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[COVID-19] Coronavirus - Good Advice From a UCSD Expert
#1
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Coronavirus - Good Advice From a UCSD Expert
I just received this information in an email today.  It seems to be excellent advice and a very interesting read.  I hope we can all stay healthy and perhaps this info will make it so.  Please read on...



Good advice from a UCSD expert: Copy and paste if you’d like to share this. 


The author is James Robb a virologist at UC San Diego

Subject: What I am doing for the upcoming COVID-19 (coronavirus) pandemic

Dear Colleagues,
as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.

The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! [LADD's NOTE: there are reports COVID-19 can be spread through the air so avoid areas where people are coughing and sneezing.] BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us!
RayBee

  
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#2
RE: Coronavirus - Good Advice From a UCSD Expert
Thank you! This is a very helpful post.
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#3
RE: Coronavirus - Good Advice From a UCSD Expert
Good, common sense advice!
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Coronavirus - Good Advice From a UCSD Expert
Some of the advice may be dated and only provide limited protection, since many experts now suggest that the virus is airborne.

Quote:1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

I personally would not even do a "fist bump"... yep, safer than a full handshake, but you're still touching the hand of another person, just not with as much surface area.

Quote:2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

Agree with the "use paper towel or disposable glove", but the advice again to use your knuckle to touch switches & buttons still has your skin in contact with the switch or button that has been touched by multiple people.  Better to use the paper towel or glove method.

Quote:3) Open doors with your closed fist or hip

Again, doing so you're still having your skin contact the door knob or handle.  Use your sleeved hand or a paper towel, or better yet a glove.

Quote:5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

I don't know for sure, but I've now heard several doctors say that while alcohol-based hand sanitizers are good for bacteria, they are far less effected for killing a virus.  I've heard others state that you really need at least a 70% solution.  The hand sanitizer I have is a 50% solution, which probably is better than nothing, but not up to the standards that some doctors suggest.  As he suggests here, washing with soap and water for at least 20 seconds seems to be the only way to ensure you're killing most of the virus particles if your hand gets exposed to the virus.

Quote:1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Agreed, but they are almost all not available now... if you still see them available, you just got lucky, buy them immediately.

Quote:Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! [LADD's NOTE: there are reports COVID-19 can be spread through the air so avoid areas where people are coughing and sneezing.] BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

Good advice, but with one addition:  This virus can get into your system through any mucus membranes - like he said, nose, or mouth... but he forgot one major way - via your EYES.  To get full protection when a virus is airborne, you'll need full eye protection with goggles that completely seal the area around your eyes.  Most of those are gone now, but swimming goggles are one thing that would do the job and may still be available.

Quote:2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!).

Couple things that are a problem here.  First, almost all masks are gone now.  Good luck finding one now that will work properly for anything less than a completely outrageous price.  Second.. not all masks are created equal... As a doctor, he should know that "surgical masks" are not intended to protect the wearer from incoming virus particles-- they're intended to protect patients from the doctor or nurse's spit.  Surgical masks (while better than nothing) are NOT the same as N95 masks.  N95 masks are what is needed for an airborne virus.  And, good luck finding one.  There's been some creative people on YouTube with instructions on how to make your own mask from HEPA air filter material... might be one option when no N95s can be found.

Quote:4) Stock up now with zinc lozenges.

Good advice there, but I would also add... stock up on any over-the-counter meds you normally use, any cold/flu items from the pharmacy you will need, as they are going fast on the shelves with massive stockpiling right now.  The more we get into this, the more people will need to realize that MANY of our household and personal products are made in CHINA.   Guess how much of those Chinese manufacturing plants are now shut down and will remain shut down for the forseeable future?  Yep, nearly ALL of them.  Remember, the U.S. gets 80% of our generic drugs from China, thanks to global supply chains.  There's not much left in the supply chain right now with our just-in-time logistical systems that we've been using now for several years.

I'll write more in the next post... some of which I posted elsewhere privately.
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#5
RE: Coronavirus - Good Advice From a UCSD Expert
It has been told me that many "consumable" CPAP-related items come in China or in other Asian countries.  Things like filters, hoses, masks, etc. may be "manufactured" or "packaged" in your country, but the core components that go into the products many times come from China (outsourced for the cheapest price using Chinese workers).

