Research Misinfo/Disinfo: Check Experts’ Homework

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[Check the byline, thanks. /~Rayne]

This is the first of two posts about research information and the disease COVID-19. I want to point out upfront I’m not a scientist/medical professional/public health expert. However I spend a lot of time reading fine print.

One thing I should set straight here is that we tend to use COVID-19 to refer to the disease and to the virus which causes it. This isn’t really accurate; I’ll be referring to SARS-CoV-2 as the virus underlying the disease called COVID-19 in this post.

~ ~ ~

Family members shared with me a link they received from a health care professional we know and trust. This professional told my family a Stanford researcher said “heat and sunshine will help to diminish the virus that causes COVID-19.”

You can imagine my family members’ concern because they’re in Florida where it’s quite warm already and yet COVID-19 cases continue to mount.

This situation provides a good example of how experts misunderstand and/or misuse research information and how lay people can be further misled or confused.

Direct link to video: https://youtu.be/xUGwGgV7r5Y

Note the researcher Dr. Lin’s background, Associate Professor in Neurology and Bioengineering at Stanford. He’s degreed in biochemistry and neurobiology, did postdoctoral work in fluorescent protein engineering. Sharp guy, great CV, but he isn’t a virologist or an epidemiologist.

At 6:45 in the video he refers to the outside of the virus as a “plasma membrane” — that’s just another less frequently-used term referring to a cell membrane. Virologists are more specific when discussing the coronavirus which causes COVID-19; it’s an RNA virus with a lipid membrane, attacked readily by soap though he does mention detergents.

When talking about sunshine or UV effects he discusses coronaviruses as a class, not SARS-CoV-2 specifically; he actually uses the word “estimate” with regard to timing.

Here is the first PubMed study Dr. Lin referred to in his video:

Photochem Photobiol. 2007 Sep-Oct;83(5):1278-82.
Inactivation of influenza virus by solar radiation.
Sagripanti JL, Lytle CD.
https://www.ncbi.nlm.nih.gov/pubmed/17880524

Emphasis mine. It’s not a study about *any* coronaviruses at all.

This is the second PubMed doc he cited:

J Virol. 2005 Nov;79(22):14244-52.
Predicted inactivation of viruses of relevance to biodefense by solar radiation.
Lytle CD, Sagripanti JL.
https://www.ncbi.nlm.nih.gov/pubmed/16254359

This study doesn’t even mention coronaviruses and was published *before* the MERS outbreak — another SARS-like variant of coronavirus which was first identified in 2012 in the Middle East, which I’ll point out is both sunny and hot compared to the northern U.S.

When Dr. Lin discussed temperature he referred to this study on the specific corona virus which causes the disease SARS:

Adv Virol. 2011;2011:734690. doi: 10.1155/2011/734690. Epub 2011 Oct 1.
The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus.
Chan KH, Peiris JS, Lam SY, Poon LL, Yuen KY, Seto WH.
https://www.ncbi.nlm.nih.gov/pubmed/22312351

Emphasis mine. Note this is a study of the virus which causes SARS, not the viruses which cause influenza or COVID-19. This is the abstract:

The main route of transmission of SARS CoV infection is presumed to be respiratory droplets. However the virus is also detectable in other body fluids and excreta. The stability of the virus at different temperatures and relative humidity on smooth surfaces were studied. The dried virus on smooth surfaces retained its viability for over 5 days at temperatures of 22-25°C and relative humidity of 40-50%, that is, typical air-conditioned environments. However, virus viability was rapidly lost (>3 log(10)) at higher temperatures and higher relative humidity (e.g., 38°C, and relative humidity of >95%). The better stability of SARS coronavirus at low temperature and low humidity environment may facilitate its transmission in community in subtropical area (such as Hong Kong) during the spring and in air-conditioned environments. It may also explain why some Asian countries in tropical area (such as Malaysia, Indonesia or Thailand) with high temperature and high relative humidity environment did not have major community outbreaks of SARS.

38C = 100F degrees.

People avoid being tightly clustered in confined spaces at that temperature. Note especially the first sentence about inhaled droplets. It’s not just that the virus may lose viability in a shorter period of time which reduces cases but the proximity of humans during the time the virus is active. Temperature alone is not a factor in reducing transmission rates.

The second study about temperature he cited:

Biomed Environ Sci. 2003 Sep;16(3):246-55.
Stability of SARS coronavirus in human specimens and environment and its sensitivity to heating and UV irradiation.
Duan SM, Zhao XS, Wen RF, Huang JJ, Pi GH, Zhang SX, Han J, Bi SL, Ruan L, Dong XP; SARS Research Team.
https://www.ncbi.nlm.nih.gov/pubmed/14631830

Emphasis mine — this is yet another study of the virus which causes SARS. This is a fairly early study dated 2003; the SARS outbreak began in 2002 with the first epidemic ending in June 2003. Here’s the results in the abstract:

RESULTS:
The results showed that SARS coronavirus in the testing condition could survive in serum, 1:20 diluted sputum and feces for at least 96 h, whereas it could remain alive in urine for at least 72 h with a low level of infectivity. The survival abilities on the surfaces of eight different materials and in water were quite comparable, revealing reduction of infectivity after 72 to 96 h exposure. Viruses stayed stable at 4 degrees C, at room temperature (20 degrees C) and at 37 degrees C for at least 2 h without remarkable change in the infectious ability in cells, but were converted to be non-infectious after 90-, 60- and 30-min exposure at 56 degrees C, at 67 degrees C and at 75 degrees C, respectively. Irradiation of UV for 60 min on the virus in culture medium resulted in the destruction of viral infectivity at an undetectable level.

37C = 98.6F (This made me laugh – it’s the temperature used for many years as a baseline for the average healthy human.)

Sure, heat deactivates the SARS coronavirus at temperatures fatal to humans, but it’s active at least a couple hours at temperatures in which humans live.

The last study cited was:

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1
March 17, 2020
DOI: 10.1056/NEJMc2004973
https://www.nejm.org/doi/full/10.1056/NEJMc2004973
https://www.ncbi.nlm.nih.gov/pubmed/32182409

I’ve referred to this several times in comments with regard to hang time of the aerosolized virus. This study is a pre-print, not peer reviewed I should point out. It’s worth reading this study in particular because it’s about SARS-CoV-2 not SARS-CoV-1 and the findings have been misreported or misused a number of times in the media.

