High-Dose Coronavirus Infections Should Worry Us More
As with any other poison, viruses are usually more dangerous in larger amounts.
Scott Gottlieb, MD
62d ago
Dose effect could be a factor in #COVID19 infectivity and lethality, and may help explain why so many healthcare providers are becoming ill, and dying.
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My PI and I wrote an op-ed about Covid19 viral dose and why it should be part of the public discussion!
Why are young, healthy clinicians being hit so hard by #COVID19, w/ deaths & ARDS?
"Despite the evidence for the importance of viral dose, ....models being used to inform policy during this pandemic ignore it. This is a mistake."
nytimes.com/2020/04/01/opi… @Caroline_Bartma pic.twitter.com/C2qwnShZZz
Another factor (thanks to the folks who shared with me): viral load. You can get more or less exposure to a virus, and more exposure can cause more harm. It's not just binary, exposed/not exposed.
nyti.ms/3dXGUWi
#CoronavirusOutbreak #COVID19
😷Worrying for HCWs who treat #COVID19 daily: “importance of viral dose is being overlooked. viruses are usually more dangerous in larger amounts. Small exposures lead to mild infections, while larger doses can be lethal.” pray for drs/nurses & #GetMePPE.
"viral dose affects illness severity"
"mice receiving..low dose of virus clear it and recover, while..same virus at..higher dose kills"
"From a policy perspective, we need to consider that not all exposures..may be the same"
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This piece from @Caroline_Bartma and her PI argue that the volume of exposure is extremely likely to be linked to symptom severity.
FWIW she's one of the handful of smartest people I went to school with at any level of schooling. Assume she's right.
As with any other poison, viruses are usually more dangerous in larger amounts. Small initial exposures tend to lead to mild or asymptomatic infections, while larger doses can be lethal.
nytimes.com/2020/04/01/opi… via @NYTOpinion
Really interesting: High-dose coronavirus infections may be more likely to lead to severe illness while low-dose infections could produce mild cases
In Wuhan there were examples of entire families dying as well as young doctors. As this NYT editorial argues, a contributory factor might have been high infection doses, which can easily happen within family setting. nytimes.com/2020/04/01/opi… 6/14
Exposure dose + host genome, both likely very important in determination of clinical manifestation.
Here's an excellent primer on the poison argument, and why masks are trending
This is easily the most informative piece I've read about why health care workers are getting particularly sick, and does a lot of work to (possibly) explain why some people get much milder symptoms than others. Viral dose matters
Exposure dose + host genome, both likely very important in determination of clinical manifestation.
Don’t know how credible this article is, because the authors are not law professors, but it is very interesting.
"Stepping into an office building that once had someone with the coronavirus in it is not as dangerous as sitting next to that infected person for an hourlong train commute," write two Princeton scientists
As with any other poison, viruses such as #COVID19 are usually deadlier in larger amounts says #PrincetonU postdoc @Caroline_Bartma and @PrincetonChem professor Joshua Rabinowitz in an op-ed for @nytimes.
Coronavirus Exposures Might Be the Most Dangerous
As with any other poison, viruses are usually deadlier in larger amounts.
So proud of @Caroline_Bartma for making this time productive and writing an Op-Ed with #JoshRabinowitz in the NY times to spur some discussion about Covid19 and viral dose!
This concept of “viral dose” (or “viral load” as doctors I’ve spoken with call it) is getting more much-needed attention. Not unlike how much one would ingest of anything else. Why masks/quick exposure matter.
.@WholeFoods is still encouraging employees NOT to wear facemasks. but two articles out today show that guidance should change NOW. 1. this story on viral load: nytimes.com/2020/04/01/opi…
2. this story on transmission: apple.news/AJm5Tz2pZQky3m…
Not all exposures are created equal: The difference between low- and high-dose infections are a little-discussed factor determining the severity of #COVID19 illness.
As with any other poison, viruses are usually deadlier in larger amounts... #coronavirus #COVID19
IGG alum @Caroline_Bartma and her PI (Joshua Rabinowitz of Princeton) discuss viral dose and COVID-19 in the NYTimes
lockdowns, while effective are costly both economically and psychologically. When society eventually reopens, risk-reduction measures like maintaining personal space and practicing proper hand-washing will be essential to reducing high-dose infections.
