California State University's Closed for the Fall →

The 23-campus California State University system plans to all but cancel in-person classes in the fall and instead will offer instruction primarily online, Chancellor Timothy White announced Tuesday.

The vast majority of classes across the Cal State system will be taught online, White said, with some limited exceptions that allow for in-person activity. The decision comes as schools throughout the country grapple with how long to keep campuses closed amid the coronavirus crisis.

We are in for a new normal. And with Los Angeles announcing a shelter-in-place order until the end of summer, it’s going to be a very different West Coast experience or lack-thereof. At least the beaches are open?

California Seeing an Uptick in COVID-19 Cases as Mobility Increases

Hopefully everyone continues to keep their distance as we start mobilizing a bit more. I know I’m getting antsy. In today's news (Monday, May 11, 2020), California is looking worse than expected and one family gathering at Easter has resulted in a cluster of 5 cases including an individual who was coughing and joking about possibly having it. Do everyone a favor and protect yourself. Wear a mask not only for yourself but for others as well. We should know this already! Thanks to contract tracing, it hopefully has been isolated.

Researchers are now predicting that California could see more than 6,000 COVID-19 deaths by the end of August, up about 1,420 from projections they released last Monday. It’s the fifth-largest increase in projected death tolls among U.S. states, after Pennsylvania, Illinois, Arizona and Florida.

The upward revisions “are a result of a combination of updated daily death and case data, recent actions to ease previously implemented social distancing measures and steadily rising levels of mobility in many places,” the researchers said in notes released with the data.

COVID-19 Affecting the Brain →

Her doctors diagnosed a dangerous condition called acute necrotizing hemorrhagic encephalopathy, or ANE, which they detailed in the journal Radiology last month. It’s a rare complication known to occasionally accompany influenza and other viral infections, though usually in children. With the flu, scientists believe such brain damage is caused not so much by the virus itself but by squalls of inflammation-inducing molecules called cytokines, which are sometimes produced in excess by the body’s immune system during an infection. Scientists are still trying to figure out if the same is true for Covid-19, or if the coronavirus called SARS-CoV-2 is actually invading the nervous system directly. It’s an open question, the answer to which could have wide-ranging implications for how doctors diagnose and treat Covid-19 patients.

We are all aware of the common symptoms of COVID-19 but other symptoms are starting to pop up more frequently leading to a whole slew of newer ailments some of which are already being documented to be long-lasting. JAMA Neurology just posted a paper on it last Friday as well.

BUT IF SARS-COV-2 turns out to be a brain-invader, it wouldn’t shock Stanley Perlman, a microbiologist and infectious disease physician at the University of Iowa. During the 2003 SARS epidemic that killed 774 people, only a few dozen autopsies were ever performed. But in at least eight of them, pathologists found bits of the virus and its genome in the brain, in addition to the lungs, kidneys, digestive tract, and spleen. Perlman wanted to understand how that might happen. So he zoomed in on a receptor called ACE2, which SARS-CoV—the coronavirus that causes SARS—uses to enter human cells. In a 2008 study, Perlman and his colleagues genetically engineered mice to express that human receptor and then squirted a small dose of SARS-CoV into their noses. Rather than descending into their lungs, the virus climbed out of the nasal cavity and into their brains using olfactory neurons like rungs on a ladder.

Lingering Long Term Effects of COVID-19 →

In a study posted this week, scientists in China examined the blood test results of 34 COVID-19 patients over the course of their hospitalization. In those who survived mild and severe disease alike, the researchers found that many of the biological measures had “failed to return to normal.”

Chief among the worrisome test results were readings that suggested these apparently recovered patients continued to have impaired liver function. That was the case even after two tests for the live virus had come back negative and the patients were cleared to be discharged.

Needless to say, this isn’t looking great at all for those who have been survivors of mild to severe cases.

At the same time, as cardiologists are contending with the immediate effects of COVID-19 on the heart, they’re asking how much of the damage could be long-lasting. In an early study of COVID-19 patients in China, heart failure was seen in nearly 12% of those who survived, including in some who had shown no signs of respiratory distress.

Degradation in lung capacity and heart function! Twelve percent is unbelievable and to think of the actual effect this has on the longevity of life? For further reading, the actual link to the medical paper can be found here.

Apple and Google Collaborate on Contact Tracing App →

I’m happy that both these amazing companies, that dominate the smartphone world, are finally collaborating for the great good of humanity but much bigger questions loom. Without a doubt, I’m happy that Apple is taking a lead in this project with their concerns for privacy as I hope that they will champion in protecting us more so than what we have seen from other corporations. You can find both Apple and Google’s Press Releases here with their images below on how the app will work. Privacy is the biggest issue here and really does seem like a big brother way of tracing but is there a better solution? If you want to read further into the technical documentation, click here!

