Some precise number of days (which I know but will redact) before I
turned 18, I know exactly where I was and what I was doing. That is
because I could not quite legally gamble, yet I was in a casino in Las
Vegas. On Christmas Day. I was doing a family thing for family
connections that lived in Las Vegas. Visiting a casino on such a
strange day is just something one can do if you don’t take traditional
holidays too seriously and you happen to be in town coincidentally.
What single adjective would I use to describe the Las Vegas casinos on
Christmas Day? Answer: Chinese. That was a while back, but I doubt
things are too much different today. Think about it. Normal
Christmas-celebrating Americans wouldn’t usually think to go to Vegas
on such an incompatible major holiday. But it would be reasonable for
normal Chinese people to happily take up the slack and cheap rates.
In 2019, exactly 8 days after flying and spending the day in airports
(SAN, PHX, BUF — LAS on the way out!), I record my first written
description of the illness that dominated my life this past winter.
What day did I travel? November 28 - Thanksgiving Day. A day I chose
because the rates (and I) were cheap — Americans do not like to
travel the entirety of Thanksgiving Day. I have no idea if this is
truly relevant, but it is certainly interesting to think about.
You know how my blog posts often maddeningly change topics a few
paragraphs in? The change often looks like a radical departure, but I
do actually try to keep a thematic strand connecting them. So here we
go.
The immune response to a virus starts with infected cells producing a
suite of signalling molecules called cytokines. Some of these tell
other cells nearby to be on their guard against attack, thus stymying
the virus’s ability to replicate itself. Others tell the immune system
to come and put some stick about. Thus called to arms, the immune
system launches both a prompt all-purpose response—inflammation—and
a subsequent targeted counter-attack using antibodies and cells
specifically programmed to attack both virus particles and the cells
they have infected. Unfortunately SARS-CoV-2 seems able to interfere
with the early steps of the immune response. It can apparently
counteract the part that dampens replication in nearby cells. It may
also enhance inflammation.
…
When inflammation gets completely out of control the body enters what
is called a cytokine storm. Such storms drive the most severe
outcomes for covid-19, including multi-organ failure.
Now take a look at this birthday greeting I wrote to a friend and
former colleague who is a computational biophysics researcher and
professor of pharmacology.
2019-12-29
I’m still struggling to get to my next birthday, still under attack by
some kind of pathogen. … I’ve never had an illness like this as an
adult. My guess is that it is a flu virus but it could be bacterial. I
feel like it went from my lungs to my major meat muscles. Each day I’d
get a new thing. For example, one day my tibialis anterior was hit
with what runners call "shin splints". I’m very familiar with muscle
pain from muscle wear and tear but it’s unnerving when there is no
sensible cause. I set up a bike inside and riding that helped my leg
muscles a lot. I think the main infection is mostly defeated and
controlling secondary infections is indeed the important thing. I lost
a lot of weight so I’m trying to eat as much as possible. That’s not
easy since I have very little appetite. I’m also wondering if maybe my
body is doing some silly overreacting, something like a cytokine
storm. Of course, as you know, at that level it all becomes
overwhelmingly complex.
Reviewing these emails has helped
me put together some other pieces of the puzzle. All spring long I’ve
been cold. Especially my shins. I moved a down sleeping bag to my
office to put on my shins thinking I was blocking a draft or
something. I crawled around to see if a fan from a computer on the
floor was blowing on my legs. I changed things around with my seating
arrangements thinking maybe my circulation was being constrained by my
chair making me cold (circulation problems are synonymous to me with
being cold — and, yes, I
am an expert). Then a few weeks ago the weather went from cool to
insanely hot (90F/32C) overnight. My shins were still cold.
That was an "oh shit" moment for sure. My illness has really messed
up my shins apparently. I am now aggressively rebuilding my shin
muscles. Now that I’m focusing on them it’s clear, they’re not right
at all. I’m a little nervous about other lasting damage. I’m sleeping
about 30 minutes to an hour longer each day than I did at the same
time last year (I always sleep the maximum amount my body will let
me).
But I feel mostly ok. I have a near comically healthy lifestyle — if
anyone is going to shake off problems that can be shaken off, it will
be me. The excellent Ed Yong (whose book
I reviewed) has
a
very interesting article in the Atlantic; it is the first I have seen
which has been properly sympathetic to the brutal hardships of
symptomatic survivors. The article is very scary because of this and
strong hints of long term effects. You can see why I’m taking this all
kind of seriously. And even though the
infallible
apolitical CDC has assured me — by fiat — that I did not suffer
covid 19 because they did not notice the infection, I’m going to pay
attention to covid 19 data and assume it is relevant for the
functionally identical illness I did have.
I’m proud that my
cultural heritage can
be helpful at this time. There might have been a translation error,
however, because I’m not sure if
the governor fully
appreciates the sarcasm that is mixed in with the stoic nihilism here.
Still, it put a smile on my face.
Life’s a piece of shit
When you look at it
Life’s a laugh and death’s a joke, it’s true
You’ll see it’s all a show
Keep em laughin as you go
Just remember the last laugh is on you
And always look on the bright side of life!
I recently had an idea for a new video game mechanic. In many game
genres, there is a common trope where the protagonist goes out into
the world and does exciting action things which often result in
surplus equipment or other valuables. You might kill a dragon which
has a valuable set of scales. Or you kill a few enemy soldiers. In
both of those cases the normal way the situation is handled is by
giving the player the chance to "loot" the scene. But how can it make
any sense to head back into town with a half dozen sets of weapons and
full suits of armor, or a complete dragon hide? Staggering back thus
encumbered might be plausible if that’s all you needed to do, but
there will be obstacles, other monsters and other things to discover.
