
We thought it was just a respiratory virus - thereare5lights
https://www.ucsf.edu/magazine/covid-body
======
DoreenMichele
_But the virus hadn’t wrecked Dowd’s lungs. In fact, she had only mild
pneumonia. Instead, SARS-CoV-2 had ruptured her heart._

A lot of the early part of the article rehashes basics, like how viruses
replicate. If you have basic knowledge of that sort, you can kind of skim
until the mid point, where we find the above factoid.

I have been reading less about the virus of late, but this fits with
everything I know. It causes blood clots. Ventilators aren't really fixing it.
The lack of oxygen is probably more about what it does to the blood (than what
it does to the lungs).

Later in the article, it talks about impacts on the feet suspected to be a
side effect. Feet issues are commonly associated with blood/circulation
issues. This is why diabetes can lead to feet being amputated.

The blood issues are well established and this has been known for some time.
I'm somewhat aghast to see this article talking like we don't already know
that detail.

~~~
hartator
Yes, COVID-19 is a bad one but it’s just another virus at the end of the day.
I feel they act as we rediscovering everything about viruses for
sensationalism.

~~~
mohamedattahri
Yes, but downplaying the fact that it’s new and that there’s a lot of unknown
unknowns about it and its effects mid/long term is dangerous. Not all viruses
are the same, and it takes time to observe and study them.

This is IMO the other important reason why it’s important to stop the spread,
besides overloading hospitals.

------
twic
Influenza does this stuff too, and we happily refer to influenza as a
respiratory virus.

~~~
makomk
Yup. For example, there's a well-established effect where influenza causes
heart attacks and strokes, big enough that the severity of the influenza
season has a noticable effect on heart attack deaths. This is, naturally,
taken into account when calculating the number of influenza deaths. The
differencce is that instead of this being spun as proof that influenza is more
deadly than people think, since Covid the press has been spinning it as proof
it's leas deadly and that the official flu stats are overstating the number of
deaths. For instance, this article - which was quite popular on HN - outright
claimed that widespread flu deaths didn't exist because doctors didn't see
people dying because of the flu and the CDC was misleading the public by
claiming otherwise:
[https://blogs.scientificamerican.com/observations/comparing-...](https://blogs.scientificamerican.com/observations/comparing-
covid-19-deaths-to-flu-deaths-is-like-comparing-apples-to-oranges/)

~~~
graeme
But on an apples to apples comparison, aren’t there very few flu deaths
confirmed by testing?

And what you cite can’t be proof that the flu is more deadly than people
think. If what you say is true, those deaths are in the numbers used for the
death rate of the flu.

The point of that article is that perhaps our algorithms for estimating flu
deaths are wrong.

Edit: Can someone explain the downvotes? Any error in my reasoning is not
obvious to me. The claim above was that:

1\. Heart attacks are included in flu death estimations

2\. This should make the public think the flu is more deadly than they believe

That seems contradictory, as the public’s belief about the deadliness of the
flu comes in stats from point #1. As for the article, the author made no real
attempt to rebut its central claim.

~~~
bradstewart
> aren’t there very few flu deaths confirmed by testing?

Is this true? An anecdote, but both times I and/or my partner had fever and
flu-like symptoms, a flu test was the first thing performed by the doctor.

~~~
graeme
Yup! Only about 20% of flu deaths are confirmed by test. The rest are
estimated by an algorithm (which the OP alluded to)

Sorry for AMP link, canonical url is paywalled:
[https://www.google.com/amp/s/www.washingtonpost.com/business...](https://www.google.com/amp/s/www.washingtonpost.com/business/2020/05/02/theres-
more-accurate-way-compare-coronavirus-deaths-flu/%3foutputType=amp)

The CDC explains its methodology here. There are valid reasons to assume
influenza deaths are higher than confirmed tested deaths. But many of these
apply to coronavirus as well: [https://www.cdc.gov/flu/about/burden/how-cdc-
estimates.htm](https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm)

------
gentleman11
Every other source online says that you can’t get Covid from eating, but this
one says your stomach cells are particularly susceptible.

> Gut specialists are finding that 20% to 40% of people with the disease
> experience diarrhea, nausea, or vomiting before other symptoms, says
> gastroenterologist Michael Kattah, MD, PhD, a UCSF assistant professor. If
> you swallow virus particles, he says, there’s a good chance they will infect
> cells lining your stomach, small intestine, or colon. As in the lungs and
> heart, these cells are studded with vulnerable ACE2 portals.