First, medical workers have different requirements from masks. They're around sick people all the time and they are trying to protect themselves. Remember, viral load matters a great deal, hence tragic young deaths of health-care workers. Please read this. nytimes.com/2020/04/01/opi… pic.twitter.com/b2IgJR9fYA
Informative and helpful piece
These Coronavirus Exposures Might Be the Most Dangerous
"Medical personnel face an extreme risk, since they deal with highest-viral-load patients" -- With #coronavirus, does the dose make the poison? The importance of viral dose is being overlooked nyti.ms/2w9Uzsy via @NYTopinion #COVID19
« Despite the evidence for the importance of viral dose, many of the epidemiological models being used to inform policy during this pandemic ignore it. This is a mistake.» These Coronavirus Exposures Might Be the Most Dangerous nyti.ms/2w9Uzsy #COVID19
Good article - opening up debate about the full spectrum of disease we are now seeing in our cohort of half a million sufferers using the covid symptom tracker covid.joinzoe.com via @NYTOpinion nytimes.com/2020/04/01/opi…
This is an important piece. The fact that viral dose matters a lot means that avoiding high-dose encounters is crucial, that masks are valuable, and that we should avoid "a panicked overreaction to low-dose exposures."
So - I am still trying to process this @nytimes opinion article: These Coronavirus Exposures Might Be the Most Dangerous nyti.ms/2w9Uzsy that focuses on the possibility that initial viral dose may be related to severity of disease for #COVID19
"The dose makes the poison," even when it comes to viruses. These Coronavirus Exposures Might Be the Most Dangerous
This seems like an important but under-appreciated distinction. (via @LilianaSegura)
Odd that no media articles on dose effects mention that it increases lockdown death rates, or makes opening for variolation. Do they not know, or are they scared to say? theguardian.com/world/2020/apr…
newyorker.com/magazine/2020/…
nytimes.com/2020/04/01/opi…
Healthy people who are together in the grocery store or workplace experience a tolerable risk--so long as they take precautions like wearing surgical masks and spacing themselves out." nyti.ms/2w9Uzsy What do you think @NAChristakis True or just a (highly) educated guess?
The corona dosage people are exposed to appears to be key in determining the seriousness of the illness. It helps sort out who is in greatest need of protection, and who shouldn't overreact to exposure.
Sensible words on importance of viral dose nytimes.com/2020/04/01/opi… "At the same time, we need to avoid a panicked overreaction to low-dose exposures. Clothing & food packaging that have been exposed to someone w/the virus seem to present a low risk." But bad for hlth care workers
Color me skeptical of the viral dose theory. A virus that replicates weakly and moves around the body slowly will surely exhibit this effect no doubt. But people are dying from what must be minor exposures based probably on physiological differences.
"The importance of viral dose is being overlooked in discussions of the coronavirus. As with any other poison, viruses are usually more dangerous in larger amounts. Small initial exposures tend to lead to mild infections, while larger doses can be lethal."
The importance of viral dose is being overlooked in discussions of the coronavirus. As with any other poison, viruses are usually more dangerous in larger amounts.
“These Coronavirus Exposures Might Be the Most Dangerous” via @NYTOpinion
Key point: It seems that social distancing, even if not so complete as to prevent infections, can make them less severe.
Opinion | These Coronavirus Exposures Might Be the Most Dangerous - The New York Times “Because dose matters, medical personnel face an extreme risk”
Dosages matter a lot.
It's most likely why I'm having a long illness. Nowhere to hide from the virus on lock down!
@VandekerckhoveJ What about doctors & other healthcare workers? and might everyone be exposed to very high dose infection?
@VincentRK @celinegounder @jimsciutto @vsawkar @DrSidMukherjee @Rfonsi1 “As with any poison, viruses are usually deadlier in larger amounts”
“For everyone, importance of social distancing, mask-wearing..is only greater, since these practices not only decrease infectious spread but also dose & lethalness of infections”
The 'dose makes the poison' is true for viruses too. And medical staff and care workers are exposed again and again and again nyti.ms/2UWnMiN #coronavirus
"While preventing viral spread is a societal good, avoiding high-dose infections is a personal imperative, even for young healthy people." #Masks4All #COVID19
"the importance of social distancing, mask-wearing and good hygiene is only greater, since these practices not only decrease infectious spread but also tend to decrease dose and thus the lethalness of infections that do occur. " #Masks4All #COVID19
I found this informative. These Coronavirus Exposures Might Be the Most Dangerous
“Stepping into an office building that once had someone with the coronavirus in it is not as dangerous as sitting next to that infected person for an hour long train commute.” #COVID19 #coronavirus