I think there's an interesting conversation to be had about the psychological nature of this pandemic. The author of the article is 39 years old, I'm quite surprised by the severity of the experience that he reports.
There was a similar article in the NYT recently by a woman whose husband contracted COVID, had a relatively 'normal' pneumonia, but the article read like a war report out of an Ebola zone, allusions to Chernobyl the TV series, and COVID as a silent killer, and so on.
Now I don't want to diminish the personal experience of anyone, but I'm still surprised how many people in their 40s, 50s, 60s who ought to have had personal experience with tragedy and illness seem to have serious psychological trouble coping with the simple fact that we're for a while living in a pandemic and that life has become somewhat more dangerous.
It's not that I'm personally not worried at all, but there has to be some perspective. Life is more dangerous, but it's always somewhat dangerous. I wonder if it's, in particular, a phenomenon of affluent societies that haven't had to deal with serious stressors in a long time.
If you've ever been to Israel and lived there for a while and you go to a wedding and five minutes later there's a bomb alarm and there's pretty much rockets flying your way all the time, and you observe how resilient people are in coping with danger in their life, observing a lot of cultural response here worries me a lot.
> I wonder if it's, in particular, a phenomenon of affluent societies that haven't had to deal with serious stressors in a long time.
Most likely it is, and I'd much rather live with occasionally being scared shitless by a global pandemic that might not be as bad as we feel it is than to deal with continual serious stressors day-in day-out.
> cultural response here worries me a lot
Why? I get that resilience is an important trait in a number of walks of life, but being concerned about a quite-deadly airborne respiratory virus that could be transferred by any Tom, Dick or Harry within close proximity seems like quite a valid thing to let get on top of you.
There's also the sense of unknown about this all.
Dying by cancer is, unless it's especially niche, quite well documented. And though you wont be around to rationalise it, being killed by a bomb is also a well understood process too.
Being killed by something that someone might just exhale into your general direction, that has no documented cure, isn't that well understood by most of the population any more (and damn well shouldn't have to be).
"It is what it is" is a great way to build mental resilience in trying times, but when you can't really identify what "it" actually "is", it becomes a lot harder.
I'm in my 40s and haven't had to deal with any really crazy situations like this. It isn't just that there's a possibility that 1 person I love could die from this, there's a possibly that any of them could. And the older they are, the more likely that they could die from it.
On top of that, I can't spend time with them in the way that I would if I knew they were at risk. I have to stay away from them instead. It's the opposite of what I'd do if I knew a loved one was dying.
I think I'm dealing with it better than most because I'm an introvert. But I watch other people around me being affected by this, and I can understand it. It's a lot of new, different stress all at once.
Anyone could die in a car crash, but that doesn't really get people worried. There's a million ways to die at any moment, but people just don't worry about it.
I don't think that day-to-day danger is without personal cost, even for people who are "resilient". My experiences with living in various levels of dangerous situations[1] is that people become "politely selfish" in direct proportion to the level of risk. If you're doing okay it's not a problem, but the people at the bottom of society are the first to lose support when this happens.
In the case of the US, I think a lot of the insane response we've gotten is because of a combination of two things. First, we've not had real personal danger within our borders in most of our lifetimes. Second, media has learned that it's profitable to sell fear. The result is a bunch of manufactured fears, that aren't rationally actionable because they don't exist to begin with, and we become accustomed to reacting irrationally to fear and not looking too closely at our responses because ultimately there's no consequence to doing something ineffective in response to a danger that doesn't exist. But when a real danger like Covid 19 comes along, people don't have a rational set of coping mechanisms honed against previous real dangers, so they react to a real danger the same way they've reacted to a bunch of nonexistent, media-manufactured dangers in the past. If people post about how WiFi causes cancer[2] on Facebook and then do nothing to avoid WiFi, that's not great, but it isn't critical. But if people post about Covid19 danger on Facebook and then do nothing to avoid Covid19, at a societal level that causes the disease to spread and kill more people.
[1] I did live in Israel, although that's not what I'm talking about. I was 5-6 so I'm not sure how relevant that experience is.
It helps to take a historical perspective. Throughout most of human history, occasional wars, epidemics, and famines were just a normal part of life. In the US many people assumed those crises could no longer impact us, but of course our luck couldn't last forever. Reversion to the mean.
Novelty plays a role in fear. People in the Midwest get used to tornadoes. People in Florida get used to hurricanes. We all drive in cars, despite passing by severe accidents at a somewhat regular cadence.
Going from healthy to struggling to breath can be incredibly disconcerting — something a relatively young person may never experienced. When there’s no certainty of outcome, rational people may lose their normal comfort in statistics.
People are human, after all. Sure, we could all work on our resilience — but some compassion for people is warranted too.
I'm thinking of this as a temporary hysteria. Nothing much you can do to reason with hysterical people. The only thing that sometimes works for hysteria is a good slap in the face.
Does that even matter? If the best estimate of fataility rate is what it is now, surely that is what any response should be based on. The media is reporting various figures from scientists, not making them up. If you don't calibrate your response based on such figures, what do you calibrate it based on? A gut feeling that everything will probably be fine?
No, the media tends to report the most sensationalized numbers, not the most accurate numbers. I rely on World Health Organization type stuff, not "the news".
I think it is not so clear that they are any more reliable than other sources. The media in the UK seems to have been candid about the low risk to younger people, but that's not the point is it? The governmental responses at least in the UK and US changed as it became clear it was more serious than we (or they, at least) thought, not less [1]. And this became quite apparent when it started occurring on the ground in Italy.
>We are going to get hyperinflation now, US dollars will become worthless soon
Do you remember swine flu? The media storm died down as experts gathered more information and made recommendations. Note how with Covid19, the information has changed over time, but not enough to change expert recommendations, which have remained fairly consistent.
No it's not, the infection fatality rate keeps going down. This is just media hype and the risks are being overblown due to the many biases in human judgment (availabiltiy bias, survivorship bias, social bias, etc).
I know, it's amazing to me the number of people that are blowing the risk way out of proportion. I think there is a degree of "survivorship bias" in the news. People who get covid-19 and have a mild case dont get reported because it's bland and everyday.
Great write up on the nature of fear! It's amazing how much the mind can fight to deny the reality of the situation you're in during such episodes.
The dull chest pain sticks around for a surprisingly long amount of time. I'm at day 25 now since my ER visit and just noticed that I haven't felt any of that dull pressure in at least 2 or 3 days at this point.
> The dull chest pain sticks around for a surprisingly long amount of time.
I also had tightness in my upper chest. It lasted a week, from 10-18 March. During that time, it didn't get better or worse. But it lasted long enough that I started planning for a future A&E visit...
Then all of a sudden, thankfully, the chest tightness was gone. Occasional dry coughs continued for two more weeks.
I have had asthma and bronchitis my whole life. So I am always very aware of the state of my lungs. This tightness and dry cough is different from anything I ever had before.
What exactly is this dull chest pain? I've had symptoms of lower chest and back-pain more than a month ago, with a strange feeling of not being able to get sufficient air through my nose as well as seemingly high blood-pressure and heart racing in late afternoons. This all lasted just short of a week, but took a couple of weeks in total until I could say it was gone, with a persistent minor dry cough. No idea if it was Covid but the symptoms sound strangely familiar with what other people experience elsewhere in my community. Could be panic attacks as well, obviously, but it felt strange.
I experienced the same. I even did gym at home with good performance but i felt weird sensation on my chest. I don't want to think i had covid, but so many people had it that I am surprised i don't.
Fact is, that when I know when something feels unusual. And when this happened, I had no idea what the Covid symptoms are like. And at the time, I also didn't think that it was this. Only after several people in my community reported the same "symptoms" did I become suspicious.
while it could be covid19, if you didn't have any fever or anything, it's probably more likely to be a mild panic attack. I'm saying this because I had something similar but then was tested negative.
of course, I'm not a doctor, and it could also be covid19.
When I was in high school I was deeply afraid of death and thought about it daily. Then a few times over that period I got sick. Not unusually, or deathly sick, but feeling like utter garbage and perhaps enough to wonder if there was a very remote chance that the illness could threaten my life. And everytime I wondered that I realized that I had no fear of death which struck me as really odd given that I would otherwise feel true terror at the thought of impending doom. This led me to the belief that fear of death is really just a biological impulse, and that pressing that mental button that says death is scary is just... not actually a reflection of your mentality but a biological response which can be dulled by physical circumstances like illness. By recognizing it wasn't really a rationally based thing, it became much easier to just not touch that biological scare button when contemplating death, and now it rarely bothers me (though it's still easy to trigger terror if I want to).
