Survivors of Covid-19 show increased rate of psychiatric disorders

Here you have it. The bridge that may finally make people see that “mental” conditions are in fact physical and that it’s the mental health stigma that is bonkers.

(Also, could we be trying too hard to stamp out the human aspects of what it means to be human – to be alive – and turning people into perfect little robots? What would life be like if we never had ups and downs? At all? Btw, one guy – I won’t mention his name; he is a geologist – once told me that when he smoked cigarettes – not weed, but cigarettes – his ups were less high and his downs less low.)

https://www.theguardian.com/world/2020/aug/03/survivors-of-covid-19-show-increased-rate-of-psychiatric-disorders-study-finds

(31% of COVID-19 survivors suffer from depression. Read the article in The Guardian to find out what else plagues them. We already knew that psychosis is linked to COVID-19 as well. Psychosis is also linked to the recovering from physical brain trauma.)

SARS-CoV2, wastewater and seashores

A few months ago, someone in Florida sent me a link to a news item – I think it was from Yahoo News – in which a professor in California was warning people to stay away from the seashore as she was sure that they would get infected by the ocean surf there.

I dissected the article and had to dismiss it as panicky nonsense. It for example mentioned the rapid spread (in Wuhan) as an argument but Wuhan is nowhere near the sea and everything that was ascribed to marine spray could much more easily be explained through asymptomatic spread. The existence of the latter was not even mentioned in the item. I did not expect the virus to be able to play a big role in the marine environment on the basis of my very limited knowledge in this area.

Just now, I spotted an article written by Kristen Kusek, who I know from my time in Florida. She is now the communications director at the place where we both were into marine science, while she also pursued journalism at the Poynter Institute a bit further down the road.

USF’s College of Marine Science has started the first American program to look at the virus in wastewater. I had earlier heard about the virus having been detected in sewage in, I think, Venice.

https://www.usf.edu/marine-science/news/2020/usf-partner-in-costa-rica-launches-the-countrys-first-program-to-detect-coronavirus-in-wastewater.aspx

It is very important to keep in mind that the virus having been detected waste water (or anything else) DOES NOT MEAN THAT YOU CAN CATCH COVID-19 from it.

I also saw this:
https://coloradosun.com/2020/07/21/poop-early-coronavirus-warning-colorado-wastewater/

It was time for a quick update.

I found this:

https://www.sciencedirect.com/science/article/pii/S004313542030436X

At first glance, this seems to confirm my assessment. Good.

Here is more on the topic:

https://www.sciencedirect.com/science/article/pii/S004896972033151X

https://reader.elsevier.com/reader/sd/pii/S004313542030436X?token=01D96FD19564AA8CCAF293E95112CB80711556EDFB30B8701D6895EEEAECA0747FB112F019F2BDD2877DDAC55EE331B7

https://reader.elsevier.com/reader/sd/pii/S004896972033151X?token=7D077B4CFF621AF2C66AAE410611192580B09C4F7AFA638CD1CBE5BB26F6121305BABE2F25608A43C70A06F0D6BC74B0

https://www.sciencedirect.com/science/article/pii/S2666016420300049

As I live in an island city, with a stormwater sewage overflow to the east of us and a (treated) sewage outlet slightly to the east of that, along the seashore, such questions have local relevance. So far, nothing to worry about.

(Please note that this does not mean that the situation will stay this way, but at this point, there is nothing to indicate that it won’t. That’s okay. We have plenty on our plate as it is.)

Is the DVLA in chaos?

After I did some more googling after I posted the information below (beyond the more tag), I suddenly found this!

“To make it easier for drivers who need to update their photocard licence with a new photograph at the end of the 10 years validity, photocard driving licences that expire between 1 February 2020 and 31 August 2020 will be automatically extended for a period of 7 months from the date of expiry.”

How come DVLA on Twitter was not aware of this?

How come this information did not show up before or during the online renewal procedure?

And how come the post office was not aware of this either? My license got snipped with scissors and discarded and I was told that as of the next day, I would be breaking the law if I drove.

(For many people, their driving licence is their main ID.)

How come that apparently this information is not that easy to find on the web? (Failure to submit to the search engines at the time? But then, it is not that easy to find on the DVLA website either.

Was the information announced retroactively, such as on 4 June, perhaps? https://www.gov.uk/guidance/dvla-coronavirus-covid-19-update#history)

(By the way, it also explains why I didn’t get the renewal reminder. Sorry anonymous.)

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Why I am no longer talking about COVID-19

Simple.

I’ve found out just about everything that I wanted find out, for myself. The NAM/APHA webinars have also started to repeat themselves. I don’t think they already know everything there is to know about whether getting infected confers permanent immunity, but we’ll learn that in due course.

There is a massive effort underway to develop vaccines and treatments and the huge sums of money that are being pumped into it means that the development process is sped up immensely. I saw a graph last week that illustrated that very well.

I regret that animal models – proverbial “lab rats”- are still being used to test treatments and vaccines. A truly sophisticated society would have no need for that.

When I am in “scientist mode”, I tend to forget that me feeling that there is nothing left for me to contribute in this area – I mean, people have finally caught up on the droplet stuff and the purpose of wearing face coverings – is not necessarily true in a broader sense.

