Coronavirus: Some recovered patients may have reduced lung function | Hacker News Reader

Coronavirus: Some recovered patients may have reduced lung function

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72 pointspseudolus46 comments

It's something I bring up when people around me from my age (late 20s) say they're not worried.

First of all, you can carry it to others who are vulnerable. Obviously bad idea. But second of all, the stats so far talk about "infections" and "deaths". But there's a whole host of things between "life" and "death" that are not stated or that we simply do not know.

A virus doesn't have to kill you to reduce your quality of life.

>> It's something I bring up when people around me from my age (late 20s) say they're not worried.

If they really think that, it's sad. Until it hits you, you really have no idea how your body reacts to it. Plus, this is new, we don't know everything about it.

>there's a whole host of things between "life" and "death" that are not stated or that we simply do not know.

Being a lifelong runner, I agree with you 100%. I'm not panicked or unreasonable about it or anything, but I do protect my body. (So glad they canceled Boston by the way.)

I would encourage people under 60 to consider the very real possibility that certain physical activities that you enjoy may become difficult for you. Some may even become life threatening. Who knows? Hiking or running at certain altitudes, etc. Consider the sense of loss you might feel at not being able to do workouts that seemed a breeze just last year? Or how would you feel if you suddenly found that you need frequent rests to "salsa the night away"?

This virus is likely harmless if you're 15 or under. It's fairly deadly if you're over 60. But if you're 15 to 55, there's a whole lot we don't know right now.

Agree with a lot of what you said, but the Boston marathon isn't cancelled, it's postponed to 9/14.

Yup, I think my chances against the virus would be pretty good but my summertime hiking is in the mountains, always above 7,000', often above 10,000'.

Perfect example of an athletic lifestyle at risk.

As I'm assuming you are over 15, protect your body right now. You won't get another one.

The cytokine storm that honeycombs your lungs (like with SARS) is a doozy.

I'm not in my 20s... but I'm not "old" either. I'm also in one of the at-risk groups (I take an ARB for high blood pressure, which seems to make one more susceptible to corona viruses like the common cold and COVID-19).

Don't spread this virus around. It isn't just about you getting it. It's about your parents. It's about your friends and coworkers who you may not know are especially vulnerable.

We really don't want a COVID-19 season every year.

Why not ask your cardiologist to switch to a calcium channel blocker during the pandemic? Until we have a vaccine for instance ...

It should be noted that this happens to you to some decree any time you get pneumonia.

I was diagnosed with "mild pneumonia" in late 2017 and it was quite the handful to deal with. Pneumonia as a potential complication of COVID-19 scares the bejesus out of me.

First, I faded within a matter of hours. Woke up feeling great and by early afternoon I needed my wife to drive me to urgent care.

Second, it was a solid two weeks before I really felt capable of doing anything. In reality I probably had walking pneumonia because I was able to WFH while taking Dayquil and Ibuprofen but I was zapped at the end of every workday.

Third, it was every bit of two months before I recovered to full capacity. I was a very active and exceptionally fit 34 year old male who was brought to his proverbial knees during this illness.

Fourth, I think I may have an advantage of early detection of catching this disease. I run at high intensity multiple times per week. I will know very quickly if my performance is falling off, I'm not recovering well, exerting more than normal effort etc.

These are the truly frightening threats from this I think. A crippled population from secondary effects we're just about to discover.

While i agree that we should be careful about this, i would say that the phrase "Some patients might have around a drop of 20 to 30% in lung function" is not a sure sign that we should be scared. More data and more time is needed to figure things out.

Of course. But this is only one of many such reports. I've read things about massive increase of cystic fibrosis and damage to testicles in males. Maybe those reports were wonky, I don't know. But the possibility of a real after-effect like that combined with a predicted massive infection rate seems to make the death number to be a trivial problem in comparison.

Imagine what this population would also do to insurance costs if we keep on rejecting a single payer system as well.

imagine what this population would do to the budget and _resources_ of a single payer system.

it's bad news for everyone.

South Korea seems to be doing fine.

you were addressing the costs.

we'll yet see what the costs to South Korea, and Italy, and all the other countries are.

even if single payer is magically wonderful, it doesn't necessarily make a natural disaster like this cheaper to deal with.

>even if single payer is magically wonderful, it doesn't necessarily make a natural disaster like this cheaper to deal with.

But...it does?

Healthcare is more expensive across the board in the US than South Korea. If all the same care was delivered in the US as has and will be in South Korea, it would still be more expensive in the US.

This is like arguing that a hundred of one thing that costs five dollars in South Korea is the same as a 100 of one thing that costs ten dollars in the US.

https://randomcriticalanalysis.com/why-conventional-wisdom-o...

Respectfully, this is just nonsense. Japan has a nationwide fee schedule that’s enforced across the board and they’re a wealthy country, with a lot of people, that consume a lot of healthcare under a single payer system. Still cheaper and with better outcomes.

Outcomes are determined by more than health system inputs alone (indeed, it has little to do with health care in the developed world), and costs have much to do with the intensity of health care. Rich countries spend more because they can, not because they need to.