I feel I arrived at a similar place to the author but on a much less romantic path. Not sure if I would have the same experience if the illness actually felt life threatening in an active way (e.g. breathing problems like the author experiences).
When I was younger, I was like you describe. I'd lay awake nights kinda freaked out that I would die some day.
I remember looking up life expectancy and comforting myself that I had more than 75% or whatever left. When that wasn't enough, I'd think about how far away I was from graduation, and how, even after that, I'd have whatever-percent left.
I knew it didn't work that way, and it was irrational, but it helped me sleep, so I did it.
I'd absolutely panic if I had a fight with a family member at night and didn't have a chance to make up before bed -- what if I died before morning!
But, illnesses never scared me much.
Then one day.
One day, I was at the doctor's office, having a minor outpatient surgery performed. Very minor, local anesthetic only, procedure takes 10 minutes.
And the doc stuck me with the needle for the anesthetic, and it hurt just a little more than expected, and vasovagal reaction, and I fainted. Tunnel vision, echoing sound, sense of impending doom, blackness.
I was awake again before I finished falling back on the exam table, but I had a major panic attack. Never happened before in my life, but suddenly I was in an unimaginable blind panic, hyperventilating like mad, hands and feet starting to tingle and feel like they were vibrating.
Took two hours to calm down enough that they let me leave.
From that day on, anxiety attacks were a part of my life. For awhile, they were uncontrollable, and I started down the path that leads to agoraphobia. Before I locked myself in my dorm room forever, I got the anxiety just barely enough under control to keep living. I learned to talk about my anxiety very frankly with anyone who would stand still long enough to listen. This might be awkward oversharing, but it prevented me from getting stuck in the feedback loop that keeps people locked at home -- fear of the embarrassment of a panic attack being enough to start one.
I eventually learned to repeat my anxiety mantra aloud: "if every time I felt short of breath was really a heart attacks, I'd already have died long ago -- so these are not heart attacks"
Anyway, long story, but the result is that 20 years later, I rarely have attacks anymore, though I'm still a bit of an anxious soul. I don't often have that existential angst that used to lead me to count lifespans as a teen.
But I do get massively panicky when I'm sick, now.
I'm not sure what you said that compelled me to write this, but... it needed to get out.
I just wanted—anonymously, sadly, because mental health issues are still stigmatized—to let you know that you’re not alone on this one.
I also had a combination of a vasovagal episode and a panic attack, and it has taken years to mostly get over the resulting panic disorder. (It wasn’t helped by the fact that, during one trip to the ER for panic, a nurse performed an EKG incorrectly and I was misdiagnosed with a heart condition and admitted to the cardiac ward for the night. I still can’t believe that one.)
Being sick makes me panicky too. I have a host of coping techniques and it seems to get easier each year, but it still sucks. Having to mentally navigate the current pandemic seems to be adding some resilience, at least.
Anyway, thanks for sharing your story. It helped to read it. Best of luck.
Thank you for replying! It is good to hear from other people who really understand!
It's hard sometimes, because even people who are sympathetic and want to help just sometimes really don't understand.
It's like "I know I'm not dying. That doesn't have any bearing on the fact that I'm currently having a massive panic over feeling like I'm dying!"
It's been 15 years since that first attack, now. I still have a few every year -- and things that used to scare me a bit sometimes now break me unexpectedly. I've just learned not to be too embarrassed by it, and I've learned how to explain it to whoever happens to be with me when I melt down, and I've learned (through experience) that those feelings are just my anxiety, and not impending doom.
Most people who know me well know about my anxiety, but if you let me casually, you wouldn't know.
Except when I get sick, I function quite well these days. When I had what I still think was the coronavirus back in February, I became a wreck again, (symptoms of shortness of breath are probably the top trigger, since they'll start the anxiety, which then makes the breathing worse, which is the anxiety spiral all over again) but I recovered after two weeks, and am actually holding up well in my locked-down world.
I was probably no fun to talk to during my illness, so I owe thanks to all my friends who listened to my panicked whining for two solid weeks
I started getting what I now think are probably anxiety attacks a few years ago. I have asthma and now some GERD symptoms, so every once in awhile, I get symptoms that mirror the online warning symptoms for heart attack: numb left arm, tingles throughout my body, lightheadedness, skipped heart beats, chest tightness, chest is painful to the touch, etc.
I'd go to urgent care and they'd always be like "well you have a normal EKG but you should go to the hospital to be sure" and then the emergency room will talk to me, take my blood, monitor me for a few hours and take my blood again (sometimes it takes awhile for the markers of a heart attack to show up), and then tell me it was probably just heartburn.
I've gone five times in the last 2 years for this same song and dance (I skip urgent care now). I have had these feelings happen about 20 times besides that, so I'm not even going every single time, there's just some especially scary ones that make me go "It's probably nothing, but just in case!" Last time I was driving and could barely focus on the road, which was new. I was pretty close to an ER and even then I pulled off the side of the road and tried to calm down for 20 minutes before finally deciding to go in.
I'm only in my 30s, but I have seeing more and more stories of people dying from heart attacks that young (I know it's still rare, but it can happen), so that doesn't help. And if for some reason it ever does become a heart attack, I probably won't tell the difference and might not go in for it, and end up dead.
So yeah, anxiety over heart attacks can be no joke. I have real symptoms that manifest over it. Sorry you're going through this. I don't know if it'll ever go away for me, myself. Worried it might just be something I have to live with from now on.
But I'm fine normally except for the rare attacks. Even this pandemic isn't really bothering me too much, although I'm doing my best to avoid getting it, especially since I have other issues that could lead to a bad outcome (like the already mentioned asthma).
Real anxiety with potent physical symptoms is very much not "all in our heads"
Anxiety can be debilitating when it strikes. On top, it can create these crushing feedback loops.
I mentioned above the common-ish version in severe agoraphobia -- where fear of having an anxiety attack becomes powerful enough to cause them all by itself. That is the usual root cause of those stories you occasionally hear about people who lock themselves away for 10+ years, never going outside or being with anyone, except maybe one or two "safe people"
It sounds like you ended up like me with a version where the feedback loop is anxiety -> palpitations -> health-anxiety -> major panic -> health panic.
I have read hundreds of detailed descriptions of the symptoms of all manner of serious diseases over they years, looking for the clue that I might not be dying. Not because I "really thought" that I was, but because I was having self-perpetuating anxiety over it.
It's not the same as hypochondria, because I don't really rationally think that I have the condition in question, I just persistently fear that I do.
It's nice to talk to someone who understands. I'm glad you are coping OK for the moment. I am too.
I don't think it's being a hypochondriac if you have actual symptoms that people go see the doctor for. If they could point to a test and go "Look, there's no way you're going to have a heart attack in the next two years, your X level is too low", then I'd be perfectly fine. It doesn't seem like there's a good test for that though.
Funny thing was, for the longest time I always thought "I'm pretty damn healthy, except for the allergies and asthma." Never really worried about my health much, except a little when I got a bad case of bronchitis.
Those thoughts and feelings suddenly stopped right around when I turned 30 and started getting combinations of minor symptoms just about everywhere on my body off and one all the time.
Probably also that's when I started knowing people that died really young and suddenly (or had close calls) from various things like sleep apnea, heart attacks, leg clots, aneurisms, etc. Seriously, video/board game industry has had quite a few of these young but sudden deaths lately, including some people I knew personally.
When you have symptoms that match those things, it's hard not to feel like it's better to be safe than sorry.
Havw you ever had a scope or scan/x-ray at the time of the attack? If it's that serious then it sounds like you may have a very significant hernia at those times.
There are surgeries that can help with hernias (which can come and go like that).
Another thing, have you tried Nexium? For me that has been really useful to reduce symptoms (although I do still have some serious symptoms).
But it sounds like you have a more significant hernia.
There might be something to the hernia idea. I noticed my solar plexus area can stick out slightly at times (especially when I was leaning back last night). I always thought it was just the bone in my ribcage (mostly feels hard like the ribs surrounding it), but maybe it's more than that. I might have to get it checked out after this is over.
If I do have it, I think it's still pretty minor, at least compared to some pictures of hiatal and epigastric hernias I see online. It hasn't ever stuck out that far, and no doctor has ever noticed a problem.
Yet another reason to lose a bunch of weight. Throw it on the pile. Need to get my act together.
