A helpful FAQ on Covid 19

1. Am I going to die?

Yes, unfortunately everyone dies.

2. No, I mean am I going to die of Covid 19?

Oh right, that! Probably not. Most people who get it have fairly minor symptoms. Though by minor, I mean not life threatening, not necessarily pleasant to experience. Current estimates are that 80% of cases are minor, 20% require some kind of medical intervention, and somewhere between .7% and 5% may die or get close enough to see that bright light coming for them.

3. You mean a near-death experience for as much as 5% of people?

No, I mean hospital lighting, it’s so bright, and so unpleasant! It gives me a headache every time. Why can’t they use warmer bulbs?

4. I’m asking the questions here.

Right, sorry, go on.

5. Will a lot of people need to be hospitalized? 

It looks that way. Mostly people around 70 or older, and people with existing health conditions, are going to need what’s called “supportive care.” Supportive care means we don’t have a cure or direct treatment, but we can often keep the body going while it fights the good fight to created enough antibodies to kill the viruses floating around inside the Covid 19 patient. That can mean extra oxygen, monitoring by healthcare staff, or more, all the way to a machine that breathes for the patient.

6. What do we do about too many people needing to go to the hospital at once? 

This is the nightmare we’re trying not to have, and we need to practice what epidemiologists call delay, to slow the rate of people heading for the hospital. You can wash your hands, clean the surfaces around you (more on that soon) and avoid getting close to other people outside. But mayors, governors, school administrations, and other authorities in charge of spaces where a lot of people are close together can do a lot more by canceling events, encouraging work from home, closing schools and universities, and limiting how many people can congregate and how close they can be. Anywhere the public comes together will become a place where the virus travels from person to person. This is important, because if we can slow it down, then the line for those plush Intensive Care Unit beds will be balanced out, and everyone won’t be rushing for ventilators like it’s Black Friday at Medical Walmart.

Here’s a great visual of what we’re trying to do with all this social distancing and hand washing especially hand washing did I mention hand washing?

The pokey curve is uncontrolled infections, the smooth, slower curve we want is what we want by delaying the spread.

7. Why don’t we have a cure? Who do I yell at about this?

Look, we live in such and age of wonders and such an age of political duplicity and ineptitude that it can seem like anything bad that happens is negligence or malice. But the fact is, Nature can still kick our collective ass anytime it wants to. This isn’t anyone’s fault, this is the kind of thing humans have been dealing with since before we were humans.

8. There must be something I can yell about and someone to yell it at?

Don’t worry! There is. There’s a lot both authorities and regular people can do to manage the spread of this disease and make the treatment more effective. On the personal level, you can yell at your children/roommates/parents/etc. to wash their hands for 20-30 seconds several times a day, before and after going out, before preparing food, using the toilet, touching food, touching their face, sneezing, coughing, spitting, or cursing…

9. Wait, cursing?

Well, it can’t hurt.

10. sigh Go on. 

You can also clean commonly touched surfaces a lot — think doorknobs, handles, counters, light switches, keyboards, knobs, buttons, faucets… your germ-nursery of a cellphone, just walk around the spaces you’re concerned about, public or private, and think about where people touch, cough, sneeze or lick.

11. LICK? You know what, I don’t want to know. What do I have to clean everything with? Alcohol, bleach, fire?

All of those things will work, but honestly soap or basic surface cleaners are fine. Disinfecting wipes are good for quick cleaning and for cellphones but you can also just spray a little surface cleaner on a paper towel and wipe things down well with a good amount of cleaner, including your disgusting cell phone. Soap (detergent) is great. In fact, it’s often better than alcohol or hydrogen peroxide. Here’s the thing, this coronavirus, SARS-CoV-2, has a single strand of RNA and four specialized proteins all supported by a lipid bilayer holding the package together. Having a lipid viral envelope makes it susceptible to detergents…

12. Could you stop with the nerd talk?

Sorry. If you put soap on the virus and rub a bit, it pops, and then it dies.

13. Wow!

I know, right? You can set it on fire and pour alcohol on it or whatever, but anything that cuts grease and little back and forth, and you can just imagine those tiny little spiky balls popping and spilling their tiny little guts everywhere. It’s great. Just makes you want to scrub everything.

Hand sanitizer works similarly, but not actually as well as regular old soap. There’s a lot of cleaning products out there, but you’re really much better off with soap. You also don’t want to use things that will dry out and cause cracking in your skin — any bloody spot is an entry point. That might also mean you should get some lotion and keep your hands soft, supple, and free of extra holes.

But seriously, wash your hands with soap and water, and don’t touch your face. That’s pretty much the best thing we can all do.

Here’s a Baby Shark video with dancers showing proper hand washing technique, and here is another. The internet is truly full of things .

14. Ok, but let’s get back to the part when I get to yell at people about this. 

Sure. The virus travels between people on the tiny droplets that we cough, sneeze, or even just exhale. It’s also potentially in our tears, spit, blood, and our bathroom business. That’s a lot of ways for it to get from one person to the next, and that means we need to get away from each other to slow the spread of the disease. You can yell at local officials and event organizers to cancel or postpone gatherings where people might be in close contact, and those people might include children. Schools, conferences, church services and other public event cancellations are already happening, and they need to happen a lot more. You can yell at your local authorities about that.

15. What about testing?

Oh, yell your head off about this. Testing, especially in America, has been abysmal. Widespread testing is one of the best ways to map out and contain any epidemic, and given that many people (especially children) seem to have mild symptoms, it’s even more important to have widely available testing. Ideally testing should be available to everyone in an infected area. South Korea has drive through testing, China made a lot of their testing mandatory. In most cases, if you have the virus you just need to know to go home and stay there until you get through it. But if you don’t know it, you can run around spreading it, which is exactly what many people who were turned down for getting tested in the USA, Australia, Japan, and more, ended up doing. Testing only the sickest people tells you about them, but not about how the virus might be spreading at the moment. Very sick people aren’t walking around anymore coughing on everything. In some ways knowing if the very sick have the virus is less important than knowing about the still walking sick who may have it.

Whatever is causing the delay in US testing, the excuse isn’t good enough.

16. Is Covid 19 the fault of Trump/Mitch McConnell/Nancy Pelosi/Jay Inslee/Gavin Newsom/Rush Limbaugh/Etc.? 

Honestly, it doesn’t much matter whose fault it is right now. The house is on fire, and we need to put it out. We can figure out who to blame later. The important thing is that we start testing as widely and quickly as possible, and getting that information into the communities to help them make decisions based on good data. Also just to be on the safe side don’t lick any pangolins you come across.

17. How do I get my uncle/mother/child/self to stop COMPLETELY FREAKING OUT about all of this?

If you’re reading this you’re probably not a medical professional working the front lines of the response or an administrator planning logistics for your area. You just don’t need to know the latest news and speculation about Covid 19, and neither does your child, spouse, cousin, or cat. Informed is good, but drowned in information and emotionally paralyzed is bad. Pick a time of day to get your Covid 19 news, and then just… stop. If you really must, go ahead and check two times a day. If people bring it up, talk about hand washing and cleaning surfaces until they drop it. Nobody wants to talk about hand washing and cleaning that much, except possibly me.

If you’re dealing with a loved one that’s just losing it, plan an activity. A board game, a movie, something that gives everyone’s brain a break from it all. Accidentally unplug your internet for a while. If you just feel like you need to do something about it, clean house, it can’t hurt. Print up hand washing posters and put them up in bathrooms you visit. Do, and talk about, other things. The world is still turning, there are books to read and movies to watch and work to do and being scared of Covid 19 is not your full time job.

