The neuroinvasive potential of SARS-CoV2
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
> If the neuroinvasion of SARS-CoV-2 does take a part in the development of respiratory failure in COVID-19 patients, the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China.
This is a good example of why writing off COVID-19 as no more dangerous than the flu is itself so dangerous.
I should also point out that most people in the US face similar conditions to those in Wuhan. The extent of infection is not known, and therefore protective measures are not in place. We have been actively discouraged from "buying masks" and told that they are ineffective.
And it would have to be apocalyptic for them to accept a box of medical equipment from some guy wandering in.
At the moment because of the misinformation people wearing masks are being mocked and chided in public and its really unhelpful. Especially since there are immune compromised individuals and individuals with other conditions that really need to take every precaution they can, including that 10% reduction a surgical mask may give them.
When you exhale it is more wet and the moisture causes the barrier to catch more of the airborne particles. The barrier also catches any more-solid material that would otherwise land elsewhere, providing a mechanism for the particle to spread.
This means the net gain for wearing them to keep from catching the disease is relatively small compared to the gain by wearing them to prevent the spread if you may have been exposed.
It may primarily be about preventing spread from those infected, but that's still super helpful.
Logically, I might extend it to everyone wearing masks would considerably reduce the spread of exhaled contagions. This might first be encouraged in high population density areas, like parts of Asia, and first need to be integrated with fashion[0] to have any chance of broad success. I suspect it will never be a preference everywhere barring some sort of serious consequence (like death) for not wearing the mask.
In this situation, I think the most important thing is to know that normally available or homemade masks are helpful for presenting the spread of the disease. The more expensive masks are better but in this instance, not better in a meaningful way for the average person. The current supplies should be saved for those at-higher-risk populations like medical staff.
[0]: https://www.pinterest.ca/charmed4evr/fashionable-surgical-fa...
It's almost a moot point right now though because they're sold out pretty much everywhere.
https://www.thetimes.co.uk/article/coronavirus-china-tech-fi...
For a less cynical take, there's a lot of conversations that do happen more efficiently in-person, particularly at a lot of places that aren't set up for "full remote".
And even that would hardly look weirder than in surgical masks. Color-coordinated bandanas with a company logo pin?
My partner is more vulnerable to respiratory problems and has always worn N95 masks when in public during flu season. What's changed now is she gets all kinds of shit from people because they think she somehow hoarded masks away from healthcare workers. We've had boxes N95 masks for years, but now we're assholes for hoarding...
I don't know what your over-under on self-driving cars being prevalent is, so I don't know if this supports your point or not.
In cities sure. Rural areas not happening. Add the fact people like to drive to Mexico Canada and Alaska I’d call it a non starter.
Example. I have a place where the road on google maps and the place people drive vary because rural Arizona uses washes as roads. Cars driven by humans get stuck.
I wouldn't want to own a car without a steering wheel, sometimes you have to do weird stuff like park on a specific patch of grass at a rural wedding and it's going to be easier to do that myself than try and convince a robot.
But a car that can a) handle 'most' driving for some value of 'most' and can b) safely hand over or come to a stop under basically all circumstances including a sleeping driver? That's actually a much simpler task and it's a very useful vehicle. I would want one of those even if I lived somewhere where road conditions were such that I had to steer it myself on a daily basis.
Like in Arizona, once you got to paved road you could enter an address in Phoenix and kick back in actual safety, without having to worry about taking over at a moment's notice. I think that's achievable in 10-20 years, and it could be less.
I'd really like to know how often those fit tests actually result in someone needing to select a different respirator size or style.
I wonder if they're only needed if you're required to be 100% sure all your people can use their respirators with near-100% effectiveness. That's probably necessary if you're working in a contagious disease isolation unit or removing asbestos all day every day, but maybe not for less dangerous environments.
I wouldn't say it's a certain type of people ("some people" vs. "sometimes people"). You could argue for it, though seems like a hard argument to push.
Cars are inherently dangerous, because there isn't a reasonable guarantee that something will not go critically wrong (as opposed to, say, a train). Also, when driving a car, you're not only betting that you won't make a mistake, but also that someone else won't make a mistake (that would affect you).
It's not just about putting the mask on; it's also about ensuring they swap them out regularly and don't self-infect in the process.
