Aceexplanation of the corona virus....why washing hands and not touching face are imp

[Lazarus]

How Coronavirus Hijacks Your Cells
By Jonathan Corum and Carl ZimmerMarch 11, 2020

The SARS-CoV-2 Coronavirus

The virus that causes Covid-19 is currently spreading around the world. At least six other types of coronavirus are known to infect humans, with some causing the common cold and two causing epidemics: SARS in 2002 and MERS in 2012.


Spike
proteins

Proteins
and lipids

Covered With Spikes

The coronavirus is named after the crownlike spikes that protrude from its surface. The virus is enveloped in a bubble of oily lipid molecules, which falls apart on contact with soap.


ACE2

Entering a Vulnerable Cell

The virus enters the body through the nose, mouth or eyes, then attaches to cells in the airways that produce a protein called ACE2. The virus is believed to have originated in bats, where it may have attached to a similar protein.


Protective
wrapping

Viral RNA

Releasing Viral RNA

The virus infects the cell by fusing its oily membrane with the membrane of the cell. Once inside, the coronavirus releases a snippet of genetic material called RNA.


Viral protein

Viral RNA

Hijacking the Cell

The virus’s genome is less than 30,000 genetic “letters” long. (Ours is over 3 billion.) The infected cell reads the RNA and begins making proteins that will keep the immune system at bay and help assemble new copies of the virus.

Antibiotics kill bacteria and do not work against viruses. But researchers are testing antiviral drugs that might disrupt viral proteins and stop the infection.


Cell nucleus

Viral proteins

Making Viral Proteins

As the infection progresses, the machinery of the cell begins to churn out new spikes and other proteins that will form more copies of the coronavirus.


Assembling New Copies

New copies of the virus are assembled and carried to the outer edges of the cell.


Spreading the Infection

Each infected cell can release millions of copies of the virus before the cell finally breaks down and dies. The viruses may infect nearby cells, or end up in droplets that escape the lungs.


Debris from
dead cells

Immune Response

Most Covid-19 infections cause a fever as the immune system fights to clear the virus. In severe cases, the immune system can overreact and start attacking lung cells. The lungs become obstructed with fluid and dying cells, making it difficult to breathe. A small percentage of infections can lead to acute respiratory distress syndrome, and possibly death.


Leaving the Body

Coughing and sneezing can expel virus-laden droplets onto nearby people and surfaces, where the virus can remain infectious for several hours to several days. Infected people can avoid spreading the virus by wearing a mask, but healthy people do not need to wear a mask unless they are caring for a sick person.


Flu vaccine

Flu antibody

Potential
coronavirus
vaccine

Antibodies
targeting
viruses

A Possible Vaccine

A future vaccine could help the body produce antibodies that target the SARS-CoV-2 virus and prevent it from infecting human cells. The flu vaccine works in a similar way, but antibodies generated from a flu vaccine do not protect against coronavirus.

The best way to avoid getting infected with the coronavirus and other viruses is to wash your hands with soap, avoid touching your face, keep your distance from sick people and regularly clean frequently used surfaces.

Sources: Dr. Matthew B. Frieman and Dr. Stuart Weston, Univ. of Maryland School of Medicine; Fields Virology; Fenner and White’s Medical Virology; Nature; Science; The Lancet; New England Journal of Medicine; Centers for Disease Control and Prevention.

[David Hosobuchi]

How to wash your hands....



If using hand sanitizer, make sure it contains at least 60% alcohol. I have been making my own, since I cannot find any in the stores.

I bought a nice can of isopropyl alcohol from the hardware store, and simple liquid hand soap, and mixed them in proper proportions. Easy.

Masks only really help keep one who is infected from spreading disease.

Good luck and good health to everyone.

[agate]

From the MS International Federation--"The coronavirus and MS: What you need to know" (March 13):

Only registered and activated users can see links., Click Here To Register...

[Jeanie Z]

Doctors letter about virus

Hope you aren't getting tired of hearing all this Coronavirus info from me, but I feel like we are fighting a battle and there is no time to waste. I have seen ridiculous examples of people not taking this pandemic seriously so I can't help myself.

Anda

Subject: Fwd: Note from Brookline physiciansm

Great info on the virus from a trusted source. Stay healthy.
😘
Signed by ~50 Boston based physicians who live in Brookline but has good info even if you don’t have children.

Stay healthy!!
“As there is so much confusion, misinformation and denial on social media about the coronavirus we hope to explain, in plain language, why the experts see this as such an emergency. Many people are reading the claim online that this virus is a lot like the viruses that cause colds, and that if you get it, it will probably just seem like a bad cold and you are very unlikely to die. Depending on who you are, this may be true, but there is more to this story that is key to our outcome as a community.

