Coronavirus

[AlanSubie4Life]

I am a physician,

That is disturbing, I suppose. Since my eyes are clearly connected directly to my nose - I can blow air out of my eyes no problem - I just did it. But anyway, you do you.

As I have always said - plenty of value to masks. Even better if all the sick people wear them too.

 

[JRP3]

Stop playing physician.

My eyeballs do not breathe. Do yours ?

Right Between Your Eyes

 

[SageBrush]

Yes. Seriously. Literally I can blow air out of my eyes if I pinch my nose shut.

You don’t have to be a physician, man.

Have you ever wondered why your nose gets stuffy when you cry?

Look up nasolacrimal duct. This is not that hard.

Just STOP.

That duct lubricates the eyes. The point is that eyes do not have a negative pressure front like the nose and mouth.
It is more than theoretically true that the eyes can be a route of infection which is why you have to learn to keep your hands clean. But in terms of avoiding infection in public spaces MASKS are the key.

You are now on ignore for the duration.

 

[AlanSubie4Life]

Right Between Your Eyes

Thank you. I was beginning to think I was crazy. If I can blow air out of my eyeballs, pretty sure a little virus can make its way from my eyes to my nose.

 

[AlanSubie4Life]

That duct lubricates the eyes. The point is that eyes do not have a negative pressure front like the nose and mouth.

Thanks. But again, to answer your question, my eyeballs can breathe (out). Breathing in seems a bit harder, but I think I was able to get a little bit of airflow.

Can you then explain why my nose gets stuffy and wet when I cry? Isn’t that drainage from the eyes, or are there tear ducts which are hermetically isolated from the eyes that drain directly into the nose and are completely isolated from the eyes? Trying to work all of this out...

Also, why do all the medical professionals wear goggles?

I see your point about the negative pressure front - you gather a lot of air and droplets through your nose. So it is not just a surface area thing. But it seems that I am right that if a droplet lands on your eye, you are in trouble! It is just less likely than inhaling a droplet (so what I said about surface area above can be disregarded).

So wearing goggles plus mask seems advisable! At least goggles are plentiful.

But in terms of getting avoiding infection in public spaces MASKS are the key.

I never said masks were not helpful. But there are not enough masks, so this is an academic point - it is not something we can do today. And they should go to the healthcare workers and the ill and at-risk people first. When they are super cheap, I will buy and use them.

 

[VValleyEV]

Whoa, cool. Who is this like minded comrad

I fear for our future with his global health crisis, and don’t want us to lose our sense of humor along the way.

That amusing post came from the Facebook account of Neelofur Ahmad, a physician practicing in Houston, TX. I had not heard of her, have since started following.

 

[dfwatt]

Just STOP.

That duct lubricates the eyes. The point is that eyes do not have a negative pressure front like the nose and mouth.
It is more than theoretically true that the eyes can be a route of infection which is why you have to learn to keep your hands clean. But in terms of getting avoiding infection in public spaces MASKS are the key.

You are now on ignore for the duration.

Could you please just take a chill pill!! Seriously. Everybody who is concerned about this disease is spreading FUD? Really?

 

[SageBrush]

It will also be interesting to see whether various forms of interferon

Cytokine storm, at your service. Please pay your bill first.

I know that the Chinese have been very aggressive in trying out (throwing the kitchen sink, actually) therapeutics in their severe patients. I understand the motivation but I won't be at all surprised if post-hoc analysis shows immuno-stimulatory treatments to be not just ineffective but worse.

 

[dhanson865]

Of course the usual complaint of the use of "mortality rate %" applies but the comparison is still interesting even if you don't agree with the terminology.

from reddit /r/dataisbeautiful/comments/fj0eef/oc_coronavirus_death_rate_by_age_italy_vs_china/

 

[KSilver2000]

In my area schools are closed yet I have seen kids out and around town hanging out. WTF are their parents thinking? My 14 year old daughter is home. In the house, not leaving.

If you smarter people here can tweet and Facebook this article please:
Pediatrician: No Coronavirus Break Playdates. Here's Why.

There was a guy that the Reno newspaper in NV interviewed in Las Vegas as part of an article about how Las Vegas is still kicking and full of people. This guy must be an outstanding role model to his kid.

"I think it's stupid," Harshman said of coronavirus fallout. "All of it."
"You know how much money Las Vegas is losing because people are freaking out?...The whole country's losing money," Harshman said. "If we're not tough enough to deal with a bug, society has gotten to be a bunch of pansies."

What a macho.

 

[KSilver2000]

Here’s a link to an ophthalmology academy FYI about COVID-19: Alert: Important coronavirus updates for ophthalmologists

 

[Krugerrand]

Have prepped weeks ago, the oddest thing in my local stores is that along with toilet paper ...Ice Cream has gone also...must be a correlation needing all that toilet paper for the ice cream

I reported that ice cream phenomenon last week. Stress eating.