(I like being on the cutting edge of developments and like having momentum, so I have a tendency to transfer momentum to something else once the momentum in one area runs out. A very practical example of that is not getting bogged down by the various hiccups we experienced during the installation of an ICP-MS in a new lab, years ago. I couldn’t just sit down, wait and do nothing. It occasionally meant we were stuck. I transferred the momentum. I arranged for the lab’s Mac to get an upgrade. I had a different card installed which was also very useful, but the kind of thing that easily gets ignored when you have something much bigger in focus.)

There will still be people who I can help by translating some of the science into plain English, for example, or with whom I can walk through a building to identify bottlenecks with them and find solutions.

I could do this in a Skype, Zoom or Telegram video session or I could travel to places like Basingstoke, Littlehampton, Andover, Salisbury and Winchester.

One way of dealing with COVID-19 measures is to turn them into positive experiences. What do I mean by that? Supermarkets and other places are already supplying hand sanitizer etc. If you have a long waiting line, why not get a busker to entertain people? Not all the time, but say, between five and six every day. This could be any kind of busker, does not have to be a musician. Someone to entertain your customers and put a smile on their faces.

You don’t catch COVID-19 from smiling. 

Worse, I’ve been dreading the end of lockdown measures because during the strict lockdown, people were much friendlier and much more considerate. The occasional jackass who pretended there was no line quickly got sent to the end of the line and his loud muttering ignored by everyone who was waiting to be allowed into the supermarket. Aggressive behaviours were suddenly not done. Bliss!

Let’s keep some of that, shall we? 

Supermarkets could also have a few umbrellas to hand out to people standing in line in the rain. (Yes, disinfection needed.)

I also remind people that cleaning is not needed of any surfaces that go unused for 7 days or longer. So instead of cleaning, in some cases, you may be able to set up a rotation system, with for example objects being used by one (different) person only each day and different objects for each of the 5, 6 or 7 days of the week that get stored for a week. In some cases, in which cleaning might be complicated or simply too much work, this may be a solution.

This could be a solution for libraries, for example, to allow limited lending again. It is hard to clean books swiftly without damaging them. Patrons would not get access to the lending materials, but staff would instead collect items from the shelves and hand them over. Any materials that are returned can be left on a cart for a week to be returned to the shelf without risk to staff after that week.

 

Excellent COVID-19 resource for decisionmakers at various levels

I started attending various webinars some time ago, like lots of people, and like lots of people, I also got a little webinar fatigue at times.

A great series continues to be organised by the National Academy of Medicine and the American Public Health Association in the US, looking into many topics such as the science of the virus, finding vaccines, health inequalities and so on.

Today’s session, on mitigating direct and indirect impacts in the coming months, was excellent for decisionmakers at all levels – also in the UK! – because it addressed a lot of practical aspects and many angles of the pandemic.

It mentioned the need to provide free wifi, talked about telehealth (telemedicine) and developments expected to take a decade suddenly being realised in a mere three weeks, about the complications food deserts pose, about the politicizing of the pandemic, about how to cope with emergencies such as hurricanes and related evacuations, how to remedy the impact the pandemic is having on non-Covid-related healthcare (such as people with heart attacks not seeking help out of fear of catching the virus), the healthcare clinics getting into financial difficulties as a result (as, I think, we saw earlier with those two doctors in California who owned a small chain of facilities and saw their turnover drop so dramatically that they resorted to unorthodox action), the challenge and need to communicate well and perhaps have ambassadors explain the purpose and reasoning behind social distancing, the massive impact social distancing has on the infection rate and the risk of people that people will no longer observe distancing when lockdowns are relaxed and developing a false sense of safety, and so on and so forth.

Here is a link for a model (simulator) that people can play with to explore the effects of lifting lockdowns: https://budgetmodel.wharton.upenn.edu/

The video recording of the webinar will be online soon, at covid19conversations.org:
https://covid19conversations.org/webinars/summer.

The slides have already been uploaded, but not all presenters used slides and the Q&A of course is not online yet either. I’ll post the unedited transcript below.

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Whoa

Greece: 150 deaths
Population: 10.5 million

The Netherlands: over 5,000 deaths
Population: over 17 million

Canada: almost 5,000 deaths
Population: almost 38 million

UK: over 30,000 deaths
Population: 63 million

Vietnam: 0 deaths
Population: 97 million

US: over 75,000 deaths
Population: almost 329 million

Conclusion: Important lessons to be learned and applied. Because these differences cannot be explained – although some might wish – by some of these countries’ populations being in better health.

I should add population density next.

COVID-19: What’s next?

This is a short video I created for Twitter, without intro as Twitter videos have to be short. I’ll make a longer one and a few short ones after this one. There is much more to this topic.

The person talking about dialing up and dialing down any measures taken to halt the spread of COVID-19 and who believes that this should be done on a relatively small scale (and not mandatory but in the form of a recommendation) is Lindsay Wiley, by the way. (Who was very patient with me when I kept asking strange questions, I should add. A little bit too patient perhaps… She’s much more a legal scholar than an epidemiologist, I realised later when I looked into her. That may explain a lot.)