This is a coronavirus that is new to the human population. Although it is related to the viruses that cause colds, and acts a lot like them in many ways, nobody has ever been exposed to this before, which means nobody has any immunity to it.

The virus is now moving explosively through the human population, spreading through respiratory secretions and 10 times more contagious that the flu or cold. Although many people will recover, about 20% will wind up with a serious pneumonia that will require hospitalization. Some will be so ill from the pneumonia that they will die. We estimate this may be 2-3%, but it is higher in Italy’s experience, partially because the healthcare system was overwhelmed so rapidly. In those over age 70, the death rate is 8-20%. So if a child catches it on a playdate, they can easily transmit it to their grandmother as easily as touching the same doorknob or countertop.

Scientists measure the spread of an epidemic by a number called R0, or “R naught.” That number is calculated this way: for every person who develops the illness, how many other people do they give it to before they are cured (or dead) and no longer infectious? The R0 for coronavirus appears to be a number close to 3 – an extremely frightening number for such a deadly disease.

Suppose you catch the virus. You will give it to 3 other people, and they will each give it to three others, and so forth. Here is how the math works, where you, the “index case,” are the first line:
1
3
9
27
81
243
729
2,187
6,561
19,683
59,046
177,147
531,441
1,594,323
4,782,969
14,348,907

So, in just 15 steps of transmission, the virus has gone from just one index case to 14.3 million other people. Those 15 steps might take only a few weeks. With school out and lots of playdates, maybe less. The first person may be young and healthy Brookline child, but many of those 14 million people will be old and sick, and they will likely die because they got a virus that started in one person's throat.
R0 is not fixed – it can be lowered by control measures. If we can get the number below 1, the epidemic will die out. This is the point of the quarantines and social distancing, but we are not doing it fast enough.

In the US, we have to slow down the virus. American hospitals, Boston hospitals, have limited resources. We have a fixed number of ventilators and an impending calamity on our hands. Our Italian critical care colleagues have shared with us that they simply do not have enough resources (ventilators, physicians and nurse, critical care beds), and are forced to choose who lives and dies based on old tenets of wartime triage. Older patients do not even get a ventilator and die of their pneumonia. These are decisions nobody should have to face, and we are only 11 days behind Italy’s fate. Their hospitals are quite advanced, and we are no better in Boston. As doctors, we are desperately trying to prepare for the onslaught of patients in the coming weeks. It is already beginning. This is an opportunity for you as the district leadership the time to be aggressive and help us fight this by “Flattening the Curve”.

We implore you, as a group of Boston’s doctors preparing to fight this, to help us. Please send a new email to ALL the Brookline school district families. Social distancing is painful. We know that kids have cabin fever, they are pleading to see their friends, they may have birthday parties coming up or special events they have been looking forward to. All of us need to work and childcare is a big worry. But we need to overcome these issues and boredom for the coming weeks so that we can survive this with as few deaths as possible. What does that mean?

1) No playdates, not even 1:1.
2) No small gatherings, no meetings between a couple families, even for birthday parties.
3) Avoid trampoline parks, climbing gyms, restaurants, movie theaters, anything in an enclosed area. Many of these places are advertising increased cleaning and hygiene. This is not sufficient! Do not go.
4) Cancel planned vacations for the next month. Avoid airline travel that is not an emergency. Many airlines and rental agencies are offering penalty free cancellations.
5) Stay at home as much as possible. Work from home if you possibly can. You may have to go buy groceries and medicine, of course, but make the trips quick and purposeful.
6) Wash your hands thoroughly after you have been in public places, for a full 20 seconds, soaping up thoroughly and being sure to get between the fingers.
7) Please avoid disseminating social media claims that the situation is not serious or is being exaggerated. This is a national crisis and conveying misinformation to your friends and family may put their lives in danger.

Thank you for taking the time to read this and stay safe and healthy in the coming weeks.”

