wuhan - coronavirus

[Pen]

 

Quote

Let's just assume for a minute that 1% of SK has been infected - the CFR goes down to .03%.  And even 1% of SK being infected sounds crazy low when you hear the predictions of how fast this could spread. They had their first documented case over 10 weeks ago. 

 

This is probably also going to sound like a lecture to you, but I think what you wrote is misinformed and misleading. Don’t read it if you prefer not to. Put me on Ignore list if you wish.  I am writing for the benefit of other people much as I tried to correct some posts that suggested things like that the CV19 is causing lung fibrosis which had been circulating.

Both my parents are physicians, with more than one specialty each, including public health (father)  and infectious diseases (mother), and it was expected that I would do that too, such that discussion of medical stuff was common my entire life. 

I have a decent lay understanding of such matters — and  afaik what you are trying to do above with assumptions about if 1% of SK were infected, etc, is not how CFR is calculated for an ongoing epidemic.  

Worldometer.info had a page on how CFR is calculated if you are interested in the basics, and if it is still there. 

 

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

(ETA- link added- The discussion about calculating CFR during ongoing epidemic is still there, part way down the page, and with links to outside articles.) 

I think, with excellent testing and contract tracing and isolation procedures, current statistics for SK are about as accurate as are available from anywhere in world.  And also SK represents about the best of what can be expected for R0 and CFR with a medical care system that has (at least so far) not been overwhelmed, and with a populace that after the big church community spread debacle, seems to have been much more compliant with isolation, quarantine, and physical distancing guidelines. 

I think the deepest error that you may be making is to think of CFR as a fixed number that depends on the nature of the virus. 

It is true that a virus may be more or less deadly. Some viruses may be entirely benign to humans and have no CFR to speak of at all (such as a feline virus that hasn’t species hopped).  Others are capable of causing much higher human mortality. 

However, R0 and CFR are not fixed qualities of an illness. They can differ hugely depending on the host community behavior, health, environment, medical care— basics like if there is good care in first place, and then even if medical system is among top in world like with Italy, the CFR will go way up if that system is overwhelmed. 

So, in part, CFR is determined by human behavior.  If humans behave in certain ways, CFR can be lower, if humans behave in other ways, CFR will go up. 

 

Edited March 28, 2020 by Pen

[Bootsie]

2 hours ago, square_25 said:

Yes, but exponential growth takes us to 10-fold in a few weeks, not “by the end of the year.” The reason that lots of places are coming out of exponential mode is likely the social distancing.

It’s like the famous lily pond problem:

”A lake has some lilies growing on it. Each day, twice as much of the surface of the pond is covered as was covered the previous day. The pond is completely covered with lilies on Day 30. On what day was exactly half of its surface covered?”

If there are approximately 450,000 active cases diagnosed as of today, most of which are mild, I have a hard time getting my mind around any projection that there will be 280,000 people dead from this in a few weeks.  Maybe I am just being optimistic (which generally is not my nature).  

[TracyP]

22 minutes ago, Pen said:

 

 

This is probably also going to sound like a lecture to you, but I think what you wrote is misinformed and misleading. Don’t read it if you prefer not to. Put me on Ignore list if you wish.  I am writing for the benefit of other people much as I tried to correct some posts that suggested things like that the CV19 is causing lung fibrosis which had been circulating.

Both my parents are physicians, with more than one specialty each, including public health (father)  and infectious diseases (mother), and it was expected that I would do that too, such that discussion of medical stuff was common my entire life. 

I have a decent lay understanding of such matters — and  afaik what you are trying to do above with assumptions about if 1% of SK were infected, etc, is not how CFR is calculated for an ongoing epidemic.  

Worldometer.info had a page on how CFR is calculated if you are interested in the basics, and if it is still there. 

 

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

(ETA- link added- The discussion about calculating CFR during ongoing epidemic is still there, part way down the page, and with links to outside articles.) 

I think, with excellent testing and contract tracing and isolation procedures, current statistics for SK are about as accurate as are available from anywhere in world.  And also SK represents about the best of what can be expected for R0 and CFR with a medical care system that has (at least so far) not been overwhelmed, and with a populace that after the big church community spread debacle, seems to have been much more compliant with isolation, quarantine, and physical distancing guidelines. 

I think the deepest error that you may be making is to think of CFR as a fixed number that depends on the nature of the virus. 

It is true that a virus may be more or less deadly. Some viruses may be entirely benign to humans and have no CFR to speak of at all (such as a feline virus that hasn’t species hopped).  Others are capable of causing much higher human mortality. 

However, R0 and CFR are not fixed qualities of an illness. They can differ hugely depending on the host community behavior, health, environment, medical care— basics like if there is good care in first place, and then even if medical system is among top in world like with Italy, the CFR will go way up if that system is overwhelmed. 

So, in part, CFR is determined by human behavior.  If humans behave in certain ways, CFR can be lower, if humans behave in other ways, CFR will go up. 

 

No, I don't mind the discussion. Nothing you wrote here is news to me. I don't understand, though, how anything you posted would make my comments "misinformed and misleading". 

I am trying to play devil's advocate. This thread also has people thinking the CFR may be as high as 10% because of the numbers coming out of Italy. I am trying to point out that we don't know!

It could just as easily be a CFR of .03% as it could be 10%. Which is to say that both are very unlikely. I will go on the record saying I think it will be between .7% and 1.7% when it is all said and done. I'm just somebody on the internet though, lol, just like we all are.

 

[Pen]

19 minutes ago, square_25 said:

 

Right, which is exactly the issue -- if we have healthcare system overwhelm, then the CFR will look very different from South Korea's case (which so far has the virus largely under control.)