Right on. For the past couple of years, because the Seattle summers have been hazy due to the wildfire smoke, I still have quite a large batch of N95 masks. I too used to wear them during my commute and the only problem I see is that if you're at risk (underlying respiratory/heart problems) you'll not be able to tolerate the mask... With a good fitment, it makes it harder to breathe.
I think it's unfair to label people hoarders for having these masks... After a couple of consecutive years of wildfire smoke, I think this is the new normal and everyone should have them. It's not my problem that the healthcare industry has a supply issue with these masks, they should have a different, hopefully more efficient and preferential supply chain. I hope they don't buy them from Home Depot (where I got them from).
This will be something that's routine, just following the plan, that exists to serve some combination of regulation, duty, and risk (burning important healthcare customer or government relationship) mitigation.
Yes, we wear n95, but we also get OSHA/niosh specific training on fitment, changing, PPE exposure limit, and appropriate environments. You do not. What people are hoping is that an industrial particulate mask is going to somehow prevent the flu or corona, which honestly I have never understood. Wearing a mask while pressure cleaning a paccar12 engine? Yes, you don't want fine grease mist in your lungs. Powder coating something? Better mask up. Wearing it for a fire? Yes, but change it out once or twice a day and check it often. The flu? How?
Please somebody show me data that proves otherwise, I'm totally open to it. (Note: I'm not saying I want you to post opinions from people in authority, I'm saying I want to see data)
> Quality commercial masks are not always accessible, but anecdotal evidence has showed that handmade masks of cotton gauze were protective in military barracks and in healthcare workers during the Manchurian epidemic.
> The prototype mask achieved a fit factor of 67 for 1 author with a Los Alamos National Laboratory (LANL) panel face size of 4, a common size. Although insufficient for the workplace, this mask offered substantial protection from the challenge aerosol and showed good fit with minimal leakage.
They don't find significantly more efficiency for N95 masks, but other studies do find N95 masks slightly better. (2)
(1) https://jamanetwork.com/journals/jama/fullarticle/184819
(2) https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-2659...
Do a search on Google Scholar for "N95" in combination with "virus" or "sars" for more studies.
Really a shame that authorities, including the Surgeon General, claim that masks are not protective, despite medical science to the contrary.
Yes, it really hurts me, as a science-based person, to have scientists with authority say things that are unscientific.
[1] https://www.researchgate.net/publication/258525804_Testing_t...
[2] https://twitter.com/chaiclate/status/1232972182667612162?s=2...
I think we should all ask ourselves why we take it for granted that we should simply have to ration masks. Why aren't there enough masks available for everyone for inevitable outbreaks like this? Why don't we have the industrial capacity to manufacture masks in the US, leaving us reliant on foreign imports?
We spend ~$80 billion dollars a month on our endless war, military and spy agencies in the name of "national security", but I'd argue that having ample medical supplies (and the ability to manufacture them) are just as, if not more important, to our "national security" as the vast majority of our military activities. Hopefully this crisis will not become to severe and will serve as a wakeup call for us to rethink our national priorities before the next inevitable crisis.
He also recounted how after the 2009 flu scare everyone was telling him how after it ends they will now stockpile masks to be ready for the next one, he increased production, but then was stuck with it because people stopped taking his calls the moment the flu faded.
I don't know anyone who has conclusively demonstrated there are not. What we have right now are runs on Home Depot and the like buying out respirators and dust masks faster than the stores can restock them.
> Why don't we have the industrial capacity to manufacture masks in the US, leaving us reliant on foreign imports?
We haven't and aren't. 3M manufactures their masks in the US.
You need an ASTM Level 2 or higher surgical mask to block coronavirus from completely penetrating the mask.
That said, any mask is better than no mask, first because it prevents you touching your mouth and nose with potentially infected hands, and second because coronavirus travels in water droplets which can be stopped by the mask from going straight into your mouth or nose.
Not my original source, but discusses the same thing: https://multimedia.3m.com/mws/media/376179O/nanotechnology-a...
This is to say, 95% filtration is the worst the mask will perform, with particles of any size, as it relates to coronavirus.
Particles smaller in size than 0.3 microns will have HIGHER capture efficiency.
