Coronavirus: How dangerous a threat?

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Beryl goes to the shop to buy beans. Before she picks up a can, she absent-mindedly wipes her lips/face and then picks the can up. As she goes to put it in her basket she notices it has been dented, so she puts it back, just like she normally would and takes a different one. After paying, her basket is returned but the staff forget to clean the handle. Enter Steve and Mary. Steve picks up Beryl's basket and Mary picks up the same tin of beans. Repeat ad nauseum in many different situations.

It's a trite example and the places I've read that were noted as hotspots in South Korea were places like gyms and call centres, where people are together for extended periods and sharing equipment, but it makes the point. It's not about droplets from peoples breath landing on things.

I find your post quite surprising and wonder how you come to that conclusion. Is the reporting in the UK (you're UK, right?) so different from here (Germany)? Because around here it has become rather common sense in the past weeks that those kind of infections (surfaces) make up of about 10%, while direct droplets are responsible for almost half and small aerosols for roughly the other half of infections. The most dangerous seems to be a) direct contact, b) aerosols in closed rooms, coming from singing, coughing, strong breathing (gyms, clubs, churches...)
(I don't have any know-how, it's just what I read / what the media around here, no matter which political direction, are reporting.)
Or did I misunderstand you?
If you're doubting the benefits of masks because they are often not handled well and lead to more face-touching, I'm inclined to support that. In addition lots of people in Germany, especially the older ones, are pulling the masks over their mouths, but leave the nose free. (I hate wearing the masks, but I try to wear them correctly, so that it does at least make some sense.)
 
I find your post quite surprising and wonder how you come to that conclusion. Is the reporting in the UK (you're UK, right?) so different from here (Germany)? Because around here it has become rather common sense in the past weeks that those kind of infections (surfaces) make up of about 10%, while direct droplets are responsible for almost half and small aerosols for roughly the other half of infections. The most dangerous seems to be a) direct contact, b) aerosols in closed rooms, coming from singing, coughing, strong breathing (gyms, clubs, churches...)
(I don't have any know-how, it's just what I read / what the media around here, no matter which political direction, are reporting.)
Or did I misunderstand you?
If you're doubting the benefits of masks because they are often not handled well and lead to more face-touching, I'm inclined to support that. In addition lots of people in Germany, especially the older ones, are pulling the masks over their mouths, but leave the nose free. (I hate wearing the masks, but I try to wear them correctly, so that it does at least make some sense.)
References?

Edit: I should also point out that you've jumped midway into an exchange and the later part of your post is really what I've been getting at.
 
Beryl goes to the shop to buy beans. Before she picks up a can, she absent-mindedly wipes her lips/face and then picks the can up. As she goes to put it in her basket she notices it has been dented, so she puts it back, just like she normally would and takes a different one. After paying, her basket is returned but the staff forget to clean the handle. Enter Steve and Mary. Steve picks up Beryl's basket and Mary picks up the same tin of beans. Repeat ad nauseum in many different situations.

It's a trite example and the places I've read that were noted as hotspots in South Korea were places like gyms and call centres, where people are together for extended periods and sharing equipment, but it makes the point. It's not about droplets from peoples breath landing on things.




Yes.
So if Beryl coughs/sneezes on the can, Mary is OK? Are Mary's chances better if Beryl has a face covering when she coughs/sneezes?

FYI, I wipe the basket handle myself.
 
So if Beryl coughs/sneezes on the can, Mary is OK? Are Mary's chances better if Beryl has a face covering when she coughs/sneezes?

FYI, I wipe the basket handle myself.
If Beryl has symptoms she shouldn't be out anyway. If she's used to wearing a mask, doesn't re-use contaminated ones and leaves it in place while she is out and about sure, it'll likely help. If it annoys her and makes her touch her face more, but she thinks she's not going to infect anyone because "hey, I'm wearing a mask", then it could make it worse.


You might, many don't.
 
It's not about droplets from peoples breath landing on things.