Apple and Google will be launching a comprehensive solution that includes application programming interfaces (APIs) and operating system-level technology to assist in enabling contact tracing. Given the urgent need, the plan is to implement this solution in two steps while maintaining strong protections around user privacy

Techcrunch put it best in summary:

There is zero use of location data, which includes users who report positive. This tool is not about where affected people are but instead whether they have been around other people.

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If you haven’t been able to stop by Google’s COVID-19 Community Mobility Papers, that’s something to definitely check out!

Airplanes Parked Around the World

My industry is seeing the likes of airplanes being parked all over the world with airlines cancelling flights, consolidating routes and closing cities. I'm hoping for the best but the reality is that these lost flights comes with many job losses.

This is definitely not a sight I want to see but it in a way it is beautifully composed. Each of these aircraft were moved to their respective locations over the past few weeks since the COVID-19 outbreak by pilots and ground crew from all over. My own company is currently parking 100 aircraft around the country but most of the US Carriers stage in Arizona at an airport called Pinal Airpark : KMZJ. Today alone, there are over 9 aircraft arriving with one carrying out the crew. I can only hope and pray that my industry recovers quickly.

How Many Days is Enough? →

The 14-day quarantine period put forward by WHO and the CDC was based on smaller studies of sicker hospitalized patients. But an estimated 80% of adult COVID-19 patients are not sick enough to be hospitalized, and people can be infectious with the new coronavirus well before they develop symptoms. The new study found that the median incubation period was seven days for adults and nine days for children, far longer than the mean of 5.2 days from an earlier study out of Wuhan.

So hopefully, 8 days is enough for me? But…

For that study, researchers from the Johns Hopkins Bloomberg School of Public Health and two other universities analyzed 181 cases of COVID-19 in 25 countries, from early January to late February. They found that 97.5% of people who developed symptoms did so within 11.5 days of exposure.

However, the researchers extrapolated that for every 10,000 exposed individuals, 101 would develop symptoms after a 14-day quarantine. Reuters reported on one such case in late February, that of a 70-year-old man in China’s Hubei Province who did not show symptoms until 27 days after he was infected.

Maybe 11.5 days is better? I haven’t been around any known cases that I know of but like I mentioned, I did traverse quite a few areas while being out on Captain training and the journey back to where I am today.

Possible Herd Immunity in California →

As of Tuesday, the state had 374 reported COVID-19 fatalities in a state of 40 million people, compared to New York which has seen 14 times as many fatalities and has a population half that of California. Social distancing could be playing a role but New York's stay-at-home order went into effect on March 22, three days after California implemented its order.

"Something is going on that we haven't quite found out yet," said Victor Davis Hanson a senior fellow with Stanford's Hoover Institute.

Hanson said he thinks it is possible COVID-19 has been spreading among Californians since the fall when doctors reported an early flu season in the state. During that same time, California was welcoming as many as 8,000 Chinese nationals daily into our airports. Some of those visitors even arriving on direct flights from Wuhan, the epicenter of the coronavirus outbreak in China.

This would be great if this were true and we’ll know in a few weeks. For the sake of safety, science, and medicine, I hope that these serology and anti-body tests get carried out more rapidly as well as general testing for COVID-19. It’s great to see that ALL RESIDENTS of Los Angeles with symptoms can get tested now.

Hanson said through all of this the Chinese have been disingenuous about the timing of the initial outbreak of COVID-19.

"They originally said it was in early January, then it got backdated to December and then early December and now they are saying as early as November 17," said Hanson.

China’s continuance of hiding the truth from the world has only hurt us as a human race. I really hope that when this is all over that something gets done about this. Victor Davis Hanson points out that with 8,000 Chinese Nationals / passengers landing at San Francisco Airport and Los Angeles Airport daily as well as direct flights from Wuhan that it would be naïve to think that we weren’t already being exposed to it back in late 2019.

How It Spread Early and Quickly →

While the flight was in midair, the results of some American passengers who'd been tested in Marseille came back. Three had tested positive for coronavirus and 13 others had symptoms, the Centers for Disease Control and Prevention told CNN.

Over 350 people who'd been in the confined space of a cruise ship continued with their journey in the even more confined space of a transatlantic flight.

"We were covered with virus from head to toe. We should not have been in the airport," said Harrell Catron.

There was no mitigation and complete disregard for how dangerous and quiet this virus could be. Now with reports saying that some were asymptomatic for up to 40 days… this is not looking good for any type of “shelter in home” / self quarantining.

For the sake of self contact tracing and history, I boarded a plane from SAN-MCO direct with only 8 people on Alaska Airlines 760 on Monday the 30th of March. I took the shuttle to our training center in Orlando, and stayed there until we received our cancellation notice on Thursday night. I did one more session to finish up our current “phase” of training on Friday night and then charted my way back to San Diego on Saturday the 4th of April via MCO-ATL-SAN.