Rely on that last study the most because it’s about SARS-CoV-2, not SARS-CoV-1. It confirms that like the virus which causes SARS that SARS-CoV-2 can hang in the air as aerosol, and in this case the study showed it was viable for 3 hours:

SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A).

A friend sent me a link to this new pre-print study, not peer reviewed yet, published Friday March 27:

Stability of SARS-CoV-2 in different environmental conditions
Alex W.H. Chin, Julie T.S. Chu, Mahen R.A. Perera, Kenrie P.Y. Hui, Hui-Ling Yen, Michael C.W.
Chan, Malik Peiris, Leo L.M. Poon
https://www.medrxiv.org/content/10.1101/2020.03.15.20036673v2.full.pdf

This work confirms the viability of SARS-CoV-2 virus drops with increases in temperature and over time, but do note the data table provided in the study.

What the March 17 and March 27 studies say is that SARS-CoV-2 does weaken and become inactive with heat and over time.

What these and the other studies above do NOT say is that “heat and sunshine will diminish the virus.” There haven’t been any studies about SARS-CoV-2 viability over time with exposure to UV that I’m aware of . And while heat does speed the inactivation of SARS-CoV-2, the virus is still active for 2-3 hours in aerosolized form.

Like exhalation from infected humans, whether symptomatic or not.

It’s critically important that the public understands this virus SARS-CoV-2 is different from its relative, SARS-CoV-1. We can see this difference in both the ease with which it spreads and its much lower case fatality rate. Using studies of SARS and SARS-CoV-1 to extrapolate what SARS-CoV-2 will do has limits because of these key differences.

The same goes for anyone claiming SARS-CoV-2 is just another flu bug, that COVID-19 is just another influenza. It’s definitely not — anecdotal evidence of dead Americans by the truckloads tell you this is not just another flu. This difference is so obvious you should reject any such claims as propaganda. And any researcher making claims about SARS-CoV-2’s viability under certain conditions based on influenza viruses isn’t helping the public.

It’s as unhelpful as telling people erroneously that “heat and sunshine will help to diminish the virus that causes COVID-19.”

~ ~ ~

The bottom line: STAY HOME because aerosolized virus from asymptomatic and pre-symptomatic carriers in closed spaces has resulted in a significant number of confirmed cases versus fomite transmission — virus left on surfaces — though fomite transmission is still possible.

I’ll point to the story the Los Angeles Times published this week — sharing The Daily Beast’s summary because the LAT article is behind a paywall:

The Los Angeles Times reports that 45 out of 60 Skagit Valley Chorale who gathered at the Mount Vernon Presbyterian Church have tested positive. Three have been hospitalized and two have died.
https://www.thedailybeast.com/coronavirus-strikes-45-of-60-people-who-went-to-mount-vernon-washington-choir-practice

These people were careful; they observed social distancing techniques and heightened hygiene. But aerosolized virus got them, and it can get to others even when the weather is warm.

~ ~ ~

Next: the lack of solid research behind a particular off-label therapy.

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128 replies
  1. Rayne says:

    Really kind of miffed about this. Hate having to explain to my folks what they can see in front of them in Florida, that all heat and sunshine they’re experiencing will do nothing about the case or fatality count ahead.

    Only DeSantis getting his head out of Trump’s ass and locking down the entire state will work.

    Also really concerned about that last study in my post, the newest one with regard to its observation about SARS-CoV-2 viability on a surgical mask — it’s not good. It must have concerned the researchers to share such a pointed observation. It’s all the more important that health care workers have access to all the PPE they need if there isn’t a means to disinfect masks between uses. (Duke University studied disinfection of N95 masks and found vaporized hydrogen peroxide is effective, can allow N95 masks to be reused, but vaporizing H2O2 isn’t something every medical facility can do right now.)

    • vvv says:

      Re vaporizing hydrogen peroxide to clean masks, I wanted to know if that’s something easily done at home (my daughter just got hired at a a medical facility that treats girls and women with various disorders on an inpatient basis, and was told they are re-using masks). I reckon not, per this article:
      ht tps://techcrunch.com/2020/03/27/duke-university-uses-vaporized-hydrogen-peroxide-to-clean-n95-face-masks-for-reuse/

        • Old Antarctic Explorer says:

          Note carefully the human exposure limit in that report: 1 ppm over 8 hours! Vaporized H202 is really dangerous stuff, not be fooled around with at home. There is a company in the UK that markets a unit for sterilizing the entire room in a hospital (I bet they are ramping up production!). The unit is wheeled into the room, plugged in and left for 24 hours. The room is locked and signed as dangerous to humans. Then the room is cleared out and available for use. If anyone were to walk into the room while it was full of H2O2 vapor they would die.

        • Pajaro says:

          I read that hydrogen peroxide is used in decontaminating bioweapon hit sites. They have this equipment (no direct knowledge). Certainly if army field hospitals are being set up Army could contribute these units as well to decontam PPE for hospitals. All it takes is the will and mobilization by our fearless leader. Oh, well nevermind.

    • Eureka says:

      With the Duke findings announced March 26th, it’s notable that 3M* made a statement that as of March 27th, no method of disinfection for reuse met all of their criteria. I’m curious to see if (and how) 3M changes their stance when the Duke paper is published (and I hope it has some more data than were in the preprint they shared; perhaps 3M is looking for more info).

      *Duke also used 100 3M masks and did fit testing in their study, which addressed a couple of 3M’s prior critiques on limitations of past work.

      3M Technical Bulletin – Disinfection of Filtering Facepiece Respirators (PDF, 213.93 KB)
      https://multimedia.3m.com/mws/media/1816576O/disinfection-of-disposable-respirators-technical-bulletin.pdf

  2. OldTulsaDude says:

    Saw Dr. Fauci on television last night and he spoke specifically on UV, saying that the amount of UV produced by the sun is not enough to kill the virus while the amount needed to kill the virus would damage the skin.

    • Mooser says:

      “heat and sunshine will help to diminish the virus that causes COVID-19.”

      Unfortunately, when the virus is ‘diminished’, the structure of the viral ‘package’ becomes a stack of minor thirds. This allows the diminished virus to substitute for dominant sevenths in our cells which contain the same tri-tone structures. And each diminished virus has two tri-tone structures.