 

Right

19 minutes ago, square_25 said:

We're seeing this in Italy and Spain (which, of course, still have numbers we can't really extrapolate, because they are ONLY testing the sickest patients.)

 

We may be able to extrapolate a tiny bit that would be helpful. For example, something like number of confirmed positive medical workers in Italy compared to dead doctors in Italy. It would be more helpful if we knew confirmed positives in doctors or deaths in all medical workers so we could compare apples to apples. 

19 minutes ago, square_25 said:

And that's before we get into the issue of other illnesses we will have to neglect to due to the healthcare system being swamped, which is likely to cause a seemingly "unrelated" spike in death. 

 

True

19 minutes ago, square_25 said:

I think the question of how many patients we are not finding is a very reasonable one, because it's definitely the case that if there were tons of asymptomatic cases, the risks would be much lower.

 

Yes and no.

More asymptomatic cases may mean that current mortality rate is less. But it also may mean that Spread is much worse which may lead to more of the overwhelmed medical system etc that will lead to higher fatalities later on. 

46 or whatever it is doctors dead in Italy so far is staggering. It means huge risk regardless of total numbers of cases. In that regard afaik the CV19 is way worse than Ebola where with proper carefulness medical workers rarely succumbed. 

 

19 minutes ago, square_25 said:

Unfortunately, I haven't seen any evidence that the countries with a ton of testing are missing a lot of people, and have seen a fair amount of evidence that those countries are probably finding more than half of the cases. 

I have Same impression 

 

 

[DoraBora]

A feel-good story:

https://www.democratandchronicle.com/story/news/2020/03/26/dr-fauci-doughnuts-selling-like-hotcakes-donuts-delite-rochester-ny/2914803001/

 

[Pen]

7 minutes ago, TracyP said:

No, I don't mind the discussion. Nothing you wrote here is news to me. I don't understand, though, how anything you posted would make my comments "misinformed and misleading". 

I am trying to play devil's advocate. This thread also has people thinking the CFR may be as high as 10% because of the numbers coming out of Italy. I am trying to point out that we don't know!

It could just as easily be a CFR of .03% as it could be 10%. Which is to say that both are very unlikely. I will go on the record saying I think it will be between .7% and 1.7% when it is all said and done. I'm just somebody on the internet though, lol, just like we all are.

 

 

If all you are trying to do is point out that we don’t know, then I totally agree with that!

(I think the potential range possible when all is said and done could be even wider than your range,but that’s immaterial.) 

I thought what you wrote tended to give impression of CFR as a fixed entity.

 So that if people could extrapolate and determine that CFR in South Korea is _____ people could then apply that to world and decide whether or not to try to mitigate or not.  Or could decide if the CFR in SK is a normal CFR risk we tend to take from other things. 

Whereas the current CFR rate (whatever it may be) in SK represents a rate based on some of the best testing, contact tracing, isolation, quarantine and other measures possible to have done, and does not at all represent what would happen if nothing is done to mitigate. 

[Bootsie]

13 minutes ago, square_25 said:

There probably won't, since everyone's doing social distancing. 

But I assume you understand how the math works if we don't limit the spread? 

Yes, I understand how the math works.  I do question, however, some assumptions about what the daily increase will be going forward, give a wide array of interventions.

[Arcadia]

@Pen@mathnerd

haven’t had my coffee. Posting first and reading through later. Article is much longer than I quoted. Might have to remove images later for copyright reasons. 

https://www.nbcbayarea.com/news/coronavirus/coronavirus-deaths-in-california-likely-to-spike-in-late-april-fade-away-by-mid-july/2263169/

“Newly released projections reveal the worst impacts of the coronavirus in California may still be nearly a month away. 

The rate of COVID-19 deaths is expected to peak on April 25 with 148 deaths per day, according to data released Thursday by the Institute for Health Metrics and Evaluation, a research center at the University of Washington. The data also predicts the number of coronavirus cases in California will largely fade away by July after peaking on April 24. The entire U.S. is expected to experience its coronavirus peak 11 days earlier, April 14, suggesting preventive measures made early on in California, such as social distancing and school and business closures, may be helping "flatten the curve" on future coronavirus cases.

The coronavirus death rate is expected to peak in California on April 25 with 148 daily deaths, according to projections released by the Institute for Health Metrics and Evaluation.

In a worst case scenario, however, the data points to as many as 356 deaths per day in California at the height of the pandemic. The death rate is expected to drop to zero by mid July. Nationally, the data predicts 2,341 deaths per day at the peak of viral infections, with a worst case scenario of twice that many.

Newly released projections, tabulated by researchers with the Institute for Health Metrics and Evaluation at the University of Washington, reveal the potential death rate across California as a result of the COVID-19 pandemic.

Unlike some previous models, which estimate millions of deaths across the United States, the University of Washington study takes into account the effects of social distancing, business closures, and shelter-in place orders. The data, according to researchers, also assumes government guidelines will be followed by all states across the country.”

[Pen]

@Arcadia possibly a moderator would want something removed for copyright reasons, but this is probably within Fair Use for educational purposes and with no financial gains.

also seeing a good visual is likely to get me to go look at the original so it might be good for the source to get more views

[TracyP]

30 minutes ago, Pen said:

 

If all you are trying to do is point out that we don’t know, then I totally agree with that!

(I think the potential range possible when all is said and done could be even wider than your range,but that’s immaterial.) 

 

I agree. Let me be more specific. I think .7% - 1.7% is the CFR with mitigation. I am looking at the U.S. in general, but MN (my state) more specifically as I try to grapple with this. There are pockets that will end up much higher, undoubtedly.

I think that some people are looking at these pockets and going - Omg! China lied! This is way worse than we thought! - I admit to having the same thoughts at times. As if it isn't bad enough as it is!! 

