What began for me as a curiosity from Wuhan Province in China, has become a full blown pandemic as I write this (March 21). To quote the National Institutes of Health from their March 2 statement, “……the current COVID-19 epidemic is resulting in a social rather than a viral catastrophe.
March 6: We had been planning for about a month to travel to Pflugerville, TX to visit Zach, Emma and the grandkids. One reason was to see them before summer and its demands were upon us and the other, perhaps the main reason, was to put the last decal onto Sophia’s little rocking chair and finish that project. We considered cancelling the trip, especially when Emma called and was concerned that we were still going to come. In the end we went anyway.
March 12, Thursday: Departed for Pflugerville. As yet there have been no state directives limiting travel. A basic directive of washing hands and social distancing has been published. Stopped overnight in Forrest City, AR at the Comfort Suites. Ate dinner at the Delta Q BBQ and went to the nearby Wal-Mart for hand sanitizer and butt wipes for cleanliness. The stocking clerk gave us what appeared to be the last bottle of sanitizer she had. She had it hidden. There were no disinfectant wipes to be had.
March 13, Friday: Ate breakfast at the motel. Ate lunch at the Cracker Barrel in Greenville, TX, east of Dallas. Arrived at Emma’s at about 5 pm local time. Stayed at the house.
March 14, Saturday: Only ventured out to Home Depot with Zach for something to fix his garden windmill. Worked on the rocking chair. Learned that one of the people at the Union meeting with Zach last week had been admitted to the hospital with COVID-19 symptoms.
March 15, Sunday: Went to St. Williams in Roundrock for church. As yet the only directives were to refrain from shaking hands, and no common cup. There were as yet no reported cases in Travis County. Finished adding the Peter Rabbit decal to Sophia’s rocking chair. It came out just as cute as I expected, but the finish didn’t bury the decal completely flush. Later in the day learned that restaurants in Ohio, Indiana and Illinois were ordered closed. Started talking about leaving early. Unclogged the kids bathroom toilet before dinner.
March 16, Monday: Decided we would leave Tuesday morning to avoid the inevitable restaurants closing in Texas and Arkansas. Went out in the evening to AutoZone for a socket wrench fitting to work on Zach’s car. No one has symptoms.
March 17, Tuesday: Left and drove to the Comfort Inn in West Memphis. Ate lunch at the Silver Star Smokehouse in Texarkana, that was under a boil water order due to a water main break. The restaurant was very empty. Ate dinner at the Cracker Barrel. It was moderately busy. A fella two tables away coughed in the opposite direction. Had Men’s Group by Zoom conference. Beforehand Mary Ann had linked me to the article from the NIH of March 2 quoted above. I began to develop my opinion on the level of risk. My conclusion was the eventual chance for infection was high, but there was a low likelihood of serious illness. Afterwards I summarized my take on the article and emailed it to Emma & Zach and eventually the guys, other kids and finally Tim Pingel a day later. It follows here:
Tim: The text below and link is the email I sent to the Men’s group after our Zoom meeting on Tuesday. The guts of the article are the Table and the conclusions/recommendations.
Friends: Having tired of the media and also “Facebook” type feeds of information on COVID-19, I thought I should go to a reputable medical source, one that the CDC would actually consult for its advice to the public. The National Institutes of Health qualifies as one these. I’ve attached the link to an NIH article published March 2, 2020, Coronavirus infections: Epidemiological, clinical and immunological features and hypotheses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064018/.
The problem is that the science and medicine is over all of our heads to a degree, but for me the message was understandable. For me, if I want to control the temptation to get hysterical or the anger welling up in me I need to see the science behind the CDC recommendations. This article has helped to put the current situation into better perspective for me.
This paragraph from the article summarizes my position:
Despite the fact that SARS-CoV-2 appears much less virulent than SARS-CoV-1 and MERS-CoV, it is associated with significant mortality among susceptible individuals with comorbidities. Moreover, the hype and scaremongering going viral on mass news and social media, predicting the dawn of a new fatal pandemic, are spurring global hysteria. Thus, the current COVID-19 epidemic is resulting in a social rather than a viral catastrophe.
There is a process of natural immunization, which happens with every disease. By separating and isolating severely infected (symptomatic) folks who could initiate high dose exposures from the general population and each other this can happen. Eventually with the very low dose exposures this strategy allows there will be an immunity built up in the general population while avoiding severe and life threatening disease. This is the point of Figures 1A, B and C. The data suggest this to be true with the earlier SARS, MERS and the other non SARS-like viruses. And so the CDC recommendations are designed to assure these low dose exposures – identify the symptomatic folks and isolate them, reduce interpersonal contact to assure that our exposures are low in number and of low dose.