Is there any published advice on re-using N95 masks? I have a handful from purchasing years ago that I'm curious about the associated risks from re-using.

edit: My use case is entering public space, possibly air travel, where the presence of COVID-19 is unknown. I'm not treating or providing care to any persons who are knowingly infected.

Reusability of Facemasks During an Influenza Pandemic: Facing the Flu (2006): https://www.nap.edu/read/11637/chapter/6#59

* Finding 1: The committee could not identify or find any simple modifications to the manufacturing process that would permit disposable N95 respirators to be reused without increasing the likelihood of infection.

* Finding 2: Any method of decontaminating a disposable N95 filtering facepiece respirator must remove the viral threat, be harmless to the user, and not compromise the integrity of the various elements of the respirator. The committee found no method of decontamination that met all three criteria.

* Finding 3: The committee found no simple modifications to currently existing N95 filtering facepiece respirators that would obviate the need for fit-testing.

* Finding 4: Many versions of reusable (elastomeric) respirators on the market have facepieces that can be cleaned and reused. Some of these are available in full-facepiece versions that also offer eye protection and may prevent conjunctival transmission. These respirators can be reused by single or multiple wearers and, although they are more expensive than the disposable N95 respirators, should be considered as an alternative to filtering facepieces.

What's frustrating with data like that is what it doesn't say: is it OK to keep using a mask?.

Obviously what this is saying is that, once contaminated, a mask can't be cleaned and made safe. But in real use, at least at the infection density we see right now, they're not getting contaminated with use. They're just dirty. Is it safer to keep using the same mask for a week or to use it once then go maskless? We just don't know.

>Is it safer to keep using the same mask for a week or to use it once then go maskless? We just don't know.

This is a better way to phrase my question and more precisely what I'm trying to determine.

tbh it sounds safer to re-use a mask (that may or may not be contaminated) that not use a mask at all especially in a crowded public space.

To put a finer point on it — while reusing an old mask might prevent you from getting Covid19, it might also expose you to a bacteria or fungus that could _also_ lead to a pneumonia or other such lung diseases.

You really don't want to be needing a ventilator for any reason in the next few weeks/months.

My thoughts too. Can’t you use 3 masks and just cycle through them so that you only use each mask every 3 days? The virus itself can’t live on surfaces for long periods of time so if cleaning won’t remove the virus, time will?

That was a 2006 study. Since then, there is a 2015 study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699414/?fbclid...) that shows that masks can be decontaminated with ultraviolet light.

It should be noted that these findings are for disposable N95 respirators.

There are also non-disposable kinds, which are intended for reuse. However, it's not clear for how long they can be safely reused, particularly in the case of this novel coronavirus.

Yes there is. Hit them with UV-C light. According to this paper, N95 masks can be disinfected and reused several times with UVGI light.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699414/?fbclid...

I'm being lazy.

These solutions with UV Light - are they consumer/DIY available? Or special equipment? etc.

Generally consumer available. Google UV-C disinfection. Not sure on the light dosing, as the paper has dose limits before you start to damage the filter media.

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...

You could probably (at your own risk) try just leaving them alone in a paper bag in a well ventilated, heated and not too humid place... For about 10 days... If they're not obviously damaged/spoiled... See CDC guidance in case of mask shortage.

If I'm not mistaken, this study seems to indicate it shouldn't remain active more than 9 days on pretty much most surfaces(source : https://www.journalofhospitalinfection.com/article/S0195-670...)

Not sure if this helps:

https://old.reddit.com/r/Coronavirus/comments/f88efh/is_this...

> But Tsang said the long-term effect on recovered patients, such as whether they would develop pulmonary fibrosis, a condition where lung tissue hardened and the organ could not function properly, had yet to be ascertained.

It sounds like there hasn’t been enough time yet to see if the effects last?

If this is anything like SARS, a lot of these people who recover but have lung damage are going to be dead within the next 3 years. To me the percent chance of any given age/gender dying is a complete red herring, because what you should care about is your chances of getting ARDS, and afaik that's around 20% across the board.

> and afaik that's around 20% across the board.

Incorrect. That’s exactly the risk factor for higher ages.

Do you have a source on this? That obviously would make sense, but I haven't actually seen any data on age vs ARDS, only age vs death rates. So absent any information otherwise, I'm not going to assume that if my risk of death (with medical care) is only 0.2% then my risk of ARDS is no more than a couple percent.

I’m on mobile. If you google, there are charts of hospitalization vs. age. The primary reason for admittance to a hospital is ARDS.

Obvious question is whether the reviewed patients were the patients with significant complications.

And age too.

Agreed, without more details surrounding the test group numbers / selection, it's hard to determine what level of concern this raises.

How long after "recovery" were these assessments made? Some colds, even, have a cough that lingers for months.

It would be quite interesting to know what treatment those persons received... Steroids? Chloroquine? Lopinavir/Ritonavir? Something else? I suppose not remdesivir since the article seems to imply they're going to start trials of it.

Does anyone have any info regarding childhood asthma and coronavirus?

I'd be curious about the long-terms effects of pneumonia in general. Are they similar? Can this be counteracted by training lung functions?

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