Social Distancing to reduce Viral Load

Has the concept of VIRAL LOAD been discussed yet?

It seems that the initial dose of the virus you are exposed to is a vital factor in how well your immune system copes with it.

This was recently shared by Dhushyanthan Surendra Kumar, Assitant Medical Director at Thames Valley Air Ambulance, Director of Clinical audit at TARN - Trauma Audit and Research Network and Flight Doctor at Thames Valley Air Ambulance

Why do we need to shut places where people group?

Remember this: VIRAL LOAD

There will be a lot about this. Why is it important?

With this virus, the amount of virus in your blood at first infection directly relates to the severity of the illness you will suffer. This isn’t unusual - HIV management is all about reducing viral load to keep people alive longer. BUT it’s very important in COVID-19.

So if you are in, say, a pub or religious building or entertainment venue with 200 people and a large number don’t have symptoms but are shedding, you are breathing in lots of droplets per minute and absorbing a high load of the virus. In a crowded space. They become ill over the next 48 hours. You then three days later wonder why you can’t breathe and end up in hospital. You’d decided because you were young and healthy it wasn’t going to be a problem. Wrong.

Fortunately but unfortunately because the elderly are isolating quite well, the initial UK data suggests that all age groups above 20 are almost equally represented in ITUs in England. Most of the cases are in London but the wave is moving outwards.

This means that being under 60 and fit and well doesn’t seem to be as protective as we thought. Why? Viral load.

This may be skewed simply by the fact that too many Londoners didn’t do as asked and congregated in large groups in confined spaces and got a large initial viral load. They then went home and infected their wider families. Which is why, as London is overwhelmed, we need to shut everything down to save the rest of the UK. We are a week at most behind London.

Our sympathies go out to the families affected in London and the critical care teams battling right now to save as many as they can.

If I sit with one person and catch this virus, I get a small viral load. My immune system will start to fight it and by the time the virus starts replicating, I’m ready to kill it.

No medicines will help this process meaningfully hence there is no “cure” for this virus. All we can do is support you with a ventilator and hope your immune system can catch up fast enough.

If I sit in the same room with six people, all shedding I get six times the initial dose. The rise in viral load is faster than my immune system can cope with and it is overrun. I then become critically ill and need me (or someone of my specialty) to fix it instead of just being at home and being ok in the end.

THIS BIT IS IMPORTANT:

If you are a large family group, remember that by being ill and in the same room, you will make each other ill or “more ill”. If you get sick, isolate just yourself to one room and stay there. Don’t all sit in one room coughing. You will increase the viral load for all of you, reducing your survival rate.

A family of six people may produce double the droplets of a family of three in the same space. Maths is important.

If one of you is symptomatic, assume you are all shedding and make sure you keep some space.

Parents are getting it from their kids because no one is going to stop comforting their child (nor should they) so the parent gets a big hit as well as the child. I don’t think that can be helped.

REMEMBER: THINK ABOUT VIRAL LOAD

It could save your life or your child’s.

Coventry and Warwickshire - it’s up to you now. We are preparing for the worst but we are hoping for the best from you. Please help us to help you. Stay home and take this seriously now before we need the army on the streets to remind you. Yes I’m serious.

i think, the articles misses one things: where does the infection start?

normally it starts in the throat and then drips down into the lungs. this takes a few days. within these days the body starts to build up immunity/resitance.

if the virus load is high the infection can start directly in the lungs. this is (i think) one of the causes why some young and healthy people get very sick very quickly.

germany has put huge restristions on social life.

my thoughs on viral load: i think, normal flue germs are nearly everywhere. but we don t get the flue everytime it comes around. so there MUST be some resitance, at least against small doses/virus loads.

do you remember the "bodies police force" from: Once Upon a Time... Life

Something I think everyone should do is wear a mask.  I'm talking fabric masks, not N95 masks.  The Czech Republic has convinced everybody to wear a mask at all times when not in their homes, and it seems to be helping.

My daughter and I have started to make masks from 100% cotton broadcloth (from the quilting section of Joann's Fabrics) using these patterns:

https://www.craftpassion.com/face-mask-sewing-pattern/#face-mask-pattern

Where does this persons theory come from? Where has it been tested? So much about this disease is stated as fact, so little science seems to be being conducted about it.

