wuhan - coronavirus

[PrincessMommy]

2 hours ago, Jean in Newcastle said:

Re. New Orleans specifically, and Louisiana in general. I was just reading about the explosion of cases starting there.  This is after they went ahead and had Mardi Gras.  They have never had a good history of dealing with crises there and I think that this will be even worse because they are competing with other states for supplies etc. 

yes, and they are a much poorer state than CA, WA or NY.   I think it will be worse there.

[PrincessMommy]

Has these been posted yet on here?

Epidemiologist Responsible for the Imperial College Model Downgrades Projections: 

"A higher rate of transmission than expected means that more people have the virus than previously expected; when the number of those with coronavirus is divided by the number of deaths, therefore, the mortality rate for the disease drops.

Based on both those revised estimates and the lockdown measures taken by the British government, the epidemiologist predicts, hospitals will be just fine taking on COVID-19 patients and estimates 20,000 or far fewer people will die from the virus itself or from its agitation of other ailments,"

I also saw this early this morning:

Nobel-Laureat Predicts Quicker Recovery;

"While many epidemiologists are warning of months, or even years, of massive social disruption and millions of deaths, Levitt says the data simply don't support such a dire scenario — especially in areas where reasonable social distancing measures are in place."

The one problem I see with Levitt's (A Biophysicist) calculations is that he seems to be relying on Chinese info.  I don't trust China to be giving the public the truth. 

 

[PrincessMommy]

8 minutes ago, Arctic Mama said:

Has this been posted yet? Some of the modeling issues and revisions.

https://www.dailywire.com/news/epidemiologist-behind-highly-cited-coronavirus-model-admits-he-was-wrong-drastically-revises-model

funny!  We were posting the same thing at the same time. 

[Jean in Newcastle]

8 minutes ago, PrincessMommy said:

Has these been posted yet on here?

Epidemiologist Responsible for the Imperial College Model Downgrades Projections: 

"A higher rate of transmission than expected means that more people have the virus than previously expected; when the number of those with coronavirus is divided by the number of deaths, therefore, the mortality rate for the disease drops.

Based on both those revised estimates and the lockdown measures taken by the British government, the epidemiologist predicts, hospitals will be just fine taking on COVID-19 patients and estimates 20,000 or far fewer people will die from the virus itself or from its agitation of other ailments,"

I also saw this early this morning:

Nobel-Laureat Predicts Quicker Recovery;

"While many epidemiologists are warning of months, or even years, of massive social disruption and millions of deaths, Levitt says the data simply don't support such a dire scenario — especially in areas where reasonable social distancing measures are in place."

The one problem I see with Levitt's (A Biophysicist) calculations is that he seems to be relying on Chinese info.  I don't trust China to be giving the public the truth. 

 

One very obvious problem:  the death rate from the virus is already over 23,000 and rising. 

[Arcadia]

@mathnerd

SF Bay Area https://www.nbcbayarea.com/news/local/about-a-4th-at-hayward-center-test-positive-for-covid-19/2262127/

“About one-fourth of the 207 people who were tested on the first day of operation for the city of Hayward's new COVID-19 Testing Center on Monday had positive results for the novel coronavirus, city officials said Thursday.

The samples taken at the testing center at Hayward Fire Station No. 7 and analyzed at Avellino Labs in Menlo Park are retested and the results are immediately reported to the U.S. Centers for Disease Control and Prevention, according to the city.

Confirmed positive results also are shared immediately by Hayward Fire Department medical clinicians with the person found to have the infection and are reported by Hayward to public health officials in that person's county of residence.

Hayward officials said differing protocols in each county may mean that results from the Hayward testing center will be added to each county's aggregate confirmed case total in different ways and at different intervals.

The city said it plans to publicly report positive results about 48 hours after each day's testing, and is disclosing the information to help residents understand the prevalence of the coronavirus infection and reiterate the importance of complying with shelter-in-place orders and other social distancing hygiene precautions.

Of the 207 people who were tested on Monday, 54 were confirmed to have the coronavirus. An additional 460 people were tested on Tuesday but their results haven't yet been released, although Hayward and Avellino officials say it only takes six to nine hours to get test results.

... City officials said that on Thursday and possibly again on Friday, the number of tests at the center will be reduced and the center will close early to allow Hayward firefighter-paramedics testing teams to conduct testing of vulnerable populations elsewhere in the community.”

[Laura Corin]

2 minutes ago, Jean in Newcastle said:

One very obvious problem:  the death rate from the virus is already over 23,000 and rising. 

Isn't he just talking about the UK?

[Arcadia]

@Sneezyone

“Coronavirus Outbreak Diverts Aircraft Carrier to Guam; All 5,000 Aboard to Be Tested

 Updated 3 hours ago

  The Navy says an outbreak of coronavirus aboard an aircraft carrier in the Pacific has forced it to divert to Guam, where all 5,000 aboard will undergo testing.

The USS Theodore Roosevelt remains "operationally capable," according to the acting secretary of the Navy, Thomas Modly.