I've had chest X-Rays at the ER each time, usually. They have yet to mention anything about a hernia. The one that seems most likely is a hiatal hernia, considering the symptoms, but that should show up on a chest x-ray, especially with as many as I've had.
Also, I used to take Prilosec, but usually now I'll just give up all caffeine, soda, fatty foods, most tomatoes and citrus for two weeks, and that seems to put me back in a state where I can tolerate it again. Until I push the boundary again. I've heard some worrying things about long-term use of some heartburn medicine, so I try not to take it.
And all of us with similar stories are all suffering now because everything we’ve worked up to control our panic is exactly the thing that triggers it. Fuck me.
It's interesting that you feared dying. I'm afraid of others I know dying, but if I were to die then I wouldn't know it, so I'm not necessarily afraid of dying (because from my perspective there's no difference between dying and going to sleep every night). I am afraid of pain or being permanently maimed however. If I were to be heavily sedated and intubated I'd be experiencing the same series of events that would happen if I were to recover from the ailment the next week. It's possible to die in my sleep but
That's more or less how I've always rationally felt, but thinking about permanently ever after being unable to even think triggers a sudden terror as if death were a looming predator. And the basic conclusion I have is that it's an unnecessary primal impulse that doesn't actually say anything about my views on death.
It's just an introspective version of instinctively smelling something after someone tells you it smells bad. Just... don't and you'll be better off.
But for those of us with Covid-19, the full force of modern social technologies that enable cooperation, communication and specialization among billions of humans around the world has been applied and come up snake eyes.
For the record, I don't think this is an accurate representation of the situation.
The world has done a remarkable job of coming up with ventilators, masks and new practices on the fly in the face of overwhelming demand and labor shortages.
The ventilators aren't working as well as expected, so doctors are collaborating via internet in real time to come up with other options. New hypotheses concerning the pathology of the condition are already emerging.
Also, with internet access, you can google up medically recommended airway clearance techniques, recommended OTC drugs, etc. You can double check that it's a reputable source and an established practice for management of lung issues.
Covid19 is not the first time people have been faced with managing deadly lung issues. You can find good info on that very thing by searching for resources for cystic fibrosis. It's very deadly and people routinely manage it from home with medically approved and doctor recommended treatment modalities.
Not to mention the delivery and curbside pickup programs that are only possible with tech logistic systems. E-commerce and work from home are all small miracles of this age. Video chat is another wonder of technology when in recent memory a long-distance phone call could easily cost more than a nice dinner, and much more if international.
As a matter of caution, I always keep psychostimulants handy. Particularly: ephedrine, pseudoephedrine, and amphetamine salts. Also keep some other beta receptor agonists, like Ventolin. You never know when it can save your life.
I'm failing to find a list of recommended OTC drugs for covid19. All I'm finding is a generic statement that OTC drugs may help with symptom management.
Ventolin is an inhaler. It opens up the airways during asthma attacks or similar. Pseudoephedrine is a decongestant.
The article under discussion indicates the author was given an inhaler and cough medicine at the ER and states they helped marginally.
Amphetamine salts are apparently used to treat ADHD. Some people use them illegally to concentrate for mid terms and finals at college or similar. I'm not personally aware of any valid reason to think they are appropriate for covid19.
Epinephrine is used to treat potentially deadly allergic reactions. You might know it better as "an epi pen."
It is contraindicated for a long list of things, including several heart issues that are potentially similar to the heart distress covid19 is causing in some patients. I'm guessing epinephrine would be a really bad idea to use with Covid19 without a really compelling reason, especially without medical supervision.
I used my Ventolin inhaler like a starving person given water and bread about two months ago. From "as needed, about once a month" to "max dosage for two weeks". Didn't get tested, but I can say the inhaler helped, but I still had trouble breathing.
> Amphetamine salts are apparently used to treat ADHD. Some people use them illegally to concentrate for mid terms and finals at college or similar. I'm not personally aware of any valid reason to think they are appropriate for covid19.
Huh, interesting. I wonder if ADHD amphetamine users get sick less often than others.
It's just a personal anecodte, but whenever I get sick, I take amphetamine salts. It absolutely lets me power through the day and relieves symptoms (mostly stuffy nose), but I don't know if it's sustainable for something as long lasting as c19.
Ephedrine is a key ingredient of many cold and flu drugs, or was until the War on Drugs caused it to be banned for being an amphetamine precursor. I wonder if any amphetamine metabolites have similar effects to ephedrine?
Amphetamines are also known as speed and, among other things, they raise your heart rate. Coronavirus is apparently also raising the heart rate and doing damage to the heart for some people.
I did say it wasn't a good choice, all I said it did is work as a decongestant. Nobody is making claims that you should take amphetamines (let alone street amphetamines), sick or otherwise.
They aren't life-saving. None of them treat pneumonia, which is what actually requires hospital care. It's possible they might keep a few marginal cases out of the hospital system, and it's not unlikely they'll make managing the disease more tolerable. They... probably wouldn't hurt.
Thanks for this. I'm from MA - woke up a couple days ago with heavy breathing and am now progressing into GI issues. Been racing through the probabilities and dependencies of my potential contact so this encapsulated how I'm feeling well - awful how we are so helpless but not much you can do..
I'm also in CO and had COVID-19 like symptoms about a month ago (fever and GI issues without any other major symptoms for a week progressing into a dry cough/heavy breathing -- completely unlike any other flu I've had). I never got tested due to lack of test kits here in CO at the time and because my symptoms stayed manageable I never saw a health care provider beyond a virtual meeting to get a rescue inhaler.
At the point when my fever started getting more severe is about the same time people were going absolutely crazy buying everything up - my girlfriend couldn't even find a thermometer or medicine to keep my fever down. Luckily I had a friend who overnighted a bunch of supplies to me.
It's really scary to realize there is a possibility that you could die, alone, in a hospital, unable to have family visit. The lowest my blood oxygen got was 89% -- I'm fortunate that if I had CVD19 I seem to have got the "light" version of it and never reached the respiratory distress that would put me in the hospital.
I strongly suspect that the reported infections in CO are off by a lot - it wouldn't surprise me to find out it is/was off by an order of magnitude.
Which would in fact be good news in a certain way, because either it's as deadly as reported and nowhere near as contagious as your last paragraph suggests, or its far more contagious and widespread but thus nowhere near as deadly as is being seen from case fatality rates derived from known cases. I'm not stating anything new with this really, but your case is likely one of many, many others in which a person felt mysterious illness symptoms for days or weeks and never was registered as a positive case through any testing procedure. This is not to even mention all possible asymptomatic cases. I'm sure many COVID-ralted deaths are also under-reported bit I strongly doubt the level of inaccuracy is nearly the same as that of cases being under-reported.
The problem with this interpretation is that whatever the combination of deadly/contagious the virus is, we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death. So exactly where the virus ends up on the grid of mortality/contagiousness doesn't seem to be all that important because it is well beyond the frontier of being problematic.
Hopefully in the next few days/weeks we'll get very concrete data on exactly what percentage of people are/were asymptomatic cases, but my guess is it will not be some crazy high number because if so we'd have likely already figured that out by now.
If we go with the highest realistic-seeming estimates of contagiousness and (and thus lowest of deadliness), then we can say that what NY and Italy saw was something close to worst-case. One reasoned estimate had 20% of Italians -- and almost 40% of Northern Italians -- infected in a six-week period.
If that estimate is correct, then even if Italy completely unlocked tomorrow, and held mass hug-ins and cough-ins at every gathering place, it still would probably only get back to as bad as it was 3 weeks ago, and probably only stay there for a month or so.
That would be incredibly tragic, but not world endingly so.
On the other hand, if you take the maximal estimate the other way, and say that Italy and NY at the peak were detecting 1/3-1/2 of their cases (it kinda can't be more than that), then there is the potential for outbreaks 5x as bad and 10x as long unless they stay socially distant until there is a vaccine in widepsread use -- and even so, hundreds of thousands more will inevitably die along the way.
Myself, I think the evidence points to higher contagiousness than this, but the difference does actually matter, even if that still outs us beyond the "threshold of ignorability"
Sweden didn't take no measures. Sweden took flexible measures[1]. Social distancing, allowing anyone who felt sick to stay home, encouraging people to work from home (and 50% Swedes apparently can do that[2]).
The problem is that when American employers grant to no sick leave to employees and are brutally against ever doing so, applying the flexible Swedish model to the US would be extremely hard. The model involves mutual trust and responsibility between the state, employers and employees and there's very little trust there in most other countries.
