The three states of matter and that of covid

[rogespeed]

In the material world is observed three states of matter : solid , liquid and gas ie  H2O : ice , water , steam 

In much the same way "covid-19" could be considered in three states namely the virus SARS-CoV-2,  the viral pathology: Covid-19 and the viral and host socio influences maybe just known a " COVID" 

Why the distinction ?   In separating the various states and so being more obligated to consider the associated influences that create different outcomes is hoped a more timely and effective intervention is realised 

In considering " COVID" what influence does diet , lifestyle , living conditions have on outcomes , considering that infected 18 years and under have a clinically insignificant chance of dying from current known covid-19 variants ( 25 per 12,000,000 )  yet geriatric aged people  have a somewhat greater chance of dying 

For example should that which adversely affects geriatrics be investigated with the objective of improving resistance to inhibiting SARS-CoV-2 infections beyond isolation

Just a thought 

[countessalmirena]

Comorbidities are a significant factor in severe outcomes for COVID-19.

Generally speaking, conditions which affect outcomes are being managed. It's possible to recommend better lifestyle choices for people suffering conditions arising from or affected by lifestyle (diet, exercise, medication, absence or presence of smoking, etc.), but there are many people who are immunocompromised for whom lifestyle choices are a negligible factor.

There will always be vulnerable people in any society, and these are the ones we must protect if we are able to do so, as relatively healthy people.

At least there are exciting new streams of research currently looking into mRNA treatments for some conditions previously untreatable, or with poor outcomes. Medical research is one of the most important areas in a wealthy or sophisticated country; trials sometimes wait for years just to be okayed for the next phase of their research and studies, and as for funding...! Lack of it holds back promising treatments that must go through the necessary rigorous studies and trials.

That applies to medical research in general, not just in the current situation with the COVID-19 pandemic.

[rogespeed]

I thought that maybe considering the covid-19 issue also as COVID ( defined also as influences in various contexts  ) would make easier modelling for a wider range of realities in a timely manner , as considering the pandemic as infection or not + effective immune response or not with reactionary medical responses is i think a fixation that , while effective for the immediate threats , is to narrow and prone to surprises

[countessalmirena]

The modelling being done by the Doherty Institute, Grattan Institute, Monash University, University of Melbourne and others does include social and medical factors as well as impacting human behaviours. You’re on the right track in considering that these are important factors in deciding upon and implementing the public health measures for COVID-19. 

[springyzone]

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@rogespeed wrote:

In considering " COVID" what influence does diet , lifestyle , living conditions have on outcomes , considering that infected 18 years and under have a clinically insignificant chance of dying from current known covid-19 variants ( 25 per 12,000,000 )  yet geriatric aged people  have a somewhat greater chance of dying 

For example should that which adversely affects geriatrics be investigated with the objective of improving resistance to inhibiting SARS-CoV-2 infections beyond isolation

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I think some of the research into such things as the impact of living conditions, age etc on covid patients has already been done. 
It isn't just covid that is more likely to kill an older rather than a younger person. Just about every other disease has that effect too. As countess pointed out, a lot of patients in the older age bracket have a raft of pre existing conditions and covid is just the straw that breaks the camel's back.

There is also the consideration that it becomes harder to treat people with several conditions. For example, years ago my mother was ill with both heart conditions and thyroid problems, while at the same time in hospital suffering some viral infection they could not identify. But the doctor said that the medication they wanted to give her for the heart condition could not be given as it would clash with the thyroid medication, so they were back to the drawing board, looking for a cocktail of drugs that would not clash.

Lifestyle changes (again as countess pointed out)  aren't going to make a massive difference to everyone either. And they aren't always possible with the elderly.
Having said that, I don't believe isolation is necessarily the best long term answer for anything. It's a short term measure and it works. But vaccinations and access to a good medical system are always going to be the main miracle workers.
You can be young & lead a very healthy, active lifestyle, eat a perfect diet etc but those factors alone wouldn't render you immune from the effects of, say, polio. They may help to make you more likely to survive though.

With our elderly during this covid outbreak, I believe we should do what we can to make those who work eg in aged care homes, safer to be around. That means vaccinations for those workers.
And isolation was a necessary short term measure last year.
But now a lot of those elderly have been vaccinated and I believe isolation should not be imposed on them at all. I believe family should be allowed to visit, even when or if the rest of the community is in lockdown. A lot of these elderly have very limited time left and if they want to see family, then that should be their choice. It becomes cruel to leave them isolated. The risk of covid  becomes a bearable risk when visitors and residents have been vaccinated.
I am just commenting on this because I have a brother in law in aged care. He is not excessively elderly but was in a car accident decades ago that left him in a bad way physically and because of frailty went into care 3 years ago. He doesn't understand lockdowns and frets. Last year was very hard on him.

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[rogespeed]

The concept of the third state allows viewing the same event from different prospectives

ie

A person was infected with covid-19 while in an elevator transporting a confirmed case person

and equally valid

A persons immune system failed them and they contracted covid-19 while they were transporting a confirmed case person while in an elevator

The third state consideration challenges a mitigation response from two different elements of the event

Viral loading and transmission

Health of the viral target immune system

[countessalmirena]

Optimum immune system does not protect against COVID-19, so far as all of the current data shows. If there were a human being with a 100% perfect immune system, it may be a different scenario, but every human being on the planet has some degree of innate genetic degradation which it is not possible to tweak to a Nietzshean Übermensch, or to perfection. The risk of successful access by SARS-CoV-2 into the human body can be mitigated by a specifically "switched-on" immune response to that specific virus, but there does seem to be an error in the view of some people that the immune system of a healthy person who lives a very healthy lifestyle is somehow primed to repulse the virus. It's not. That isn't how the immune system functions.

It's a case of the immune system "recognising" the pathogen, and then mounting a defence against it. That defence occurs intracorporeally.

It doesn't hurt to have a healthy diet with sufficient nutrients and to be of a healthy BMI, with no autoimmune disease, no genetic predisposition to certain conditions, etc., etc. Some things we can affect positively by our lifestyle choices, and some things we cannot. Even at best, though, with optimal health and lifestyle, SARS-CoV-2 can and does invade. It is unknown at this stage why some people will be asymptomatic (or have very mild symptoms), and why some people will experience medium to severe symptoms, even to the point of dying.

[rogespeed]

'COVID" would suggest that the country of Iceland with 85.3 % of over 18 years olds having been fully vaccinated an assessment in 4 weeks time of  pandemic status would be informative , as to what to expect locally.

Although what influence diet and climate may have to be factored in

[rogespeed]

One may notice that China is reported to be planning a total covid  test of all the inhabitants of a particular city

This is something a certain city here might have to consider , for certain problem suburbs

This would detect the clueless asymptomatic  and the self-treated unreported cases

Need not be a whole plague suburb - just start with section to test the validity , cost effectively, against a same sized baseline sample from a suburb that has no known cases

The current Sydney crisis is characterized by persistently high unlinked cases and a rather flat line of daily newly reported cases , so using the "COVID" prism of thought , may justify such semi-involuntary testing in the interests of timely eradication and return to normal trade and commerce 

[springyzone]

China can and does do a whole lot of stuff we could not get away with here.

If they want to test a whole city, I have no doubt they could enforce it.

Not so here. 

I suspect, as you do, that there are some unreported cases, especially in Sydney. But if you sent round people to do street by street testing, the unreported cases would most likely be the very ones who would refuse to be tested.