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WHY ITS SO HARD TO CONTROL: “becoming clearer that this virus is exquisitely suited to spreading. Old SARS mainly transmissible when people sick or hospitalized, #Covid19 transmits very early in infection, even before people start to become unwell.” 🧵 statnews.com/2020/03/26/wha…
2) “When people have a disease that is only contagious once they start to get sick, it’s much easier to order them to isolate themselves the moment they feel unwell. But that doesn’t work with this virus (#SARSCoV2).” #COVID19
3) A number of studies have reported that a significant portion of people are even spreading the virus while presymptomatic — in the day or two before they start to feel ill. Presymptomatic spreaders are, well, gonna spread. It’s not their fault. #COVID19
4) “How much this type of transmission is driving the pandemic is unclear but it could be significant. Gabriel Leung has estimated about 40% of cases transmit before symptoms develop. (Another) study pooled data from seven countries and estimated a very similar 43%.” #COVID19
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#COVID19 #SARSCoV2

More from @DrEricDing see all

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Eric Feigl-Ding
@DrEricDing
⚠️HUGE! Abbott Laboratories is unveiling a #COVID19 test that can tell if someone is infected in as little as 5 minutes, and is so small and portable it can be used in almost any health-care setting. plans to supply 50,000 tests a day starting April 1. bloomberg.com/news/articles/…
2) “The molecular test looks for fragments of the coronavirus genome, which can be detected in as little as five minutes when it’s present at high levels. A thorough search to definitively rule out an infection can take up to 13 minutes” #COVID19
3) “This is really going to provide a tremendous opportunity for front-line caregivers, those having to diagnose a lot of infections, to close the gap with our testing,” Frels said. “A clinic will be able to turn that result around quickly, while the patient is waiting.” #COVID19
Read 8 tweets
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Eric Feigl-Ding
@DrEricDing
UV disinfection of N95 masks: good study of repeated UV. First, past studies show “UVGI on respirator appearance, fit, airflow resistance, and filtration efficiency after 1-3 decontamination cycles and have found no sig effects”. But >3? 🧵 #COVID19 ncbi.nlm.nih.gov/pmc/articles/P…
2) In the lab, UVGI has been successfully used to decontaminate N95 respirators exposed to the bacteriophage MS2 (15,16) and influenza virus.(6,8) #COVID19
3) “However, the effects of extended exposures to UVGI after multiple decontamination cycles are not known, and it is unclear how large a cumulative dose of UVGI respirators can withstand, what damage eventually occurs, or how many times disposable FFRs could be decontaminated”
Read 13 tweets
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Eric Feigl-Ding
@DrEricDing
Pretty high % of severe cases needed ICU in @TheLancet study on #COVID19 mild/severe: 📌61% mild, 39% severe. 📌Of the severe cases, 77% needed ICU. (79 Cases from Nanchang China, Jiangxi Provide; ie not Hubei). thelancet.com/journals/lanin…
Erratum: 76 cases not 79. Apologies for the mental copy paste slip.
2) “The mean viral load of severe cases was around 60 times higher than that of mild cases, suggesting that higher viral loads might be associated with severe clinical outcomes”. #COVID19
Read 6 tweets

Related threads

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ilyse hogue
@ilyseh
Because there's literally not one single moment when these radical ideologues aren't obsessed with how to control women--especially poor women and women of color--they found a way to use the #COVID aid package to expand the unjust and discriminatory #HydeAmendment. It's sick.
This whole experience watching these people deal with #COVID is that those of us who deal with reproductive freedom and justice have seen this coming a mile away. You have a GOP entirely co opted at this point by a radical right for whom fundamentalism--religious and market-- /2
has completely supplanted any rational thought or science and data-based policy approaches. Medical disinformation and anti-enlightenment thought is core to their identity. Add Trump's peculiar mix of narcissism and megalomania, and it's a truly toxic brew. #COVID /3
Read 13 tweets
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Aaron Richterman, MD
@AaronRichterman
.@EricMeyerowitz and my talk about #COVID-19 literature update today -

Slides: docs.google.com/presentation/d…

Recording:
dropbox.com/s/bj0bbvggh1jr…

Key points with slides, links to papers below 👇
Virology: most important structural protein S ("spike") protein required for cell entry; nonstructural protein RNA polymerase, helicase; viral proteases that cleave non-structural proteins (PLpro, 3CLpro). Cell entry via ACE2/non-endosomal path