All I know is that the streets are just as crowded, people are still going out and businesses are still open. There are plenty of news reports showing that.
There is no known method of stopping the spread of this disease. Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
The area under the infection curve does, but not the area under the death curve. The entire point of flattening the curve is to avoid doctors having to ration care due to overwhelming demand.
Fwiw, I'm also in the camp that cases are an order of magnitude off and there is significantly more immunity in the population than we think. However that's a hunch and with out widespread antibody testing it would be irresponsible for anyone to act on such a hunch.
However that's a hunch and with out widespread antibody testing it would be irresponsible for anyone to act on such a hunch.
Wow, it is gratifying to see someone able to say this. Absolutely, with some luck there are a bunch of limiting factors (both that there's are harmless infections, that ) that are going to keep the epidemic from reaching the potential it seems to have "on paper". But these are unknown, these are the major unknowns and acting like we can just guestimate them and be safe is supremely irresponsible since if get it wrong, an order of magnitude more people die. A flu season? Ten flu season? A hundred flu season? Do you really want to roll those dice? To a fair extent, we already are but it's not comforting.
There's never ever going to be enough antibody kits for everyone in the world. Same with the PCR test, its impossible to make so many. The only discussion is going to be about the definition of "wide-spread". Whats yours?
> Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
Not necessarily. The higher the social distancing at the peak, the lower the percentage of infection needed for herd immunity to kick in. Ergo, in effect, lower number of cases. If you drop your R0 by half, your her immunity percentage necessary halves as well!
No, even in your hypothetical case, the disease still continues to infect when you lift the social distancing and the economy re-opens. That is not herd immunity.
It's really too early to say one way or the other because spread of the virus started a different times in different countries. Plus we have to factor in the long term excess deaths that will be caused by lockdown measures. Poverty kills (even in Scandinavia).
Sad as it may seem, you cannot avoid those deaths. Stopping the spread of this disease is impossible. Even if you flatten the curve, the virus will continue to infect just as many, just slowly.
>and Sweden's tactics don't seem to be working that well.
Their healthcare isn't being overwhelmed and that is the only thing that matters in any country at this moment.
There is one problem with what you say about its spread at levels that saturate healthcare systems and cause extreme amounts of sickness and death: They may not be the case so much because the virus is particularly deadly or even much deadlier than the flu -which may indeed be the case: that it's only part of an order of magnitude deadlier than H1N1, we don't know yet until we get more concrete infection rate surveys- but there are reasoned arguments supporting this idea.
Instead it saturates in such ugly ways because it's so contagious (as the comment below this mentions). Thus, highly contagious + entirely virgin population of susceptible people (of all types: asymptomatic, lightly symptomatic, moderately, severely, mortally) will inevitably result in very high infection rates and thus an initial saturation that's also high even if hospital-worthy cases are a small percentage of total known and unknown cases.
This saturation may or may not be capable of getting worse than what we've seen so far in NYC, Northern Italy, Spain and Iran to a lesser extent, but though we don't yet know this for sure, if it is the case, the virus being allowed to spread far and fast will likely cause these bad but possibly tolerable saturations to happen quickly only once, and then simply cease as enough people become immune or at least resistant, and healthcare systems steadily adapt.. So far, it seems that Italy and Spain might actually be close to as bad as it gets even with widespread infection of the population, since credible estimates are presupposing at least 2 million cases in total in Italy at this point, for example. Even in New York there are signs of slowdown already. Again, if that is in fact the worst case scenario in any given region, its cost, as tragic as it is, might be worth weighing against the possibly more catastrophic cost of prolonged quarantine and its resulting economic and social consequences.
We could possibly be delaying an inevitable event with only briefly heavy localized consequences and moderate general clinical consequences by artificially creating a much worse long term problem that kills too, albeit more indirectly and among a wider demographic through missed clinical care appointments of other kinds, depressive suicides, economic ruin, substance abuse and other general population harm factors we can only start guessing at so far.
I believe there have been several random studies and very educated estimates that came from these that show that the mortality rate is about 0.5% or even lower, which might put it close to the same order of magnitude as the flu. However, crucially, it is much much more contagious than the flu. With an R0 of 2 or more (some estimate up to 6) the difference after a few days, because of exponential growth, is as much as a thousandfold more infections.
My thought is that the mortality rate is rather low, especially for those that are healthy, but there's a ton of people that have it. More than 1% of New York State is now infected with Coronavirus. That's crazy.
I have a proble with a single number mortality rate gor this virus, because mortality differs by the two or three orders of magnitude depending on the age. Not an infant and younger than 2 (or even 30)—almost zero chances to die (Italy's data).
Over 70/80? It's 30-40%.
> Which would in fact be good news in a certain way
This holds for the calculus of personal risk ("I'm sick, will I die?"), but not public risk nor policymaking.
Whatever the "true" severity of this disease is, it's known, experimentally, to be high enough to overwhelm regional hospital capacity. That means that it has to be controlled, because if it isn't then a lot of people will be sick without care, and thus a lot more people will die.
It's true that we don't know the "pessimal peak" of case load. Maybe we'd be looking at a doomsday scenario of only 4M people dead globally, and not the 40M the measured fatality rate would indicate. But... who cares? We won't get that high, because we had to lock down even for the "good news" 4M number.
The U.S. has about 600k cases. One order of magnitude more is 6M cases. That's still very far from broadly spreading. It's worrying about the viability of the herd immunity theory (too few people had it), and opening the country soon (a few weeks of exponential case increases would overload hospital capacity, even after stemming the case growth through sheltering-- putting us back to square one). It feels, 1-2 months into this, we have no good options.
At least in Europe the results of quarantine are starting to show results, Italy, Spain and Germany and all seeing a drop in new daily cases and deaths. Spain will allow factories and businesses that can't work remotely to reopen today, although there are concerns it may be too early. Other European countries that imposed quarantine 'ahead of the curve' are not facing any issues in terms of hospital capacity.
That still doesn't explain how opening businesses can avoid infecting many more people. Now certainly but even when infection rates get considerably lower.
A scan of recent news seems to indicate Spain doesn't have anything like a testing program in place.
A look at Italy, Spain, France and Germany seems to indicate the epidemic has plateaued, not stopped and it's plateaued at a fairly high level.
You know if we start to open/close in cycles in theory it's possible that a manageable equilibrium of cases can be achieved while we work out a prophylactic or cure. Capacity everywhere for supplies is ramping up and I imagine once that happens masks will be commonplace and perhaps the stigma around masks will die once a couple hundred thousand Americans do.
I'm in BC, Canada. People are talking about our lockdown going too well. The hospitals are not overwealmed like those in New York. Infections are under control, mainly contained to care homes. But you don't get to herd immunity if the virus does not spread. Vaccines are a year or more away. Holding the lockdown that long would devastate a generation. The government isn't saying it but people are deciding to head out on their own. Outside of urban centers, this Easter weekend looked almost normal.
I was at the grocery store today. Maybe 1 in 10 people had some form of mask. Tomorrow I go to work, where we aren't using masks either. We never did. I have some homemade masks but have never felt the need. There is virus in our area but it just isn't spreading at nearly the predicted rate given our relaxed "lockdown".
You can't enter my grocery store without a face covering. I didn't see anyone strictly enforcing it, but there was a >80% compliance rate, based off what I saw.
In Germany you cannot enter most groceries stores without a shopping cart. It did not used to be that way, they made shopping carts mandatory to stop covid.
If I had a blood oxygen of 89% I would have gone to the emergency room immediately. That's 80 year old smoker with emphysema levels. If you were previously healthy that is far more serious than the "light" covid-19 that many people get, assuming the reading was accurate.
That's what my friend said, too, but it didn't linger there for long and I felt comfortable enough with my breathing that I didn't feel it warranted going to the hospital.
As my symptoms got better it gradually improved and the last time I did a reading it was at 99%, which I think is where I normally am (it's not something I measured before this though).
I only suggest that it was the "light" version because it seems like the advanced cases develop into pneumonia and I definitely didn't have pneumonia. The breathing problems felt no worse than a bad cold to me.
I have asthma and bad allergies, so it could just be that I'm somewhat used to sub-par breathing in general. I also know of some breathing exercises that always seem to help.
Anybody living in CO has already self-selected for being able to adapt to lower oxygen levels, maybe you were at less risk of getting really bad than the average for the US.