 

 

I can see what she means and why it might be needed – we’ve just seen Hokkaido dial measures up again after the infection numbers went up – but if you do this country-wide or island-wide as in the case of Hokkaido, it’s a very different story than if you do it regionally.

Regionally, though, has been the approach in the US so far as far as I can tell. I don’t know whether that has led to any problems with people travelling from a location with no or limited restrictions to a location with strict measures. County borders, state borders, city borders.

People have been protesting against various measures – unfortunately partly inspired by the hogwash spread by two doctors in California who would lose their licences if it were up to me – but these protests make bigger headlines than the news about Americans who have been defying their governor who eased or lifted a lockdown.

(And if you keep people in a lockdown too long, their physical health will start to decline because their lives have become so much more static, particularly for people who live in small apartments. That might make them more susceptible to COVID-19. When does that effect start to kick in and make a real difference? After two months? Three?)

What I don’t know is how it would work out longer-term if you were to dial up and dial down measures regionally or locally.

Would it cause chaos, such as when someone has a job interview or a project planned for which he or she needs to be in Chicago and then all of a sudden, the recommendation changes?

If it is not mandatory, then how effective would such measures be? Effective enough, presumably, as this is the approach that’s most strongly endorsed by expert panels in pre-pandemic plans/studies, so I understand.

If such measures are not mandatory and you have a job interview, then not many people are involved and the situation can be resolved.

But for anything involving more people – say, a large company – it may be tricky. If the company does not follow the recommendations, it may be sued by its staff. If the company does follow the recommendations, it may be sued by its clients.

Imagine having to construct a hotel for a famous real estate mogul and not showing up because the recommendation for the location in question has changed (been dialed up). Or having to install new computers and networks for a bank or a call center.

(There is also the question of how you would keep people informed. I think it could be part of the weather predictions, just like UV radiation and pollen counts are. If you travel, you usually check the weather at your destination before you travel or on the way.)

If, on the other hand, you limit people to traveling within their own city or county or state, you cause fewer problems for people who normally never travel beyond those geographical borders.

But how would you ensure that people would do that? If it costs them their job if they follow the recommendation or if their job is ten miles away but in a different county, how likely are they to follow that recommendation?

Then you might have spreading from the borders of your geographical area, inward, if the neighboring counties have a higher rate of infection. Do you use travel permits?

Do you test everyone within a certain distance of such a geographical border to identify new cases and quickly isolate them?

From a purely epidemiological point of view, it probably all makes perfect sense.

Does it also make sense from a practical point of view? That’s less easy to figure out. What does small-scale dialing up and down of measures mean for Joe and Jamie Public when they get up in the morning and prepare to take their kids to school? I can’t get a clear response to that question.

Besides, there also is a strong cultural angle to this. In some countries, citizens will be more likely to follow recommendations than in others, I’ve noticed. Socioeconomic aspects – level of inequality – as I’ve mentioned, play a role as well.

I have to conclude that the experts don’t have all the answers yet either. The experience is new for almost all of us, with the exception of people in parts of Asia that have gone through MERS and through SARS aka SARS-CoV-1.

The previous whopper of a pandemic we had occurred a century ago, after all (Spanish flu). Even the Hong Kong flu that hit around 1968 happened too long ago to be able to translate that experience into the way we are living now. In those days, most women in my home country stayed at home all the time anyway because they were home makers, for example.

But that’s for the here and now and short term. How about the longer term?

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Hang on to your umbrella against COVID-19

Two doctors in California have been telling everyone that COVID-19 is not a problem at all, that they have tested lots of people and that most had the virus and that many were not ill.

But they were testing people who were screened and suspected of having the virus. It means that there are many more people out there that do not have the virus yet (and preferably should not get it either). I could say a lot more about these two doctors, but I won’t.

I also see a lot of confusion about what is called the prevention paradox. If you prevent something bad, some people will stop believing that it exists (or think it’s not actually that bad).

That’s like noticing that using an umbrella stops you from getting wet and then concluding that there is no rain.

That Kern County Dr Erickson who talks about COVID-19 on YouTube

Update 3 May 2020: YouTube has meanwhile removed the two doctors’ “presser”. YouTube also sometimes deletes videos and channels when it shouldn’t. This time, I am very pleased that it did.

To my dismay, I had also received these doctors’ rubbish as news in an email a few days after I posted the stuff below. (If you subscribe to news media other people follow, people whose views may not overlap with your own, you get a much better idea of what is out there, what people outside of your own circles are thinking.) So I emailed them.

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COVID-19 resources at US National Academy of Sciences and elsewhere:

First of all, here are two living documents elsewhere:

https://rega.kuleuven.be/if/pdf_corona

https://covid19treatmentguidelines.nih.gov/

Here are some resources at the US National Academy of Sciences:

https://t.co/ezodPowbg6 (lab testing)
https://t.co/QHR4Gjborg (effectiveness of fabric masks)
https://t.co/iDArCYuk99 (viral shedding)
https://t.co/19VZuy0Oz5 (effects of temperature etc)
https://t.co/djGokzK7Eg (bioaerosol spread)
https://t.co/pwmYVxfX38 (stability on surfaces)

Apprentice Johnson, you are fired!