You know, the stuff that makes the game have a plot.
Currently there are a few strategies to deal with this. One is to
severely limit what you can loot from the set of what one would
reasonably expect. Was everyone you just fought wearing socks? Yes?
Yet the game is not going to let you loot socks. It limits things to
just the salient weapons or even just some random items drawn from a
loot table.
The other main strategy — and they’re not mutually exclusive — is to
just let the player carry an absurd amount of stuff.
Related to that is discounting how much items weigh. A champion of
those strategies would be the deliberately fanciful Minecraft where
players
can carry nearly 10 billion kg! (I actually disagree with that
analysis because I don’t assume nondestructive crafting in Minecraft.
And a player can carry only 36 hats before collapsing under their
weight. But the point of the analysis is still quite correct and
illustrative.)
But what if you’re going for a game with maximal immersion and
fidelity. I can not recall ever seeing this problem addressed
realistically. How might a game do better with this problem?
I imagine an open world game like Skyrim or Borderlands or Fallout or
Witcher3 or or Red Dead Redemption or even GTA handling this problem
in the following way. Once a player encounters a situation where
collecting an absurd amount of stuff is possible, they have the option
to shuttle it to a cache, basically a hiding place. They then make a
note of that on their maps.
How this works is that back in the village among safe and helpful
NPCs, the player can then choose to sell these notes to various
salvage operators. These guys are not professional dragon slayers.
They are just professional movers of stuff. If you tell them exactly
where to go and what to find — with assurances that the local
monsters are all dead! — they can then make the implausible portaging
plausible. Why bother bringing all this stuff back to town to sell,
when the shopkeeper you’re planning to sell things to could also be
handling the moving? You’re this world’s messiah — outsource a bit!
Geralt Should Hire A Sherpa
Besides making games less unrealistic, what’s cool about this mechanic
is that it can have a lot of tunable elements which could be
interesting for the player. For example, let’s say you come to town
and tell a salvager that you have buried a chest of gold that you want
to sell and reveal the general area it’s in. All of this can be done
by selecting from a menu that is essentially your notes. At this point
the salvager has to decide if he trusts you enough to go attempt to
get your stuff. You could have a system where you build trust slowly.
Maybe at first you can only hire shady itinerant movers who commonly
set out after your gold and then disappear forever, maybe stealing
your treasure or maybe failing and its still there waiting. Or maybe
the earnest recovery effort is robbed by bandits or their ship is
dashed on the rocks in a storm. These kinds of problems set up new
missions where you, the hero, can go salvage the salvage operation or
hunt down perfidious cheaters.
As you do more business, you might be able to pay, up front, someone
in a permanent location to go fetch your stuff. They have a good
reputation and will likely work to keep it. Eventually you are
trustworthy enough that these professional salvagers will simply pay
you coin for your notes and the transaction is complete — you have
gold in your pocket from some lootable adventure without the clumsy
impossible process of hauling that loot.
Khajiit Trader Says: Necessary Assets Ready To Go
You could imagine that different towns would have different
reputations. You could trick some of these merchants if they aggravate
you or you don’t mind burning your reputation there. They may charge
more commission if the trip is long or requires visiting dangerous
places. There can be a whole complex dynamic to work out optimal
routes for multiple pickups, a famously tricky
travelling
salesman problem. They might even tell you that they could loot the
cave in the elven ruins if it weren’t for the trolls that lived nearby — prompting you to go kill
three stone
trolls and add their loot to the shipping manifest. This would make it
plausible to capture entire ships or wagons or cars and leave them for
others to sensibly pick up and liquidate.
There might be interesting dynamics in how long it takes to get paid
or take possession of the item back in town, maybe timed for correct
leveling. You could have a system that allows players to basically act
as scouts for some things; for example, they might come back and sell
to a craftsman the general location of a crafting ingredient (e.g.
mine’s ore vein or rare plant grove or animal sighting, etc). Or even
"loot" entire buildings or towns by delivering to the right people the
information that it is now safe to occupy.
You could hire trustworthy movers to go to your remote base and
retrieve needed items from storage for some particular mission. A
lighter version of this would be where the player has to haul all of
the loot to major hubs which functionally act as railheads.
Maybe have different levels of caching. A poorly stashed hoard may be
found by someone else by the time your mover arrives sparking all
kinds of interesting tension. Maybe if this is a common problem the
player can improve their odds by dividing the loot and performing
multiple hiding operations. Maybe there could be a dynamic where poor
hiding results in the mover not being able to find the loot; the loot
is still there, but the mover is too annoyed to try again. Or maybe
that problem doesn’t result from poor hiding but rather careful
hiding!
By having a system like this, players can obsessively loot a place and
yet the carrying weight limit can still be set at something sane. It
opens the door for all kinds of intrigue. You can duly approve and
appreciate all the junk items you’re taking from the battlefield sets
without having them clutter your real working inventory. And if you
come across an item that’s a keeper, but you can’t take it now, it can
be handled later — by someone else!
Some may object that this makes the game too complicated, like running
a logistics business. But I’m afraid that fast travel wagon has
already rolled out of the city gates. Have a look at
this hilarious scene CD
Project Red scripted into Witcher3 to troll people who run mods to
give themselves unaccountable wealth.
Clearly players can enjoy such bookkeeping details!
Imagine you’re swimming in a small lake and some massive creature
grabs your leg and mauls you with hundreds of sharp pointy teeth. You
kick and thrash and barely make it to shore. "Holy shit! What was
that!?", you would wonder as you frantically look for a tourniquet.