Working through the numbers myself has been therapeutic. 😋

[Jean in Newcastle]

3 hours ago, Ausmumof3 said:

I think the closest thing I’ve seen along those lines to a thorough testing was that town in Italy where they tested the whole town and about 3pc tested positive.  

But the problem even with that is that it’s a snapshot of one day (Or period of testing). I keep hearing about people who have tested negative but who have still had it and have subsequently died (without going back out into the community). So maybe some get false negatives?  And because we’re still in an active pandemic, unless you can put people in a bubble (because even with social distancing there is some spread) it just seems like no numbers are going to be definitive until the very end because this isn’t a controlled situation. 
 

Speaking of controls, does anyone know if all the tests being used around the world are the same in what and how they test and in accuracy and in sensitivity (so some might detect it earlier)?  

[Arcadia]

6 minutes ago, Jean in Newcastle said:

 

Speaking of controls, does anyone know if all the tests being used around the world are the same in what and how they test and in accuracy and in sensitivity (so some might detect it earlier)?  

California supplement CDC supplied tests with private labs. Many countries developed their own tests.

[Arcadia]

16 minutes ago, Pen said:

@Arcadia possibly a moderator would want something removed for copyright reasons, but this is probably within Fair Use for educational purposes and with no financial gains.

also seeing a good visual is likely to get me to go look at the original so it might be good for the source to get more views

This link from the article is useful for visuals

http://covid19.healthdata.org

“The charts below show projected hospital resource use based on COVID-19 deaths.

The projections assume the continuation of strong social distancing measures and other protective measures.”

[Jean in Newcastle]

Last night the news predicted over 1400 deaths in Washington state by August. Right now there are 175 deaths. 

[Arcadia]

“Thousands of employees for grocery delivery service Instacart are planning to strike Monday, arguing that they deserve hazard pay and personal protective equipment such as masks and gloves during the coronavirus pandemic.
http://nbcbay.com/PPOCBHQ”

[Arcadia]

1 minute ago, square_25 said:

Hmmmm, I see their point :-/. I've been wondering how long we'll be able to get groceries delivered around here -- we haven't been using Instacart, but still. 

Masks and gloves are already in short supply for healthcare workers though. Hazard pay I can understand though instacart fees (plus tips) are already too high for us to splurge on. 

[Jean in Newcastle]

6 minutes ago, square_25 said:

Yeah, I don't think they CAN get this, but I can see why they are worried. 

I think that in addition to upping the production of N95 masks for healthcare workers, they should up the production of “normal “ masks for “normal “ people. Or perhaps some of the handsewn masks (which honestly are not being accepted by hospitals where I live) should be used by delivery drivers and others in the community. 

[Pen]

8 minutes ago, TracyP said:

I agree. Let me be more specific. I think .7% - 1.7% is the CFR with mitigation. I am looking at the U.S. in general, but MN (my state) more specifically as I try to grapple with this. There are pockets that will end up much higher, undoubtedly.

I think that some people are looking at these pockets and going - Omg! China lied! This is way worse than we thought! - I admit to having the same thoughts at times. As if it isn't bad enough as it is!! 

Working through the numbers myself has been therapeutic. 😋

 

Yes, I have liked working through numbers myself too.

0.7 CFR iirc is officially rate for China outside of Hubei, So could possibly be in ~ range for a low figure for CFR outside of a hotspot for epidemic and given a police state level of control, and extreme shutdown for ?  ~ 2 months ?  

Though we aren’t at end of story yet.  And we really don’t know accuracies at all as to Chinese information. 

I like to look at information from places more likely to have relatively reliable reporting 

 

 

 

 

[Pen]

53 minutes ago, Jean in Newcastle said:

But the problem even with that is that it’s a snapshot of one day (Or period of testing). I keep hearing about people who have tested negative but who have still had it and have subsequently died (without going back out into the community). So maybe some get false negatives?  And because we’re still in an active pandemic, unless you can put people in a bubble (because even with social distancing there is some spread) it just seems like no numbers are going to be definitive until the very end because this isn’t a controlled situation. 
 

Speaking of controls, does anyone know if all the tests being used around the world are the same in what and how they test and in accuracy and in sensitivity (so some might detect it earlier)?  

 

Afaik they are all antigen tests.  So far. 

They are not all the same as to what specimens are used or other factors.

[Acadie]

@Pen @Jean in Newcastle

Any suggestions on handling grocery shopping or sanitizing surfaces for people with environmental illness, who can't use bleach or products with fragrance? Soap and water work for many purposes, but I'm trying to figure out what to tell my parents, who are in their 80s, about shopping and handling their groceries. Shelf stable items stay in the car for a few days, and they are washing their produce well, but how should they handle items that need to come right into the fridge or freezer? 

They are set for regular cleaning products that work for my mom with her chemical sensitivities, but not sanitizing things. I read that hydrogen peroxide can take 10 minutes to kill coronavirus. That works for sanitizing a counter because it can sit, but maybe not so much for wiping grocery packages down. 

My dad, who does the shopping, is 87, and they live in a rural area where New Yorkers have vacation homes, so I'm worried about them. There are no grocery delivery services in their area, and curbside pickup slots have been unavailable as well. I'm checking with some friends and their housecleaner to see if we can find someone to shop for them, but they're resistant to that and I haven't found anyone yet anyway. So I'm trying to make it safer at least.

Since it's my mom who has environmental illness, Dad may be able to use something like rubbing alcohol outside, if it dissipates before anything comes inside. Also hoping to persuade him to wear a mask at the store, and either wear gloves or bring soap & water so he can wash his hands in the parking lot. I'd shop for them but I'm a 12-hour drive away 😞 

ETA: I debated making this a separate thread, then thought it might be useful for others to see in this big thread. Happy to start a new thread if that seems preferable.