“Ministers declare the NHS Nightingale project a great success”, but staff tell The Independent’s health correspondent Shaun Lintern they want to do more – and they fear prominent PR is not helping.”

We’ve now also had the cheerful optimism beyond what is medically rational about a delayed shipment of gear from Turkey to protect frontline NHS staff against corona virus that apparently contained only 32,000 gowns. Worth several hours of protection.

And now US President Donald Trump has suggested injecting disinfectant may be a good treatment for COVID-19 patients.

With Boris Johnson sharing the optimism of Trump and wanting to cooperate with him closely on tackling the corona virus crisis, we should all be afraid, very afraid.

In spite of having all the information that was coming from China, the UK took TWICE AS LONG to respond effectively than China. Because on 3 February 2020, ten days after the lock-down began in Wuhan, Boris Johnson declared very loudly that he did not feel a need to respond strongly and swiftly to the virus. He said that imposing a lock-down went “beyond what is medically rational”.

Apprentice Johnson, you are fired!

The corona virus crisis: My message to the police in the UK

In this video, I ask British police to be understanding toward us when enforcing the social distancing rules because, in spite of the fact that the lock-down resembles being imprisoned to some degree, we haven’t actually done anything wrong.

Police officers should also comply with the rules themselves.

Why governments in the west have responded the way they have

A friend of mine in Florida responded that she had really enjoyed listening to this. That is a great compliment, coming from her. She is a microbiologist who used to work at the HRS Sarasota County Public Health Unit (now retired). I remember a fierce discussion we had when I was setting up some lab experiments of my own and wanted to add a guaranteed abiotic control.

Disaster and emergency planning

Did western governments really have no plans to deal with this emergency at all?

GCHQ. Source: Wikipedia.

Yet we regularly hear about bioterrorism threats… Should I conclude that there is not really such a massive threat – no, not really – because if there was, there would have been plans in place? Was it only used to gain votes by scaring voters?

I am ASTONISHED that there seems to have been zero preparedness for dealing with events like this new corona virus.

Not only do too many politicians appear to have assumed that the Chinese (and the people in other Asian countries) were being stupid… They had no scripts and had no information on the shelves to tell the public about what was going on.

While corona viruses don’t all behave the exact same way and some facts only become clear after a while, governments could have given clear general information about how corona viruses tend to spread.

Instead we heard:

  • “Wash your hands.” So these viruses are excreted by hands, perhaps from fingertips or from sweaty hands? (No!) It’s bound to have made many people assume that as long as they were washing their hands or wearing gloves, they couldn’t get or transmit the virus.
  • “I’ve just been to a hospital that had several corona virus patients and I shook hands with all of them.” (Said by Boris Johnson at a press conference on 3 March 2020.) So people are just being silly, there is no real health danger, and the Chinese are overreacting and being stupid?
  • “Be wary of people who cough. Or sneeze.” But talking and laughing spread these droplets as well! This is general, very basic knowledge. It was not available??? Really???
  • “Stay inside.” This must have caused confusion all over because now it sounds like it’s something in the air, maybe like radioactivity. Or air pollution. (Or maybe something that only posh people who exa-cise get?)

What the hell is the public supposed to think and do on the basis of all this?

Clear general information could have been provided, with a note that more details would be added later.

We didn’t know, for example, whether our pets could become ill as well, whether they could spread the virus too. If so, might it be only dogs? Or cats too, or both? We didn’t have that kind of detail yet.

But we did have the kind of detail that said: IT IS SPREAD FROM HUMAN TO HUMAN because that was clear enough to conclude from what was happening in China. COVID-19 is caused by a corona virus, so it was likely to spread like other corona viruses like the flu and the common cold. We know how they spread among us.

And, with hindsight, I say: It seemed to be highly infectious, so the possibility that asymptomatic people were spreading the virus too should have been identified early on.

(Instead, we in the west must have assumed that Asians were just being really really stupid and coughing and spitting in each other’s faces?)

I was and remain quite flabbergasted to see that my own information which was mostly pulled out of my hat (head) and from the internet has been much more complete and accurate – earlier – than what the western world’s leaders had. How on earth can this be???

A long time ago, I was a member of the American Society for Microbiology (ASM), for about ten years, but I certainly do not consider myself a microbiologist or virologist. I know very little. I consider myself completely out of touch these days.

So how come I – with near-zero financial resources and no staff – appear to know and understand so much more than the western’s world’s top leaders?

Last night, I saw an American governor (Georgia’s Brian Kemp) state that he had no idea – until yesterday – that asymptomatic people can spread the virus. I’ve known that for what feels like weeks. Ten days? Two weeks?

I also note that many Asian countries have actually been doing well relative to the west, in spite of all the blaming that some politicians are doing. China is sending medical teams to help all over the world, also to the UK.

Taiwan continues to be dismissed and excluded (by the WHO; no exchange of information is formally taking place). Taiwan learned a heck of a lot from SARS (also called SARS-CoV or SARS-CoV-1) in 2002-2004 and it remembered and applied those lessons.

In theory, we in the west had access to that information too. We saw what happened in Taiwan back then, didn’t we?

