Wuhan Coronavirus: 01/27/20

A nightmare scenario and a nothing-burger are just two possible Wuhan Coronavirus outcomes, and there’s a whole lot gray area in-between. This post is what I have been thinking about the last day or two. Keep in mind these are just my opinions and observations over a thin veneer of facts. And not much more.

The less-than-forthcoming Chinese are a problem. From my perspective, this could double as season two of HBO’s ‘Chernobyl’. As of today in China, we have around 2.5K cases reported with under 100 deaths and something like 50-60 ‘recovered’. It may just be a communication glitch, because otherwise, something is very wrong with those numbers. I’ve watched some video, disturbing, of scenes from China. However hard to say if real or faked, and even if not faked, it appears some of the people collapsing and lying down are doing so because they’ve been told to go home. Still, it’s a mess over there, and there is cause for concern.

Severe Wuhan Coronavirus cases can result in pneumonia, kidney failure and death. Deaths seem most associated with the elderly or infirm with pre-existing conditions such as hypertension, diabetes, or cardiovascular disease that impaired their immune systems. However a study of the first 41 patients admitted to hospitals in Wuhan with confirmed cases reported that a majority of the patients were healthy before contracting the infection, and that over a quarter of previously healthy individuals required intensive care. Among the majority of those hospitalized, vital signs were stable on admission, and they had low white blood cells counts and low lymphocytes. Was this low immunity a consequence of the infection or a specific type of susceptibility?

During the Spanish influenza epidemic (1918) the US Army noticed that regardless of severity of infected cases, about 30% of the soldiers in any dormitory would not become infected; probably because they were either just getting over something similar enough to heighten their defenses, or they had some immune cross-reactivity from a previous infection. However, this strain of coronavirus is ‘novel’ and we probably do not have much specific resistance. Plus, at least for now, the R0 (an index of infectivity) has it pegged anywhere from 3-5, meaning each person infected will lead to 3-5 new people being infected. This is high, compared to the average influenza (1.2-1). Also the coincidental appearance with the New Year meant that lots of infected, asymptomatic people were traveling all over the place. In short, there might not be a way to stop it from spreading to all parts of the world, exposing large numbers of people, in as little as one month. Will this happen? Hopefully not. Could it happen? Yes.

There is a difference between prudent concern and running for the exits. As Louis Pasteur famously said, ‘chance favors the prepared mind.’ So let’s do some thought experiments and see what’s really worth preparing for.

If it’s possible to not contract the virus, so much the better. Depending on how extensive the pool of communicable people becomes, that would require adopting protective measures until the virus essentially burns itself out. Obviously public health measures, such as quarantines, and big-time support care for the most serious, are the first line. On a more personal level, some basic behavioral and barrier strategies are probably warranted. The virus spreads by droplets, so if all else fails, sneeze into the crook of your arm at the elbow. Then follow up with some hand sanitizer. A hand sanitizer is probably a smart thing to tuck into a pocket. The virus does not appear to last long outside of a living host (a few hours, apparently) but that is plenty of time to get it from your hands to your mouth, eyes, nose, etc. Masks are also a wise idea, perhaps for no other reason that they my help someone not get something from you (reasonable evidence), and may also prevent you from getting something from someone (modest evidence). However if enough people wear them the results are probably good. Despite protestations from the medical profession in 1918 that they were useless, the epidemic began its decline in the US as soon as people started wearing them. Medical grade masks or N95 rated masks are best. The virus can be transmitted via the conjunctiva of the eye, so if need be, take a vacation from the contact lenses and wear your glasses for a while.

Not having the option of avoiding the virus altogether, the next best strategy might be to try to engineer getting the mildest possible form of the infection. Under these circumstances, you are looking at a sore throat, a fever, muscle aches and maybe some mild respiratory stuff. Stay home, push the fluids (with things like meat and vegetable stocks, simply cooked easily digestable fish and starchy vegetables, cooked fruits and lot of water. Garlic is in a family of plants noted to contain a protein lectin that has been shown to inhibit coronavirus. Fresh-crushed garlic probably has some anti-infective effects in the mouth and throat, but also has really good action in the lungs. Onions and leeks also have this anti-viral protein. Elderberry has a traditional use as an antiviral. As with garlic some of its actions may be due to the lectin it contains (it actually contains five, and they are very cool, in that they adhere onto something called neuraminic acid, on the outside of our cells and which is often used as a point of attack by viruses to attach to the cell using an enzyme they make called neuramididase to drill through it. Elderberry has been shown (like the drug Tamiflu) to block neuramidadase, but studies on coronavirus seem to indicate that they are not as susceptible to this as the influenza viruses. One well-studied medicinal herb that may play an important role in mitigating the severity of infection is Andrographis paniculata, which has an extensive research basis for symptomatic relief of acute respiratory tract infections in adults

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I’ll post another update as I learn more.

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