We are the chief medical writer for The Associated Press and a vice dean at Johns Hopkins Bloomberg School of Public Health. Ask us anything you want to know about the coronavirus pandemic and how the world is reacting to it. Science

UPDATE: Thank you to everyone who asked questions.

Please follow https://APNews.com/VirusOutbreak for up-to-the-minute coverage of the pandemic or subscribe to the AP Morning Wire newsletter: https://bit.ly/2Wn4EwH

Johns Hopkins also has a daily podcast on the coronavirus at http://johnshopkinssph.libsyn.com/ and more general information including a daily situation report is available from Johns Hopkins at http://coronavirus.jhu.edu

The new coronavirus has infected more than 127,000 people around the world and the pandemic has caused a lot of worry and alarm.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

There is concern that if too many patients fall ill with pneumonia from the new coronavirus at once, the result could stress our health care system to the breaking point -- and beyond.

Answering your questions Monday about the virus and the public reaction to it were:

Marilynn Marchione, chief medical writer for The Associated Press
Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health and author of The Public Health Crisis Survival Guide: Leadership and Management in Trying Times

Find more explainers on coronavirus and COVID-19: https://apnews.com/UnderstandingtheOutbreak

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179

u/ValidatingUsername Mar 16 '20

Not the OP, but have extensive background.

1) Not really, but warm water has been found to increase likelyhood that individuals actually meet the required timeframe that will be useful in removing any foreign contaminants

2) Yes, at almost every stage of the preparation the surface of the dish is not reaching the heating zone required to sterilize RNA

3) No, exercise reduces your ability to fight virus when you are past the incubation phase and before you have started recovery. Your body is confused as to where it is supposed to send nutrients so it focuses on muscular damage as it thinks you are escaping predation. Obviously, this isn't a 1:1 shift but it's a non negligible effect.

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u/gstormcrow80 Mar 16 '20

I don’t doubt your credentials, or the accuracy of this information, but I would encourage the inclusion of references since you are posting medical advice in a verified thread from an unverified account. Basically, readers have no reason to trust information otherwise.

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u/ValidatingUsername Mar 16 '20

That's why I made sure to clarify that I was not OP and I'm not concerned if they don't want to read the comment.

I knew a medical professional was going to be in the thread regardless so I wanted to make sure info got to important questions they might not have gotten to.

Burden of proof is on me, absolutely, but if I dont care about proving my point I don't have to. Take the information or leave it and defer to the medical professional if you want to appeal to authority for these kinds of issues.

It's almost like I know how serious this issue is and didnt want to come across as pretending to be an authority in the field to those who aren't checking for usernames and references.

-4

u/abdulgruman Mar 16 '20

Unfortunately, critical thinking is dead and people can't evaluate information on their own.

They only believe information coming from an authority aligning with their worldview, which is rarely examined.

14

u/ValidatingUsername Mar 16 '20

If people think the bar for authority is who can post on reddit, the world has much bigger issues at hand than a flu.

45

u/rock192 Mar 16 '20

Regarding #2, if I order let's say Pad Thai that I KNOW with 100% certainty is infected with coronavirus, would microwaving or putting it in a hot oven for a few minutes kill the virus?

48

u/ValidatingUsername Mar 16 '20

No, if you've ever seen the double slit experiment visualized your microwave is essentially a 50 slit experiment with electromagnetic wavelengths in the micrometer spectrum.

What this means is that there are hot and cold zones in the containment vessel where the waves interact. Normally this is counteracted by the heat capacitance of water dispersing the energy in your food as evenly as possible.

However:

The RNA may not be near a water molecule

The RNA may be in a cold spot

RNA is less susceptible to heat degradation, hence the extremely high temperatures required to sterilize reusable operating devices

56

u/phriot Mar 16 '20

For the sake of discussion, I would think that you only need to heat enough to denature the envelope and spike proteins, not degrade the RNA.

42

u/ValidatingUsername Mar 16 '20

You are a blessing unto which you cannot imagine.

