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wuhan - coronavirus

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6 minutes ago, Pen said:

I would like to see the cases with conclusions starting to head toward a 3% or so death rate. Instead trend has been going toward climbing death rate.  Does anyone else find this disturbing?

current bottom? 20% deaths, 

yesterday : 19% deaths 

and a few days ago it was 17% deaths 

 

75C664C6-BF06-41A0-BFBC-0A3292EE9FFB.png

E7EB304F-5B17-43CE-A89F-CCC6AB1ABC53.jpeg

 

But the vast majority of cases in the US are relatively recently diagnosed.  Recently enough that the only options are 1) Still sick (or at least not confirmed as recovered) or 2) Dead.   That number should change as we get further out from diagnosis for a lot of people.  

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1 minute ago, CuriousMomof3 said:

 

But the vast majority of cases in the US are relatively recently diagnosed.  Recently enough that the only options are 1) Still sick (or at least not confirmed as recovered) or 2) Dead.   That number should change as we get further out from diagnosis for a lot of people.  

 

Exactly. Thanks for explaining the math better than I did. 

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I wouldn't worry about whether you will live through a ventilator (most do, even if it takes 2-3 weeks) and whether you will be disabled afterwards or not (I don't think there's any evidence you will have anything more lasting that reduced lung capacity, probably temporarily).  Dying because you can't breathe is incredibly uncomfortable. It brings many people who chose to go on hospice for something like COPD or lung cancer into panic attacks.  And whether people will need to be triaged into getting one or not when needed is impossible to predict. If that is the situation you may not be getting the level of nursing attention you normally would, so no one can promise you'd be properly medicated until you were no longer panicking.

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https://www.bbc.com/future/article/20200330-coronavirus-are-children-immune-to-covid-19
 

Easy to read overview on what we know about the impact on kids in relation to our discussion yet.  It seems to be slightly worse for infants (1/10 severe) and preschoolers, mild in school age children then in teens it becomes more serious as the immune system becomes more adult.  It possibly relates to ACE2 receptors and cytokine storm, more resilience to coronaviruses due to more recent viral infections or maybe other factors.  

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@square_25the officials involved are still waiting on Holland America. I think they don’t want to be played out. They want a legal binding plan.

https://www.sun-sentinel.com/coronavirus/fl-ne-ships-infected-port-everglades-20200401-mf4komanench5m7lwp34oeajly-story.html
“A memo outlined by the cruise line had called for sending guests home on commercial flights and charter flights, and Floridians driven to their houses. But the county is still waiting for an official plan that would be binding, including details about who would pay for what, an outline of the medical plan, and talks about security.

Zaandam and Rotterdam combined have 1,250 guests on board, including 311 Americans from 19 states; 52 of those are from Florida. Nine are from South Florida.”

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5 minutes ago, Katy said:

I wouldn't worry about whether you will live through a ventilator (most do, even if it takes 2-3 weeks) and whether you will be disabled afterwards or not (I don't think there's any evidence you will have anything more lasting that reduced lung capacity, probably temporarily).  Dying because you can't breathe is incredibly uncomfortable. It brings many people who chose to go on hospice for something like COPD or lung cancer into panic attacks.  And whether people will need to be triaged into getting one or not when needed is impossible to predict. If that is the situation you may not be getting the level of nursing attention you normally would, so no one can promise you'd be properly medicated until you were no longer panicking.

This is part of what I was wondering. But would the patient be aware enough to know, as curious mom mentioned?

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12 minutes ago, CuriousMomof3 said:

 

But the vast majority of cases in the US are relatively recently diagnosed.  Recently enough that the only options are 1) Still sick (or at least not confirmed as recovered) or 2) Dead.   That number should change as we get further out from diagnosis for a lot of people.  

 

Also if / when widely-available antibody tests become available, we should have more reliable information on the many people who are self-diagnosing & staying home & recovering. (I know scientists are working frantically on it, and my thanks goes to them.)

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Just now, wilrunner said:

This is part of what I was wondering. But would the patient be aware enough to know, as curious mom mentioned?

 

Aware enough to know what?  That they felt like they are dying and need help?  From some reports yes, people need to be sedated to be ventilated with this too.  But with others it seems like they aren't aware how sick they are and drop dead at home, so I don't think we know that yet.  I've helped people in respiratory distress but honestly I don't feel I know enough about it generally to answer that any better.  Most of my patients who came in and needed to be transferred to the ICU came in for pneumonia and it turned out they had cancer everywhere.  That's a very different scenario than this virus.

