We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Yes, it is stressing hospitals in hot spots, but compared to what? As Bulldog suggested yesterday, this virus is partly a political and media event - not entirely medical as with the past nasty viral epidemics.
As with any viral illness, it's best to protect the frail and elderly. Best, but rarely possible. Numbers are cold things, death is not, but some perspective on the big picture is good.
What we are likely seeing, in my estimation, is an epidemic with a real case fatality rate between 0.2 and 0.5%, which is similar to the 1957 Asian Influenza A:H2N2 or 1968 Hong Kong Influenza A:H3N2 pandemics, which were also essentially virgin field respiratory epidemics. These pandemics rate, not as PSI5 events, but as PSI2 events on the CDC scale. They are certainly atypical and more severe than a PSI1 event (such as a routine seasonal flu epidemic), but not a shattering event like the 1919 influenza A:H1N1 pandemic. These earlier pandemics essentially tripled the number of deaths due to influenza experienced annually, and were posed little long-term economic or other damage to the population despite being handled without the extreme measures that are currently being adopted or proposed by political figures. Like those pandemic events, SARS-COVID-2 [Wuhan] has its most significant impact on elderly or otherwise compromised individuals, with few fatalities observed in the population under the age of 60. From what we have observed, half of those infected show no symptoms, 40% show mild symptoms such as a cold, and only about 2% advance to serious or critical illness. What is needed now is for politicians and the population to pause, take a deep breath, and address the epidemic with rational measures, such as social distancing of the older population, ring screening around identified cases, quarantine of identified infected individuals, and adequate hospital triage systems to protect other patients and health care staff rom infection in order to preserve our ability to treat the most severe cases.
Not too long ago, I shared my views on Covid-19 and the lockdown. I still stand by my (often misunderstood) position and I feel that after this is over, I'll still stand as having a well-developed viewpoint. Meanwhile, as we sit in the midst of all this, I am now officially 3 weeks working-from-home. The Covid numbers have continued to rise, the deaths have risen as well, and the newsmedia has...ratcheted up the fear factor as high as possible. Even my sister, down in Florida (where even she admits nothing is happening of any note) is freaking out and running scared.
Well, today I chatted by phone with her and shared with her something I'll share with all of you. I am Covid-19 positive. I found out yesterday.
Let me share some of my own personal thoughts and some of my doctors' comments.
First, I was told "this is a high-powered flu". By 3 different doctors who checked me or spoke with me. Second, "No, there's nothing we can do unless you have respiratory distress, so please monitor yourself carefully." Yup. I do that anyway. Third, there were no lines at the station where I got checked. Called first, drove up, got out, they checked me in a field tent, sent me to another field tent, and did the swab (annoying, but not horrible...a Q-Tip WAY UP into your sinuses). Doesn't hurt. You do sneeze a little.
I am in good general health. I work out regularly, good BP, good pulse rate, not an ox by any standard, but I'll keep up with most people my age, and probably surpass them (55+, in case you're wondering).
My first hints of the virus were on Tuesday 3/24. A little coughing, lots of mucous, etc. Not a dry cough. By Thursday, Mrs. Bulldog was saying "You're coughing too much, I don't want people on our walks to think you have it, so stay home." Fine...I stopped taking walks. I had started having headaches (sinus) anyway. The headaches got worse. By Friday, my head was pounding, the cough was persistent, and it was dry. No fever. No rash. 3 days of (sorry) diarrhea began.
Over the weekend, the headaches intensified, the coughing got worse. I was more or less stuck on the couch watching movies, in a very annoyed frame of mind. By Sunday, it was suggested I get tested.
So we arranged it, and yesterday at 3pm the results were back. Positive.
Of course, by now the headache is starting to fade. It's still there, but Tylenol keeps it reduced. The coughing is still there, but laying down helps it stop (don't lay down too much...no need to promote pneumonia). I've been sleeping 10 hours a night. The really weird things, and there are 2 of them, are the general haziness of frame of mind - I can't concentrate very long - and what I'd call "fever dreams without the fever." I don't know how to describe these, but I have the strangest dreams all night. Then I wake up in the morning very dehydrated and have to drink a pint or two of water.