After extensive reconstructive surgeries and weeks of healing you’d
still really love to know what the hell could have done that.
Now imagine it’s a few months later, say March, and some old people
who had gone for a swim in this popular lake have been found washed up
on the shore dead, torn to pieces by some beast. Ok, that’s weird.
Now the police department and animal control officers go to
"thoroughly" search the lake. Nothing. Some more people get mauled,
but only people who go swimming in the deepest water — the kids in
the shallow beach area never have any problem. But clearly there’s
something going on. The police and officials get more serious about it
because now things are starting to look bad. Still nothing.
Now we’re hearing that because of "air travel" one of the river
dolphins from the Wuhan Institute of Hydrobiology has gone missing.
(By the way, that’s a real place where
such things live; so slightly less imagining should be necessary.
You’re welcome.) Ok, so now we’re thinking that yes, this could have
been the work of a rogue cosmopolitan river dolphin, and, sure "air
travel", whatever… why not? It’s got to be something, right?
River dolphins - do they look trustworthy to you?
This is a busy swimming lake and people keep swimming in it because
only a really small percentage of people have any bad experiences.
Come on, who gets mauled by something swimming in a lake anyway? It’d
be really bad luck, right? But now that officials are paying
attention, yes, it does turn out that shark bite specialist surgeons
are becoming overbooked for some reason related to this lake. It would
seem that there must be a river dolphin in the lake! It all fits!
Scientists set up monitoring cameras and finally, at the end of March,
they catch a glimpse of it. It has been confirmed — there has been a
river dolphin in the lake! The shark bite surgeons inspect some of
their patients for river dolphin bites and it does turn out that a
vague percentage of them may have been bitten by river dolphins!
Because of such scientific analyses people are starting to worry.
This dolphin is trained to do tricks and therefore is good at hiding
and very hard to catch. While professional dolphin humiliaters are
summoned from Seaworld, the lake is declared a danger zone. Outside of
their own homes, everyone must breathe through a snorkel and wear a
pointy hat to approximate the snout of a dolphin (unless they’re
buying fish of course). No one is sure if this is sufficient or
necessary but it is decided that literally everything
possible must be done — even the things that don’t exactly make
sense.
My important question to you is this: when did this dolphin book his
flight?
For most people the dolphin obviously arrived in March when everyone
started talking about it and wearing the pointy hats. When scientists
got photos of it, that made March seem "scientific". But is that a
satisfactory explanation? If you had your leg mauled swimming in
December, I’m going to suggest that you would have some different
feelings. Sure, some people who got bit by a snapping turtle or
scraped their skin on sharp submerged rocks may be over-imagining that
they had been mauled by a river dolphin years ago the last time they
visited the lake, but if you still have scars of hundreds of little
teeth marks in your leg from December, you may feel that the March
hypothesis leaves something to be desired.
It’s going to take a lot to convince you that this river dolphin
wasn’t there when you got mauled. If videos of that specific
dolphin doing tricks at a February show in China emerge on Tik Tok,
that is still not the end of it. Even in that case where we have
high-quality information exonerating the river dolphin in December,
there is still something very important to say about the lake,
something important that must be done once the dolphin is captured…
Keep looking.
Because that’s not your only problem is it? Either that river dolphin
was mauling people in December, or there’s another lake monster doing
naughty things.
Who Cares?
Why should anyone care? That’s a solid question. I personally care
because I was mauled by something functionally identical to Covid19 in
December and the official story is that it could not possibly have
been related to the pretext for our current global calamity.
I would consider it epidemiologically curious if I did have Covid19.
However, it would have been a serious and interesting freak
coincidence if I did not have it.
If I did not have it, clearly there’s something else out there that
we may additionally want to freak out about. If you think Covid19 is
scary, wait until you hear about Covid19 plus some other thing that
will horrifically kill you!
I feel like I have insight into contracting and surviving a
Covid19-style disease. (If that sounds especially interesting, see my
other post where I go into too much
detail about exactly what happened to me.)
For example, I have heard no one hypothesize that having some external
temperature stress could exacerbate the disease, but in my case I feel
that is likely what happened. It definitely is worth considering and
such information would have policy recommendation implications.
Also as a survivor of a serious Covid19-like disease, there’s another
topic I’d love to address — no one ever talks about how to help the
afflicted.
These CDC guidelines
on how to take care of "yourself" when you’re sick suck ass. They are,
in fact, basically guidelines to keep you from passing it on. They are
how to take care of others while you are sick.
This
document says:
"People with COVID-19 who have stayed home (home isolated) can leave
home under the following conditions**:"
Fine but what about when the victim is losing a lot of weight and
needs to buy some food and can barely stand? What was that
disinfectant they were supposed to go acquire? How many times were
they supposed to do spring cleaning every day?
What I would have said in December is, "See you in Hell!"
Seriously, to offer "help" to people who are knocking on death’s door
by basically saying, "stay away from me you icky monster", is not
help. How about some resources or tips on how to get food or take care
of your family when you’re more than half dead?
What Is The Reality Of Covid19?
Not the societal reaction to it; right or wrong, that is going to be
a colossal mess. No, what is the reality of Covid19, the infection, in
real life? Well, obviously I can’t say because I had exactly all of
the symptoms in December. But I can can say exactly what it’s like to
have a functionally identical disease. When you get Covid19 I’m told
that you are likely to present the following symptoms.
By the way, "anorexia" is
the symptom
anorexia, which just means that getting enough to eat becomes
problematic, not the full
eating disorder thing.
Sputum is stuff you’re likely to
cough up when your respiratory system is sick. And the only other
symptom with a fancy medical term is
myalgia which is simply
obfuscatory doctor talk for "muscle pain".