Then how does the virus get on Beryl's face? There seems to be a vicious cycle here. People assume that the virus gets on their face because they constantly touch their face. But what do they touch before that which puts virus on their fingers? Maybe someone touches a contaminated can of beans, but how did the virus get on the can? What was touched before that? It can't be the face, unless you think that Beryl constantly breathes out a cloud of viral particles, some of which move back and land on her face. But if that's the case--Beryl we assume isn't wearing a mask--just by picking up a can and examining it closely enough to see that it's dented, she's more likely to put more virus on it by breathing than by touching it.
 
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More on the origin of SARS-CoV-2:

http://www.mattridley.co.uk/blog/where-did-the-virus-come-from/

New research has deepened, rather than dispelled, the mystery surrounding the origin of the coronavirus responsible for Covid-19. Bats, wildlife markets, possibly pangolins and perhaps laboratories may all have played some role, but the simple story of an animal in a market infected by a bat that then infected several human beings no longer looks credible.

A study published in early May by scientists at the Broad Institute in Cambridge, Mass., and at the University of British Columbia has uncovered an unusual feature of the virus’s recent development: It has evolved too slowly. The genomes of viruses sampled from cases during the SARS epidemic of 2002-2003 showed rapid evolutionary change during the early months of the epidemic, as the virus adapted to its new host, followed by much slower change later. By contrast, samples taken from recent cases of the new coronavirus, SARS-CoV-2, have comparatively few genetic substitutions compared with an early case from December.

The authors, Shing Hei Zhan, Benjamin Deverman and Yujia Alina Chan, write: “We were surprised to find that SARS-CoV-2 exhibits low genetic diversity in contrast to SARS-CoV, which harbored considerable genetic diversity in its early-to-mid epidemic phase.” This implies, they argue, that “by the time SARS-CoV-2 was first detected in late 2019, it was already pre-adapted to human transmission to an extent similar to late epidemic SARS-CoV.”… That leaves little time for evolutionary adaptation, so the months during which the virus fine-tuned its ability to infect human beings were presumably before this and somewhere other than the market in Wuhan…

Nikolai Petrovksy and colleagues at Flinders University in Australia have found that SARS-CoV-2 has a higher affinity for human receptors than for any other animal species they tested, including pangolins and horseshoe bats. He suggests that this could have happened if the virus was being cultured in human cells, adding that “We can’t exclude the possibility that this came from a laboratory experiment.”

Petrovsky came to this conclusion based on theoretical calculations of binding energies between the SARS-CoV-2 receptor binding domain (RBD) and angiotensin converting enzyme (ACE2), the receptor the virus uses to enter host cells:

https://arxiv.org/pdf/2005.06199.pdf

However, he doesn’t cite a study of actual binding affinities determined experimentally that comes to a very different conclusion:

https://www.nature.com/articles/s41423-020-0400-4#Fig4

The authors, using a recombinant RBD protein from SARS-CoV-2, reported that affinity for bat ACE2 was comparable to that for human, and most strikingly, the affinity for bat ACE2 was higher than the affinity for SARS-CoV, the 2003 virus, for human ACE2. Also, another study of binding energies came to the conclusion that SARS-CoV-2 could bind with reasonable affinity to a wide variety of non-human ACE2 sources, though they didn’t actually incorporate these sources in their models. This latter study also noted that receptors other than ACE2 are likely to be important in the viral infection:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221370/

Finally, even Petrovsky’s data show that the binding energy for the bat virus is comparable to that of several other species which have been shown to be capable of infection by SARS-CoV-2, including cats, which exhibit high infectivity and the characteristic lung disease. So I don’t find his arguments that SARS-CoV-2 could not have originated in bats convincing.

I'll just add that this is the nub of the argument Baltimore and I had earlier. He believes that SARS-CoV-2, or a virus very similar, could not have directly infected humans from bats, based largely on the supposed inability of the RBD to bind to ACE2. I don't regard this question as settled.