  3. Vicks says:

    From what I understand, a large number of the 60K deaths attributed to the flu “they” keep comparing this virus to, were actually deaths from pneumonia or some other complication.
    What I am not clear on, is from a medical standpoint, is something similar happening with the Covid-19 virus, or is this virus attacking the body in a unique way that directly causes death in those that can’t fight it off?

    • Rayne says:

      SARS-CoV-2 which causes COVID-19 does act in a unique way. That’s the entire problem with the virus. We have nothing to stop its insertion into human cells, nothing to stop its replication, and no vaccine to condition the body to attack the virus before it attacks the human host.

      SARS-CoV-2’s attack is very similar to what the coronaviruses for SARS and MERS did to its victims, but not identical; more patients appear to experience the “cytokine storm.”

    • Ken Muldrew says:

      Most of the deaths of older people are from ARDS (acute respiratory distress syndrome) – pneumonia and lung-related complications. The lung failure is a result of corona virus killing cells in the lung tissue that are needed for normal function. Some of the older patients, and many of the younger patients that succumb to the virus are killed by cardiac and organ failure caused by a cytokine storm. Cytokines are cell-to-cell signalling molecules (like hormones). The inflammation associated with the virus causes a positive feedback loop where cytokines are released too quickly and in too great a quantity for the body the handle. This was also the case with the Spanish Flu pandemic that killed so many young people.

      • paulpfixion says:

        “Many of the deaths are from ARDS…”

        There, fixed it for you. We need to stop suggesting this is somehow just an old people thing. Young healthy people are also dying the exact same excruciatingly painful death. Young healthy people are also being intubated. Referring to “deaths of older people” propagates the myth that the young are invincible which in turn has killed more people.

        • Ken Muldrew says:

          I don’t think I insinuated anything of the kind (about it being an old people thing), but maybe I was too brief. What I tried to get across was the difference in the cause of death (and this is just a difference in proportion) between older and younger patients who succumb to the disease. I apologize if I gave the impression that young people were not being affected.

        • paulpfixion says:

          Thanks for the clarification. My apologies for being perhaps too sensitive on that point. I just keep hearing from young and middle-aged friends and family that the virus is mainly dangerous to the old and the sick and it has been driving me nuts.

      • Rayne says:

        Yeah. Thanks a bunch, Ken. I did explain at least 2-3 weeks ago that COVID-19 patients were described by the Chinese as having died not of hypoxia but of fulminant myocarditis because of the cytokine storm.

        Influenza doesn’t do that; death is more often hypoxia or from an opportunistic secondary infection.

        • CCM says:

          Second that, death by intractable hypoxia associated with ARDS is not common. Most deaths are due to organs other than the lung failing. This assumes that ICU is using a modern, high tech ventilator. Application of oxygen, gas flow and pressure and monitoring are crucial. Grabbing a 1970’s vent from some warehouse or using a quickly designed vent may not provide the some mortality benefits. I worry we are looking too much at numbers of vents and forgetting quality. An analogy would be asking your pilot to fly a plane with ancient avionics, safety may suffer.

        • Rayne says:

          I don’t know how many health care workers could intubate patients with older equipment. Not helping, either, when we’re losing so many to sickness and death.

  4. viget says:

    There is some hope. Here’s a nice study looking at the stability of the SARS-CoV-2 Spike protein at different temps vs. S protein in SARS-CoV-1.

    link to article from Nature Communications

    See fig 4d,e in the above. The S protein is much more heat labile in SARS-COV-2 vs. SARS-COV-1, being nearly 100% inactivated at 50C, which is 122F.

    Now, this is in pseudotyped lentivirus, which means it’s a common virus we use to get cells to express proteins of interest stably that will not produce more infectious virus, that is just using the Spike protein for cellular entry, instead of the other common cell receptors used for other experiments (such as VSV-G protein). I would also point out that the cells being infected are NOT human airway or lung cells, but rather a common cell line we use for virus infection and production called 293 cells, derived from human kidney cells from embryonic remains. It’s been engineered to express high levels of ACE2, the cellular “lock” if you will for virus entry for SARS-CoV-2. So it’s a bit of an artificial system, but I’d imagine if anything, due to high levels of ACE2, these cells might be even more susceptible than our cells in our lungs or other respiratory tract lining cells.

    The reason I even mention it is that while 120F isn’t a classic sterilization temp, it might be hot enough to destroy all the Spike protein, thereby rendering the virus non infectious. It is a temperature that shouldn’t ruin the integrity of a mask, so it could be another way to “sterilize” a mask at least from SARS-Cov-2.

    Of course this would need to be verified with actual Coronavirus, but it is interesting. I won’t go on, but there is a valid scientific reason for why this might be so.

    And I am a medical professional, and have a PhD too, so this is informed speculation.

    • Rayne says:

      I like this informed guess, in no small part because you acknowledge it’s an informed guess and in part because you’re specific about your guess.

      But the issue that drove this post — the claim that “heat and sunshine will help to diminish the virus that causes COVID-19” — is too easily interpreted by the public as “this virus is seasonal and will dissipate with warm weather.” Which means the public won’t think in terms of disinfecting surfaces in the sun or by seasonal heat; they’ll think that COVID-19 cases will go away with the change in seasons. I really think they’ll perceive the tapering of cases as a sign of seasonality and not the effect of social distancing, especially when researchers like Dr. Lin swag statements about heat’s effect on SARS-CoV-2.

    • Old Antarctic Explorer says:

      I’ve read a lot of reports on Covid-19 and all the comments here; I’ve yet to see anyone report the results of a simple experiment. How can we sterilize PPE, masks, etc with heat. That is what temperature for how long will kill this virus. You’d think someone would have done this, but I can’t recall seeing it anywhere. And will that temperature/time damage the masks, PPE, etc?

  5. taluslope says:

    I could be wrong but I’d like to make a couple of points. Beware that while I’m a scientist, I’m have no domain expertise in epidemiology or anything remotely similar.

    Regarding “flattening the curve” and staying at home. We live in Oregon which so far is doing well in terms of COVID-19. This is likely do to early action by our governor to issue social/physical distancing guidance. Our hospitals and beds and respirators are currently not overwhelmed. We only have 18 deaths and just under 5% of those tested are positive.