But don’t rest yet.
Here is a differentlist
from the CDC (from 2020-05-14 with order preserved):
Cough
Shortness of breath or difficulty breathing
Fever
Chills
Muscle pain
Sore throat
New loss of taste or smell
In December, because I suffered all of these exact symptoms, I looked for
what malady they likely imply. Only once Covid19 found me (and
everyone else) did I have a perfect candidate. If you know of an
illness that is exactly like Covid19 and valid in Western New York
or Southern California at the end of 2019, do let me know.
Were there any other interesting symptoms I had that are not on this
list? Nothing major really. The things I would add are the following.
Loss of mental acuity, but that is directly related to hypoxia
("shortness of breath"). I’m lucky to have recreationally played
with that one (without drugs! e.g. at high altitude, freezing
temperatures, sunstroke, anaerobic sprinting, et al.) and I am good
at handling it.
Hypoxia is also related to the numbness in my fingertips. That
second CDC list does mention both of these items under "When to Seek
Emergency Medical Attention". (They say bluish lips or face - that’s
related to bluish fingers,
cyanosis that can accompany
serious pneumonia — they weren’t blue but I did describe numb
fingertips before learning all this.)
I also had an ear infection at the end of the ordeal. That was
unnerving because I couldn’t hear out of my left ear for a while.
That did thankfully clear after a couple of weeks.
Reading the record today I was reminded of little red spots on my
chest and back. I’m a middle aged guy and I still get acne, so my
skin isn’t the most easygoing in any case. These little red spots
were almost too small to notice and they went away quickly. Still, I
must mention them for completeness as a symptom I’ve not heard
about.
Let’s consider symptoms I did not have because I think that’s
just as interesting.
Some sources vaguely mention diarrhea but it is not a hallmark
symptom. I did not have any such problems.
Likewise my stomach was fine. I wasn’t hungry in a profoundly
pathological way, but it was not from nausea or the kinds of things
people must mean when they say "stomach flu".
One of the official symptom lists includes sore throat. I don’t have
strong memories of that being a serious problem but I do remember
some level of throat irritation. It was just overshadowed by much
more serious problems. With all that coughing, this symptom seems
almost redundant.
Congestion. My sense of smell broke, but not simply because my nose
holes were blocked. At the end once the main symptoms were receding
I did have a bit of congestion but nothing out of the ordinary
really.
The loss of smell, or anosmia,
was a very strange symptom. I went from eating 500g of chocolate per
week to temporarily not liking chocolate. Thankfully that recovered!
A lot of my food preferences were completely messed up. It might be
wise for the CDC to add "sensation of taste" even though it is
ultimately related to smell.
I feel like reports are pretty solid that anosmia is idiosyncratic to
Covid19. Yes, other viral infections can do this, but it appears to be
unusually common with Covid19 victims.
This
infectious disease researcher, who suffered a serious case of Covid
19 himself, says…
Loss of sense of smell is kind of a unique symptom. It’s not present
in everyone. But if I have a patient call me and say, I don’t feel
good and I’ve lost my sense of smell - until proven otherwise, they
have COVID, there’s no question about it.
Here is a
short paper about the loss of smell in Covid19 patients, written by
people at UB just down the street from me.
Not Just Me
I’m not alone here. There are a lot of people who are hearing about
Covid19 and thinking to themselves, ah, well that perfectly explains
my very strange mystery illness.
The
NYT wonders
if maybe C19 was earlier than commonly supposed.
By the time New York City confirmed its first case of the coronavirus
on March 1, thousands of infections were already silently spreading
through the city, a hidden explosion of a disease that many still
viewed as a remote threat as the city awaited the first signs of
spring.
Hidden outbreaks were also spreading almost completely undetected in
Boston, San Francisco, Chicago and Seattle, long before testing showed
that each city had a major problem, according to a model of the spread
of the disease by researchers at Northeastern University who shared
their results with The New York Times.
…
"We weren’t testing, and if you’re not testing you don’t know," Dr.
Heguy said. The new estimates suggesting that thousands of infections
were spreading silently in the first months of the year "don’t seem
surprising at all," she said.
There are other signs that the outbreak was worse at an earlier point
than previously known. This week, health officials in Santa Clara
County, Calif., announced a newly discovered coronavirus-linked death
on Feb. 6, weeks earlier than what had been previously thought to be
the first death caused by the virus in the United States.
…
In mid-February, a month before New York City schools were closed,
New York City and San Francisco already had more than 600 people with
unidentified infections, and Seattle, Chicago and Boston already had
more than 100 people, the findings estimate. By March 1, as New York
confirmed its first case, the numbers there may already have surpassed
10,000.
The Mount Sinai study looked at 90 SARS-CoV-2 genomes from 84
confirmed COVID-19 cases in its health system in New York and found
"multiple, independent but isolated introductions mainly from Europe
and other parts of the United States from January through early March
2020," the researchers wrote.
Van Bakel told the Times that his team identified seven distinct
lineages of the virus circulating in New York.
"We will probably find more," he added.
Without early testing and then sequencing of the virus, though, public
health officials weren’t able to know where the virus was coming from
and who could be at risk before it grew to its current levels, Heguy
said.
"Every single case of strange pneumonias here in New York, they could
have been testing earlier and then do immediately the contact
tracing," she said.
Heguy said continuing to collect data and build out a larger sample
size will be a next step in the research. Scientists are also hoping
to understand the clinical implications of the different strains of
the virus. Sequencing the virus' genetic information now will also
help in case a second wave were to occur, she said.