The carrier is the first U.S. Navy ship to have reported an outbreak while at sea.” https://www.nbcbayarea.com/news/coronavirus/coronavirus-outbreak-diverts-aircraft-carrier-to-guam-all-5000-aboard-to-be-tested/2262189/

[Jean in Newcastle]

5 minutes ago, Laura Corin said:

Isn't he just talking about the UK?

Ok. That makes more sense 

[GoodGrief]

25 minutes ago, Arctic Mama said:

Has this been posted yet? Some of the modeling issues and revisions.

https://www.dailywire.com/news/epidemiologist-behind-highly-cited-coronavirus-model-admits-he-was-wrong-drastically-revises-model

 I would be interested in an antibody test. I feel confident that the virus was in our area starting in January. Several friends and acquaintances quite ill with something that was not flu. When my daughter was in the pediatric clinic in Feb (she had flu B), the pediatrician told me that he had seen many kids with high fevers caused by an unspecified virus. Who knows, but I am not so sure the cases being revealed in our area now are the first. It would certainly help to inform policy if we knew some herd immunity was well underway.

[Pen]

47 minutes ago, chiguirre said:

The Pope will celebrate Holy Week liturgies without public participation due to the Covid19 epidemic:

https://www.ncronline.org/news/quick-reads/vatican-says-public-will-not-be-admitted-papal-holy-week-liturgies

 

I haven’t clicked link. 

Does this give dispensation and indeed papal guidance  to Catholics  everywhere  throughout world to stay home rather than attend church on a holy day of obligation? 

[Sneezyone]

10 minutes ago, Arcadia said:

@Sneezyone

“Coronavirus Outbreak Diverts Aircraft Carrier to Guam; All 5,000 Aboard to Be Tested

 Updated 3 hours ago

  The Navy says an outbreak of coronavirus aboard an aircraft carrier in the Pacific has forced it to divert to Guam, where all 5,000 aboard will undergo testing.

The USS Theodore Roosevelt remains "operationally capable," according to the acting secretary of the Navy, Thomas Modly.

The carrier is the first U.S. Navy ship to have reported an outbreak while at sea.” https://www.nbcbayarea.com/news/coronavirus/coronavirus-outbreak-diverts-aircraft-carrier-to-guam-all-5000-aboard-to-be-tested/2262189/

 

Yeah, I already know. The news broke yesterday. Whoever the CO was that allowed that port call was a freaking idiot.

[TCB]

24 minutes ago, Jean in Newcastle said:

One very obvious problem:  the death rate from the virus is already over 23,000 and rising. 

I wonder if he meant 20,000 in the UK?

[kbutton]

6 hours ago, saraha said:

Ohio's nonessential business shut down is a joke. The only thing it changed in our community is that the only clothing store in our county closed. My dh and those of all my neighbor's are still working, as the businesses are allowed to self determine their essentialness. Yesterday in his address the governor responded to questions about employees who feel like their place of business should not be open with the statement to take it up with your employer. I have been with him up to this point and think that on all of his other actions he has been a front runner in this, till we got to here.

He said to TRY to bring it up with the employer first. He reiterated that you can report your employer to the health department. I think, but am not positive, that he said if you are concerned you'll lose your job by bringing it up with your employer, you should report to the health department (or possibly, it was part of a question).

The health department is super busy, so I don't think it's out of line to hope that people with talk to their employers first. 

I am really annoyed that reports are still coming in about employers not following the rules. We need this shut down. 

People are still having playdates though. 

There are a lot of people I'm not going to like when this is over. 

[TCB]

We should be looking at what Germany is doing. Their death rate and serious cases rate is so low!

[chiguirre]

19 minutes ago, Pen said:

 

I haven’t clicked link. 

Does this give dispensation and indeed papal guidance  to Catholics  everywhere  throughout world to stay home rather than attend church on a holy day of obligation? 

No, each bishop will issue a dispensation. Here's a link to the latest list of US dioceses and their current status:

https://www.catholicnewsagency.com/news/do-we-have-mass-coronavirus-closures-and-dispensations-in-us-dioceses-96801

[Slache]

10 minutes ago, TCB said:

We should be looking at what Germany is doing. Their death rate and serious cases rate is so low!

They're testing everyone, I believe. Most places only test the sick. I believe the most accurate numbers will be from Germany and South Korea in the end.

[Terabith]

Wasn't Iceland attempting to test literally everyone?  That would give some useful information.

[PrincessMommy]

1 hour ago, GoodGrief1 said:

 I would be interested in an antibody test. I feel confident that the virus was in our area starting in January. Several friends and acquaintances quite ill with something that was not flu. When my daughter was in the pediatric clinic in Feb (she had flu B), the pediatrician told me that he had seen many kids with high fevers caused by an unspecified virus. Who knows, but I am not so sure the cases being revealed in our area now are the first. It would certainly help to inform policy if we knew some herd immunity was well underway.

I agree..  I want an antibody test.  But as to the people sick with something not the flu.  Were there also a lot of people on ventilators at that time?  That seems to be a consistent issue with the worst cases of Covid-19.   I suspect it wasn't Covid-19  Otherwise, we would have already had a lot of people on ventilators in Feb.