My doctor voiced concern over the number of cases, but also pointed out that "it's just a flu that is worse for at-risk people, you're not at risk. Just stay vigilant, take care of yourself and you should be fine."
So if this were the normal world - I'd take 2-3 weeks off from work, and get better. Instead, I've had 3 weeks off, and based on current protocol I will have AT LEAST (if my symptoms play out normally) 3 more weeks off (because my office says 2 weeks after cessation).
For what it's worth - most people in the US, after 6 weeks off from work, will be broke. If it goes longer, who knows. At this point, the "cure" is worse than the disease. Trump is right to consider opening some counties as soon as possible - like any other pandemic, this has areas of concentration. We can limit exposure to those regions, and keep the rest of the nation working well.
Stay healthy. Stay vigilant. I do believe there is much more, politically, to play out. At this point I no longer believe it's mainly a health crisis (if it ever was). It's a political one.
ps - I had to inform my HR Department - just a public safety thing. Naturally, I got a call back today...all pre-arranged, and about exactly what I supposed. They were trying to determine if I could have caught it anywhere else but at the office. "AVOID LAWSUITS AT ANY COST" must be their view. Can't blame them, I suppose. Not that it would stop me if I was litigious. Thing is, nobody can EVER prove where they got it from. I commute, via train, every day. I went to the bank. I was playing poker one night with 50 people at a bar the week before being sent home (won $650 and the tournament WITH A ROYAL FLUSH - not a joke, totally telling the truth, I have pictures...it's the poker players' Hole-in-One). So I could have gotten it anywhere...and I admitted that. Because it doesn't matter where I got it from. I KNEW I was going to get it. That was the point of my original article. If you believe you can avoid it, you're fooling yourself. I DO NOT believe social distancing works. But don't worry - they politicians and other liars will convince you it's working.
For what it's worth, I found this useful. There are several typos and some sentences don't make sense, but I suspect English may have been the second language for the author. You'll get the ideas, which are accurate and helpful.
This is from an Asst. Prof in infectious diseases at Johns Hopkins University. In our community chat, here, they sent this excellent summary to avoid contagion. I share it with you because it is very clear:
The virus is not a living organism, but a protein molecule (DNA) covered by a protective layer of lipid (fat), which, when absorbed by the cells of the ocular, nasal or buccal mucosa, changes their genetic code. (mutation) and convert them into aggressor and multiplier cells.
Since the virus is not a living organism but a protein molecule, it is not killed, but decays on its own. The disintegration time depends on the temperature, humidity and type of material where it lies.
The virus is very fragile; the only thing that protects it is a thin
outer layer of fat. That is why any soap or detergent is the best remedy, because the foam CUTS the FAT (that is why you have to rub so much: for 20 seconds or more, to make a lot of foam). By dissolving the fat layer, the protein molecule disperses and breaks down on its own.
HEAT melts fat; this is why it is so good to use water above 25 degrees Celsius for washing hands, clothes and everything. In addition, hot water makes more foam and that makes it even more useful.
Alcohol or any mixture with alcohol over 65% DISSOLVES ANY FAT, especially the external lipid layer of the virus.
Any mix with 1 part bleach and 5 parts water directly dissolves the
protein, breaks it down from the inside.
Oxygenated water helps long after soap, alcohol and chlorine, because peroxide dissolves the virus protein, but you have to use it pure and it hurts your skin.
NO BACTERICIDE SERVES. The virus is not a living organism like bacteria; they cannot kill what is not alive with anthobiotics, but quickly disintegrate its structure with everything said.
NEVER shake used or unused clothing, sheets or cloth. While it is glued to a porous surface, it is very inert and disintegrates only between 3 hours (fabric and porous), 4 hours (copper, because it is naturally antiseptic; and wood, because it removes all the moisture and does not let it peel off and disintegrates). ), 24 hours (cardboard), 42 hours (metal) and 72 hours (plastic). But if you shake it or use a feather duster, the virus molecules float in the air for up to 3 hours, and can lodge in your nose.
The virus molecules remain very stable in external cold, or artificial as air conditioners in houses and cars. They also need moisture to stay stable, and especially darkness. Therefore, dehumidified, dry, warm and bright environments will degrade it faster.
