Healthy Indoors Magazine - USA Edition

HI March 2020

Healthy Indoors Magazine

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Page 18 of 68

Healthy Indoors | 19 These 15 people were all at a BioGen Incorporated con- ference on February 26th and 27th, There were only 175 people in attendance and less than one and a half days of meetings. Most attendees left at noon the second day. But that morning was an awards presentation – one would as- sume lots of hand- shaking and shoulder-clapping. Thefirstreported'flu-like"symptomsfromthisgroup of people were on Monday, March 2nd. The following day, TuesdayMarch3rd,BioGenofficialsreportedaclusterof 50conferenceattendeeswithflu-likesymptoms.These50 people were already spread out not just across the Boston region but also oversees. ThefirstCOVID-19caseconfirmedinthestateofMas- sachusetts was Monday, March 2. It was not related to the BioGen people. Within only one week, by the end of Tues- day, March 10, the state of Massachusetts total case load hadexceeded90confirmedpositivecases. 70 of the 92 cases in Massachusetts on Tuesday March 10 were people who were either at the BioGen meeting or associated with people who attended. This situation is cer- tain to change rapidly and get worse in the coming days. NOTE: by 11 am Wed March 11 the total cases in Massachusetts had passed 445. ohns Hopkins Coronavirus Resource Center, Confirmed COVID-19 cases worldwide as of 3/26/2020 7:29:40 AM EDT INCUBATION Incubation period matters because this is the time people are contagious - when they are spreading the disease to others. If symptoms do not appear during the contagious period, no one knows. The person does not know they are spreading it and those they interact with do not know they might get it. In every situation so far, from the huge volume of initial cases in Wuhan, China, to the Assisted Living facility in 1. Transmission rate: how fast the disease spreads. At this time, it appears that 2 to 3 people contract the disease for every one that has it. This is due to it being contagious under certain common circum- stances. 2. Incubation Period: how long it takes for symptoms to appear after the initiating exposure. The latest goodstudyfindsthat50%ofpeoplewillshowsymp- tomsAFTERfivedays(5.1tobeprecise).2%willnot showsymptomsuntilAFTER11days.Andabout1% will not show symptoms for more than 15 days. The recommendation for self-quarantine, aka isolation, is 14 days. 3. Virulence: how serious the symptoms are. About 1/4 of those infected will have serious symptoms and about 1/10 will probably require hospitalization with serious life-threatening symptoms including pneumo- nia (common with all respiratory infectious disease, forexampleseasonalfluandRSV).Alargefraction, perhaps50%ofallcaseswillexperiencerelatively mild symptoms, not much different than a common cold with only a slight fever. While symptoms are lim- ited, their presentation has a wide range of severity, makingitdifficulttoidentifyanddiagnosewithoutlab- oratory testing. 4. Fatality Rate: how many people will die. Best esti- mateatthistimeisprobablyintherangeof1%to3 1/2%.Thisisafluidnumberastestingofpeopleto seeiftheyactuallyhavethediseaseisalsofluid.The more people in a given population tested will proba- bly lower initial estimates. However, the range is 10 to30timeshigherthanseasonalfluwhichhasaFa- talityRateof1/10ofonepercent(0.1%). TRANSMISSION The risk of transmission is highest when people expe- rience close contract with others for an extended du- ration. This means, when an infected person is part of a group of people that interact with each other such as afamilyinahomeorworkersinthesameofficespace. Indeed, an assisted living facility in Washington state has experienced nine deaths, making it the most tragic single isolated situation seen in the U.S. so far. By the end of Friday, March 6th, it was also the situation with the highest rateoftransmissioninawell-definedknowngroupseenin the U.S. so far. That is, perhaps, until March 9th, when it was discov- ered that at least 15 people who had attended the same business conference were reported positive for COVID-19.

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