But in any case, Petrovsky’s suggestion that the virus could have been designed in a lab by passing it through cell culture is pretty far out. The Nature Med paper that was discussed in this thread earlier, which concluded the virus could not have been intentionally designed, did consider the cell culture scenario as a possibility that could have led to a lab accident releasing the virus to the local population. However, they provided several reasons against it, including that it would be very unlikely to have resulted in the polybasic cleavage site that is a key to viral entry to cells. And to this can be added that if a researcher wanted to design a highly infectious virus, direct genetic engineering would seem to be the more certain way to go, and as the Nature Med paper discussed, the structure of SARS-CoV-3 doesn’t seem to be consistent with that.

So what did happen? At present, the evidence is pointing tentatively to a chain of person-to-person infections occurring somewhere outside a city before somebody brought the virus to Wuhan, where the market acted as an amplifier. The first case could have been a rural farmer or possibly a bat researcher collecting samples for virologists. Or it is possible that another animal was involved in some way, with the virus bouncing between a farmer and his animals, or a wildlife smuggler and his poor pangolins.

Let me provide some more details for this scenario. As noted by the Nature Med paper, the RBD for a pangolin virus is much more similar to that for SARS-CoV-2 than the RBD for bats. The problem is that the rest of the pangolin virus has less sequence similarity. This leads Petrovsky, and some other scientists, to doubt that pangolins were the intermediate host that directly infected humans. Another possibility is that SARS-CoV-2 could have resulted from recombination between the bat virus—which has a very high sequence homology with SARS-CoV-2 outside of RBD--and the pangolin virus. This is possible, but would be rare. An infected bat or pangolin would have to become infected by a second virus, and Petrovsky provides some reasons why he thinks this is unlikely. However, if it did occur, the recombined virus might have jumped to humans from either bats or pangolins. The polybasic cleavage site might have evolved either in one of these animals, or possibly, in humans.

The only way to settle this debate definitively will be to demonstrate the existence of SARS-CoV-2, or a virus far closer to it in sequence than anything else yet reported, in some animal species. There could be such a virus in a bat, or a pangolin, or possibly some other species, but it could be a long time, if ever, that it’s found.
 
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If Beryl has symptoms she shouldn't be out anyway. If she's used to wearing a mask, doesn't re-use contaminated ones and leaves it in place while she is out and about sure, it'll likely help. If it annoys her and makes her touch her face more, but she thinks she's not going to infect anyone because "hey, I'm wearing a mask", then it could make it worse.


You might, many don't.
She's asymptomatic or thinks that her allergies are acting up.

Gross, who reuses masks? EDIT: cloth face coverings that we wear to the store.

Wearing a mask makes me not touch my face because its a glaring reminder that I'm not supposed to.

EDIT 2: Let me take it back to the base for me: I will wear a mask in public to protect others just in case I am asymptomatic.
 
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References?

Edit: I should also point out that you've jumped midway into an exchange and the later part of your post is really what I've been getting at.

Then I really misunderstood.



I know, all my sources are German. The first is an overview that relies more on Christian Drosten, the second more on Streeck, two virologists around here that don't seem to love each other.
Like I said, I don't claim knowledge, it's what I read.

(I use washable masks, cook them each evening in a pot for at least 10 minutes.)
 
This head of IC, has said some strange things on RAI (Italy):

Basically, he says that the virus has changed, that the viral loads in new patients are much lower than before. But, it's unclear why he claims that and what proof he has.

here is something about it in English as well:


What he says about the viral load actually makes sense, from my understanding, not sure if his conclusion that the virus just gets weaker by itself is true, though.

Due to distancing, masks and so on, (if at all) most people get faced with a lower virus load than at the beginning, and therefor also get a weaker form of the disease.
 