18. Is this the Zombie Apocalypse?

No, this is just another boring bug that causes a bad lung infection. There are a lot of them, but because this one is new (hence novel) we don’t have any immunity to it. It’s just going to be difficult and sad for a while.

19. You know what I mean. Is this… that virus? Is it the deep state, or an escaped bioweapon from an evil government lab? Is the SARS-CoV-2 virus going to be played by Dwayne “The Rock” Johnson one day, when the Truth is Revealed? 

Oh Lord, OK, this one. Let me tell you how boring, and inevitable, this kind of thing is. This novel virus is from a family of viruses called Coronaviruses. They were discovered in the 1960s, most of them cause common cold symptoms. They’re genetically similar RNA viruses, but you can almost just think of them as simple machines for injecting RNA into certain cells who then unwittingly make copies of them. But none of this is very precise, and errors get into the next generation of RNA viruses all the time, which is how you end up with new viruses. It’s about as sinister as self replicating Roombas, which is kind of sinister but also kind of stupid. Novel emerging viruses that cause epidemics are inevitable, and they’ve been happening not just since before we were humans, but before we were even animals. Not only is creating a viral bioweapon that happens to mostly kill older people and people with immune conditions not terribly possible with current technology, it’s also not particularly desirable.

This is not the only novel infectious agent we’ll see, it’s not even the only one we’ve seen in recent years — SARS, MERS, AIDS, H1N1, Ebola, MRSA, they’re all new(-ish) infectious agents we’ve been fighting in the last few decades. As we disturb habitats and invade bat caves viruses and bacteria that aren’t used to our bodies will end up trying us out. Most of them will die and we’ll never know they were there in us, looking for something to latch onto. But every once in a while, one of these tiny bastards hits the Lotto numbers. That’s part of what we have the scientific and clinical field of Epidemiology for. We forget this in our age of technowonders, but Nature is still the OG asskicker, and always will be.

20. That’s depressing, and kind of a letdown. 

I know. Maybe we can get Dwayne Johnson to play Dr. Tedros Adhanom, head of the World Health Organization (WHO) and he can beat up people who are withholding testing and demand that the public be allowed to go home and practice social distancing.

21. OK that’s a terrible idea for a movie, but fine, it’s not a secret government plot. If I’m not even a zombie, how do I know if I have Covid 19?

The symptoms to keep an eye out for are a fever, shortness of breath (difficulty breathing), and a cough.

22a. Whoa wait that exactly what I-slash-the person reading this next to me have! WHAT DO I DO NOW?!

First off, calm down. Those can be common flu symptoms, and thankfully the flu (with its much lower fatality rate) is still more common. But if you’re in an area with community transmission or have recently traveled to an area with an epidemic outbreak, it’s worthwhile to get testing if testing is available. If you’re sick, don’t go to the hospital or the doctor’s office. Call your doctor or the hospital, and tell them why you think you might have Covid 19. If you’re very sick, and you need to go to the hospital, call for an ambulance, and tell them you believe you may have Covid 19. That way they can show up with the right equipment to keep you and everyone else safe.

22b. I have a runny nose and a sore throat and generally feel a bit crap.

Chill. I have that too, it’s a cold. It’s why this FAQ is so late.

23. Will this just all go away when it warms up?

Well… It’s complicated. The short answer is no, but maybe it kind of could? A lot of this has to do with how well the SARS-CoV-2 virus survives on surfaces, and it doesn’t survive as long on warm surfaces, or enjoy being hit by UV rays from the sun. That could, in theory, lower the overall infectiousness of the disease, but we just don’t know yet.

24. I have really great health insurance, that means I’m cool, right?

Oh, sorry, not this time. The problem is whether or not we can slow the virus down enough to make sure the hospital beds aren’t full when you need them. No matter how good your health insurance is, if hospitals are racing to catch up with how many sick people there are and the epidemic is in a crisis, you’re going to be stuck waiting. Have I mentioned washing your hands a lot?

25. Why are children immune? Why don’t they suffer like the rest of us? 

Harsh, but ok. Children aren’t immune, they get the virus in the same timeframe and probably have it as long as we grown-ups do. They just don’t seem to have a lot of symptoms. If you put a swab in their nose you can detect the virus, but they don’t seem to get very sick. As for why, we don’t know. They could have very little viral activity, or they could be shedding it like tiny adorable Typhoid Marys all over their grandparents. There’s a lot we just don’t know about this virus or what it’s doing the the world. It’s novel, and that’s hard to deal with. Many papers are coming out about it, many scientists are pouring over all the data we have. Research on Covid 19 may be one of the only things traveling faster than than the virus, but there’s still so much to figure out.

26. How much social distancing should I be practicing?

Some of that depends on you. If you’re older, immunocompromised, or otherwise high risk, you should probably at least be prepared to stay home for a few weeks if the virus comes to town. If it’s in town already, avoid crowds and busy transit. Work from home if you can, and prepare for school closures. If you’re sick with something else and you must go out, that’s the time to wear a mask, but a surgical mask is fine. Wash your hands and don’t touch your face. If you’re sick with Covid 19, really, don’t go out. Try to get anything you need delivered until you’re well again.

27. Once I’m well, and I’ve beat the virus, I’m an invulnerable coronavirus superhero, right?

Well, uh, there’s more than one strain, and we don’t know if having one confers general immunity. Until we know you should probably still be careful.

28. SERIOUSLY?! 

Yeah, we’ll probably know more soon, but this is novel, and we’re all still figuring it out.

Sorry.

29. It looks like I’m living with someone who has the virus and I have to take care of them, or they are high risk and I’m worried about giving it to them. 

That’s beyond the scope of a sarcastic FAQ, but I’ll try. If you’re living with a vulnerable person, you need to go their speed when it comes to social distancing, self-isolation, and safety precautions. If you’re taking care of someone, this is the situation in which you need PPE (Personal Protective Equipment) like N95 masks, gloves, etc.. And you need to fit the masks correctly. Youtube tutorials are your friends.

30. Should I go to school? To work? Can I still go out to eat? Or get delivery? Man, I don’t know how to boil water. 

A lot of this depends on what’s going on where you are. There should be local announcements about schools, work, and gatherings that help guide your decisions, but you may also need to be more careful based on your own health situation.

As for getting prepared food, a cooked meal is going to kill the virus, though it would be nice for people working in commercial kitchens to wear masks and wash their hands a lot. If you’re going out, don’t go somewhere crowded. You want 4-6 ft between between people, with good ventilation. If you’re getting delivery, make sure your food is hot and treat sacks and containers as possible contaminated — wash your hands, throw packaging out, wash your hands again.

31. What are you doing about it, yourself? Huh, Quinn?

Oh, put my money where my mouth is, eh? (That’s a terrible idea, money is almost always contaminated, so I’m using my credit card as much as possible) I’m currently in San Francisco, where there isn’t a medical crisis (yet) but we do have community transmission. My daughter’s school is still open, which I’m unhappy about but for now she’s going. When I had cold symptoms I wore a mask out. I’m checking my temperature periodically and so are my roommates. I wash my hands a lot. I’m wiping down high-touch surfaces with detergent a few times a day.

My daughter and I are taking multivitamins. Some people think Zinc can help, or Vitamin D, or C, or whatever, and honestly no one knows — novel virus! What I am sure of is that deficiencies make illness worse, and a multivitamin can’t do any harm. (Except biological males should not take women’s vitamins due to the iron they contain.) I’m still going out and doing a few things, but I don’t stand in lines or get close to people. I went to Safeway, saw lines, and noped right out of there. I’m usually walking to get around, but will get on a mostly empty tram. I’m still going for runs, and see people walking dogs. That’s fine, as long as we stay well away from each other.  When I get back, I wash my hands.

