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Discussion thread IV - COVID-19 (new coronavirus)

FluTrackers.com
@FluTrackers

Hi everyone. Thanks for following.

We again want to say how sorry we are that these terrible events are happening to you.

We were horrified about what we saw in China and then to watch it roll through the entire world....

Heartbreaking.

Please take care of you.
 
A cargo ship has been denied entry to Halifax in Canada. This is part of a much larger problem we will have to address as a matter of urgency. While the cruise ships have got a lot of coverage the real problem is supply chain disruption which is being exacerbated by no clear policy on accepting vessels with suspect cases. The consequence is owners and crew are understandably concerned about putting to sea without a guarantee that if they get sick on route they will be looked after on arrival. I saw a figure of 10,000 cargo ships sitting in port, although I can not vouch for its accuracy or exactly what they were counting as ships. It is all very well telling the public to stay at home but if the food stuffs we need are not moving around the globe the shops will not be supplied and fuel of all types will stop being available. This is not just human foods there is panic buying of everything from fish farm pellets to fertilizers and pesticides.
https://flutrackers.com/forum/forum/...ndemic-and-bdi
The link is to an old post looking at shipping in a pandemic and its supply chain implications. There are also many posts on the site covering all aspects of supply chain issues including other potentially catastrophic issues like water purification chemicals. Many of these issues have long timescales so lack of movement now can be compensated for by use of stockpiles but, like PPE these will not last indefinitely. Respirators and PPE are the tip of the iceberg and many more items will start becoming limiting unless we reconsider international boarder restrictions and treat the merchant marines as we do HCWs - essential to our collective survival.
 
Rick Scott Demands Investigation of China–WHO Ties

By ZACHARY EVANS
March 31, 2020 5:48 PM

Senator Rick Scott (R., Fla.) called Tuesday for Congress to investigate the World Health Organization’s ties to China, accusing the organization of relaying Chinese propaganda during the Wuhan-coronavirus pandemic.

The WHO needs “to be held accountable for their role in promoting misinformation and helping Communist China cover up a global pandemic,” Scott said in a statement. “We know Communist China is lying about how many cases and deaths they have . . . and the WHO never bothered to investigate further. Their inaction cost lives.”
...

https://www.nationalreview.com/news...tion-of-china-world-health-organization-ties/
 
China Concealed Extent of Virus Outbreak, U.S. Intelligence Says

By Nick Wadhams and Jennifer Jacobs
April 1, 2020, 10:15 AM CDT Updated on April 1, 2020, 12:21 PM CDT

China has concealed the extent of the coronavirus outbreak in its country, under-reporting both total cases and deaths it’s suffered from the disease, the U.S. intelligence community concluded in a classified report to the White House, according to three U.S. officials.
...
Deborah Birx, the State Department immunologist advising the White House on its response to the outbreak, said Tuesday that China’s public reporting influenced assumptions elsewhere in the world about the nature of the virus.

“The medical community made -- interpreted the Chinese data as: This was serious, but smaller than anyone expected,” she said at a news conference on Tuesday. “Because I think probably we were missing a significant amount of the data, now that what we see happened to Italy and see what happened to Spain.”

China isn’t the only country with suspect public reporting. Western officials have pointed to Iran, Russia, Indonesia and especially North Korea, which has not reported a single case of the disease, as probable under-counts. Others including Saudi Arabia and Egypt may also be playing down their numbers.
...

https://www.bloomberg.com/news/arti...s-outbreak-u-s-intelligence-says?srnd=premium
 
gsgs said:
Emily, where is the CDC-data of weekly deaths from all causes ?

The CDC keeps track of weekly mortality in the US and the data available for the most recent week (ending March 7) shows about 48,000 deaths, sharply down from the normal 55,000.

See: https://www.dropbox.com/s/2y2gvh2q7a...ences.pdf?dl=0
Click to expand...

gsgs, that was etudiante that posted the dropbox data, not me. I tried looking for recent weekly mortality on CDC's site and went round in circles with no success but I'm not an expert on digging into their data. The dropbox link doesn't work for me now. Maybe ask etudiante?
 
I wonder if Tamiflu could make things worse? I think they are using it as part of a trial cocktail now. I read that some drugs made SARS1 patients sicker.

https://www.cleveland.com/news/2020...zation-while-warning-people-to-stay-home.html
"CLEVELAND, Ohio -- Kevin Harris thought he had the flu. His doctor thought he had the flu.

But after taking Tamiflu, the 55-year-old body shop owner from Warren just kept feeling sicker and sicker, to the point where he couldn’t walk to the bathroom without stopping 20 minutes to rest."