UV LIGHT on any object that may contain it breaks down the virus protein. For example, to disinfect and reuse a mask is perfect. Be careful, it also breaks down collagen (which is protein) in the skin, eventually causing wrinkles and skin cancer. [DB added this link regarding UVC light: https://www.insider.com/does-uv-light-kill-germs]
The virus CANNOT go through healthy skin.
Vinegar is NOT useful because it does not break down the protective layer of fat.
NO SPIRITS, NOR VODKA, serve. The strongest vodka is 40% alcohol, and you need 65%.
LISTERINE IF IT SERVES! It is 65% alcohol.
The more confined the space, the more concentration of the virus there can be. The more open or naturally ventilated, the less.
This is super said, but you have to wash your hands before and after touching mucosa, food, locks, knobs, switches, remote control, cell phone, watches, computers, desks, TV, etc. And when using the bathroom.
You have to HUMIDIFY HANDS DRY from so much washing them, because the molecules can hide in the micro cracks. The thicker the moisturizer, the better. * Also keep your NAILS SHORT so that the virus does not hide there.
3. The median incubation period is 5 days. So without symptoms after a close exposure for a week or so, you likely aren't infected.
4. In the US you can see numbers of cases (+ tests) rising rapidly. That doesn't mean the numbers of cases are increasing that rapidly. It means more people are getting tested.
5. This germ does not appear to be spread as easily as feared, but I were elderly (80+), frail, overweight, or with significant pre-existing ailments, I would self-quarantine for a while. Not sure what "a while" means, yet.
7. My expert medical friends tell me we'll have a good idea of when the infection rate will plateau or begin its downturn in the next 5-10 days. Can't go by "cases," though.
Addendum: For those who chose to be quarantined at home, we recommend several activities: Sex, home workouts, taking hikes or runs outdoors, reading Maggie's, doing one or two of The Great Courses, getting some outdoor clean-up done, doing an hour of paperwork, cleaning some closets and getting rid of junk, and having civilized cocktail hours. All sorts of ways to make the most of it. Churches are live-streamed now, so that too.
Some things to consider in the Covid-19 panic. I've always known Covid is real, and that it's slightly more dangerous than the flu. I'm quite aware of how the mortality rate is considerably higher than some other viral outbreaks, especially with the elderly and those suffering health conditions. I've been less than convinced there is anything we could have done to stop it, short of shutting the nation down completely in January and keeping it shut down for about 2 months....which seems to be where we've gone anyway. That said, even extreme measures are unlikely to stop the spread. I've always supported an abundance of caution. But now that we're here with extreme measures, let's think calmly about HOW we got here.
Fear. Just fear. Yes, many of us would've gotten sick. Yes, some people would die. We can talk all we want about flattening the curve to keep hospital facilities from being overrun...while ignoring how herd immunity is being compromised. Furthermore, in shutting down in the manner we did, we basically sent people on 5 days of panic shopping whereby anyone infected and shopping was busy spreading the virus. It seems to me, the 'cure' is just as bad as letting it run its course. By increasing fear and panic, and even potentially the spread.
What's really concerning to me, however, is less the health issue and more the socio-political issue. This is the largest non-partisan event of our lifetime, and it's been heavily politicized. To that point, consider this - Democrats, who only a week ago complained that President Trump was abusing power, now are complaining that he isn't using enough power to 'fix' this.
Epidemics typically fizzle out with warm weather, and through "herd immunity."
The real purpose of precautions is to change the shape of the epidemic curve from a steep up and down to a slower, gradual up and down. That helps with demands on medical care, but does not reduce exposure, or the numbers of people exposed. Viral epidemics can not be stopped, just slowed. Flattening the curve is the purpose of public health.
Get a thorough physical exam every two or three years, 5 years tops.
Preventive medicine is expensive and, they say, not cost-effective but my life is not a statistic to me.I schedule it every 2 or 3 years. It's annoying and inconvenient, and leads to all sorts of annoying and inconvenient tests to make sure nothing (detectable) bad is going on anywhere. Do it in memory of my dear brother-in-law Uncle Bob, a very fit, skinny, strong athlete who dropped dead last year at age 59 on a treadmill. Avoided doctors for 30 years like an old-time Yankee. He would be alive today, still climbing the White Mountains, if anybody had known his cardiovascular situation. Never had any symptoms, and could run and climb like a monster. I remember our last run together on Cape Cod a couple of years ago. No way I could keep up.