32. Where do I find good and reliable information that’s less sarcastic than this FAQ?

Did I mention you should wash your hands?


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130 replies
  1. e.a.f. says:

    Thank you. All the information with a laugh!

    Will read three times a day to maintain my cool.

    Will continue washing hands. Dish detergent rules.

    • Katherine M Williams says:

      A virulent pandemic isn’t funny, and “Quinn” put out some misinformation.

      “Honestly, it doesn’t much matter whose fault it is right now.” That is utter bull. The US authorities are responsible for this terrible situation; it is their JOB to protect this country, and they must be held to account for their abject failure.

      I do not consider calling criminal negligence leading to thousands, maybe a million deaths “shouting at someone”.

      Stupid article, poorly written, not funny.

      • e.a.f. says:

        Katherine, none of this is funny, but if we don’t laugh, we will make ourselves very unhappy during this time. I agree with Quinn. Right now it doesn’t really matter how things got started in the U.S.A and/or any where else. Its here. After its over, we can focus on how it got here and why the American government did what it did or didn’t do what it was supposed to. Right now the important things is people get on with the job of ensuring people remain safe. The State of Washington Gov. is doing the best he can. The Minister of Health in B.C., Canada are doing the best they can. They’re organizing, planning, keeping their citizens updated. The Gov. of New York ditto.

        Hard times frequently produces a lot of humour and we all need to keep our sense of humour. What Quinn Norton wrote, many will actually read instead of something drier. Just the opening Q & A;. got my attention. it made me laugh and right now that is important because I and the sibling are prime candidates for this disease. If the sibling catches it, there is a good chance I’ll be the last one standing. Reading this a couple of times a day, is good medicine for me.

        • Katherine M Williams says:

          This isn’t the time to laugh. People drowning in their own mucus while you giggle at the wit and wisdom of ‘Quinn” isn’t funny. I live in Lake Oswego OR and I’ve been ill for a few days with a dry hacking cough. So laugh it up, enjoy yourselves YOU’RE probably one of the 80% who will be just fine, and hell with the other 20%, the “herd” should be regularly culled, anyway, hahahaha.

          • Eureka says:

            Hi, Katherine. I have risks, too — a lot of us do; further, my amore is a front line healthcare worker, and I don’t want him to die. They have been dealing with these risks for months now, before anyone really registered a care. It is stressful. A stray pangolin reference brings me a moment of joy, and I will take that.

            I understand that while the testing criteria have expanded, they remain inanely limited. Still: have you called your doctor and county or state health department? Please do that, if you haven’t (and I’d say to keep calling anyway) no matter how futile it might seem to do so from news reports.

          • P J Evans says:

            I live in California. We make jokes about earthquakes, because it’s better than breaking down and doing nothing. Humor is a defense strategy.
            (Have you ever heard of “black humor”? That’s what we’re engaging in.)

          • e.a.f. says:

            As I mentioned the sibling and I are prime candidates for the disease. The sibling has Parkinsons, is diabetic, and could well die if they acquire CO VID 19. My age and health history leaves me more vulnerable.

            We have learnt that if you don’t laugh about some things, what is the point. There is no point in getting unhappy about the fact you may die sooner than expected. Just make sure the will is updated and some body knows where it is.–next project. And wash you hands after signing the new one.

            One of the benefits, if you’re going to die, dying now from CO VID 19, is if you never wanted a funeral and thought there was no way out of it, now there is because of social distancing. it will save the estate a bundle and leave more for your favorite animal charity. For some of us, those attending would only be there to either check to ensure you really were dead or to see if they were in the will.

            As Quinn wrote, every body dies. Always thought there was an out, but given some of the people who have died over the decades, she’s correct. No one gets out of here alive.

            In Canada we have, what I refer to as the Trudeau exit. Dying, for some of us, isn’t a big deal except you don’t get to see the end of the movie. It is those who remain who have the pain and grief. For all those who are religious, you finally get to go to the after life which was supposed to be some big deal. For us non believers, its the end of the story.

            I worry about the first responders, the health care workers, those with loved ones, the homeless and whatever forbid the dog catches it.

            Having had a number of very dear friends die, leaving me grief stricken for years on end and having to deal with the grief of their loved ones. yukking it up, culling the herd is not part of my make up. However, when it comes to my own death, its O.K. to make fun of it. No point in crying. As Quinn wrote, no one gets out alive. My apologies for offending you. That was never my intent. Coming from a family where people died young, stories about the aunt who would miss the funerals to clean out the houses, I developed an irreverent attitude towards it all.

          • Sela says:

            Humor is a great stress reliever. With all the stress about the new pandemic, now is the best time to laugh about it, more than ever. Its one of the most effective ways to keep us sane in times like this.

            “The US authorities are responsible for this terrible situation”: there is no doubt about it, the authorities handled the situation terribly so far. But they didn’t start the pandemic. Maybe handling it better in the US would’ve made a difference. But it wouldn’t eliminate it, and probably wouldn’t even change the number of people who get sick. At best, it could help flattening the curve a bit. Which is important, but not the kind of protection you might be looking for.

            There will be time for reckoning, but not now. Not when we just started fighting this threat. It is important to identify mistakes so we can fix them, but not to pass blame around. Not at the moment.

          • DAT says:

            Katherine, you call Quinn out for laughing at something that’s not funny, and to clinch your case you say “culled, anyway, hahahaha.” Katherine, with this riposte you are DOING exactly what you object to Quinn doing. You are employing gallows humor to make your point. The time to laugh and the time to cry never fall at exactly the same instant for everyone. I appreciate Quinn’s attempt to both educate and entertain, and hope she’ll do more posts like this.

      • Eureka says:

        There is nothing funnier than staring (the (slow) risk of) death and societal collapse in the face. They make that two-sided comedy-drama mask for a reason: laughter and tears.

        Gallows humor.

        Although I get it, sometimes that’s not the mood we are in or the take we are up for participating in at any given time.

        • Katherine M Williams says:

          Well, enjoy yourself, laugh it up while you still can. Martial law and Fascism are being planed and probably will be implemented in Mid May. So laugh while you may.

          • bmaz says:

            Jesus, take a chill pill. A little humor while reinforcing sane steps to mitigate the problem is fine. What Quinn wrote is exactly that. Frankly, it is great. And, no, martial law is not on the horizon.

            • Katherine M Williams says:

              I’m 65 and live in an infected area; I’m showing symptoms; I’m updating my will. HAHAHAHAHA! “Am I going to die?” Not if I’m one of the 80% young healthy people.

              It’s SOOO funny!

              • Quinn Norton says:

                Hey, I’m sorry you’re feeling this way, and it’s clear this isn’t the piece for you. I’m hoping it will help the 80% (as well as the other 20%) understand the virus and keep you safer by making good choices. People don’t learn when they’re scared, so I wanted to create something that helped people feel less afraid and follow the right proceedures to slow the spread.

                That said, if you don’t like it, don’t read or share it, just take care of yourself. It’s a hard time. And just to echo what others are saying: call and keep calling to get tested. Be gentle with yourself, keep washing your hands, eat good food, and just take good care. You’re still probably going to be ok, but you’re even more likely to be ok with good and loving self care as well as medical care.

                • RLHall says:

                  Thank you so much for the clarity. A dose of gallows humor, too.
                  I really appreciate your contribution here.

          • Raven Eye says:

            1. There are people planning fascism every day, pandemics or not. They are just as susceptible to COVID-19 as everyone else — unless they’ve already retreated into their cave in Idaho and are happily slurping up their freeze-dried “entrees” whilst gazing knowingly at their horde of toilet paper and Everclear.

