COVID-19: CB's house nurse takes your questions

gafftaper

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My wife Mrs Gafftaper is a nurse in a cancer clinic. She isn't an expert on viruses, but a big part of her day is spent talking to cancer patients who are extremely vulnerable and answering their questions about COVID-19. To do her best to keep her patients safe, she spends a lot of her time reading the latest research and guidelines from the CDC, WHO, the Hospital she works at, and other prominent medical institutions. I've asked her to come on and comment on some of our previous discussions here and take your questions if you have them.

If you have any questions about COVID-19 please post them here. She'll stop by and respond.
 
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gafftaper

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I'm going to start this off with a couple of questions that I have already asked her but think you might like hearing:

1) How long will it take for us to get from where we are now to a vaccine and this being something like polio that we no longer worry about?

2) What is the deal with these treatment drugs? I've heard about drugs for treating Aids, Ebola, and malaria that they say might be helpful. What is the deal with all the safety testing. People are dying why aren't they just using them right now?

3) Bird Flu, Swine flu, both fizzled out and didn't do much. Influenza comes every year. Why is this such a big scary thing to the medical people? Why do they think that the death numbers will be so much worse this time?

4) What's this I hear about permanent damage to people who have survived?
 
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MNicolai

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1) Can you kill the virus by parking a blow dryer up your nose?

2) How should I prepare my face and nostrils for getting singed up to 136°F while I apply the hair dryer to my nostrils? Is there a lotion I should be using? If I don't have any lotion is there a video I can watch on YouTube about how to roll my own from household cleaning and grocery products?

"SOURCE" (yes...it's Florida...):
 
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seanandkate

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Good questions @gafftaper . Can I take this opportunity to offer profound thanks to @Mrs Gafftaper and all the healthcare professionals out there that are selflessly doing what needs to be done. HUGE respect. As to question, for a disinfectant solution, what's a good bleach / water ratio to disinfect household surfaces?
 

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StradivariusBone

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At 136 degrees the virus falls apart. At what temp do the membranes in my nasal passageways also fall apart? Being that it's Florida, I'm kinda surprised he didn't suggest putting your nose in the smokestack on your offset smoker while cooking some brisket. How do we get through the stall when slow-cooking the coronavirus? Should I use a dry rub intranasally?
 
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How long will it take for us to get from where we are now to a vaccine and this being something like polio that we no longer worry about?
The best estimates at this point are 12 to 18 months for possible release of an effective vaccine. This doesn't mean that in 18 months we'll all be vaccinated, however. It likely will take months of production of the vaccine to have enough for mass distribution. (My suspicion is that it will be released in a gradual, organized form- first to those most vulnerable to dying from COVID19, then to health care workers, then to the general public.) So, even at best estimates, it's likely to take at least a couple of years before we all have the opportunity to be vaccinated against this particular virus. One problem is that this virus has already started mutating, making it harder to pin down and treat. According to the CDC, both the SARS (2003) and MERS (2012) viruses are still infecting people worldwide, although at much lower rates than the current viral threat. So, unfortunately I don't see this realistically becoming as obscure as polio any time soon.

What is the deal with these treatment drugs? I've heard about drugs for treating Aids, Ebola, and malaria that they say might be helpful. What is the deal with all the safety testing. People are dying why aren't they just using them right now?
Well, that is a loaded question. The reason the FDA tightly controls development of treatments is because drugs, or combinations of drugs, can potentially cause more harm than good. As of today, there are already several people who have died because they took hydroxychloroquine without FDA approval or physician approval in hopes of keeping themselves from getting sick. Every medication ever produced has potential side effects. There is always a "risk vs. benefit" discussion when submitting a drug for approval. Also, even if a drug is approved as "safe" in humans, the dose (amount) of the drug that is effective for one health condition may be totally different from the dose that is effective for another condition. Drug testing is a rigorous, tightly controlled scientific process that ultimately produces the best treatment for the condition. In the end, the time taken to carefully study the drug's use saves lives. During WWI and WWII, soldiers on the battlefield were given experimental drugs (without informed consent and under non-scientific conditions). The end result is that some great drugs were "discovered", but likely many soldiers died needlessly from receiving untested drugs in these conditions.