In that case, is the info about not getting it from eating as thoughtless and
parroting as saying masks don’t work, or is this article fake news? It makes a
huge life changing difference to know for high risk people

~~~
graeme
So there are a few unknowns:

1\. Does the virus remain infectious in food? In particular, does hot or
reheated food affect it?

2\. The digestive process produces more acid. Will that kill the virus?

3\. Will the virus even touch the wall of the stomach? It may be _in_ food
after chewing, rather than directly on the stomach wall

There are some reasons to think that swallowing virus replicating in your
throat is different than having some inside a chewed up piece of food
surrounded by saliva.

We don’t know of course, and someone super high risk should perhaps avoid
takeout salads. But as of yet we haven’t had _any_ case cluster reports where
a superspreader cook spread the virus to their colleagues + customers via
food. No country has reported a single instance of a traced infection via
takeout.

This doesn’t mean it’s impossible, as contact tracing is not perfect. But the
lack of any evidence so far is suggestive.

------
tomohawk
Interesting explanation for why children rarely get sick or transmit this
disease:

> Fattahi’s team has found evidence suggesting that male sex hormones such as
> testosterone may increase the number of ACE2 receptors that cells produce,
> which could help explain why SARS-CoV-2 seems to wreak greater havoc on men
> than on women and why kids rarely get sick.

~~~
zspade
This is only true for Children under 10. Children over 10 transmit contract
and transmit at similar rates. Considering 11 is when puberty kicks in for
many kids, this appears to support Fattahi's findings.

([https://www.nytimes.com/2020/07/18/health/coronavirus-
childr...](https://www.nytimes.com/2020/07/18/health/coronavirus-children-
schools.html))

~~~
tomohawk
That article puts people in 10 year bins, so it is not useful to determine
what the cutoff age should be with more granularity than 10 years of age.

However, Sweden did not close school for children through 14 years of age.

[https://www.sciencemag.org/news/2020/05/how-sweden-wasted-
ra...](https://www.sciencemag.org/news/2020/05/how-sweden-wasted-rare-
opportunity-study-coronavirus-schools)

And their excess mortality rates for that age group are indistinguishable from
other European countries:

[https://euromomo.eu/graphs-and-maps](https://euromomo.eu/graphs-and-maps)

When you go to that link, near the bottom select graphs by age and see that
Sweden ages 0-14 looks like all the other countries shown there. I think that
is a pretty good indication. We have a country that kept their schools open
and a number of countries that did not, and the results look the same.

EDIT: in fact, the excess mortality for that age group looks indistinguishable
from other years.

------
g3houdini
The article based on studies by UCSF is a good read for many who are not
understanding the basics of what is happening. I would suggest giving this out
to friends and family who have concocted their own version of science and are
refusing to wear a mask.

------
stanski
If a lot of the damage is often caused by an overreacting immune system, why
isn't this disease harder on younger people who presumably have stronger
immune systems? Kind of like the Spanish flu? This doesn't add up for me and
this article doesn't dwell on that either.

~~~
gnusty_gnurc
I've seen the idea of cross-reactivity and T-cell immunity being passed
around.

I think the idea is that younger, healthier people with better immune systems
are able to prevent the virus from replicating as much, whereas sluggish
immune systems and bodies that are highly inflamed like overweight ppl,
diabetics, etc. (high leptin, also related to il-6) get overwhelmed.

T-cell immunity/cross-reactivity meaning that most people have the ability to
fight the virus from exposure to other coronaviruses.