I have mild breathing issues during winters, which affects my sleep and I used to wake up with a headache. The fingertip SpO2 meter helps quantify the problem, so it was a good buy. According to my readings, headaches were bad when my readings were 92 or lower. Also helped when my son was having bouts of bronchiolitis when he was younger.
It's only about $50 and batteries last long, so I'd totally recommend it if you have breathing ailments. Maybe even otherwise.
Oximeter. They're cheap, you can grab one on Amazon for $40. My friend who mailed me the medicine supplies (who is married to a doctor) insisted I have it and that I measure it regularly.
> Is this something that people with rescue inhalers also typically have?
I'm not sure. I usually get a rescue inhaler prescribed roughly once a year to help get over a cold. I have light asthma and bad allergies. The breathing here in Denver is definitely more challenging in general as well.
It's a small rural county and they haven't finished processing the tests and it's a couple weeks old at this point and maybe it isn't reliable and so on, but San Miguel County didn't have a lot of people test positive in the 1600 blood tests they have results for.
Professor Victor Davis Hanson is one of America's smartest and most lateral thinkers. If he proposes a theory, it's a good idea to at least think about.
Because of how highly contagious corona virus is, I agree with him. It also matches the Daily Mail article.
I lean towards lockdown as being a rationalization now that we know ventilators don't work with 66% to 90% mortality, and that we (the US) don't have the testing and tracing capabilities to stop a highly contagious disease.
Most people can't separate their personal fear of death with public policy. This seems to go all the way up our political structure.
I have seen those theories that it has already spread <in whatever area> and that is why there aren't the cases now, but I find it difficult to believe from the following reasoning:
1. California has ~40 million people
2. Herd immunity would start at what ~30 million cases?
3. Elsewhere in the world, it seems that there is a ~1% infection fatality rate
So how did California get herd immunity without ~300,000 people who died of pneumonia from an unknown cause piling up in the corridors in a couple of months? I read elsewhere that fatality rate of people on ventilators is about 50%. Assuming that the Californian cohort were treated properly means there would have been ~600,000 people in critical condition and only half of them died. There will be more who went to hospital but weren't considered critical enough for ventilation. Its a rough guestimate but lets say twice as many "non-critical but hospitalized" as "hospitalized and critical" so there were ~1 million people queuing in the hospitals. These figures are pulled out of the air and can be adjusted, but it doesn't really help with the sheer numbers, for example there are ~7000 ICU beds in California, so the 300,000 who might have got better with care wouldn't have had access to it.
It seems obvious that to get to the immunity, you have to go through the eye of a needle.. The basic premise of theories like this seems to be that the fatality rate may be actually negligible and therefore that the whole issue has been overblown. But I have seen video from Wuhan and from Italy and New York that shows images of body bags piled in the corridors. That is not normal and it would surely have been remarked on in California or <whatever area> at the time. Don't forget that Wuhan had ~3000 deaths. Furthermore, California is not an island and for it to have been widespread there that long ago means it would have had to be widespread across the whole USA if not the entire world.
It is tempting I think to believe that <yourself> cannot be affected by <external threat> and obviously, extrapolating from the fact that it never happened before, <yourself> would be entirely correct. Unfortunately history is littered with people who chose to just live their lives like that until the <external threat> came along and wiped them out without blinking. All of us here are the descendants of the lucky ones!
Iceland and a couple European countries did some sample testing studies where they tested a random sample of the population(1-2 %) to see how many people have coronavirus antibodies. Even in Italy in the most affected regions this was only about 10%, on Iceland it was about 1%.
So it's really unlikely large amount of the population anywhere has already had the coronavirus and might be immune without anyone noticing (without you know, all the totally overloaded hospitals and lots of people suddenly dying).
Unsure. I work from home so my exposure to germs is already pretty minimal, however, I did take a trip to SF about two weeks before I showed symptoms. My girlfriend is also a school teacher so she ends up bringing a lot of colds home. She never (and still hasn't) showed any major symptoms other than a small fever that lasted just a day or two a week after we got back from SF (although she could have been an asymptomatic carrier).
I am going through pretty much an identical situation, except that a doctor prescribed antibiotics over the phone (assuming that the chest pressure and shortness of breath are due to the bacterial secondary infection) and I seem to be getting better.
The uncertainty has been eased by a little gizmo to measure the oxygen saturation in blood, which I got on amazon for £75 as soon as it was obvious that I could not breath well. I am probably fine as long as the saturation is > 92% or so.
Of course I have doubts about the reliability of a medical device off amazon, but it seems well done and, interestingly, it gives my mind a piece of seemingly objective truth to latch on.
[Edit - saturation level that will make me go to the hospital]
Blood oxygen saturation measurement techniques are pretty simple and well understood. Even the cheaper devices are usually accurate within a few percent. But if my level was getting to 85% I would head straight to the ER.
Yeah, I heard a lot higher number myself. Here's a study I found online about it:
"Conclusion: Among outpatients with pneumonia, oxygen saturations <90% were associated with increased morbidity and mortality. Our results indicate a hospital admission threshold of <92% would be safer and clinically better justified."
So he claims that he got it despite practicing all the social distancing protocols, hand-washing, etc.
Has anyone calculated what are the probabilities of infection in an area with an active infection cluster while practicing social-distancing and other hygiene measures?
I don’t know but I’ve become aware of just how difficult it is to remain pristine. Touch a door handle? After that did you touch your phone, keys or wallet at the store? Did you touch your car door handle? When you washed your hands, did you disinfect the faucet handle and soap dispenser after? It’s always a game of percentages even when you’re careful.
In order to be infected from a door handle, somebody the last few seconds had to sneeze in his hand, touch the handle, you'd have to really touch the whole handle and then take the hand to your mouth/nose. It is unlikely. They find virus RNA on surfaces but it is not activate. Infections from surfaces are vastly overestimated. Staying and talking with an infectious person in a room is underestimated.
There's the simple expedient of 1) touching potentially contaminated stuff only with your left hand, 2) only touching clean stuff with your right hand, and 3) never cross contaminating your left and right hands. And whenever you can, wash or use 70% alcohol. When I'm out, I always carry a paper towel soaked in 70% isopropanol in my right hand, and periodically wipe my left hand.
I also have decades of muscle memory with using disposable gloves in a lab context, but that's not so useful when you don't have 100 gloves per day to burn through. But even so, I'm always conscious of what I've touched when, and with what.
That's the tough part - not touching things that other people touch or ensuring that you sanitize your hands after. A new CDC study claims this coronavirus can survive for hours on shoes, wall, floors, etc.
Like you say, it's a game of percentages. The only way to completely eliminate the possibility of infection to yourself personally is to stay inside and live off whatever you've managed to stock up on for supplies. Not exactly practical and likely not sustainable for long.
This would be an awesome opportunity for AR-based training.
Imagine being able to "see" the simulated virus in the air and on surfaces. See it spread due to airflow and gravity, see it diminish over time due to sunlight, surface cleaning, etc.
Yes. It's extremely hard. Clothes are especially hard. I have to take my dog out two times a day and I always try to use the same shoes and same hoodie for this activity. I wash them every other day, but that's a half-baked hygiene measure.
In reality, the only way to be safe is to always wash all your clothing every time you go out, but with a dog, I find that pretty hard.
> In reality, the only way to be safe is to always wash all your clothing every time you go out, but with a dog, I find that pretty hard.
Quarantining the exposed clothes is a better method IMHO, just setup a FIFO of quarantine bins. Add sunlight if possible. I've been using 2-3 days personally, depending on what it is.
Just brushing rapidly against any of those surfaces can potentially aerosolize it as well. Not to mention that the radius of air-borne transmission route keeps changing. And on top of that we haven't got a lot of data on other vectors like food.
Those numbers probably aren't knowable at this time. Over the last day I've seen stories that claim person to person transmission is twice as likely as previously thought but transmission via an object is much less likely than previously thought. Wouldn't be surprise if tomorrow there were stories claiming the exact opposite. It feels like we're both drowning and dying of thirst when it comes to information. But this crisis has not really been going on for very long. We have become so accustomed to getting information instantly that it's going to feel like an eternity before we get data that we are confident in strongly.
Two things I'd like to share on the topic of how easily covid infections are transmitted:
A Washington state choir decided to go ahead with their practice on March 6th. There were no handshakes or hugs, everyone was given hand sanitizer on the way in. 45 members contracted COVID-19, 2 died.
https://www.latimes.com/world-nation/story/2020-03-29/corona...
