex. The majority of therapies will be focused on immunotherapy, in which your body is shown how to identify the virus infected cells and destroy them before they can release virual copies, but there is also some work on preventing your cells from replicating RNA which would slow down the viral progression, and on reducing your bodies disproportionate immune response (cytokyne storm) which does more harm than good with this specific disease in some patients. 

Regardless of the approach, proving it out is yet another challenge because nothing can be fully tested invitro. Think for a second that you have a ward of 100 patients all with Covid-19 symptoms. You give half of them treatment A and the other half nothing, and let's assume for this scenario that 1% of Treatment A group die whereas 2% of the untreated die, is that a success? What's to say that 1% improvement is not by chance or because a selection of the patients given Treatment A had slightly less underlying health conditions? This is unfortunately the reality of testing with a virus where most survive. You would need to repeat the test week after week to get enough data to conclude any clinical significance and this is why there's no 'cure' even though its been several months. 

Financial Support

If you're PAYE and take time off work sick, then you'll receive sick pay immediately, which is good. If you're PAYE and you're keeping your job but the company has closed then you can get 80% of your wage from the government at some point in the future. If you are self-employed then at some point in the future, on some basis you'll receive some sort of money. If you're a company director being paid dividents, as probably 90% of small businesses are, and you're company cannot trade because of this crisis then you're basically screwed as there's no provision to help you at all. You should already know that the government is immune from any legal action so you get what you get, or don't get whichever way it goes. 

Two Stories

Unfortunately, because of the wealth of mis-information available some people make poor choices. One such example is the anti-malaria drug Hydroxychloroquine, which has been doing the rounds on the internet as a 'cure'. It is not, and there is limited evidence to support its efficacy in treating Covid-19. However, just because a product has the word Chloroquine in it DOES NOT mean it's the same thing. In fact there are many instances of chemical names being similar and sharing parts for completely different compounds. For example; dinitrogen oxide will make you laugh, nitrogen dioxide will kill you.

In this specific case Chloroquine Phosphate which is found in Aquarium cleaner IS NOT THE SAME as Hydroxychloroquine which is used to treat malaria. In this example someone purchased Chloroquine Phosphate, consumed it and died from it as was the likely and expected outcome.  Additionally, the efficacy of drugs is very patient specific, with some responding well, others far less so. Any drug or drugs will need to be clinically proven to be effective and that effectiveness weighed against the side effects and contraindications by medical professionals.

A man in his 50's was telling the story of how his farther had just died from Covid-19, and how he didn't know how he was infected because he never goes out being fairly immobile and is only visited by him every few days. A week later the man's wife was diagnosed with Covid-19 and admitted to hospital, again the man had no idea how she was infected. It is of course blindingly obvious that this man had infected both his father resulting in his death and his wife, but he just couldn't see it because he claimed to have no symptoms. Very sad but true. 

The Future

To anyone who thinks all this disruption is too much, and particularly to those who ignore the rules, think of SARS-Cov-2 as a dry run. If the country and the world can operate with restrictions and limit cross infection then that's great and if we can't then that's bad, really bad. At some point in the future a virus will come along with a fairly high death factor and the global death toll from that will depend very much on how prepared we are to follow the rules. Had SARS-Cov-2 had a death factor half that of spanish flu, then one third of the worlds population would have been sithed from existance by now. Slowing or breaking transmission IS THE ONLY PROTECTION we have against a pandemic because there is no cure, will never be a cure, only a possible vaccine after months or even years of work, and even with a vaccine there's no guarantee of long term proteciton.  

Links

The World Health Organisation has a wealth of information on the virus and should be considered as a reliable source. 

The NHS in the UK is the only legitimate source of information on the virus and what to do if you think you may be infected. 

E&OE - This situation is changing daily, and this article was published on April 9th 2020. We will try and update it as new information becomes available but please use the links we've provided for the most current information and assistance.