I think a major component of the death toll from the pandemic is basically a
consequence of obesity. I'm suspicious that govt interventions, planning, etc
make that much difference when the US is an order of magnitude more obese than
Japan, for example.

~~~
bart_spoon
That hasn't really been seen in the data though. Yes, obesity has been linked
to more severe cases, but some of the hardest hit, highest mortality rate
areas, like NYC and Italy, are markedly lower in their rates of obesity that
other areas with lower mortality rates.

------
sharken
Always interesting to learn more about the virus and that there is a lot of
knowledge about handling ventilators. But even so, the numbers from New York
say that 80% of people over 80 years do not make it once they are on the
ventilator.

Source:
[https://www.google.dk/amp/s/www.washingtonpost.com/health/el...](https://www.google.dk/amp/s/www.washingtonpost.com/health/elderly-
covid-19-patients-on-ventilators-usually-do-not-survive-new-york-hospitals-
report/2020/05/19/ba20e822-99f8-11ea-89fd-28fb313d1886_story.html%3foutputType=amp)

I do hope that more attention will be focused on telling that this virus is
both causing respiratory issues and heart issues. The leading comorbidities
data from New York says it very clearly.

Source: [https://www.the-
hospitalist.org/hospitalist/article/220457/c...](https://www.the-
hospitalist.org/hospitalist/article/220457/coronavirus-updates/comorbidities-
rule-new-yorks-covid-19-deaths)

------
LinuxBender
I will get beat up for bringing this up, but I think that these facilities are
operating in bubbles / silos. The reason I believe this, is that for months
everything discussed in the article has also been discussed by an ER doctor in
Riverside, CA that makes Youtube videos in his down time. [1] He is just
reading the research available on nih.gov and a few other sites. What would it
take to get all of the medical research groups to start collaborating on a
common platform? Is the issue that they do not have a platform to share
findings, theories, tests, or is everyone depending on the scientific review
process and waiting for peer reviewed papers? Should we set up a forum for all
the medical groups to share findings, theories, debate theories, etc?

[1] -
[https://www.youtube.com/user/MEDCRAMvideos/videos](https://www.youtube.com/user/MEDCRAMvideos/videos)

~~~
rpearl
The article is a summary of research findings over the course of the pandemic.
What makes you think the research is happening in a silo? it's not. Medical
researchers, just like, uh, that guy you saw on YouTube, are quite capable of
reading the research on nih.gov and capable of discussing and sharing findings
with each other.

The article even says "By June, clinicians were swapping journal papers, news
stories, and tweets describing more than three dozen ways that COVID-19, the
disease the coronavirus causes, appears to manifest itself."

~~~
LinuxBender
I see each group reaching the same or similar conclusions, but months apart.
This suggest to me they are not collaborating with one another. It feels to me
like there is a gap.

Think of it this way. If there were a giant asteroid heading towards earth and
we have a limited time to solve this problem, would I want 500 teams all
operating by themselves and using the incredibly slow process of sharing data
via NIH / NIST and other research paper repositories, or would I want them all
in a war room (virtual or physical) and someone coordinating the effort to
risk rank all the solutions and quickly form action plans? My vote is the
latter. It feels like the scientific community may have artificially painted
themselves into a corner because of something like the banana ladder
conundrum. [1] meaning, doing it that way because that is the way it has
always been done.

[1] - [https://security.stackexchange.com/questions/33470/what-
tech...](https://security.stackexchange.com/questions/33470/what-technical-
reasons-are-there-to-have-low-maximum-password-lengths/33471#33471)

~~~
bart_spoon
I think the issue here is less that they are arriving at the same conclusion
months apart, and more that the reporting makes it sound like a sudden, recent
revelation rather than a consensus that has been building for months and
months.

------
oxymoron
This article claims that they are able to isolate live virus from stool, which
seems to contradict the observations here:
[https://www.nature.com/articles/s41586-020-2196-x](https://www.nature.com/articles/s41586-020-2196-x)

------
notJim
I'm surprised to read the stuff about asymptomatic cases. I thought the
current thinking was that asymptomatic people are really pre-symptomatic,
because of the incubation period. In other words, truly asymptomatic cases are
rare. Am I wrong about that?

~~~
bart_spoon
Yes you are wrong, though I suppose what you consider "rare" could be
arbitrary. It seems that asymptomatic cases are anywhere from 20-40% of cases,
although even that could be low, given that you are more likely to be missed
if you have no symptoms prompting you to get tested.

------
gbasin
This is potentially concerning, but it's worth playing devil's advocate. What
are the confounders? Most people have been more sedentary than usual this
year. What impact does that have on circulation?

------
digibri
Does this mean that it's possible blood thinners could help some patients with
covid-19?

------
rhacker
Zinc

------
yread
Dear reader, it's ok, you can skip the comments here. Just read the article
and move on

~~~
swebs
It's only been an hour, and insightful comments take more time to type out
than ignorant speculation. Have some faith that this community isn't just
another Reddit.

------
hellofunk
> If we did a mass testing campaign on 300 million Americans right now, I
> think the rate of asymptomatic infection would be somewhere between 50% and
> 80% of cases

Wow that’s incredible. 200 million Americans could have the virus.

~~~
cataflam
That's not what it says. It says if you tested everyone, out of those who
tested positive, 50-80% would be asymptomatic, not 50-80% of the whole
population.

~~~
hellofunk
Ah, thanks for the clarification. That was indeed not obvious to me the way
they worded it.

