
'Finally, a virus got me’: Scientist who fought Ebola and HIV reflects - akeck
https://www.sciencemag.org/news/2020/05/finally-virus-got-me-scientist-who-fought-ebola-and-hiv-reflects-facing-death-covid-19#
======
jobu
_" Many people think COVID-19 kills 1% of patients, and the rest get away with
some flulike symptoms. But the story gets more complicated. Many people will
be left with chronic kidney and heart problems. Even their neural system is
disrupted. There will be hundreds of thousands of people worldwide, possibly
more, who will need treatments such as renal dialysis for the rest of their
lives."_

There have also been reports of people in China with significantly reduced
lung capacity even months after recovery. Still so many scary questions about
the long-term effects of this virus, possibly the biggest ones being about the
post-recovery immunity. How long does the immunity last and how encompassing
is it?

~~~
pl0x
There is so much we donot know about the long-term effects. It shocks me to
Silicon Valley icons like Elon Musk, Paul Graham, and Justin Kan pushing to
reopen and spreading conspiracy theories over building tools to understand the
long term effects.

~~~
deathgrips
We know for sure that if we force Americans to stay at home, tens of thousands
will kill themselves or be the victims of domestic violence as a result. An
untold number of people will go hungry or become homeless. These are
certainties. If you want to make a real cost benefit analysis (as opposed to a
fear-motivated choice to stay inside), then provide some good data about the
long term effects of covid19. Sorry, but saying "it could have terrible
effects 5 years after you get infected" isn't good enough. Try again.

~~~
rjtavares
I'm all for proper cost benefit analysis of a lockdown, but the fact that
you're asking for good data on the long term effects of a disease that is six
months old shows me that you are not interested in it.

Any decision has to be made considering uncertainties. You either accept the
risk or you don't.

BTW, this is what we know for sure can happen when you risk normalcy:

[https://twitter.com/jburnmurdoch/status/1258031434981392389](https://twitter.com/jburnmurdoch/status/1258031434981392389)

~~~
nradov
While the exact long term effects are obviously unknowable, we can make some
reasonable predictions by looking at patients who survived similar viruses
such as SARS and MERS.

~~~
SomeoneFromCA
No, you cannot. Regular colds are also caused by weaker coronaviruses, and
leave no serious long-term consequences.

~~~
filoleg
I don’t know if you caught this, but I think that’s exactly what the parent
comment was driving at.

------
fermienrico
How are people catching COVID-19?

It would be good to hear plausible scenarios of how people still catch it
despite of masks and social distancing. There is something to learn from each
story. And I see a distinct lack of focus on anecdotal stories of how people
think they caught it. How the fuck are people catching this disease?

~~~
Marsymars
I expect mostly poor hygiene when it comes to touching contaminated things and
faces. I basically can't go out in public without seeing someone with their
mask pulled down to talk/eat/smoke. You should be sanitizing your hands every
single time you don or doff a mask.

~~~
Mediterraneo10
> I basically can't go out in public without seeing someone with their mask
> pulled down to talk/eat/smoke.

Many countries that have lifted their lockdowns and are now requiring masks in
the post-lockdown stage, require those masks to be worn only on public
transportation or in shops. Overall, public-health authorities do not believe
that people pulling down their mask in the open air to eat or talk on their
phone, will significantly change the infection curve for the worst.

Let us remember that the public-health goal here is not to prohibit any and
all behavior that could potentially, under very ideal circumstances, result in
transmission. Rather, the goal is to institute a few general rules that will
flatten the curve to the point where contact tracing is effective. People
should heed their local authorities on what to do, but I am troubled by the
moral panic where posters such the above are insisting on even more stringent
behavior than required by the public-health authorities.