Yes, the vast majority of transmission can be avoided denaturing the envelope and spike proteins.

However, there is still a non-zero chance the RNA can make it's way into a damaged cell outside of the viral envelope.

1

u/Grimloki Mar 17 '20

I've been reading about Bromelain, and how it can denature the spike proteins on coronavirii.

Any application here for food safety?

1

u/ValidatingUsername Mar 17 '20

Not without lots of research, as it denatures essentially many proteins, if not all, it comes in contact with.

It is so powerful it can literally slough off the lining of your stomach which produces it's own protein digestive aid.

1

u/Grimloki Mar 17 '20

It's interesting stuff. I bought some for chronic sinusitis and then read about it's bizarro properties.

2

u/rock192 Mar 16 '20

Well what about an oven at 200 degrees? No way it could survive that, right?

4

u/ValidatingUsername Mar 16 '20

Air circulation and internal temp is in effect here.

Also what units are you using?

Do you have a radiative oven or convection oven?

2

u/rock192 Mar 16 '20

convection at 200* F

3

u/ValidatingUsername Mar 16 '20

200°F most likely not.

70

u/onlinebeetfarmer Mar 16 '20

You really want your take-out Pad Thai :)

52

u/rock192 Mar 16 '20

I can't get enough of it, I've never had Bad Thai lol

3

u/timetospeakY Mar 16 '20

omg that was good. I'm using it.

2

u/Yozhik_DeMinimus Mar 16 '20

Strange, since leaving NYC, almost 80% of the Pad Thai I've had has been terrible.

1

u/[deleted] Mar 16 '20

Come to one of my locals, they managed it. Somehow it tastes more like a tomato pasta than a pad thai. It's almost a joke how bad it is.. Like a 10 year old tried to make it based on what was in the pantry at home, not a 50 yo thai chef..

2

u/way2funni Mar 16 '20

Reddit Food Safety guy here, I got this (kidding, no I really don't 'got this' but the below sounds right) transfer from fast food delivery packaging to a proper plate or pan and nuke/bake until temp is consistently above 140F using a thermometer.

SOURCE:

https://www.webstaurantstore.com/article/29/following-food-safety-temperatures.html

3

u/ForeXcellence Mar 16 '20

My dude, why would you want to eat Pad Thai that is 100% infected with Coronavirus?

You wouldn’t eat a muffin with aids so why would you eat Pad Thai with coronavirus

3

u/alieninthegame Mar 16 '20

You wouldn’t eat a muffin with aids

comedy gold thank you!

3

u/VitiateKorriban Mar 16 '20

Put it in the oven for 15 minutes at 150 degrees Celsius and you are good. The entire food. With packaging. I‘m serious. Been doing this with all my orders since it got serious here.

There are studies that 65 degrees for 15 minutes are sufficient. However you can really make sure by doing this. At 150 degrees the paper won’t burn either, so that is good.

5

u/rock192 Mar 16 '20

The entire food. With packaging.

Why can't I just throw the packaging away and heat the food in my own oven-safe dish?

3

u/VitiateKorriban Mar 16 '20

You could also do that.

However, you’ve got the packaging that has to be disposed properly if you suspect that it could carry the virus. Heating up the food and the packaging eliminates that trouble.

4

u/OsamaBinFuckin Mar 16 '20

this melts the containers :P

2

u/TunaCroutons Mar 16 '20

Sure just wash it really well with soap and water first

79

u/[deleted] Mar 16 '20 edited Mar 29 '21

[removed] — view removed comment

24

u/ValidatingUsername Mar 16 '20 edited Mar 16 '20

You shouldn't order pizza if you suspect the individuals at your local pizzeria are coming in to work sick.

Continue on as if you would normally, just ask if anyones sick when you call in.

Edit¹ : Removed a comma to clear up the intent of the sentence.

60

u/hypermarv123 Mar 16 '20 edited Mar 16 '20

I stopped ordering food. Especially from fast food restaurants. I don't trust that a hard working dude will stay home despite being sick. I don't want that guy cooking my food.

