What We Know About Coronavirus and COVID-19
Almost a year later, what we know about Coronavirus and COVID-19 has expanded greatly and we have some idea of what to expect in the future. It has been a long and rough year made even more difficult by some of our reactions to a virus that although deadly has not been as bad as we actually thought it would be.
Overview of Current Understandings on The Transmission of COVID-19 or Coronavirus
This virus infects humans by droplets and aerosols. We are told there is a 2-14 day incubation period and the most common presentation is primarily as a respiratory illness with fever, cough, headache, muscle pain and sometimes intestinal symptoms. It is known that there are a significant, but unknown amount of people who are tested as having come in contact with the virus (not same as being sick) but never show symptoms and we are further told that half of all transmission occurs from these asymptomatic people although this has not actually been studied. We are told that transmission will come from people that are not known to have the virus and not yet showing symptoms in the "incubation period". Do we actually know that people who are testing positive are in an incubation period? Many of them never actually show up with the actual illness. We have a lot of theories floating around, but the reason we are given mixed messages that change over time is that we simply have a lot of theories and little in the way of studies.
This is why everyone has been asked to wear a mask. We don't really know if people are sick or not. The mask is to keep those who might have it and not know it from spreading droplets or aerosols while coughing, sneezing or even talking. They are not completely effective, but it helps a lot. How much it helps is not actually known for sure and causes some of the debate we see take place. Additionally, rules are created by governors that the governors themselves do not follow and the public observes a "do what I say and not what I do" presentation by the leaders that makes no sense to people and when you create rules that don't follow common logic, people start to ignore the rules. For instance, in Oregon where I live everyone from 5 years and up is required to wear a mask. I see small children in the grocery store without masks and we are told by the "Experts" if these children are sick they are less likely to show symptoms. If this is true, it would mean that those who are the least likely to show symptoms are walking around without a mask while the older folks who are more likely to show symptoms are for the most part all wearing a mask. I realize why they don't make the young ones wear a mask, but this is a chink in the mask armor for sure and it dilutes the effectiveness of mask-wearing as this makes no sense to the public that those who may be most likely to be contagious without us knowing are allowed to run around grocery stores without a mask. If you question the lack of symptoms in children and their ability to transmit the virus, note that the CDC says "Most children with COVID-19 have mild symptoms or have no symptoms at all. " They also say "Children, like adults, who have COVID-19 but have no symptoms (“asymptomatic”) can still spread the virus to others." If this is true, why are these young children allowed to run around without a mask? If everyone really was wearing a proper mask, the mask would indeed keep any of us who are ill from transmitting the virus to others as long as our hands touching items around us are also clean. The idea of everyone wearing a mask to keep the droplets and aerosol in the mask rather than in the environment is in my opinion a good idea, but it only works if we all wear it and we are clearly not doing that since young ones do not wear masks and we are told we can't tell if they are contagious and if they are they will spread the illness. Something is not making sense here. Are kids and adults who are testing positive for viral contact but never showing symptoms actually contagious? There are many people who test positive but not sick. No one has done the research to see if these people are contagious.
There are additional issues with the masks as they are not 100% effective. Many don't even come close to being fully effective. Many people worried about catching the virus feel they are safe by wearing a mask, but just how safe are they? Masks are not all created equal. Only masks and other PPE studied and certified by Occupational Safety and Health Administration (OSHA) are known to be safe to use with viruses. Most people are wearing surgical masks or cloth masks that were not studied. Cloth masks in a hospital study published in the BMJ in 2015 found " The rates of all infection outcomes were highest in the cloth mask arm compared with the medical mask arm." They said, " Penetration of cloth masks by particles was almost 97% and medical masks 44%. " According to OSHA, " Wow, so the surgical masks protected the person by only 44%? Surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants." For details on masks, go to OSHA's website here. Remember these surgical masks are worn to protect the patient. If the practitioner coughs or sneezes during surgery it keeps them from contaminating an open wound. This is what they are made for. They don't stop virus transmission as shown during seasonal flu in hospitals. They are not tight, sealed respirators as you may have seen practitioners wear in photos when they are working in an infectious disease ward. This is what is needed to actually give decent protection from a viral illness. With all protective equipment, any place there is a gap, a virus can pass through. These masks are not sealed to your head very well. The N-95 masks seal the best of what OSHA lists as "masks".
Masks are not so good at protecting you unless you have a really good mask like a certified N-95 mask that will do a better job of keeping the virus from getting through and around it and if you additionally wear some type of good fitting goggles or tight-fitting glasses around and over your eyes, wear disposable or washable gloves, or at least clean your hands after leaving the store or other areas where people congregate. Do we really want to live this way and why are we not told this is what is really needed to give some semblance of protection from disease?