This page from sciencemediacentre.org is interesting too, and covers similar ground.

expert reaction to questions about COVID-19 and viral load

It consists of comments about viral load and covid-19 made by several experts, including Dr Michael Skinner, Reader in Virology, Imperial College London, Prof Wendy Barclay, Action Medical Research Chair Virology, and Head of Department of Infectious Disease, Imperial College London, Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, Dr Edward Parker, Research Fellow in Systems Biology at the London School of Hygiene and Tropical Medicine, and Prof Richard Tedder, Visiting Professor in Medical Virology, Imperial College London.

My mask is cool!!  Don't you want a cool mask like this??  I got the plans here, there are multiple sizes, which is great: https://www.craftpassion.com/face-mask-sewing-pattern/

From the awesome site xkcd.com:

I wrote this a few days ago (Tuesday, May 26, 2020), for another site.  I preface the posting of it with this:  I am not judging, just sharing facts; nor am I picking on the USA or the rest of Canada, they were just convenient, easy to acquire statistics.

So, you think Covid 19 is "just like the flu"? Here are a few, simple, indisputable, facts.

In the USA: "CDC estimates that the burden of illness during the 2018–2019 season included an estimated 490,600 hospitalizations, and 34,200 deaths from INFLUENZA." https://www.cdc.gov/flu/about/burden/2018-2019.html  Considering the USA is now at 100,000 deaths, in just a few months, and that number is rapidly climbing....THIS IS NOT THE SAME AS THE FLU!!!  

We call this a NOVEL CORONAVIRUS as it is completely foreign to our DNA.  Our bodies have no experience, no memory, no attack plan for this virus; it is not a "mutation" of a known virus like the flu or a cold, which our bodies have a least some historical information on, and some basic plan of attack to deal with the virus.  It is new, unknown, and highly transmissible.  That means our bodies literally must start from scratch to figure out a defense, mount that defense, and start to fight this virus.  We have no inherent blueprint or map to follow, our bodies are, literally defenseless, until each body learns and figures out a defense strategy.  In the interim, all we can do is provide supportive therapies - to help the body cope while it fights - this is why there is no medicine, no treatment protocols, no magic bullets.  It is new, it is novel, it is unprecedented, and it can be deadly to those whose bodies are not strong enough to weather the virus while figuring out how to vanquish it.

Monday, North Carolina had over 1,000 new cases, in a single day; their population (https://www.census.gov/quickfacts/NC) of 10.1 million is approximately double that of BC, we have had a total of just over 2,500, total cases, to date (in 3 months), with a population of 5.3 million (https://www150.statcan.gc.ca/t1/tbl1/en/tv.action...).  On average, we now experience 0-12 new cases daily; we now have less than 10 in the ICU, and never exceeded 100.

BC has a very large (2nd or 3rd busiest in Canada) International Airport, and a very large Metropolitan area, home to almost half the population in the province. All you have to do is look how much worse it is back east; Ontario has roughly triple the population of BC (https://www150.statcan.gc.ca/t1/tbl1/en/tv.action...), with TEN TIMES the cases in BC at 26,191; Quebec (just over 8 million) has less than double BC's population - they have ALMOST TWENTY TIMES as many cases than BC, at 49,598.  This is what happens when governments and/or people delay or do not enforce social distancing etc., for even a few days/weeks...the numbers explode exponentially.

I am beyond grateful, that our BC government, in particular, took early steps, at appropriate times; including the very strong recommendations (no "laws" were enacted, except for those returning from away being required to self quarantine and businesses that provide personal care who were ordered to change or shut down) to stay home, institute social distancing, proper hygiene (and now mask wearing) - that thankfully was/is followed by the majority of the population here - we have not only slowed the curve, we have damn near halted it, not a single new case on Tuesday, vs over 1,000 in North Carolina!  

BC has a population of just over five million, we are not special, we just took early preventative measures, continued steadfastly with appropriate closures, increased hygiene, and social distancing.  Now, as we are re-opening, the recommendation of wearing non-medical masks has been added IN ADDITION to continued social distancing, hand washing etc.  We are still encouraged to maintain as much of a "social bubble" as possible - keeping contacts with others low; keeping group gatherings to a minimum, even things like drive in theaters are limited to 50 cars (controlling potential spread via washrooms).  This is the key to SLOWING the spread, this allows medical facilities to keep up with demand, prevents burnout in front line workers, keeps as many people healthy, for as long as possible, while we figure out how best to handle this virus.

Please, please, please, do not think this is uncontrollable, or that there is nothing that can be done.  This lies in each and everyone of our hands, wash them well, wash them often, practice social distancing, keep your "social bubble" small, and wear a mask.