    So far so good, but be forewarned, here comes rank speculation on my part. I think we may be near the point of having too few positive cases in Oregon. I know how awful this may sound to some, but from my limited understanding unless a miracle occurs on the vaccine front, roughly 60% of us are going to get the disease (at which point herd immunity can protect us). Our goal at this point in time is simply to save our health care workers not necessarily to simply drive the number of infected cases down. This means in Oregon it might actually be better if our transmission rate was a wee bit higher. I worry that when we begin to socialize we overdo it and then the disease comes roaring back.

    I’d like to hear comments from all (especially those more enlightened than I) on this thought.

    Note that my interpretation of the Spanish flu outbreak in Philadelphia and St Louis seem to support this theory. I attempted to visually integrate the death rates from those two cities and found that total deaths were roughly the same, the difference being that Philadelphia got them mostly all at once and St Louis spread them out over time.

    So I’ve resigned myself to the odds being roughly 60% that I or a family member will contract the disease. We are currently limiting virtually all contact with others (or is that limiting all social contact to virtual :-)

    Here is wishing the best to you all and hope to see you on the other side.

      • taluslope says:

        I just thought of a flaw in my argument. Since I’m a physicist, I look at an infected person as a neutron seeking a U-235 nucleus to infect and blow shit up. Neutron production rate (fair warning I’m not that kind of physicist) is between 2 and 3 (2.45 on average) per fission event. Surprisingly, that is the same rate (2-3) I’ve heard quoted for the number of people an infected person infects as the disease ramps up (but can go even higher). So when one hears exponential growth, in this case it really is exponential like a nuclear explosion — I emphasize it is NOT exponential in the way that has crept into the common vernacular (which to get truly geeky should rather be called polynomial).

        But I just looked at curves from the daily press briefing and the total number of deaths is lessened by social distancing. So I guess what happens is that (to use the physics analogy) when the density is high enough (no social distancing) there are enough neutrons produced to ignite most of the fuel before it blows up (extreme social distancing). If the density of the fuel is low enough then most neutrons will escape the reactor without being captured by U-235 atoms.

        So I think that with little social distancing the infection rate is so high that nearly everyone becomes infected. But with the correct amount of distancing we can keep the infection rate just above 1 until we reach herd immunity, at which point the virus is unlikely to find an uninfected person in time to do its evil deed.

        • taluslope says:

          Yikes, I just realized that even though my original theory was flawed, the BEST odds are that 6 out of 10 contract the disease.

        • Ken Muldrew says:

          A nice analogy. Social distancing is like the control rods used to reduce the cross-section. Without good testing, though, we’re kind of playing with fire by pulling those rods out and hoping the reaction doesn’t runaway. Maybe best to keep everything shut down until testing capacity gets way better.

        • Pajaro says:

          I was kinda liking that series Manhattan, about the A-bomb development at Los Alamos. Then it ended.

        • mosswings says:

          @talusslope, the analogy to nuclear fission is fairly apt. In a paper published a couple of weeks ago by researchers modeling the spread of the virus (equivalent to U of W’s IHME that is driving response decisionmaking in the US, at least at the state and local level), the point was made that categorizing the spreading profile as exponential is not correct. Contemporary models use network theory to describe the spreading behavior as a function of social distancing. Human networks have a dense proximal/sparse distal network complexity, which is why social distancing works at all. A purely exponential behavior basically says that IF there is a host anywhere, a carrier will find and infect it. That’s not true; get carrier and host far enough away and the virus will die before it reaches the next host. The declining density of human networks limits the spread.

          The result is that the natural infection curve looks exponential to begin with, but degrades to a power-law as the epidemic matures. Of course, with such a high “production rate”, we don’t see that slowing down for a long time.

          So I can definitely see the control rods analogy…its application, though, is a bit nuanced.

        • taluslope says:

          Mosswings, thanks for the information regarding degradation to a power law, I’ll have to read more about it.

          I’ve been pondering how the growth slows. Even here the nuclear analogy may apply. As the fuel becomes denser (think lots of people coming in close contact with someone infected) fission (infection) starts to occur and the growth rate is exponential with each event producing between 2 and 3 other events. But as time progresses the fuel is burning (more and more people becoming infected and producing antibodies) so the remaining fuel effectively becomes less dense thus reducing the growth rate. Eventually, as fuel burns out a neutron (newly infected person) will find fewer and fewer U-235 atoms (uninfected people) and the burning (infection) rate slows down showing exponential decay. Toward the end, the density is low enough (most people have developed antibodies) that there is a high probability that the neutron will escape the system (infected person will recover) before producing a new event.

        • CCM says:

          The herd immunity, just let everyone get it argument could only be made by someone who is deluded enough to think of themselves as immortal. A sure sign the politician thinks of themself as a master of the universe.

        • Max404 says:

          I believe this is a widespread phenomenon among the wealthy and would-be wealthy. Look at global warming “deny-ers”: they belieive their wealth will insulate them, that they’ll have the funds to purchase electricity for A/C ( that being their interpretation of the need warming will cause ). Or adherents of market-based health care: they believe they will always have the funds to buy their care, whatever the price.

          Once I had to have surgery in Paris. I went for the pre-admission appointment and told the clerk I had private “top-off” insurance (la Mutuelle) so they could give me a private room, my insurance would cover it. The clerk replied: Monsieur, here in this hospital, if you need a private room, you get it even if you cannot pay for it, and you don’t get a private room if you don’t need it, even if you can pay for it. Voilà.

    • DrFunguy says:

      According to the PNAS pub comparing 1918 St. Louis and Philadelphia the final total dead was approximately twice as high in Philadelphia.
      Working from my phone or I find you the citation…

    • paulpfixion says:

      Taluslope, the answer is testing and contact tracing. Look at South Korea as the model. The failure to execute testing at scale is the major failure of the response in the United States. You are very lucky to live in Oregon. The goal needs to be to keep caseload low until the tests are widely available (both a covid-19 test and an antibody test). Then, maintain quarantine hospitals and a massive testing program until a vaccine is available.

