COVID-19 is, in many ways, proving to be a disease of uncertainty. According to a new study from Italy, some 43 percent of people with the virus have no symptoms. Among those who do develop symptoms, it is common to feel sick in uncomfortable but familiar ways—congestion, fever, aches, and general malaise. Many people start to feel a little bit better. Then, for many, comes a dramatic tipping point. “Some people really fall off the cliff, and we don’t have good predictors of who it’s going to happen to,” Stephen Thomas, the chair of infectious diseases at Upstate University Hospital, told me. Those people will become short of breath, their heart racing and mind detached from reality. They experience organ failure and spend weeks in the ICU, if they survive at all. Meanwhile, many others simply keep feeling better and eventually totally recover. [...] This degree of uncertainty has less to do with the virus itself than how our bodies respond to it. As Murphy puts it, when doctors see this sort of variation in disease severity, “that’s not the virus; that’s the host.” Since the beginning of the pandemic, people around the world have heard the message that older and chronically ill people are most likely to die from COVID-19. But that is far from a complete picture of who is at risk of life-threatening disease. Understanding exactly how and why some people get so sick while others feel almost nothing will be the key to treatment. [...] The people who get the most severely sick from COVID-19 will sometimes be unpredictable, but in many cases, they will not. They will be the same people who get sick from most every other cause. Cytokines like IL-6 can be elevated by a single night of bad sleep. Over the course of a lifetime, the effects of daily and hourly stressors accumulate. Ultimately, people who are unable to take time off of work when sick—or who don’t have a comfortable and quiet home, or who lack access to good food and clean air—are likely to bear the burden of severe disease. [The Atlantic]
"We are running a medical study here in Miami-Dade, we're trying to figure out exactly what is the penetration of COVID-19 here in Miami-Dade. Over last week we did a random sample of about 800 of people in Miami-Dade. And what we found is that 60% of those people tested positive to the antibody which means they had it or they have it now, and they have exhibited absolutely no symptoms in the last 14 days." [Miami-Dade County Mayor Carlos Gimenez | The 11th Hour with Brian Williams]
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prevalence, intensity, and timing of an altered sense of smell or taste in patients with SARS-CoV-2 infections altered sense of smell or taste was reported by 130 patients (64.4%) among these 130 patients 45 (34.6%) also reported blocked nose. Other frequent symptoms were fatigue (68.3%), dry or productive cough (60.4%), and fever (55.5%).
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At least two people who died in early and mid-February had contracted the novel coronavirus, health officials in California said Tuesday, signaling the virus may have spread — and been fatal — in the United States weeks earlier than previously thought.
On Jan. 15, at the international airport south of Seattle, a 35-year-old man returned from a visit to his family in the Wuhan region. He grabbed his luggage and booked a ride-share to his home north of the city. The next day, as he went back to his tech job east of Seattle, he felt the first signs of a cough — not a bad one, not enough to send him home. He attended a group lunch with colleagues that week at a seafood restaurant near his office. As his symptoms got worse, he went grocery shopping near his home. Days later, after the man became the first person in the United States to test positive for the coronavirus, teams from federal, state and local agencies descended to contain the case. Sixty-eight people — the ride-share driver at the airport, the lunchmates at the seafood restaurant, the other patients at the clinic where the man was first seen — were monitored for weeks. To everyone’s relief, none ever tested positive for the virus. But if the story ended there... [...] A genetically similar version of the virus — directly linked to that first case in Washington — was identified across 14 other states, as far away as Connecticut and Maryland. It settled in other parts of the world, in Australia, Mexico, Iceland, Canada, the United Kingdom and Uruguay. It landed in the Pacific, on the Grand Princess cruise ship. The unique signature of the virus that reached America’s shores in Seattle now accounts for a quarter of all U.S. cases made public by genomic sequencers in the United States. [...] Even as the path of the Washington State version of the virus was coursing eastward, new sparks from other strains were landing in New York, in the Midwest and in the South. And then they all began to intermingle. [...] on Feb. 24, a teenager came into a clinic with what looked like the flu. The clinic was in Snohomish County, where the man who had traveled to China lived. [...] Only later did they learn that the teenager had not had the flu, but the coronavirus. [...] The case was consistent with being a direct descendant of the first U.S. case, from Wuhan. [...] The teenager had not been in contact with the man who had traveled to Wuhan, so far as anyone knew. He had fallen ill long after that man was no longer contagious. [...] This could only mean one thing: The virus had not been contained to the traveler from Wuhan and had been spreading for weeks. [NY Times]
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