Edited March 28, 2020 by Acadie

[ElizabethB]

9 minutes ago, Acadie said:

 

Any suggestions on handling grocery shopping or sanitizing surfaces for people with environmental illness, who can't use bleach or products with fragrance? Soap and water work for many purposes, but I'm trying to figure out what to tell my parents, who are in their 80s, about shopping and handling their groceries. Shelf stable items stay in the car for a few days, and they are washing their produce well, but how should they handle items that need to come right into the fridge or freezer? 

They are set for regular cleaning products that work for my mom with her chemical sensitivities, but not sanitizing things. I read that hydrogen peroxide can take 10 minutes to kill coronavirus. That works for sanitizing a counter because it can sit, but maybe not so much for wiping grocery packages down. 

My dad, who does the shopping, is 87, and they live in a rural area where New Yorkers have vacation homes, so I'm worried about them. There are no grocery delivery services in their area, and curbside pickup slots have been unavailable as well. I'm checking with some friends and their housecleaner to see if we can find someone to shop for them, but they're resistant to that and I haven't found anyone yet anyway. So I'm trying to make it safer at least.

Since it's my mom who has environmental illness, Dad may be able to use something like rubbing alcohol outside, if it dissipates before anything comes inside. Also hoping to persuade him to wear a mask at the store, and either wear gloves or bring soap & water so he can wash his hands in the parking lot. I'd shop for them but I'm a 12-hour drive away 😞 

ETA: I debated making this a separate thread, then thought it might be useful for others to see in this big thread. Happy to start a new thread if that seems preferable.

Maybe Oxygen Bleach?  It is bleach but with the same mechanism as Hydrogen Peroxide.  I buy it, I'm sensitive to VOCs, but I've only found it in powder form, it would be hard to convert into a form you could use to wipe something down.

ETA: This is the one I buy: https://www.amazon.com/gp/product/B00UCKCBEQ/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

Edited March 28, 2020 by ElizabethB

[Pen]

11 minutes ago, square_25 said:

I think if there are a TON of asymptomatic cases, then there's evidence that you need a LOT of cases to cause overwhelmed medical systems. If there are actually 10 times as many cases walking around as we think, then the healthcare overwhelm only starts to happen when there are 10 many people as we think with cases. That would actually be good. 

However, I don't think the data supports this. 

 

Again, maybe yes, maybe no.

 I actually do think there are probably at least 10 times as many people walking around with it at least in my area (County) as have been diagnosed.  When first confirmed cases are ones that have to represent community spread, and one is a death, that’s pretty indicative that only tip of ice berg has been detected. 

Or otherwise, at point when first cases for my county were reported (2 cases, one death) CFR would have looked like 50% which is clearly ridiculous.  

 

And for USA as whole, when other places like Australia are getting cases incoming from USA, or when smaller communities that were apparently free of it are getting cases from people who traveled there from New York or Florida, that tends to suggest significantly high amounts of community spread in the origin areas.

 

I particularly suspect that there are quite a lot of asymptomatic child carriers. 

 

 

We also don’t know yet if there will be second wave type cases, such as with 1918 flu.

 We don’t know if this virus can go dormant and then later re-emerge.  

There’s just an awful lot we don’t know. 

We do know that in many communities in USA a small number of serious/ critical cases could easily overwhelm medical care.

We know that it took very little time for that to start happening in places that have not been careful about physical distancing such as NY area, or looks likely where they have not cancelled large gatherings such as New Orleans.  

 

I know you and @TracyP are enjoying running your own figures, possibly of interest in that regard https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext

[Terabith]

https://finance.yahoo.com/news/hell-coming-mathematical-proof-185019616.html

[wendyroo]

25 minutes ago, Acadie said:

@Pen @Jean in Newcastle

Any suggestions on handling grocery shopping or sanitizing surfaces for people with environmental illness, who can't use bleach or products with fragrance? Soap and water work for many purposes, but I'm trying to figure out what to tell my parents, who are in their 80s, about shopping and handling their groceries. Shelf stable items stay in the car for a few days, and they are washing their produce well, but how should they handle items that need to come right into the fridge or freezer? 

They are set for regular cleaning products that work for my mom with her chemical sensitivities, but not sanitizing things. I read that hydrogen peroxide can take 10 minutes to kill coronavirus. That works for sanitizing a counter because it can sit, but maybe not so much for wiping grocery packages down. 

My dad, who does the shopping, is 87, and they live in a rural area where New Yorkers have vacation homes, so I'm worried about them. There are no grocery delivery services in their area, and curbside pickup slots have been unavailable as well. I'm checking with some friends and their housecleaner to see if we can find someone to shop for them, but they're resistant to that and I haven't found anyone yet anyway. So I'm trying to make it safer at least.

Since it's my mom who has environmental illness, Dad may be able to use something like rubbing alcohol outside, if it dissipates before anything comes inside. Also hoping to persuade him to wear a mask at the store, and either wear gloves or bring soap & water so he can wash his hands in the parking lot. I'd shop for them but I'm a 12-hour drive away 😞 

ETA: I debated making this a separate thread, then thought it might be useful for others to see in this big thread. Happy to start a new thread if that seems preferable.

Soap and water work really well, so in most cases I have been washing packaging in warm soapy water or transferring foods out of their packages.  So gallons of milk get washed and eggs get transferred from the carton into a tuperware.  Ice cream tubs get washed and frozen peas get transferred to a ziplock.  I've been doing the same with dry goods rather than leaving them in quarantine for days.  Cereal bags come out of the boxes, canned goods get washed well, chocolate chips get dumped into storage containers, etc.

