Saturday, March 07, 2020

COVIR19 or Covir-19 or Corvid19 OR WHATEVER

We are told to ignore everyone but trustworthy experts who are in a position to really know about Covid19 and that's good advice, but the problem is so far-reaching that several kinds of experts are needed, from Umaihr's critique of American culture (poverty, lack of health care, inequity) to Quammen's explanation that the genome code is a sheet of tiny bits that can cross skins, species, plants, and even can float as fragments in the ocean and as crime clues.  The specific nature of Covirus19 needs description as well as the devising and preserving of public health mechanisms like detection, interdiction, availability of needed meds and machines, and so on that we once had on hand ready for the inevitable next wave of predatory viruses: Spanish flu, SARS, MERS, HIV, Ebola. The precautions were cashed in for political profit.

"Spanish" flu and Swine flu were caused by H1N1 virus.  Covid19 is a kind of corona virus.  Other corona viruses (classified by shape, being crown-like) can cause conventional colds or seasonal flu, both so good at mutating that vaccines must be redesigned again and again.  Smallpox was an infectious disease caused by one of two virus variants, Variola major and Variola minor. The last naturally occurring case was diagnosed in October 1977.  Antibiotics cannot cure viruses.

This lively vid is a visual presentation of the differences among the various epidemics.  Covid19 seems to be most like Spanish flu in contagiousness and not much like Ebola, which had an 80% death rate, so didn't travel well.  There are two "kinds" of Covid19, "L" and "S".  "L" is more virulent which means that "S" is now prevailing -- milder versions travel better.
https://www.youtube.com/watch?v=6dDD2tHWWnU

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30462-1/fulltext?rss%3Dyes
This second vid is similar but more conventional.

Yesterday I was lucky enough to catch a streaming panel discussion from the University of Texas Health Center which was evidently not recorded in a video. I was not alert enough to get much contact info.  They were exceptionally clear and detailed.  One man (didn't get his name -- this is a very bad reference) finally explained the action of the virus.  First, it is not spread by an aerosol that hangs in the air but rather by expelled micro-droplets from the lungs that land on surfaces and cling, sometimes for 4 hours.  Hands pick up droplets and carry them to eyes, noses, and mouth which are portals to the body interior.  Luckily they are all on the face, so if you never let your hands touch your face, you are performing the most vital interdiction of the contagion.  Masks protect against inhaling aerosols but do not protect eyes, so goggles would be needed.  But masks will keep an infected person from ejecting the contagious micro-droplets onto the environment, another interdiction.

The only way to know as much as we need to know in order to cope as a society is taking data through tests, which is only possible if test kits are easily and widely available.  This is not happening so far.  It is guessed that the virus is spreading very quickly and broadly since it can linger on surfaces after the source is gone and since many people have strong enough immune systems to keep it symptomless or felt as a version of seasonal flu, which is still around.  Also, there are cases of people who test as free of infection, even after recovering, but then having a recurrence.  So this is a fluid and nimble virus.

In a small percentage of cases -- which is different than raw numbers which are more expressive of the importance of individual patients -- help will be needed to sustain the life of the body's cells.

1.  Basic bedrest, plenty of fluids, nutrition, addressing of bacterial tagalong microbes.
2.  Maybe auxiliary oxygen, like what we see people trailing along for weak hearts.
3.  Actual respirators that force oxygen rich air into lungs.
4.  If lung tissues fail to pick up breathed oxygen, a cannula can be put in place in a large blood vessel to push oxygen directly into the blood stream.
5.  If even that is not enough, lung function of gaseous exchange that takes out CO2 and puts in oxygen, can be done by taking the blood in a loop through a machine, something like replacing kidney function.

At present we don't even have enough face masks, much less oxygen sources like the ones used for heart weakness.  By the time treatment gets as far as injecting oxygen into blood vessels, a hospital is needed.  A machine that replaces lung function is scarce and expensive.  Only specialized hospitals could provide such a thing.

The far more disruptive impact than the challenge to infected individuals is the waves of consequences to daily life.  Businesses may be shut, major amounts of sick, quarantined workers or the failure of transportation and communication systems -- even police and ambulances -- are seriously crippling and will have economic consequences that may take some entities out of existence.  Activities that ask for assemblies, like sports or concerts or even malls, may have to be banned or may simply suspend out of caution.  Prisons trap people.  Public schools and universities are already suspending.  

I do not understand why toilet paper should suddenly be hoarded.  No one has said needing it is relevant.  But pandemics are not rational.  It has already become a political righteousness issue since only "the West" uses the stuff while other nations use bidets or even . . . use your imagination.  Those "others" do not eat soft predigested foods that produce gooey excretions,  I also do not understand the fixation some Twitter users have specifically on males who do not "wash their legs or asses" which they consider a sign of evil.

This specific pandemic, which is not as bad as some have been but certainly bad enough, is predicted to spread through the world and become as lingering as flu or colds.  The tremendous variety of strategies of nations from blithe fantasies like Trump's; to near-draconian control like Singapore; to flat denial and suppression of information like Russia, we are being offered a workshop to study at least one use of government, which is the welfare of humans.  One effect that we also knew was coming, though we expected it to be from climate disruption, will be radical population reduction like the bubonic plague cutting the population of Europe in half or smallpox eliminating whole tribes of American indigenous people.


The most evil dynamic of this happening is that the poorest, least educated, and most edge-dwelling people are most likely to die.  But the most remote, least technical, and most traditional people are most likely to survive.  I think of Hanford or Chernobyl where most people have left, but the wildlife thrive and a few stubborn old ladies persist.

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