Jackal99 said:

---

AggieDawg12 said:

---

What's the story with takeout and/or delivery of food? We're under full shut down. However, still want to try and help some businesses any way we can. Ordering takeout or delivery is a way to do that and have some family fun. If someone is sick making or delivering food can they transfer the virus through food contamination?

---

I'm not a doctor, and I didn't sleep at a Holiday Inn Express last night, but I did just read this article about this issue.

https://www.seriouseats.com/2020/03/food-safety-and-coronavirus-a-comprehensive-guide.html

---

This was actually pretty reasonable article and thanks for sharing.

TexjbA&M said:

---

Quote:

---

Thank you Dr. To be more clear on my question though, what is the seperation from requiring additional care to being sent to the ICU. I understand were learning everyday about this but I thought persons under 60 or so were in the category of being able to ride it out without hospitalization but this report seems to contradict that.

---

Correct me if I read it wrong, but I read it as saying the age group from 20 - 44 makes up 20% OF hospitalizations, not 20% in that age range are hospitalized. Also, that's a 24 year age range whereas the others are 10-year age ranges. I think the report does confirm the older you are to more at risk you are.

---

Yes you are correct it does confirm the older are more at risk but it also shows that the younger crowd is at a more significant risk than initially thought. They are a making a high percent of hospitalized patients so they need to be careful too. Not just think he I am 23 and I am invincible to this virus. The good news is while the make up 20% of hospitalizations. They rarely die and still make up an extremely small percent of the fatalities.

hillcountryag86 said:

---

How will this virus "end?" How does the threat go away?

I understand containment keeps, or slows, it's spread. But even those who have it and then get over it, can't they get it again? Or does our immune system eventually fight it and in time, the virus just goes away?

---

So far, it would appear that once your body has cleared the infection, the vast majority of people will not get re-infected.

Once approximately 60% of people have cleared this virus, we will have "herd immunity" and the virus will no longer be able to spread through the population.

However the larger the percentage of the population that clears the virus before other people can catch it, the slower the virus will propagate through the population. And that is a large part of why we are quarantining. Probably the biggest reason to quarantine right now, actually.

agsalaska said:

---

Hey Doc. Thanks a lot for the thread.


Does anyone in the medical community have a real grasp on the ACTUAL infection rate? We know that they are not testing the VAST majority of probable cases. Is there some kind of multiplier they are using yet or is it too early to even worry about that since most people do not require hospitalization?

Thanks

---

Data is being collected every day that is narrowing down how fast this is spreading, but we need more tests. We can't test everyone who is concerned right now. In fact, we can't even test everyone we (as physicians) are concerned may have the virus at this time due to lack of testing.

Until we can test everyone who has a legitimate chance of being infected that needs/wants a test, we will not be able to accurately portray the true infection rate.

fullback44 said:

---

Sorry not sure how that imoj got there

Doc, I have a question regarding taking vitamins. I started taking them in fairly high doses about 3 weeks ago. Vit D 10,000 -15000 + plus units a day, 1000 % daily Vit C also, 1 selenium and 1 zinc a day. Anyway, I'm having issues w the pollen and my lower back (kidneys I believe) have been really starting to bother me. I increased my water intake and it has helped, but I can still feel some pain. I get some fever w my allergies also (who knows maybe Covid)

Can you give a guideline as to what's a safe but healthy limit on taking some of these vitamins so that I don't cause other bodily harm? Should I be taking a lower quantity?

---

This is one is rather complicated I am looking for some good information for you. I think all of the above are a good idea.

But essentially Zinc in the lab if it is intracellular it can potentially slow down or inhibit the the replication the virus by blocking the enzyme replicase which sounds awesome. Everyone should take take zinc then. NO SO FAST!! Zinc is charged ion +1 which keeps it outside the cell. In order to get inside the cell you have to have an ionophore which essentially opens a gate allowing the Zinc to get into the cell. There are studies showing that chloroquine opens these gates allowing Zinc to now get inside the cell. So I think taking Zinc is likely a good idea. I take it for my prostate I just don't know a good ionophore to allow the Zinc to get into the cell. If you get ill and are given hydroxycholoroquine it would be good to have zinc around to be get into the cells when the gates are opened.

Keep in mind these are all in laboratory studies and trials are ongoing. Zinc has been shown to potentially help in some cancers. I take it for my prostate so I don't see any harm in it.

Maybe a microbiologist or virologist could give us more information on this.

reload85 said:

---

The article below is an statistical look at the positive folks on the cruise ship. It is a neat data set because I think everyone was tested .
The most interesting tidbit here is the level of asymptotic cases were higher in the middle older age groups. Preexisting immunity to other Coronaviruses or waining immunomonitor production (cytokines)? Thoughts?
Take care!
https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf

---

Thank you for sharing and it is very interesting article for sure. The scary thing of this article is they actually found more asymptomatic patients than patients with the disease. So as we have always expected the numbers are so much higher than we see because we are only testing the ones who are very ill.