[Pen]

10 minutes ago, Acadie said:

 

Any suggestions on handling grocery shopping or sanitizing surfaces for people with environmental illness, who can't use bleach or products with fragrance? Soap and water work for many purposes, but I'm trying to figure out what to tell my parents, who are in their 80s, about shopping and handling their groceries. Shelf stable items stay in the car for a few days, and they are washing their produce well, but how should they handle items that need to come right into the fridge or freezer? 

They are set for regular cleaning products that work for my mom with her chemical sensitivities, but not sanitizing things. I read that hydrogen peroxide can take 10 minutes to kill coronavirus. That works for sanitizing a counter because it can sit, but maybe not so much for wiping grocery packages down. 

My dad, who does the shopping, is 87, and they live in a rural area where New Yorkers have vacation homes, so I'm worried about them. There are no grocery delivery services in their area, and curbside pickup slots have been unavailable as well. I'm checking with some friends and their housecleaner to see if we can find someone to shop for them, but they're resistant to that and I haven't found anyone yet anyway. So I'm trying to make it safer at least.

Since it's my mom who has environmental illness, Dad may be able to use something like rubbing alcohol outside, if it dissipates before anything comes inside. Also hoping to persuade him to wear a mask at the store, and either wear gloves or bring soap & water so he can wash his hands in the parking lot. I'd shop for them but I'm a 12-hour drive away 😞 

ETA: I debated making this a separate thread, then thought it might be useful for others to see in this big thread. Happy to start a new thread if that seems preferable.

 

I have chemical / environmental illness.  

I am removing original package exteriors as much as possible/ or washing my hands with non fragrance soap as much as possible. 

Or wearing gloves and then washing the gloves. I also have a mask I am carrying around all the time now— it isn’t a great method as the mask itself can be contaminated that way, but I think it is better than none.  I am disinfecting the mask itself via heat or sunlight Or H2O2 or ethanol from time to time as I am able. And balanced with not getting myself sick from cleaners. 

For things okay with setting in sun (and if we have sun) I am using natural solar UV to help disinfect them. 

For durable cartons like milk, a spray down with Hydrogen peroxide — if I do anything— so far I haven’t done that much yet, but probably should. 

Vegetables/fruits: I am now soaking delicate ones in 1-4 drops iodine per 1 quart water 

Rugged fruits/vegetables I am washing in fragrance free soap and water

egg containers I have so far just put away as usual — I am likely to start spraying with hydrogen peroxide if eggs are again available in my area anytime soon     Currently I have a couple eggs reserved to make a gluten free something probably brownies for my b’day am are Otherwise just using up eggs we had (though I may freeze two more sets of two for future baking).  

I also have a steamer as advocated by @Spycar and have now used that to clean shoes, jackets etc ... I also have the last outer clothes I wore to city draped in my garden...  I have had it on one side up to rain and sun, then flipped it over.  So that it will be less both cleaning product and fragrance laden when I go to wash it and also less pathogenic microbes from the city— though if I don’t get it into laundry shortly it may start acquiring mildew fungi instead. 

 

I think mask mask and gloves and immediately stripping off of outdoor clothes into a plastic bag and good shower upon return from store would be good for your father to do.

Do they have blue ice that could keep fridge things okay while he cleaned himself up? Then he could get to clean up of store stuff, or maybe your mother could do that carefully herself using disinfection things tolerable to her. 

Many things could probably be sprayed down and let sit in a plastic bin with some ice packs for the needed 10 minutes. We live a 45 minute drive from stores so pretty much everything has to survive that long before it can be put in refrigerator or freezer.

now, that actually gave me an 💡 idea

 maybe I will  take a hydrogen peroxide spray bottle with me next time I have to go shopping and spray things while in (durable) shopping bags and the outside of the bags themselves so they are getting mostly passively disinfected as I am driving home. 

I have been taking soap, water, and a pail to be able to actually wash my hands. 

 

 

[Corraleno]

29 minutes ago, Arctic Mama said:

More to suggest the counts being published by the Chinese government about Wuhan were off by an order of magnitude 😞

http://shanghaiist.com/2020/03/27/urns-in-wuhan-far-exceed-death-toll-raising-more-questions-about-chinas-tally/amp/?

I don't doubt that the real number of CV19 deaths in China is higher than reported, but keep in mind that mortuaries there have been closed for three months or so, so those urns are for everyone who died of CV19 plus all the other deaths that would naturally have occurred in that area during those 3 months plus all the extra deaths caused by people not being able to get access to healthcare when hospitals were overwhelmed. So the number of urns would represent the number of deaths directly attributable to CV19 + deaths indirectly caused by CV19 + the normal 25-30% of annual deaths in that area.

[Pen]

Good Dr John Campbell review this morning:

 

 

[DoraBora]

48 minutes ago, Corraleno said:

I don't doubt that the real number of CV19 deaths in China is higher than reported, but keep in mind that mortuaries there have been closed for three months or so, so those urns are for everyone who died of CV19 plus all the other deaths that would naturally have occurred in that area during those 3 months plus all the extra deaths caused by people not being able to get access to healthcare when hospitals were overwhelmed. So the number of urns would represent the number of deaths directly attributable to CV19 + deaths indirectly caused by CV19 + the normal 25-30% of annual deaths in that area.

Thank you.  Incidentally, Wuhan, though I had not ever heard of it before January, has a larger population that NYC (11+ million).

[AmandaVT]

Vermont is not testing even high risk people with symptoms. 😞 My friend brought her son to the ER yesterday (we now need to have Dr's permission to go to the ER). He was on day 4 of symptoms, fever of 104, aches and fatigue and what prompted them to call - intense chest pain. He has a heart condition. He was allowed to go to the ER, but my friend couldn't go in with him, she had to wait in the car. Spoke to the Dr. on the phone. They wouldn't test for Covid, saying there is no cure. Sent them home and reminded her to use Tylenol for his symptoms. Also told my friend that the people in the house that didn't have symptoms do NOT have to quarantine themselves because Covid is currently so widespread it wouldn't matter. 