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All essential workers in Aus will have access to free childcare from tomorrow.

so far we’ve had

Amalgamation of public and private health systems

job seeker/job keeper payments (Increases on the normal)

free childcare 

Almost all things that this gov would have strongly opposed in normal circumstances.  Obviously temporary and circumstance specific but I must admit I’m wondering whether some changes will be more long term.

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4 minutes ago, StellaM said:

 

Yikes.

 

Yes, this is why it makes so many other professionals I know feel this emotional state that's close to panic.  Or maybe it's anticipatory grief.  Dying patients are emotionally difficult enough.  Being so overwhelmed you cannot provide everyone the care they need is terrifying.

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Just now, StellaM said:

PM in AU says 'no chance of restarting the economy for at least six months'. 

Aussie WTM'ers - is the federal government doing better in the last week, do you reckon?  They seem to be? Also...most unexpected outcome of the entire pandemic....Sally McManus, head of ACTU, being thanked by Scotty ??!!

I think scomo learned some lessons from the bushfire crisis and has been much more proactive about that.  I think there’s still a leaning to economy over life.  I’ve got to say although I don’t particularly like the guy he’s copped a heck of a bad time to be prime minster.  Abbott and Turnbull are probably thanking their lucky stars they got turfed when they did.  I think he’s making a lot of decisions that probably go against the grain.  

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Just now, Katy said:

 

Aware enough to know what?  That they felt like they are dying and need help?  From some reports yes, people need to be sedated to be ventilated with this too.  But with others it seems like they aren't aware how sick they are and drop dead at home, so I don't think we know that yet.  I've helped people in respiratory distress but honestly I don't feel I know enough about it generally to answer that any better.  Most of my patients who came in and needed to be transferred to the ICU came in for pneumonia and it turned out they had cancer everywhere.  That's a very different scenario than this virus.

Thank you for your response. I won't like your posts. It's all too sad.

One thing I have to do periodically is remind myself that, though the death rate is higher than anyone would like, the likelihood of anyone in our family dying is pretty low. I think the likelihood of all of us contacting it is fairly high, especially with dd working and dh getting take out twice a day.

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I also think we’ve seen a significant movement away from following America on making policy.   Is that controversial?  I hope not.

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11 minutes ago, wilrunner said:

This is part of what I was wondering. But would the patient be aware enough to know, as curious mom mentioned?

 

Sorry, that wasn't what I meant to say.  I think that being aware enough to feel pain or panic, is different from being aware and calm and capable enough to communicate end of life decisions.  I think the latter is less likely than the former, unfortunately.

I guess my assumption is that if things are really bad, with a shortage of nurses and medications that leads to people with DNI's not getting help, then likely the people who are intubated and ventilated are also under supported, and probably panicking too, and maybe for a longer time. 


 

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https://amp.theguardian.com/society/2020/mar/28/coronavirus-intensive-care-uk-patients-50-per-cent-survival-rate?CMP=Share_AndroidApp_Tweet&__twitter_impression=true
 

the 50 percent stat from ICU.  I do think again the stats may be worse early in the outbreak?  Because people going to the icu stage are people that go down very quickly.  People going into intensive care in a couple of weeks may be stronger to start with so more chance of pulling through?  I’m hoping so.

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Prime Minister Scott Morrison says Australia has reached a testing rate of more than 1,000 tests per 100,000 people, about 1 per cent of the population. He says the Government will also provide support to 13,000 childcare centres across the country to ensure they remain open.

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I have to be careful what I say because of an anxious kid, but I am the President of Covid-19 Operation Force  (COF) in our house for a reason:  I know more (because of the Hive) than just about everyone else in my state. I'm in charge of setting up the new procedures (package & mail quarantine, mailbox gloves, gloves for pumping gas, wiping down groceries, wiping down everything after DH comes home, etc). I'm sure DH thinks I'm over-reacting, but he's been pretty good about humorimg me. And yes, I am a bit insufferable about already knowing things because I stopped telling him stuff because he got tired of hearing it.

Not sure how he's going to take my newest task (hospital to go bags - thanks, @Garga?) I was in the middle of getting my mom's will rewritten when everything locked down. Not sure if people can witness a will online....