      This should have been the Federal Government’s plan starting December 31, the day that China reported “suspicious pneumonia” cases to the WHO. Taiwan, for example, immediately started screening and tracking passengers who had arrived on flights from Wuhan, even tracing back for passengers from flights in December. Taiwan is currently reported to have only 5 deaths.

    • greengiant says:

      Herd immunity is a non starter for this virus, too painful to get there. It is Epstein talk. Popular in the UK leadership a few weeks ago. Masks and Isolation and no gatherings will get the R < 1.0. Politicians can't make people go back to restaurants. They can't make everyone do the no gathering thing. A lot of those people will get sick. They can't make other people stop their desire to survive. People who isolate will get sick less.
      https://www.theguardian.com/commentisfree/2020/mar/15/epidemiologist-britain-herd-immunity-coronavirus-covid-19

      • Mooser says:

        While isolating socially, I try to concentrate on the happiness I am spreading. I think of all the people I am not inflicting myself or my conversation upon, all the people who will remain unbored, or free from the awkward embarrassment my presence inevitably infects a gathering with.

      • taluslope says:

        Greengiant, I see it likely that we reach herd immunity. This need not necessarily be the horrible thing we imagine. Likely the infection rate is double what the numbers are showing because perhaps 50% of the infected population are asymptomatic. When we can widely test for antibodies to the virus, these people can go back to work and freely associate. The unaffected should stay home until we slowly reach herd immunity or develop a vaccine.

        Though perhaps a few of the younger of us who are uninfected should return to work so that we keep the infection rate going at a low rate, thus eliminating a large rebound effect.

        • Rayne says:

          Nice concept but “herd immunity” requires something like 70-80% exposed+infected which represents millions of deaths. Here, lower end chicken scratch:

          328M x 70% = 229.6M

          229.6 x 2% case fatality rate = 4.592M deaths

          Come on, don’t even start with this crap. The only way we can rationally and ethically achieve “herd immunity” is with the introduction of a vaccine hopefully before we reach 30-40% exposed+infected so we only have 2-3 million dead Americans.

          I can’t even believe I have to write all this out. The numbers are fucking obscene.

          ADDER: I was so annoyed I published this comment before I was finished.

          There’s two problems with the Let-it-burn to 50% with testing to screen out the previously infected. First, some of the infected are not going to be healthy. We still don’t have data on the long term affects of this virus on previously exposed people.

          Second, there’s been a case in which the patient developed a chronic active infection lasting 49 days. They weren’t negative until they were offered plasma therapy using donated antibodies from other patients. A cryptic, chronic case who isn’t identified would still be a nightmare; testing will not identify everyone already exposed and recovered. We need continued stop-and-go social distancing to buy time for a successful vaccine and an effective antiviral therapy, that’s all.

        • dude says:

          There is another thing to add insult to injury for the infected: long term lung damage. Survivors who experience mild symptoms and those who manage to get off ventilators do not necessarily recover their previous lung function. Long term ventilation can destroy some lung tissue or scarring portions of it. This is something my own physician pointed out to me (as I already have some minor respiratory issues). So even if someone becomes part of the herd of survivors by naturally fighting off the disease, they may also be weakened in other ways.

        • Rayne says:

          This worries me enormously. Future influenza viruses will savage these same recovered cases if they don’t get flu vaccines regularly.

          Will also destroy some careers. Quite a number of singers/voice actors/actors will lose their livelihood because of this disease.

    • Lisa says:

      I beg your forgiveness in advance for what might be a stupid question:

      What about steam to disinfect surfaces? Or does steam not get hot enough to kill the virus either?

      • Ken Muldrew says:

        A standard autoclave uses steam under pressure at about 120’C to sterilize. For things like masks, the problem is that you have to wash all the gunk off, too; it’s not enough just to sterilize it. So the mask has to be made so that it can be washed multiple times without degrading. For a surface, you have to get the surface up to the temperature of the steam and keep it there for a while. If you can do that, then you will kill everything on that surface, but it’s not so easy for a large surface, and not so easy to prove that you have done it.

        • Lisa says:

          Thank you for your response.
          “ For a surface, you have to get the surface up to the temperature of the steam and keep it there for a while”

          How long is “a while”?

    • orionATL says:

      one of the fundamental problems about measuring the growth of this epidemic is that all (or most) of the data on illness comes from those who are likely to be ill. this happens because the decision to administer the test has been (until very recently) limited to those suspected of being ill. this in turn has been caused in part by a physical paucity of tests and a federal embargo on univ and local gov tests. this in turn was caused by hhs secretary alex aziz’s decision to rewrite fda rules to favor private corporations’ development of tests.

      the current testing, essential as it is, is biased. because tests have not been done on the population at large, and because we do not yet have a measure of sars-vov-2 antibodies, we really can’t say with any precision what damage the virus has done or will do other than sicken and kill x and y numbers.

      right now we are just doing a goss body count in the world’s third largest nation by population and saying “wow. look at those numbers grow.” academic as it may sound, a random sample from our population might be a very wise and beneficial medical study.

  6. Granville Kennedy says:

    I work at UPMC Presbyterian hospital in Pittsburgh. I know our Environmental Services/Housekeeping department has robot like machines, sort of a skinny and taller R2D2, that use ultraviolet light to sanitize the surfaces in rooms. I think they just wheel it into a room and turn it on and leave. How well it might work on the complex 3D shape of an N95 mask might be less than optimal, but it may be something to try. And I’m not a scientist nor an expert in any sense of the word. I’m just an overeducated grill cook cooking and serving food to the staff that still patronize our cafeteria.

  7. rg says:

    I’ve been concerned about the exhalation source for some time, and have lately began to consider another transmission vector that involves the common access to heating and cooling systems and their air movers that sweep up exhaled infected air and redistribute it. Thus small environments such as airplanes, single-occupancy rooms in retirement homes, hospitals, even dwellings, can magnify the effective range of a single spreader, one believed to be isolated behind walls and a closed door.

    • it's complicated says:

      Yes, that concerns me, too.
      We live in a 4 story building, and there are vertical ventilation shafts connecting all bathrooms (and all toilets respectively) of the apartments on the same side of the stairs. Quite usual for such blocks erected at least during the 1960s and 1970s.