This is similar for HEPA filtration as well.
Also my understanding is that a N95 mask that isn't properly worn (doesn't have a good seal) then it's nearly equivalent to no mask at all.
So you combine those two together and you have people who aren't effectively protected by the mask and are making riskier decisions.
--
I have looked at a fair bit of research on masks lately, and everything I've seen is that they are significantly protective, and, for example, reduce your risk of catching SARS by about 70%.
Yes, if a mask doesn't fit properly, some air will come through the sides. Even in that case though, the mask is still filtering some air, and it's protecting you from touching your mouth or nose, and it's protecting you from droplets hitting your mouth or nose from being coughed or sneezed on.
If the mask becomes contaminated, it becomes an ideal vector for encouraging infection -- so if you touch the inside of the mask with your contaminated hands (say you move the mask to touch your face or adjust it or whatever), for example, the mask becomes the opposite of protective.
Masks are somewhat effective at reducing spread if the already-infected person is wearing the mask.
Surgical masks are meant to protect surgery patients from the medical staff and the droplet-encased germs they emanate. N95 masks are meant to protect the wearer from particulate matter (harmful dust) in the air, specifically those particles over 30 microns. SARS-CoV02 is roughly half the size, so as an aerosolized virion, as opposed to droplet-suspended virions, they may have limited effect. N95 masks also often come with exhalation valve releases to improve inhalation fit - so exhalation pressure does not break the seal around the sides. A sick person wearing a mask with a valve that releases right in front of their mouth may be better than no mask, but it is a potential bypass for droplet suspended virions.
The US just doesn't have the culture where everyone puts on masks during flu season, like some places (HK for one), and that level of herd usage is really what might be likely to slow transmission to a breakable rate.
The N95 filters are tested with particles at 30 microns, but that doesn't say anything about their effectiveness against other particles.
3M, naturally, has released some information on this exact topic [1] which goes into a fair bit of detail on the various methods by which masks effect filtration. The tl;dr version is that there are several ways by which filtration is achieved that generally overlap and work towards providing effective protection well above and below 30um. There is generally a small dip in the transition between two primary methods which creates a specific size range where filtration is less effective.
Whether that's an issue depends on your definition of "limited effect". For the masks they tested, that dip generally occurred around 0.04-0.1um. Even in the worst case scenario, however, the worst masks tested were still filtering ~94% of the particles (in a mask that only claims 95% effectiveness to begin with). The linked document has coronaviruses listed as being about 0.125um in size, which has them falling toward the end of the dip where the mask is trending back towards 100% efficacy.
(For what it's worth, they also have the distribution of droplet sizes in a sneeze and they are all smaller than 30um as well. However they're still in a range where the mask will be about 100% effective.)
Which is all to say I certainly wouldn't describe an N95 mask as being of "limited effect".
[1] https://multimedia.3m.com/mws/media/409903O/respiratory-prot...
I suspect that even a spare cotton t-shirt material affixed over the face would stop a significant amount of droplets from transmitting.
It would be worth researching the effectiveness improvised masks, at the very least.
It took most of the war for that plant to get to the point of building a bomber an hour.
If you are thinking about coronavirus, you are more likely to feel the symptoms of a coronavirus infection, or what you think are the symptoms.
That is not only completely false but is extremely dangerous misinformation.
https://www.sciencedaily.com/releases/2019/09/190903134732.h...
> The study reported 'no significant difference in the effectiveness' of medical masks vs. N95 respirators for prevention of influenza or other viral respiratory illness.
[0] https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...
> One study found that nurses averaged 25 touches per shift to their face, eyes, or N95 respirator during extended use.
How problematic that touching is probably scales with how problematic your environment is. They're pretty sponge-like. Wearing a surgical mask over an N95 would help a lot.
In a controlled biosafety level 3 lab, "single use" things are definitely the most common, where everything exposed to the outside world is destroyed after you're done. What's worn underneath is washed and you're forced to take a shower. So that's what you do if you know you're in a contaminated environment – not sure what I'd do in a public place.
How effective is the virus after the mask has been unused for a while (so "cold", like a doorknob or a desk)? If it is not, the mask should be good to go then, doesn't it?