[SeaConquest]

“A Texas nurse with 17 years of experience in emergency rooms wrote: 'Never seen anything like this. Protocols change minute to minute if there are any at all. I can no longer trust the CDC. For the first time in my career I am scared to go to work.'”

https://www.nytimes.com/2020/03/25/business/media/coronavirus-nurses-stories-anonymous.html?fbclid=IwAR0QNWvl4KrJY5VT8nRgj7m7ZnshEvwvkLvy4bPKnJPbXVMy7UiBTi5rrvE

Nurses Share Coronavirus Stories Anonymously in an Online Document

A health care worker in New Jersey created a digital venue for people in the field to chronicle poor working conditions that may put patients at risk. “It is disgusting,” one nurse wrote.

Related: https://www.nbcnewyork.com/news/coronavirus/nyc-nurse-who-treated-covid-19-patient-dies-another-hospital-reports-13-deaths-in-one-day/2344831/?fbclid=IwAR0jmanohLeG-pmE3W8_Z33aldIS5YxN3VmP1-w5Q93dIa8klD2pgty2EME

Edited March 27, 2020 by SeaConquest

[Slache]

50 minutes ago, square_25 said:

Well, they are certainly not testing EVERYONE. Are they randomizing? 

Oh, maybe. That should still be closer to the truth.

[Ausmumof3]

1 hour ago, Arcadia said:

@Sneezyone

“Coronavirus Outbreak Diverts Aircraft Carrier to Guam; All 5,000 Aboard to Be Tested

 Updated 3 hours ago

  The Navy says an outbreak of coronavirus aboard an aircraft carrier in the Pacific has forced it to divert to Guam, where all 5,000 aboard will undergo testing.

The USS Theodore Roosevelt remains "operationally capable," according to the acting secretary of the Navy, Thomas Modly.

The carrier is the first U.S. Navy ship to have reported an outbreak while at sea.” https://www.nbcbayarea.com/news/coronavirus/coronavirus-outbreak-diverts-aircraft-carrier-to-guam-all-5000-aboard-to-be-tested/2262189/

I guess this is what this tweet from global times was about

Confirmed #COVID19 cases on US aircraft carrier #TheodoreRoosevelt, which was on a mission to flex its muscles against China, will deal a heavy blow to the US’ military capability and global deployment: experts https://bit.ly/39kIHkV

[TCB]

20 minutes ago, kdsuomi said:

Except, not everywhere sees heavy ventilator use. We now have over 50 confirmed cases (many more who have it since we don't have a ton of testing) and only one person has needed to be in the ICU. That's why that argument, at least for my area, doesn't hold water.

They usually have the illness for about 10 days I think before they get to the point of needing ICU and ventilation. Maybe it's too early in the cycle where you are.

[SeaConquest]

Wipe down your boxes!

https://nymag.com/intelligencer/2020/03/sick-worker-says-ups-puts-profits-over-people.html

No Masks, No Hand Sanitizer, Filthy Facilities: A Sick UPS Worker Speaks Out

[Terabith]

21 minutes ago, square_25 said:

They've tested 3.4%, I think. Does it say how they are selecting who to test? The important thing is not the percentage, it's the randomization. 

Yeah, I don't think they're anywhere's near there yet.  I think their goal is to eventually test everyone.  

Of course, by the time they do it, it may be a moot point for the rest of the worth with regard to their information.  I don't know.

ETA:  I agree a better approach would be truly random testing.  I don't think anyone is really doing that though.

Edited March 27, 2020 by Terabith

[itsheresomewhere]

Another hospital near me has put out a plea for used video baby monitors.  They are planning to use these to help communicate with covid 19 patients and minimize interaction with them.   Glad to see we are trying to think outside the box here.  

[Terabith]

I had terrible insomnia last night.  Have you guys ever played the game Plague?  Real life plague spreads much, much, MUCH faster than game Plague, even in the easy scenario where nobody washes their hands and sick people are given hugs.

[Ausmumof3]

1 hour ago, PrincessMommy said:

I agree..  I want an antibody test.  But as to the people sick with something not the flu.  Were there also a lot of people on ventilators at that time?  That seems to be a consistent issue with the worst cases of Covid-19.   I suspect it wasn't Covid-19  Otherwise, we would have already had a lot of people on ventilators in Feb.

Aus has a fingerprint antibody test that hopefully will be in use soon

[Ausmumof3]

Initially I felt like most people were underplaying it.  Now it think some of the models are most likely overstating it.  There are risks with this as well.

one is, while I think there’s some community spread already there’s people now thinking ive had a cold so I’ve probably had it so I’m most likely already immune.   If you haven’t tested positive you don’t know you have it and we don’t know how long immunity lasts.

overplaying the spread makes some gov figures assume it’s not stoppable so they don’t take measures to try to contain it at all.  

[Slache]

15 minutes ago, Terabith said:

I had terrible insomnia last night.  Have you guys ever played the game Plague?  Real life plague spreads much, much, MUCH faster than game Plague, even in the easy scenario where nobody washes their hands and sick people are given hugs.

That's a game? I thought that was Ohio.