#2: This video was posted on /r/Coronavirus/ and was pretty interesting. It's got some visualizations of how micro droplets remain suspended in air:
https://vimeo.com/402577241
Note that the protocol was followed for the "previous two weeks". The incubation period can easily be two weeks[1], so the infection could have happened earlier.
That said, more than 98% of corona cases involve fever[2] so this might have been something else.
Interesting, earlier reporting said that it frequently presented without a fever. I know that now they basically won’t even test you if you don’t have a fever. I wonder what’s correct.
Is there not a middle ground of food delivery? Nonperishable foods can sit out for several days before use, significantly reducing the risk.
Likewise with wiping everything down when you get home. Supposedly soap is effective - it's not difficult to soak everything in soapy water. You can't completely eliminate all risk but you can certainly mitigate it.
Food delivery services are overwhelmed in many areas. It's better that those of us in good health continue doing our own shopping, and leave the available delivery slots for customers at higher risk.
The point is to slow it down, not actually know which ritual failed.
We aren't worried about how you or I really get it, it doesn't matter if it actually was carried by a supernatural deity following certain people around or if someone has a death note that uses 5g radio waves to target individuals in the phone book. We only know that crowds and ignoring hygeine carry it faster and we just need time to treat it.
If you are personally in an at-risk group and are avoiding it like the plague that it is, none of the policies have real answers you. We are operating on probabilities, not absolutes.
My understanding was the social distancing won't actually prevent everyone from getting covid19, it'll just slow it down so that we don't all get it at once. Most people will end up with it.
So given that, I'd say the changes are nearly 0%.
To actually keep infections to a minimum, we need to actually quarantine, but (again, my understanding) that will have too many other negative effects, and the economic hardships could actually kill more people than the disease would have.
So much this. And I wish people would understand this concept. We are going to get hyperinflation now, US dollars will become worthless soon, and the social safety net will disappear. This is going to cause a lot more societal grief than corona.
That isn't something you can quantify. By all means take reasonable steps to avoid infection, but the most likely outcome is that no matter what we do the majority of us will be infected before a vaccine is available. There are already four other endemic coronaviruses which circulate in humans and SARS-CoV-2 is going to be the fifth.
I had wondered whether the flu our family got hit with over Christmas could have been coronavirus (had mentioned previously that my wife actually broke a rib from coughing).
But then a few weeks ago we all started to sneeze, cough, and run low grade fevers. Wife lost her sense of smell. And then a bunch of symptoms between us that I later learned are all coronavirus symptoms.
The dominant things for me was the shortness of breath, and the extreme fatigue. Like, feeling like you’ll just go “goodnight!” and collapse on the kitchen floor fatigue.
The breathing was the most disconcerting. I’d wake up in the morning thinking I was getting better, but by the afternoon I’d feel like someone was sitting on my chest. The cough never really got crazy bad for me. Where a panic attack might feel like you can’t catch your breath, this felt more like trying to breath under a swimming pool.
Caring for 3 young kids with a sick spouse has been... a test, lol. But fortunately we’re all young and healthy and things are returning to normal. As slowly as it came on. Luckily I stocked up on things just in case, but at the height of being sick it was impossible to get any grocery delivery windows. They did finally come through about a month into this process, so, feeling grateful all around.
I had what would be called a “mild” case, but it definitely sucked. Looking forward to antibody testing so we can know fo sure it’s what we had, but based on all of the symptoms, the long incubation time, etc, it seems very likely.
Not really. Only in that the kids symptoms were fairly mild — cranky, cold-like symptoms, etc. Which is apparently fairly common with coronavirus and younger kids (thankfully).
> So I had a higher chance of dying from this disease than winning a raffle at a small concert.
I know this is not the main topic of this article, but I’ll steal this sentence to convey the importance of taking precautions against COVID-19 to people who feel that it’s statistically irrelevant.
Hehe. Just before this started I was named a finalist in a board game design contest where there was enough entries that my chances of being selected as a finalist were just a little bit higher than the likely death rate of me getting Covid-19, with my higher risk factors.
I'm using that as a bit of a self-reminder. If I can win that, then I can "win" (i.e. die) from Covid-19.
I think the risks shouldn't be downplayed, but the news media, aka advertising industry, frenzy over this pandemic is disgusting. Nobody that contracts this virus should fear death, yet that is what the mainstream media is selling and people are consuming: fear, death, uncertainty.
>Nobody that contracts this virus should fear death, yet that is what the mainstream media is selling and people are consuming: fear, death, uncertainty.
Except, you know, about 1 in 30 that contracted it in Northern Italian cities with heavy spread and not enough ICUs, and 1 in 10 or so over 70 or with a prior condition...
I chose my words carefully in my original post. Fear accomplishes nothing. Worrying about something (ICU Beds) you ultimately have no control over fixes 0 problems. "Worrying doesn't take away tomorrow's troubles, it takes away today's peace". People absolutely should take every precaution recommended by their local officials. But living in fear for their life is both unneeded and counter-productive.
I think visualizing the odds with playing Russian roulette drives the odds home: 1 in 30 means randomly picking one revolver from five, of which one has a single bullet chambered, putting it to your head and pulling the trigger. 1 in 10, you have two (very roughly), 1 in 300 (0.3%), you have fifty.
If you are elderly than you should definitely fear death. But yes if you are under 50 it's more likely you will be killed driving to the hospital than by the virus.
> if you are under 50 it's more likely you will be killed driving to the hospital than by the virus.
Apologies if this was intended to be hyperbole, but it is not true according to our current knowledge. Estimated fatality rate for adults 20-30 is 0.03%, 30-40 is 0.08%, and 40-50 and 0.16% [1]
The probability of dying from one single vehicle ride to the hospital is several orders of magnitude less than 0.1% or even 0.01%. There are 1.25 deaths per 100 million vehicle miles driven in the USA [2]. Even if the hospital is 100 miles away, your odds of dying on the way there are 0.000125%.
I'm guessing the intent was more along the lines of "Car trips generally are more deadly on an annual basis and we don't stress about that. In fact, if you try to encourage people to walk, bike and take public transit based on the idea that car trips kill and maim, you will be generally blown off."
Fair enough, it was just an offhand comment I should have run the numbers. It looks like if you are under 50 and have COVID, you are ~3x more likely to die of COVID then to die of a car crash in that same year. So that's probably the better comparison when looking at risk, although it probably says more about how we underestimate the risk of car crashes rather than overestimating the risk of COVID.
Rough average COVID deaths per 100k infected under 50 (using average death rate from categories 0-50): 36
Deaths per 100k by car crashes in a year in the US: 11.2
Don't forget that automobile fatalities are far lower now with significantly reduced traffic due to lockdowns. This analogy works without coronavirus existing and only then.
Agreed. There are cases of people getting this that are not recorded because there are people who get sick and stay at home and go through it as best as they can. I myself never go to a hospital when sick I just stay home to recover.
At this rate I'm fast approaching the point where I would rather have an infection positively confirmed and roll the dice that is heavily loaded in my favor.
Not knowing if you properly decontaminated that last batch of groceries is nerve wracking.
> I asked him about his experience, which was very much like mine. This was a different kind of encouragement than my friends and family could provide who did not share my experience.
A little more useful than "it'll be fine"? eh?
I honestly hate the empty empathy from people with no say in the matter. Its cultural and I think it develops into a mental issue of denial. Saying "you'll die if you don't breathe, I don't want that" is good enough, for me. People of some cultures would say that. Are we really worried about the patient losing the will to live without other people's hopium? Is that really a co-morbidity?
Sorry if I sound salty, I just finished doing a bunch of interviews where other people told me it'll be fine and it wasn't and I already knew how random it is. These are binary events.
If you don't get tested - the odds are you won't - the relief of recovery is quickly replaced with doubt, "was it really Covid-19?" And you must fearfully go on acting like it wasn't.
Not if you're people I've talked to recently -- any cold or flu and people are like "yeah I had it any it wasn't too bad, I don't get all the fuss. I'm immune to it now!" Even though they never got tested
For the vast majority of corona viruses cases, it is, in fact "not too bad".
There is survivorship bias in the media reports. Mild cases don't get reported because it's bland, common, and everyday. The ones that cause death DO get reported because it's clickbait basically. This biases the population to overestimate the risk from this.