Shuttle, train to plane DL 418 MCO-ATL, then terminal to train to terminal, Willie’s for a naked burrito then plane DL 1951 ATL-SAN, then terminal to Uber to Hilton Torrey Pines and have stayed in the room mostly except for the coffee grab in the morning. I have been here since Saturday night at around 20:30 when I checked it.

There were hardly any persons in the airports as noted on my instagram story, and I only had to use the facilities once at each airport. Maybe once on the plane too if I think about it. I was spaced out on all my flights but did have a cat that was taken out of its carrier on the ATL-SAN leg and I could see hairs flying around in front of me. I did use my mask the entire way while walking around everywhere even on the entire flight.

Originally, I was going to stay until Monday or Tuesday, but then my wife and I felt like 5 days or more just in case would be smarter, so that brings us to Friday, and now, with newer reports saying 14 days isn’t enough, we’re thinking at least until Sunday which would bring it to just over 7 days + 14 hours. I’ll be pissed if I get sick and it was all for naught. Follow the thread below from twitter user Eric Feigl-Ding who is currently the #1 CoronaVirus Authority on twitter and Harvard Epidemiologist / Health Economist and John Hopkins alumni.

Thread 🧵- INCUBATION TIME LONGER THAN 14 days. ⚠️This is a serious problem that I can’t stress enough because we based all our quarantine on this magical 14 day number. But many people have longer incubation periods than 14 days- this is problem. #COVID19 https://t.co/ZhyJW3Ywxg

— Eric Feigl-Ding (@DrEricDing) April 6, 2020

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Just Because It's Been 17 Days in Cali →

And the problem is, the data shows that there can be presymptomatic or asymptomatic transmission. I don’t want to be exposed to someone who may not be having symptoms but can get me sick.

-Krutika Kuppalli, infectious diseases physician, Johns Hopkins University Center for Health Security

Trusting your friends is fine and all but trusting everyone else who's circle could be much larger... and the fact that you don't know where they have been in the previous 14-days, it gives you pause. Unless you are fully quarantined for the two weeks which is being at home w/ 0 exposure e.g. not going to the grocery store or anyone at the home going out, you’ll never know.

But [if you’re going to interact with one other person], be very explicit about what the agreement is, and try to choose someone who’s got [a similar level of risk]. If you’re a writer and can work from home, ideally your friend would also be somebody who’s able to work from home, not an emergency medicine physician.

Let me give you an example of something else a student of mine decided to do. She lives alone in Philadelphia and her best friend also lives alone in Philadelphia. They each isolated themselves for two weeks and then moved in together for the duration [of the pandemic].

I like that plan so much more than the other plans I’ve heard of, because then you’re in constant communication with the other person and you’re aware of anything they need to do to break the protective bond. It’s easier to have an ongoing conversation about preventative strategies when you’re living with the person. If people are living separately, one person might forget to update the other.

-Carolyn Cannuscio, social epidemiologist, University of Pennsylvania

If you are going to isolate together, that’s great, but first you have to be 0 percent exposed for 14 days.

That being said, at its crux, social distancing doesn’t mean you need to stay home by yourself in a dark room. Really it’s about keeping to small, small groups of people. So if you have dinner with a friend, that makes sense as long as it’s just you and them.

For people who are going to have those one-on-one friend hangout sessions, it shouldn’t be, “I’m going to have five one-on-one sessions with five different people” — that defeats the purpose. Really limit it to just one friend.

If you want to be an awesome coronavirus epidemiology buddy, do it every 14 days, because that’s the incubation period. You’d want to do that from the last known date of exposure. That includes going to the grocery store, because theoretically anytime you go into an environment with a lot of people, there’s more potential for exposure to the disease. Then you want to ask each other, “Have you been symptom-free for 14 days? Have I? Yes? Okay.”

-Saskia Popescu, senior infection prevention epidemiologist, Honor Health hospital system in Arizona

I see too many friends still violating this. And damn if I don’t continue to quarantine for 14-days after coming back from Orlando, Florida where our training center is to which I went to the Orlando Airport via local shuttle, train, plane, Atlanta Airport, train, plane to San Diego Airport, Uber to hotel. Now what…

Collaboration is Key →

In interviews with a dozen of the world’s leading experts on fighting epidemics, there was wide agreement on the steps that must be taken immediately.

Those experts included international public health officials who have fought AIDS, malaria, tuberculosis, flu and Ebola; scientists and epidemiologists; and former health officials who led major American global health programs in both Republican and Democratic administrations.

Americans must be persuaded to stay home, they said, and a system put in place to isolate the infected and care for them outside the home. Travel restrictions should be extended, they said; productions of masks and ventilators must be accelerated, and testing problems must be resolved.

For some reason, Americans are still being complacent, denialist and love ignoring the specialists. We need to work together and nip this NOW! Besides it being already a bit late, it is ever too lat to save yourself and friends.