2 minutes ago, Ausmumof3 said:

Initially I felt like most people were underplaying it.  Now it think some of the models are most likely overstating it.  There are risks with this as well.

one is, while I think there’s some community spread already there’s people now thinking ive had a cold so I’ve probably had it so I’m most likely already immune.   If you haven’t tested positive you don’t know you have it and we don’t know how long immunity lasts.

overplaying the spread makes some gov figures assume it’s not stoppable so they don’t take measures to try to contain it at all.  

I know! Can you please just tell us the truth? I promise to behave.

[SKL]

2 hours ago, square_25 said:

I'd be surprised. Given that it seems like emergency rooms get flooded when there are perceptible cases, I'd guess it was something else. But of course, that's just a guess.

Not sure I understand what you mean here.  Why would emergency rooms get flooded when there are perceptible cases?

[SKL]

2 hours ago, TCB said:

We should be looking at what Germany is doing. Their death rate and serious cases rate is so low!

On the website I'm looking at (Worldometer), their death rate per million is not that much different from the USA's.

[DoraBora]

4 hours ago, square_25 said:

 

Two of the doctors advising the nation :-P. There are lots of doctors. I get the sense that Cuomo has his own doctors who are telling him their own estimates. 

You should try running the numbers yourself :-). See what you think the expected numbers of vents should be. You can start with 1,000 vents right now and work with the current rate of increase. See what you think is a reasonable estimate. Try it and tell me what you think. Argument by authority is never as convincing as being able to actually test people's prediction! (Of course, sometimes the models are too complicated to run yourself, but we are in the strange situation here that the models in the short term boil down to a simple exponential growth model.) 

Well, the starting number is important, of course.  Yesterday's New York Times ran an article in which it listed ICU numbers at 888 and the current doubling rate at 4.7 days. 

https://www.nytimes.com/2020/03/25/nyregion/coronavirus-new-york-update.html

I'm still looking for the JAMA article I read in which it estimated a 71% rate of ventilator use among Coronavirus ICU patients, but how 'bout I inflate that to 75%?

I think I remember you saying that you are a mathematician.  I am not, so I had to keep this calculation simple (for me).  75% of 888 is 666.  (Ahem.)  Even if I double 666 five times instead of 4.7 times (taking us beyond the peak, which is supposed to be three weeks from yesterday), I still only get 21,312.  Needing 21,312 ventilators at the peak assumes that the mitigation strategies already in place don't result in further slowing of the doubling rate and that no one ever gets off a ventilator to free it up for another patient.  (I think I read that the average time on a vent is 11 days, but I've read so much lately, I couldn't begin to tell you where.)  

Btw, I am aware there are other doctors (sigh), and lots of opinions, but your governor evidently speaks to Dr. Fauci about this stuff. It's a difficult time.  I hope the numbers end up being much, much better than Mr. Cuomo fears they will be, and I wish you and all of your fellow New Yorkers the very best.

ETA:  Here's some interesting info, but it's from Wuhan, so it will probably be quickly dismissed: (from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?source=history_widget)

In one study of 138 patients hospitalized in Wuhan for pneumonia due to SARS-CoV-2, dyspnea developed after a median of five days since the onset of symptoms, and hospital admission occurred after a median of seven days of symptoms [36]. In another study, the median time to dyspnea was eight days [34].

Acute respiratory distress syndrome (ARDS) is a major complication in patients with severe disease. In the study of 138 patients described above, ARDS developed in 20 percent after a median of eight days, and mechanical ventilation was implemented in 12.3 percent [36]. In another study of 201 hospitalized patients with COVID-19 in Wuhan, 41 percent developed ARDS; age greater than 65 years, diabetes mellitus, and hypertension were each associated with ARDS [58].

Edited March 27, 2020 by DoraBora

[EmseB]

2 hours ago, Sneezyone said:

 

Yeah, I already know. The news broke yesterday. Whoever the CO was that allowed that port call was a freaking idiot.

I feel like saying...if anyone is so inclined, contacting your congress people and urging them to postpone future carrier deployments so as to not have this happen again...that would be very awesome. I am just a civilian but I feel like having a bunch of Diamond Princesses floating around isn't super great for national security.

That and praying for the sailors on the TR and their families.

[SKL]

A thought about testing.  If we tested 100% of the population tomorrow, what would that really accomplish?  Everyone who tested negative could go about their business and still catch the virus, unless we are in total lockdown + isolation, which would be nuts.  Or should we test everyone weekly?  I don't see the point of testing the general population.

If they could come up with a quick test for people arriving at airports etc., healthcare workers, etc., that would be super.  But we are long past the point where testing individuals who aren't sick is going to make a difference here.

[Arcadia]

A lighthearted news article from BBC https://www.bbc.com/news/blogs-news-from-elsewhere-52040256

“The Malaysian government's decision to allow only "the head of the family" to leave the house to shop, as part of measures to suppress the Covid-19 coronavirus outbreak, has had unintended consequences. 

Some men are unexpectedly finding themselves responsible for the grocery shopping and suddenly having to distinguish between bewildering varieties of vegetables, spices and herbs.

"Govt allowing a man to shop unsupervised? Disaster," was the immediate jokey conclusion of one woman on Twitter.