This feels like we are in some kind of horror movie. 

[Pen]

https://youtu.be/SQ0vXVyTdVk

 

Has clip of Emergency Department Doctor in Queens, New York 

[Corraleno]

16 minutes ago, AmandaVT said:

Vermont is not testing even high risk people with symptoms. 😞 My friend brought her son to the ER yesterday (we now need to have Dr's permission to go to the ER). He was on day 4 of symptoms, fever of 104, aches and fatigue and what prompted them to call - intense chest pain. He has a heart condition. He was allowed to go to the ER, but my friend couldn't go in with him, she had to wait in the car. Spoke to the Dr. on the phone. They wouldn't test for Covid, saying there is no cure. Sent them home and reminded her to use Tylenol for his symptoms. Also told my friend that the people in the house that didn't have symptoms do NOT have to quarantine themselves because Covid is currently so widespread it wouldn't matter. 

This feels like we are in some kind of horror movie. 

There may not be a cure but there is treatment — if the standard protocol was just to send everyone with symptoms home to either die or recover without medical intervention, we wouldn't have governors begging for ventilators and PPE! If there was no need to quarantine even those with direct contact with a presumed positive the whole country wouldn't be shut down! 

I would tell her to take her son to another hospital, and call the state health department and demand testing, and I would be calling all the news media to get some attention to the fact that doctors are sending high-risk symptomatic patients home untested and untreated. There have been some really scary stories in the news lately about young adults, including teens, who went from mild cold symptoms to dead in a day to two. 

 

Edited March 28, 2020 by Corraleno

[Pen]

12 minutes ago, AmandaVT said:

Vermont is not testing even high risk people with symptoms. 😞 My friend brought her son to the ER yesterday (we now need to have Dr's permission to go to the ER). He was on day 4 of symptoms, fever of 104, aches and fatigue and what prompted them to call - intense chest pain. He has a heart condition. He was allowed to go to the ER, but my friend couldn't go in with him, she had to wait in the car. Spoke to the Dr. on the phone. They wouldn't test for Covid, saying there is no cure. Sent them home and reminded her to use Tylenol for his symptoms. Also told my friend that the people in the house that didn't have symptoms do NOT have to quarantine themselves because Covid is currently so widespread it wouldn't matter. 

This feels like we are in some kind of horror movie. 

 

That’s the way the Pacific Northwest coast seemed to be dealing with it up until not very long ago.  

Officially there were (and still are) low rates due to not testing.  While unofficially there was acknowledged widespread community spread.

But the reality imo is that is a stupid approach. 

There is “no cure” but there do seem to be some things that might help especially if done earlier rather than later.

 

I have done a lot of writing to my state Governor, the White House etc, and it sounds like similar is needed in Vt.  

 

If I had a family situation like that of your friend, even though there is no proof of efficacy, I would go ahead and try herbs, supplements, even homeopathy since standard medical has made it clear it won’t / can’t do anything 

[Pen]

2 minutes ago, square_25 said:

That's ridiculous. If the hospitals in state aren't helping, have them drive to one of the nearby states. We're definitely treating people in NY, and I'm sure Massachusetts is treating people, too. 

 

Not sure how that works with Stay Home rules/guidelines

phone calls from home to figure out what to do seems like better approach whether calling locally to nearby states or to national numbers

where I am our County health Department was open last weekend during day when I called to ask about my son’s situation (usually only open M-F), but have extended open phone line hours and to 7 days per week for CV

 

[Terabith]

My brother in law's brother had close, sustained contact (drove over an hour in the car) with someone who has been diagnosed.  Nobody has told him to quarantine himself, so he's not.  ARG!  

[AmandaVT]

6 minutes ago, square_25 said:

Yeah, I guess I don't know. What are Vermont rules? Are you not supposed to leave the house? I don't think there are restrictions like that in NY (although maybe there should be.) 

Calling first seems like a really prudent idea, anyway. But I would definitely suggest looking out of state as well as in state, if that's the line Vermont is taking :-/. 

 

Right now we're under a "stay at home" policy through 4/15. Essential employees can go to work, people can still go to the grocery stores, get gas, etc. 

 

5 minutes ago, CuriousMomof3 said:

 

I agree with that.  If everyone has it, then there's no point in social distancing.

However, I have heard that if you've been living together normally (e.g. not quarantined, touching each other etc . . . ) then by the time you're having significant symptoms you can assume the rest of your household has it too, and so quarantining at that point would be too late to be useful.  I don't know if that's true or not, but it makes a little bit of sense to me.  

 

The Dr. meant - they are free to go out and about to shop etc. Be in public like everyone else. They are assuming everyone in the house has been exposed and are keeping everyone home despite the Dr.'s reassurance last night.

 

15 minutes ago, square_25 said:

That's ridiculous. If the hospitals in state aren't helping, have them drive to one of the nearby states. We're definitely treating people in NY, and I'm sure Massachusetts is treating people, too. 

 

She's on it - thankfully we're only about an hour from Dartmouth hospital which is taking this more seriously from what I've read. 

I've told her to reach out to VT Digger, which has been publishing a lot of good articles right now. The governor too. 

I'm worried about her son, obviously, but I'm more worried about the bigger picture. If we're not testing even relatively serious cases, then it is going to look like we have very few cases and people will relax their social distancing. Also, not having accurate reporting just feels dangerous. I'm seeing a LOT of NY and MA plates over the past 24 hrs. I think a number of people are coming up to their ski/lake houses. I totally get the impulse, but our hospitals are already warning us that they're not going to be able to handle the influx of Vermont patients. Having loads of second home folks here will exacerbate the problem.