The point I was trying to make though is that people that almost certainly didn't have it are assuming that they did, which is dangerous because now they'll be much less cautious
I've been struggling with health issues for the past 3 years. My heart races. My blood pressure spikes to dangerous levels. I get heart palpitations. I get pains in my chest. When it happens it's alarming and it's easy to fall into fear. I've gone to the hospital a few times absolutely sure I'm having a heart attack. But it seems that my heart is fine (as far as anyone can tell). I have a host of other problematic symptoms too, but for years nobody could find any real problem.
It's easy to say, "It's a panic attack". It does not appear to be life threatening. But boy does it feel life threatening. The doctors all say, "We can't find anything wrong with you" (apart from you heart racing randomly, your blood pressure spiking to dangerous levels, heart paplitations and various other problems). But what if they missed something? It's pretty hard to gamble your life on this stuff. I was absolutely fine until one day I wasn't. Something must have changed.
One of the problems with getting symptoms and not being able to diagnose the illness exactly is that you will never know. Pain in your chest. Difficulty breathing. Complete lethargy. It could be corona virus. It could be a panic attack brought on by worrying about the corona virus. You will never know unless you are tested (and even then it might not be right).
My experience has been that sometimes I take comfort in imagining that I have some strange disease that nobody knows about. It certainly feels better to me than, "My nervous system is making me ill through stress that I don't know how to relieve". But, I've also found that if I believe I'm ill, then the symptoms feel worse as well, even though I get some psychological relief from the stress of experiencing the symptoms.
The best way that I've come to deal with the problem is simply to believe that I will feel well again soon. I may feel bad now, but soon I will feel better. I may have an illness. I may not have an illness. It may be life threatening. It may not. Even if it is life threatening, there is nothing more I can do. So it is best to believe that I will feel better soon. This has helped me immeasurably, even though it is quite difficult to do.
I recently (and as a last resort) had a sleep test. I averaged 52 apnic arousals per hour. In other words, at most I was sleeping for a minute or so at a time. They gave me a cpap machine and while I would be lying if I said all my symptoms are magically going away immediately, I do feel a lot better now that I've started to get used to the machine.
But the reality is that your belief is powerful medicine in an of itself. Whether your are ill or not. Whether you have corona virus, or the flu, or whether you are just very tired and stressed: believing that you will feel better soon will help enourmously in my experience.
I hate to be that guy on the internet, especially since this is so unlikely, and since your description is also very consistent with anxiety/psych which is much more common...
...but particularly because you mention that this is a recent issue and not a lifelong deal, have you had a doctor rule out a pheochromocytoma? It's really unlikely since they're rare, (~1000 cases per year in the US) but they can cause the symptoms you are describing and it would tend to manifest in the age range of young adult to middle aged adult. And the labs needed to diagnose it aren't super routine.
But they way you described being totally fine until one day you weren't makes me have a stronger index of suspicion for a non-psychological cause.
This is super speculative, but there's a tiny chance it could help you since the treatment (surgery) is usually pretty definitive.
Yes, I did actually. And it's not only not necessarily causative, but they indicated that their symptoms weren't fully resolved. More importantly, it could very well be that the elevated catecholamines from just such a tumor are interfering with their sleep and causing excessive arousals. In fact, that may even be totally consistent with a pheochromocytoma.
Patients with a pheochromocytoma are notorious for presenting with secondary conditions that get misdiagnosed as the primary issue and the tumor isn't discovered until death. They're often called referred to as one of the "great mimics" of medicine. Note it on the list here: (https://en.wikipedia.org/wiki/The_great_imitator)
My wife is a doctor and she caught it at work. She and 7 other doctors (8 in total) all fell ill in the same week. This was about 3 weeks ago.
My wife had a bit of fever for the first 2-3 days (~38C), and she mostly suffered from a bad headache for about a week, and a cough (mild) for about two weeks and a sore throat (mild) for the first few days. After a few days she also lost her taste and smell of food which all came back on day 12 roughly. She is also in her super early 30s and never had shortness of breath or other issues with the lungs. After 7 days she even returned to work as her body has fought off the virus by then (even though some symptoms might remain like a cough).
I contracted the virus from her obvioulsy whilst she was quarantined at home for 7 days. After 5 days I also started to get my first symptoms. It started with a lot of fatigue, a sore throat and really high fever. During the first two days I had >39C fever, lots of shivers, cold sweats, and just feeling terribly tired.
Whilst that sounds terrible it was not anything different from what I experienced from previous flus. When my fever soared I felt totally shit, but as soon as the paracetamol kicked in and my fever declined I was feeling better and was even able to do minor tasks at home.
My sore throat lasted for about a week, it first got worse and then disappeared. I also developed an annoying dry cough after 5 days which stuck with me for about a week. Today I have a mini cough left a bit, but that is normal again, just like with a normal cold a cough can stick with someone for weeks after being completely fine again.
My fever disappread after the first 2 days. I also had terrible headaches, which were the worst and lost my smell and taste, but no shortness of breath. I was actually documenting all my symptoms every day and I'm thinking of uploading it to YouTube.
Overall I have to say if there was no stigma with COVID-19 I would have not even lost a second of a thought thinking that I was seriously ill. It was honestly a really mild flu after all. The actual flu which I had earlier this year was much worse if I'm honest. Not even two weeks after I got my first symptom I was working out in my garden and doing some mild cardio exercises again. Normally when I get a cold it affects my sinuses which means that I can't do cardio for at least two full weeks as I always struggle to breath through my nose for quite some time, but COVID-19 doesn't normally give you a runny nose and it didn't give me one indeed which means that in my case COVID-19 was even much nicer to get than a regular cold.
There's a lot of bad stigma and panic around COVID-19, but after all it's just a new repiratory coronavirus, just like colds and the flu your body should be able to fight if off normally without any real issues, unless you already have some serious problems.
It's important to remember that COVID-19 is not a lottery or survival by luck. It is a mild illness if you are a healthy and relatively young human being. It does discriminate against fragile, old and people with a pre-existing conditions. If this wasn't true then we would see a much more evenly spread death rate, but we don't because to most people who are fine this is barely an illness.
There's only two types of people who die from it:
- People with a pre-existing health condition
- People with a pre-existing health condition who don't know about it yet because no doctor has diagnosed it yet
Thanks for sharing, and glad you are well. However, you can't possibly know this to be definitively true: "People with a pre-existing health condition who don't know about it yet because no doctor has diagnosed it yet". It could be that some people just aren't as good as fighting it off, perhaps because they hadn't had the "right" set of previous illnesses, or who knows what else, that can lead to fatality. I don't think we know enough to make such bold claims.
This is true, there is always some outliers, but I was just trying to speak generally that for the most part COVID-19 is not this scary crazy lottery. I see currently so many young people getting mentally more ill than COVID-19 would ever make them ill, because they are constantly being drip fed scary news stories which makes everyone believe that as soon as you step outside your house you can breath in a killer virus which will make you suffocate the next day.
Like with everything in life there are some outliers who just happen to have really really bad luck, but you can't look at those and be afraid. It's like with cancer, most people who get cancer are old because for obvious genetic reasons, but there are some poor children who also develop cancer, but no child should live in fear thinking that one day they could wake up with a bad bowl cancer. It's irrational.
It is true though. Where we live 70% of the COVID-19 patients which are currently in intensive care are very overweight men. Just being fat itself puts a huge strain on your health, you're more likely to get a lot of illnesses with age and a lot of these patients probably should be taking already medication in order to prevent a heart attack or other issues coming up and the only reason why some of them are currently "without an existing health condition" is because they didn't go to their GP yet who took some blood samples and decided that they are a risk group who should start making some lifestyle changes.
Like it or not, but I'm not going to sugar coat the reality of the situation because I might hurt some obese person's feelings.
> Here's data from the UK ICUs. Page 15 shows BMI.
> Here are the numbers of people by BMI. First column is BMI, second column is the percentage of people in ICU.
BMI COVID-19
<18.5 0.64
18.5 to <25 25.79
25 to <30 35.04
30 to <40 31.33
40+ 7.20
Your data kind of proves the point which the OG has made that 70% of patients are overweight though.
A BMI > 25 is overweight. When I look at the table which you have posten then I calculate that ~73% of patients in ICU in the UK are overweight indeed then.
There is 35.04% of patients with a BMI > 25, another 31.33% of patients with a BMI > 30 and 7.2% of patients with a BMI of > 40.
Either I don't understand the data which you have posted or you didnt?
You're neglecting to consider the rates of obesity in the general population.