I need to face the fact that I will be exposed to SARS-CoV-2 eventually, as will we all, just like any of the flu bugs we already know. Provided the exposures are incidental and low, like getting within 6’ of an asymptomatic carrier at Menard’s or Costco, or shaking hands at church, I will build up my immunity with no serious consequences. Of course we already know that there are predisposing conditions with which this model doesn’t work as well, but the principle is the same.
Unfortunately, trying to totally isolate the infected from the uninfected is, first of all, impossible, and secondly only serves to prolong the natural immunization process. To quote the article, “It is important to note that collective infection control measures can actually reduce the frequency of infection, though at the price of a prolongation of the epidemic period.” So the governmental edicts to eliminate all public assemblies really irks me. From another angle, however, the creation of an effective vaccine will really shorten the immunization process. I would like that option. The article has this as its 5th recommendation.
Tim: FYI to help understand the article:
- Comorbidities = pre-existing medical conditions that decrease the immune system’s ability to ward off disease, like chemotherapy, diabetes, COPD, emphysema
- Nosocomial = an illness contracted while in a medical care facility; also sometimes referred to as an HAI – hospital acquired infection, or HCAI – health care acquired infection
March 18, Wednesday: Drove home from West Memphis after breakfast at the same Cracker Barrel. Ordered Jimmy Johns online and picked it up at the drive-in window in Mt. Vernon, IL since the restaurants are all closed. Arrived home at about 5 pm, and picked up our dinner from Applebee’s carry-out on the way in. Note to self – don’t microwave a medium rare steak and expect anything other than well-done. After dinner sent my synopsis of the March 2 NIH report to the rest of the family and the Men’s group
March 19, Thursday: After a conversation with Tim Pingel. I sent him my NIH report email. Made a trip to Martin’s for some things.
March 21, Saturday: Mary Ann found an article from John P.A. Ioannidis, professor of medicine and professor of epidemiology and population health, as well as professor by courtesy of biomedical data science at Stanford University School of Medicine at Stanford that was helpful concerning the current confidence limits of our statistics on the SARS-CoV-2 infections to date, which are not good at all, whether one wants to be pessimistic or optimistic. Tim Pingel and I went to Caron Stante’s new apartment and set up her hospital bed and grab bar for the shower/bathroom.
March 23, Monday: Made a trip to Martins, Fresh Thyme and Whole Foods. Martins folks were uptight, with sanitizing grocery cart handles a priority. At Fresh Thyme and Whole foods it was like, “What virus thing?”
March 24, Tuesday: President Trump and Dr. Anthony Fauci from NIH conducted a press conference concerning the COVID Task Force. I am impressed by Dr. Fauci’s knowledge and diplomacy combined with honesty. Here is someone I can believe in. My trust in the Task Force increases as does my confidence in an early resolution.
Sent an email about the Stanford article to the Men’s group with this commentary. Here is the link. https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/. This commentary points to the dilemma that President Trump and our Task Force are facing. It also helped me get a grip on the widely varying reports concerning the mortality (death rate) of the disease. I find his comments on the Princess cruise ship interesting. I figure it’s better to be informed and consider both sides.
March 25, Wednesday: Trip to Menard’s for project supplies – working on the noisy water filter drain. Jim Shaw called asking to borrow the splitter. We came to an agreement about that and as things go with the present situation we discussed the COVID quarantine. My observation was that the self-preservation instinct is the strongest human instinct and people around me seem to be running in fear of death from this infection that mostly displays mild symptoms. To which he replied, “So what, if you die you just get to see God sooner. What’s wrong with that?” Well, for those without the faith death is the only outcome, which explains the fear. To the degree that I don’t truly appropriate the assurance of the resurrection, I too am in fear of dying. Careful not to love life and all its goodness more than life eternal.
March 26, Thursday: President Trump indicated the need to get the country back to work and that he is directing the Task Force to develop a workable plan, likely state-by-state and county-by-county. So it will be delegated to the states with federal guidance. Made another trip to Menard’s for project supplies. I added it to my list of sane places in the midst of the siege of fear. Went to Martin’s to cash in coupons forgotten earlier and got bananas. Put on the front Jetta splash guards.