[Twolittleboys]

6 hours ago, TracyP said:

Yes, I agree that some places would be much higher and others much lower within a country. Of course. But what are saying? Do you think that the number of cases is being accurately counted right now? Because I'm just saying that I think we could be *vastly* under counting cases, even in places like South Korea and Germany. 

Well, I think it depends on what you mean by "vastly undercounting". I do think there are quite a number of unknown cases in Germany but I wouldn't call it a huge number. I would estimate (just a guess, nothing to back it up with) that there might be twice as many actual cases as known once. I seriously doubt there are 10 times as many (for example) because a) comparing death rates to other comparable countries and assuming the difference is mostly due to different percentage of tested cases it would mean that for example in the UK the number of undetected cases would be even larger (like 50x known cases) and b) there is a lot of testing/tracing in Germany (obviously, some clusters don't show up until someone gets seriously sick and there is a timing delay).

 

[Matryoshka]

12 minutes ago, AmandaVT said:

I'm worried about her son, obviously, but I'm more worried about the bigger picture. If we're not testing even relatively serious cases, then it is going to look like we have very few cases and people will relax their social distancing. Also, not having accurate reporting just feels dangerous. I'm seeing a LOT of NY and MA plates over the past 24 hrs. I think a number of people are coming up to their ski/lake houses. I totally get the impulse, but our hospitals are already warning us that they're not going to be able to handle the influx of Vermont patients. Having loads of second home folks here will exacerbate the problem.

Yeah, it seems a lot of NY and MA folk are having this impulse.  I already posted a couple of times about people packing the ferries to Martha's Vineyard. ..  Now I've heard they're having the same problem with people jamming the Cape. Wouldn't surprise me at all that they're also heading up to the mountains of VT and NH. Stay at home, people!!!

I hope she can get better care for her son at Dartmouth.

Edited March 28, 2020 by Matryoshka

[Pen]

25 minutes ago, square_25 said:

Yeah, I guess I don't know. What are Vermont rules? Are you not supposed to leave the house? I don't think there are restrictions like that in NY (although maybe there should be.) 

Calling first seems like a really prudent idea, anyway. But I would definitely suggest looking out of state as well as in state, if that's the line Vermont is taking :-/. 

 

10 Point Plan

Governor Cuomo announced the "New York State on PAUSE" executive order, a 10-point policy to assure uniform safety for everyone.

The 10-point NYS on PAUSE plan is as follows: 

1. Effective at 8PM on Sunday, March 22, all non-essential businesses statewide will be closed;
2. Non-essential gatherings of individuals of any size for any reason (e.g. parties, celebrations or other social events) are canceled or postponed at this time;
3. Any concentration of individuals outside their home must be limited to workers providing essential services and social distancing should be practiced;
4. When in public individuals must practice social distancing of at least six feet from others;
5. Businesses and entities that provide other essential services must implement rules that help facilitate social distancing of at least six feet;
6. Individuals should limit outdoor recreational activities to non-contact and avoid activities where they come in close contact with other people;
7. Individuals should limit use of public transportation to when absolutely necessary and should limit potential exposure by spacing out at least six feet from other riders;
8. Sick individuals should not leave their home unless to receive medical care and only after a telehealth visit to determine if leaving the home is in the best interest of their health;
9. Young people should also practice social distancing and avoid contact with vulnerable populations; and
10. Use precautionary sanitizer practices such as using isopropyl alcohol wipes

[Pen]

Just now, square_25 said:

Well, they are in Vermont, not here. But also, I would assume that you if CAN'T get medical care locally, leaving the house by car would be considered justified... 

But yes, definitely calling first is good. 

 

I don’t think sick people, especially with suspicion of CV19, are supposed to start going to Emergency Rooms unannounced in advance. Unless it is the case that NY is so overloaded with CV19 that all Emergency Department workers in all hospitals are already in proper PPE and there are no non CV19 patients at any Emergency Departments.  

In any case sounds like the family found an option in New Hampshire.  

[Twolittleboys]

As for the study done by Washington University (I think) someone quoted earlier which came up with a fairly low number of deaths and predicted the end of the pandemic in just a couple of months I read a fairly long twitter review that disagreed with the conclusions. Not with the conclusions per se but with the possible implication for real life. I think the main criticism was a) some mathematical stuff I didn't quite get but more importantly b) that the whole paper assumed social distancing measures similar to Wuhan (or at least close to them) which seems fairly unlikely at this point in the US. So they thought the conclusions made sense given the assumptions but that the assumptions were far too optimistic.

[AmandaVT]

1 minute ago, Pen said:

 

I don’t think sick people, especially with suspicion of CV19, are supposed to start going to Emergency Rooms unannounced in advance. Unless it is the case that NY is so overloaded with CV19 that all Emergency Department workers in all hospitals are already in proper PPE and there are no non CV19 patients at any Emergency Departments.  

In any case sounds like the family found an option in New Hampshire.  

 

They definitely called first! They had called the Pediatrician when symptoms started and followed guidance. Then when symptoms were more serious yesterday, they called the pedi again, who called the ER and received permission to head there. They're being as safe as they can - but he did need to be seen. He was in really serious pain.

[Bootsie]

Does anyone know of a good comparison of outcomes when measures of quarantining and social distancing are compared?  I see that Sweden has followed a much different path than Norway or Denmark in that they have done little of ordering things to be closed, hoping to build herd immunity.  They have asked for social distancing--especially for those over 70.  Norway and Denmark have been much more aggressive.  However, it isn't clear that they are experiencing much different outcomes.  In fact, some of the measures show Sweden is fairing better.  