Below=SARS
nature.com/articles/nrd.2…
Environmental viability in EXPERIMENTAL conditions - 3+ hrs aerosol (does not imply routine aerosolization by patients), up to 72 hours steel and plastic.

nejm.org/doi/full/10.10…
Read 45 tweets
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LOrion
@LOrion
MAR 24 #COVIDー19 #MDTHREAD 1: tinyurl.com/se479vy
TODAY's #US Numbers as of 10:58 AM
CASES 50,212 DEATHS 606..
#Recovered 333 (see Importance below)
By Rick Noack, Lateshia Beachum, Kim Bellware,
Marisa Iati, Siobhán O'Grady, Adam Taylor and
John Wagner
10:51 a.m. PDT
MAR24 #COVID19 #MDTHREAD 2: Here from my AM MD Threadlet.. SOMETHING POSITIVE about it all..
The Importance of our #RECOVERED
tinyurl.com/ty32gxb .. with #Immunologic data from @NAChristakis .. LINK in my TWEET 1.
Please read esp #Medicals who will understand. @maddow @CNN
MAR 24 #COVID19 #MDTHREAD 3: Here is link to Yesterdays's MAR 23 ...36 TWEET THREAD..

tinyurl.com/s2x2ffx
AND ICYMI: Last WED. March 18 #US NUMBERS...
Read 32 tweets
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Ognjen Gajic
@ogi_gajic
1/ Please use EXTREME caution with using human resource intensive strategies in patients with #ARDS from #COVID-19.
Very early intubation, very early prone position or early ECMO will expose staff to risk and are unlikiy to bring additional benefit to most patients.
2/ I have been treating and studying ARDS for 20 years and extremely simple approach is by far the most beneficial:
- Try high flow/NIV
- Intubate if above contraindicated/failing (not based on ABGs, no need for ABGs) AFTER informed consent and goals of care discussion
3/ If intubated: AC, low VT (Ppl<30), PEEP 10-15, if needed occasional 10 sec recruitment with PEEP 20-25 going back to 10-15. Occasional bolus vecuronium (+midazolam)for severe asynchrony
- Reverse Trendelenburg in obese
- NorEpi +\- Vaso for MAP 60
- Furosemide, K, Mg
Read 6 tweets
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CLLynch
@lynchauthor
This is the kind of attitude that gets people killed.

Here is how I explained it to my nine year old:

Ebola and other plagues are usually easy to catch and stop. They are deadly, but that very deadliness makes them stand out. We spot them. We stop them.

#COVID is different.
#Covid ‘s mildness is the most dangerous aspect of it.

Many people who catch it don’t even experience symptoms.

Children, who cough on everything and never wash their hands CARRY IT WITHOUT SYMPTOMS.

When symptoms do show, they come two weeks later. Two WEEKS.
That means that for every sick person we see and test and hospitalize, there are probably a hundred people walking around feeling just fine, infecting other people who feel just fine, who infect OTHER people who feel JUST FINE.

Then two weeks later... KABOOM
Read 24 tweets
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Jennifer Brea 🦒
@jenbrea
Please stop telling young people they should avoid #COVIDー19 infection to protect the old. Tell them to protect themselves.

Long-term symptoms 6+ mo post-infection:

EBV: 11%
Q fever: 11%
Ross River Virus: 11%
West Nile Virus: 31%
SARS: 87%
Ebola: 90%
COVID-19: We have no idea
In general, the topic of long-term, post-infectious sequelae is not well-studied, probably for the same reasons #MECFS has not been well-studied. But maybe a few hundred million people being infected by a novel, zoonotic virus will (unfortunately) change things.
The quality of data by infectious agent varies––a lot. By the time we start worrying about survivors, the pandemic apparatus has usually long moved on and the money just isn't there to study the people left behind.
Read 16 tweets

Trending hashtags

#CoronavirusUSA #Covidー19uk #FACT #LivePDFans #routine #SMEAR #Guangdong #Croatia #LIE #transmissible #CAKE #vaccines #COVIDー19 #TrumpNationalGolfClub #HUSH #COVERINGUP #publichealth #hacks #AMERICA #SARS #lifebood #Herat #CoronavirusOutbreakindia #Sanitizer #evidence

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