Then how does the virus get on Beryl's face? There seems to be a vicious cycle here. People assume that the virus gets on their face because they constantly touch their face. But what do they touch before that which puts virus on their fingers? Maybe someone touches a contaminated can of beans, but how did the virus get on the can? What was touched before that? It can't be the face, unless you think that Beryl constantly breathes out a cloud of viral particles, some of which move back and land on her face. But if that's the case--Beryl we assume isn't wearing a mask--just by picking up a can and examining it closely enough to see that it's dented, she's more likely to put more virus on it by breathing than by touching it.
Yeah, your lips and tongue are never wet and that never gets on your face which then ends up on your hands...

Pretty sure you can tell if a can is dented without holding it close to your face.
 
She's asymptomatic or thinks that her allergies are acting up.

Gross, who reuses masks? EDIT: cloth face coverings that we wear to the store.

Wearing a mask makes me not touch my face because its a glaring reminder that I'm not supposed to.

EDIT 2: Let me take it back to the base for me: I will wear a mask in public to protect others just in case I am asymptomatic.
Unfortunately lots of people reuse masks, just like lots of people reuse gloves when they shouldn’t.

Do you put the mask on as you enter a store, wear it the whole time, then remove it when you leave/go home and wash it before the next use? If so great, but personal experience tells me the majority of people remove and replace it in between going to different stores, wash them every other day or less and so on. It increases contact with their faces.

Whether that’s an issue hasn’t yet been shown, but it certainly could be.
 
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Then I really misunderstood.



I know, all my sources are German. The first is an overview that relies more on Christian Drosten, the second more on Streeck, two virologists around here that don't seem to love each other.
Like I said, I don't claim knowledge, it's what I read.

(I use washable masks, cook them each evening in a pot for at least 10 minutes.)
Thanks, my German is none existent but I’ll try Google translate.
 
I don't see the problem with masks. Yeah, some people won't use them properly and that reduces their efficiency, but that's why the governments should run ads or whatever instructing people on how they should be used. Even so, it is still a net positive. I've read lots of folks having misgivings about people potentially fiddling with their masks but most of the time what I hear from people actually wearing them is that masks are a great reminder not to touch their faces (this is also my experience).
Why wouldn't you? All you have to do is wash them.
Well, it depends on the mask. If it's a homemade one that's only there to stop your biggest droplets, then sure, rewash it all you want. Actual medical masks however may become less efficient if you wash them. Most of them are meant to be single-use.
 
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personal experience tells me the majority of people remove and replace it in between going to different stores, wash them every other day or less and so on.

on his daily podcast, a German virologist (Alexander Kekulé) said that this is exactly the way he does it himself as well. So I assume it's not a major issue.

(although I guess he doesn't wash but replaces them every now and then).
 
on his daily podcast, a German virologist (Alexander Kekulé) said that this is exactly the way he does it himself as well. So I assume it's not a major issue.

(although I guess he doesn't wash but replaces them every now and then).
If you know what you are doing, remove them by the straps, sanitize your hands after handling it (both taking it off and putting it on) then it’s probably fine. It’s the grabbing of the mask itself, moving it from chin to face, taking it off and shoving it in a pocket then putting it on and not cleaning hand so that I see happenings regularly that I’d question.

If we seen lots of threads on social media about people reusing and washing single use masks.

It’s all a balance of risks, I just don’t think it’s as easy as saying wear masks if you don’t teach people to use them properly (and address some other issues we can’t discuss here).
 
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More on children being harmed by covid-measures (much, much more than from covid itself):
(Guardian live report)

Child protection experts say that Covid-19 school closures have exposed children around the world to human rights abuses such as forced genital mutilation, early marriage and sexual violence, Harriet Grant writes.

Globally, the World Bank estimates that 1.6 billion children were locked out of education by Covid-19. As schools in England and around the world prepare to reopen this week, NGOs warn that millions of the world’s most vulnerable children may never return to the classroom, and say that after decades fighting for girls’ education the pandemic could cause gender equality in education to be set back decades.

In Tanzania, girls sent home from boarding schools where they were being protected from FGM have already been cut. In the Sahel region, where early marriage is widespread, Unicef worries that many girls will never return to school.