Is it the decision-making that takes too long? But that too would point in the direction of a lack of preparedness.

People!

We need to change a few more things than starting to respect non-human animals more so that we stop making ourselves ill with diseases that come from what is essentially animal abuse.

The lock-down in Wuhan, China started on 23 January 2020… And the west knew about it.

There are lessons to be learned, on all sides.

It seems weird to be saying all that from the sidelines.

https://www.theguardian.com/world/2020/mar/23/how-coronavirus-advice-from-boris-johnson-has-changed

But this here, this too, seems to be saying that leadership is “not done”:

“Coronavirus: US Navy removes Captain Brett Crozier who raised alarm”

“The commander of the USS Theodore Roosevelt has been removed after saying the US Navy was not doing enough to halt a coronavirus outbreak on board the aircraft carrier.”

 

Why are British police officers considered immune?

One of the strangest things about the corona virus crisis is that police officers do not apply distancing, do not wear masks, do not use sanitising gel or gloves and behave as if police officers are 100% immune.

That is, if they are modifying their behaviours to take the infection risk into account with regard to themselves (and us), then I haven’t seen a shred of evidence of it yet.

(photo not related to corona virus situation)

Not only does it put them at risk, and us, it also creates inadvertent resentment, particularly if you combine it with some of the overzealous activity we saw until somebody told them to stop doing that. (Except, then they tackled Marie Dinou and locked her up for two days: https://www.independent.co.uk/news/uk/crime/coronavirus-fine-police-lockdown-travel-newcastle-marie-dinou-a9444186.html)

When I see photos of cops standing around as if nothing has changed, I automatically feel anger welling up in me.

It comes out of nowhere.

I think it’s because them standing around pretending they are immune while were stuck in our homes, often living in limited conditions as a result, feels thoroughly unfair.

Plus it somehow makes it feel as if they are our jailers.

We’ve done nothing wrong.

So that makes it feel doubly unfair and that can create resentment.

These are two strong arguments for changing this:
– For health reasons (to protect the officers too);
– To prevent resentment from citizens down the line.

Because if we end up being stuck in our homes for many more weeks or months down the line, many people may become increasingly frustrated.

Solidarity helps. We are all in this together. Police officers are NOT immune against the virus.

How to wear a face mask in combination with glasses

Many more of us will soon be wearing simple face masks, in view of this https://www.bbc.co.uk/news/science-environment-52126735

When we wear them, it help protect others.

I happened to have some left from a DIY job. When I first tried mine on, my glasses – for distance – fogged up completely.

I searched the web on the problem and fiddled a bit and discovered that in my case, I need to let the glasses rest on the metal strip instead of on the bridge of my nose, so at a slightly greater distance, but that works fine.

(Yes, my glasses are very old. Does it show?)

Low trust in UK government: Debunking needed

Note: this is about right now. This is not to say that I applaud this government and its approach, not at all.

The UK government has lied a lot in the past ten years and also often sucks at communicating well. That is causing some problems now, I noticed on Twitter.

There are 12,000 ventilators” followed by “8,000 within the NHS” does not by definition mean that the government is lying but may mean that its communication skills are not up to par.

It could mean:

  • 4,000 on the way to the NHS;
  • 4,000 within the Navy, Army, Air Force, private facilities and also some on the way to the NHS;
  • etc.

Something similar is going on with COVID-19 tests and reagents. It is very hard to find info in the UK as it is a low-transparency country. (I for example found detailed information about a local water treatment facility (Budd’s Farm) in the Netherlands some years ago, but was unable to find much about it in the UK.)

I looked into it, found some info on the CDC site, spotted the name Roche, and remembered something I had read in the Dutch news. The Netherlands is much more transparent than the UK, so I looked into that angle.

It may also be helpful to keep in mind that the Netherlands is a highly egalitarian country. A lot of the wheeling and dealing that goes on in the UK would not be permitted in the Netherlands. (I am not saying that none goes on there.)

Roche makes a lot of the equipment needed for the tests and that equipment requires certain chemicals to run. Roche also manufactures the required lysis buffer and was briefly not able to keep up with global demand.

It initially was not willing to share the secret “recipe” either. It did later release it after all, but it is actually not that easy to make so it cannot simply be made by anyone and has to involve certification of the labs who make the stuff. Roche currently is able to keep up with demand again, so I understand.

In addition, the Dutch health minister, too, mentioned shortages in other test-related materials on 27 March.

(The UK government specifically mentioned a shortage of swabs.)

Main source (a reliable Dutch newspaper): https://www.trouw.nl/zorg/farmaceut-roche-deelt-toch-het-recept-voor-coronatests~bdb6a844/

I am assuming that the UK is using the same test as the Netherlands or a very similar test (which is also likely the same as the US is using). (I have a report – collection of international information – from a Belgian university in my pc that probably has details on that; I will see what it says and add that info later.)

Conclusion: The UK government for once appears to be NOT LYING.

The information given by the UK government appears to match the information available in the Netherlands.

(The – possibly inadvertent – spin in the UK currently appears to be coming from… Labour?, I say tentatively, on the basis of the tweets that I saw.)