With regard to hand-washing, touching things is now seen as so relatively
unlikely a form of transmission, that some countries which initially required
supermarkets to provide gloves and hand sanitizer, have decided to lift that
requirement (while keeping the mask requirement). Of course hand washing in
general is a good thing, but authorities in many countries do not think that
obsessively doing so will make a real impact on COVID-19 transmission rates
across society.

~~~
DanBC
> Overall, public-health authorities do not believe that people pulling down
> their mask in the open air to eat or talk on their phone, will significantly
> change the infection curve for the worst.

No. "Public health authorities" are all really clear: if you're going to wear
PPE you need to do it properly. DIY cloth masks are not PPE, they're theatre,
so it doesn't really matter whether you wear it or not.

> With regard to hand-washing, touching things is now seen as so relatively
> unlikely a form of transmission

This is untrue. Some people on HN are fixated on droplets and aerosols, but we
know that fomites are a significant risk.

[https://www.nejm.org/doi/full/10.1056/NEJMra032498](https://www.nejm.org/doi/full/10.1056/NEJMra032498)

> The primary mode of transmission appears to be through direct or indirect
> contact of mucous membrane (eyes, nose, or mouth) with infectious
> respiratory droplets or fomites.3,26,27 The use of aerosol-generating
> procedures (such as endotracheal intubation, bronchoscopy, and treatment
> with aerosolized medication) in hospitals may amplify the transmission of
> SARS-CoV, and outbreaks have involved more than 100 patients on
> occasion.3,26-28 SARS-CoV survives for many days when dried on surfaces and
> in feces at an alkaline pH.33 Although data from direct comparisons are not
> yet available, a review of previously published data suggests that SARS-CoV
> may be far more stable than other human respiratory viruses, such as
> respiratory syncytial virus. The role of fecal–oral transmission is unknown
> but may be important, given that profuse watery diarrhea is a common feature
> of the disease and that SARS-CoV is shed in large quantities in stool.

~~~
Mediterraneo10
> "Public health authorities" are all really clear: if you're going to wear
> PPE you need to do it properly.

You are confusing two things here. For preventing certain people in certain
contexts from being infected, PPE is important. For preventing the average
person walking around from infecting others to the point of upsetting curve-
flattening efforts, any kind of face covering (even if it be a scarf or a
Buff) will satisfy the requirement in most countries now.

Indeed, the public health authorities – at least in Europe which is presently
my main concern – are very clear here: the authorities overall are calling for
masks to be required only in shops or on public transportation. Countries like
Poland and the Czech Republic which require masks to be worn at all times in
public are outliers. (And I expect their rules to soon be harmonized with the
less strict countries. De facto in Poland the outdoor requirement is not even
being strictly enforced outside the major cities).

------
battery_cowboy
There's so much conflicting information out there right now that I'm not even
listening to it. I'm wearing masks and avoiding people, because my wife has
bad lungs and I have a 6 month old. Until there's more facts that are rock
solid, all anyone is doing is speculating. The real issue here is lack of
consistency and leadership from the top levels of government (USA here). If we
had a consistent message from the experts and politicians _together_ , then
there would be less speculation, less fighting over lockdowns, less
misinformation, and less grasping at straws guessing what the virus is doing.
Instead, we (Americans in aggregate) have lost trust in both the experts and
politicians, which is resulting in major issues. The deadliness of the virus
isn't the major issue, it's the infighting that's preventing us from fixing it
that's the issue now and will result in more dead.

~~~
afarrell
When you walk around outside, are you also carrying an umbrella? Because cloth
masks aren't that effective at protecting the wearer and I don't see how else
you can prevent someone else from getting close to you.

~~~
battery_cowboy
I had n95 masks saved from the fires around me in previous years, but i
generally don't run into people where i live so i can skip the mask when
outdoors. People generally stay away from each other where i live, too. I
don't live in a big city, so it's easier for me.