In work situations, people are not put into masks without training as to how to wear them. If not used properly you will not only decrease any protection that they offer you, but they may worsen a person's chance of getting an infectious disease from reusing the mask, wearing it too long, fiddling with it, and contaminating it in other various ways.
If you want your mask to work well get a certified N-95 mask and be sure it fits well. The downside is it is really hard to breathe in one of these. In fact, the harder it is to breathe in a mask, the better it is working, but it is not safe for some people to wear these masks due to the decreased oxygen and buildup in the body of CO2 from wearing them long term. N-95 masks are estimated to reduce oxygen intake by 5-20%. This can bother a healthy person, causing lightheadedness, but it can be a bigger hazard for those that are already medically compromised. I commonly see people wearing masks that do not fit tight on the face. Any place that they pucker and do not adhere to the skin is an opening for viral particles even if the mask is made with fairly good material. The face shields with no mask are not much use at all. They will keep someone from sneezing directly on your face, but aerosols floating in the air can easily go inside of them. You will note when you see medical personnel wearing these, they always have a surgical mask on also.
I would also point out that masks are hot and often give people a runny nose. If you watch in the supermarket, you will notice people lower their mask and rub their hand or sleeve over their nose and then put their hands onto produce or other items at the market. There is no way masks will help when people absent-mindly display this behavior.
The other thing I would mention about transmission is that where most people are getting the virus is in their own homes. One person brings it home and the rest of the family gets it. Parties are also an issue in homes due to the close contact. The fact is that many of the stores we go to if they have good air-flow are not a big source of the virus anyway. The more outside air flowed into a building, the better. If you are outside or if you are inside and there is good airflow from outside, there is much less chance of infectious spread of the virus. If you want to know more about this, check out "The Risks - Know Them - Avoid Them" by the biologist Erin Bromage.
Signs and Symptoms Of Coronavirus And COVID-19
What we know about the presentation as of COVID-19 has not changed much recently. Many people who have COVID-19 experience only mild symptoms. Someone may have a mild cough and not even feel ill. Symptoms show up within 14 days of exposure.
Common signs of infection
- fever or chills
- muscle aches
Some patients have had
- Loss of taste and smell (seen in up to 40% of people with other viral infections too, such as common cold and influenza as well as in allergies, other causes too)
- other aches and pains
- nasal congestion, runny nose or sputum production
- sore throat
- shortness of breath
- nausea or vomiting
- other gastrointestinal symptoms
- skin rashes (17 per cent of SARS-CoV-2-positive respondents had skin rashes as the first presentation and 21 per cent reported rashes as the only COVID-19 clinical sign.)
In more severe cases, infection can cause
- shortness of breath or
- difficulty breathing
- pneumonia is the most serious manifestation
- severe acute respiratory syndrome
- kidney failure
What We Know About The Course of The Coronavirus and COVID-19 Disease
Most COVID-19 (the disease) cases caused by the SARS-CoV-2 (virus) are mild to moderate in the majority of healthy individuals and in young individuals. However, in some people it can be life-threatening and there are folks who experience persistent symptoms long-term.
The number one determinant of severity of COVID-19 is age. Those over 65 years have the greatest risk of needing intensive care and we also know that men have greater risk than women. Children appear to be less affected in contrast to most other known respiratory viral infections that usually are harder on both the young and elderly.
Comorbidities are a risk for more severity of disease. These comorbidities known to be most problematic are hypertensive disease, chronic obstructive pulmonary disease, cardiovascular disease, obesity, and Diabetes. Smokers are also at increased risk of severe disease.
Although older age is the norm, there is a minor subset of young and middle-aged individuals who have severe COVID-19.
We also now know that there can be long-term effects after the primary infection is over that appears to be a hyperinflammatory state.
A retrospective study in Shanghai looked at the progression of 249 hospitalized patients to get an idea of the clinical presentation and progression of the Cornovirus or COVID-19.
It turned out that 94.3% of them developed a fever and the median length of the fever was 10 days after symptoms began.
It has been known for some time that there are abnormal chest x-rays in patients that are called "ground glass opacities". In these 249 patients it was found that 65.7% of them had x-ray abnormalities that occurred on the 7th day of the onset of symptoms.
The authors of this study noted that most cases of COVID-19 are mild and early control of viral replication and therapy to support the patient was able to improve outcomes. I would add that they commonly use herbs to support patients in China. Traditional Chinese Medicine has been a big part of their effort to contain COVID-19.