(As I have posted some tweets from Tory MPs in the past, I should also do it with tweets from other MPs. I have no idea what was said during Newsnight)


From the “living paper” report in my pc (“Overview of information available to support the development of medical countermeasures and interventions against COVID-19” by Martine Denis, Valerie Vandeweerd, Diane Van der Vliet, version 23 March 2020):

“Testing methods
A list of assays commercially available for diagnosis of COVID-19 is updated by FIND (https://www.finddx.org/covid-19/). Assays that are still in development stage are also presented.”

The report has a lot more information on testing, but does not state details on which country is using which tests and protocols. If you click on the above link, however, you’ll find a lot of information that indicates that Covid-19 testing requires rigid procedures to be able to work. In other words, ramping up capacity is likely not as simple as some MPs think it is.

(For comparison: You wouldn’t want a sloppy pregnancy test that is often wrong either.)

Why is the ICU survival rate so low in England, Wales and Northern Ireland?

Why is the ICU survival rate for Covid-19 patients so low in England, Wales and Northern Ireland?

It’s been reported as 50%, here: https://www.theguardian.com/society/2020/mar/28/coronavirus-intensive-care-uk-patients-50-per-cent-survival-rate

Note that this article was amended on 30 March, saying that it may not be accurate, however.

Dr. David Price at the Weill Cornell Medical Center in New York City – which currently takes in almost exclusively Covid-19 patients – reported a week ago that the majority of the ICU patients there get to go home, here:
https://vimeo.com/399733860

If accurate, what does the difference reflect?

  1. The difference in socio-economics between these three countries in the UK (extensive poverty) on the one hand and NYC on the other hand?
  2. That only the most serious cases are going to the ICU over here?
  3. A higher level of specialization at that hospital in New York? (Better doctors or better practices at the hospital as it is a university hospital?)
  4. Dr. Price not having the actual numbers for his hospital?
  5. Does that hospital only treat patients from a certain segment of the population, and do they tend to be fitter and better-nourished?
  6. Something else? If so, what?

Let’s take a closer look at what the Weill Cornell Medical Center is.

Reason number 3 is my guess. Possibly in combination with reason number 5.

I looked at the insurance packages but I don’t know enough about how this works to be able to assess it.

If it’s only reason number 3 that causes the difference, then theoretically, there is room for improvement over here as the standards, theoretically, could be raised.

But we all know what’s been happening in the past 10 years of Tory reign and so there likely is no room at the moment. Or am I being too biased now?

As we just had a team of Chinese medical specialist arrive in the UK, it still looks like reason number 3 may be the main reason. That we don’t know enough and  that we can still raise our standards. That would be good news, then.

https://platform.twitter.com/widgets.js

(Tweet has video.)

China also sent such teams to Italy and Iraq and maybe even more countries.

And then there is this (from 9 hours ago):
https://www.bbc.co.uk/news/av/world-us-canada-52066105/coronavirus-us-death-rates-v-china-italy-and-south-korea

“The US has seen its cases spike dramatically in recent days and these graphs show what could be in store.”

So it’s also possible that the Weill Cornell Medical Center was still in the beginning of the developments at the time, that it had not seen the worst cases yet.

And also, while the death rates in other countries have slowed down, the death rate in the US sped up. So for some reason, the death rate may have been slower there at first.

Of course, every number has to be followed by “that we know of” because some countries do a lot more testing, which means that in some countries, many mild cases go undetected and aren’t counted, which could make their death rate look higher.

Covid-19-related deaths of people who weren’t tested likely don’t count either, so countries that are finding a lot of the deceased at home may only appear to have a lower death rate.

Note that “death rate” is not the same as “ICU survival rate”.

This was followed by this, a few hours later:

https://www.theguardian.com/world/2020/mar/31/england-and-wales-coronavirus-death-toll-40-higher-than-previously-stated

One in four deaths are occurring at home, it said, and England and Wales initially had not counted those deaths.

How can we support supermarket staff? Etc

Yesterday, I read on Twitter that a guy made someone at a Coop checkout burst into tears just because he thanked the person.

On Friday, the initial flash of emotion on the person’s face surprised me when I said “Stay well” to someone at a reception desk somewhere else. That too made me think few people had been expressing concerns for the people behind that counter.

I am often not great at it either.

Earlier this week, at Aldi, I thought I saw some tension in the person at the checkout, not surprisingly. I wish I could do something about that. When I got home, I noticed that one of the products I had bought had some substance on them and it took me a while to realize that the person at the checkout likely had been using a lot of hand sanitizer.

Although that helps, I don’t think it is enough and there is also the important task of doing things for the sole purpose of reassuring staff (making them feel protected) to help keep their stress levels down.

It kept bothering me.

I looked into what was happening in the Netherlands and read that screens had been placed around some checkout counters at DIY stores, though I haven’t been able to find any photos of it yet. Possibly, this was done to maintain the recommended distance (which protects people against this spray of tiny droplets of saliva when we speak).

(Update: When I looked into it some more just now, I saw that the Albert Heijn supermarket chain will be placing acrylic screens.)(Not sure if this is for the entire chain.)