13

u/OTTER887 Mar 16 '20

I actually admire the strict food handling procedures at fast food restaurants. McDonalds being the best. These guys are professionals. Worst case: buy the food, bring it home, and throw it in the oven at 350 degrees for ten minutes.

37

u/[deleted] Mar 16 '20

[deleted]

6

u/slug_in_a_ditch Mar 16 '20

My salad, she’s ruined.

1

u/[deleted] Mar 16 '20

People eat anything other than McNuggets from McDs?

3

u/AlexG2490 Mar 16 '20

You can have my Sausage McMuffin when you pry it from my cold dead potentially infected fingers.

6

u/cloudsdale Mar 16 '20

When it comes to washing my hands, I just pretend I'm back at Starbucks and we're getting audited by our in-company health inspectors... literally washing your hands raw, wiping down every surface, cleaning out that damn milk drain, etc. The Starbucks I worked at was so insanely clean.

1

u/OTTER887 Mar 17 '20

See you guys are pros.

2

u/Fishercat Mar 16 '20

McDonald's food-handling procedures may be excellent, but their employees don't get paid sick leave, and can't afford to stay home without pay. Businesses with >500 employees are exempt from the deal Pelosi made with Azar to require 14 days paid sick leave during the COVID-19 crisis. That's more than half the employers in the U.S. Personally, whatever I buy during this mess is coming from companies that do pay their sick employees to stay home. Politics aside, it's just safer.

1

u/OTTER887 Mar 17 '20

Yeah how bizarre was that, that they didn't make that requirement for big companies.

-7

u/ValidatingUsername Mar 16 '20

That is more than your right to do so.

Please realize that many peoples lives will be drastically impacted if everyone acts in this manner, to the point where there will literally be a spike in homelessness in the next 6 to 18 months.

Why do you assume the only persons who would be cook[ing] your food would be sick hardworking dudes?

11

u/[deleted] Mar 16 '20

"Why do you assume the only persons who would be cook[ing] your food would be sick hardworking dudes?" He didn't assume that.

he assumed 'could be.'

Seems a reasonable assumption.

-7

u/ValidatingUsername Mar 16 '20

There is literally no "could be" in their post.

That's not even the issue I was addressing either, why is the assumption male?

Also why did you assume they are male?

4

u/[deleted] Mar 16 '20

I don't trust that a hard working dude will stay home despite being sick. I don't want that guy cook my food.

you got 'only' out of that.

It's not in there at all. It's clear that OP is talking about the possibility of a worker being sick while making food.

If you're going to be a pedant, be right lol.

I assumed they were male because they said dude and because it's reddit.

0

u/ValidatingUsername Mar 16 '20

Only a sith deals in absolutes, I was just trying to clarify.

1

u/[deleted] Mar 16 '20

Whoever adds the only where there is none is the sith

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u/MJBrune Mar 16 '20

Honestly it's more of a refection that fast food and the like don't give reasonable sick days or unlimited sick days. If everyone in the industry had unlimited paid sick days then I'd feel very safe ordering anywhere.

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u/RYouNotEntertained Mar 16 '20

Guys—fast food employees (and anyone else!) can pass the virus along days or even weeks before becoming sick. Staying home while sick is great, but it won’t stop the spread of the virus. It’s really important that you understand this.

I also think it’s worth pointing out that most fast food franchises, although we think of them as giant corporations, are just mom-and-pop small businesses with a recognizable logo. They’re subject to cash flow constraints just like any other small business.

3

u/MJBrune Mar 16 '20

That's true, even more reason to not get fast food at all. Frozen home cooked food is safer because you can ensure that after the cooking process no one with the virus has handled the food.

I also think it's insane that anyone would rise to the defense of fast food. Oh yes it's just mom-and-pop style. Ignore the fact that franchisee fees are far more expensive than their employees and that they prey on American's obesity epidemic.

0

u/RYouNotEntertained Mar 16 '20

rise to the defense of fast food

Huh? I’m not rising to the defense of anything. I’m asking you to realistically gauge the cash flow restrictions of a small business. You can hate fast food as a concept all you want, but it won’t change the fact that individual franchises are small businesses.

