Buttonville Flying Club

COPA Flight 44

COVID-19 Q&A from BFC member and virologist Simon Lam

06 Apr 2020 11:35 AM | Anonymous member (Administrator)

Editorial note: there have been a lot of questions and rumors posted about the novel Coronavirus and COVID-19 -- many sent to the club newsgroup or WhatsApp chat.  Club member Simon Lam has a PhD in Virology and works in the pharmaceutical industry, and has addressed a list of these questions. 

This is not medical advice; just a Q&A.  For medical advice, follow the guidance of your doctor, and check official public health resources such as the following:

Public Health Ontario

Public Health Agency of Canada

The World Health Organization

The following responses were contributed by Dr. Simon Lam:

Why should I believe you?

I have a PhD in virology. I am not specifically a Coronavirus expert, but I know viruses in general. Unlike "A prominent doctor at xxxxxxx hospital", I actually exist. We've had coffee together at Druxy's and we've gone flying together. I just want all of us to be safe, sensible, and educated.

If there is a question you don't see answered below, please ask.


How is the virus transmitted?

The virus is transmitted via droplets for the most part. (i.e. someone coughs, the virus hitches a ride in droplets, ends up being inhaled by someone else.) These droplets are microscopic. The droplets can also land on a surface, where someone soon after touches it, and that person then touches their eye/nose/mouth, but this is much less likely. To be clear, there is no evidence the virus is "airborne" as in floating in the air by itself. (There is some evidence of <5 micron aerosols carrying the virus, but it's not strong evidence.)


Why is social distancing effective?

Maintaining distance from other people drastically reduces the chances of being infected because most of the transmission is direct from one person to another, and the droplets from a cough/spittle can only travel a few feet. 

 

What is "flattening the curve"?

Flattening the curve is based on a pessimistic assumption that we cannot reduce the rate of infection to a point where the virus goes away slowly, which has since proven true. On this curve, X is time, Y is number of new cases. It assumes that the virus would continue to spread. If we know we cannot stop the spread, the goal then becomes slowing it down as much as possible so that the medical system doesn't get overwhelmed. The more resources are available, the better the care available, and the fewer deaths will result from this. Sadly, it doesn't mean fewer people will be infected, but it does mean you'll get better care when you get infected. (For the nerds: the area-under-the-curve remains the same.)

 

What age group does Covid target?

Simply put, all age groups. Like most diseases, the risk of severe outcomes goes up with age. The early data shows ~3% death rate from 60-69 and ~8% death rate from 70-79. Most of these cases had some "complications" such as high blood pressure or diabetes. That said, the death rate varies widely from country to country, and perfectly healthy young people have died from Covid as well. It's difficult to predict, and some evidence points towards an immune response called a "Cytokine Storm" that may be a factor in younger victims. (Further reading: https://en.wikipedia.org/wiki/Cytokine_release_syndrome")

 

Should I wear a mask/gloves?

Masks:

Surgical masks are designed to protect the public from the wearer. They do give some limited protection to the wearer. Many Asian countries recommend/enforce wearing surgical masks in public because of people who are infected and can spread the virus but don't know it yet. So, wearing surgical masks is sometimes recommended for the general public, but we now have a world-wide shortage and it's questionable whether these products should be used by the public, taking them away from healthcare workers.

N95 and other "respirators" need to be worn properly (tightly). When worn properly, they can be very uncomfortable. They also need to be fit-tested for individuals. There should be no gaps around the respirator at all. A recent study has shown that they are usually not worn properly and have about the same effect as surgical masks as a result. When worn properly, they do offer protection to the wearer. To be clear, these respirators are proper professional equipment, not designed for public use. As with surgical masks, the general public using them deprives the supply for healthcare workers.

Cloth masks offer even less protection than surgical masks but do offer some minimal protection, especially in protecting the public from the wearer.

Masks are single use. If absolutely necessary, store them in a clean, dry environment between use. Don't put them in zip-lock bags because that traps in moisture and encourages bacterial growth. Store in a paper envelope if absolutely necessary, but the best practice is to dispose of them.

Gloves: 

Don't touch your face. Wash your hands. Use hand sanitizer if you can't wash your hands. That said, gloves don't do any harm. Remember to take them off before getting home or getting in your car.

 

Why is handwashing effective?