The Dutch charity Terre des Hommes runs a safe house for girls in Tanzania, protecting them from FGM.

The community has taken advantage of this situation of Covid-19 and where children are now back at home they are cutting their girls. They know it is against the law but they are not afraid. We had one mother who was jailed for a year after carrying out FGM but for her she is happy. She is locked up but her girl is cut.
Many girls have been cut, including girls we had managed to keep safe through the cutting season, which began in October last year. Some girls escaped and they ran to our FGM centre; we had several girls just turn up. For these children, school is a safe place.
 
More on the origin of SARS-CoV-2:

I'll just add that this is the nub of the argument Baltimore and I had earlier. He believes that SARS-CoV-2, or a virus very similar, could not have directly infected humans from bats, based largely on the supposed inability of the RBD to bind to ACE2. I don't regard this question as settled.

But in any case, Petrovsky’s suggestion that the virus could have been designed in a lab by passing it through cell culture is pretty far out. The Nature Med paper that was discussed in this thread earlier, which concluded the virus could not have been intentionally designed, did consider the cell culture scenario as a possibility that could have led to a lab accident releasing the virus to the local population. However, they provided several reasons against it, including that it would be very unlikely to have resulted in the polybasic cleavage site that is a key to viral entry to cells. And to this can be added that if a researcher wanted to design a highly infectious virus, direct genetic engineering would seem to be the more certain way to go, and as the Nature Med paper discussed, the structure of SARS-CoV-3 doesn’t seem to be consistent with that.

Let me provide some more details for this scenario. As noted by the Nature Med paper, the RBD for a pangolin virus is much more similar to that for SARS-CoV-2 than the RBD for bats. The problem is that the rest of the pangolin virus has less sequence similarity. This leads Petrovsky, and some other scientists, to doubt that pangolins were the intermediate host that directly infected humans. Another possibility is that SARS-CoV-2 could have resulted from recombination between the bat virus—which has a very high sequence homology with SARS-CoV-2 outside of RBD--and the pangolin virus. This is possible, but would be rare. An infected bat or pangolin would have to become infected by a second virus, and Petrovsky provides some reasons why he thinks this is unlikely. However, if it did occur, the recombined virus might have jumped to humans from either bats or pangolins. The polybasic cleavage site might have evolved either in one of these animals, or possibly, in humans.

The only way to settle this debate definitively will be to demonstrate the existence of SARS-CoV-2, or a virus far closer to it in sequence than anything else yet reported, in some animal species. There could be such a virus in a bat, or a pangolin, or possibly some other species, but it could be a long time, if ever, that it’s found.
I didn't post the article, but last week there was pretty interesting news that the market was likely not the entry point into humans, but more likely an early super-spreader site like the choir practice in Washington, or the call center in South Korea, or the restaurant in China, or the Diamond princess. It might've been that WSJ article, I can't remember. I don't think Petrovsky's claim is that different from mine. Nothing can exclude that it came from a laboratory, I just don't think it is the most likely reason. I don't think anybody believed that SARs came from civets until it was demonstrated by the researchers in Wuhan. And in my experience, culturing viruses in tissue cells does not generally increase virulence. Passaging viruses in tissue culture generally leads to attenuation because it fosters mutations without any selective pressure from the immune system. HEK cells and the like often have major deficiencies in innate signaling pathways, which really helps you get high titer viral stocks. The analogy is letting the Patriots prepare for the season by scrimmaging Holy Cross. The phenomenon is true of bacteria as well. Lab adapted strains of pathogens are used for research purposes frequently, but there are valid questions about how well they emulate the actual pathogens. I do really like Ridley's Red Queen book. I based one of my lectures off of it.