1

u/MJBrune Mar 16 '20 edited Mar 16 '20

I would call them medium-sized businesses not small. That's simply my argument. They are big enough to treat their employees with unlimited sick days and decent wages.

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u/[deleted] Mar 16 '20

^ exactly this.

1

u/Pardonme23 Mar 16 '20

This is why restaurants need to livestream their kitchens

3

u/cpnHindsight Mar 16 '20

You want to livestream your office too?

2

u/rawdenimquestion Mar 16 '20

A lot of the time kitchens are already semi-public. McDonalds you can see into the kitchen, Chipotle it's literally all right in front of you, Five Guys, etc.

Dealing with food is a lot different than an office setting dealing with personal info, financials, etc

1

u/Pardonme23 Mar 16 '20

No. I've been to a restaurant that had a tv with a live feed on their kitchen. It was fine.

35

u/sonofaresiii Mar 16 '20

Continue on as if you would normally, just ask if anyones sick when you call in.

If this is a joke, it's both funny and well-executed.

7

u/ValidatingUsername Mar 16 '20

I'm glad someone caught the wordplay.

14

u/HotSauceHigh Mar 16 '20

People can be asymptomatic and contagious. That's why this is all happening.

2

u/ValidatingUsername Mar 16 '20

Absolutely, but sadly there isnt much one can do if no one they know actually becomes symptomatic.

Except wash their hands and practice safe hygiene.

16

u/Kougeru Mar 16 '20

Lol I doubt they'd be honest. No employer would admit to otherwise

2

u/ValidatingUsername Mar 16 '20

I'm assuming you mean employee, push your friends to be honest about being sick and "be the change you wish to see in the world".

6

u/RYouNotEntertained Mar 16 '20

just ask if anyones sick

This is terrible advice. The whole reason the virus has gotten out of control is because of the long incubation period. The dude at the pizza place could pass it on to OP days or weeks before showing symptoms.

1

u/ValidatingUsername Mar 16 '20

What precautions would you add to normal daily activities that are easy to implement instead?

1

u/RYouNotEntertained Mar 16 '20

The normal social distancing and hygiene advice, I guess. My preference would be to make food at home—although I’ve heard that food is actually not a particularly likely way for the virus to get transferred.

I’m not an expert. I just know enough to know that asking if anyone is sick won’t make any difference.

1

u/ValidatingUsername Mar 16 '20

Clean your hands of infectious individuals seems to be the go to method being discussed now.

2

u/RYouNotEntertained Mar 16 '20

I'll be avoiding takeout for the foreseeable future. Quarantine is a great time for young dudes to learn to cook if they've been putting it off.

1

u/ValidatingUsername Mar 16 '20

If only that were the case.

2

u/lannister80 Mar 16 '20

You shouldn't order pizza if you suspect the individuals at your local pizzeria are coming in to work sick.

So don't order pizza. Got it.

1

u/ValidatingUsername Mar 16 '20

That is more than your right as a citizen who can make decisions for themselves.

1

u/lannister80 Mar 16 '20

That is more than your right as a citizen who can make decisions for themselves.

It's hard to make good decisions with a lack of good information.

We have no idea how many people are/were infected.

1

u/ValidatingUsername Mar 16 '20

Expect everyone you come in contact with for the next 12 months is a vector for the illness.

2

u/WiKeDx Mar 16 '20

What about, Papa Murphy's? Wouldn't baking it at the 425° cook off the virus?

2

u/Aberdolf-Linkler Mar 16 '20

Yep, and then they put it in a box which they handle with their hands and is in the presence of the air everyone is breathing and coughing into. Then they hand it to a delivery driver who does the same and doesn't have gloves. Even if he or she did they are getting into their car and touching the steering wheel before handling the box again.

2

u/ValidatingUsername Mar 16 '20

And then they have to take it out of the oven, cut it, and put it in the box all while it's in open air.