A French hospital which has retested old samples from pneumonia
patients discovered that it treated a man who had COVID-19 as early as
Dec. 27, nearly a month before the French government confirmed its
first cases.
In that article, a doctor foolishly entertains the idea that this may
have been "patient zero" in France. To me it seems ridiculously
unlikely. That’s like finding a
6e6 year old hominid fossil and
assuming you must have found biblical Eve because that’s really old!
Counter Argument
Here are some
scientists who
think they’ve done sufficient science (checking mutations and assuming
the rate is constant per time). And maybe they have and their methods
are sound. Still I thought of some pointy questions for them.
One problem is if they see a second line that they can’t tell is a
sequential mutation or just that such mutations are more likely
(perhaps because they are benign). Sort of like two distinct
populations of people could get a genetic resilience to alcohol, not
because they’re in communication or descending from each other, but
because it promotes success.
It seems a big assumption to assume mutations are constant. Maybe
that’s ok though. They say "about two mutations per month".
What’s the error rate on correctly transcribing the sequence?
Surely it must be something. And there must be self-checks that would
be much less likely to happen from gradual mutations. I
get the
feeling that the error rate could be as high as 3 in 29811, C19’s
genome size. See the above point about 2 mutations a month and think
of how long we’re talking about here.
This may be effective methodology for very well established cases
and outbreaks, but there could have been entire outbreaks where no one
cared. Clearly that was true in my case whatever specific pathogen I
had. (Still no one cares!) It is quite reasonable to consider whether
there was a much more massive outbreak among relatively healthy people
(one that reached all over the world) before it finally got into
nursing homes and vulnerable populations in a noticeable way (where
dying frequently is normal).
Without better controlled data and source material, this seems like a
just so story. But I
understand that so does the other hypothesis that this pathogen was in
the wild before people realized it explicitly by name. It will be
interesting to see if the hypothesis in this work holds for subsequent
data.
Here
is a report from my local WNY county which expresses surprise that
a decent number (actual quantity strangely unspecified) of antibody
tests showed a low percentage of infection.
Earlier this week, Erie County Executive Mark Poloncarz told us 92% of
the community has tested negative for antibodies at this time.
There are a lot of unknowns here. For example, maybe it was 90% of
the population had the antibodies at some point but they wear off.
[The Erie County Health Commissioner] also says we’re still learning
more about antibodies, including if they even provide more immunity
for those who test positive and for how long.
Conclusion
My goal here was to put my personal situation and observations down in
writing so I can stop thinking about them. One of the following things
is true.
Covid19 was far more prevalent in the USA in 2019 than
previously assumed.
There is some very nasty other thing that is every bit as bad and scary
as Covid19 out there unaccounted for that was in WNY in 2019.
I am ridiculously unlucky to get a Covid19-style epidemic of one.
As with most medical facts, the surest thing you can say is
we don’t know.
UPDATE 2020-06-01
I mentioned that a potential false positive symptom I experienced was
red skin bumps on my chest and back, about sternum level. I had not
heard of this as a symptom but listed it because my written record
reminded me of it and I wanted to be complete. Now I find this
short report at the NIH’s
Pubmed which seems to echo my experience.
Conclusion: Infection with COVID-19 may result in dermatological
manifestations with various clinical presentations, which may aid in
the timely diagnosis of this infection.
It further singles out my presentation as exactly compatible with the
findings.
Majority of lesions were localized on the trunk (66.7%, 50/72)…
Again, let me stress that if the CDC wishes me to not have had Covid19
by fiat, that’s fine, but clearly we then have some additional major
disease going on too that needs to be addressed.
UPDATE 2020-06-05
Another post, this one with some
more observations and some long term effects.
UPDATE 2020-06-18
A
mayor in NJ publicly asserts he had a Covid19-style illness in
November 2019.
A slightly
different
origin story from a phylogenetic research group at Cambridge. Still
pretty confusing/confused.
UPDATE 2020-06-18
A BBC article about a
study of Italian sewage samples from 2019-12-18 shows genetic traces
of the virus.
Here is a good photo of me illustrating my baseline health in 2019. I
am visiting San Diego and because it is the main activity I miss about
the geography itself, I rode a bike to the top of Mt. Soledad. At
least four times. The last time was on 2019-11-27.
Less than 10 days later I was in the poorest state of health of my
entire life, as close to dying of natural causes as anyone ever has
been who ultimately recovers on their own. Normally I would be
horrified to complain or seem like I was complaining about any
untoward ill-health. And I am not complaining now! Or fishing for
sympathy or whatever it is that normally motivates people to
complain/brag about their maladies. But because of the Virus That
Broke The World, obviously everyone is much more interested in novel
coronavirus symptoms than they’ve ever been before and ever imagined
being.
I am hoping that this account can possibly be helpful in discussions
about that other virus, which official people assure me, I could not
possibly have had. My recollection of events was challenged even as
they happened and time has naturally made them even fuzzier. I thought
it would be interesting to review any writing I had from that time
where I share interesting and relevant details about my ordeal. It
turns out that my personal email was rich with statements which
clearly illuminate my situation.
If you don’t like reading about other people’s medical problems (I’m
with you there) or you don’t feel my personal life is worth a lot of
reading (it is my blog after all) then feel free to skip this one.
If however, you’re interested in my life, this is definitely one of
the most interesting things that has happened to me. Let’s review the
historical record.
2019-11-28
The day after my last ascent up Soledad, I was in airports/airplanes
all day, Thanksgiving Day, returning from a visit to SD.
2019-12-06
My wife leaves for a routine visit to her family in SD. Something
isn’t perfect with my health, but nothing worth mentioning. With some
rest I expect to feel fine.