Several men concurred, however, expressing their anguish on social media.

One Facebook post of three men scrutinising pieces of paper in a supermarket aisle has been shared more than 30,000 times, with poster Muzaffar Rahman saying the shopping felt like "a treasure hunt", with everyone checking their lists several times. 

"The real meaning of panic buying is when the husband as the head of the household has to go and buy groceries on their own. Adding to the panic is when the husband has never had to recognise what ginger, galangal, turmeric, Chinese celery, spring onions or chives are," joked another Twitter account. 

Several men certainly admitted to being confused. 

"I felt dizzy trying to work out which were mustard greens, which spinach, and which pak choi," said another Twitter user. "Then there were many kinds of cabbages - the long ones, the round, the short."

Another just listed his many possible choices on being told to buy red onions: "Rose onions, big onions, big Indian onions, little Indian onions, Myanmar onions, Thai onions, Indonesian onions".

One said he had no trouble with the shopping list until faced with the variety of menstrual pads on offer. 

'I was a bit shy about taking out the list'

Saidatul Akhmar Yahya, a 37-year-old banker told BBC Monitoring she normally does the shopping, and that her 30-year-old brother Amirul Shafiq often comes along to help. 

As she was working from home this week, however, she gave him a shopping list, which included "green beans" - dried legumes she intended to use to make a sweet soup for tea. 

But he returned with long beans. "I am speechless and keep on laughing, in tears," she said. 

Amirul said his sister had briefed him on each item but, at the supermarket, "I was also a bit shy about taking out the list... because I saw a few other men also struggling, searching for the items on their list." He just remembered he had to buy beans.”

[mathnerd]

3 hours ago, Arcadia said:

@mathnerd

SF Bay Area https://www.nbcbayarea.com/news/local/about-a-4th-at-hayward-center-test-positive-for-covid-19/2262127/

“About one-fourth of the 207 people who were tested on the first day of operation for the city of Hayward's new COVID-19 Testing Center on Monday had positive results for the novel coronavirus, city officials said Thursday.

Unfortunately, this number does not surprise me at all since I have had a suspicion that our area had the C19 virus as early as November. I guess that if the government had taken this threat seriously and had tested in Feb, the numbers would have been equally high. (In my son's music school, every single teacher and student had a "bad flu" that was very different from last year's and would not respond to drugs in January/February timeframe. I was guessing that it was the covid19 doing the rounds considering how there is so much China traffic in our county. One elderly piano teacher was admitted to hospital in the end of January for pneumonia and took 4 weeks to recover.) 

I worry for the whole tech sector and silicon valley, to be honest 😞

[Ausmumof3]

6 hours ago, DoraBora said:

I don't know whether someone else has also said this, but I think I said it twice in the context of one "conversation" with square.  Fwiw, I thought earlier that I should have added a comment to say he probably won't need them at the peak rather than he won't need them, because no one can be absolutely sure.  This thread moves fast and I have a lot to do, so I let it go.

I'm sure Gov Cuomo is getting solid advice about what he might need as he tries to prepare for the impact of this growing crisis for New York.  It occurred to me that he may be using the 30k number as a point of negotiation:  hoping to get that many, but knowing that isn't possible right now.  Maybe not.  If I'm very honest, I would say he might also want to inflate that number for political reasons -- long-time politicians of all stripes are always on the campaign trail.

"Just the comments at the briefing" are not insignificant, as they are based on the data collected about cases elsewhere in the world.  I suspect that people on this board will dismiss such numbers, as they were obtained from untrustworthy China, or testing-more-than-we-are South Korea, or some other nation that is handling this differently from our own.

I think Dr. Birx's point is that 30k vents at one time won't be required (and that such statements frighten people unnecessarily) because the data doesn't bear out that number of patients requiring them in the next few weeks.  She added that the mathematical models that show such a need are worst case/no mitigation models, and that they show the progress of the virus over successive waves (fall 2020, etc.). In NY, the mitigation strategies appear to be making a difference, though it takes time to know for sure, but the task force is focused on dealing with this current wave.  Of course, anything is possible.  I could be wrong, but I'm listening to Drs. Birx and Fauci. 

I humbly apologize for upsetting you.

(I also try to watch Gov Cuomo's daily briefings because I have a personal connection to NYC.  My very, very dear BIL lives on lower east side of Manhattan.  He is a former smoker.  I am concerned about him, but he is taking the directives to stay at home seriously, so I remain very hopeful.)

https://mobile.twitter.com/mlipsitch/status/1243356285585649664
 

this is an epidemiologist from Harvard’s commentary on dr birx take.  Haven’t had time to analyse in depth but the take away for me is we can’t rely on the virus stopping like it did in China because were not containing like China.  Even now the restrictions there are higher than in my country.  

[Corraleno]

10 minutes ago, Ausmumof3 said:

https://mobile.twitter.com/mlipsitch/status/1243356285585649664
 

this is an epidemiologist from Harvard’s commentary on dr birx take.  Haven’t had time to analyse in depth but the take away for me is we can’t rely on the virus stopping like it did in China because were not containing like China.  Even now the restrictions there are higher than in my country.  

