Current Events > AMA about Coronavirus

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AMA. I am a Pulmonary and Critical care doctor and I consider myself very well read on infectious disease... Particularly since I see the worst infectious disease cases in the ICU. I think I'm up to date on medical literature about this Covid19. Obviously I don't know everything but I can try to answer questions. I sleep early and will get to it in the morning.

Do you have it?

how underreported are the actual cases in your estimation? in and outside china

how are they actually testing it and whether is it accurate ?

is the re-infection rate and mortality as bad as they say?

are we all going to die?

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Do I have it?

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This really should be deleted before people actually start taking advice from a random poster on a gaming board.

is it the trigger for the mitochondria to become a powerhouse

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apolloooo posted...

are we all going to die?

apolloooo posted...

how underreported are the actual cases in your estimation? in and outside china

how are they actually testing it and whether is it accurate ?

is the re-infection rate and mortality as bad as they say?

are we all going to die?

It's impossible to say. Alot of the Chinese data comes from the Chinese cdc. Typically the medical community is fairly reliable but take that for what it's worth. That's why I'm waiting to see what the Italian and South Korean data looks like. Last I read out of 800 something south Koreans, the case fatality rate was like 0.9% which is better than some of. The Chinese data which ranges greatly, but averages out to about 2%. Jama has a nice paper with the Chinese data summarized.

I don't know about reinfection but for mortality...the numbers I've seen have ranged pretty greatly but 1-3% is a safe estimate. This number is much higher in population above 70 and 80 years old, and with comorbid conditions. Young healthy people tend to be fine. 80%of cases are mild, 15% are severe and 5% are critical. The fact that this California person had it with no known exposure I think suggests that there are mild cases out there that aren't being diagnosed.

The only testing centers are at the cdc so the tests have to be sent out. I'm not sure about the sensitivity and specific data but I think that's being worked on now. The turn around time I believe is like 3 days from the time the test is sent off. It's difficult to determine who to test because these symptoms are so nonspecific. You'd lose count of how many times an urgent care or ER doc heard about complains of "fever, cough, chest pain" on a daily basis.

Will this all blow over when spring arrives?

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SaltyWet posted...

Will this all blow over when spring arrives?

along with this; do viruses spread faster in warmer weather?
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SaltyWet posted...

Will this all blow over when spring arrives?

Dunno, no one knows. The best comparison is influenza virus. We all know how it spreads and how common it is. The r0 for flu is about 1.28. For coronavirus it's 2.2 approximately. So roughly speaking in layman's words, this is twice as infective as influenza. So the fact that it's here, I don't see why it can't spread, similar to how flu spreads. Every year 30 mil people get the flu in the US. About half of those receive medical attention in some way, and about 1-2%get hospitalized, and about 0.1% die. Think of the flu but more infective, slightly worse illnesses, and for the high risk population much more serious

i am more worried about economic disaster than the actual death tolls since the mortality rate is fairly low. some food price have increased in local market here

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DanHaren2019 posted...

This number is much higher in population above 70 and 80 years old, and with comorbid conditions. Young healthy people tend to be fine. 80%of cases are mild, 15% are severe and 5% are critical.

Is the media over-blowing the severity, iyo?

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I wouldn't panic, but I don't think the cdc is wrong. As much as I want this to die down, if influenza can spread to tens of millions of people every year, why can't this? It's usually the people who don't know they have it that infect others.

Still alot of info and studies coming out. I'll try to stay up to date and keep you guys up to date.

A few treatments they are testing right now that can work on cousin viruses. If a patient is very sick some of these anti viral are being tried and some have been effective. A vaccine is also of the utmost importance.

So did this come from a bat or a lab?

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DanHaren2019 posted...

Dunno, no one knows. The best comparison is influenza virus. We all know how it spreads and how common it is. The r0 for flu is about 1.28. For coronavirus it's 2.2 approximately. So roughly speaking in layman's words, this is twice as infective as influenza. So the fact that it's here, I don't see why it can't spread, similar to how flu spreads. Every year 30 mil people get the flu in the US. About half of those receive medical attention in some way, and about 1-2%get hospitalized, and about 0.1% die. Think of the flu but more infective, slightly worse illnesses, and for the high risk population much more serious

So its basically Super Flu? Due to not showing symptoms for almost 2 weeks. Being twice as infective and a worse illness? Sounds like if it gets out in the wild it would be hard to stop.

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21WIVES_CHILL posted...

This really should be deleted before people actually start taking advice from a random poster on a gaming board.

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Did you remember to credit the genius who gave you the own topic AMA idea?

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SaltyWet posted...

So did this come from a bat or a lab?

It seems to share much of the same rna as bat coronaviruses, so that's the leading theory. I won't get into conspiracy theories or anything like that.

yunalenne10 posted...

Is the media over-blowing the severity, iyo?

Ive seen some media overblow the mortality numbers which were published in smaller studies with higher mortality. But those were older news articles when alot of this stuff was still coming out. I think current media might be more accurate as we know more about it.

Right now I'm in bed on my phone. Tomorrow when I'm on my computer I'll try to give you guys citations for all the numbers and details that Im posting. But to. Be realistic, most of you all are young and healthy and the overwhelming likelihood is that you'll be totally fine. It's your grandparents that you have to worry about and getting them sick. So certainly if you are someone who is in a high risk area, a dense population, and you're in public alot, I may consider wearing a mask when interacting with grandparents

I'm gonna call it a night but I'll get to every question tomorrow.