            2. And what the heck (really) is “martial law”? Do you mean 10 USC, Chapter 13, §§ 251–255?

            • Katherine M Williams says:

              What the heck is martial law? Well, I guess you’ll find out in May.

              Meanwhile lets all focus our thoughts and prayers on Trump & the rest of the oligarchs catching the virus and dying. It’s a plan.

              • bmaz says:

                This is seriously batshit. I truly hope you are fine and understand your concerns. I am no longer young either and just spent a week with someone barely a week out of Milan and Lombardy generally when she arrived here. And was already trying to recover from a touch of pneumonia.

                We are all exposed to a degree or two. Please stop screaming at people and calm down. A bit of perspective will serve you, and all, a LOT better.

              • Charlie Hargrave says:

                Wow, bitter much?

                Life is just a series of risks, some calculated, some unknown.

                If you are unable, or unwilling, to laugh at yourself, call me, I’ll laugh for you.

              • e.a.f. says:

                I live in Canada and what they do here is declare the War Measures Act. The current Prime Minister’s father did it when he was P.M. back in the day. However, Canada is a different country with different attitudes. The current federal government is some what left from an American political perspective.

                As to the U.S.A. and fascism that has been moving forward at some level for awhile. Its not going to get there though. there are a lot of good people in the U.S.A. who won’t ever let that happen. IF it ever does, living in Oregon, don’t worry, we’d take you in Canada. A lot of us in B.C. have always left a certain kinship to those living in the 3 western seaboard states, if for no other reason, you all grew about as much weed as B.C. did back in the day.

            • bmaz says:

              Raven Eye, yes that is right. Were it to ever occur, it would likely be under §252-253. That is certainly not going to happen here.

          • CEI says:

            Katherine,

            Humor is good medicine. I hope you can come to understand that the article was obviously written to shed some light and humor on a very serious matter.
            I am sorry that you feel bitter.

    • Veronica says:

      Thank you, Quinn, for lightening the load of gloom and doom that this situation has Created accelerated. Deciding and proclaiming FAULT is the least of our concerns. That will not lessen the severity. (Besides, SOMEHOW, Obama will be blame. I digress. )
      Rather than wash our hands of this entire thing, it is time to KEEP CALM AND CARRY ON! Taking precautions and vigilance is the way to go. The globe needs to be proactive as opposed to over reactive.
      Using our heads is crucial. Anger and bitterness only breed contempt.
      I appreciate the levity as I am capable of making the separation between common sense measures and raw mayhem.
      Time to scrub in to life.

  2. Alan says:

    > think about where people touch, cough, sneeze or lick

    You left out poop. There’s some indication SARS-CoV-2 may be spread through fecal matter.

  3. Geoff says:

    Great stuff. I have a problem with one part :

    “If it’s in town already, avoid crowds and busy transit.”

    This is correct, but the problem is, since we didn’t really test anyone, and it’s out in the wild, you can’t know whether it is in town already, as it may be there in incubation stage. Or someone may have it without symptoms while someone else has it at home but never got tested.

    The problem all comes back to the criminal, and I do mean criminal, lack of testing. This cannot go unpunished. There were workable tests. And we chose banana republic. Sinful, really.

    What this means is that we have to do much more social distancing to be safe, and assume its much worse, especially if we are high risk (old, high blood pressure, previous pneumonia, etc.)

    From my biased, non-objective and small sample of inquiries on this, it seems a lot of organizations and people refuse to believe that this is a big deal, and are resisting shutting things down. I’d say half are aware and taking precautions and the other half is of the “it’s just a flu” variety of person, seen in the cartoon above.

    It’s hard to feel too optimistic that we are going to flatten the curve. I think the groups that are acting now to curb things will flatten it to some extent, but there appear to be pockets of ignorant resistance to the risk that will get a big lump curve that will overwhelm their health care systems.

    • pdaly says:

      I agree that the lack of a working test in the US despite the presence of a working test recommended by the W.H.O. is criminal and is negatively impacting Americans’ ability to respond to this coronavirus.

      As of Tuesday afternoon 3/10/20, Massachusetts has joined the group of states that have declared a state of emergency.

      MA has 92 cases of COVID-19 today (the count was 41 yesterday), but the CDC has only confirmed the first one back on 1/31/20!
      Massachusetts hospitals are still being instructed to test based on travel history or interaction with a proven case of COVID-19. Until more tests arrive by end of this week or next, we have no way to check for community spread.

      As Quinn mentions in her main post, hand washing and social distancing are going to be the main ways to slow down the infection peak.

      • bmaz says:

        Yeah. Our daughter, despite having just returned from Milan, and still being within the 14 day window at the time, could never get a test here, It was kind of insane. And look out pdaly, she is back in Boston now!

  4. pdaly says:

    Rayne asked a question on a prior COVID-19 thread:
    ” New York investment banks were notified [about the COVID-19 cases at the Biogen conference in Boston], said one article — does this mean financial people were present?”

    I thought I’d suggest one answer here where she can see it:
    Biogen conference took place Feb. 24-27, 2020, Marriott Long Wharf hotel, Boston.

    175 attendees included residents from MA, as well as out-of-state, and overseas including Europe.


    Then 4 Biogen employees who attended the Biogen conference subsequently attended a health care investor conference on March 02, 2020 at Marriott Copley Place, Boston. It is a a DIFFERENT Marriott hotel from the Marriott hotel that held the Biogen conference.
    The event was sponsored by Cowen investment bank.

    I have read somewhere that 2 of the 4 Biogen employees who attended the investor conference were symptomatic, and I think at least one of them later tested COVID-19 positive, but I have not been able to find the article more recently.

  5. pdaly says:

    Quinn’s post needs to be shared widely.
    Especially this message “If you put soap on the virus and rub a bit, it pops, and then it dies.”

    My mother was in the pharmacy and had to discourage a person from trying acetone as a substitute for non-available hand sanitizer.

  6. Peterr says:

    Just finished a meeting of our church council, at which we discussed various changes to practices and procedures, including stepping up the general cleaning. Among the changes: as the pastor, I will *not* be shaking hands with folks at the end of worship each Sunday. I’ll still greet them, and they’ll still say “Nice sermon, pastor” (whether it was or not, but that’s another story), but the shaking hands part is not going to happen. At least not for a while.

    And if a pastor can quit shaking hands indiscriminately, so can a politician. IOW, Mike Pence and Donald Trump are idiots. Also potential Darwin Award candidates.

    COVID-19 does not care if you are the President of the United States or the panhandler in Lafayette Park. Wash your damn hands, and (generally speaking) keep them to yourself.

      • Peterr says:

        We’re adding “wipe down the offering plates” to the expanded cleaning protocol. Checking out which products can be used on which surfaces is the next challenge. Stainless steel kitchen workspaces are easy to deal with, as are laminated counters and all the doorknobs, drawer pulls, and crash bars. But what is appropriate to use on the organ keyboard and organ stops?

        • mass interest says:

          Dr. Bronner’s castile soap on a soft cloth has always been my go-to. Doesn’t damage ivory, finished/waxed wood or bone.

        • VoltOwner says:

          Disinfecting Wipes. I have some from Costco that come in a big tube. When the earlier ones dried out I put some 91% alcohol and a little aloe in the container and shook it around. (Current bottle is not going to get a chance to dry out…)
          91% alcohol and a little aloe is all that hand sanitizer really is, or at least needs to be. The aloe helps keep your skin from drying out. Maybe skip the aloe for keyboards and such since the aloe won’t evaporate fast enough. Wear gloves to keep the straight alcohol from drying your hands.

  7. Savage Librarian says:

    Thanks, Quinn. Very informative. I loved the conversational tone. It was realistic, helpful, and even calming. Now we have some straightforward ways to wash some of our worries away while still being vigilant. It was good of you to remind us to check our local resources, too.

