An Illustrative Fable

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?

riverdolphin.jpg

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.

  • Fever (83–99%)

  • Cough (59–82%)

  • Fatigue (44–70%)

  • Anorexia (40–84%)

  • Shortness of breath (31–40%)

  • Sputum production (28–33%)

  • Myalgias (11–35%)

That information is from this CDC web page.

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 different list 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.

Here’s another one in USA Today citing some of the same researchers.

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.

This Reuters report is also very suggestive.

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.

  1. Covid19 was far more prevalent in the USA in 2019 than previously assumed.

  2. 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.

  3. 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.