If the cruise ship people can be securely quarantined until they get private flights, that's probably best. They are people & even stupid people deserve mercy & kindness. 

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2 minutes ago, StellaM said:

 

Is that testing rate good, bad or indifferent ?

I think it’s good.  It actually surprised me given the requirements for access to testing that that many people fit the profile.

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54 minutes ago, square_25 said:

No, I don't think it's disturbing. A LOT of the cases are new. That means they don't have resolutions. 

That, and we're going to have a much harder time tracking recovered people as opposed to dead people. Dead bodies don't disappear in the same way. 

I wouldn't worry about this statistic. I think any epidemiologist would tell you it's not meaningful. 

 

I can see if there are a lot of new cases discovered only at death how that would skew the statistics hugely.

And we don’t have our treatment ducks in line.

But I thought it was supposed to usually be around 3 weeks from case discovery to either death or recovery,  such that the concluded cases would be primarily the rough results from cases that were new  ~ 3 weeks prior. 

 

59 minutes ago, TCB said:

I think the survival rate is going to go up quite a lot quite quickly once we get our feet under us. I don’t think what is going on these first few weeks is indicative of what the survival rate for ventilated patients will be soon. I think that was what happened in Wuhan too. That’s why not overwhelming the health system is so important.

 

I hope so.  

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37 minutes ago, StellaM said:

PM in AU says 'no chance of restarting the economy for at least six months'. 

Aussie WTM'ers - is the federal government doing better in the last week, do you reckon?  They seem to be? Also...most unexpected outcome of the entire pandemic....Sally McManus, head of ACTU, being thanked by Scotty ??!!

well I am still stuck on the PM saying buying jigsaws is an essential shopping trip

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Just now, Melissa in Australia said:

well I am still stuck on the PM saying buying jigsaws is an essential shopping trip

Keep the children entertained while parents work from home 😉 

As an aside, jigsaws on tables at the cancer center I go to for my appointments is very popular with patients.

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13 minutes ago, RootAnn said:

If the cruise ship people can be securely quarantined until they get private flights, that's probably best. They are people & even stupid people deserve mercy & kindness. 

Zaandam and Rotterdam are supposed to reach the port tomorrow. Hopefully Holland America comes up with a legal binding plan and abides by it. If Holland America “play dirty”, the other cruise ships waiting to dock in Florida suffers. 

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3 minutes ago, Arcadia said:

Keep the children entertained while parents work from home 😉 

As an aside, jigsaws on tables at the cancer center I go to for my appointments is very popular with patients.

I know what Jigsaws are good for. I was just a bit shocked when our PM announced that you should only leave the house for essential shopping only , then gave the example of buying jigsaws- something that can be bought online 

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6 minutes ago, Melissa in Australia said:

well I am still stuck on the PM saying buying jigsaws is an essential shopping trip

I’ve been laughing about it because I bought jigsaws to send to a friend with a broken arm and we have been doing jigsaws.  Saying to dh, see I’m ahead of the PM yet again!  
 

but yes the definition of an essential shopping trip is very broad right now.  I think they do want to give people time to stock up for the next six months.  I hope that doesn’t impact too much on our ability to slow things down.

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3 minutes ago, Arcadia said:

Zaandam and Rotterdam are supposed to reach the port tomorrow. Hopefully Holland America comes up with a legal binding plan and abides by it. If Holland America “play dirty”, the other cruise ships waiting to dock in Florida suffers. 

This seems to be what happened with the one in Fremantle.  They initially refused permission to dock, changed that on humanitarian grounds and now the ship is refusing to leave.  

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1 hour ago, Ausmumof3 said:

Anyone seen reliable info about Ecuador?  That situation looks bad

 

Yeah, looks bad and could be true.

I’m on another forum that’s discussing Covid. Areas prone to Dengue are seeing increases which might be Covid and not Dengue. 

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30158-4/fulltext

Quote

Dengue and coronavirus disease 2019 (COVID-19) are difficult to distinguish because they have shared clinical and laboratory features. We describe two patients in Singapore with false-positive results from rapid serological testing for dengue, who were later confirmed to have severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the causative virus of COVID-19.

 

I’ll ask if anyone knows more about Ecuador.

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16 minutes ago, Pen said:

But I thought it was supposed to usually be around 3 weeks from case discovery to either death or recovery,  such that the concluded cases would be primarily the rough results from cases that were new  ~ 3 weeks prior. 