This guy was part of the team that did some of the modeling that Birx referenced, and he says that she is talking as if the absolute best case scenario, where we do everything perfectly AND get lucky, is the most likely. And he's saying that's BS.

So the scenario Dr. Birx is "assuring" us about is one in which we somehow escape Italy's problem of overloaded healthcare system despite the fact that social distancing is not really happening in large parts of the US. That is unlikely.

Then the rosy scenario assumes we get to minimal numbers of cases everywhere, develop and maintain testing and tracing capacity, execute well on it, don't miss imported cases that spark new chains of transmission, and somehow maintain this delicate balance for the 12-18 months (best case under current models) till a vaccine. I desperately hope she is right, because much suffering will be avoided. But reassurance that this is likely, or even plausible, with the disorganized track record of the US response, is false reassurance. 

We should work our hardest to create the conditions to make the scenarios being described here (one bad wave, contained by social distancing, and we're down to a point of controllable spread) a reality. Doing so will make us better prepared, even if they don't come to pass. But it would be extremely naive to imagine that they are likely, and what do I know, but it seems like bad politics to "assure" the American people that they will come to pass when so many things could go wrong, any one of which leads to much worse outcomes.

[Arcadia]

@Ausmumof3@Pen@Sneezyone

🇰🇷 🇺🇸 https://www.channelnewsasia.com/news/asia/south-korea-pleads-residents-stay-in-isolation-covid19-spread-12582064

“SEOUL: Authorities in South Korea pleaded with residents on Friday (Mar 27) to stay indoors and avoid large gatherings as new coronavirus cases hovered close to 100 per day.

South Korea reported 91 new coronavirus cases on Friday, taking the national tally to 9,332, the Korea Centers for Disease Control and Prevention said.

The country has reported similar daily numbers for the past two weeks, down from a high of over 900 in late February.

The government has sought to convince a restless public that several more weeks of social distancing and self-isolation may be needed to allow health authorities to tamp down the smaller but still steady stream of new cases.

"As the weather is getting nicer, I know many of you may have plans to go outside," Yoon Tae-ho, director-general for public health policy at the health ministry, told a briefing.

"But social distancing cannot be successful when it’s only an individual, it needs to be the whole community."

The US military command this week also moved to try to restrict the movements of roughly 28,500 American troops stationed in South Korea.

An American soldier stationed at the sprawling Camp Humphreys south of Seoul tested positive late on Thursday, US Forces Korea said in a statement.

She is the second soldier and 11th person related to United States Forces Korea (USFK) to test positive.

Officials are seeking to trace her previous movements, as she was at work and other locations on the base as late as the day she tested positive.

Earlier this week an American contractor also working at Camp Humphreys - which hosts the headquarters of the US military command in South Korea - tested positive.

USFK declared a public health emergency, which gives commanders more authority to ensure "total force compliance" with regulations aimed at stopping the spread of the disease by restricting the movements of not only troops, but also their families, as well as other civilians who work on the bases.

"We cannot allow the actions of a few, who knowingly and selfishly take matters into their own hands, place the rest of population at an unacceptable level of risk," USFK said in a letter this week.

"Leaders have a responsibility to do everything in their power to protect all members of the team and make certain no one can infiltrate our protective ‘bubbles'".”

[Arcadia]

48 minutes ago, mathnerd said:

I worry for the whole tech sector and silicon valley, to be honest 😞

I’m being cautiously optimistic since my area has a high number of China citizens and *touch wood* no bad news.

[Ali in OR]

RE: everyone who has been unusually sick this winter and thinks they must have had Covid-19 already but have no test results to verify it.

In Oregon, it's not easy to get a Covid-19 test. It's getting easier, but you're not getting a test for having mild symptoms. And yet, testing only people who are really sick, we have had 316 positive tests out of 7269 total tests. That's only 4.3%. I know that number is higher in other places, but still, chances are it's some other respiratory virus that made you sick. There's no way you can know or guess that you have already had it (without testing) just because you had something that fit all the symptoms. And remember, we've had a bad, double-peaking flu season before this virus really got going here.

 

[TCB]

4 minutes ago, kdsuomi said:

Nope, not the case here. I don't know why it's such a dirty word to say that outcomes aren't the same everywhere. Around 20% have been put it in the fully recovered category, and almost all the rest are still at home.  We've also been "shelter in place" for over a week now. 

Not sure how you get “don’t know why it’s such a dirty word to say that outcomes aren’t the same everywhere “ from what I said.

Time will tell what the truth is. I don’t think we know enough now to say either way conclusively. 

[TCB]

7 minutes ago, Plum said:

@TCB

Do you or anyone know if those helmet vent masks we saw the Italians using are legal in the US? After looking up what they were, all the studies show they are so much better than the regular face masks. Less patients requiring intubation complications and it seems like they could help with PPE. The original studies came out in 2016. The company that sells them does not offer them on the US site, only the International. 

https://www.intersurgical.com/info/starmed

https://www.uchicagomedicine.org/forefront/patient-care-articles/helmet-based-ventilation-is-superior-to-face-mask-for-patients-with-respiratory-distress

I’m not familiar with those helmet things at all. Saw them for the first time in that video from Italy and had to look up what they were. I read the study and it sounded positive. I don’t know if they are legal here but I’ve never seen them used. 