29% of adults in the UK are obese (BMI > 30) and another 36% are overweight (25 < BMI < 30).[1] So the pattern you see above is really just "people hospitalized for COVID-19 have roughly the same distribution of weights as the general population". There's a little bit of correlation with the obese being a little more likely to be hospitalized, but I'm not sure that pattern holds up if you correct for age. In any case, it's not nearly that exciting or strong of a correlation, to let you guess who is going to die.
> There's only two types of people who die from it:
> - People with a pre-existing health condition
> - People with a pre-existing health condition who don't know about it yet because no doctor has diagnosed it yet
This is untrue. From the UK ICU data:
First column is discharged from critical care alive numbers (percentage), second column is died number (percentages).
Assistance required with daily activities
No 715 (50.5) 700 (49.5)
Yes 66 (37.3) 111 (62.7)
Any very severe comorbidities
No 744 (49.8) 749 (50.2)
Yes 48 (38.1) 78 (61.9)
What you recommend probably doesn't hurt, but I don't think it has been shown to work either. You should maybe be careful with giving out medical advice on the Internet.
I'm not German but I'm pretty sure that you're from the 50 cent army given that this account was created super recently and has only posted in this one thread with utter nonsense straight out of Google translate. Especially since your post is about how drugs don't work on a predominantly American used forum...
(By the way: I'm sorry I didn't respond to https://news.ycombinator.com/item?id=22837826. I mean to, but there just wasn't time to write a longer explanation. This unfortunately has been happening increasingly.)
To those scientific minds who enter the symptoms of Covid-19: if you find a desire and ability to experiment, you may find the courage to try a light ozone generator in a mostly closed room.
Healthcare systems of many countries are cornered by these assumptions: 1) light ozone generators cannot do a thing because they produce tiny concentrations of gas 2) the ozone is toxic.
While both of those statements are somewhat true, here is the thing.
The dangerous side of Covid-19 is its ability to target lungs in a fraction of patients. While this is a dangerous situation, it also makes it potentially susceptible to inhale treatments.
Now back to ozone. It is basically a recombined atoms of oxygen, but instead of ubiquitous O2, ozone is O3. As you might expect, it has higher oxidizing ability. Human can safely breathe ozone as long as its concentration goes below 0.2 mg/m3.
Ozone is not only a breathable gas. It also has an ability to disinfect. For example, it deactivates the viruses by over-oxidizing its surfaces.
Regarding the concentrations. It was shown that to kill 90% of SARS-CoV you would need an exposure of 20-112 mg / m3 during one minute. Which sounds like a lot but bare with me.
A disinfection with ozone has an accumulative effect, pretty much like with UV or radiation. For instance, a home ozonator (ozone generator) typically produces a concentration of 0.02 mg/m3. It would not kill the virus in a minute. But it will start to do so in 17 hours of exposure (20 mg/m3 / 0.02 mg/m3 / 60 min/hour = 16.6 hours).
Ozone can be generated in several ways. One of those is by exposing the air to UV-C. This is a preferable method for virus situation, because not only the desired gas is generated, but also because UV-C light has an ability to disinfect the air and surfaces by itself. A win-win.
Please note that UV-C may be critically dangerous to skin and eyes. To overcome that problem, UV-C lamp should be placed in a black or UV insulating box, where only a small laminar flow of air produced by the fan is exposed to UV-C. The suggested power of such a lamp would be something < 10W where 3W looks like a sweet spot for a 18 m2 room.
Now to effects: tiny fractions of ozone would cause a small sedative effect. If the breath is difficult then you may find a tiny amount of O3 more supportive comparing to conventional air mixture which is already a big bonus.
In 17 hours or so of exposure, you are going to feel better, as the consumed concentration is already promises to deactivate a substantial amount of exposed virus material (like 90%).
The good things do not end here, as deactivation rate is exponential and in 34 hours you are going to get 99% of exposed virus material deactivated.
Now to the not so good things: ozone is slightly toxic and you would not be able to use it for too long. 3 days of presumably safe concentration is already close to a stretch. It not only damages viruses and bacteria, it also over-oxidizes human cells which leads to their eventual damage. It is usually felt like a soar throat.
The important points to consider when trying to implement the experiment like this: 1) safe O3 concentration 2) no direct human exposure to UV-C 3) room should be on a smaller side, as it is easier to control (8-20 m2 is a sweet spot) 4) the room should be mostly closed, do not ventilate the room more often than once or twice per 24 hours for short periods of time like 5-10 minutes; note, that you still need an air to breathe, so a "mostly closed room" would not mean a "scientifically firmly closed room".
Did I try this extreme idea myself before publicly suggesting it? Yes, I did. Though for more conventional viruses like seasonal flu. I was never officially diagnosed with Covid-19, but I'm pretty confident I went through it in the middle of February when nobody had a test yet.
The idea may sound controversial to the most of population nowadays. But it surely is effective on viruses as I've experimented with it for 7 years.
I am putting this publicly to spark the minds of researches, including professionals. This is a low hanging fruit so I'm surprised to admit that nobody had tried it before in scientifically controlled environment, with control groups and stuff.
DISCLAIMER: If you do this you do it on your own risk. The large dozes of ozone and UV can be extremely dangerous and may lead to fatal consequences or even death. This is not a scientifically proven treatment of Covid-19.
i mean when he's going grocery shopping, etc around here everyone seems to have a mask everywhere even when walking their dog with no one else round for hundreds of feet.
I hate to say it, but I’m actually jealous of people who have gone through and recovered from COVID-19. You can enter normal life again, you don’t need to have the fear, the rest of us are simply waiting because the chances of us getting it at some point is very high.
I actually wonder if some controlled exposure might be a good thing, I can get it and (statistically) recover from it at a place away from my family, and then come back and be the one that does everything for everybody.
> I hate to say it, but I’m actually jealous of people who have gone through and recovered from COVID-19. You can enter normal life again, you don’t need to have the fear, the rest of us are simply waiting because the chances of us getting it at some point is very high.
Even if you have antibodies it's not going to be normal a life. There will still be social distancing expected and enforced, capacity limits at stores, many businesses closed, and you still need to exercise caution to not spread it unnecessarily just like everyone else.
Or instead of "running around spreading" you could take reasonable precautions - shower, put on clean clothes, drive directly from your house to theirs. Pretty negligible risk in that case.
You can still be contagious for a while after being free of symptoms - how long to isolate after that is still difficult to gauge. The NHS suggests 14 days after being free of symptoms. But when is that? That dry cough can last for quite a while...
NHS says If you have symptoms the NHS tells you to self isolate for 7 days. If you still have symptoms you need to self isolate until those symptoms go.
NHS says If you live with someone who has symptoms you need to self isolate for 14 days from the day their symptoms started.
I think this is one of the reasons we have such high rates of infection in the UK.
Sure, but even if you bump that up by a lot, like to 90 days, you're likely still better off after those 90 days than people who don't have antibodies.
> Not every virus functions the same way, though, and extensive research into whether the SARS-CoV-2 virus that causes COVID-19 generates enough antibodies to impart a durable immune response is unclear. But there’s plenty of reason to hope that a vaccine can be developed, and, in fact, clinical trials have already started.
> For one, it appears that some people who get COVID-19 may not develop antibodies to the virus. Additionally, there are still many other uncertainties related to the body's immune response to this particular pathogen.
And long term:
> For example, is this virus going to behave more like the flu, which changes each year and thus requires a different vaccine formulation each year? Or is it going to be more like tetanus, which is a more stable virus. The tetanus vaccine typically covers you for about 10 years at a stretch.
There was a similar article in the NYT recently by a woman whose husband contracted COVID, had a relatively 'normal' pneumonia, but the article read like a war report out of an Ebola zone, allusions to Chernobyl the TV series, and COVID as a silent killer, and so on.
Now I don't want to diminish the personal experience of anyone, but I'm still surprised how many people in their 40s, 50s, 60s who ought to have had personal experience with tragedy and illness seem to have serious psychological trouble coping with the simple fact that we're for a while living in a pandemic and that life has become somewhat more dangerous.
It's not that I'm personally not worried at all, but there has to be some perspective. Life is more dangerous, but it's always somewhat dangerous. I wonder if it's, in particular, a phenomenon of affluent societies that haven't had to deal with serious stressors in a long time.
If you've ever been to Israel and lived there for a while and you go to a wedding and five minutes later there's a bomb alarm and there's pretty much rockets flying your way all the time, and you observe how resilient people are in coping with danger in their life, observing a lot of cultural response here worries me a lot.