March 27, Friday: Remained at home working on projects. Finished the new plumbing for the water filter drain. Put on the rear Jetta splash guards. It became clear to me that New York City is under siege and in serious shape. To be expected with their population density. News from Italy shows pictures of folks in hospital hallways, as the beds are all taken. The plot thickens. Congress approve a 2 Trillion financial package to address the needs and loss of jobs and income. I paid my 2019 taxes on March 1 although the deadline has been extended to July 15.
March 28, Saturday: Mary Ann showed me a link to Johns Hopkins this morning with the SARS-CoV-2 statistics worldwide this morning (https://coronavirus.jhu.edu/map.html). It has nearly all of the statistics I would want to assess my situation if one assumes that the difference between the total cases and deaths equals those that will recover. But of necessity there is a group of the sick that have not yet died or recovered, and this is the biggest group by far. As the infected and deaths groups grow larger the mortality of the infection perhaps can be assessed but there can still be quite a bit of over-estimation on the mortality side. The other information that is missing for now is the demographics on the deceased, specifically age and comorbidities so that I can get a better comparison of my risk group, plus a normalized value, say infections and deaths per one million population. I assume that eventually I will contract this disease and it will be helpful to know how serious that will be. Of course the virus can be mutating with time, hopefully attenuating.
But as of right now (March 28, 1007 EDT) the numbers are :
- 618,043 infected worldwide; 104,865 in US
- 135,736 recovered worldwide
- 28,823 deaths worldwide
The WHO marks the first case, which was in Wuhan province, China, reported on December 31, 2019. The first case in the US was diagnosed on January 20 in Snohomish County, Washington, a 35 year old male who had returned from Wuhan 5 days earlier (CDC). He had no comorbidities and was a non-smoker. His case history is reported in the New England Journal of Medicine March 5 here: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
He has since recovered but did progress to pneumonia while hospitalized. As of January 30 he remained hospitalized but in stable condition with only the dry cough remaining. Curious in this case to me is that the pneumonia didn’t develop until during Day 5 of the hospitalization (Illness Day 9). The hospital course of treatment was primarily fluids, which countered the water lost through vomiting and diarrhea, and helped with the characteristic dry mucous membranes, plus oxygen at the peak of the pneumonia.
March 29, Sunday: Mass streamed from St. Pius X at home this morning at 10 AM. It locked up before Communion so we finished up with the end of the pre-recorded Mass from March 15. Started refinishing the 6-string guitar yesterday with the primer coats on the neck. Put the 4th coat on this morning before church. The spray booth and rattle cans are working much simpler than the spray gun so far. Next will be doing the finish coats on the sides without the primer. Will need 9 – 12 coats, 3 per day, scuffed daily according to the can instructions. Should have read that the first time through three years ago.
The most useful site I’ve found thus far has been the Johns Hopkins Coronavirus Resource Center (https://coronavirus.jhu.edu/map.html). The numbers posted on the world map by country are interesting. I only trust the numbers from the countries I expect to be organized and honest enough to report accurately. This rules out Iraq, Iran and perhaps China, but the data sources include WHO, CDC and Worldometer. The latter has all the data I have been looking for (https://www.worldometers.info/coronavirus/#countries). A cursory review shows Italy way out of line with the other countries with a fatality rate of 166 per 1M and 1,529 cases per 1M population. Their first case is reported as January 29. Spain is equally as bad. By contrast China’s numbers are 57 cases and 2 fatalities per 1M population. Their first case is January 10, but my other sources say December 31. They show only 45 new cases since midnight GMT and have had the illness the longest, so if their numbers are to be believed they are on the downside of the curve perhaps. Right now the US has the most cases at 125,266 with 1,688 new cases today, 378 cases and 7 deaths per 1M population. The US population calculates from their numbers at 321M, which seems about right. So the per M numbers are based on total national population not the exposed population. The death rate in the US of those infected is running 1.8%. There are currently 119.780 active cases of which 2,666 are critical, so if all these are fatal that is still about 2%. So the death rate does not seem to be lagging behind because of the active cases. China’s rate is 4% with only 25 new cases today and 742 critical cases currently. On the other end of the spectrum Japan recorded its first case January 14 and to date has only 1,693 cases, 52 deaths and a fatality rate of 0.4 per 1M. Someone needs to look at how they are doing that.
March 30, Monday: President Trump announced last night that he is extending the social distancing directives through the end of April. So hello Easter on the internet. This morning Mary Ann read a statement to me from the St. Joseph County Health Department that said they expect the peak to arrive in about 2 weeks. So there is a light on the horizon.