I don't think there is much more to add about the masks. I believe that they can be effective, but that may not be always evident in practice. Some of that is unintentional, but there are quite a few who take it off once they enter the train, because they view it as a rule that can be skirted because they are not sick. I wish it was made more clear that you can transmit the virus before symptoms. One hint at potential effectiveness is that the hospitalizations peaked in MD at the end of April, about two weeks after the institution of mandatory mask wearing in all workplaces across the state. Yes, correlation vs causation.... and there are other variables...but it was the only policy change made in that time frame.

https://coronavirus.maryland.gov/
 
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Unfortunately lots of people reuse masks, just like lots of people reuse gloves when they shouldn’t.

Do you put the mask on as you enter a store, wear it the whole time, then remove it when you leave/go home and wash it before the next use? If so great, but personal experience tells me the majority of people remove and replace it in between going to different stores, wash them every other day or less and so on. It increases contact with their faces.

Whether that’s an issue hasn’t yet been shown, but it certainly could be.
Either I've been giving people more credit than they deserve, or you are giving them less.
I put the mask on in my PU, don't touch it while I'm wearing it, sanitize my hands, remove the mask by the straps, fold it so the inside is out*, put it directly in the washing machine with the other clothing that I wore, and wash it.

*my snot out, just in case it has others' droplets on the outside

All of those steps are to reduce my chances of getting sick, but...get ready for the broken record...I'm wearing the mask for others. I'm also really careful about physical spacing so that I reduce the risk of getting others droplets and giving them mine.

Get ready for a big BUT: There is a thought in my head that if there are droplets in the air when I walk around a corner where someone without a mask just sneezed, my mask will at least reduce the viral load. So I guess, secondarily, I am wearing it to protect me from a big viral blast.
 
Why wouldn't you? All you have to do is wash them.

Last 14 days:

Cases increasing: CA, VA, NC, TN, AZ, WI, MS, AL, SC, UT, AR, WV, VM, AK

Cases level: TX, FL, MD, GA, LA, OH, IN, CO, MN, WA, IA, NE, MO, NV, SD, ID, ME, WY, HI

Cases decreasing: NY, NJ, IL, MA, PA, MI, CT,RI, KY, KS, DE, DC, NM, OK, NH, OR, ND

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
KB typed about people reusing dirty masks so I was asking who reuses dirty mask. I wash my cotton ones after every use.

All of the state abbreviations typed together like that made my eyes bug out! o_O
 
Yeah, your lips and tongue are never wet and that never gets on your face which then ends up on your hands...

Pretty sure you can tell if a can is dented without holding it close to your face.
I think that the viral load in the saliva on your lips is really small compared to the load emitted when you cough or sneeze.

If KB sneezes into his hand (he thinks its just his allergies acting up, but is asymptomatic and just emitted C19 droplets in his hand and sprayed around), picks up the can, decides not to get that flavor, puts the can back, and moves on, then the next person who touches that can probably just grabbed a pretty heavy load of C19. Obviously their behavior dictates what happens after that, but KB has increased their risk.

That scenario is less likely to infect someone than walking through a cloud of droplets loaded with C19 right?
 

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Sometimes it is easy to forget what a cluster**** the US response to coronavirus has been compared to other places in the world. It is just crazy. A 'good' day here is still over 500 people dying

According to these numbers one could argue that the US has done quite well compared to many countries.

CountryConfirmedDeathsCase-FatalityDeaths/100k pop.
US1,790,172104,3815.8%31.90
United Kingdom276,15638,57114.0%58.01
Italy232,99733,41514.3%55.29
Brazil514,84929,3145.7%13.99
France189,00928,80515.2%43.00
Spain239,47927,12711.3%58.06
Mexico90,6649,93011.0%7.87
Belgium58,3819,46716.2%82.88
Germany183,4108,5404.7%10.30
 
Sometimes it is easy to forget what a cluster**** the US response to coronavirus has been compared to other places in the world. It is just crazy. A 'good' day here is still over 500 people dying.

View: https://twitter.com/tackettdc/status/1267484366172835841
Spain changed the way it reports new cases and deaths a week ago and now basically the daily data is useless. Maybe the system will catch up eventually, but as of right now you can't trust those figures.