As mentioned earlier, if you touch a surface that has the virus and then touch your eye/nose/mouth, you can catch the virus. Hand washing is effective because it physically removes the virus. Only if you cannot wash your hands should you use an alternative such as hand sanitizer. Remember to moisturize your hands after washing, otherwise your skin may crack and leave you open to other infections.

 

Why is alcohol-based sanitizer effective, and what concentration do I need?

Alcohol is great at killing just about anything. It "denatures" the proteins on the surface of the viruses. Don't worry too much about the concentration if you're using a store-bought hand sanitizer. (If you must know, not all of them are alcohol based, and the alcohol ones are usually >= 65%.) Let your hands air-dry. But remember, washing your hands is better than using a sanitizer. Please don't try to make your own hand sanitizer.

 

What are some other substances that make good disinfectants, and what concentration do I need?

Buy a household disinfectant from the supermarket. Anything available in stores for kitchen, bath, or household cleaning that claims to be a disinfectant is probably effective. If you need an alternative, 1% bleach in water. You can use 2% in higher traffic areas, but don't go higher. Don't mix bleach with anything except water. Generally speaking, disinfectants work best if you let it sit for a few minutes before wiping off. You might want a second pass with plain water to get rid of the residue.

 

Will it help to adjust the heat/humidity in my house?

You won't be able to get your house hot enough or dry enough to matter to the virus. Keep your home in a comfortable temperature and humidity. That will help keep your mucous membranes (the inner bits of your nose and mouth and sinus) moist, which will help protect you.

 

How does the virus testing work?

Very simplified version: A swab goes very-very far up your nose and into your sinus to pick up the virus if it’s there. That swab holds only a very very small number of virus even in a positive sample, so few that it cannot be detected. The sample then goes into a machine that looks for and replicates a very small piece of the virus's genes and makes enough copies to actually detect it. If it replicates it and detects it, it's a positive. If it can't find the gene, it can't replicate it, then it can't detect it and it's a negative. (Further reading: "Real-Time RT-PCR" https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction) There are also antibody tests but those aren't yet common. 

 

Is there anything I can eat or drink, or any medicine that would help/cure Covid?

Nothing has been proven to have any effect.

 

When will a vaccine be available?

I don't know. I would guess at least 12 months as an absolute minimum. More likely 18-24 months. For a vaccine to be safe enough for the public, there has to be a lot of testing, which takes months to years. In a typical non-emergency scenario, testing takes years, then setting up the manufacturing facilities to make it for millions of people takes a few more years.

 

When will this be over?

I don't know. I don't even dare guess.

 

The "I heard that..." section:

I heard that heat kills the virus?

Yes. Enough heat kills everything. But you can't get your body hot enough to kill the virus without killing yourself. Don't wash your hands with extremely hot water. The objective is to wash the virus off, not kill it. You'll just end up with burns on your hands. Don't stick a hair dryer in your face. You'll just burn your face and it won't affect the virus deep in your sinus.

 

I heard that UV kills the virus?

Yes. Enough UV kills everything. For that to work, you need proper industrial grade UV lamps which give off enough power at the right wavelengths to kill. These lights are also highly damaging to almost all materials, including humans. (The ones we have at work have a safety interlock so the shield must be closed or they won't turn on. That's how damaging they are.) A store bought black-light won't work.

 

I heard that I should drink hot water / lemon juice...

I see this going around a lot. Something about using hot lemon water to kill the virus and wash it off your throat. It doesn't work. The first point is you can't drink something hot enough to matter. The instant the hot water touches you, it burns you and cools down before it even affects the virus. Second is that the acid in lemon water gets diluted as soon as you swallow it. You can't drink enough acid to affect the virus without killing yourself. The third is that the virus doesn't live on your throat; it lives deep in your sinuses and lungs. The fourth is that the virus lives inside your cells and in the layers of cells deep inside; it doesn't just sit on the surface waiting to be washed off.

 

I heard that I should gargle with salt water...

No. Same as the above; the virus lives mostly in the sinus, not throat.

 

I heard that I should steam my face...

You can't get your sinus hot enough to kill the virus without killing yourself.

 

I heard that I should microwave my mail...

Don't. Your mail and/or microwave will probably catch fire.

 

I heard that I should wipe my shopping/parcels...

There's no harm in it, but I'm not sure how much there is to be gained either. It is highly unlikely to catch the virus this way. If you insist, wipe down the entire surface of your shopping/parcels, and then put it somewhere else so your wiped and un-wiped stuff don't mix. Also, make sure you clean off whatever disinfectant you used afterwards. (Obviously, don't disinfect fruits that you eat the skin of. Wash those in clean water.)