Respectfully,
Erika Rangel, MD, Director of Surgical Critical Care, Brigham and Women’s Faulkner Hospital
Shawn Rangel, MD, Pediatric Surgery, Children’s Hospital Boston
Asaf Bitton, MD, Executive Director Ariadne Labs and Internal Medicine, BWH
Daniel O’connor, MD, Pediatrics, Longwood Pediatrics and Children’s Hospital Boston
Beth O’connor, MD, Pediatrics, Roslindale Pediatrics
Vandana Madhavan, MD, Clinical Director of Pediatric Infectious Disease, MGH
Parag Amin, MD, Pediatrics, Centre Pediatrics
Christy Cummings, MD, Neonatology, Children’s Hospital Boston
Eric Bluman, MD, Orthopedic Surgery, BWH
Trimble Augur, MD, Internal Medicine, Hebrew Rehabilitation Center
Dasha Weir, MD, Pediatric gastroenterology
Amy Evenson Warren, Transplant Surgery, BIDMC
William Oldham, MD, PhD, Pulmonary and Critical Care Medicine, BWH
James Kryzanski, MD, Neurosurgery, Tufts Medical Center
Ben Zendejas-Mummert, MD, Pediatric Surgery, Children’s Hospital Boston
Johanna Iturrino Moreda, MD, Gastroenterology, BIDMC
David Berg, MD, Cardiology and Cardiac Critical Care, BWH
Jennifer Crombie, MD, Hematology Oncology, BWH
Jenifer Lightdale, MD, Chief of Pediatric Gastroenterology, U Mass Memorial Hospital
Wayne Tworetzky, MD, Pediatric Cardiology, Children’s Hospital Boston
Elaine Yu, MD, Endocrinology
Jonathan Li, Infectious Disease
Nancy Cho, MD, Surgical Oncology, BWH
Eric Sheu, MD, Minimally Invasive Surgery, BWH
Reza Askari, MD, Director, Surgical Critical Care, BWH
Cindy Lien, MD, Internal Medicine and Palliative Care, BIDMC
Hannah Parker, MD, OB/GYN
Alysa E. Doyle, PhD, Center for Genomic Medicine, MGH
Christopher Smith, MD, Internal Medicine, Charles River Medical Associates, Wellesley, MA
Maya Greer, NP, Children’s Hospital Boston
Rusty Jennings, MD, Pediatric Surgery, Children’s Hospital Boston
Emily Oken, MD, Professor of Population Medicine, BWH
Chinwe Ukomadu, MD, Head of Clinical Hepatology, Novartis
Jennifer Kaufman, MD, Internal Medicine, BWH
Ann Poduri, MD, MPH, Pediatric Neurology
Susan Yehle Ritter, MD, Rheumatology
Diego Martinucci, MD Psychiatry, Atrius Health
Shih-Ning Liaw, MD, Pediatric Palliative Care, Dana-Farber Cancer Institute/Boston Children’s Hospital
Wolfram Goessling, MD, Gastroenterology and Oncology, MGH
Paola Daza, Pediatrics, MGH
Juan Matute, Neonatology, MGH
John Ross, MD, Internal Medicine, BWH
Megan Sandel, MD, Pediatrics, Boston Medical Center
Kathy Calvillo, MD, Surgery, BWH
Christine Greco, MD, Anesthesia, Children’s Hospital Boston
Niteesh Choudhry, MD, PhD, Internal Medicine, BWH and Harvard T.H. Chand School of Public Health
Chandru Krishnan, MD, Ophthalmology, Tufts Medical Center
Amy Ship, MD, Internal Medicine, Associate Director of Medical Education, Atrius Health
Yen-Lin Evelyn Chen, MD, Radiation Oncology, MGH
Daihung Do, MD, Dermatology, BIDMC
Chloe Zera, MD, MPH, Maternal Fetal Medicine, BIDMC
Alejandra Barrero-Castillero, MD, MPH, Neonatology, Children’s Hospital Boston
Jesse Esch, MD, Pediatric Cardiology, Children’s Hospital Boston
Alison Packard, MD, OB/GYN, MGH
Vik Khurana, MD PhD, Chief Division of Movement Disorders, BWH
Tu-Mai Tran, MD, MSc, Family Medicine, BMC
Yu Liu, MD PhD, Internal Medicine, Bristol Myers Squibb
Yih-Chieh Chen, MD
Lily Li, MD, Allergy and Immunology, BWH

[nuthatch]

Thank you for posting this, Jeanie. I am terrified of getting this virus, especially since I was hospitalized with pneumonia just an hour into the new year. I often wonder if I've already had it. Here's why.

My DH got a sore throat shortly after Christmas. No runny nose, but a very dry, almost continual cough that is unproductive. In the many years we've been together, I've never seen him so sick. After a week, he was better but I now had a sore throat which was followed by the same unproductive cough. By New Year's Eve I was exhausted and was wheezing and having a hard time breathing. Around midnight I could hardly think and told DH to call an ambulance. Believe me, I have to be feeling very, very badly to ask for that! I remember the EMT asking me test questions, like where are you, and what year is it, but all I could do is stare at him blankly.

I was admitted to the local hospital and placed into the new intensive care for four days, then moved into what I call the dungeon of the old wing of the hospital. I have no idea why I was moved there so abruptly, without warning, at 1 a.m. (intensive care had at least 3 vacant rooms that I could see from mine!) to an uninhabited part of the hospital. Probably an insurance decision but why at 1 a.m.?