The Worldometer numbers from midnight GMT: 770,165 cases, 36,938 deaths, 160,243 recovered. This leaves a big number of active cases, of which 95% are mild,. Looking at the plots of cumulative cases and deaths with time with a logarithmic y-axis shows an inflection in mid-February of new cases and an inflection in the deaths lagging about 2 weeks behind. The Johns Hopkins site has a plot of daily increase versus time and the rate of increase looks to be tapering off worldwide over the past week. For now New York City is the worst hit locale in the US. Indiana is still very isolated and spotty because of our agrarian economy for the most part. Detroit and Chicago as one would expect have many more cases due to their urban nature.
It’s one thing to say, “One’s degree of fear when facing death is in proportion to one’s belief in the Resurrection,” but another thing again to live it. I find myself anxious, although it must be subconscious, as my chest is a bit tight and my blood pressure seems to be a bit higher than usual. The death rate in the US is at 9 per 1M, up from 7 per 1M yesterday. Things are getting more serious, but the cases continue to be 95% mild.
The LaSalle Council BSA is launching an initiative to have Scouts assist REAL Services with food distribution to their elderly clients. I generated 45 volunteers from my email to the Troop. This is overwhelming. We will go in family units with those we are already quarantined with. We are just waiting for our assignments. With the indications from this mornings news of an end in sight in a month , things seem to be shaking loose a bit.
Went to the grocery with Mary Ann this morning with the intention of not going again for 2 weeks.
March 31, Tuesday: Jim Shaw came to get the log splitter this morning. We were briefly not properly distanced.
I’ve had three important questions in my mind that needed answers to properly assess my risk of contracting the virus. Yesterday Mary Ann and I worked on getting them answered
First, how exactly is this beast transmitted. Found this article, a synopsis of a video call from Dr. David Price a NYC Critical Care Pulmonologist who is right in the thick of the worse area in the US, to his family. https://medium.com/@paulanderson_73765/nyc-lung-doctor-tells-his-family-how-to-protect-themselves-from-covid-19-fb0b117b3472.
He told his family four things to prevent their getting the disease. Besides the well known social distancing, he added the following:
1. “Become a Hand-Nazi”
“We know that if you keep your hands clean, you’re not going to get this. Keep your hands clean, and you will not get this disease.”
Dr. Price says to always be aware of your hands and what they’re touching — especially in public. He carries hand sanitizer with him everywhere. He said he WILL touch elevator buttons and grocery carts. That’s fine as long as you have hand-sanitizer and clean your hands right away. If you don’t have hand sanitizer, bump the elevator button with your elbow. You don’t need to worry about washing your clothes right away when you get home. You don’t need to live in a bubble. But you should obsess about keeping your hands clean all the time.
2. Stop Touching Your Face
You can wear a mask, but not for the reason you think… According to researchers, all of us unconsciously touch our faces more than 20 times every hour. According to Dr. Price, the coronavirus takes advantage of this exact behavior. Become aware of how much you’re touching your face and STOP IT. Surprisingly, this is the one reason Dr. Price says you can wear a surgical mask. It won’t do much to shield you from the virus directly, but it will train you to stop touching your face. but Dr. Price is very clear — you only need a general cloth surgical mask…
3. You Have Zero Need for an N95 Mask (a NIOSH designation for those approved for protection against asbestos and pneumoconiosis inducing particluates). “The general community has zero need for N95 masks.” Again, “The general community has zero need for N95 masks.” Dr. Price and his team wear no masks when walking around the hospital hallways. When they’re walking into a room to talk to a patient, they’ll wear a basic cloth surgical mask. Only when they are going to perform what is known as an Aerosol Generating Procedure — ex. hooking someone up to a ventilator or doing anything where a patient is likely to spit, sneeze, or cough in their faces — will Dr. Price and his team wear N95 masks. According to Dr. Price, when healthcare providers are following these steps, zero of them are getting sick. He did acknowledge that some doctors and nurses are getting sick, but only because they were interacting with COVID-19 patients several weeks ago and didn’t realize what they were dealing with and how to protect themselves
Dr. Price reiterated that all over the world, as long as doctors and nurses are keeping their hands clean, not touching their faces, and wearing N95 masks only when up close with patients performing Aerosol Generating Procedures, none of them are getting sick. That’s a long way of reiterating that there is no need for the general public to wear an N95 mask when walking around.
Becoming a “hand-Nazi” about not touching my face will take some practice, as just thinking about not touching my face I immediately get the urge and have itches that need to be scratched.