My own doc admitted to me that he himself had not had a thorough physical for 6 years. Whatever. He's a serious athlete and presumably knows his body. He found a lump on me (harmless lipoma) and asked me if I had noticed it. "Nope," I replied. "I am not in the habit of caressing my body."
The only complaint I could come up with for him is my waking up between 1 and 2 in the morning with trouble getting back to sleep. Not to pee, just waking up with a head full of vivid memories and some sad or dark thoughts. Plus a little heartburn sometimes, especially with late suppers. He gave me some sleep meds which I have not used. Also, my darn traumatic right shoulder arthritis from sport accidents, which I do not plan to do anything about anytime soon (shoulder replacement? Not today, thank you, even though it makes handling a shotgun painful and awkward).
I do whatever he tells me to do because he will fire any patient who will not. He has a waiting list for new patients, like an exclusive club.
Besides the routine exam, he made me endure three separate sets of blood drawings, 2 full-body CAT scans (one with and one without contrast), Echo stress test, breathing test, Colonoscopy and Endoscopy, a Urologist consultation, and an Oncology consultation (cuz I had a sarcoma sliced out 15 years ago). That is called a thorough check-up but I put up with it all, somehow.
I am healthy and strong enough (passed his strength test - deadlifts by age and weight), with below-average body fat by caliper measure. Below-average body fat feels good because "average" is pudgy. Other than well-controlled blood pressure and triglycerides, I am good for now. Readers know I have a serious daily exercise regimen for what it's worth. Could get killed by a falling crane tomorrow.
It is well-known that vigorous exercise does not "work up an appetite." On the contrary, it tends to reduce hunger and appetite.
That might not apply to 8 hours on the Appalachian Trail or a day job as a lumberjack, but it is certainly true for me with my 1-hr daily exercises. The more consistently I exercise, the less interest I have in food and the smaller the portions I can handle. This effect is most pronounced with demanding cardio and calisthenic exercise, not much with strength exercise or with sports. There is a theory that the effect has something to do with Peptide YY.
Nobody wants to eat anything after a hour of tough cardio exercise and that suppressive effect tends to last 24 hrs.
Maybe it makes some genetic sense. If you need to move yourself vigorously and frequently, the less fat you have on you the better you can avoid becoming part of a Tiger Dinner Party. Hunger is an interesting instinct and only recently has it been studied biochemically. One thing we know for certain is that subjective hunger or attraction to food is not a signal for a need for nourishment for most adults in a food-rich environment.
Overweight people seem to have the strongest subjective hunger, and sedentary people tend to have stronger appetites. Cause or effect? Chicken or egg?
Everybody knows that academic politics are ugly. Alzheimer's is uglier than that, and there is lots of money available too.
The problem with searches for cures is that the #1 risk factor for Alheimer's is genetic, via the maternal line. If your Mom has it, your odds for it are worrying but not certain. The second risk factor is being overweight. The viral idea doesn't really seem to fit with the genetic. Maybe they are synergistic? Who knows?
Genetic testing for Alheimer's risk is available at any age. With certain genetic conformations, your risk is almost certain. Bad news.
From all I have read about it (not an expert at all), the brain rot begins long (years, even decades) before there are obvious clinical symptoms other than, maybe, being less energetic, social, and driven. My amateur guess is that the brain tangles and brain shrinkage are not causal, but results of a genetic brain rot, a sort of programmed obsolescence.
"Cures" for genetically-weighted diseases are elusive, of course, because they are baked in the cake. Unbaking a cake is a tough challenge.
A recently-retired friend decided to take up EMT training. He wants to remain a useful citizen. Thus far, he loves it more than he ever liked his job. The chance to save a life is an appealing thing, while learning all sorts of new skills.
As an MD, I have to admit that these people can do things that I have no clue about how to do. Never learned, or can't remember. Most of the car crash victims I saw in ERs were DOA, and most MI people were beyond saving. Death happens, often, as it must. That was a while ago, though.
There are several levels of it, so you can keep aspiring. There is always work too, part-time or full, or volunteer.