2019-12-07
Instead of the deliberate rest I remember explicitly planning, I get a
surprise opportunity to have some work done on my (job-related) boat.
This prevents me from sleeping in and I end up standing outside
chatting with the guys doing the work for 3 hours in 32F/0C weather.
That’s standing outside doing nothing physical which is actually
harder on the body than being active. I knew I wasn’t feeling full
strength the day before, but this is where I think things took a
serious wrong turn.
2019-12-08
Because my wife is away, I have a nice written record which provides
detailed insights. I write to her…
I hope you’re feeling ok. I am definitely fighting off a tough
illness. I got out of bed today at noon and now, 1830, I’m going to
head back to bed. I’ve had severe chills all day and I’m wearing my
outdoor winter gear and my robe! I’m super unsteady and clumsy. My
lungs want to cough, but it hurts too much for that. I could barely
eat anything. Ug. Tough day.
The next few days I’m really out of it with no written record.
I am completely alone in the house and time goes by in strange ways as
I spend almost all of my time sleeping. I’m having serious fever
issues. I made a change to my bedding format because despite being
around 60F/15C in my bedroom, I was sweating so much that the
polyester comforter could not vent the moisture fast enough. I
remember doing that because I liked the format change well enough that
it is still that way now.
2019-12-12
Despite not having enough snow to ski I report that I barely managed
to shovel the driveway, something I usually find easy and enjoy doing.
Later, I write, "I did laundry. And now I’m very tired." Usually my
lifetime of athleticism adequately provides for folding clothes!
I write to my dad…
I’ve been very sick for the past 5 days or so which is a novelty for
me. This one’s a strange one. No food tastes good; I’m losing about a
pound a day. My fingertips go numb. I can hear my eyelids. Each
follicle of hair on my scalp seems somehow individually in mild pain.
I’m wearing my outdoor gear all the time inside now and just can not
be warm. I’m clumsy and have poor balance. All terrific fun! Still it
clocks in at 3rd place behind real pain like dislocating your
shoulder. And of course I can laugh this stuff off to my grave thanks
to migraines spoiling the scale for any pain related phenomena.
Writing to a friend asking me for help with something…
I personally am unlikely to help at the moment. For the first time in
my memory I have some very bad pathogen — worst since I had mumps at
age 8 in Iran.
In retrospect — worse than mumps.
2019-12-13
Despite taking me to a doctor precisely zero times for illness
the entirety of my early life (including mumps), my dad was actually
concerned enough about what I described that he recommends I think
about professional help. I allay his fears by demonstrating his
apprehension of doctors has been duly passed on. Maybe amplified.
This illness is not a big deal. It’s annoying to lose so much time,
sure, but I’ll live. This ailment is nowhere near as bad as whatever
would be required to see a doctor. [I meant the hassle to just figure
out US medical "care" which is prohibitively complex to me. I
literally have no idea how to "see a doctor".] It’s a bit hard to take
them seriously when their ROI R is questionable and their I seems
designed to cause poor health. I’ll be fine though. Migraines taught
me patience waiting for health to come back. I’m just thankful that it
hit me right as [my wife is out of town] - so she neatly missed it.
I’ve had experience/practice with my thinking being compromised.
I’ve stopped [having fires in my fireplace] while sick because I am
not touching my razor sharp axes until my clumsiness is quite gone. My
metacognition is fine!
Here I’m concerning myself with what I can possibly eat that I will be
able to enjoy enough to make up the caloric deficit I’m sensing.
I had an exhausting day which under normal circumstances would seem
like I didn’t do anything. I walked to the [nearby] store and they did
sell matches. I was surprisingly exhausted after that, like I’d just
run, on foot, [20km] or something. After a nap, I actually
went to Trader Joe’s where I amazingly not only remembered everything
on my list, but thought of the things I couldn’t remember when making
the list! I was interested in getting some of that horrendously
delicious [chocolate] bark stuff that in normal times I feel like I
could eat non-stop until I died of an overdose. But they didn’t have
it. Fresh squeezed OJ was a gamble, but fortunately, its taste is not
too badly corrupted in my system. I bought lots of bottle water. I
guess I need to drink more so I will.
I knew I was very dehydrated from all the fever sweating. The matches
were for the fireplace once I felt able to use an ax.
2019-12-14
I write to my mother in SD…
I meant to write earlier to say thank you for hosting me on my recent
trip. But I’ve been attacked with some kind of lung infection that has
kept me in bed pretty much this entire week. And it’s not letting up.
I’ve lost about 5% of my body weight this week and if it keeps going
down, that could get bad.
To my wife…
Well, still alive again today but really no change. I’m extra tired
today, probably sorting out yesterday’s over ambitious activities [a
short walk and shopping for food]. I’m pretty nervous that this will
not be gone by the time you’re back. If I still have this I’m pretty
sure you’ll conclude the best way to make me stop making the horrible
coughing noises I can not not make is to just kill me.
…
Yesterday’s preliminary experiments suggested I could eat an entire
tamale and so I’m going to do that now. I’m also going to try to make
some lemonade. I’m very tired already just outlining the plan. Ugh.
My son had been sick with a strange fatiguing illness when I visited
SD. My mother in a different household also reports recent strange
lung infections. Here I reply to her skeptically about the source of
my illness assuming my temporally closer contacts might be more
relevant. But at this point, who knows? It seems well established that
in December 2019 a lot of people in the USA were more sick than usual
in weird ways.
→ I also have been coughing up stuff from my chest. … Now [other person in household is] showing the same signs and symptoms.
