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Practical coronavirus advice from prominent pathologist

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I’m using the excuse that college sports post-seasons are being affected by declining attendance to post this here. Dr. Robb was one of the first researchers on coronaviruses and write this email to his friends and family. The email went viral from there and I got it. I hope you find it useful. 
 

 

 

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.
    1. Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! 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.
    2. 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 masksand 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 (edited: animal)-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.

 

Good luck to all of us!

James Robb, MD FCAP

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38 minutes ago, wrestlingnerd said:

I’m using the excuse that college sports post-seasons are being affected by declining attendance to post this here. Dr. Robb was one of the first researchers on coronaviruses and write this email to his friends and family. The email went viral from there and I got it. I hope you find it useful. 
 

 

 

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.
    1. Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! 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.
    2. 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 masksand 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 (edited: animal)-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.

 

Good luck to all of us!

James Robb, MD FCAP

Interesting because most of the medical advise says no to masks unless you are sick and then they help you keep from infecting others.  The mask stays moist collects virus etc on it thus right there to breath in.  Big thing is wash your hands like a surgeon, most dont know how or do it often enough.  Also saying new data showing 60+ yr old are the at risk group, young appear to recover perhaps better than regular flu.  Course being healthy is important.

Edited by ionel

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BTW, what is the relationship with coronavirus and toilet paper?

My daughter came home with two 30 packs saying they were running out at the store she works at.

I can understand the hand sanitizer and Clorex wipes, but toilet paper ?? Don't get the association.  

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4 minutes ago, ionel said:

Interesting because most of the medical advise says no to masks unless you are sick and then they help you keep from infecting others.  The mask stays moist collects virus etc on it thus right there to breath in.  Big thing is wash your hands like a surgeon, most dont no how or do it often enough.  Also saying new data showing 60+ yr old are the at risk group, young appear to recover perhaps better than regular flu.  Course being healthy is important.

I believe the author was advising the use of masks in order to keep you from touching your nose/mouth. Similarly, I've had discussions with Costco employees who wear nitrile gloves to remind them not to touch their face - not because it blocks contracting the virus through the hands. And exactly as you say in your post, the author also goes on to mention that the mask won't protect you from a sneeze in your face. Since the virus isn't airborne, it otherwise wouldn't 'collect virus' on the mask. 

I agree with you. We seem to be getting a lot of conflicting information. Which, in this day and age, is inexcusable. Our federal government is doing a very poor job of disseminating the information that all of us need. I understand the desire for the public not to panic, but that takes a distant second place to having basic information on how to protect ourselves.

The federal government's message that "it'll be fine, it'll work itself out" and "we have the best healthcare in the world" is utter B.S. We deserve much better.

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3 minutes ago, Tommy Payan said:

BTW, what is the relationship with coronavirus and toilet paper?

My daughter came home with two 30 packs saying they were running out at the store she works at.

I can understand the hand sanitizer and Clorex wipes, but toilet paper ?? Don't get the association.  

It is more of a prepper thing.

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7 minutes ago, Tommy Payan said:

BTW, what is the relationship with coronavirus and toilet paper?

My daughter came home with two 30 packs saying they were running out at the store she works at.

I can understand the hand sanitizer and Clorex wipes, but toilet paper ?? Don't get the association.  

It’s a social media thing. Last week there was stuff about a toilet paper shortage in Australia, then it went viral, then there were videos of people fighting in stores over TP (not Tommy Payan), then it became a self-fulfilling rumor.

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FWIW I have two family members who are infectious disease specialists and I also work in China so have had plenty of discussions re protocol.

1) Take hand washing seriously (20-30 seconds...wash palms, top of hands, each finger, and finger nails).  This is the best thing you can do to prevent picking up the virus.  Most people, including health care workers, do not wash their hands sufficiently.  

2) The masks are mainly used to prevent one from touching one's face.  Same idea applies to gloves and safety goggles.  There is some speculation that N95 masks may prevent inhalation of corona virus but it's not 100% confirmed, these masks are uncomfortable to wear correctly for long periods of time, and there is a shortage in the US, which is why the CDC is telling ppl not to wear them as ultimately hand washing, and self quarantine if in a high risk group are most effective strategies.

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3 minutes ago, pamela said:

It’s a social media thing. Last week there was stuff about a toilet paper shortage in Australia, then it went viral, then there were videos of people fighting in stores over TP (not Tommy Payan), then it became a self-fulfilling rumor.

OK, got it. I guess I need to run out and stock up on beer and cigarettes....just in case.

BTW, did anybody notice the ad at the bottom of the page for 'N95 Mask Respirators"

 

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4 minutes ago, GreatWhiteNorth said:

I believe the author was advising the use of masks in order to keep you from touching your nose/mouth. Similarly, I've had discussions with Costco employees who wear nitrile gloves to remind them not to touch their face - not because it blocks contracting the virus through the hands. And exactly as you say in your post, the author also goes on to mention that the mask won't protect you from a sneeze in your face. Since the virus isn't airborne, it otherwise wouldn't 'collect virus' on the mask. 

I agree with you. We seem to be getting a lot of conflicting information. Which, in this day and age, is inexcusable. Our federal government is doing a very poor job of disseminating the information that all of us need. I understand the desire for the public not to panic, but that takes a distant second place to having basic information on how to protect ourselves.

The federal government's message that "it'll be fine, it'll work itself out" and "we have the best healthcare in the world" is utter B.S. We deserve much better.

Regarding the mask, people will still touch the mask with their hand, touch their eyes etc.  Every expert I've heard, and they specifically talk about it, say no to mask.  Now if you are sick, then wear a mask so your spouse,  others not as likely to get it.

At a restaurant last night went to bathroom first to wash, guy went straight from urinal back to restaurant.  An example if go out to eat, wash you hands before you sit down, after paying bill go wash your hands before you leave.  Maybe go wash your hands after you handle the menu, think about it.

Experts today said current data (could change) covid-19 not fatal to healthy young but regular flu does kill young kids every year.  Covid-19 risk 60+ and existing health especially lung issues.  If everyone followed the simple hand wash etc advice we could save thousands of lives regular flu season.   

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2 minutes ago, Tommy Payan said:

OK, got it. I guess I need to run out and stock up on beer and cigarettes....just in case.

BTW, did anybody notice the ad at the bottom of the page for 'N95 Mask Respirators"

 

My local grocery stores and Target were all out of the big jugs of water (but not the small single serve ones) and mostly out of canned goods over the weekend. I heard Costco got pummeled also. Lots of bare shelves. 

Preppers be preppin’

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29 minutes ago, Tommy Payan said:

BTW, what is the relationship with coronavirus and toilet paper?

My daughter came home with two 30 packs saying they were running out at the store she works at.

I can understand the hand sanitizer and Clorex wipes, but toilet paper ?? Don't get the association.  

People are stocking up on all staples in case they need to reverse quarantine themselves to stay safe. Same behavior as preparing for a hurricane or other natural disaster. 

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Honest question here for anyone in the know. I have read that the coronavirus has 4% mortality rate. 

In 2009 atleast 700 million people got the swine flu or H1 N1. If that had been as high of a mortality rate as the corona virus there would have been 28 millIon, likely more, dead world wide. 

Stats can be deceiving, so what is something that maybe I am missing when viewing these numbers?

Edited by russelscout

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