Stay Safe! It’s a cliche!

The tidal second wave of Coronavirus is surging across the globe. What went wrong? Was easing the lockdown a wrong decision? or was it our inadequacy to understand the virus behavior? Can we understand what went wrong? We each define the microcosm of the society and we contribute towards the spread via our Social Bubble or contain the Spread with our responsible behavior.

I have captured all the risks factors and how to fix our own behavior during this tidal surge of COVID wave.

Stay safe has become a cliche, like Good morning, bye etc.

Friends, this week has been extremely bothersome as the second wave has been not just huge, not just a tidal wave but a seismic wave, and a tsunami that may overwhelm our healthcare system. Not just in Texas alone, it is across the US mainland, the UK, the EU, China, India, Brazil, Mexico, etc. It is extremely scary.

What went wrong?

First – let us understand some principles of transmission of the virus. Second, let us understand our fallacies. Next, let us understand our social dynamics.

A) Virus Transmission –

A virus multiplies in 100,000 copies in one single day. Almost, one bout of coughing produces 54 million copies, that fly as aerosol and also settle as fomites. Being a tough virus, it survives in the air for almost 3 -5 hours, depending upon the ambient conditions. The warm and humid environment makes it hang around longer. It drifts with the air current or stays suspended without a drifting, with no wind current. The peak is 14 days, thereafter the virus gets neutralized in the patient.

Symptomatic patients are not the only bug spreaders, for every symptomatic patient, we have 10 asymptomatic patients who are spreading the virus. However, for asymptomatic patients, the virus cycle continues for almost 28 days. Unfortunately for us and fortunately for the virus, it is colorless and invisible and since it is invisible, we feel pseudo confidence that we are invincible.

B) Our fallacies –

We presume the virus is not there. That and given our boredom of staying inside makes us extremely prone to catching the infection. We are frustrated staying secluded, within the confines of our four walls. But you are not alone, almost over two billion people on this planet earth are secluded and claustrophobic within the confines of their home. We all know social distancing but I see several families taking a stroll without masks, not knowing that they may be inhaling the virus.

Somewhere, we presume, it is a disease of the elderly. I have seen several case reports of a death within the young and healthy. I have seen case reports of kids suffering immensely from COVID. I have seen elderly parents escaping death. This all points towards one thing – that Science has not yet definitely identified risk factors for mortality and morbidity. Thus the virus behavior remains elusive and erratic. You may get the bug, harbor it and unknowingly, you become a super spreader. I see school kids interacting with each other. How can we ensure that those they are playing with have no disease (asymptomatic carrier)?

Social Bubble – Exactly, this small social network connects us with other tiny bubbles, and this is becoming the route of spread. New Zealand is the first country to realize this and they broke the vicious cycle and almost eradicated the virus. They will, however, get reinjected, once they start air travel though.

Work Bubble – We think, we are acutely dependent on running our family for a livelihood, not realizing that those who are working can become asymptomatic carriers and transmit to vulnerable parents staying with us. Are we so careless? (@Dr. Shashank Heda, for COVIDRxExchange.Org). If we have to essentially step outside for a living, let us live under a different roof, not with those family members who are vulnerable.

What Do We Do?

  1. Strict Social Distancing is not enough, we will be inhaling the bug via several routes.
  2. You all need to suspend all strolls, shopping, and other errands. Let us minimize exposure as much as we can. Can we buy online?
  3. Fomite transmission is deprecated. That means fomites do not pose as much risk as was considered previously. Please visit CDC for the guidance.

Summary: If you have let your guards down, a “new high probability” risk factor that will determine your chance of getting the infection. You can make your choices.

Coronavirus – A Weekly Roundup

Friends, ‘First a Happy Friday’. Let us round up the events of this week (June 15, 2020) as we have seen exciting and not so exciting stories for this week. Let us demystify those one after the other – Dexamethasone, Testing, Huge Second wave, Unscientific Americans, declining Antibody titer.

Dexamethasone

This steroid is suddenly touted as a panacea for mankind to protect its herd from Coronavirus. Let me say, Dexamethasone is used only for seriously ill patients. The drug has been shown to reduce the mortality in severely ill COVID patients those on a ventilator. So, make a note – It is for severely ill patients on a ventilator. It is not for prevention or cure of mild or moderate disease, and of course not for asymptomatic carriers.

How does this help me as a common man? This is not for prevention or cure of the mild to moderate disease. Other drugs and vaccines are in the pipeline.

Testing

The percentage of positive tests is rising across the Sunbelt, Arizona has 15.9%, Texas 7.9%, and Florida is high. Rising temperature and spreading Corona has dispelled a myth, that it is associated with Cold. Beyond numbers, an average of 5% – 8% positive are considered within the normal range for a pandemic (ideal is 0%), however, when the numbers rise above 8% it is time for a lockdown. However, let us understand, if the probability of positivity is 8% that means you have a 92% probability of negative test results, or in other words, 1 in 10 patients will test positive with a similar spectrum of symptoms.

Let us look at these 1 out of 10 positive cases. The probability of mild disease (given you have no risk factors) is 80%, another 15% have a probability of moderate disease and 5% have a grave outcome. It is surprising that Corona takes a toll on the young and healthy, and spares often the elderly recover from the disease. Another aspect is the residual scarring after recovery. Both these aspects mandate taking deferring unrequired risk.

How does this help me as a common man? The symptoms between Coronavirus and other respiratory virus overlap a lot. It is wise to get tested and be confirmed negative, rather than deny it and get delayed help.

What is an unrequired risk?

I see several kids interacting in my neighborhood, adults taking a stroll, and few doing their business without masks or adequate protection protocol after presumed exposure. Of course, Coronavirus is not a cloud. So if you have an asymptomatic person taking a stroll in the 2-3 hours window preceding your stroll (let us add no wind current during this time), he has left behind a cloud of virus-laden aerosol which you will naturally inhale. I presume you recollect how tightly the S protein binds to the ACE2 receptors of the human cells. (@ COVIDRxExChange.Org; Visit http://www.covidrxexchange.org).

How does this help me as a common man? It is best to avoid walking in a public place until the second wave has waned.

The Second Wave

We predicted it right before Memorial Day that a second wave is in offing. What I failed to predict was the Floyd Protests and the huge second wave due to claustrophobia. This wave is huge and I will not be surprised to see another lockdown. However, the economy has exhausted its appetite for another lockdown, and only when the hospital beds are exhausted, that they will say, “Flatten the Curve” and impose another lockdown. Let us not worry about the schools reopening in fall. Fall is too long, let us follow R0 (naught).

How does this help me as a common man? 99.99% is not enough; do not let your guards down. Follow precautions as stringently as possible.

Unscientific Americans –

Dr. Fauci is right when he said, Americans are unscientific. Look at the malls, the beaches, and the pool parties. What is the point in having a six feet separation?

How does this help me as a common man? Follow precautions as stringently as possible. Try to understand the science behind the cause and effect. Model your life according to the scientific principles. I would visit CDC guidelines and follow those as strictly as possible.

Antibody Titer

Reports have started emanating that the antibody titers wane after 2-3 months. It does sound scary as the protection from the previous disease (in the exposed and affected) lasts only for 3 months. Well, I want to assure you, cross-reacting antibodies and memory persist and even if re-exposure happens, this memory gets activated and will build a faster immune response. This is how all vaccines work.

How does this help me as a common man? I won’t worry if I read news about waning titer after 2-3 months. My small pox childhood vaccination still offers me a lifelong protection.

Quiz time –

If you inhale one virus, how many daughter coronaviruses are produced in 24 hours?

Shashank Heda, Dallas, Texas (June 19, 2020)