Gregory Travis

Who the hell are you and why should I bother?

Great question. I'll start by telling you what I am not. I am not a licensed medical professional. I am not an academic statistician. I am not an epidemiologist. I am not an expert, domain or otherwise.

Now, what I am: I am a technology specialist with a background in the liberal arts (history) and a writer who has written about the interface between society and technology for four decades. I am also a businessman who has worked in the healthcare space for nearly three decades, beginning with starting my own company to share medical imaging between providers and ending with a decade years of intensive patient-centric healthcare applications the oncology and patient relationship fields. I have analyzed dozens of clinics and dozens of hospitals, including the largest in the nation. I know the business of healthcare, in the US, very well.

I also have a very personal relationship to the healthcare industry, having cared for my father between the six months when his symptoms began and when he died (he was 53 and fit). As well as caring for my late wife between the nine months when her symptoms began and when she died (she was 45 and extremely healthy). In both cases I took them to the best healthcare institutions in the country (Sequoia, Cleveland Clinic, St. Vincents', Stanford, Indiana University Medical School). In neither case was the system able to diagnose what either was afflicted with until their autopsies (dissected aorta and amyloidosis, respectively)

I have been following the progression of the SARS-CoV-2 virus, and associated disease COVID-19, since early January, 2020. For example, see this text I sent to my son's nanny on the third week in January (I was in a hotel in Madison, WI). I also began posting on Facebook extensively about it at that time.

What are the terms we should use?

Throughout this I use the term SARS-CoV-2 to denote the virus responsible for the pandemic. SARS-CoV-2 is also often referred to in the vernacular as "Coronavirus." I use the term COVID-19 to denote the disease that an individual contracts when exposed to the SARS-CoV-2

Why?

I have long held an interest in the concept of exponential growth. I am also intensely interested in history and would have become a history professor had technology not paid so much better. As such I was already familiar with major historical pandemics, particularly the 1918 influenza pandemic. My gut, I know that's not "evidence-based," told me this was going to play out a lot like that with similar infection rates and deaths.

Give me some basic information I can use

The average time between being exposed to SARS-CoV-2 ("coronavirus") and showing symptoms is 5 days. By 15 days, 97.5% of those infected will show symptoms.

The average time between symptom onset of SARS-CoV-2 and death is two weeks. In other words if you are going to die from the disease, you are going to die in two weeks after you feel ill.

The average time between symptom onset of SARS-CoV-2 and recovery is five weeks. In other words if you contract the disease, it is going to take you over a month before you can expect to go out again.

The virus can remain alive in the air for at least three hours. It can remain alive on paper/cardboard for 24 hours. It can remain alive on plastic and metal (except copper) for as long as five days. Copper, shorter. This does not necessarily mean you can contract it from the air within three hours of someone sneezing, just that it has been observed to be alive in the air that long. Err on the side of caution, however.

The virus appears to be fairly easy to kill. It is surrounded by (protected by) a "fat capsule." Anything that dissolves that capsule (ordinary soap, hydrogen peroxide, rubbing alcohol, Clorox). NBC News has a good primer along with links to more extensive lists. Note that it does not appear that vinegar solutions or low-proof alcohol (< 160 proof) are effective.

If I get it, how will I get it?

Evidence is that the overwhelming transmission mechanism is direct human-human contact. That means getting sneezed or coughed on (see more, below) or touching an infected person.

Other methods, not as well understood, included touching something that someone else has touched. As the virus survives particularly long on metal surfaces, consider all door handles, handrails, subway poles, etc. to be thoroughly contaminated. Also serving utensils, like spoons, etc. used at a buffet (but you're not going to any buffets, right?)

If you must touch one (and it is hard to go outside without having to) make sure to wear gloves if possible and do not touch your face under any circumstances until you've had a chance to disinfect your hands.

I have heard that most people are asymptomatic or have mild symptoms. Why should I worry?

I don't believe that anyone is asymptomatic. I believe this is a myth we are telling ourselves to make us feel more secure. It makes us less secure. Again, the studies that have been done show that 97.5% of people infected develop symptoms within two weeks.

Until there is more data that emerges about the concentration of asymptomatic cases, which is impossible without widespread random testing, I call bullshit.

As for mild symptoms, same thing. Also note that the definition of "mild" symptoms varies tremendously but most definitions of mild symptoms mean "did not need to be ventilated." There's a whole lot of "I feel really, really, really terrible" that happens before "I need to be on a ventilator."