It would take him an hour to cover 50 ft to the bathroom:
https://nypost.com/2020/03/18/coron...i-was-screaming-for-mercy-and-praying-to-god/
 

Craig Spencer MD MPH

@Craig_A_Spencer
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There's really no way to describe what we're seeing. Our new reality is unreal. The people and places we've known so long & so well have been transformed. Our ERs are ICUs. Everything looks, sounds and feels different. Just one week and it's a whole different world. THREAD
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Craig Spencer MD MPH

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There are tents outside our hospitals. Every time I see them, I stop, startled. Their drab and dirty flaps seem so out of place against the grand facades of world-class hospitals. Desperate times, desperate measures. The last time I worked in a tent was West Africa.
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Craig Spencer MD MPH

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In those same tents, I saw too much pain, loneliness, and death. People dying alone. I never thought I'd have to see or experience that ever again. I never wanted to. Once was painful enough. We have no other option now. Our ICUs are filling fast. Our ERs are ICUs.
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Craig Spencer MD MPH

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The patients I normally see are nowhere to be found. Every single person I see has #COVID19. Every single patient. Working in the ER means walking through a corridor of coughing. All a slightly different pitch & different frequency, but all caused by the exact same thing.
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Craig Spencer MD MPH

@Craig_A_Spencer
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It's not just the volume of patients that's hitting us. It's the severity. Respiratory arrest. Respiratory arrest. Respiratory arrest. Each takes 6-8 professionals. Nurses, respiratory techs, ER docs, anesthesiologists. Each takes an hour or more. Back to back. All shift.
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Craig Spencer MD MPH

@Craig_A_Spencer
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And it's not just the severity, back to back. We're all being asked to do things we've never done before. Run a code as your goggles fog & you can't decipher the vital signs on the monitor. Try to predict which COVID patient will crash if you send them home. And which won't.
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Craig Spencer MD MPH

@Craig_A_Spencer
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Talk to palliative care. Talk to family members. Long discussions about likely outcomes. Listen as family members sob. They aren't here to say goodbye when they ask to withdraw care. We FaceTime so they can say goodbye. We stop the drips. Turn off the ventilator. And wait.
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Craig Spencer MD MPH

@Craig_A_Spencer
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Your hands upon theirs. You think of their family. At home. Sobbing. Someone starts saying a prayer. You can't help but cry. This isn't what we do. You stand by. You wait. This isn't what we do. You stand by. You wait. Time of death: 7:19pm
 
Zhong Nanshan: Worried that some countries cannot control the epidemic and will bring disaster to the world


April 02, 2020 21:06


　　Chinanews client April 2nd (Song Yusheng) On April 2nd, Academician of the Chinese Academy of Engineering Zhong Nanshan said at the Xinguan Epidemic Prevention and Control International Sharing Conference. From China ’s experience, the key areas of the epidemic were closed and people remained social Distance and wearing a mask are certainly the best way to prevent further spread of the epidemic. "I am concerned that the epidemic is spreading rapidly in some countries. Too many patients will place a huge burden on the medical system. There are no beds, no medical facilities, and no professionals. This will cause a vicious circle. If some countries cannot control the epidemic Will bring disaster to the whole world, and no country can stay aside. "
[Edit​


zhttp://www.chinanews.com/sh/2020/04-02/9145940.shtml
 
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'Take This Serious': Bus Driver Dies Of COVID-19 After Calling Out Coughing Rider


April 3, 20204:01 PM ET


Jason Hargrove was behind the wheel of a bus in Detroit when he said a passenger began to cough. The middle-aged woman let loose four or five times without covering her mouth, he said, and watching her do this — at the same time Michigan was under a state of emergency for the coronavirus — got him so upset, he felt compelled to vent his frustrations in a video afterward.

more...

https://www.npr.org/sections/coronav...coughing-rider
 
The woman in question may have had any number of conditions that caused her to cough, perhaps she is a smoker. None the less she should have been practicing cough etiquette. She should have stayed home if her cough was due to a transmissible respiratory illness

The tragically dead bus driver may have caught the virus from an asymptomatic passenger. ?This Field Briefing using data from the cruise liner Diamond Princess states "A total 255 (48%) of the confirmed cases were asymptomatic when the respiratory specimen was collected" https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html
 

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Again, we are so sorry for all of the suffering. Reading all these case counts & deaths is just unbelievable.

Thank you to all of our health care providers, delivery people, everyone who is holding society together. We owe you.

Please take care.

The Team at FluTrackers
 

FluTrackers.com
@FluTrackers
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32m
Thanks for asking. I am doing ok. I have been going through a process like everyone else. First, horrible events in China, but hoping they could contain it. Then the spread in Asia. Then Europe and the US. It is just like every pandemic tabletop exercise I have ever seen. --->
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FluTrackers.com
@FluTrackers
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I kept hoping there would be a stop to the cases. A new way to use an old drug...something really effective to stop the deaths from climbing...but each day the numbers increase...--->
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FluTrackers.com
@FluTrackers
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So at this point we are in it. I get up everyday and log on, and try to find the best way to help the most people. Our entire team feels this way. How can we help the most people today?