BiochemAg97 said:

---

Reveille said:

---

Today's update

https://www.facebook.com/1998386763777604/posts/2646045772345030/?sfnsn=mo

---

Doc,

You talked about the value of an antibody test in your update today.

One other factor to consider...
early vaccine availability will likely be limited as supplies build. Depending on how quickly those supplies can be built up, we might want to prioritize who gets it. If we combine the immunity test data as part of the vaccine criteria, we can stretch the initial vaccine supply further.

---

Yes I agree the vaccine becoming available early is huge. It will be critical to start protecting healthcare workers. Knowing who is immune or we have given immunity to will change the way we are functioning.

Reveille said:

---

fullback44 said:

---

Sorry not sure how that imoj got there

Doc, I have a question regarding taking vitamins. I started taking them in fairly high doses about 3 weeks ago. Vit D 10,000 -15000 + plus units a day, 1000 % daily Vit C also, 1 selenium and 1 zinc a day. Anyway, I'm having issues w the pollen and my lower back (kidneys I believe) have been really starting to bother me. I increased my water intake and it has helped, but I can still feel some pain. I get some fever w my allergies also (who knows maybe Covid)

Can you give a guideline as to what's a safe but healthy limit on taking some of these vitamins so that I don't cause other bodily harm? Should I be taking a lower quantity?

---

This is one is rather complicated I am looking for some good information for you. I think all of the above are a good idea.

But essentially Zinc in the lab if it is intracellular it can potentially slow down or inhibit the the replication the virus by blocking the enzyme replicase which sounds awesome. Everyone should take take zinc then. NO SO FAST!! Zinc is charged ion +1 which keeps it outside the cell. In order to get inside the cell you have to have an ionophore which essentially opens a gate allowing the Zinc to get into the cell. There are studies showing that chloroquine opens these gates allowing Zinc to now get inside the cell. So I think taking Zinc is likely a good idea. I take it for my prostate I just don't know a good ionophore to allow the Zinc to get into the cell. If you get ill and are given hydroxycholoroquine it would be good to have zinc around to be get into the cells when the gates are opened.

Keep in mind these are all in laboratory studies and trials are ongoing. Zinc has been shown to potentially help in some cancers. I take it for my prostate so I don't see any harm in it.

Maybe a microbiologist or virologist could give us more information on this.

---

Some zinc will get inside the cell. increasing zinc outside the cell will lead to an increase of zinc inside the cell, so taking zinc is fine and will increase intracellular zinc conc, but maybe not enough to completely shut down the virus. An ionophore makes it easier and increase the intracellular concentration even more.

Btw, it is Zn2+ that has been shown to be effective, which is what OTC Zn supplements contain.

Doc,

Please explain this to me. We have had several diseases in the past which had a higher death rate, high infection rate and as long or longer incubation time. There has never been a response like this before. Why? Is it because this is a novel virus? The ones I think of are Polio, Small Pox and somewhat Tuberculosis. Just asking.

FrecklesDad said:

---

Doc,

Please explain this to me. We have had several diseases in the past which had a higher death rate, high infection rate and as long or longer incubation time. There has never been a response like this before. Why? Is it because this is a novel virus? The ones I think of are Polio, Small Pox and somewhat Tuberculosis. Just asking.

---

So in part it is because this is a new virus. No one anywhere had any immunity to this virus before a few months ago. This is the first time since we have become a global economy and such frequent global traveling we have had a new disease like this occur.

I cannot say this enough. We are NOT doing this to stop this virus from spreading. It will likely eventually infect somewhere between 40 and 70% of the population. We are doing this to slow the spread of the virus so all the really sick people don't end up in the hospital at the same time where we will not have enough ventilators and medicine to treat them. We will then end up making mass casualty triage decisions where doctors decide who is worth trying to save and who is too far gone to get the possible benefit of a ventilator.

Most people will end up having minor symptoms from this but some will get very sick. We are trying to keep everyone from getting sick all at once.

Edit: Also, Tuberculosis is a bacteria and the developed world can treat it with antibiotics (it is really hard to kill and takes a while to get rid of but it can be treated). There are very effective vaccines for Polio and it is rare to see an outbreak of it now due to herd immunity in a lot of populations. Smallpox is all but extinct because vaccines got rid of it. Before vaccines, smallpox murdered entire populations and races of people. It was awful. If something like smallpox happened now, ( a new virus that was similar to smallpox in infectivity and mortality, not actual smallpox cuz we still have the vaccine,) it would be bad... real bad.

FrecklesDad said:

---

I know this is going to lessen the blow from the virus in the short term, but in the long term aren't more people going to die due to their economic circumstances caused by what we are doing to flatten the curve?

---

Maybe, maybe not.

But trying to assist a lot of people in dire economic need over a span of time I think is a more manageable decision than trying to assist a lot of people starving for air on a hospital bed at once.