    • Rayne says:

      There’s a Chinese report about this virus in ventilation systems which I have to track down. I’ve been really worried about anybody on planes because of their air handling (though a commenter in the last several days has attempted to argue they’re well filtered – I remain skeptical). Any closed space without negative pressure (vented not recirculated) is risky in my opinion.

      • posaune says:

        Rayne, I recall the reporting on that particular transmission in China, infections spread through vertical plumbing chases.
        I think we’ll see re-design of high-rise residential HVAC and plumbing from all this — eventually.

        My heart is with you — I cried when I read your post about the young engineering graduate. Makes my heart break. Seeing the field hospital set up in Central Park just broke me. NYC should claim some of those vacant, foreign investor condo buildings for medical wards.

        • Rayne says:

          I found one study last night though I don’t think it’s the one I was thinking of. There were problems with SARS as well with aerosolized virus, though I think in both SARS and COVID-19 there have been clusters around poor plumbing venting. Yuck.

          The field hospital in Central Park gives me the willies. Those tents look less like wards for treatment than morgues.

        • Anne says:

          According to a general contractor friend (and expert plumber) whose wife lives in Harbin, China — still waiting for the immigration visa — there aren’t any P traps. A P trap always has water in the bottom thus blocking sewer gas. In
          China, the bathrooms smell. This would explain the spread of the virus.

        • VoltOwner says:

          Generalizing about all plumbing in China is not helpful.
          I’m sure there are places that have cut corners, such as, apparently Harbin, but I have not seen any such defective plumbing in all my travels in various parts of China.

        • Rayne says:

          Dude, really? We can see from two different events that there are places where plumbing has been implicated in coronavirus transmission related to COVID-19 and SARS. I’m certain we’ll see more studies about plumbing as a vector, it’s just too soon.

          Just because you personally haven’t clapped your eyes on the problem doesn’t mean it doesn’t exist.

  8. Pajaro says:

    FEMA sending 85 refrigerated trucks to NYC as temporary morgues. Complete and utter failure of US government response to this pandemic. All on Trump and the GOP. It didn’t have to be this way!

  9. BobCon says:

    Imagine speculating about the risks of norovirus based on the way it is affected by weather and sunlight, when the major issues of its spread are related to hygiene and food handling.

    I think it’s fine for academics to investigate how this virus may be damaged in summer conditions, but I agree it potentially misleading or confusing to just put this kind of early hypothesis out there, and has a chance of undercutting important risk reduction strategies.

  10. DLup says:

    Rayne, the point about Florida is good but can be amplified by the ongoing spread in tropical and equatorial regions (sub-Saharan Africa, India) and the southern hemisphere (i.e., South America, Australia). SARS-CoV-2 is apparently not very good at geography if warm weather and sun are supposed to slow it down.

    • Rayne says:

      True, but average American isn’t monitoring numbers in tropics/equatorial countries. Not even paying attention to the cruise ships with cases which are floating in subtropics/tropics versus no cases reported on ships in north Atlantic, north Pacific.

      At least one commenter here in the last several days also mentioned Bangkok, Thailand had case growth.

      • vvv says:

        Seth Myers this evening commented on the King of Thailand allegedly being holed up to avoid the virus in a hotel room in Paris(?) with 20 girlfriends, saying he rather thought that was a good way to catch a virus.

  11. P J Evans says:

    A commenter at Kos is pushing massive doses of vitamin C, plus a multi-ingredient package and homeopathic remedies (water with a fancy package), for the virus. I don’t think that’s going to be useful.

    • bmaz says:

      Can we PLEASE not put up dubious stuff? First it was home brew chlorine solution, now some dope from DKos. This blog is not DKos, and we don’t purvey bullshit. Especially recycled bullshit from DKos.

      • P J Evans says:

        bmaz, did you read past the first few words? I don’t believe that one, either, and I thought I made it clear that I think it’s BS. (The chlorine one is actually real; I’ve run into it on very-much-reputable sites, though it shouldn’t normally be necessary.)

        • bmaz says:

          There was no reason to repeat that which you already thought was garbage on the intake. And I absolutely object to people prompting home chemistry experiments with chlorine.

          If folks want to purvey that stuff on Nextdoor or some other forum, fine. But, no, that liability is not going to be encouraged nor incurred here.

        • earlofhuntingdon says:

          I hope it’s not necessary to remind people how dangerous chlorine is. It is highly toxic: it was used, for example, as one of the early chemical weapons in the First World War.

          As strong as it smells, household bleach is made from only a 5-6% of a chlorine compound. It is normally further diluted when used, an ounce or two in a 128 ounce gallon of water.

          Even that can kill, such as when it is accidentally combined with other household cleaning products (which releases the chlorine as a gas), in the toilet of a closed bathroom. Let’s not try home experiments with it.

      • Rayne says:

        Pretty sure Paltrow is smart enough to know that’s dangerous ground ripe for lawsuits. I’m waiting for the class action suit to nail Fox News for its grossly irresponsible sycophancy allowing Trump’s “coronavirus is a hoax” to guide their content and assure their audience that this was just another flu. Imagine it: a massive lawsuit for their bullshit is what finally takes them down.

  12. Kick the darkess says:

    With respect to scientific information, I thought the rationale for the CDC potentially recommending everybody wearing some sort of “mask” in a social setting was interesting; it looks like my county DPH is now requiring this. The rationale is not that non-filtering masks provide any sort of direct protective barrier. Rather, such masks decrease the likelihood that a person who does not know they are infected will shed virus in a way that expose you to infection. From the link below: “the approach is about crowd psychology and protection. If everyone wears a mask, individuals protect each other….because the stigma of wearing one is removed”

    https://www.nytimes.com/2020/03/27/health/us-coronavirus-face-masks.html

      • ernesto1581 says:

        thanks for this link. I had seen a summary but this is better.
        sent it on to family members who are doctoring in Phila and Rochester NY.

      • Max404 says:

        Christian Drosten on his daily podcast discussed a study of the way the first few “generations” of infections, stemming from Germany’s “patient 0” in Bavaria end January (at the car parts manufacturer), occured. They quarantined all contacts of the first infected, and tracked successive generations. They interviewed all these people to discover exactly the nature of their interactions.

        They discovered that in each 10 interactions consisting of 15 minutes of normal conversation, 1 transmission occurred. There was one case of a person who was eating at the company cafeteria and turned to the person at the table behind him to ask to pass the salt, and that brief interaction was enough.