2

u/riptaway Mar 16 '20

Papa Murphy's doesn't cook the pizza, they just prep it for cooking. You cook it at home

1

u/ValidatingUsername Mar 16 '20

You're still looking at infinitesimal rates of transmission.

But you shouldn't forgo experiencing life for the sole purpose of never coming in contact with infinitesimally small chances of harmful situations.

2

u/riptaway Mar 16 '20

I'm no medical expert, but I think cooking the pizza at the recommended temperature and duration should kill any harmful pathogens, including covid-19

1

u/ValidatingUsername Mar 16 '20

Theres a reason cleaning wipes say 99.9%

1

u/riptaway Mar 16 '20

I don't follow...

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u/[deleted] Mar 16 '20

[deleted]

1

u/ValidatingUsername Mar 16 '20

Is that the incubation period for this virus?

1

u/Mako_ Mar 16 '20

You can't get the virus by eating it right? At that point you'd only be worried about contaminated packaging?

1

u/ValidatingUsername Mar 16 '20

You can get contract many viruses through oral ingestion.

Fecal to oral transmission is one of the most common ways to transmit after illnesses that are airborne.

Breath through your nose, wash up often, cook for yourself when you can, drink lots of fluids, but dont add too much additional stress to your life.

1

u/Mako_ Mar 16 '20

So the virus can survive stomach acid? Or does it hit the back of your throat on the way down?

2

u/ValidatingUsername Mar 16 '20

I cannot confirm or deny if this particular virus can survive your specific stomachs acidic environment.

If the virus is intact, any cell it can infect before it is denatured is susceptible to infection. This includes cells in your stomach lining even if all that remains is the RNA managing to wiggle through a damaged cell membrane from when your toast scratched and damaged the lining of your stomach.

As for reasonable transmission?

Most of that occurs in the throat and the virus causes the mucosal tissue to produce a protective barrier so it can bypass your stomach acid and infect the rest of your body.

This is why coughing up mucus/phlegm and rinsing with salt water before bed is actually helpful.

It reduces the build up of infectious material and creates a semi sterile environment while you go about the rest of your day/night unconsciously.

1

u/Mako_ Mar 16 '20

So if I'm hearing you correctly the risk of infection via eating the virus is low compared to inhaling droplets.

2

u/ValidatingUsername Mar 16 '20

I am unsure if this particular virus is primarily airborne, so I will not claim to know that off the top of my head.

2

u/mndtrp Mar 16 '20

Yeah, but they did counteract that by saying exercising is bad. So maybe it isn't all terrible.

1

u/Mahalo9 Mar 17 '20

I know someone whose girlfriend is believed to have the virus, and her boyfriend who has been taking care of her was told to come into work anyways. So definitely don't order Pizza Hut if you're wanting pizza at the moment.

1

u/MechChef Mar 16 '20

Papa Murphy's is a compromise. But would be one option.

20

u/mydisposableacct Mar 16 '20

Why don’t you let the actual doctor answer the questions here instead of cluttering the thread with answers to questions the AMA has already provided.

-9

u/ValidatingUsername Mar 16 '20

This doctor has much more important things to worry about than getting to every single comment.

If he sees comments that he wants to answer that the community can benefit from, that is the point of an AMA.

If someone can clarify based on their own education, why do you have an issue with that?

6

u/mydisposableacct Mar 16 '20

Because your “education” is merely anecdotal opinion, you are not providing any actual data, and again you are cluttering up the thread and answering questions without any authority to do so.

-6

u/ValidatingUsername Mar 16 '20

I don't have to prove to you that my actual education is more than anecdotal.

I can supply facts very readily, but as you want to condescend I am not going to.

1

u/[deleted] Mar 16 '20

[deleted]

-1

u/ValidatingUsername Mar 16 '20

Because you didn't ask reddit to do an AMA to open scientific dialogue on a recent issue.

You're also not contributing much to the dialogue either.