 

I heard that you can tell if you have Covid-19 by holding your breath....

No. It's so silly, I don't even know how to answer that. If it worked, we wouldn't need test kits.

 

I heard that this will go away as soon as it warms up because the virus dies in the heat...

It's hitting 30 degrees C in many parts of the World where the outbreak is... so, no. The effect, if any, is very small. Keep in mind, your body is 37 degrees C...

 

I heard this drug (chloroquine) works against Covid and was approved by the FDA...

There has been no solid evidence it works against Covid. There was a research article that said it works with SARS, but the evidence so far with Covid is questionable. FDA didn't approve it's use. FDA approved experiments on using it, but not for its general use.

 

I heard this virus was man made...

I don't think so. I don't think we're remotely that good...

 

Other:

Can COVID-19 mutate and spread to domestic animals, and what will that mean?

For a virus to jump from one species to another, a lot of luck (and therefore time) is involved. A virus that crosses into a new host is most likely going to die there as a dead-end because the virus hasn't adapted to spreading within the new host species. Over time, by the luck of mutation and evolution, it will. Once it has established in the new host species, it will spread much faster within that new host species. The bright side is by that point, the virus is no longer adapted to spreading back to the first species. In other words, because a virus needs to adapt and optimize itself for each host-species, jumping between species is relatively rare. When it does, it can cause an outbreak like the current one.

What a virus does once it's in a new host is unpredictable. How the virus affects one host species does not allow us to predict how it will affect another host species. There have been reported cases of pets testing positive for Covid-19, but it's impossible to say for now how they will react.

Comments

  • 06 Apr 2020 12:32 PM | Anonymous member
    Thank you Simon, this article is very useful and answers many questions. We are all used to going to the internet for information but unless we can verify the source of the information, we should not follow it.

    Be safe, wash your hands and don't touch your face.
    Link  •  Reply
  • 06 Apr 2020 12:37 PM | Anonymous member
    Excellent article Simon - thanks for writing it. Great answer to
    I heard this virus was man made...
    Link  •  Reply
  • 06 Apr 2020 12:56 PM | Anonymous member
    Nicely written! Now if only we could get everyone to read it !
    Link  •  Reply
  • 06 Apr 2020 1:28 PM | Anonymous member
    Simon, thank you for that, excellent. Just one question, you say "the death rate varies widely from country to country". Is that really so, or is the death rate most likely really quite the same all over the world and only how it is measured based on what data does it vary from country to country?
    Gerd
    Link  •  Reply
    • 06 Apr 2020 2:15 PM | Anonymous member (Administrator)
      Copying/pasting Simon's emailed reply with his permission (he's not at a computer where he can log in right now):

      There are many many things that affect the death rate.

      First of all, let's be clear that almost everyone considers "death rate" to be "number of deaths per confirmed case", or [# of deaths] / [# of confirmed cases]

      1) Quality of Medical Care. Some countries have more medical resources. Some have been overwhelmed already. Keep in mind that medical care means supporting the patient until they recover on their own, which takes time and resources.

      2) Reporting. Some governments' numbers may be questionable for political reasons.

      3) Test availability. If you don't have enough tests, your [# of confirmed cases] drops. The probably of being tested is higher for those severely ill, so the [# of death] isn't as affected by test availability. This results in higher than actual death rate. (As an additional kink, early on in the epidemic, some health authorities included a match of symptoms without testing to be good enough as confirmation, causing numbers to change over-night.)

      4) Age distribution. As mentioned earlier, age has a huge effect on outcome of Covid-19. A country with an older population will be more severely affected. It was mentioned that northern Italy had a particularly old population, but I haven't seen the data.

      5) Time & Infection rate. Death lags behind infection by approximately 2 weeks. If a region has a very rapid spread, the # of cases can increase quickly and artificially bring the death rate down... until the deaths catch up

      So, in answer to you question, it's both. (Sorry it wasn't a more useful and direct answer).
      Link  •  Reply
  • 06 Apr 2020 3:05 PM | Anonymous member
    Tks very much for this extra effort. Keep safe and really enjoy what the Mrs is giving you soon!
    Link  •  Reply

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2833 16th Avenue, Box 100

Markham, ON, L3R 0P8

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