        Drosten said that he wears a mask when going out to shop for groceries.

        • bittersweet says:

          My question would be did the “ask for the salt” pass the virus, or the hand on the salt shaker?

        • Rayne says:

          This study by Bourouiba is the most important chunk in that article.

          There are simply too many anecdotal infections which can only be explained by aerosolized droplets in the form of exhalation. There was a death in Michigan yesterday which may fit the mold — a 50-year-old shut-in (I assume he was disabled) who had no contact with the general public got sick and died. His caregivers likely washed their hands but if they weren’t wearing masks? That.

  13. Kick the darkess says:

    Also, since its down my line a bit, a comment on the Stanford guy and the “plasma membrane” vs “lipid membrane” thing. So, he is wrong about a coronavirus being enveloped by a plasma membrane, although he might perhaps be forgiven for that mistake (the part about sunshine being protective, on the other hand, is pretty silly; if you hit any kind of nucleic acid-based genome with enough UV you will effectively kill it, but get a helluva sunburn while doing so).

    All cellular membranes are comprised of lipid bilayers and could therefore be described as lipid membranes; it is a very general term. The plasma membrane refers to a specific lipid bilayer that physically separates the cell from its external environment. The plasma membrane is thus distinguished from a variety of internal lipid membrane compartments within the cell, with names like the ER, the Golgi apparatus and so forth. In considering viral replication strategies this is not a completely academic distinction. Newly assembled flu virions (which perhaps the Stanford guy might be most familiar with) do in fact exit the cell via the plasma membrane, from which they derive their membrane envelope.

    Coronaviruses, however, first “bud” into an internal membrane compartment (a transport intermediate between the ER and Golgi) and that is the source of their membrane envelope. This difference gives a certainly flexibility to a coronavirus in how it finally exits the cell, allowing it to pursue a lateral or systemic mode of propagation in the epithelial layers of the unfortunate human host. For example, to my knowledge this distinction underlies the different pathology of SARS v MERS flavors of coronavirus. But it won’t be something many are familiar with. Can dig up some reviews if anybody cares to get into the weeds. For all the misery they cause, viruses are actually quite sophisticated little creatures.

    [FYI, paragraph breaks added to improve readability./~Rayne]

  14. diggo says:

    the virus is one thing, the experts are another, the ‘pretend-experts with agendas’ are another but the politicians, religious leaders and poorly informed media are killing people via misinformation and ignorance.

    This is not business as usual for ANYTHING and our world is now changed. The so-called “Gig Economy” has literally vanished without trace, which will leave a lot of people under 30yo feeling very confused, lost and (later) very angry. The status quo will no longer hold. Change will come from the young, not the old guard (who will be left exhausted by this)

    Fighting misinformation MUST be our main objective here, as those of us who understand scientific evidence and the meaning of the phrase “peer reviewed” need to argue persistently with those who simply put their faith in others. Those people will get lots of people killed if we don’t persevere in educating them with the facts.
    One of the biggest threats to the survival of Americans is religion, particularly evangelicals who want this to be The Rapture.
    But mostly, people armed with the facts need to educate people unaware of the danger this pandemic represents to the human species, young and old. They wont learn of their own volition – they have to be told, because that’s how they already run their lives.The leading evangelical pastors in America need to be persuaded to band together and educate their followers, because if their followers die, so does the flow of money into their private jets.

    • Stephen Calhoun says:

      First of all, thank you for the expert dialogue here.

      I have emphasized the lethality of the virus—marking this roughly at 2%—and used analogies like driving a car, going out to eat, to contextualize what would be unacceptable risk were it incurred by doing such common activities.

    • Rayne says:

      Thanks for sharing those links. I’m afraid to read them for fear I’ll know what they say and I won’t feel any more assured for reading them.

  17. Mitch Neher says:

    Slightly Off Topic: Last night’s WH coronavirus task force briefing included a spontaneous confession from Trump that he [paraphrased] knowingly, willfully “downplayed” the threat that the pandemic posed to our country because he wanted to play the role of cheerleader giving us [false] hope for the future, instead.

    https://www.businessinsider.com/trump-admits-downplayed-coronavirus-i-knew-it-could-be-horrible-2020-3

    Presumably, Trump’s confession, too, shall pass. BUT IT OUGHT NOT TO BE LET TO PASS. Trump confessed on live TV whilst shrugging his shoulders over it for crying out loud.

  18. Vicks says:

    Sorry to be asking such basic questions but are there additional risks for pregnant women or their baby beyond a lowered immune system that would make them more susceptible to the virus and distracted and overburdened doctors and nurses?

    • Frank Probst says:

      Short answer is that we don’t know. In terms of the baby, the virus hasn’t been around for long enough to us to gather a significant amount of data about what happens to the fetus if the mother is infected early in the pregnancy, so the possibility of birth defects linked to the virus is still out there. Infection in newborns appears to be VERY rare, although a few cases have been reported. I haven’t seen any data on pregnant or postpartum women being more susceptible to COVID-19.

      My personal opinion is that anyone under 15 years-old who dies from COVID-19 needs an autopsy and tissue banking for possible DNA analysis at a later date. These individuals could just be outliers, but there are genetic diseases out there that are “triggered” by certain viruses. X-linked lymphoproliferative disease, for example, gets much more severe with EBV infection: https://www.ncbi.nlm.nih.gov/books/NBK1406/

  19. harpie says:

    Long wait times to get test results?
    Read, via Quinta Jurecic:
    https://twitter.com/alexismadrigal/status/1245131130275115008
    7:29 PM · Mar 31, 2020

    California has been the biggest question mark in the coronavirus outbreak. The state has the lowest per-capita testing rates in the country and a huge number of pending tests. After a lot of digging, we know (at least part of) what’s going on now. [link]

    Links to:
    Private Labs Are Fueling a New Coronavirus Testing Crisis
    Backlogs at private laboratories have ballooned, making it difficult to treat suffering patients and contain the pandemic.
    https://www.theatlantic.com/health/archive/2020/03/next-covid-19-testing-crisis/609193/ MARCH 31, 2020

    […] The overreporting error, the lackluster testing rate, and that persistently huge number of pending tests suggest something is rotten in the Golden State’s testing regime. Even more troubling, they raise the possibility that all across the country, huge numbers of results are stuck in purgatory. […]

