Transmission routes and Ease of spread

[Christer Svensson]

Ease of spread: Public sanitation facilities may contribute to transmission 

https://www.bloombergquint.com/global-economics/fecal-transmission-may-be-behind-coronavirus-s-rapid-spread

 

Also 2019-nCoV ACE2 receptor affinity is 10 to 20 fold that of SARS

 

 

"Surprisingly, ACE2 bound to 2019-nCoV S ectodomain with ∼15 nM affinity, which is approximately 10- to 20-fold higher affinity than ACE2 binding to SARS-CoV S"

 

"The high affinity of 2019-nCoV S for human ACE2 may contribute to the apparent ease with which 2019-nCoV can spread from human-to-human(1),

however additional studies are needed to investigate this possibility."

 

https://www.biorxiv.org/content/10.1101/2020.02.11.944462v1.full

[Stephen Flynn]

From the top article: "The finding of live virus particles in stool specimens indicates a fecal-oral route for coronavirus, which may be why it’s caused outbreaks on cruise ships with an intensity often seen with gastro-causing norovirus, which also spreads along that pathway."

This could be partly true.  I wish I could point to an article that I read long ago about noro-virus transmission in a restaurant.  The restaurant was linear with three segments, the last separated by an open doorway.  A diner vomited near the entrance.  I think every other person in the restaurant contracted noro-virus which meant aerosol transmission.  However I have not heard of vomiting--has there been any with this virus?

Fecal: Consider the case, was it HK, where an upper floor (7th level) seemingly spread NCOV through the sanitary system.  I've read other reports of virus being shed in feces.

Fecal-oral, aerosol, persistent presence on doorknobs.... 'tis a clever virus.

[Christer Svensson]

Noting that

for instance Beta-corona viruses like MERS produce a viral load in urine

"Low concentrations of the virus were detected in urine" 

https://link.springer.com/article/10.1007/s00705-014-1995-5?shared-article-renderer

It should be of interest to quantify similarly the case for the presence of a COVID19 viral load in urine

And possibly advise against the use of public urinoirs which may hypothetically act as aerosolisers.

 

 

 

 

 

 

[Christer Svensson]

Contact tracing through antibody assay 

Duke-NUS

 

@dukenus

·

26 feb.

 

"We're proud and happy to help," said Asst Prof Danielle Anderson from

@dukenus

' Emerging Infectious Diseases programme. She elaborated how the team developed the #COVID19 serological test kit which helped the Singapore authorities with contact tracing.

 

Contact tracing now possible via novel use of antibody assays

 

 

https://mobile.twitter.com/dukenus/status/1232459030506786816?s=02

 

https://www.duke-nus.edu.sg/directory/detail/anderson-danielle-elizabeth

[Christer Svensson]

Secret carriers of COVID-19 non-symptomatic children ?

https://nypost.com/2020/03/02/ex-cdc-head-tom-frieden-says-kids-may-be-secret-coronavirus-carriers/?fbclid=IwAR02ygcSXSRsDeZ7PyskamSQaS3N7u1MJSY3XQ33PBPv5ArxuhjJv5okkSg

https://pubs.rsna.org/doi/10.1148/radiol.2020200241

 

[Christer Svensson]

Reconsideration of necessity and duration of post convalescens selfquarantine

 

The longest observed duration of viral shedding in survivors was 37 days.

 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext#back-bib33

 

 

In light of the above Lancet article  observation 

▪ post recovery selfquarantine is necessary and

▪ should be prolongued to at least 5 weeks

 

 

[Christer Svensson]

Skin epidermis ACE2 receptors: Possible novel mechanism of spread of COVID-19

 

 

Background of hypothesis

Every human sheds numerous

skin flakes in a process 

refered to as:

 

"desquamation. Every 28-40 days, on average, a new skin cell is "born" in the stratum germinativum, the deepest layer of the epidermis. ... 

This desquamation process happens 

over the entire body."

 

 

Presence of ACE2 receptors on the skin epidermis

"In the skin, ACE2 was present in the basal cell layer of the epidermis 

extending to the basal cell layer of hair follicles"

 

https://onlinelibrary.wiley.com/doi/full/10.1002/path.1570

 

"The basal layer is the innermost layer of the epidermis, and contains small round cells called basal cells. The basal cells continually divide, 

and new cells constantly push older ones up toward 

the surface of the skin, where 

they are eventually shed"

 

 

 

ACE2 is a ligand for SARS CoV 2

As is now commonly known:

ACE2 is also known as the binding receptor for Sars CoV 2

 

A recent skin related patient symptomatology 

States:

"and tested positive for coronavirus.

 

One of these positive passengers had no symptoms and the other had a faint rash and a mild sore throat. When she took their testing samples back to the lab, she successfully infected a cell culture with the patients' swabs."

https://edition.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

Adjusting post convalecense quarentine duration to the desquamation cycle

Conclusions

▪ Desquamated skin flakes may still contain viable COVID-19 

and are easily made airborn through air turbulence.

▪ Further more extant skin epidermis ACE2 receptors

may increase the risk of transmission and 

account for a significant 

part of the R-0

▪ Post convalescense quarantine duration 

should be adjusted accordingly

[Christer Svensson]

The distribution upon sucessfull contact tracing  of virus profylax Chloroquine diphosphate plus Zink

to the contacts of the infected will effectively reduce the production                                                               

 of viral loads generated, thus diminishing for COVID-19                                                                         

 the R-0 of the person to person transmission potential

As an aside note: Chloroquine derivative will be distributed to 300 000 French patients in trials according to this article  

https://www.sudouest.fr/2020/03/18/coronavirus-sanofi-offre-de-l-anti-paludique-plaquenil-pour-traiter-300-000-malades-des-essais-prometteurs-7340262-10861.php?fbclid=IwAR1KG2I4mrZ69r-U6GjvU6FOfYYSVLOpEko6Z52WGpD_AKTH9DzZzDsnPF0

 

 

[Christer Svensson]

A recent paper and review on the antiviral properties of Zink

Perhaps also a rationale for the combined use of Zink with Chloroquine

https://academic.oup.com/advances/article/10/4/696/5476413

Further more:  

Front line Healthcare workers might benefit from the combination as a profylax

 

 

[Christer Svensson]

Ease of inactivation of COVID-19

 

Here below, 

is a recommendation to increase the themostat warmwater temperature 

in hospitals and public and private housing to 60 ° C or above in order to inactivate COVID-19

which inactivates 

at 57 ° C

 

Through taps and showerheads i.e. bathtubs etc. Dish washing etc.

That is to at least 140 ° Farenheit 

 

Please spread this info to the building managers organisation in the US and worldwide