2

u/golden_n00b_1 Mar 16 '20

For number 3, after the immune system has started fighting the virus, does exercise help circulate lymph fluid? This is what they taught us in the biology requirement for the X-ray school that the Army sponsors... but the Army is big on physical fitness l, though I don't suspect they would like about this fact since the requirements for radiography certification are created by an independent association

1

u/ValidatingUsername Mar 16 '20

Most viral infections should be exercise neutral once the body temperature comes back down, as this is one of the primary characteristics you can track easily.

Any exercise before this point is essentially putting your entire body in denaturing temperatures that damage everything.

This is why high heat events for endurance athletes can experience kidney failure during competition when their body starts breaking down tissue and it needs to be filtered out.

1

u/golden_n00b_1 Mar 17 '20

Good to know, thanks for the reply

2

u/[deleted] Mar 16 '20

lolwut. the immune system doesn't need "nutrients" required for healing muscle, and the body isn't "confused". exercise spikes cortisol which is a systemic immunosuppressant.

1

u/ValidatingUsername Mar 16 '20

Would you like an actual response or a joke?

1

u/[deleted] Mar 16 '20

go ahead, im open to learning something new.

2

u/ValidatingUsername Mar 16 '20

Your homeostatic balance is directing where micronutrients are directed.

As you exercise your body requests amino acids in that section

This shifts the balance globally in the body and it has to recalibrate - confused was a quick layman's explination for a dynamic system that uses molecular signals for information exchange

Your homeostatic system has codified fight or flight over immune response, to what degree I haven't exactly determined.

So yes, the body needs to molecularly calculate priorities, where to send micronutrients, which also creates a feedback loop in the enteric nervous system and vasoconstriction in the smooth muscles and digestive tract.

1

u/[deleted] Mar 16 '20

But this doesn't explain why the immune system is affected. Your immune cells don't need amino acids to do their work.

2

u/ValidatingUsername Mar 16 '20

Your immune cells dont have any form of proteins?

1

u/[deleted] Mar 16 '20

? These cells are already formed. People who work out don't have a low white count. I think I'm gonna slowly back away here.

2

u/ValidatingUsername Mar 16 '20

Your immune cells dont need amino acids to do their work

Yea, you probably should

2

u/SenorSoup Mar 16 '20

How a germ could survive a scalding hot pizza is beyond me.

1

u/ValidatingUsername Mar 16 '20

Extremophiles are the GCA for almost all life in the known universe.

1

u/driverofracecars Mar 16 '20

Not really, but warm water has been found to increase likelyhood that individuals actually meet the required timeframe that will be useful in removing any foreign contaminants

Is that because they have to wait for the water to warm up before rinsing or do people just like to keep their hands in the warmer water for longer periods?

-2

u/ValidatingUsername Mar 16 '20

Capillary reflex and vasoconstriction is likely the cause here, I haven't seen much research into WHY it is true psychologically, but that is the suspected mechanism.

1

u/Ofreo Mar 17 '20

How long does a virus last outside a body? If I’m getting take out and someone did cough on my food, it’s probably 15 minutes before I’m eating at least. Could I still get infected? Does hot or cold food matter, like would heat keep it alive longer?

2

u/ValidatingUsername Mar 17 '20

A virion can almost last indefinitely outside the body when temperatures are below 20°C, above that denaturing occurs at a noticeable rate.

If someone coughs on your food it's quite unlikely that that

A) The food handlers are contagious

B) Have virions in their mouth at that moment

C) The virons managed to get aerosolized

D) Those vapor droplets ended up on your food as opposed to stuck in the air current

E) The heat of the food didn't break down enough of the virons

F) You end up eating any that manage to survive

G) Your body cant fight them off

H) You are immunocompromised

I) You dont have access to modern health care

J) You ignore all other health recommendations

K) You don't go to the hospital when you think your dying

L) You died eating the food you love

P(L) ~ P(A》K) = P(A) • ... • P(K) / P(A || ... || K)

As you can see it's quite a few very interesting steps to even get you sick, before you even have to worry about contracting the virus.

Practice safe hygiene and dont let a few health issues concern you too drastically.