  21. harpie says:

    I Spent A Day In The Coronavirus-Driven Feeding Frenzy Of N95 Mask Sellers And Buyers And This Is What I Learned
    https://www.forbes.com/sites/daviddisalvo/2020/03/30/i-spent-a-day-in-the-coronavirus-driven-feeding-frenzy-of-n95-mask-sellers-and-buyers-and-this-is-what-i-learned/#1936492656d4
    Mar 30, 2020, 04:40am

    […] (Note: events in this article occurred about a week before [so, about 3/23/20] it was published. […]
    In the interest of brevity, I’m going to summarize what I learned below and then jump into a bit more detail.
    1] Millions of N95 masks have been available throughout the U.S., Canada and the UK during the pandemic, according to brokers trying to sell them.
    2] The high price point per mask, driven by extreme demand, has contributed to an overwhelmed reaction among potential buyers, especially in the U.S.
    3] Scrutiny surrounding these deals is high because of ongoing scams and claims of price-gouging, both of which are triggering emotionally charged reactions and fear of making deals.
    4] Millions of masks are being purchased by foreign buyers and are leaving the country, according to the brokers, while the domestic need remains alarmingly high. […]

    • harpie says:

      Also, via bmaz:

      Warren to feds: Why did you take Massachusetts’ medical supplies?
      https://www.bostonglobe.com/2020/03/31/nation/warren-feds-why-did-you-take-massachusettss-medical-supplies/
      March 31, 2020, 9:00 a.m

      Senator Elizabeth Warren is pressing federal officials for answers on why they seized at least two of Massachusetts’ recent orders for protective equipment, charging that it appears they are still interfering with states’ efforts to track down medical supplies amid the coronavirus pandemic.

      In a five-page letter Monday, Warren asked Peter Gaynor, the Federal Emergency Management Agency administrator, to outline how the agency is ensuring states aren’t outbid for supplies by the federal government, which she called a “new and inexplicable obstacle.” […]

  22. harpie says:

    Via Laura Rosen:
    https://twitter.com/QuilLawrence/status/1245056818998661121
    2:34 PM · Mar 31, 2020
    ProPublica: Taxpayers Paid Millions to Design a Low-Cost Ventilator for a Pandemic. Instead, the Company Is Selling Versions of It Overseas.
    As coronavirus sweeps the globe, there is not a single Trilogy Evo Universal ventilator — developed with government funds — in the U.S. stockpile. Meanwhile, Royal Philips N.V. has sold higher-priced versions to clients around the world.
    https://www.propublica.org/article/taxpayers-paid-millions-to-design-a-low-cost-ventilator-for-a-pandemic-instead-the-company-is-selling-versions-of-it-overseas-
    March 30, 7:40 p.m.

  23. harpie says:

    I guess the theme of today’s harpie comments is THE VULTURES

    Loeffler reports more stock sales amid insider trading allegations
    https://www.ajc.com/news/state–regional-govt–politics/loeffler-reports-more-stock-sales-amid-insider-trading-allegations/YFPDT3pChO873nuzNKa44K/

    […] The largest transactions — and the most politically problematic — involve $18.7 million in sales of Intercontinental Exchange stock in three separate deals dated Feb. 26 and March 11. […]

    During the same time period reflected on reports filed late Tuesday, the couple also sold shares in retail stores such as Lululemon and T.J. Maxx and invested in a company that makes COVID-19 protective garments.

    The Atlanta Journal-Constitution got the first look at these reports, covering mid-February through mid-March and shedding new light on Loeffler’s financial transactions during the pandemic. Previous reports — which have put Loeffler in the national spotlight — covered her trading during the first six weeks of 2020. […]

    • harpie says:

      “Sen. Loeffler came to Washington on a promise to be a different kind of elected official,” [spokeswoman] Kerry Rom said. “She holds herself to high standards of ethics and transparency, including acting in accordance with both the letter and spirit of the law, which she has done at every step of her time in the Senate and in her lengthy career in financial services.”

      Loeffler is NOT ANY kind of “elected official”.
      She is the Senate’s MOST junior member, and was APPOINTED.

      • earlofhuntingdon says:

        She’s also probably the Senate’s wealthiest member, which means she can pay for all the good news PR the world has to offer.

  26. orionATL says:

    “… One thing I should set straight here is that we tend to use COVID-19 to refer to the disease and to the virus which causes it. This isn’t really accurate; I’ll be referring to SARS-CoV-2 as the virus underlying the disease called COVID-19 in this post.. ”

    thanks, rayne. boy am i glad to see this. not to get into a fuss about word choice, but i was getting really tired of seeing sars-cov-2, the new, improved version of the sars family’s lineage, have its lineage hidden by the covid-19 moniker. it was as if it had been adopted😉.

    • Rayne says:

      At the same time you can see why a very different name was necessary. It’s far too easy for people — even well-educated persons in STEM professions — to extrapolate the wrong things from SARS which don’t apply to COVID-19, whether the disease or underlying virus.

  27. orionATL says:

    I have a suggestion. I suggest that all American tax payers (citizens, permanent residents, or others) who have earned in excess of $10 million in any of the last 10 years be required to refund to the u.s. treasury or a state treasury all of that excess income, stock gifts, in-kind, or other compensation.

    • orionATL says:

      perhaps I should state the obvious – to help the governments help those less-monied Americans by the tens of millions who will suffer from severe sars-cov-2 economic disruption as well as the viral sickness.

  30. Willis J Warren says:

    We still don’t know the answer, but there’s evidence that this disease is very easily transmitted.

    Now, the early spread in China would be good to know, but their numbers are low because, fuck, they couldn’t keep up with counting the dead. Their numbers seem to be about tenfold of what the reports are, and Italy’s seem to be threefold. This suggests the Chinese were not honest, probably with themselves, about the severity of the disease. Likely this is because they were on the verge of their biggest holiday. I’m skeptical that their motives were more evil than denial, but I digress.

    https://www.cnn.com/2020/04/02/health/aerosol-coronavirus-spread-white-house-letter/index.html

    That said, bandannas, while better than nothing, aren’t enough to stop an aerosol. People that are still going to church are insane.

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