Bird Flu, Swine flu, both fizzled out and didn't do much. Influenza comes every year. Why is this such a big scary thing to the medical people? Why do they think that the death numbers will be so much worse this time?
If you look back at the actual numbers of Bird Flu and Swine Flu, you will see that they did kill lots of people. The swine flu in particular caused >12,000 deaths in the US in its first year, as well as an estimated 150,000 to 500,000 people worldwide in the first year. Both viruses are still active in the world and causing illness, particularly in less developed countries. The yearly flu viruses have similarities to previous year's versions of the same, meaning that many people already have developed immunity to them, either by way of vaccine or having already had the virus. COVID19 is a "novel" virus, meaning no one has immunity to it. Death rates are still being studied in this virus, so we don't yet know if it's more or less deadly than previous viruses (in percentage of the population). However, there is good proof that humans can shed the virus for 14 days before showing any symptoms, unlike the "typical" flu which doesn't shed infectious cells until after the patient becomes physically ill. This has led to massively accelerating numbers of infected people worldwide in a short amount of time.

What's this I hear about permanent damage to people who have survived?
It's probably too early to speculate fully on the lasting effects of this virus. However, the fact that the virus causes damage/fibrosis to the lungs indicates that patients who recover from more severe forms of the illness may have long lasting decrease in their lung capacity.


Good questions @gafftaper . Can I take this opportunity to offer profound thanks to @Mrs Gafftaper and all the healthcare professionals out there that are selflessly doing what needs to be done. HUGE respect. As to question, for a disinfectant solution, what's a good bleach / water ratio to disinfect household surfaces?
The CDC recommendation is 1/3 cup bleach per gallon of water.
 

Jay Ashworth

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Have you seen the MMWR piece, promulgated by CDC in the last 48 hours, that suggests, based on the 2 cruise ships, that the virus may stay alive on some surfaces for 17 days, instead of the 2-5 we've been hearing. Any opinion on whether that's just because cruise ships are pessimal environments for killing virii?

 

dvsDave

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@Mrs Gafftaper I've seen a lot of UV-C lamps being offering to sterilize phones and gadgets. Have there been any studies published yet that list the efficacy or time/intensity of UV-C light on the COVID-19 virus to kill it on a surface?
 
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gafftaper

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@Mrs Gafftaper I've seen a lot of UV-C lamps being offering to sterilize phones and gadgets. Have there been any studies published yet that list the efficacy or time/intensity of UV-C light on the COVID-19 virus to kill it on a surface?
I can mostly answer this. UV-C is generated by the Sun but filtered out by the Earth's atmosphere. So Microbes have never encountered it in nature and have never developed an immunity to it. This makes it highly destructive to bacteria and viruses. UV-C is used in hospitals to sanitize equipment and the rooms themselves. There are some really cool UV-C sanitizing robots that are out now that look like a 6 foot tall Roomba of UV light. There is also some cool UV-C technology being used to sanitize airplanes because UV-C is effective on all surfaces including fabrics. So it's great for seats. There is this cool machine called the falcon that has these wings of UV-C emitters that they roll down the aisle blasting UV on the seats to sanitize an entire airplane in just a few minutes. This Video is pretty cool.

UV-C is dangerous to human skin. I have seen people saying don't use UV-C to sanitize your phone because it's dangerous to human skin too. There are some wand products out there that definitely fall in this category. But smart people are interested in these smaller phone sized boxes that you put an item into and blast it from all sides with UV.

I haven't been able to find any UV-C vs COVID-19 specific studies, but if it can kill MRSA easily and works on the other Corona viruses, it should be effective on COVID-19.

I did some research into phone sanitizer devices and from what I can tell the products from Phone Soap and Homemedics are the only brands that have been through scientific testing to prove they actually use UV-C and that they are effective. They are also the most expensive products on the market. There are a lot of cheap Chinese knock off products out there for 1/3 the price but you have no way of knowing if they are just using a cheap UV-A or UV-B emitter instead of a true UV-C.

@Mrs Gafftaper can you comment about the general use of UV-C to sanitize in the hospital?
 
