Ask HN: NYC with autoimmune disease, what should I do?
I'm 30 years old with an autoimmune disease that puts me at high risk of COVID19. I'm otherwise very healthy -- vegetarian, yoga instructor, runs marathons, sleeps 8 hours, non-smoker. I'm isolating well in my apartment: haven't left in 10 days, and work well as a software eng. My main concern is if I do get infected (which is likely [1]), my immune deficiency suggests I'm very likely to become a critical case and need hospitalization, yet the lack of healthcare resources in NYC is appalling [1].
Should I leave NYC? How? Where should I go?
[1] https://www.businessinsider.com/makeshift-morgue-built-in-nyc-to-deal-with-coronavirus-deaths-2020-3
45 comments
[ 3.2 ms ] story [ 98.0 ms ] threadOf course nothing is known yet to be effective against SARS-CoV-2, but, see paper on IV ozone by Robins and Robert Rowen, MD: https://scholar.google.com/scholar?cluster=78032311573342346...
I got turned onto the alternative doctors, who got me back to work, after conventional medicine failed me for years. Turns out regulatory capture isn't in the public interest after all. Who knew?
Anyway, if there is any upside of being in NYC right now, it may be access to broader variety of treatment options.
If that's the case, keep calm store food for 1 month and wait.
That would give the groceries enough time to decontaminate before you touched them, even if later on nobody is able to make deliveries to you.
I don't know about refrigerated / frozen foods though. Not sure how long covid19 remains viable when frozen.
https://youtu.be/F2EK-XRBsSo?t=468
Also, staying with family has its risks. Maybe someone is infected but asymptomatic.
Sorry man, I don't have much advice for you. Best of luck.
Whatever you decide to do, think it through, preferably with some other brains involved. Don't rush. As others have said, you're reasonably safe inside where you are now.
Why do you think it's likely? If you haven't left in 10 days and continue to stay home you're probably safe - safer than if you decided to leave the city now. Is there something preventing you from staying in your room for another couple months? Groceries can be delivered and carefully handled on your end.
P(failure) = P(infection) * P(critical) * (1-P(icu))
0.1 * 0.8 * 0.9 = 0.072
That infection probability is optimistic, considering what you mention above. That ICU availability probability is the situation we're facing in NYC.
If it were me and I had family out in the country somewhere, I’d consider staying with them. But... you seem to have your stuff together and the devil you know may be better than the one you don’t!
It's a hard problem that I struggle with personally. My parents are elderly and not in great health. I live in fear every day that the efforts of my family and their support network (visiting nurses, etc) to help them can kill them.
If you do go out wear rubber gloves and a mask. Never touch your face when out. Thankfully you got a job that allows WFH and you should be able to ride this out.
I am curious if you have a source for the two day number.
I have seen various reports ranging from 12-24 hours for how long this particular virus can last on surfaces like cardboard. The longest estimate I have seen for any surface is 72 hours for stainless steel under lab conditions (i.e. not real-world conditions).
So presumably if it takes 2-3 days for a package to arrive, the contents should be okay if you wait another day or so for the exterior surface to become safe.
Not sure why parent is subtracting the transit time: Who delivered the package? Were they infected? Exactly.
> wait another day or so for the exterior surface to become safe.
Unless you think that for some reason the exterior of the box is going to have live virus for more than what’s been reported, this seems reasonable.
Although I'm not an epidemiologist, I suspect that your probability of catching the disease from a package decays roughly exponentially with time.
Personally, and as someone not immunocompromised, I've been setting my packages aside (in my apartment) and washing my hands thoroughly afterwards. In cases where I'm particularly eager to get the contents, I'll open them after a day and not worry too much. Otherwise, I'll let them sit for two or three days.
Although NY might not be the best place, where would, and can you get there in time, and without risk.
I see how the calculation is that NY ICU will be overwhelmed, not sure that there is anywhere which will not be. I see little difference between a 1% chance of getting an ICU bed and a 0.02% chance. If it was me, I would stay put.
My thought experiments have been hand-wavy expected value calculations like this: P(failure) = P(infection) * P(critical) * (1-P(icu))
0.1 * 0.8 * 0.9 = 0.072
and cost of failure is, well, infinite.
That infection probability is optimistic, considering what you mention above. That ICU availability probability is the situation we're facing in NYC.
If the theory that people who already got covid19 develop immunity from it and won't catch it again is true, then one thing to realize is that NYC (and Italy and others) will become a "safe" place sooner than other places. Yes, there's the horrible downside that a lot of people are dying, but since so many people already caught it (and so many will catch it in the next days/weeks), after this peak passes you'll reach a point where mostly everybody around you will be immune, so you will benefit from herd immunity. If you move to another city, one where the number of cases is still increasing, it will likely take longer for this stage to be reached.
I should note that I'm not advocating in favor of society pursuing herd immunity strategies: letting people die is never a good strategy. I am just pointing the fact that the since the curve is not very flat in NY, herd immunity will be a thing there sooner than in other places. It's happening whether we like it or not.
I'm not a doctor and I'd love to hear arguments on how this theory could be wrong.
The nice thing about NYC is that I literally don't have to leave my apartment. I get all groceries delivered (perishables from Whole Foods, non-perishables from Walmart). Medication for my condition is delivered as well. I'm blessed enough to have a doorman so the only exposure I have to the outside world is going down to my lobby to pick up the packages which I do late at night to avoid running into anyone else.
My only concern would be if I did get sick and was hundreds of miles away from any of my family members. However as far as risk of getting sick goes I'm pretty confident that bunkering in my apartment is the right call.
I'm concerned about this as well.
> I'm pretty confident that bunkering in my apartment is the right call.
Thank you, that's reassuring
Unlike in normal circumstances, people who die in this epidemic die alone without seeing their loved ones since the moment of hospitalization.
[edit] Sorry for the morbid implications! The vast majority of people do get better, the risk definitely exists, but even with previous conditions it's not overwhelming, getting it is not a death sentence.
When you have to come into contact with people, wear gloves, a mask (you can make it yourself, and sterilize it too), and eye protection (safety glasses). We call it MEGG, but you probably won't need the gown.
Here is how some of my colleges do it: https://www.youtube.com/watch?v=k-tw-7XRV5w
The TP makes sense. I don't understand why you're suggesting to order water, though.
Can you elaborate?
I haven't seen any recommendations that tap water would be unsafe.
If you're in an earthquake prone zone like SF or LA of course having water at home is a very good idea any time of the year.
Robert Cathcart, MD, prescribed vitamin C, orally to bowel tolerance, for all viral illnesses, including common cold, which is a coronavirus: http://orthomolecular.org/resources/omns/v16n14.shtml
Robert Rowen, MD, suggests IV ozone for coronavirus and explains why: https://scholar.google.com/scholar?cluster=78032311573342346...
A prolific teacher of IV ozone is in NYC, has trained many nearby, and may share a list of doctors he's trained: https://www.ozonedoctor.net/
Dr. Rowen is interviewed by Dave Asprey here: https://blog.daveasprey.com/robert-rowen-352/
An MD-PhD neurologist at Mayo Clinic recommended Rowen to me, said she'd sent patients to him.
I got turned onto the alternative doctors, who got me back to work, after conventional medicine failed me for years. Turns out regulatory capture isn't in the public interest after all. Who knew?
See also the doctors interviewed in https://thatvitaminmovie.com/