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COVID-19 Podcast Rec

Hope all of you are staying safe and healthy.

Like many of you, my eyes have been glued to the endless stories coming out on the topic. In particular, I’ve been following Peter Attia for an understanding of the mechanism of the virus.

  • A big difference from the Spanish flu and prior epidemics is that the Spanish flu would cause the immune system to become hyperactive, thus, young people and pregnant women were most at risk. In the coronavirus, immune response does not seem to have an impact on the disease. The virus attacks both the lungs and heme in the blood (or the ability to carry oxygen):
    • Lungs: The virus hijacks the ACE2 receptor to attack pneumocyte cells which prevent the lungs from making biological detergents which keep the lungs open.
    • CoV genes 1 and 8 interfere with heme and kick out iron (not from podcast, source David Sinclair)
  • Other topics discussed on the podcast:
    • the importance of the morbidity of the disease instead of mortality
    • Rundown of the numbers before ICU is overrun (i.e. 3 weeks – New York has 3,000 beds and the nation has 95,000), assuming a 1.3x growth rate, 20% hospitalization, and 5% needing ICU)
    • Exponential growth: Only the city of Wuhan and S Korea have passed their inflection point, where the growth is no longer upward sloping. In no city are cases are going down – cases are still rising but the growth rate is slowing in those two. Everywhere else is exponential growth.
    • Risk factors: It seems that Cardiovascular disease is a higher risk than lung disease. Diabetes is another high risk factor.
    • Long term health consequences: People on ventilations can be there 3-6 weeks and have permanent damage, including those in their 30’s and 40’s.
    • Expectation: UCSF projects 50% of population exposed. 1% mortality. 1.3M – 1.5M projected lives lost in the next year.
    • Full podcast:
      • Notes are on the bottom of the podcast

I have also been tracking the cases in Los Angeles, ever since the LA Marathon. I came across this report (shared by Mark Suster) of someone who clearly has the coronavirus, but is getting her tests denied (but tested negative for the flu). This just confirms what we already know – cases are severely underreported.

Finally, I was also reading a study looking into two risk factors:

  • being over 50, and
  • having a neutrophil-to-lymphocyte ratio above 3.13.

Outcomes were grouped into having neither, one, or both conditions. Patients with neither were 9% likely to have severe conditions and patients with both were 50% likely. The paper definitely went over my head, so I’d take it with a grain of salt but it’s a metric that you can pull up from your/your loved ones’ most recent blood tests.