[DoraBora]

6 minutes ago, square_25 said:

First of all, they are up to 1300 ICU beds (I think), and secondly, they stated that their ICU bed count was the ventilator count. That's how he was treating the numbers at the briefing today. So I think your starting number is too low. 

The problem is that it really depends how fast thing double. If you listened to Cuomo yesterday, he said that the estimates of doubling times kept changing. Yesterday was the longest possible estimate, at 4.7 days, but it may very well be 3 days. If it's doubling every 3 days, then in 21 days it doubles 7 times, giving us an estimate of 2^7*1300, which is unreasonably large -- 5 times more than 30000, in fact. 

As you can see, small changes in the numbers make a huge difference. That's why I'm not feeling all that willing to take the more optimistic estimates... it seems imprudent. 

I did just listen to most of Cuomo's briefing from earlier today, but I disagree that he is certain that the ICU bed count is the vent count.  That didn't seem definitive.

Yes, even though I am not a mathematician, I do understand that small changes in the numbers in such scenarios make a huge difference.  As I wrote in my reply to Dot, I should have softened my earlier statement about your leader overreacting.  I didn't mean to upset you. 
 

[Ausmumof3]

So now anyone returning to Australia to quarantine will have to quarantine in hotels.  The process will be handled by defence.  This is what happens when people don’t do the right thing.
 

I have to admit things that seemed creepy and over the top when China did them two months ago now seem normal.  Forced quarantine.  Talk of using drones to detect cases.  Check.  Hopefully we don’t get to welding doors shut.  I do believe in the danger but it would be a fabulous way for a gov to do a giant power grab!

ABC:  All passengers who arrive in Australia after midnight on Saturday will go into mandatory quarantine in hotels for a fortnight, Prime Minister Scott Morrison has announced.

Key points:

Passengers will be quarantined in the city they land in, irrespective of where they live

Two-thirds of Australia's coronavirus cases are from people travelling from overseas

Defence personnel will help state and territory police enforce self-isolation rules

Concerns have been raised about people not adhering to self-isolation requirements, particularly after getting off cruise ships.

Defence Force personnel will be brought in to support state and territory police in enforcing self-isolation rules for people who are already in Australia or who arrive before the Saturday midnight deadline.

Mr Morrison said two-thirds of the nation's confirmed cases of coronavirus had come from people travelling from overseas.

"States and territories will be quarantining all arrivals through our airports in hotels and other accommodation facilities for the two weeks of their mandatory self-isolation before they are able to return to their home," he said.

"If their home is in South Australia, or in Perth, or in Tasmania and they have arrived in Melbourne, they will be quarantining in Melbourne."

[DoraBora]

26 minutes ago, square_25 said:

Well, I'm afraid to leave the house, because the NYC hospitals are already getting overwhelmed, and I'm pretty sure if I get sick or hurt in any way, I won't get good medical care. 

Do you want to tell me about how I'm overreacting, though? 

(Gently) Is there anything more can you do than what you are already doing (to stay safe)?  Why not step away from the daily briefings and mathematical models, just for a while?  They will still be there when you come back.  You wrote earlier that you can't even sleep, that you are running on adrenaline.  The constant barrage of negative information -- and dwelling on that information -- is bad for your health and your spirit.

Edited March 27, 2020 by DoraBora

[Jean in Newcastle]

1 hour ago, square_25 said:

That's just what's happened in every place that had measurable amounts so far -- lots of acute respiratory distress syndrome. If that wasn't happening, there probably wasn't a ton of coronavirus going around. 

It’s also why this is such a bigger issue than a cold or the flu. 

[Arcadia]

@Ausmumof3@StellaM@Melissa in Australia I had the BCG jab thrice so this is a less scary trial

https://www.channelnewsasia.com/news/world/australian-researchers-trial-tb-vaccine-fight-coronavirus-12581592

“SYDNEY: Australian researchers are fast-tracking large-scale human testing to see if a vaccine used for decades to prevent tuberculosis can protect health workers from COVID-19, they announced on Friday (Mar 27).

The trial of the BCG vaccine will be conducted with 4,000 health workers in hospitals around Australia to determine if it can reduce COVID-19 symptoms, the researchers at the Murdoch Children's Research Institute in Melbourne said.

"Although originally developed against tuberculosis, and still given to over 130 million babies annually for that purpose, BCG also boosts humans' 'frontline' immunity, training it to respond to germs with greater intensity," they said in a statement.

"We hope to see a reduction in the prevalence and severity of COVID-19 symptoms in healthcare workers receiving the BCG vaccination," said lead researcher Nigel Curtis.

He said the 4,000 subjects would be enrolled in the trial within weeks under a fast-tracked process with the approval of state and federal health authorities. "The clock is definitely ticking," he said.

Similar trials are being conducted in several other countries including the Netherlands, Germany and the United Kingdom.