I use a reusable mask, and honestly, I don't wash it very often. It's there mostly so if I absentmindedly touch my nose I don't actually touch my nose, and so I never remove it until I've thoroughly washed my hands.
Source: https://www.journalofhospitalinfection.com/article/S0195-670...
I haven't heard of nasal irrigation using soap; hypertonic saline solution is usually recommended.
But I'm sure my coworker is wearing a mask for their own set of reasons...
As of yesterday, China, a country of 1.4B, had 80,000 cases and 3,000 dead.
Last year, the US had 36M infected with the flu and 34,000 died.[1]
Are you panicking about the flu?
Edit: source added
https://inews.co.uk/news/world/china-coronavirus-covid-19-de...
My point is that based on how many die from the flu each year, you’d have to see 130,000 deaths in China for the impact to be the same as the flu.
Check out Spanish Flu for worst case scenario.
China restrictions have been much more stringent than what you imply. People in Wuhan were prevented from leaving their apartments at all and needed to wait for food from the government.
The jury is still out whether softer forms of restrictions can work once the disease is widespread. We will see about that by watching South Korea and Italy. (We know it works if there are not too many cases around, like in Singapore.)
Yeah, that would be bad, but there is no data to suggest it would get that bad.
The flu infects nearly 20% of the world's population each year. Estimates by the NIH are 10-20% annually in the US, and those numbers are probably similar in other countries. China has a billion people, so that means the flu infects probably 200 million people each year but only 130,000 die. The death rate is below 0.2%.
In contrast, only about 90,000 people have been infected with WCV so far. Thousands have died. The death rate is at 3.8%, or roughly 19-20x higher than the flu.
The reason to not panic but be prepared is that humanity has zero immunity to this virus, whereas there's lots of group immunity to influenza. I'm not sure why it's so hard for people to see the issue here.
It's significantly more deadly than the flu. But also, people should probably take influenza more seriously anyways.
34,000 / 36,000,000 = ~0.00094
36,000,000 * 0.0375 = 1,350,000
That's the concern.
China also had some pretty extreme measures to get their low number of cases, measures I don't think will play out too well in the US. And probably won't have a full count yet.
We can hope for the best, we can wash hands etc., but it's not unrealistic to say this can get bad.
Some people seem to be bothered by it for months after.
This is never not a good idea, so no time like the present to get into it.
however:
Yan-Chao Li [etal.] ABSTRACT Swine hemagglutinating encephalomyelitis virus (HEV) has been shown to have a capability to propagate via neural circuits to the central nervous system after pe- ripheral inoculation, resulting in acute deadly encepha- lomyelitis in natural host piglets as well as in experimental younger rodents. This study has system- atically examined the assembly and dissemination of HEV 67N in the primary motor cortex of infected rats and provides additional evidence indicating that mem- branous-coating-mediated endo-/exocytosis can be used by HEV for its transsynaptic transfer. In addition, our results suggested that this transsynaptic pathway could adapted for larger granular materials, such as viruses. These findings should help in understanding the mechanisms underlying coronavirus infections as well as the intercellular exchanges occurring at the syn- aptic junctions. J. Comp. Neurol. 521:203–212, 2013.
https://doi.org/10.1002/cne.23171
it seems if you are not a swine or a rat you have little to worry about.
the optic nerve is hidden behind the eye with a substantial barrier of non nervous tissue in front of it.
https://upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Sc...
what you should also take from this espescially if you are involved in policy is that this corona virus we are experiencing has in its distant heritage ancestors with reported neurotrophic properties. It is possible, that at some time in the future, this virus will accumulate signifigant genetic drift and gain or lose certain properties.
Where can I buy noseplugs?
I don't think that's true.
> It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally.
Are they so high tech you can't just ramp up production? And how many months in advance would you need to ramp it up? We're about 3 months in and nobody got the idea to increase production of masks until about a week ago (similar for hand sanitizer, soaps etc)? What am I missing, why is that a thing?
I read about a hand sanitiser manufacturer ramping up in the UK; by increasing hours, not throughput. And obviously to increase hours you need more staff, training, and maybe to review some policies, local bylaws, and other procedural stuff.
Not exactly. I'm hopeful that differences between the typical American lifestyle and the typical Chinese lifestyle will help make the epidemic less severe in the US.