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What would be initial symptoms a person should notice to get themselves tested out?

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Well, there's no specific symptom that indicates testing. The actual symptoms are very nonspecific. Most commonly you'll have fevers, in addition to that you can have some coughing, shortness of breath, maybe chest pains. These are all symptoms you may see with any common cold, flu, pneumonia, or upper or lower respiratory infection. The key thing is if you've been exposed to people who have been infected or exposed. If you're very sick and doctors can't figure out what's going on, then they may test you. You'd be hospitalized at that point.

At this moment, health authorities are trying hard to contain it but it seems that they are failing too without resorting to extreme measures.

So my question is do you think it's better to let it go seasonal and just focus on a vaccine or cure ?

As a 30yo dude, should I even be worried about this or is it only babies and old farts like every other epidemic? >_>

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Have there been any clues as what, if any, long term health risks this brings? Like potential heart damage or lung problems?

jwlim80 posted...

At this moment, health authorities are trying hard to contain it but it seems that they are failing too without resorting to extreme measures.

So my question is do you think it's better to let it go seasonal and just focus on a vaccine or cure ?

I don't think so. I think there needs to be a multimodal approach. As archaic as china's infection control methods have been, they are working to decrease the rate of infection. Public health and limiting spread is absolutely important. To do this we need to identify where the cases are so that we can be most vigilant. It takes a collective effort of good hygiene and awareness to limit these things and ultimately decrease its rate of spread.

At the same time we need to work on a vaccine and treatment. They are trialing some anti-virals to see if they'll work on this, and realistically speaking it takes years to even prove that a vaccine works. They can make one but its very hard to expedite the clinical testing to prove its efficacy. Thats why when Trump said the vaccine is almost here, the CDC official immediately said, a vaccine is at least a year away if not more. But at this point I think the most important thing is identify where the cases are in the community. CDC has broadened its diagnostic criteria. These viruses (coronaviruses) tend to shapeshift quite frequently. Thats why we don't see a vaccine for the common cold. And as we have all experienced in our lifetime, its possible to have colds back to back within a short timespan.

I think it should also be a priority to make a rapid form of testing. Right now we'd have to send samples to the CDC to be tested, and the turn around time is about 3 days. Imagine if every hospital had a rapid test, we could be so much more effective at identifying cases and help limit its spread.

NeonOctopus posted...

As a 30yo dude, should I even be worried about this or is it only babies and old farts like every other epidemic? >_>

The case fatality rate for anyone under 40 is like 0.2%. To be realistic, you will likely be fine, at worst you may get sick and need to be hospitalized briefly. But the overwhelming likelihood is that you have some mild symptoms that go away and nothing happens to you. But the problem is you may be spreading it to others who may be asymptomatic also and they may spread it to people who are more vulnerable. Like I said earlier, these epidemics/pandemics need everyone to be responsible, which means if you do get sick and you live in an area where there have been cases, it may be best to quarantine yourself, wear a mask, wash your hands, avoid crowded areas.

Justin_Blackmon posted...

Have there been any clues as what, if any, long term health risks this brings? Like potential heart damage or lung problems?

Literally impossible to tell. In very severe cases it may cause ARDS which is described and possibly myocarditis which I believe I read about, but I'm not certain. These can both have lasting effects depending on the severity and both can be life threatening in the short term. Again these are very severe cases. ARDS would be more common I'd guess.

How effective is otc medication such as Nyquil, robitussin, etc. Against this virus compared to the usual ailments theyre used for? Is the severity too much for nonprescription medication to deal with?

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dib153 posted...

How effective is otc medication such as Nyquil, robitussin, etc. Against this virus compared to the usual ailments theyre used for? Is the severity too much for nonprescription medication to deal with?

May have some symptomatic relief, its worth a try if ur miserable. But it won't fight the virus or resolve the illness any sooner, the same way that none of those fight any common cold viruses...purely symptomatic relief.

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What's your suggestion for someone that is in their 30s, but with end stage cancers? I'm 31, and I've got stage IV colon cancer.

Also, I should elaborate that I get treatment done at Duke, in NC. If you're familiar at all with the hospital, it's a pretty acclaimed campus but also extremely trafficked.

And what do you think is the route taken if I ended up with covid-19, especially in regards to a compromised immune system?

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EverDownward posted...

What's your suggestion for someone that is in their 30s, but with end stage cancers? I'm 31, and I've got stage IV colon cancer.

Also, I should elaborate that I get treatment done at Duke, in NC. If you're familiar at all with the hospital, it's a pretty acclaimed campus but also extremely trafficked.

And what do you think is the route taken if I ended up with covid-19, especially in regards to a compromised immune system?

Damn that's tough. I would suggest continue living your life as you always would. I would suggest if ur going to ur appointments it might not be a bad idea to wear a mask, I probably would, particularly if ur on chemo. Cancer itself can lower your immune system and chemo can as well obviously. Keep hand sanitizer on you and of course frequent hand washing. But one of the main things in cancer particularly stage 4 is maintaining quality of life. So it's important you do all the things you like to do, with just a bit of caution and good hygiene. Im sure ur doctors have told you that if you have fevers or signs of infection to get it checked out. If ur immunocompromisd and you somehow end up with coronavirus, I would more than likely be hospitalized. Beyond that, it's hard to predict how sick you'll get but if immunocompromised generally most infections are serious and not to be taken lightly.

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