But like i said before, I don't care about what people say about the efficacy
of masks, i will wear one anyways. Your comment had no bearing on my plan to
keep doing so, because, like i said, i don't trust any "facts" about this
virus right now, so i default to the most safe choice: wearing a mask.

~~~
afarrell
oh sure. And good that you aren't finding it hard to keep distance.

Stay healthy fellow human.

------
jansan
The German hospital Universitätsklinikum Hamburg Eppendorf (UKE) performed
more than 190 autopsies of patients who died with COVID-19. In a study (where
they covered the first 12 cases) they found an unusually high number of of
thromboembolic events. Therfore they are now recommending a prophylactic
heparin treatment (a commonly uses blood thinner to prevent thrombosis), even
for ambulantory care.

Here is the study: [https://annals.org/aim/fullarticle/2765934/autopsy-
findings-...](https://annals.org/aim/fullarticle/2765934/autopsy-findings-
venous-thromboembolism-patients-covid-19-prospective-cohort-study)

And for those who speak German, here is their press conference:
[https://www.youtube.com/watch?v=VvH3mG-v0Ms](https://www.youtube.com/watch?v=VvH3mG-v0Ms)

~~~
novaRom
Interesting, natural sunlight is also a strong blood thinner - can it be used
as a treatment?

~~~
glormph
I had never heard that about sunlight before, but if true, it seems
impractical to roll out ICU beds into the sun. (Not sure if patients outside
of hospital would need blood thinning of course.) Edit: read too quick when
typing "outside of hospital", ambulantory care has nothing to do with
ambulances.

------
amelius
> It turned out I had severe oxygen deficiency, although I still wasn’t short
> of breath.

I've read about this pitfall before. It might be an idea to have a blood
oxygen saturation meter at home to keep an eye on this.

~~~
beamatronic
They to be about $25 and now they’re about 70, Thanks to price gouging

~~~
chrischen
What's the difference between price gouging and price increases due to
shortages?

~~~
ken
IANAL (or economist), but I'd say price gouging is when hoarders raise prices
to profit from artificial shortages that they created.

As a people, we did not run low on hand sanitizer. As a free market, we ran
low on hand sanitizer because a small minority decided they needed 10,000
bottles in their garage.

When there exists plenty of product for everyone, and there are distribution
networks by which we can get it to everyone who needs it, and yet opportunists
insert themselves in the middle for no purpose other than to make a quick
buck, I call that price gouging.

~~~
javagram
I’m pretty sure we actually did run low on hand sanitizer.

Yes, there were some hoarders, but people also started buying and using a lot
more sanitizer, the supply chain was overwhelmed. Companies didn’t have huge
excess warehouses of the stuff ready to ship when demand suddenly spiked over
the period of a few days.

~~~
Raidion
I think he's referring to the feedback loop that hoarding causes.

If you're confident you'll be able to buy the good in the future, you'll buy
less now. If a hoarder clears out the supermarket, that means that everyone
that shops at that supermarket and doesn't get what they want is more liable
to make a larger purchase when do find it at another store. This chain
reaction leads to shortages. It's impossible to prove the direct amount of
causation (and of course organic demand spiked), but the relationship is
clearly there.

~~~
javagram
Sure, but people also just used up what they had.

I had a box of mini hand sanitizer in the closet i purchased 2-3 years ago, I
brought it out at the beginning of march and began to use it. I ran out and
there was no more to be found in any store. Still have only seen it once or
twice in a store, behind the counter now 2 months later.

Even if we had all just tried to buy 1 bottle of hand sanitizer each that
would have been 330 million bottles, I don’t think store shelves had that many
in march.

(Edit: It’s the same thing as happened to stuff like toilet paper - we usually
make just enough toilet paper for everyone, between commercial and retail
toilet paper sales. Suddenly commercial toilet paper became unsaleable with
industries shuttering their doors, and the existing supply of home toilet
paper wasn’t enough anymore since now all the bum-wiping that would have been
done with commercial toilet paper needed to be done with the different rolls
that are sold to home goods buyers)

------
guscost
> That’s why I get so annoyed by the many commentators on the sidelines who,
> without much insight, criticize the scientists and policymakers trying hard
> to get the epidemic under control. That’s very unfair.

Do viral epidemiologists have much insight about the effects of economic
depression, combined with all-but-unprecedented fear and social isolation, on
public health? Do they have any at all? This comes across as incredibly
arrogant, and just as unfair.