Ya, [my son] seemed to think I was suffering from his illness too, but
I do not think so. I was back home for days feeling fine and got sick
after hanging around my colleague at work who had been quite seriously
sick. He’s a tough hombre too who we were surprised to see lose a week
to this.
You know something is off when I overlook a chance to use
whom pedantically.
2019-12-15
Writing to my wife who is about to return, I first mention being
worried about having the strength to shovel snow to get the car out to
pick her up. Then I joke around about the grimness of the previous
week…
It’s just too bad you can’t wait until I’m not half dead. You also
must start working on your expectations. You can’t come back and say,
"What the hell happened here?! This place is awful, like no one has
done anything but awkwardly sleep in the bed since I’ve been gone."
Because that is exactly what has happened. I stopped weighing myself
but am still struggling to be calorie positive. I boiled some eggs
tonight and eating one was not bad, a huge concession, I think, to
the fact that I’m starving to death. I’m also quite worried about how
much you will not love the horrible noises, which I can not stand to
hear, which I must make or die. Yup, all night long!
2019-12-16
My wife returns, so I no longer am writing to her to tell her how I
am. She can see first hand now and wisely starts sleeping in a
different room. (My emails to her now are, ironically, us trying to
win the exhausting fight to maintain health insurance. No, not to
receive care — that’s a ludicrous idea — but merely continued
coverage to avoid a billion dollar liability if something really bad
happened involving cars + my bike.)
Email to a friend…
Sorry to be out of touch for a while. I’ve been uncharacteristically
very ill. I’m not that good at flu/cold/pneumonia terminology because
it does not really ever happen to me, but this last week, holy fuck,
it happened to me! I’d like to say I’m recovering, but who the fuck
knows? I could still have this in May. Or at my current weight loss
pace, I’ll disappear by May. I usually get up and then after hacking
and coughing and getting dressed and ready, I’m exhausted and ready to
lie down again and rest. The day pretty much repeats like that. A good
measure of how useless I am is that I can’t even play video games for
very long. Now I kick myself for not learning how to "watch TV" as a
modern person. I can’t even do that!
2019-12-18
My son arrives. Less activity in the written record. Most of my energy
is spent worrying about finding enough food for him and me to eat.
Thankfully, grocery stores and restaurants were open but after making
whatever meal preparations were necessary, I was exhausted. He
was not feeling completely healthy at this point either. He does know
how to "watch TV" like a modern person so we do lots of that.
2019-12-24
This mail to my dad is the first recorded mention of the serious
myalgia. First we get an idea of the general situation at this time…
I would not dare eat one [of the beloved holiday foods of my ancestral
culture] anyway for many weeks since this pathogen has seriously
messed up how things taste for me. I’m still fighting it but the
chances of me surviving are much higher now. I can definitely see how
a pandemic (e.g. 1918) can kill a zillion people in a hurry. It’s
mostly on the run from my respiratory system and now has tried messing
up the chemistry of my heavy meat muscles. I had some worry as it
crept up my back (almost as painful as a migraine, but you can’t rest)
but it mostly went for my legs where I can fight back. Thanks to the
bike stand you have lent me, I was able to set up a "Pathogen Heater"
and bake any imposter chemistry in my legs. In the last 24 hours it
has lamely gone after my tibialis anterior muscles — this causes shin
splints, something that while famously painful, is something I’ve been
dealing with recreationally for decades. Again, burned some of that
off on the bike. Feels great to be able to take the fight to the
pathogen. Always an adventure to see what’s next on the hit list. I
even had little red pox-like bumps (though not nearly so numerous or
serious as, say, chicken pox, which I’ve had) on my chest and back as
it messed with my skin chemistry. A tough thing has been the grinding
pain making resting difficult and then I couldn’t get the Heater up to
full burn because my lungs had been broken. And then it’s just dragged
on and on. So many days wasted. So much of me wasted — I lost about
10lbs which I did not have to lose! Hopefully I’m coming out of the
wraith world soon. I’m hopeful that my body has been laying good
defenses for this kind of nonsense as we’ve made the grand tour
through all my important subsystems. I figure if I can keep this shit
at bay to every couple of decades (this is the worst I can remember)
then it is probably acceptable that each recurrence will probably have
half the chance of survival. But this one will not kill me. I will
beat it. I believe very soon.
That’s a pretty interesting intuition about how being old produces a
nonlinear susceptibility to dying from such an illness!
My dad then captures the essence of this blog post writing,
"That is really weird. Don’t you want to know what it is?"
He suggests I go to some medical service, the thought of which makes
me ill for different reasons. And I offer my best guess at the time.
So my diagnosis is "some kind of virus, probably one of the many flu
viruses". In theory I could get a "rapid test" (RIDT) but they’re not
that accurate.
…
I picked up some flu virus (probably). I’m a very weird specimen with
weird physiology. I am practiced at internal physiology battles. I am
strong, especially in respiration (1918 flu strangely was especially
harsh to the especially strong, but still, probably not a bad thing).
…
Now, if the situation radically worsens, say a bacterial infection
wracks my lungs and I cough up too much blood, well, then some magic
beans may be in order. Maybe some oxygen and other serious
intervention. But I’m not to that point. No need to poke that bear
with a stick just yet!
2019-12-25
At this point I’m fighting back — my idiosyncratic belief is that
there are only ever two ways to cure any and all health problems: 1.
rest 2. ride a bicycle. I knew that doing my normal matador routine
with cars would quickly be fatal in the state I was in, but there was
a solution — I set up a (stationary) bike inside. And so how was that
DIY approach working out? Here I describe things on Christmas Day.