  8. Molly Pitcher says:

    Proof that The Very Stable Genius is an idiot is that he looked at an eclipse with his bare eyes….Maybe that is his problem ! He fried his brain !!

  9. PhoneInducedPinkEye says:

    Outbreaks in my area but large company I work for is still open and holding meetings as normal where people are in close proximity. I’m sure I’m not the only one. It won’t be that bad nationally if we slow down spread rate and don’t overwhelm hospitals but it feels like no one is really taking it seriously.

  10. Mathias the Younger says:

    This is an AMAZING article, and it’s readability, humor, epidemiological accuracy, and PR functionality. I’m going to go donate to this website now (after I post this article on all the social medias)

  11. rosalind says:

    local news just reported the Life Care facility in Kirkland, WA has 180 employees. 60 are home w/coronavirus symptoms. 30/180 have been tested. 30.

    on a more positive note, Amazon is supposedly still paying their hourly workers who are off while salaried staff work from home; they are giving a free month’s rent to stores in their buildings, and have funded grants to small businesses in the area like food trucks to keep them going. the food truck guy said: “it’s like they’re finally becoming part of the neighborhood”.

  12. Dan Porter says:

    Covid-19 stays on surfaces for nine days afterward. Evidence out of China seemed to suggest that it wasn’t fussy about temperature and varying climates did little to discourage it. Mortality rate estimates from China suggested 15% for those 80 and up, though doctors now are concerned it may be closer to 18-20%.

    Clean with bleach spray in high traffic areas (1/2 cup bleach to one gallon water) and let people know so that it can be left in place for five minutes.

    You can make your own hand sanitizer with aloe gel and strong rubbing alcohol.

    Wash your hands at length and focus on cleansing deeply for 30 seconds.

    Even though I am only 38-years old, I live in a significant retirement community in the Bay Area. If this thing hits here, it would be a potential bloodbath with maybe hundreds upon hundreds of fatalities. I’m fully expecting to be under lockdown in two weeks.

    • Peterr says:

      I’ve never seen that “9 days” figure for the length of time the virus can survive on an open surface from any reputable medical source. The current guidance from WHO says this:

      It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).

    • vvv says:

      “You can make your own hand sanitizer with aloe gel and strong rubbing alcohol.” – This one is a bit problematic. I’ve seen a few of the TV doctors/pundits say it’s not a good idea for various reasons including guesswork and false reliance. As we know from the press release from the makers of Tito’s vodka (the first one is good, then it tastes like all the others), you need 60% alcohol (Tito’s is 80 proof = 40%.) As well, I have been told by a food safety expert (I posted in another thread here about this) that gels are not effective sanitizers as they don’t penetrate well (ex., around fingernails, wrinkles, etc.) and often just sit on the surface; in the food service industry, they use sanitizers with consistency near water. Q.E.D., as in the excellent and amusing Quinn posting, better to use soap and water, bleach if you feel the need.

      • Raven Eye says:

        A mix of three parts grain alcohol (95%) and one part aloe gel will give you around 70% alcohol by volume — probably a safe margin of error above the effective threshold of 60% alcohol. (I have not tried glycerol, which is commonly used in commercial hand sanitizers.)

        — Based on my own experience, the result will not be a gel, but rather a liquid a little more viscous than water. However, you can still feel the aloe on your skin as the alcohol evaporates. Straight high proof, 90% IPA, or 99% IPA can dry and irritate the skin, leading to other problems (as discussed).
        — Proper hand washing is the recommended option, but availability of proper hand washing stations can be problematic. Ideally, they should be no-contact; sensors for the soap, water, and paper towels. How many of those have you seen? And there are concerns with the wind storms that air dryers kick up. So hand sanitizer is a portable alternative. (If you have an RV, you could do all your errands in that…)
        — Proper handling alcohol at those concentrations is important. It is highly flammable, and the flames may be invisible outdoors or in strong indoor light. Alcohol absorbs moisture from the atmosphere, so it must be kept tightly capped.

  13. Eureka says:

    OK, first of all I would burst into spasms of adorbs amazement if a pangolin crossed my path (hushed tones only, tho. Respect.). I would *never* lick it. My dog might try (in which case we’d have a long two weeks* ahead of us).

    A duckduckgo of the mysterious Dadex reveals that the American Library Association likes Worldometers.

    Pertinent to a convo on an older thread (someone said JHU was tracking US cases at city level; at that time, they were mapping county level, and an unknown number of states were not revealing cities, in any case): yesterday or so, JHU dropped the county-level differentiation within states and is just giving numbers per US state now.

    ETA: report of a dog harboring virus in schnoodle via environmental contamination, believed:
    https://www.emptywheel.net/2020/02/26/preparing-for-the-inevitable-coronavirus-disease-2019-outbreak/#comment-829535

  14. Worried says:

    Thank you for taking the time to provide this thought provoking dialogue.
    The more info the better, but we need guidance from the authorities we trust.
    I have a friend in Rome; his family has to abide by a set of government rules. They cannot currently make many choices about what they can do.
    Sunday night (5/8) my wife and I had tickets (purchased long ago) for a Patti Smith concert at The Fillmore in San Francisco. She’s on my bucket list.
    I called the concert venue several times to find out if the concert was still on (the Mayor of SF had strongly encouraged activities which lead to close personal contact to be cancelled).
    Every time I was told that all concerts were going to be held as planned.
    So, I had a choice.
    My wife and I discussed what to do.
    We decided that, currently, the odds were very low of contracting the disease if we wash our hands and not touch our face.
    The authorities did not decree that the concert should be cancelled.
    So we went.
    My friend in Rome would not be able to participate in a similar event there……
    Not sure how many times I touched my face during the wait in line to get in and during the concert, but way more than I expected; it is virtually impossible to stop reflex actions.
    I don’t think our current approach toward this disease is designed to minimize it’s impact upon our health care system capabilities as recommended in your dialogue.

    • Hug H says:

      Wilco Concert, Seattle Paramount next week. (Although I’ve seen Wilco many times, Patti is also on my bucket list) I keep checking… the show remains on schedule.
      My wife and I won’t go either way.

      Each of us has a responsibility to our fellow citizens now- Social Distancing is critically important! We live near Seattle and even here it’s obvious people still don’t get it.

      Case in point-
      I’m on a couple of Non Profit Boards. One has monthly Board Meetings in the recreation/dining facility of a high end Senior Living facility on Mercer Island. (Mercer Island is only 10 miles South of Kirkland where 10+ residents at a Senior facility have died)
      Two day’s ago I received a confirmation for our next Board meeting which took place last night. I replied with a question to the Board President (a Toxicologist)- “given the Coronavirus outbreak, would our usual meeting location be sensible, or even accessible to outside groups?” He seemed surprised by my question but said he’d check.

      His contact at the Senior Living facility was out for the week but another employee thought “it’s ok to go ahead with the meeting since 7:30pm is after most residents have left the building”. BUT… “someone will check with the home office just in case and we’ll be back in touch.” Mid Day yesterday the Board President received a call- “all outside group meetings are now suspended”. Last night we had our meeting via teleconference.

      If I hadn’t spoken up, I’m pretty sure our meeting would have taken place at the usual location.

      I’m 59 and healthy- Each of us has a responsibility to our fellow citizens- SOCIAL DISTANCING IS CRITICALLY IMPORTANT, otherwise we face the risk of an overwhelmed US Hospital/Healthcare System!