(Update: I also found a video of a Dutch DIY store placing screens and staff saying they are really happy about that: https://www.nhnieuws.nl/nieuws/264087/spuugsschotten-moeten-caissieres-wormerveer-tegen-het-coronavirus-beschermen)

I think that placing any kind of larger screen around the people operating the checkouts might go a long way toward keeping their stress levels down. (In some supermarkets, the distance between them and the customers is smaller than at others.)

Such a screen could be acrylic (or wood or maybe even cardboard, with a small opening that might be covered with plastic, but even not covering it up but having a screen should already help protect checkout staff somewhat from the teenie tiny small droplets that fly from our mouths when we speak).

Having them wear gloves that they discard during breaks, into bins that have bags in them (liners) and then using new ones might be good but they’d go through a lot of gloves that way. But it would work as a physical reminder for them to stop them from touching their faces, which happens so automatically. (I too constantly catch myself doing things I know I shouldn’t be doing.)

Signs at counters – such as at Royal Mail – need to be at face height for standing people because we look at people first and only notice signs placed on the counter later. (But the signs on the counter may need to stay in place, too, for anyone who uses a wheelchair or mobility scooter.)

If you are working checkouts, also consider doing anything that stops your hair from falling into your face if you’d then automatically would want to push the hair out of your face – and touch your face at the same time.

And if you go to the supermarket, don’t use cash to pay if you can help it so that the cashiers don’t need to touch money.

To help protect supermarket staff. To help make them feel safer.

After customers leave the supermarket, they too should take care and for instance wash hands when they get home, but they’re already doing that, I am sure.

Regular cleaning of the self-checkout tills – to protect staff – is needed as well, but I am sure that that is already being done.

Particularly key people (management, local government) have to start doing things that will feel like total paranoia to them to protect themselves because so many people rely on them in so many ways.

Government officials and key managers may want to look into n-acetyl cysteine and assess whether it might help keep them maintain more functionality should they become infected, even though there are no data on this yet. See for example:
https://www.sciencedirect.com/science/article/abs/pii/S0882401017300505

While I am typing this, it feels like I am exaggerating, being totally over the top, but I only need to remind myself of Northern Italy to realise… no, I am not and the only thing that seems to have been able to stop (which may be merely “slow it down enough”?) the virus is to shut down all contact, the way it happened in China. (What that means for the long term is hard to tell. Delayed peaks, the virus coming back later and all that.)

Yes, I am bored as I have nothing else to do (which goes with my life in England at just about any time) and I like looking for solutions. And, also, I am furious about the weather gods having dropped the temperatures. At least it’s sunny. That’s something.

 

 

If you do catch the Covid-19 virus

For those of you who catch it and may be short of breath:

  • Drink coffee. Caffeine is a bronchodilator that works for a few hours. It can help you a little bit and make you feel more comfortable.
  • Patting your ribcage – percussion therapy – can help you loosen up mucus and get rid of it. It’s called “coupage” in the veterinary sciences. (Thanks, J. It helps a lot.)
  • Listen to your body. Sleep on the side of your body that your body tells you to sleep on, which will likely be on the right or on your belly. 

How do I know this?

I caught viral pneumonia in 2017, or rather, it caught me. There was a virus at the end of 2016/start of 2017 that even forced the British Queen to take it easy for a while.

I noticed at some point that the people around me seemed to be recovering whereas I was not really getting better and had very little energy. It puzzled me. I ran a fever of up to 38.6 degrees C and it was only when I read in an online newspaper that you weren’t supposed to be running a fever with this thing that I realized that I was probably “developing complications”.

One evening, I noticed that I became antsy very soon when I was on my left side and turned around to sleep on my right side. It may have been the following morning when I woke up with sharp pains in my ribcage (in my side, only on the right).

In hindsight, it was as if my body was thinking to itself and tried to say to me “No no no no! There is something going on in the right lung and I don’t want whatever it is to get the chance to end up in the left lung.” Weird? No.

24 March 2020: It’s meanwhile dawned on me that my body was probably (also) telling me that sleeping on my right side made it easier for me to get more oxygen.
Try to sleep on your belly if you find that you’re now constantly waking up. Sleeping on your belly gives your lungs more room to work. It is called “prone position”.

The brain gets lots of input from all over the body. We’re just not consciously aware of it. Sometimes, the brain tries to convey a “warning” to our consciousness via physical signals that we’re not really aware of either. I mean, what does “I became very antsy” mean? I don’t know. For whatever reason, I just really did not want to sleep on my left side. I had no idea at that point that something was going on in my right lung. (My respiratory system has always been my weak spot. I suspect I may have some scarring in that lung from previous colds or something like that. I have meanwhile learned that I always have to work at helping that lung stay clear. It is like brushing your teeth.)

Thanks to the internet, I knew what to look out for and my case proceeded by the book. There was little if anything my GP could have done unless I developed a bacterial infection on top of it, but that did not happen. (Your temperature will usually be a good guideline.)

Now, this Covid-19 thing is new and I don’t want to compare what I had to this new disease, but I did learn from what I had back then.

I felt that I should share it. This new disease is causing a lot of uncertainty and makes people feel that they have no control.

I’ve read that this is why people are stockpiling. Because it is something that they can do. Makes sense to me.