This coronavirus is already starting to affect the global supply chain for many products.  CPAP supplies are part of that.  And, as you may have suspected (at least here in the U.S.) 80% of our drugs and the precursors that go in to making those drugs come from China.

If you need CPAP supplies or need to update your supply of medications, you may wish to consider getting them now.  Hopefully it won't be a problem right away, but as this virus spreads and countries increasing shut down public meetings & businesses, it could become a major problem in a short time.

Think about this:  As of today one-tenth of the entire world population (over 800,000,000 people) are now either quarantined or on lockdown in China cities and provinces.    Factories are closed throughout the nation for the forseeable future.   The Chinese Communist Party is essentially destroying their own economy over this.   They tried to open up a few factories a few days ago, but only 20% of the workers even showed up, so they had to shut back down.  That is not being done for something that is "no worse than a bad case of the flu".

Take this post however you like.  But at least you've had a heads-up.
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#6
RE: Coronavirus - Good Advice From a UCSD Expert
There are now reports on the nightly news stations that people are hoarding all kinds of supplies.

When people are scared, that's what they do.  That's why where the virus spreads in a region, the people panic and the groceries store shelves are wiped out, which is what happened in northern Italy this week.  It's uncertain right now how this virus will play out, but one thing is for sure, and that is you can count on people being people, and people buy up food, supplies and meds and everything else in sight when they're in a panic.  I think the worse impact of this pandemic is going to be economic depression, with major supply chain issues.

Our global supply chains, global economy and fancy computer-driven "just-in-time" logistical systems all come to a screeching halt when one link in the supply chain is broken.  China is a huge part of that chain, and they're down for the count, at least through spring and maybe into summer.   Many companies are already having supply issues. Proctor & Gamble said 17,600 of their products will be not be available, since they're made in China (article HERE).    They make MOST of our consumable products, as you probably know.  Many other companies in the same boat, don't have time to list them all here.

Again, China isn't destroying their own economy for something as simple as "the flu".

One family member parroted back to me the oft-repeated media phrase that "More people die from the common flu each year than have died from Coronavirus".  Thing is, that's a false comparison.  The coronavirus hasn't hit here in full force yet, so we have no idea what the death rate is.  China is clearly and obviously lying on the death rate (there is proof of that, I'll post about it later), and we don't yet know what that rate will be now that it's spreading to other countries, as it's been estimated that it could have up to a 24 day incubation period, so you don't know the real death rate until it's been strong in an area for over a month.

My relative's response is like someone living in 1917 America warning of an influenza pandemic coming in the winter of 1917-18, and upon hearing that seemingly "paranoid" claim, another person objects, saying "Hey, we've never had something that bad come this way before, and besides more people have died from horse-and-buggy accidents than die of influenza each year".  Little does this person know that the very next year, the Spanish flu would kill over 50 million people.  It's not over (as they say) until the fat lady sings.
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#7
RE: Coronavirus - Good Advice From a UCSD Expert
Regarding ordering N95 masks, gloves, goggles and other supplies online, be careful on the delivery dates.

I ordered some reasonably-priced N95 masks two weeks ago week and it took forever to ship.  I sent an email out to the company last week asking when it would ship.  Got a reply today that it was on back-order and they have no estimate of when it will be back in stock due to the cononavirus.  Took 2 weeks for them to tell me that they can't fill my order.
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#8
RE: Coronavirus - Good Advice From a UCSD Expert
There's a lot of media-star doctors out there now claiming that face masks are useless to protect against the virus.  Unfortunately, many times they're not talking about N95 masks, but instead "surgical masks".  So they're confusing the issue.  Surgical masks provide little virus protection to the wearer, while N95 masks do provide solid protection.  There's only one reason that the press is playing down the effectiveness of N95 masks - and that's because there simply aren't enough of them to go around.  So they want to calm the panicked public by these stupid statements (like I heard on NBC Nightly News a few nights ago) when the reporter asked about N95 masks, and the "doctor" replied by stating something like "There's no indication that these masks provide any degree of protection against the coronavirus" (he said this while holding up a surgical mask, not an N95 mask).  Not many people caught that, I'm sure.  But I did.