Next question – how long with the virus, or viruses in gneral, survive on surfaces and in the air. Found the following article from the NIH addressing the issue. https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces
Here is an excerpt from the opening paragraph:
The virus that causes coronavirus disease 2019 (COVID-19) is stable for several hours to days in aerosols and on surfaces, according to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine. The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. The results provide key information about the stability of SARS-CoV-2, which causes COVID-19 disease, and suggests that people may acquire the virus through the air and after touching contaminated objects.
So for my money, get the grocery to bag it in kraft paper, the main component of corrugated cardboard and don’t stress about the air if you aren’t coughed at or on. The key in potential air transmission is that the virus can survive in an aerosol, i.e. droplets of water, and I would say moisture in general. They looked at copper specifically because it is known to have germicidal effects. They looked at stainless steel and plastics because hospital operatory and exam room surfaces involve a lot of these.
And thirdly, what about the chance of infection from fresh produce. Early on in Texas no one was buying the fresh vegetables, only frozen. Here is an article from good ‘ol Purdue addressing this issue:
Here is the heart of the article:
According to Amanda Deering, an Extension specialist in Purdue’s Department of Food Science, current research indicates that the virus is not foodborne or food-transmitted.
“From all indications, the virus that causes COVID-19 appears to be transmitted just like other viruses,” Deering said. “This is very positive in that the same practices that we normally use to reduce contamination risk, such as washing your hands and washing fruit and vegetables before eating, should be applicable to reduce the risk of contracting COVID-19.”
Scott Monroe, Purdue Extension food safety educator, points out that many produce growers already incorporate good agricultural practice that reduce the risk of contamination by a human pathogen.
“While viruses may be transmitted from surfaces, most growers take steps to prevent contamination. At this point in time, fear of COVID-19 should not be a reason to stop purchasing fresh fruits and vegetables,” he said.
This article goes on to say:
- Try not to manipulate produce items. While part of the buying experience is feeling, touching and manipulating the produce, this may increase the probability of a pathogen being deposited on or acquired from the produce.
- Consumers who are immunocompromised should consider purchasing pre-packaged fruits and vegetables as an added measure of caution or choose to eat cooked fruits and vegetables at this time.
- All produce items should be washed thoroughly before consumption.
Mary Ann and I got to these three articles last night before bed. I fell asleep thinking through how to put off being a hand Nazi and how to get into and out of the grocery and hardware stores with no contamination. I demonstrated to Mary Ann how to remove contaminated gloves with a minimum of risk of transfer to the underlying skin. I was greatly encouraged by all of this and slept a lot better than the night before, too.
April 1, Wednesday: Please, no virus-related April Fool’s Day pranks or jokes! But knowing humanity they are inevitable.
I had a discussion with neighbor Jim Bark from across the street soon after we returned from Texas, probably on that Monday (3/23). He told me a story about his recent respiratory infection. I didn’t get all the details, but he said that he figured it was COVID-19 and that he has already survived it. The timing of his illness is the surprise. He was sitting out today so I decided to get the specifics in more detail. Here is what he told me. Sometime in mid-December he realized he was coming down with a cold and by December 24 figured it was progressing into pneumonia (which I know he has had before) and decided to see his physician. The physician took a chest x-ray, and came back saying, “I haven’t seen anything like this before. Have you been out of the country or had any contact with someone that has?” At the time, Jim said, he couldn’t recall and said no. However later he remembered that around Thanksgiving he visited a friend in the neighborhood at her home who had recently returned from Italy. He continued to tell me that our neighbor Jamie, next door to his south, reported a similar illness – a very serious pneumonia-like infection. Jim said that Jamie was one of the people he had been talking to. From this it sure seems like COVID-19. If it is, then the disease was in the US a full 2 months before the first case reported in Snohomish WA. It makes some logical sense, too, if as reported 95% of cases have mild symptoms and people recover in a couple of weeks, so it could have been misdiagnosed and treated as a bad cold, the flu or pneumonia and dismissed, or the individual might not have gone to the doctor with only mild symptoms. I was socially distanced from Jim on both occasions and am not infected after 11 days now.
Convinced it’s the hand to mouth route, we are trying to figure how to keep our hands clean when coming from the grocery or hardware store, what to use for hand cleaner in a depleted market and where, oh where, to find surgical masks. Also practicing the hand-Nazi thing at home.
Also the Community Seder meal, Good Friday and Easter are all bagged. So now I need to check on our Seder prayers, unleavened bread choices (almond buns – does baking powder count as leaven?), haroses and bitter herbs (rotting cilantro perhaps), plus get a Mass feed that doesn’t lock up half way through.