In a small German study done as part of autopsies they found blood clots are often a part of this disease process and thrombosis and microangiopathy with injury to the inner lining of blood vessels exists in the worst-case scenarios.
What We Now Know About Long Term Effects And Clinical Presentation of Coronvirus and COVID-19 a Year Later
Although men have increased risk of severe acute COVID-19, women are more likely to develop what is called "long COVID".
It is not surprising that anyone who has went through mechanical ventilation, general anesthesia and severe COVID-19 illness would have a period afterward that would include extensive symptoms and would need a long rehabilitation period to support the person. However, some individuals with milder symptoms of COVID-19 also have long-term symptoms that can affect their life. This is often called "long COVID". Anything over 2 months is usually considered long COVID. These patients present with long term complications that include fatigue, shortness of breath, coughing, joint pain and chest pain as some of the more common symptoms, but may also have autonomic dysregulation manifested as postural orthostatic tachycardia syndrome, abnormal thermoregulation, intestinal disturbances and skin manifestations that can last for months after the acute disease is over.
It has been noted that these post-COVID syndrome individuals resemble postinfectious syndromes that follow chikungunya illness and Ebola. The symptoms also look similar to what folks with myalgic encephalomyeltitis and CIRS due to water-damged buildings (mold illness) experience.
An international web-based survey of almost 4000 people who had confirmed or suspected COVID-19 found the most frequent symptoms continuing after 6 months were fatigue, postexertional malaise (exhaustion from exerting one's self), and cognitive dysfunction.
A long-term study of patients with what is called non-critical COVID-19 found that 28% of people had issues with lack of taste and smell one month later and two months later this had decreased to 23%. There was a 36.7% finding of shortness of breath at one month and at two months it was down to 30%. Fatigue and weakness was found in 48.3% of the individuals while it became 40% at two months. Those who had symptoms after the two-month period were in were found to be more likely to be either 40-60 years old, had been hospitalized, or had abnormal body sounds such as lungs or heart at the time of symptom onset.
Another study that followed 1733 patients in Wuhan, China after they were discharged from the hospital and found 63% had sleep difficulties and 23% had anxiety or depression.
A study of 55 patients in China found that 3 months after they were discharged (85% had moderate disease and 9 patients had underlying comorbidities) 71% at 3 months discharge had abnormal chest CT scans often with interstitial thickening. Lung function was abnormal in 25.5% of these individuals. Most patients had no respiratory complaints.
In the Netherlands a similar study of 124 patients showed 6 weeks after recovery from COVID-19, 99% had improved imaging but 91% of them still had some amount of abnormalities on imaging and 42% had reduced lung diffusion capacity. Exercise capacity was reduced in 22% and cognitive function issues were found in 36% of the patients.
What We Know About Multisystem Inflammatory Syndrome Associated With COVID-19 (MIS-C)
A serious postinfectious condition of COVID-19 may present 2-6 weeks after the infection. It was first noted in children and now is also recognized in young adults. It is a hyperinflammatory syndrome that has a clinical picture similar to Kawasaki disease but affects kids at an older age and is more likely to have intestinal involvement and heart failure as well as shock as part of the picture. This has some similarities to toxic shock syndrome and septic shock clinical pictures. MIS-C patients are treated with high-dose steroids, IV immunoglobulins, and anti-cytokine therapies with anti-coagulation measures to take care of the microangiopathy and activation of complement and coagulation cascades during the hyperinflammatory disease phase.
What We Know About Reinfection With SARS CoV-2 And Clinical Presentation of Coronovirus or COVID-19
Reinfection has been looked for in the public, but few cases have been found. However, they currently seem to be few and far between. A few of them have been noted to be different viral genomes suggesting a reinfection and not a long period of viral shedding.
The second infection was more severe than the first in some instances, but serological responses suggest that patients never seroconverted after the initial infection so they had lack of immunological protection in some of these cases.
What We Know About Immunodeficiency and COVID-19
One study showed no difference in the reaction to COVID-19 in immunosuppressed individuals but most studies have shown an increased risk for people with solid-organ transplants and some patients with cancer. Those patients with cancer who are treated with checkpoint inhibitors are at greater risk of severe COVID-19.
One study showed patients with combined variable immunodeficiency associated with low-grade inflammation developed severe COVID-19, while patients with similar low antibody levels from other forms of inborn errors of immunity had milder courses of the illness.