And then I eat some chocolate. Play with the dogs. Hope for the best.
 
I had to setup a first responder today with handful of n95 and a 30% h2o2 vapor sterilization kit for reuse with protocols because they have nothing being provided by their department. He has a wife and baby at home and is living separately because he was unable to protect himself much less his family. With proper sterilization knowledge one mask can be used 50-80 times. All first responders need access to this ability. Give a first responder a mask and he will protect himself for a day. Give a first responder a mask and teach him to properly sterilize it and he can protect himself and others during the entire outbreak.
 
Supa said:
I had to setup a first responder today with handful of n95 and a 30% h2o2 vapor sterilization kit for reuse with protocols because they have nothing being provided by their department. He has a wife and baby at home and is living separately because he was unable to protect himself much less his family. With proper sterilization knowledge one mask can be used 50-80 times. All first responders need access to this ability. Give a first responder a mask and he will protect himself for a day. Give a first responder a mask and teach him to properly sterilize it and he can protect himself and others during the entire outbreak.
Click to expand...

So I’m not a scientist and this is not a suggestion or recommendation. My question is would it be possible that a store bought pressure cooker could potentially be used to sterilize N95 masks similar to what you describe Supa. Questions to be determined would be does the mesh/fabric deform with stream and the mask stay usable, should water or some other liquid like H2O2 be used (and specifically the safety of using H2O2 in a retail pressure cooker), times and pressures needed to be effective on a virus verses bacteria and fungus, safety.

For comparison this study shows that retail pressure cookers can be used as effectively as an autoclave.

“All four pressure cookers tested were able to inactivate the microbes present in all of the trials except for the inactivation of G. stearothermophilus spores, in which only the Instant Pot was able to produce steam, pressure, and heat to the level necessary to achieve sterilizing conditions.”

https://journals.plos.org/plosone/ar...l.pone.0208769

“ Assessment and verification of commercially available pressure cookers for laboratory sterilization”

The first study looked at sterilization of liquids and metals.

this older one looked at syringes but with stove top pressure cookers

Christensen EA, Skadhauge K, Ravn-Jonsen A. Autoclaving of syringes in pressure cookers. Acta Pathol Microbiol Scand. 1963;58(521–527).

Here is a 3M material sheet on the material used to construct a 3M N95 mask https://multimedia.3m.com/mws/media...pirator-8210-n95-technical-specifications.pdf



• Straps – Thermoplastic Elastomer
• Nose Clip – Aluminum
• Nose foam - Polyurethane
• Filter – Polypropylene
• Shell – Polyester
• Coverweb - Polyester
• This respirator contains no components
made from natural rubber latex
• Approximate weight of product: 0.35 oz.

and interesting enough it says that it can also be used for liquid mists

Use For
• Use for solid particulates and liquid mists in concentrations not exceeding 10X PEL/OEL

This plastic industrial spec sheet seems to show that polypropylene can achieve good sterilization in an autoclave. It seems to note that polyurethane (nose foam) and polyester (covering) don’t do as well.

https://www.industrialspec.com/resources/plastics-sterilization-compatibility/

and this notes that polyurethane (the nose foam again) is not compatible with autoclaves

https://ehs.princeton.edu/book/export/html/380

Compatible/Incompatible Materials
[TABLE="border: 0, cellpadding: 0, cellspacing: 0"]
[TR]
[/TR]
[TR]
[TD]
  • Tissue Culture Flasks
  • Surgical Instruments
  • Glassware
  • Pipette tips
  • Media Solutions
  • Animal food and bedding
  • Waste
  • Polypropylene (Secondary containers)
  • Stainless steel
  • Gloves
[/TD]
[TD]
  • Acids, bases and organic solvent
  • Chlorides, sulphates
  • Seawater
  • Chlorine, hypochlorite, bleach
  • Non-stainless steel
  • Polystyrene(PS)
  • Polyethylene(PE)
  • Low density (LDPE) and High
[/TD]
[/TR]
[/TABLE]


So maybe the nose piece and covering and elastic straps would be an issue.

finally the 3M technical bulletin on disinfecting disposable N95 masks

https://multimedia.3m.com/mws/media...disposable-respirators-technical-bulletin.pdf
 
The CDC looked at quite few methods and their pros and cons and it appeared VHP was a winner as it did not impact the filtration performance, did not have penetration issues, and byproducts are water and oxygen that evaporated without residue.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html

Steam if I recall correctly degraded the filter fabric

Duke University studied and documented VHP as their preferred method

https://www.safety.duke.edu/sites/default/files/N-95_VHP-Decon-Re-Use.pdf
 
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