~~~
Caligatio
There's a huge difference between criticizing the people/science and
criticizing the decision. We collectively need to have a real conversation
about the pros/cons/risks of reopening parts of society. However, we're stuck
in this rut of just calling the science bad (it's not) in order to avoid
talking about the harsh reality of increased death rate.

------
balb0a
In Slovenia we did random sample testing. Out of this we concluded that 3% of
population had covid-19. This is 60000 people of which ~100 people die. This
gives death rate around 0.17. Majority were people in elderly homes with many
other diseases.

~~~
Isinlor
NYC has population fatality ratio of 0.17% to 0.23%. 8.4 million people and
14,753 confirmed COVID-19 deaths [0]. They have also 5,178 probable COVID-19
deaths. In other words, around 1 person per 500 overall died due COVID-19.
Serology tests shows that only one in 5 people had the disease [1]. So the
population fatality rate could still go up to 1 in 200. Imagine a wedding
party, then imagine one person dead and 5 hospitalized, that's how bad it can
get. There are very similar statistics in Bergamo, Italy and on board of
Diamond Princess. Well, Diamond Process has infection fatality rate of 1.8% -
13 people out of 712 infected died.

[0]
[https://www1.nyc.gov/site/doh/covid/covid-19-data.page](https://www1.nyc.gov/site/doh/covid/covid-19-data.page)
[1] [https://www.nytimes.com/2020/04/23/nyregion/coronavirus-
anti...](https://www.nytimes.com/2020/04/23/nyregion/coronavirus-antibodies-
test-ny.html)

~~~
balb0a
I am just pointing this out because severe seasonal flu that appears in some
years has reportingly ~0.1 fatality rate. Then my explanation would be that
those two are comparable. Except covid spreads faster and therefore we see
more death in shorter period?

Please poke holes in my theory:) I would like to se poking holes in my
theory:)

~~~
Gibbon1
I'm on the edge of what I know here but. I think the flu is innately self
limiting because the virus only infects cells in the respiratory system, and
generally only the upper part. It tends to kill people who are frail.

Covid19 most of the time mimics the flu. But because the receptors it uses are
wide spread in the body it can an does cause systemic illness. In particular I
see more and more comments from doctors about clotting and vascular issues.

Consider strep. You have step throat. And then you have scarlet fever. Covid19
is similar, presents at a mild respiratory disease mostly, or as a serious one
with pnumonia, or deadly systemic.

------
op00to
I’m so, so sad.

------
chvid
“Let’s be clear: Without a coronavirus vaccine, we will never be able to live
normally again. The only real exit strategy from this crisis is a vaccine that
can be rolled out worldwide.”

Worldwide? It is fair to expect this will take years.

In the mean time what does normalcy look like? Sweden?

~~~
rustybelt
With the death rate is so slow for large portions of the population, the
vaccine will have basically no margin for error. How do you convince parents
to vaccinate kids for a disease that has say a .001% fatality rate for those
under 17 unless the vaccine is even safer?

~~~
tpnCC
The complete details on the pathophysiology of the disease are far from known
yet. For instance "The death of a five-year-old boy in New York of
inflammatory complications possibly linked to Covid-19 has prompted Andrew
Cuomo, the state’s governor, to warn of “an entirely different chapter” of a
disease that had been believed to cause only mild symptoms in children."

"Cuomo later tweeted that there have been 73 reported cases in New York of
children falling severely ill with a toxic shock-like reaction that displays
symptoms similar to Kawasaki disease."

[https://www.theguardian.com/world/2020/may/09/children-
coron...](https://www.theguardian.com/world/2020/may/09/children-coronavirus-
death-kawasaki)

~~~
pvaldes
In the same hospital?