My new room was on the ground floor in the old wing, down by the lockdown part of the hospital where they treat prisoners! I was wheeled in my bed into an uninhabited double occupancy room that was dark, cold and damp, next to the window that was missing a slat of the vertical blind and was later discovered (by my DH) to be unlocked and partially open. What privacy and safety!!! When my DH found me the next day, he soon discovered the water didn't even work and when he told the nurse, he was told to go to the unoccupied room across the hall for water when he needed to wash his hands!

3 of my 4 nurses in ICU were male. Being immobile and incontinent . . . that was just plain humiliating! Some day I'll explain what a peri-wick is.

Although I was given a halfa$$ sponge bath while I was in the dungeon, I was only once offered a toothbrush and a washcloth to wash my face (the first day in ICU), my hair was never brushed. I had a different nurse every single day. They also put me on a BIPAP machine while there even though I've never used one before. The BIPAP kept me from sleeping at night much, it made outlandish sounds on my face because it didn't seal properly. You're supposed to inhale and exhale with the thing but it was going a bit fast to keep up with and was very irregular!

I was concerned that the BIPAP was forcing the junk my body was trying to expel right back down into my lungs, but when I tried to voice my concerns to the ICU nurse, I was spoken over, my concerns were not addressed and I felt very disrespected and helpless.

The last night I was there I got a roommate who arrived in my room at 3:30 a.m.! I was awakened by the talking as they went over her whole health history and extensive list of meds she took. In the next 12 hours she called for help to the toilet every 5-10 minutes, never once being able to wash her hands in the waterless bathroom. Sometimes her calls were not answered so she got up unassisted and went herself.

The food . . . ugh!

I'm lucky I came out of that place alive with only 5 IV holes, numerous bruises and a yeast infection from the peri-wick they use to deal with incontinence! I will never go back there again! I went straight from the van into the shower!
It's very clear I am deemed expendable.

Oh yeah, my GP has chosen to spend his time down in LA where he has established another practice and to be with his new wife, so I am told by his staff that he is only here the first weekend of the month! *#@%*!!!!!! Now I have no doctor and it's not exactly a good time to find and try a new one.

Sign me, TERRIFIED!

[Lazarus]

Oh my gosh! You had a nightmare of an experience. I am speechless and just want too say I am so sorry this happened to you.

[stillstANNding]

Just dreadful, Nuthatch. Did anyone give your husband or you an explanation as to why you were moved?

Love and chocolate for you!
ANN

[Jeanie Z]

:) Wow Nuthatch that is awful. I am glad you are recovered. You are in my prayers nightly. I pray for all of us. Jeanie :)

[agate]

That's my impression of the way hospitalizations go too, nuthatch! My hospital stay for removal of a parotid gland some years ago was quite similar. I made up my mind then and there to avoid any further hospitalizations at all costs.

Moreover, hospitals are teeming with germs. No matter how clean they try to be, they're still breeding grounds for germs.

I think of the fellow with severe MS who lived just across the hall from me for 17 years. He liked to drink and often fell out of his chair. The Fire Dept. knew him very well because they often had to come and pick him up. And yet in all those years I can't recall that he ever went to the hospital. He died in his apartment, where he lived alone though he had a full-time helper who was there all day on weekdays.

I've often wondered how he avoided hospitals. I'm pretty sure the EMTs would have wanted to take him there any number of times and I'm also pretty sure he declined every time.

He was former military and may have known a thing or two about how bad hospitals can get....

Still there are times, like nuthatch's recent illness, when hospitals are unavoidable. They can clear up an infection in ways you probably couldn't do by yourself at home. I'm so sorry this happened, nuthatch. Maybe it was COVID-19, which is respiratory, and you're now immune. But just by the law of fairness if there is one, the coronavirus should pass you by completely as it makes the rounds.

[stillstANNding]

Agate, could we all get in on that “law of fairness” doctrine? It would be a big relief.

ANN

[Virginia]

Nuthatch, what a nightmare of a story. You might have had coronavirus, but I bet it was whatever your DH had and you just couldn't fight it off. I am glad you came through that, but I know you are frightened now of not only the virus, but also of the hospitals as we all would be.

Agate, I also want in on that law of fairness doctrine. You can put us all on that list because after all, we all do have MS and that should get us a spot on it.

It is 1:15. I must brush my teeth and get to bed.

[stillstANNding]

Good advice from Pluto in case you haven’t seen it:

Only registered and activated users can see links., Click Here To Register...

ANN