    • talislope says:

      Yeah, tough decisions. Talked to my son in the U.K about coming home last week but he wanted to stay and finish his dissertation (he is confining himself mainly to his apartment). We canceled tickets to Shakespeare in Ashland so my wife could fly to New Jersey two weeks early to help with a new granddaughter (I was worried she soon may not be able to travel). I’ve dropped out of a choral group and my daughter and I are primarily self isolating at home.

      it’s not that I’m really worried about getting the virus but I’d like to help flatten the curve. I assume we all will eventually be exposed. However, I would prefer not getting sick at the peak when health care facilities will be swamped and I may need care (however unlikely).

      To my son and I it’s kind of fun; an interesting problem to solve and work around. However, my daughter is on sensory overload and a bit freaked out about it — as are some readers of this site. Perhaps it is some comfort to those who are worried to know that the odds are pretty heavily in your favor.

      I recently got an unexpected personal call from my doctor after a blood test. After more testing it turned out ok but I think I’d rather have a go at the virus, frankly, than another call on my cell from my doctor.

  15. talislope says:

    Thanks Quinn! You wrote:

    “Many papers are coming out about it, many scientists are pouring over all the data we have. Research on Covid 19 may be one of the only things traveling faster than than the virus, but there’s still so much to figure out.”

    Couldn’t stop laughing over that one. Although I suppose only a research scientist (former in my case) can fully appreciate the humor (my wife only found it mildly amusing).

    So Quinn, love your writing, where were you when I was writing my dissertation? (I’m fully ok with plagiarizing.)

      • Rugger9 says:

        Lehrer’s great and his work still rings true. Part of my bucket list is to do an audition where I sing the “Masochism Tango”. All I have to do is keep my beloved from finding out because she’ll murder me for doing it. After all, I did play the King in “Once Upon a Mattress”.

        • Eureka says:

          Rugger, I would pay with my last roll of toilet paper to see this! Please at least consider a livestream ;)

          *2nd-to-last. But still.

      • AndTheSlithyToves says:

        What exactly is it that the “many scientists are ‘pouring’ over all the data we have”–maple syrup, clorox, hand sanitizer? lolol
        Apologies, Quinn–couldn’t resist. Great piece!

  16. Jim White says:

    First case was just confirmed here in Alachua County. I opted not to go the Gator baseball game last night since games with FSU are typically sold out and I didn’t think sitting shoulder to shoulder in such a crowd was a good idea. I’m likely still to go a small venue concert tonight. They set up the stage at the Performing Arts Center as an intimate jazz club with small tables. I’ll skip the dessert buffet and hope to find a table around the outside edge of the arrangement. After that, my sphere of travel will likely be the two miles to my local grocery, with trips only at very odd hours to avoid crowding.

    It’s too bad they seem to be going ahead with Gatornationals this week. It brings about 100,000 visitors to the area. Granted, the venue is outdoors but the bleachers look crowded. Ironically, many in the crowd will use hearing protection but will be breathing their neighbors’ exhalations.

    PS. After spending Sunday holding my grandkids, I found out Monday the younger one has respiratory synctial virus (she’s fine: virtually all babies get this one and it almost never gets complicated). At least with this one most of us adults have seen it so many times it shouldn’t matter, but it will be jarring if I get respiratory symptoms soon.

    • cavenewt says:

      RSV is not completely innocuous (“it almost never gets complicated”). My son had it as a baby, and it led to childhood asthma and indirectly to pneumonia and a life-threatening liver failure episode.

      • Jim White says:

        Oh my. So sorry about your son’s experience. Those in the “almost never” category are truly the victims of the crueler side of probability.

        • Frank Probst says:

          It can be pretty bad. I can remember a few patients from when I was doing general pediatrics that needed mechanical ventilation for several days.

  17. paulpfixion says:

    Thanks for the great post, Quinn. I’ve shared the “flatten the curve” gif by Dr. Siouxsie Wiles that I saw here with many of my friends back in the states. It has been the most effective method of communicating the problem. Their response: “oh. shit.”

  18. Raven Eye says:

    Thank you Quinn!!

    I guess we could (for this brief micro-moment on the Cosmos’ arc of time) consider the entire planet an “Act of God Theme Park”.

        • orionATL says:

          re harpie @3:40, 3:43

          kidnapped !!

          honest to god unbelievable.

          our kniving president kidnapped his science chiefs to keep them from testifying.

      • harpie says:

        https://twitter.com/OversightDems/status/1237820463025401858
        3:19 PM · Mar 11, 2020

        “In terms of resuming our hearing today, we have been informed that Dr. Fauci and Dr. Redfield have been unavoidably detained at the White House. We don’t know what is going on, but they cannot come back.” -Chair @RepMaloney

        “As a result, we will resume this hearing tomorrow, Thursday, at 11am. We have been informed by the agencies they will all be here and we hope to have enough time to finish all of our Members’ questioning.” -Chair @RepMaloney

      • harpie says:

        So, here it is:

        Trump fears emergency declaration would contradict coronavirus message
        Trump is concerned that declaring an emergency would hamper his narrative that the coronavirus is similar to the seasonal flu.
        https://www.politico.com/news/2020/03/11/trump-emergency-declaration-coronavirus-message-125902
        03/11/2020 04:12 PM EDT Updated: 03/11/2020 06:46 PM

        […] Trump’s concern at this point is that going further could hamper his narrative that the coronavirus is similar to the seasonal flu and could further agitate Wall Street, said the three people familiar with the discussions.

        “The president isn’t persuaded because [an emergency declaration] contradicts his message that this is the flu,” said a Republican who speaks to Trump.

        Health experts have rigorously disputed any assertion that the coronavirus is equivalent to the seasonal flu, noting it is much more lethal and particularly dangerous to the elderly and those with other health conditions. […]

    • harpie says:

      Brandi Buchman of Court House News has a [as usual] great thread of the Hearing here:
      https://twitter.com/BBuchman_CNS/status/1237693147402178561
      6:53 AM · Mar 11, 2020

      This is what she wrote just before they recessed:

      11:42 AM · Mar 11, 2020
      Maloney, before recessing the hearing, says WH is telling reporters that this meeting with Fauci and others is “not an emergency” but that’s not what CDC staff told Congress this morning. Maloney: “There seems to be a great deal of confusion and lack of coordination at the WH.” […]

    • harpie says:

      Dr. Anthony Fauci spoke with Sean Hannity last night:

      Dr. Fauci Schools Hannity on Dangers of Coronavirus “But even if it’s one, it’s ten times more lethal than the seasonal flu. You gotta make sure that people understand that!” the top infectious disease expert said.
      https://www.thedailybeast.com/dr-anthony-fauci-schools-sean-hannity-on-dangers-of-coronavirus
      Justin Baragona Updated Mar. 11, 2020 5:00AM ET / Published Mar. 10, 2020 10:59PM ET [VIDEO]

      FAUCI: “But Sean, to make sure your viewers get an accurate idea about what goes on, you mentioned seasonal flu. The mortality for seasonal flu is 0.1 [percent]. The mortality for this is about two, two-and-a-half percent. It’s probably lower than that, it’s probably closer to one. But even if it’s one, it’s 10 times more lethal than the seasonal flu. You gotta make sure that people understand that!

    • Frank Probst says:

      It looks like they’re gearing up to silence Fauci. Again. It’s clearly not working, so this administration’s next move will probably be to fire him and/or drag his reputation through the mud. I’m guessing that the administration is just going to classify anything Fauci might say, so that even if he quits, he won’t be able to talk to the press.

    • Rugger9 says:

      It is as wretched as it sounds, but it’s worse with any decision waiting for Jared to complete his “research” before issuing an emergency declaration that would allow WA to get some critical stuff done.

      So, the politics interferes again because Individual-1 thinks Governor Inslee is a “snake”.