 

[pz1975]

As an ophthalmologist, I feel I should step in here and provide some info. Yes, your eyes connect to your lungs. Your tears drain through the small openings (each is called a punctum, plural puncta) in the inner aspect of your upper and lower eyelids (you can see them in the mirror) through the canaliculi, into the nasolacrimal ducts and then into the back of your nose (which then of course connects down to your lungs). The diagram above is accurate.

If the virus gets onto the surface of your eyes, you can get conjunctivitis (red eyes with swollen eyelids and discharge). A study in the NEJM found 0.8% of COVID19 patients had conjunctivitis.
https://www.nejm.org/doi/pdf/10.1056/NEJMoa2002032

The AAO (American Academy of Ophthalmology) is recommending eye protection for health care workers due to the risk of conjunctivitis and possible extension of the disease from the eyes to the lungs. These masks have plastic shields that block direct exposure to droplets but do not seal around the eyes in any way.

It would be unlikely (but still possible), however, to contract the disease and transmit to your lungs solely via the eyes. The size of the puncta vs the size of your mouth and nostrils is relatively extremely tiny. If you get the Coronavirus in your eyes and through the puncta, etc., you are probably almost certainly getting at least as much or more in into your airways even with a mask on when directly exposed to an infected patient. I don’t think it’s worth it for non-medical personnel to wear masks with eye shields because the shields don’t block particles floating in the air (they aren’t sealed), only direct exposure if someone coughs/sneezes/breathes very close to you, and even then likely some droplets will go around the shield anyways eventually.

Social distancing and regular masks are for sure beneficial of course.

 

[SageBrush]

I wish I could get away with taping a 2-meter diameter circle on the floor around my desk with a "do not chat within this space" sign in it.

Have you tried salt ?

 

[AlanSubie4Life]

As an ophthalmologist, I feel I should step in here and provide some info

Thank you for the informative response. More information than I have been able to find anywhere else.

Somewhat of an irrelevant side question:
So if you had conjunctivitis due to the virus, but did not get the lung infection (I suppose this is unlikely?), you are saying it is possible the virus would never establish itself in your lungs?

Would you develop antibodies to the virus in this case and have immunity even though you never got the lung infection?

 

[dfwatt]

Of course the usual complaint of the use of "mortality rate %" applies but the comparison is still interesting even if you don't agree with the terminology.

from reddit /r/dataisbeautiful/comments/fj0eef/oc_coronavirus_death_rate_by_age_italy_vs_china/

Yes it's pretty clear that there's something about aging that directly compromises our response to the pathogen. Although it's tempting to see this straightforwardly as an extension of immunosenescence, I do not think that explains the similar causes of death across the elderly groups. In other words even though 60 year olds die less frequently they are dying from the same kind of process that's killing 80 year olds. This suggests that it's not immuno senescence per se (and most 60 year olds are not immunosenescent by virtually any definition although they do have fewer so-called naive T helper cells) but perhaps some way in which immune responses are exaggerated, self-destructive, and result in sepsis, respiratory failure, and multiple organ system failure, which most believe is an extension of the system getting flooded by various pro-inflammatory cytokines. An interesting speculation discussed earlier is the partial evidence-base for the idea that this is because older immune systems have a partial recognition of the coronavirus while younger more naive immune systems may not recognize it and thus may do less damage to various tissues particularly in the lung. See prior posts on this here

 

[Causalien]

There seems to be a narrative change in the health community. They are leaning towards not testing mild cases as the treatment is the same as flu. Self isolate and wait 14 days. Even if they have enough testing capacity.

I think they are missing out another argument. By testing mild cases, you allow the person to know that they are now immune or resistant. Immune ppl can go back to reckless spending which is important for the economy.

 

[ohmman]

reckless spending

That Model Y has been staring me down..

 

[bkp_duke]

Meanwhile, where America's Day Begins... Zero case so far (fingers crossed) thanks to smart leadership from a former nurse, now governor. And this is at a place that hosts tens of thousands of tourists from Asia each month.

Adelup: Six Guam COVID-19 tests are negative

Talk about cherry picking your data for political motives. Guam is about as geographically isolated as anywhere on earth. It also has practically no economy outside of its dependence on the US Military.

Of course isolation in this case could keep the virus at bay.

 

[SageBrush]

Yes it's pretty clear that there's something about aging that directly compromises our response to the pathogen. Although it's tempting to see this straightforwardly as an extension of immunosenescence, I do not think that explains the similar causes of death across the elderly groups. In other words even though 60 year olds die less frequently they are dying from the same kind of process that's killing 80 year olds. This suggests that it's not immuno senescence per se that's the problem but perhaps some way in which immune responses are exaggerated, self-destructive, and result in sepsis, respiratory failure, and multiple organ system failure, which most believe is an extension of the system getting flooded by various pro-inflammatory cytokines. An interesting speculation discussed earlier is the partial evidence-base for the idea that this is because older immune systems have a partial recognition of the coronavirus while younger more naive immune systems may not recognize it and thus may do less damage to various tissues particularly in the lung. See my prior post here

First correct for co-morbidities as people get older. If any excess morbidity or mortality is left over then look for contributory mechanisms.

How do you hypothesize immunosenscense and exaggerated immune response in the same sentence ?