Keep in mind, surgical masks are typically thin cloth or paper with ties in the back or ear-loops and they're designed primarily to prevent the doctor/nurse from infecting the patient.

N95 masks are thicker and multi-layered and are designed primarily to prevent the wearer from getting infected.  

According to CDC "N95 FFRs are capable of filtering out all types of particles, including bacteria and viruses."

The NIOSH-certified N95 masks that are commonly made by 3M are able to capture over 95% of particles down to 0.007 microns.  That's over 10 times smaller than the coronavirus.  States that right on the box of N95s I have on my shelf.

Again, the "95%" is really misleading.   One would think that this means that 5% of the virus particles are able to get through and infect you.  This is again an incomplete understanding of how they work.   A nurse friend tells me that with viruses, it's all about "viral load", and whether or not you succumb to the virus depends greatly upon how much "viral load" enters into your system via your eyes/mouth/nose.  If a mask reduces the "viral load" by 95%, that is an excellent preventative measure.  Your body can produce anti-bodies to fight off small viral loads - it's the large loads that bring on severe respiratory distress syndrome and/or pneumonia.   This is why N95 masks are valuable and are standard PPE for medical staff dealing with viruses.  But they usually also have nitrile gloves and a sealed eye protection as well (you can use standard swimming goggles for that).  Those are also items that may be disappearing from stores soon as well.

N100 is better for filtering, of course.  But I challenge you to wear one properly for more than an hour.  For me, N100s are very difficult to breathe through for anything but short periods of time.  Personally, I can't get enough air through them.  N95s are much better in this regard.

But one of the best reasons to use any type of face mask is to prevent you from touching an infected surface, then touching your face.  That's where people fall down on the job - we normally touch our face numerous times every hour by habit, without even realizing it.  A mask will prevent you from doing that, even if it's simply a surgical mask.  Anything is better than nothing, but N95s are much better and are the standard in hospitals for PPE, especially when dealing with airborne viruses like this one.

And (of course), you're not going to be wearing an N95 all day long.  Only for short trips when you go out and about for shopping or whatever.  They increasingly loose effectiveness after 2-3 hours anyway, due to the dampness caused by your breath.
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#9
RE: Coronavirus - Good Advice From a UCSD Expert
Posted this in our staff forum also:

Okay folks... 100 Apnea Board Bucks to anyone who can tell me what's wrong with this statement that was put out by the U.S. Surgeon General on his Twitter account:

Direct Link:
https://twitter.com/Surgeon_General/stat...5283932160

Quote:Seriously people- STOP BUYING MASKS!

 They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!
Coronavirus Disease 2019 (COVID-19)
 — U.S. Surgeon General (@Surgeon_General) February 29, 2020
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#10
RE: Coronavirus - Good Advice From a UCSD Expert
Interesting factoid that proves the Chinese government is lying about the death rate of this virus...

If you look at their published numbers during the past month, it's clear that the numbers cannot be accurate.

For instance, the ratio of infected to deaths for the first weeks are a completely constant ratio, EVERY SINGLE day..  something like .021, day after day, week after week.  Epidemics don't work that way.  You can't take the daily number of deaths, divide it by the number of infections and come up with a constant .021 ratio each day, day after day for several weeks.  It's like the Chinese officials are simply plugging the numbers into a computer that's pre-set to automatically spit out a .021 death/infection rate no matter what.

Something is fishy in Denmark Woohan.  [Image: thinking-about.gif]

A few press outlets reported on this apparent discrepancy, and geee wiz... all of a sudden the next day, Chinese numbers began to be more varied in their ratio so that it doesn't look like they cooked the books, and they went back and "corrected" the past numbers.  But even then, they were such minor "corrections" that no one believes them to be accurate and some have said that the numbers are 10 times as high as is being reported now.

That's in a communist, controlled system... but even so, I wouldn't put it past our own government here in the U.S. to do the same thing to avoid panicking people.  Heck, just look at the double-speak of the Surgeon General.  That ought to reveal that they think the average citizen is just plain stupid and can be lied to if it's "all for the greater good".
SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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