Americans are more "spread out" than Chinese: we often drive personal cars instead of taking public transit; our homes are freestanding with more private space per person; our public spaces are often less crowded, etc. I think open offices are even more common in China. Hopefully that extra distance will help.
The media is profiting off this story big time. It's like when the plane went missing and a news station actually put some moron on the air who said there's technically a chance a black hole swallowed the plane. It's disgraceful, to be honest.
That said, it looks like the rate of fatalities is overblown significantly [0](0.2% in a healthy population (COMPARED WITH THE 3.4% NUMBER BEING SPOUTED ALL OVER THE PLACE). I've yet to see coverage that is remotely reputable about long-term health effects after recovery.
EDIT 2 - Case in point about premature statements being made.
> [1]“I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year. What proportion of those will be symptomatic, I can’t give a good number.”
followed by:
> [2]"Because I am now less certain of where the R0 will end up (and how it may vary geographically) I am going to revise downward the range of outcomes I consider plausible to 20%-60% of adults infected. This involves subjectivity about what range of R0 may turn out to be true."
[0] https://institutefordiseasemodeling.github.io/nCoV-public/an...
[1]https://www.wsj.com/articles/how-many-people-might-one-perso...
I have mild persistent asthma, for example, which for me means if I take a daily (low) dose of an inhaled corticosteroid, I can generally go about my business like a normal person and almost never need to use my rescue inhaler.
I've only seen stats for COVID-19 fatalities for people with "respiratory conditions." Which could be anything from mild asthma on up to stuff like emphysema and cystic fibrosis.
I know, insufficient data.
"While this correction does not change the assessment that COVID-19 exhibits severe pandemic potential in the absence of effective interventions, the shift in framing brought about by this three-fold revision from ‘possibly comparable to the 1957 flu but not 1918’ to ‘possibly comparable to 1918’ may meaningfully impact risk perception."
Getting irritated at me for pointing out that the average person is not at severe risk of death, contrary to what the media is currently saying, seems a bit of an over-reaction.
So perhaps like saying chlorine is harmless because people drink it. It's a "well yes, but no ..." situation.
Its CFR is 3.4% according to WHO (actual number may be be higher than this because it is an early statistic and does not take into account patients that are still struggling and may eventually die).
https://edition.cnn.com/2020/03/03/australia/new-south-wales...
0.2% of 40% of the US Population is 260,000 deaths within a year[1]
"it's just the flu" greatly underappreciates just how deadly influenza actually is
If the mortality rate is more in the 2%+ range, we're looking at millions of deaths in the US alone.
[1] https://www.wolframalpha.com/input/?i=0.2%25+of+40%25+of+US+...
[0]https://twitter.com/eugenegu/status/1235247642814214145
[1]https://www.cdc.gov/coronavirus/2019-ncov/about/related-stig...
https://www.wsj.com/articles/how-many-people-might-one-perso...
> “I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year. What proportion of those will be symptomatic, I can’t give a good number.”
Then, he goes on to give an entirely different range on Twitter, including another statement that he should have said "without effective controls" - https://twitter.com/mlipsitch/status/1234879949946814464?s=2...
So, basically, you proved my point that everyone is so damn eager to talk about this that they'll make claims without sufficient evidence and scare people into distress.
The R0 is the highest driving factor for how many people will end up getting it the first year (aka R-Naught, is how many people on average an infected person spreads the infection to).
R0 for flu is 1.3. R0 for COVID is estimated to be 2.6, but I just read that the R0 is thought to be overestimated. and closer to 2.0. An R0 of 2.6 => closer to 70% of people. R0 of 2.0 => closer to 40% of people.
This is frightening as hell.
This doesn't lead to protesting easily. It doesn't stop the fact that pretty much everyone here is unhappy with Carrie Lam.
And to be fair, the relatively slow growth of the number of cases we have in Hong Kong might be due to all the precautions people take (although I haven't found any information on the total number of people tested in Hong Kong so it might be because not enough people are tested)
SARS caused permanent lung damage in a large proportion of the survivors, sometimes to a debilitating extent. How common is that with nCov?
https://www.nationalgeographic.com/science/2020/02/here-is-w...