  19. Pajaro says:

    Three cases, all travel related, identified (presumtive) in my state. Governor and state Health Dept. to implement drive-thru testing in NM. Declared Health Emergency which frees up resources and funds for effective response, testing, screening, lab contracts, etc.

  20. Geoguy says:

    I thought this was a great post. My spouse works for a not-for-profit (human) tissue bank. Their chief medical officer used to work at the CDC and still has contacts there. He has suspended all travel and encouraged as much work from home as possible until mid April when he will re-evaluate his decision. And yup, Dawn dish soap is wonderful especially when mixed with a touch of ammonia and water. It really is used to clean oil spill soaked wildlife. Don’t ever mix ammonia with other household cleaners. For example, ammonia mixed with bleach produces chloramines and liquid hydrazine which can be fatal.

    • cavenewt says:

      Dawn in particular, or is dish soap in general ok? I use some sort of cool-and-groovy environmentally-friendly stuff.

      • bmaz says:

        Quinn is right, but, yes, Dawn in particular is better by my experience, and it is cheap. Geoguy is right about it being commonly used to clean oil drenched wildlife. I learned about it long ago when restoring classic cars. It seriously cuts through without pain or damage.

        • Molly Pitcher says:

          bmaz, You aren’t going to be able to scalp your Democratic Debate in Phoenix tickets !!

          • bmaz says:

            Lol! I had an in, hilariously enough, as “press” because I know several people close to Sanders. But I wasn’t going to go anyway. So, no loss.

        • FunnyDiva says:

          Dawn is my brand of choice.
          Excellent for scrubbing out a scratch or bite from my cat.
          (the one time I didn’t scrub enough…got pasteurella cellulitis. will NOT make that mistake again, OUCH!)

      • Geoguy says:

        I don’t know why but Dawn seems to be the stuff. Sometimes I work on the water and the mechanics all carried Dawn to disperse a stray oil slick. Fortunately today, most of the hydraulic equipment uses vegetable oil instead of petroleum based oil.

  21. PhoneInducedPinkEye says:

    Large company wide meeting in a crowded auditorium today, leader ship urged people to “move up to the front” and fill empty seats closer to them. I can’t say much about the leadership as they would be easy to identify based on their craziness, but part of the presentation was them saying, “news and social media are trying to scare people”. They deumerred when asked if they would give extra PTO for people who had to stay out two weeks.

    Then they had everyone go to lunch counter at the same time. I remoted in to presentation, and while yes the outbreak is no one’s fault, I think some corporate leadership and executive branch decisions are definitely yell-worthy.

    I’m pissed off sry for venting here

    • BobCon says:

      That’s vent-worthy.

      If you trust your HR department (not all are trustworthy) ask them about it in writing. Some of them are savvy enough to know what the risks are and will send out the necessary memos.

  22. XRacerX says:

    Should I wash my hands after laughing out loud?

    Thanks to Quinn for the good information & advice wrapped in a few giggles!

  23. Gerontar says:

    Great post and comments. As a long-term care physician (and medical director) with decades of experience I have seen several mysterious viral respiratory infections. I have a few footnotes to add.
    First, there are other viruses floating around and if you develop symptoms (cough and fever) how can you tell if you have possible SARS Cov2 or not? Obviously there is no iron clad way to tell, but influenzas characteristically have an abrupt onset. One minute you are fine and then wham, you are really sick. As mentioned in Quinn’s excellent summary, if you have runny nose or sinus congestion Covid is less likely.
    Second, The hand washing with soap and water (I also like Dawn) simply cannot be over stressed.
    Third, if you start having symptoms call your health advisor first , do not just show up or go to the ER unless you feel deathly ill. Also wear a surgical mask to protect others from your potentially infected droplets. The mask will not protect you from others but will protect them from you.
    Fourth, as noted above, a perfectly fitted N-95 mask can probably protect you but they are seriously uncomfortable to wear for an extended period. It is critical to wash your hands immediately after removing the mask.

    • Quinn Norton says:

      I recently told someone who was thinking of wearing an n95 for a long flight that if it wasn’t horrible and uncomfortable the whole time, it wasn’t fitted well enough to be doing any good.

  24. FunnyDiva says:

    OK, here’s the latest from WA state.
    Press conference in Seattle this morning with Gov Inslee, King Co Exec Constantine, King Co Health Officer Dr. Jeff Duchin, Seattle Mayor Durkan, and Execs and Mayors from Pierce and Snohomish counties. King, Pierce and Snohomish are contiguous, and home to half the population of WA state. I hope the video of the press conference will be available at some point. Gov Inslee really was not having any “but how will you enforce it?” from the press: “This is a lawful order from the elected Governor” and he essentially said that if you don’t comply, vulnerable people like our grandpas and uncles or immune-compromised friends WILL DIE. “And I trust the citizens of WA to understand that and take it VERY seriously and do everything they can to protect other people, and to ‘flatten the curve’ so our hospitals can care for everyone who needs them.”
    though, yes, there are also legal implications, but through a complaint model, there won’t be Social Distancing Police roaming around measuring 6-foot distances…

    Anyway, some links
    https://www.governor.wa.gov/sites/default/files/20-07%20Coronavirus%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery

    https://publichealthinsider.com/2020/03/11/new-limits-on-large-gatherings-other-emergency-strategies-to-slow-the-spread-of-covid-19/

  25. Randy Vogel says:

    In the same tenor as Quinn’s original post: A doctor friend (who went through his training in SF during the HIV-crisis) that I talked to this morning mentioned fist-bump as ~5% as risky as a handshake, and elbow-bump as about 1% (it’s way harder to touch your face with your elbow). He then shared a story about doing rounds in an HIV ward (before it was known how that virus was spread), and how many of the employees greeted one another with a sort of hip-shimmy-bump: personal contact with less risk. Wash hands, wash hands, wash hands!

    • Jim White says:

      The closest I came to wanting to strangle someone when I was in grad school was when the bozo I shared an office with used the microtome in the lab next door to our group’s main lab (he was an MD-PhD student for the professor of that lab, not ours) to slice an eyeball from a deceased AIDS patient who had gone blind during the course of the disease. Think of a microtome as a lab version of a deli slicer but set to make slices so thin they can be looked at in the electron microscope. The virus hadn’t been identified at that point, so his actions were incredibly irresponsible since the lab was not even the lowest level of biocontainment outside of its tissue culture hoods. Granted, the microtome has a cabinet of sorts around it and is set at freezer temperatures, but still…

    • talislope says:

      Too late to help with your sleep but the secrecy MAY not be as bad as it sounds. I can imagine some classified briefings by political types discussing potential responses to the outbreak. You really don’t want to panic the public and perhaps there were discussions of information coming out of China (and elsewhere, perhaps Iran) that required protection of sources. It’s been my experience that there is a lot of seemingly evil information that is actually not classified while some little detail, that at first doesn’t seem important, is classified. But sources always must be protected.

      Not exactly my area of expertise but it would surprise me if more than a few medical scientists have clearance. So participants at meetings held in the SCIF may have known shit if they were discussing science topics. This aligns with information from a NY Times article today that indicated that Pence’s team hasn’t even had (accepted?) briefings from scientists running models predicting the spread of the virus.

      As a scientist, this makes me extremely angry! Top level political leaders are making decisions with apparently little guidance from science domain experts. Rather Kushner goes out and scrapes information from Facebook posts. G*d save us all.

  26. greengiant says:

    Outside of Hubei, China reports less than 120 dead of over 21,000 cases. Seattle recommended self isolation stay at home for those at risk a week ago on Wednesday. Traffic in Seattle and the Bay area is crazy light.
    Question will lock down light be enough to flatten the curve? Cause it appears what China did worked to great effect. Truth be told they test everyone coming into the country now, a barn door the US still has open.