[TracyP]

47 minutes ago, Twolittleboys said:

Well, I think it depends on what you mean by "vastly undercounting". I do think there are quite a number of unknown cases in Germany but I wouldn't call it a huge number. I would estimate (just a guess, nothing to back it up with) that there might be twice as many actual cases as known once. I seriously doubt there are 10 times as many (for example) because a) comparing death rates to other comparable countries and assuming the difference is mostly due to different percentage of tested cases it would mean that for example in the UK the number of undetected cases would be even larger (like 50x known cases) and b) there is a lot of testing/tracing in Germany (obviously, some clusters don't show up until someone gets seriously sick and there is a timing delay).

 

 

Yeah, Germany seems to be doing a good job testing. I think the idea that even they could have twice as many cases is... something to keep in mind when looking at all these numbers.

[DoraBora]

From a Forbes article about current situation in NY:  (Savoring small blessings is good for the weary soul.)

Surprising fact: Though the rate of infection in New York is still doubling, it is doing so at a slower pace, Cuomo said again on Saturday. The number of ICU admissions fell slightly, as did the number of new hospitalizations. ICU admissions were down to 172 yesterday—the lowest level since earlier this week and down from 374 a day before. Patients who have been newly hospitalized also decreased to 847, down from over 1,000 during the two days previously. “I wouldn’t put too much stock in any one number—the overall trend is still up, but you could argue that the trend is slowing,” Cuomo said of the data.

[TracyP]

22 minutes ago, Bootsie said:

Does anyone know of a good comparison of outcomes when measures of quarantining and social distancing are compared?  I see that Sweden has followed a much different path than Norway or Denmark in that they have done little of ordering things to be closed, hoping to build herd immunity.  They have asked for social distancing--especially for those over 70.  Norway and Denmark have been much more aggressive.  However, it isn't clear that they are experiencing much different outcomes.  In fact, some of the measures show Sweden is fairing better.  

I don't know the answer, but I do think it's a good question. When you get behind on this, like in Italy, shutdown is the only option. If you can stay ahead of it, there might be more tools in your toolbox. My governor keeps mentioning this, but I would love to see actual modeling.

[Arcadia]

@CuriousMomof3@Jean in Newcastle@Pawz4me

https://www.nbcbayarea.com/news/health/demand-for-lupus-drug-also-used-to-treat-covid-19-skyrockets/2263445/
“When President Donald Trump announced the medication hydroxychloroquine was a game-changer in treating COVID-19 patients, demand for the prescription drug skyrocketed.

Now a San Diego, California woman who uses the medication to treat her lupus can’t get her prescription refilled.

When Micaela Jimenez came to the pharmacy at the Kaiser Permanente in Rancho Bernardo, her prescription was denied. She’s worried about when and if she’ll get the medication that keeps her lupus from flaring up.

Since her diagnosis about seven years ago, Jimenez has relied on hydroxychloroquine to keep her healthy.

“It prevents me from having flares, it can do awful things depending on what that flare wants to do at any point. It can attack any organ,” Jimenez explained.

Her prescription is so essential, doctors kept her on the medication when she was pregnant with her now 6-month-old son.

NBC 7 found out some Kaiser Permanente patients received a letter saying the medication was being saved for critically-ill COVID-19 patients.

Jimenez did not get the letter, but she did try to contact her doctor and hasn’t heard back.

 “It’s literally just waiting for that house of cards to fall,” she said.

NBC 7 reached out to Kaiser Permanente and received this statement about hydroxychloroquine prescriptions not being filled:

“These drugs were identified as having a potential beneficial impact in the treatment of some severely sick COVID-19 patients who are hospitalized, which has caused demand to rise dramatically. Supplies from drug manufacturers have not caught up.”

The statement goes on to say Kaiser is working to continue filling current prescriptions. But, until supplies can be increased only 14-day refills will be given.”

 

[lewelma]

Has anyone posted this?  Interesting take on the data.  This chart is 3 days old, but he also has a live one where you can compare countries. 

 

[kbutton]

1 hour ago, Pen said:

I don’t think sick people, especially with suspicion of CV19, are supposed to start going to Emergency Rooms unannounced in advance.

This varies by location--some hospitals have triage tents or areas where all respiratory patients go so that they don't mingle with the regular ED crowd. 

[TracyP]

1 minute ago, square_25 said:

I think, sadly, that's what Cuomo was trying to do in NY with getting the state labs to do the tests. But it turned out we were behind on it, anyway. We just didn't know it because the testing had been so sparse. 

This is precisely why we shut down the state even though the initial social distancing/school shut downs seemed to be working. The governor is hoping to only keep the shelter in place order for 2 weeks. He said, though, that he will not open up until they can get testing for anyone with symptoms. Testing is crucial in this.

[lewelma]

18 minutes ago, square_25 said:

So... I have a question. Does anyone have any theories about WHY New York wound up as such a hot spot? 2 weeks ago, we weren't first in deaths or cases or anything in the US. I know this is a dense place, but some place (like South Korea) are also dense. We weren't particularly late to shut schools, compared to numbers of cases and deaths. So what gives? 

I think it is because NY is so international.  Of the 481 cases NZ currently has, it looks like about 450 are from international travelers.  Even after we closed the borders to all visitors, we still have gotten about 400 cases from the kiwis returning.  And we closed the borders with about 20 cases.  NY has simply had a ton of people coming in from overseas, not tested, not self-isolated, mixing, and spreading it. 

I think it would have been politically impossible to close all International flights down when you had 40 known cases with none in the hospital (NYC is 8million to NZ 4 million population, so I doubled the numbers). And to close ALL domestic flights and go into lockdown, when you had 500 cases and two in the hospital with none in ICU (double our numbers again).