Can touching a barbell in the gym get you sick with the coronavirus?

Discussion in 'Steroid Forum' started by Michael Scally MD, Mar 7, 2020.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Can touching a barbell in the gym get you sick with the coronavirus? How about food? Or having sex? A guide to what is known about how it can and cannot be transmitted.

  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Persistence of Coronaviruses on Inanimate Surfaces and Their Inactivation With Biocidal Agents

    Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces.

    We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities.

    The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05–0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective.

    As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.

    Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection 2020;104:246-51.
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  3. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds
    One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds

    · Hospitals are confronting the rising threat of the novel coronavirus in the US.

    · The spread of the coronavirus outbreak in the US could push the healthcare system to its limits.

    · In a February webinar presentation hosted by the American Hospital Association, an expert laid out "best guess" estimates about how many Americans could be impacted.

    · He projected that there could be as many as 96 million cases in the US, 4.8 million hospitalizations, and 480,000 deaths associated with the novel coronavirus.
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  4. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Adjusted age-specific case fatality ratio during the COVID-19 epidemic in Hubei, China, January and February 2020

    60-69 yrs: 4.6%
    70-79 yrs: 9.8%
    80+ yrs: 18%

    * The 2017 US flu CFR, CDC data 65+ yrs: 0.86%

    The coronavirus disease 2019 (COVID-19) epidemic that originated in Wuhan, China has spread to more than 60 countries. We estimated the age-specific case fatality ratio (CFR) by fitting a transmission model to data from China, accounting for underreporting of cases and the time delay to death.

    Overall CFR among all infections was 1.6% (1.4-1.8%) and increased considerably for the elderly, highlighting the expected burden for populations with further expansion of the COVID-19 epidemic around the globe.

    Riou J, Hauser A, Counotte MJ, Althaus CL. Adjusted age-specific case fatality ratio during the COVID-19 epidemic in Hubei, China, January and February 2020. medRxiv 2020:2020.03.04.20031104. Adjusted age-specific case fatality ratio during the COVID-19 epidemic in Hubei, China, January and February 2020

    Table 1 - Estimates of case fatality ratio during the COVID-19 epidemic.PNG
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  5. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math. 1/n

    Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate. 2/n

    We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts. 3/n

    We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go. 4/n

    As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population. 5/n

    What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted. 6/n

    The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc). 7/n

    Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients). 8/n

    By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.) 9/n

    If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd. 10/n

    If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption. 11/n

    As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now. 12/n

    Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing). 13/n

    There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.) 14/n

    As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day. 15/n

    One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused. 16/n

    How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas... again, predominantly from China. 17/n

    Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor. 18/n

    Now consider how these 2 factors – bed and mask shortages – compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix. 19/n

    HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above. 20/n

    We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going. 21/n

    Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works. 22/n

    Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease. 23/n

    I’m an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan. 24/n

    Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong. 25/n

    But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”. 26/n

    These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system. 27/n

    And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared? 28/n

    Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out. 29/n

    One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year. 30/n

    Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population. 31/n

    But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months. 32/n

    That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge. 33/n

    This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data. 34/n

    That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end

    Thread by @LizSpecht: I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet.…
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  6. kinkos

    kinkos Member

    Good post. Mean while please wear gym gloves and sanitize your gloves after your workout and if tour gym has the disinfectant spray please use them before and after you use the equipment.
  7. Theworm

    Theworm Member

    People are over reacting to this...

    Can’t believe those numbers out of China, they are sketchy at best.

    Live your life and follow common sense and you’ll be fine.

    I really believe there is a big political push behind this, anything to make trump look bad and destroy the economy to further the lefts agenda... they can’t get rid of trump any way else.
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  8. Havah

    Havah Member

    Time will prove you wrong, just remember that dumb post you just made
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  9. kinkos

    kinkos Member

    It has nothing to do with trump look at the Iran right now day by day their numbers are increasing, this is serious you cant take it lightly.
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  10. Theworm

    Theworm Member

    will do.

    You really don’t think there’s mass hysteria over this?

    Maybe I should panic like you and run the streets screaming we are all going to die!
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  11. Theworm

    Theworm Member

    True death rate is more like 1.4%, I’m taking it serious, I just don’t think 40 million us population will die
  12. Theworm

    Theworm Member

    I’m entitled to my opinion.

    You are the definition of a liberal, if one doesn’t agree with you, you resort to childish name calling. Very mature.
  13. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    New York ...

  14. Michael Scally MD

    Michael Scally MD Doctor of Medicine

  15. Michael Scally MD

    Michael Scally MD Doctor of Medicine

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  16. Theworm

    Theworm Member

    Ok we get it, stop reposting tweets.

    The world is ending and we are all going to die
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  17. Old

    Old Member

    One of the biggest fears is how business will be affected. A drop of 1% of customers (because they died) will ironically cause a bigger drop in stocks.

    Actually, since it kills mostly the elderly, plenty of governments might welcome this virus. This could easily reduce Social Security and Medicare outflows 10 to 20%. It is claimed that 50% of a person's health care costs are the last 5 months of their life. Now cut 5 months to a few days in the hospital ... voilà, what a significant savings!

    Seems the only real concern is for the workforce to keep going so they can pay tax and make thing to buy.

    Keep posting man!

    Coronavirus: Residents 'welded' inside their own homes in China - LBC
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  18. Michael Scally MD

    Michael Scally MD Doctor of Medicine

  19. Switcher

    Switcher Member

    I tried another thread in the training forum. Pretty much the same stuff I have been reading. Not intending to scare but this virus is unreal.

    Once you are infected, it shows no real signs at first so you are contagious without knowing (asymptomatic). Then, after you spread it around, you start to feel sick. Oh, and the period for which you are contagious is most certainly longer than 2 weeks.

    Piers Morgan of all haters said it best:

    Dr. Richard Hatchett said on England's channel 4 news, ‘This is the most frightening disease I’ve ever encountered’. <span class="hanging-lsquo">‘</span>This is the most frightening disease I’ve ever encountered’ – virus expert Dr Richard Hatchett

    This is hitting the US where we are most vulnerable. We have many people running around that live paycheck to paycheck, they have no sick leave to take, and no healthcare insurance. Even if a person in this group gets sick enough to go to a clinic, will they pay for a test? Will they accept a quarantine? Can they afford to do so? I love capitalism but this could really show its ugly side.
    Last edited: Mar 8, 2020
  20. Kingsmountain

    Kingsmountain Member

    So why isn't everyone flipping the fuck out over the yearly number of deaths via simple flu in the U.S. ?

    Bottom line is, use common sense during seasons where flu strains are dominant.

    Wash your fucking hands frequently, use hand sanitizer, don't pick your nose, keep your hands away from your face, etc , etc

    Contrary to popular media belief ... the sky is not falling

    Also, Epstein didn't kill himself for all the clueless out there:rolleyes:
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