    • it's complicated says:

      That barn door has sailed.
      Once you have community driven transmission, like in the US and Germany, closing borders to visitors from some or all countries doesn’t make a lot of sense apart from scoring political points, I fear.

      What you see in China now is what we might see in other places, too, once the horse there has been brought back to the barn. A second wave of containment at the border. We will have to see how that will play out.
      On another note, China is now in a position to try scoring points by offering help to Italy while the US does… precisely what?

      • Rayne says:

        No, closing borders as in halting air travel makes sense. This bug is not airborne like measles but can linger in the air in aerosol. It also hangs around on surfaces longer than expected, according to a new study published today (not peer reviewed).

        AP article
        Study (pdf)

        May explain why transmission rate seems higher than influenza.

        • Quinn Norton says:

          Air travel is not great, but with community transmission already in play I’m not sure grounding planes it does a lot to limit disease transmission. But it might cause some panic, which would be bad. It also might limit some supply chain logistics, and basically would doom a lot of transplant patients. On the other hand, there is danger to the people traveling, definitely. It’s a tough call to make.

          • Rayne says:

            And airlines and government can’t temporarily restrict air travel to accommodate freight, transplants, and humanitarian emergencies?

            It’s amazing how we tolerate banning people from traveling to the U.S. because they’re from Muslim-majority countries we don’t like or black from “shithole countries” but we can’t stop people from traveling from countries with known endemic disease. So much for national security.

            • Quinn Norton says:

              The thing is, the WHO doesn’t usually recommend it because it doesn’t work. Even the Chinese aren’t bothering with it, they’re just testing and tracking people coming it, and they’ve controlled backflow infections. Trying to close borders is consistently counter productive.

              One of the great things about air travel is that you can definitely figure out who came in and out, and track any contacts they’ve made. If desperate family members of pissed off business critters are dodging your shut down, and they always do, you can’t figure out if they’re carrying viruses.

              • Rayne says:

                And yet we did not need to send people to an obviously collapsed system in Italy, nor did we need to allow people from Italy back here without a coherent system of quarantine on arrival. The lack of such a system is why the virus is now pandemic.

                • Quinn Norton says:

                  it probably got to us well early of italy, at least on the west coast. and yes, we should be tracking travelers in. we should be checking people, asking them to isolate, tracking their condition for the first couple of weeks at least. but if we’d been doing contact tracing and containment we wouldn’t be in this mess now anyway.

    • greengiant says:

      They still had over 21,000 cases outside of Hubei. BUT LESS THAN 120 DEATHS.
      What are the factors in that success? They make 1.5 million tests a week. China controls its own mask and health care supply chain. They made a 15 minute test February 17th, and gave such a test to Italy. They are allowing incoming air travel but testing. And finding fewer cases in China than incoming. China quarantined Wuhan around January 21. Was China more effective in tracking down later case contact histories outside Hubei and practicing social distance or?

      Denmark 740 cases, population 5.46 million, Norway 598 cases, population 5.4 million, Sweden 500 cases population 10.1 million. Not as widespread as Hubei yet.

  27. orionATL says:

    i am curious about this:

    https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

    specifically, there are 938 cases of covid-19 as of today.

    this does not seem like very many for a nation with a population of 330 million, given that the first case was announced on jan 20:

    https://www.npr.org/2020/01/21/798252671/cdc-announces-first-u-s-case-of-new-coronavirus-in-washington-state

    this coming monday, mar 16 will be 8 weeks exactly from that announcement (but not from the date of that infection). have we seen the geometric changes in numbers infected that we would expect?

    is this indeed a slow start to an epidemic, or about what could be expected, or greater than expected?

    if it is a slow start could this be associated with conditions here such as the physical size of the nation, the fact that so many of us use autos to rather than bus, rail, or bike, or even weather?

    • harpie says:

      …both via Laura Rosen:
      1] https://twitter.com/ShimonPro/status/1237857167895457792
      5:45 PM · Mar 11, 2020

      In less than 24 hours over 200 new cases.

      There are at least 1209 cases of the novel coronavirus in the United States, according to the state and local health agencies, governments and the U.S. Centers for Disease Control and Prevention.

      2] https://twitter.com/drbarnard/status/1237857136069054469
      5:45 PM · Mar 11, 2020

      “the lack of evidence of widespread transmission in the country may be making people feel any aggressive step right now may be an overreaction. But this is precisely the time when public health measures of this sort can have an impact” /via @mlipsitch [link]

    • it's complicated says:

      I think there is yet another factor limiting the number of detected infections.
      The number of tests administered. Start testing in earnest, and the numbers will climb.

      We can all learn a lot from looking at what South Korea has done and what it is still doing.
      It is heartening to see because it shows that yes, you also have a chance in that struggle when you are a democratic country and have to respect civil liberties and handle stuff in a maximally transparent way.
      But it will involve a real fight and hardships.

      Disclosure: I’m not a Korean, just a German who is very worried about his own government’s slow response. I also have to say that I’m not trying to bash the US, but yes, I am even more worried about what will happen there. Good luck to everybody, and wash your hands!

      • Rugger9 says:

        I have mentioned this before, and it is borne out by the frequent tales of test denials reported here and elsewhere: the business strategy I would see as a QA manager is bearing it’s expected outcome. Remember it doesn’t fail until it is tested according to the MBA strategy.

        • P J Evans says:

          The only MBAs setting QA policies where I worked were people who got the degree after starting to work there. (The QA policies were sane. Mostly – I had to argue a couple of times where following the rules was going to f*ck things up down the road. Special situations happen.)

    • Rayne says:

      Don’t confuse *confirmed* cases reported by CDC with actual number of infections.

      Bedford Lab estimated ~600 cases in Washington state on March 1, with approx. ~1100 yesterday. Likely 2000-5000 this weekend in Washington state alone. A real EXPLOSION of cases would have happened if that huge comic con had not been cancelled for this week.

      There are a lot of cryptic cases walking around. Because Trump fucked up testing — yeah, I’m blaming that corrupt bastard — we don’t know when this will suddenly take off. Quite a few people were being monitored because they traveled from China or were on cruise ships, but exposures from other locations haven’t been tracked as aggressively.

    • orionATL says:

      thanks to everyone from harpie thru rayne. each comment adds an important piece to the puzzle.

      it sounds like the componding of infection is finally starting to show up.

      serious undertesting and questionable reporting are likely behind at least some, probably a great deal, of any “missing” numbers.

      and then there is the presidential muzzling of medical science experts like the national institutes of health’s highly experienced dr. anthony fauci who could be informing us of what can be done and what to expect, thereby reassuring us.

      what is happening is not incompetence; it is willful presidential malpractice.

  28. Yogarhythms says:

    Qn,
    Thank you. 10MAR20 QN posts FAQ Covid19 on EW. Here is latest CDC “Recommendations and Reports / February 14, 2020 / 69(1);1–11”
    Centers for Disease and Infectious Control is just a tad delayed. Quinn, I’m a working nurse in AZ and this blog is as informative as anything I’ve read and the humor is infectious. Please continue.

  29. orionATL says:

    re orion above @6:13

    there a very interesting tidbit if you read down in this article which cites a news report that the “official doctor of the congress and supreme court” is quoted as saying u. s. cases could number 70-150 million:

    https://www.theguardian.com/world/2020/mar/11/us-coronavirus-death-toll-states-total-cases

    that’s a big number, presumably from a classified briefing (why classified?). i have never seen any such number bruited before now. while imprecise, it certainly seems credible enough give the size of our population.

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