"This trial will allow the vaccine's effectiveness against COVID-19 symptoms to be properly tested, and may help save the lives of our heroic frontline healthcare workers," said Kathryn North, director of the Murdoch Institute.

She said the hope was that improving people's "innate" immunity against COVID-19 symptoms would buy time to develop a specific vaccine against the disease.

"These trials will allow the rapid advancement of the most promising candidates to clinical practice, giving us the most number of shots on goal against COVID-19 as possible," she said.”

[Jean in Newcastle]

Just now, Arcadia said:

@Ausmumof3@StellaM@Melissa in Australia I had the BCG jab thrice so this is a less scary trial

https://www.channelnewsasia.com/news/world/australian-researchers-trial-tb-vaccine-fight-coronavirus-12581592

“SYDNEY: Australian researchers are fast-tracking large-scale human testing to see if a vaccine used for decades to prevent tuberculosis can protect health workers from COVID-19, they announced on Friday (Mar 27).

The trial of the BCG vaccine will be conducted with 4,000 health workers in hospitals around Australia to determine if it can reduce COVID-19 symptoms, the researchers at the Murdoch Children's Research Institute in Melbourne said.

"Although originally developed against tuberculosis, and still given to over 130 million babies annually for that purpose, BCG also boosts humans' 'frontline' immunity, training it to respond to germs with greater intensity," they said in a statement.

"We hope to see a reduction in the prevalence and severity of COVID-19 symptoms in healthcare workers receiving the BCG vaccination," said lead researcher Nigel Curtis.

He said the 4,000 subjects would be enrolled in the trial within weeks under a fast-tracked process with the approval of state and federal health authorities. "The clock is definitely ticking," he said.

Similar trials are being conducted in several other countries including the Netherlands, Germany and the United Kingdom.

"This trial will allow the vaccine's effectiveness against COVID-19 symptoms to be properly tested, and may help save the lives of our heroic frontline healthcare workers," said Kathryn North, director of the Murdoch Institute.

She said the hope was that improving people's "innate" immunity against COVID-19 symptoms would buy time to develop a specific vaccine against the disease.

"These trials will allow the rapid advancement of the most promising candidates to clinical practice, giving us the most number of shots on goal against COVID-19 as possible," she said.”

Is there any real reason why they think it would work for this particular virus?  (Says the person who is immunocompromised and had the BCG vaccine. ). 

[Arcadia]

10 minutes ago, Jean in Newcastle said:

Is there any real reason why they think it would work for this particular virus?  (Says the person who is immunocompromised and had the BCG vaccine. ). 

No idea.

https://www.abundance.org/coronavirus-faqs-by-dr-megan-murray-harvard-infectious-disease-specialist/

“Coronavirus FAQ’s by Dr. Megan Murray (Harvard Infectious Disease specialist)

...

Can anything be done in the meantime in terms of vaccination?

Some vaccines have been shown in previous studies to have non-specific effects, meaning that they lower the risk of infection or disease due to infectious agents that are not specifically targeted by the vaccine. One of these is BCG, a live attenuated vaccine specific for tuberculosis. This vaccine is given at birth and is the most widely distributed vaccine in the world with almost all countries mandating its use with the exceptions of the Netherlands and the US, where TB rates are extremely low. We and others have shown that the efficacy of neonatal BCG against tuberculosis wanes with age (which may be a proxy for time since vaccination) (1,2).

Remarkably, in addition to its effect on TB, BCG has been shown to reduce the occurrence and severity of a range of other unrelated infectious diseases. Both observational studies and randomized controlled trials suggest that BCG vaccination can halve the risk of childhood death in countries with high rates of under-5 mortality (3,4). Notably, the mortality from TB in children in these areas was not high enough for a decline in TB incidence to explain this result; common causes of early childhood mortality in these settings were diarrheal and acute respiratory infections.   Other studies found that BCG-vaccinated individuals experience lower rates of acute lower respiratory tract infections among many types of other infections (5,6). Interestingly, a decline in respiratory infection was observed in several randomized clinical trials in adults, including one conducted in individuals 60-75 years of age (7,8). These non-specific effects of BCG have also been shown in animal challenge models for a range of different pathogens (reviewed in 9-11) as well as in human challenge studies for malaria (12) and an attenuated yellow fever virus (13).

Revaccination with BCG has shown to be safe and immunogenic. In a recent clinical trial of re-vaccination of adolescents in South Africa, the BCG re-vaccinated group experienced a reduction in the rate of TB infection compared to people vaccinated only once as well as a three-fold reduction in upper respiratory infections compared to those who received either a placebo.    Given that BCG vaccine is widely available, and that vaccination/revaccination is safe, cheap, and immunogenic, we feel that it will be important to explore its possible efficacy in this epidemic. The safety of the BCG in the setting of Covid-19 disease could be rapidly explored through infection in an animal model and unlike other more specific vaccines which will require phase one and two testing, a phase three clinical trial of vaccination/revaccination with BCG could begin promptly.  We currently believe this should involve a first BCG vaccination in health care workers who are likely to be exposed to Covid-19 in the US and revaccination of similarly exposed health care workers in countries where BCG is used at birth.”