We Know It Can Spread Between Humans and Animals
We do indeed know that it can spread between humans and animals. We now know it has infected large groups of minks who were then all killed (in more than one country). It was thought an infected worker transmitted it to the minks. The disease has also been found in pet cats and dogs in several countries including the USA. A ferret was positive for it in Slovenia. Zoos have had large cats, great apes as well as lions, tigers , pumas, leopards, and gorillas come down with it. In one California zoo an outbreak was traced to a Zoo keeper who tested positive.
What We Now Know Conclusion
Here we are a year later and we know a few things about this disease. We originally thought it might kill large groups of people and now we know that most people show no symptoms or recover fine. However, we also now know that some smaller groups of people have lingering symptoms that appear to slowly recover over time. We don't yet know if some of them will continue to have problems. We also know our elders are more likely to have issues as well as those with comorbities. These folks need to be protected in manners they are comfortable with.
The CDC claims it came from a bat at a market although it started in Wuhan where a virology lab was studying SARs-CoV's in bats and had been warned of safety issues in the past. The USA had supported their studies financially. We don't know for sure where it really came from.
We also have seen that shutting down the economy has not stopped the march of this disease. We would have to be naive to think we could stop it. We can't stop the common cold or the flu. We have not yet come up with a great test either. We have not even come up with a good test for Lyme Disease which has been with us for a long time now.
The fact is that with a disease that often shows no symptoms we do not always know who should stay home in seclusion. We can't lock everyone up in their homes or our social system comes to a halt and people starve to death with no one to grow, process, and transport food or process supplements, herbs, other medicines etcetera. If you are a person who still has work from home or you have the finances to support yourself through lock-down that is great, but what of those who do not? Those in power have deemed who gets to continue in business and who does not and the big corporations are raking in the bucks while the small business are being removed from society. The small businesses are not allowed to be open during lockdown no matter what steps they take to provide for safety. In September of last year 100,000 small businesses were permanently out of business forever according to Fortune. Now there are 400,000 permanently closed. Small business owners get no unemployment, they have nothing when they go out of business. The majority of them have no financial assistance to help them. Putting people out of work creates more poverty, increases theft and you will see more people in the streets rioting. Do you want to live in the society we are creating with the lockdowns? Do you want power and money consolidated even more into big business and the hands of a small amount of individuals.
This virus is what is what it is. We go on. We learn how to live with it as we have other viruses. It will ultimately learn to live with us also.
Look on the positive side, if we tell those over 70 they should stay home as well as those with comorbidities, the rest of society should be able to go forward with daily life. Yes, the illness will continue to spread and a minority of people will not do well and have complications. However, this is not abnormal. We need to admit that death is a part of our daily life. We have people who are sickened due to infectious disease, environmental toxins, accidents, etc. on a daily basis. In fact, the third leading cause of death in the USA is due to medical error. According to John Hopkins University more than 250,000 people in the USA die each year due to medical errors. Some reports claim this is as high as 440,000 per year. So, in light of our physicians and other medical personnel causing 250,000-440,000 deaths each year and most folks not being terrified at medical visits thinking they will die, why as a society are we so scared of this virus which over a years period has caused about the same amount of deaths that medical personal usually cause? I think we need to admit that this disease is not as bad as we thought as far as number of deaths. We certainly have not reached the millions of deaths predicted to take place in the USA. If we would have let the virus go through the population normally, rather than setting it up to linger amongst us, we could be closer to herd immunity at this point. Instead it has smoldered and during that time new variants have popped up.
I think at this point after the fearful story-telling that has been repeated over and over on TV, the radio and blogs that everyone is terrified of a virus that has proven to be less destructive to human life than we imagined. Only time will tell what the final story is though, I can't predict what path this virus or humanity will choose and I certainly would never tell you how to think or behave. I simply provide information and my point of view.
There are many doctors supporting people through COVID-19 out of their offices and some use alternative style treatments. Some of these physicians have attempted to share what they are doing and have been told they are not allowed to present alternative treatments as these treatments are not studied. Some of these practitioners have said they received letters from their boards or other governmental bodies threatening to take their licenses away. So, if you wonder why more specific information is not shared by medical professionals who use alternative medicine this is why. Most of them do not have the time or money to get their license back when it is taken away.
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What Can You Do To Stay Healthy
- Eat well by eating fresh, real food
- Get good sleep
- Get exercise outdoors
- Stay hydrated
- Say no to unnecessary drugs and alcohol
- Turn the news off and watch the birds, read an uplifting book or do anything that gives you joy
- Spend time in meditation or prayer. If you do neither, spend time sitting quietly and breathing slowly and deeply.
- Contemplate the good things in your life
Additional articles on this virus and COVID-19.
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