April 21, 2020

High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 (HOPKINS SENT AND INCLUDES CHINESE C-19 STUDIES-NEW)

“… suggesting a much faster rate of spread than initially measured. This finding would have important implications for forecasting epidemic trajectories and the effect on healthcare systems as well as for evaluating the effectiveness of intervention strategies.

“How contagious SARS-CoV-2 is in other countries remains to be seen. Given the rapid rate of spread as seen in current outbreaks in Europe, we need to be aware of the difficulty of controlling SARS-CoV-2 once it establishes sustained human-to-human transmission in a new population (20). Our results suggest that a combination of control measures, including early and active surveillance, quarantine, and especially strong social distancing efforts, are needed to slow down or stop the spread of the virus. If these measures are not implemented early and strongly, the virus has the potential to spread rapidly and infect a large fraction of the population, overwhelming healthcare systems. Fortunately, the decline in newly confirmed cases in China and South Korea in March 2020 and the stably low incidences in Taiwan, Hong Kong, and Singapore strongly suggest that the spread of the virus can be contained with early and appropriate measures.”

(JHarris-note there is still active disease in all of the above countries and public health measures are still being dictated and followed) 


The Infection That’s Silently Killing Coronavirus Patients   

“There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.

“These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?

“To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition.

‘We are only just beginning to understand why this is so. The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath.”

(JHarris: C-19 Pneumonia is different from what most doctors and patients are familiar with as described above. This whole article is readable and recommended.)

Experience in Spain

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