If it gets to the point of causing pneumonia, you may end up with permanent loss of lung tissue. If it spreads to the rest of the body, liver and kidney damage are also on the menu.
I'm not sure exactly how they evaluate risk, but they probably estimate the error based on populations where very few people are studied (probably most people below 50), so it's likely if you're below 50 the chances are actually lower, I'm not sure.
Risk factors for immune disorders and car accidents are probably similar if I were to conjecture (just in: sick people tend to die), so most people on this subreddit will just get the fever. 15% of people don't even present with a fever, so it seems like the immune system can typically fight it off.
https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...
There were plenty of them that still remember the residual effects of SARS, resulting in bone loss and other symptoms.
There's other literature out there saying ACE2 is ubiquitously expressed (including brain) - so that means one of two things: People saying it's expressed everywhere are wrong, or SARS-COV-2 requires more than ACE2 for infection. There are papers saying that transfecting cell lines with ACE2 doesn't always render the cells susceptible, so it's probably a good idea to consider the requirement for a co-receptor.
Like anything, the true answer probably lies in between all these possibilities.
Anyone has any link to secondary sources where other scientists try to put this in perspective?
Sounds like something from a horror movie!
Edit: changed "oral/fecal" to "fecal-oral," thanks calmworm. Also removed a period.
> Taken together, the neuroinvasive propensity has been demonstrated as a common feature of CoVs. In light of the high similarity between SARS-CoV and SARS-CoV2, it is quite likely that SARS-CoV-2 also possesses a similar potential. Based on an epidemiological survey on COVID-19, the median time from the first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to the intensive care was 8.0 days 15. Therefore, the latency period is enough for the virus to enter and destroy the medullary neurons. As a matter of fact, it has been reported that some patients infected with SARS-CoV-2 did show neurologic signs such as headache (about 8%), nausea and vomiting (1%).
There's also this rather disquieting anecdote used as evidence of a link to the nervous system:
> According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath.
Supposing that this neurological link is real,
> the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral [sic?] or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China.
So let me ask a dumb question for someone with actual biomedical knowledge. Are they saying that infection of the CNS is somehow easier through the nose, in which case high-quality face masks actually do matter?
I'm also confused by this sentence in the introduction, which appears to contradict the hypothesis that the upper respiratory tract is a high-impact area?
> However, different from SARS-CoV, SARS-CoV-2-infected patients rarely showed prominent upper respiratory tract signs and symptoms, indicating that the target cells of SARS-CoV-2 may be located in the lower airway.
I will note that, unlike some other papers on this topic, this one has been peer-reviewed in what seems to be a legitimate medical journal (Journal of Medical Virology), so there should be some genuine substance here.
> According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath.
Would that explain people collapsing suddenly on the streets as seen in Wuhan and Iran?
And if it actually were causing neurological damage, I'd expect still more causes like seizures and the like.
The olfactory receptors (nerves that smell) are among the most exposed nerves of the body, and IIRC they are single cells stretching from the mucus membrane in your nose all the way to the brain. And because smell is such an evolutionary ancient function, the relevant brain region is really close to the centre of the brain (and brainstem).
So it's really just two hops from the outside world to the command post of your autonomous nervous system (i. e. breathing)
2. Upper versus lower: when people have a URI the upper airways meaning the nasopharyngeal, oropharyngeal, and trachea are predominantly affected. The typical symptoms are runny nose, nasal congestion, sore throat. However, SARS/COVID tends to cause a lower respiratory syndrome affecting the small airways deep in the lungs, namely the alveoli and small bronchioles. It is entirely consistent to hypothesize that infection through the upper airway mucosa is “worse” but the target cells that primarily cause disease are in the lower airway.
Is this how people typically write a paper to Medical Virology?
I wont assume that (I am software engg.)
I see where you are coming from. Here is my perspective, think of this like a outage of your service. No one has exact answers so team starts to dive in and starts sharing what they find.
These findings mostly prune the "solution space" of the problem.
Feels like a new weapon was added to my cognitive toolkit.
I see it's your first day on the internet. Welcome!
As with the other person, I'm not in the field so I can't actually answer.
My prior, though, would be that papers that come in the early period of a response to a global widespread disease are not representative of the typical status quo in the field.