People always say "Diet and Exercise." Unless you hike 10 miles daily, or work out 2 hrs/day, I just say "Nutrition" to lose bad fat. Not "diet," "nutrition" because diets fail but appropriate nutrition is a way of life. Just enough of pretty good things for the fitness you want. That article more or less says the same thing.
Daily exercise is great for fitness, but not for fat. The bonus is that the less fat you are carrying, the better your exercise and activity endurance.
Joseph Henry Green (1791-1863), an English surgeon who became the literary executor of Samuel Taylor Coleridge. The word was spoken upon checking his own pulse.
Joseph Henry Green, a surgeon and professor of anatomy, suffered from inherited gout and died of an acute seizure at his house in 1863.
An account of his final moments has been given by Sir John Simon:
“I would show that not even the last sudden agony of death ruffled his serenity of mind, or rendered him unthoughtful of others. No terrors, no selfish regrets, no reproachful memories, were there. The few tender parting words which he had yet to speak, he spoke. And to the servants who had gathered grieving round him, he said, ‘While I have breath, let me thank you all for your kindness and attention to me’.
Next, to his doctor, who quickly entered – his neighbour and old pupil, Mr. Carter – he significantly, and pointing to the region of his heart, said – ‘congestion’. After which, he in silence set his finger to his wrist, and visibly noted to himself the successive feeble pulses which were but just between him and death. Presently he said – ‘stopped’. And this was the very end. It was as if even to die were an act of his own grand self-government. For at once, with the warning word still scarce beyond his lips, suddenly the stately head drooped aside, passive and defunct for ever. And then, to the loving eyes that watched him, ‘his face was again all young and beautiful’. The bodily heart, it is true, had become more pulseless clay; broken was the pitcher at the fountain, broken at the cistern the wheel; but, for yet a moment amid the nightfall, the pure spiritual life could be discerned, moulding for the last time into conformity with itself the features which thenceforth were for the tomb.”
You have to admire someone who takes his own pulse and pronounces himself dead. Now that’s cool.
The terror of medical opioids is on an upswing. I have seen the upswings and downswings during my career. I wish we could find a middle course, because medical opioids are a blessing to suffering people. Yes, I include Oxycontin in that because it is an excellent medicine.
Of course opioids are habit-forming. For refractory pain, they are also life-giving. For people with life-impairing chronic pain, there is something called "pseudoaddiction." AGAINST AGAINST PSEUDOADDICTION
These days, I have seen people in that category treated like drug addicts. Sooner or later, there will chemicals with the pain effects of opioids but without the habit-forming effects. Not yet.
Doctors, researchers, scientists--even ancient philosophers--have long claimed exercise works like a miracle drug. Now they have proof.
As I have said before, a rigorous exercise program might not extend your life. It will definitely enhance and extend your quality of life even if you begin it at any age. Everybody knows that they ought to do it, but it's hard and it hurts and we're lazy and "busy." Plus there is that terrible part: delayed gratification. Everybody hates that. As I say, "The flesh is willing but the spirit is weak."
Our quite well-informed recommendations for general fitness and conditioning for the ordinary person who wants to achieve or maintain maximal functionality for life:
1. Nutrition: Don't be visibly overweight - it's the worst thing you can do to yourself besides being an addict, and no exercise can help being fat. Does a demanding exercise program require a specific pattern of nutrition? Yes. We have discussed that in previous posts here. With a serious exercise program, you have to keep up with the protein and fats - approx. 70-90 gms of protein/day. 2. Weight training - as heavy as possible, approx 50 minutes twice a week 3. 1-2 hrs total of calisthenics/wk for mobility, balance, and athleticism 4. 2 or 3 twenty-min sessions of cardio intervals/wk (HIIT). (For HIIT, I do stairs once, elliptical once, rowing once. Occasionally sprints in the pool.) Can add an hour of endurance cardio.
Under age 35, it can take 12 months to be whipped into decent shape. Over 35-40, depending on your fitness starting point, 18-24 months. Intense sports like basketball can substitute for calisthenics. Yoga is excellent, but does not substitute for any of the above. Many men find Yoga to be quite challenging and helpful. Lots of pro football players do it. If your day job is physical, all of the above recommendations would differ.
They are annoying in the kitchen, but why are they so useful? 
"To lengthen the life, lessen the meals."