I figured that sharing what I learned in 2017 might also give some people a feeling of control.

Why did I get pneumonia?
It appears that notably or perhaps only my right lung has a tendency to fill up with goo. That makes you vulnerable to pneumonia.

(I’d had a slowly increasing lung problem for years, with my body not even always getting enough oxygen; I had noticed minor changes to the tips of my toes, was often tired and my bloodwork was very slightly off, among other things. The pneumonia helped me identify and put a lid on a few things. I found out that I am slightly allergic to wheat, for example. It irritates my throat, among other things, but it depends on the state that the wheat proteins are in. The flour on flour-dusted bread is particularly bad for me – I have to remove it – and some really yummy breads make my throat scratchy. Overall, I avoid bread. I’d started avoiding bread decades ago and ate mainly rye crackers, but circumstances can sometimes cause you to eat more wheat. Wheat allergies can also cause an asthmatic response. I also seem to respond to barley, perhaps even more. If you seem to prefer rice beers over wheat beers, that may be because you’ve subconsciously learned that wheat is not so good for you if you’re allergic to it. Budweiser, for example, has a lot less wheat in it than some other beers. Many people who have hay fever also respond to wheat etc; that response is mostly restricted to the mouth and throat area and the sinuses etc.)

Eye drops like latanoprost can also have a pronounced effect on the lungs (in spite of the fact that perhaps notably older male ophthalmologists are perfectly happy with ignoring this) and can for instance cause a chronic bad cough.

What can YOU do for your lungs?
1. Aerobic exercise. When I am extremely stationary for a few days, it throws me back because it makes it harder for my lungs to empty. (I later started taking n-acetyl cysteine, which helps me a lot because it thins the mucus and also helps calm down inflamed tissues, but if you don’t have a lung problem, don’t worry about that.)
2. Avoid foods that give you heartburn. You may not notice it at all, but it can cause a lot of irritation and slime production in your esophagus and all that can end up in your trachea. Take MaaloxPlus if you have to or to find out whether you might have this problem with acid reflux/heartburn. (It’s also sometimes called having a hole in your diaphragm or something like that, but you don’t really have a hole in your diaphragm, lol.) Exercising is also good for heartburn because it helps your digestion.
3. Take care to avoid foods that cause allergies. Those too may cause some irritation in your esophagus. They can also cause some swelling in your throat which can make it easier for bits of food and beverages to go down the wrong way, perhaps also caused by excess mucus (slippery slime).
4. Hint: If you sometimes have vague problems swallowing vitamin pills and so on, that may be because of some minor swelling (due to allergies/acid reflux) in that throat area, which could be due to such an allergy. Do you sometimes end up with weird “bumps” on the skin inside your mouth after you eat something? Well, that too could be a hint. And if it happens in your mouth, it likely also happens in your throat, right?
5. Stop smoking.

Percussion therapy (coupage)
This was a tip I got from a friend. It means clapping or patting hard on your rib cage with a cupped/flat hand to help loosen mucus. It works very well. If you do this regularly, you’ll get the hang of it and may even be able to hear whether your lungs are clear or not and you can also often feel the effect in your trachea. If you do this after you get out of the shower (the humidity of the shower is likely to help), then perhaps also blow out air very gently over a long period through pursed lips (akin to blowing long notes/tones on woodwinds), you may find yourself coughing up some goo, telling you that it’s working. Do it three times per day or so. See how it goes. You’ll learn.

Recovery during and after pneumonia
Yes, the pneumonia knocked me out for some time, as anything lung-related tends to do. (Lung-related problems can also make you very cranky because they make it hard/er for your entire body to function well.) Walking shorter to longer distances was hard for a while. When I started to feel better again and started sending myself on walks, I still would sometimes have to pause along the way. (I also used that as a gauge for how I was doing.) I’d sit down if I could or simply stopped and pretended to be busy with my phone for a little while. That was enough.

Already in an earlier stage, pneumonia means that you have to learn to pace yourself. You may have to learn to be gentle on yourself, be patient with yourself. Look after yourself well. Eat well. Nutritious food. Sleep lots, too.

Sleep whenever you feel like sleeping. Listen to your body. I sure slept a heck of a lot and kept needing to take daytime naps for a while.

Please note that I am not saying that you shouldn’t contact your GP or the like! By no means! But before your GP or another medical professional can assist you, there may already be little things that you can do for yourself and that you can continue to do afterwards, too.

For example, if you notice that you’re short of breath in the morning and usually have tea or orange juice in the morning, have coffee instead. It can help ease you into the day a little bit more gently.

These little things can really make a difference and are harmless in themselves (unless, for example, you have some kind of condition that means that you cannot sleep on your right side).

Fingers crossed. Most people who catch the virus seem to be barely affected by it.

Fingers crossed for everyone, also for everyone who does end up in intensive care, of course.

 

PS
No, my GP still doesn’t know. In case you wonder. I’ll tell them if I ever need to because of medical circumstances. I did contact them via the website when I found out that I was not supposed to be having a fever; didn’t hear back, likely because they had just been taken over by a large firm, but I was not worried and as it turned out, had no reason to worry either.

Disclaimer: I am not a medical professional.