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Have you seen the MMWR piece, promulgated by CDC in the last 48 hours, that suggests, based on the 2 cruise ships, that the virus may stay alive on some surfaces for 17 days, instead of the 2-5 we've been hearing. Any opinion on whether that's just because cruise ships are pessimal environments for killing virii?
My take on this article is that there is one brief question (among many hypotheses posed) asking if this is one possibility of why the virus was so widely passed through the ships. There are 1001 other more likely reasons the virus persisted, the least of which is that people can be COVID19 positive for up to two weeks without any evidence of illness. This, along with the fact that many of the ship's workers were found to be infected coupled with the insanely close quarters of thousands of people is much more likely to be the cause of the infection. Not that it's impossible that the virus could have lingered on surfaces for 17 days- there's just no solid evidence to this hypothesis as of yet.

@Mrs Gafftaper can you comment about the general use of UV-C to sanitize in the hospital?
Ultraviolet "robot" units are already widely used in many major hospitals to provide a second layer of sanitation. The room is thoroughly cleaned by housekeeping, then the UV machine is placed in the room for an allotted amount of time to further decontaminate all surfaces.
 
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gafftaper

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First, a big thank you to ETC. They are now making face shields for the medical industry and selling them at cost to hospitals. You guys are the best. My wife has already forwarded the information to people in her hospital. Hopefully her hospital can get in on some sweet ETC PPE. Thanks so much for doing your part to help in this difficult time!

The Mrs has been following this doctor on Facebook who goes by the name ZDoggMD for years. She really respects his insight and he posts some funny things too. His recent post gives some hope in these dark times, which I found interesting. Not that much in here for us civilians to do, besides washing our hands, but hopefully he's right and hopefully there is a solution in this data that will get us back to normal soon. If you just want a laugh skip to 18:40 in the video.
 
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Jay Ashworth

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My take on this article is that there is one brief question (among many hypotheses posed) asking if this is one possibility of why the virus was so widely passed through the ships. There are 1001 other more likely reasons the virus persisted, the least of which is that people can be COVID19 positive for up to two weeks without any evidence of illness. This, along with the fact that many of the ship's workers were found to be infected coupled with the insanely close quarters of thousands of people is much more likely to be the cause of the infection. Not that it's impossible that the virus could have lingered on surfaces for 17 days- there's just no solid evidence to this hypothesis as of yet.
Ok, so your take was about the same as mine. Thanks. :cool:
 

gafftaper

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So, you are staying at home and doing all the good isolating stuff... But what about the groceries? How many people have picked up that apple? Who squezed your Charmin? Where did the guy stocking the shelf grab your bottle of ketchup?

This video seems a bit paranoid at first but when you think about it, he's right.
 

gafftaper

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Researchers at the University of Washington have put together a website with all their latest projections. You can see their numbers on a nation wide or state by state basis. When will the virus will reach maximum strain on the health care system? How many beds will be needed? How many ICU beds? How many beds are available? How many ventilators will be needed? How many deaths? It's sobering but our shut downs are working and the numbers are much better than we originally thought. They set total projected deaths between now and August at 81,100. That's a lot better than the original projected numbers before we started shutting things down.

 

JChenault

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Researchers at the University of Washington have put together a website with all their latest projections. You can see their numbers on a nation wide or state by state basis. When will the virus will reach maximum strain on the health care system? How many beds will be needed? How many ICU beds? How many beds are available? How many ventilators will be needed? How many deaths? It's sobering but our shut downs are working and the numbers are much better than we originally thought. They set total projected deaths between now and August at 81,100. That's a lot better than the original projected numbers before we started shutting things down.

as near as I can tell this is not being updated. Still very useful, but as we move away from the inception date of March 26 it will become less accurate.

its really nice to see someone trying to forecast hospital resource needs over time.
 
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gafftaper

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as near as I can tell this is not being updated. Still very useful, but as we move away from the inception date of March 26 it will become less accurate.

its really nice to see someone trying to forecast hospital resource needs over time.
Yeah, at this point it's only been 2 days since publication, so it's pretty current. But the numbers are changing every hour. So, will they update the data in the future and how often? Hmmm.
 
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