What goes wrong is articles are picked up by mass media and they drop the "may", "possible".
"I'm allergic to WiFi."
"No, you're not. Nobody is allergic to WiFi."
"Yes, I am. Here's an official PubMed citation: https://www.ncbi.nlm.nih.gov/pubmed/26372109 . Why do you hate science?"
The paper you linked admits that there are studies that show it's the same as a placebo. Just because most people aren't qualified to realize that the studies in the first half of the sentence might be more reliable than the studies in the second half doesn't mean the paper shouldn't be published.
This strategy is meaningless in terms of scientific value, but it certainly sounds authentic enough to non-specialists.
That seems like the hypothesis they suggest. Interesting implications.
[1] https://en.wikipedia.org/wiki/Nasal_concha#Immunological_rol...
isn't the point of the corticosteriods to rapidly reduce widespread pulmonary inflammation that would otherwise kill the patient?
As a sort of "vaccine", would it make sense to have people intentionally infected orally so they build up antibodies before it has a chance to spread to their brain?
Warm and wet.
No smoking is good for you but then again the leading cause of death is birth so enjoy the time you have. If cigars are your thing smoke it up
"If you wear a mask your testicles will shrink and everyone will hate you!"
But the more important question: Is it time to stop trimming nose hairs?
Looked for interventional studies testing whether face masks and eye protection work in humans to protect against airborne viral particles. A critical issue with many such studies is that medical staff only use masks and/or eye protection at work, opening them to being infected outside of work.
Found a small study [1] getting around this problem by exposing subjects (n = 28, avg age 30.5 years) to monodispersed live attenuated influenza vaccine particles by placing them in front of a vibrating-orifice aerosol generator for 20 minutes, subsequently testing for infection using RT-PCR and culture in nasal washes.
Surgical mask: 3M 1818 | N95 mask: 3M 1860/1860S | Eye Protection: Z87 Uvex non-vented
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RESULTS
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No precautions: 4 out of 4 infected.
Ocular exposure only: 4 out of 4 infected.
Surgical mask only: 5 out of 5 infected.
Surgical mask + eye protection: 5 out of 5 infected.
N95 mask only: 3 out of 5 infected.
N95 mask + eye protection: 1 out of 5 infected.
1. Bischoff WE, Reid T, Russell GB, Peters TR. Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of n95 respirators, surgical masks, and eye protection in humans. J Infect Dis. 2011;204(2):193–199.
"...may be at least partially..."
https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728
[edit] Or you can just click the very tiny "PDF" link on the linked page that I apparently missed the first time.
https://sci-hub.se/10.1002/jmv.25728
keep in mind this is a preliminary, the grammar used in this paper needs to be revised so as to avoid as much as possible, people coming to errant conclusions after misinterpreting poorly written phrases.
so that means that while reading this paper one should not skim but should take the effort to interpret this paper.
there is an absence of references in the abstract, this makes it hard to examine the basis for statements in abstract
[1] Glass WG, Subbarao K, Murphy B, Murphy PM. Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice. J Immunol 2004;173:4030-4039.
https://doi.org/10.4049/jimmunol.173.6.4030
[11] Li, Y.-C., Bai, W.-Z., Hirano, N., Hayashida, T., Taniguchi, T., Sugita, Y., … Hashikawa, T. (2012). Neurotropic virus tracing suggests a membranous-coating-mediated mechanism for transsynaptic communication.
2019-nCoV (2019 Novel Coronavirus) was a temporary name.
SARS-CoV-2 (Severe Acute Respiratory Syndrome-related Coronavirus 2) is the official name for the virus.
COVID-19 (Coronavirus Disease 2019) is the official name for the disease that the virus causes.
[0] https://www.sciencemag.org/news/2020/02/bit-chaotic-christen...
[1] https://www.snopes.com/fact-check/people-collapsing-coronavi...
>If we strip the above-displayed videos of their captions, we can take a look purely at what the videos show. In one case, it looks like a person was the victim of a traffic accident. In another, it appears that a man suffered a head injury. But since these videos appeared online during heightened hysteria about an outbreak of an illness, it’s easy to see how a passerby may have made the assumption that these incidents were connected to the coronavirus.