Critical reading of COVID-2 "Advice" letter

The letter below or some variation thereof has been circulating on the Internet. There are a number of issues with the letter that I will outline below the letter.

I received this from a friend of mine who’s brother is on the Stanford hospital board. This is their feedback for now on Corona virus: The new Coronavirus may not show signs of infection for many days. How can one know if he/she is infected? By the time they have fever and/or cough and go to the hospital, the lung is usually 50% Fibrosis and it's too late. Taiwan experts provide a simple self-check that we can do every morning. 1) Take a deep breath and hold your breath for more than 10 seconds. If you complete it successfully without coughing, without discomfort, stiffness or tightness, etc., it proves there is no Fibrosis in the lungs, basically indicates no infection. In critical time, please self-check every morning in an environment with clean air. Serious excellent advice by Japanese doctors treating COVID-19 cases: 1) Everyone should ensure your mouth & throat are moist, never dry. Take a few sips of water every 15 minutes at least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat and into the stomach. Once there, your stomach acid will kill all the virus. If you don't drink enough water more regularly, the virus can enter your windpipe and into the lungs. That's very dangerous. Please send and share this with family and friends. Take care everyone and may the world recover from this Coronavirus soon. Part 2 on CORONAVIRUS- Last evening dining out with friends, one of their uncles, who's graduated with a master's degree and who worked in Shenzhen Hospital (Guangdong Province, China) sent him the following notes on Coronavirus for guidance: 1. If you have a runny nose and sputum, you have a common cold 2. Coronavirus pneumonia is a dry cough with no runny nose. 3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27 degrees. It hates the Sun. 4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne. 5. If it drops on a metal surface it will live for at least 12 hours - so if you come into contact with any metal surface - wash your hands as soon as you can with a bacterial soap. 6. On fabric it can survive for 6-12 hours. normal laundry detergent will kill it. 7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice. 8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but - a lot can happen during that time - you can rub your eyes, pick your nose unwittingly and so on. 9. You should also gargle as a prevention. A simple solution of salt in warm water will suffice. 10. Can't emphasis enough - drink plenty of water! THE SYMPTOMS 1. It will first infect the throat, so you'll have a sore throat lasting 3/4 days 2. The virus then blends into a nasal fluid that enters the trachea and then the lungs, causing pneumonia. This takes about 5/6 days further. 3. With the pneumonia comes high fever and difficulty in breathing. 4. The nasal congestion is not like the normal kind. You feel like you're drowning. It's imperative you then seek immediate attention. SPREAD THE WORD - PLEASE SHARE."

I am always skeptical when people use anecdotal evidence;  "friend of mine whose brother", "Taiwan experts", "Japanese doctors", friend's uncles. I also don't like when an e-mail states "please share".  I trust the WHO's symptom's page (below) which says that sore throat is a "sometimes" symptom.  Dry cough and fever are the most common symptoms.  Here are a couple more points: 

  • I have a big issue with the 26-27C statement, the virus replicates in the lungs which are at 37C.   

  • Lung fibrosis is lung damage, the problem with COVID-19 is pneumonia (liquid in the lungs) not fibrosis.  

  • There is also an issue with stomach acid inactivating the virus, as some Coronaviruses, particularly bat Coronaviruses, where SARS-CoV-2 probably came from, are known to replicate in the gut (we don't know about SARS-CoV-2, which is the current problem). In fact people have found SARS-CoV-2 sequences in human stool samples, not sure if they have found infectious virus yet, but it does NOT appear that fecal transmission is a major route of transmission for SARS-CoV-2, it is a respiratory virus.  

  • The data for virus survival on surfaces is a little less clear.  There have been some recent experiments with SARS-CoV-2 on surfaces that show that it can still infect cells in a petri dish after being on different surfaces for varying lengths of time, up to 10s of hours.  Whether the virus is infectious to humans after that time is less clear.  It does lose infectivity in the petri dish test over time. 

  • No idea about cold vrs. hot water, in general hydration is good, I would love to see some data on this other than anecdotes (reminder the plural of anecdote is NOT data).

  • I would say wash your hands after touching surfaces that might be contaminated before touching your face, every 5-10 minutes seems excessive (>150 times a day), unless you are touching lots of common surfaces and are very close to a sink all day. 

  • Same issue with gargling, I have not seen any data on this.

COVID-19 vs Cold vs Flu.jpg