AggieAuditor said:

---

As we all should, and will. That doesn't mean you have to be afraid to think and challenge ideas through all this. Some will be right, some will be wrong, including doctors.

40-70% infection for the US is a range of 130m to 225m people. That is worth questioning.

---

Wait till this is all over - then you can do the auditing.

Unfortunately, It ends with either a vaccine or we have to develop immunity to it by all of us recovering from it.

Reveille said:

---

Unfortunately, It ends with either a vaccine or we have to develop immunity to it by all of us recovering from it.

---

Wow. So, if a vaccine is several months away, a very large percentage will get it. Good thing many healthy people will get thru it just fine.

And again, Reveille, thank you and all the experts who contribute to this thread.

Y'all are such a refreshing source of logical explanation -- not sensationalism from so many gov't and "journalists."

Thank you so much.

Badace52 said:

---

FrecklesDad said:

---

Doc,

Please explain this to me. We have had several diseases in the past which had a higher death rate, high infection rate and as long or longer incubation time. There has never been a response like this before. Why? Is it because this is a novel virus? The ones I think of are Polio, Small Pox and somewhat Tuberculosis. Just asking.

---

So in part it is because this is a new virus. No one anywhere had any immunity to this virus before a few months ago. This is the first time since we have become a global economy and such frequent global traveling we have had a new disease like this occur.

I cannot say this enough. We are NOT doing this to stop this virus from spreading. It will likely eventually infect somewhere between 40 and 70% of the population. We are doing this to slow the spread of the virus so all the really sick people don't end up in the hospital at the same time where we will not have enough ventilators and medicine to treat them. We will then end up making mass casualty triage decisions where doctors decide who is worth trying to save and who is too far gone to get the possible benefit of a ventilator.

Most people will end up having minor symptoms from this but some will get very sick. We are trying to keep everyone from getting sick all at once.

Edit: Also, Tuberculosis is a bacteria and the developed world can treat it with antibiotics (it is really hard to kill and takes a while to get rid of but it can be treated). There are very effective vaccines for Polio and it is rare to see an outbreak of it now due to herd immunity in a lot of populations. Smallpox is all but extinct because vaccines got rid of it. Before vaccines, smallpox murdered entire populations and races of people. It was awful. If something like smallpox happened now, ( a new virus that was similar to smallpox in infectivity and mortality, not actual smallpox cuz we still have the vaccine,) it would be bad... real bad.

---

This is absolutely correct. We can not stop this vaccine but we can slow it down to the point that the fatality rate is very low. We must keep it contained the point that the hospitals can handle load of people coming in. Italy did not do this and now they have tremendously high numbers dying from it.

I feel like there's a distinction worth making regarding testing that will hopefully help many of you understand why so many people are being denied access:

People being tested can basically be split into two groups:

Group 1:
- Heathcare workers
- Admitted patients
- People with at-risk essential jobs that cannot avoid direct public contact

Group 2:
- People potentially exposed
- Anyone who is sick, but not life-threateningly so
- General public
- .......everyone else

Testing for people in group 1 is essential and is being prioritized over all others because the results are actionable. The test result changes how/when things that are happening are done. It's used to determine which care protocols are used. (e.g. where to keep a patient, which workers to isolate, etc... )

For everyone else in group 2, a test is purely an academic endeavor. If someone is sick (but not bad enough for hospital admission) whether they're tested changes nothing with regard to the recommended course of action, which is to isolate yourself and treat the symptoms with otc meds. The only value is the testee's (giggle) peace of mind.

Unfortunately, all the epidemiological questions, rates of this, percentage of that, cannot be answered without significant testing of the group 2 population. Those of us that are researchers know this. Much of the new testing capacity being brought online is to do exactly that kind of population screening to further our understanding of the virus.

I would argue that the most effective way to beat down the virus before having a vaccine is when we can completely test group 2. Since we know that 80% of people who are infected were infected by someone who was asymptomatic, then our best chance is to have the ability to catch the virus BEFORE it becomes symptomatic and isolate those people.

In South Korea, where testing was so widespread, after they found an infected person, they could track down people that had a lot of contact with that person, test those people and figure out who had been infected and who didn't.

Additionally, that's one way we could begin resuming travel between countries. Test people as they come in. 45 minutes is not so long to wait to enter the country.

You can think of a million ways that fast, available testing can enable us to resume a more normal lifestyle with a more targeted approach to discovering people infected with the virus and treating them and isolating them.

Right on,

The 45 minutes comes from the test the FDA approved today:
https://www.cnn.com/2020/03/21/politics/fda-coronavirus-test/index.html

"The US Food and Drug Administration announced it has authorized the use of the first rapid diagnostic test that could detect the novel coronavirus in approximately 45 minutes.

The authorization was made Friday and tests will begin shipping next week, according to a statement from California-based Cepheid, the company manufacturing the tests."