I went to bed last night and writhed in pain all night until I
couldn’t take it any more. I finally got up at 0500 and did 30m on the
bike. Went back to bed and could then sleep fine. Tonight, I’ve got
30m scheduled before bedtime. I just need to marshal enough calories
but being able to ride that bike inside has been a huge help.
This is what I was doing to fight the serious muscle pain in my legs.
I’m no stranger to serious leg muscle pain but I’ve never felt
anything this severe.
2019-12-27
I’m feeling a lot better today. I think I’ve chased the pathogen out.
If it’s not completely gone it will be soon. There are still some
lingering strange things like I can’t look at close objects because if
I position my eyeballs to look at something near, they hurt. That’s so
weird, it’s almost funny. And I was sitting here and I realized my
shins (those tibialis anterior again!) were freezing cold for no good
reason. I now just need to recover from 3 weeks of being in the wraith
world. But I survived this one.
2019-12-28
Recovering. Replying to my dad.
→ Glad to hear that the worst may be over. Quite an experience.
Indeed. I used to know in a statistical way that people did die from
such things but now I know exactly how that could happen. But not this
time!
2019-12-31
I feel better this morning than I have in about 3 weeks. Still that’s
not great but encouraging. I was getting nervous about a secondary
infection that was going after my ear. I had lost hearing in my left
ear. … I feel like I just need to keep aggressively going after
calories. If I can regain some strength I’ll be able to kick this mess
out of my body for good.
The best I’ve got though is going to [a restaurant with normal
American food] where I could relatively easily pick up 2500 calories
and burning some pathogens on the bike. I always feel better after
such a burn but the weight loss is an unnerving challenge.
It was frustrating that it was winter because my California solution
to severe calorie deficit is simply ice cream.
2020-01-01
Feeling well enough to commit historical puns.
Ya, this serious illness thing is completely new to me. After a month
of fighting it I think I’m starting to get on top of it. … If modern
medical quackery (and agribusiness) continue to tragedy the commons of
antibiotics, we’ll be back to [pre 19th century] levels of medical
barberism pretty soon.
2020-01-05
However, my illness is finally starting to properly go away. In
retrospect, it is more obvious to me now that I had pneumonia. A
simple influenza infection shouldn’t last more than a month! That’s
why my lungs were so damaged and filled with pink sludge. With lungs
at 25% power, breathing is difficult. With that kind of hypoxia, my
appetite went away and my brain stopped working as well as it normally
does. Pretty much like altitude sickness. I was down around 61kg which
is much too light for my frame. I’m now eating everything I can and
looking a bit less skeletal. I can breathe properly and my health is
coming back.
2020-01-07
My son goes back to SD.
2020-01-09
I lost a lot of weight and am now trying to eat as much as I can. My
lungs were pretty beaten up. I either cracked a rib or tore some
connective rib tissue from coughing and that’s still not healed. There
were a lot of random bizarre problems that were caused by the pathogen
or my overactive pathogen defense — things like sore eyeball muscles,
couldn’t taste things properly, couldn’t hear in my left ear, etc. The
attack systematically went through all my main muscle groups
simulating various large athletic exploits (e.g. running a marathon)
when I had actually done nothing. For example, one morning I might
wake up with shin splints… The next day, it was the muscles in my
feet. Etc. But I’m actually pretty good at having those muscles be
pushed to the limits. I know how to sort it out. I mostly was trying
to stir up my main meat muscles on a bike set up on a trainer inside.
But with my lungs very weak it was hard to generate wattage. But it
helped. I’m mostly back now. I’m back to work and I’m hoping I’ll be
ready to bike to work by next week. I don’t want to push my luck
though. It was definitely a surprising brush with non-invincibility.
2020-01-10
I’m still weak in the thermoregulation department. Wearing a puffy
jacket (basically outerwear) right now indoors. And it’s not even cold
outside!
2020-01-12
I’m pretty much over my illness. It’s pretty obvious in retrospect
that it was pneumonia. That’s how you take a normal flu in a very
healthy guy and drag that out close to death for over 5 weeks. But I
outlived it. Now I’m just beat up and weakened by it. But I’m coming
back! I was on the bike (inside) today long enough to actually
generate enough wattage to be mostly naked and covered in sweat.
That’s a big improvement over having thermoregulation problems and
being cold all the time. I still have to be careful with that but
reminding my body that generating heat is something I’m good at is a
reasonable part of the recovery IMO. My lungs are starting to work at
a reasonable level again. It was a pretty huge change to go from my
normal high level of oxygen processing to that of a heavy smoker. I
could barely climb the stairs! … I also have some rib damage
[presumably from all the coughing] that is lingering as rib damage
does. Sit ups are still very hard for me. But overall, I’m coming
back. My thinking is back to reasonable levels (no oxygen to the brain
isn’t the best for mental clarity).
Patent drawing for my new invention
2020-01-16
Here’s a good benchmark for my recovery.
Yesterday I just rode my bike to work for the first time in about 6
weeks (didn’t go in for 5 weeks!). (Last winter I rode pretty much
every day.)
If going for a bike ride in the winter does not seem normal, remember
that for me it is.
2020-01-17
I’m still very weak on the bike but I have resumed riding to work
again. And my rib still hurts when I do sit-ups but I can do sit-ups
again. My thinking seems to work as well as ever now too. Making
progress.
And that concludes my personal story. It is obviously weird to have
had an exact functional replica of the terror-inspiring Virus That
Broke The World, but my pretty reliable written record does seem to
indicate that’s how it happened.
With personal details about me now safely ignorable here, I am likely
to continue commentary about the strangeness of this generally in
another post. Which I have now
written.