Yes, the concluded cases (the ones being tracked) are from like a month ago, and the deaths are much newer. So it just doesn't make sense to divide. 

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42 minutes ago, Arcadia said:

Keep the children entertained while parents work from home 😉 

As an aside, jigsaws on tables at the cancer center I go to for my appointments is very popular with patients.


This is a jigsaw in the US, so I was 😅 at this! I mean, obviously I could figure it out, but it was a funny image. 
https://www.amazon.com/BLACK-DECKER-BDEJS600C-Select-5-0-Amp/dp/B00OJ72LHK/ref=sr_1_2?keywords=jigsaw&qid=1585800194&sr=8-2

Edited by Sk8ermaiden
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Another article, this time from Spain, showing that excess mortality is way higher than is captured in the official COVID numbers:

https://elpais.com/sociedad/2020-03-27/el-coronavirus-causa-mas-muertes-de-las-detectadas.html

It's in Spanish, which I don't read, so I did Google translate. 

And some discussion in English: 

https://talkingpointsmemo.com/edblog/hidden-mortality-in-spain

 

Edited by square_25
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5 minutes ago, square_25 said:

You mean one would have to say jigsaw puzzle? 


I think the boxes say jigsaw puzzle, but in my whole life I've only ever heard them called puzzles. "We're doing a puzzle." 

I do think it's funny/interesting they're called jigsaw puzzles and our country picked puzzle and yours picked jigsaw. 

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1 minute ago, Sk8ermaiden said:


I think the boxes say jigsaw puzzle, but in my whole life I've only ever heard them called puzzles. "We're doing a puzzle." 

I do think it's funny/interesting they're called jigsaw puzzles and our country picked puzzle and yours picked jigsaw. 

Oh, I definitely call them jigsaw puzzles and sometimes just puzzles. But I definitely think of the complete phrase as containing the word "jigsaw"! 

Edited by square_25
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I think our fatality rate is artificially high right now because most people can only be tested if they are really, really, sick or already dead. All of the people with mild symptoms or are asymptomatic aren't being counted.

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59 minutes ago, BeachGal said:

 

Yeah, looks bad and could be true.

I’m on another forum that’s discussing Covid. Areas prone to Dengue are seeing increases which might be Covid and not Dengue. 

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30158-4/fulltext

 

I’ll ask if anyone knows more about Ecuador.

It is bad down there from what I know.   One of DH’s friends FIL who lives in Ecuador just passed away this week from Covid.  

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24 minutes ago, Sk8ermaiden said:


I think the boxes say jigsaw puzzle, but in my whole life I've only ever heard them called puzzles. "We're doing a puzzle." 

I do think it's funny/interesting they're called jigsaw puzzles and our country picked puzzle and yours picked jigsaw. 

?  Jigsaw, puzzle and jigsaw puzzle are used interchangeably. 

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I've never heard an American say just jigsaw when referring to a puzzle. It's usually puzzle and sometimes jigsaw puzzle, but maybe it's regional?

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49 minutes ago, Paige said:

I think our fatality rate is artificially high right now because most people can only be tested if they are really, really, sick or already dead. All of the people with mild symptoms or are asymptomatic aren't being counted.

Or artificially low, because some places aren’t even testing the dead. It’s really hard to say.

NY is definitely testing mostly sick people, but it is running a lot of tests. So I’m sure the numbers are inflated, but I’m not sure how much. And then there are the related deaths due to healthcare system overload...

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1 hour ago, Sk8ermaiden said:


This is a jigsaw in the US, so I was 😅 at this! I mean, obviously I could figure it out, but it was a funny image. 
https://www.amazon.com/BLACK-DECKER-BDEJS600C-Select-5-0-Amp/dp/B00OJ72LHK/ref=sr_1_2?keywords=jigsaw&qid=1585800194&sr=8-2

We call the tools jigsaws too.  I think they used to make wooden puzzles using that kind of tool or similar and that’s how it got the name.  Jigsaw puzzle because they were made with a jigsaw.  Now they’re made out of cardboard but here we still call them jigsaws

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9 news Qantas have confirmed that an Adelaide Pilot has tested positive for COVID 19. The airline says this case isn't related to another cluster at the airport where 12 baggage handlers and 5 close contacts of them have tested positive. 

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7 minutes ago, square_25 said:

Or artificially low, because some places aren’t even testing the dead. It’s really hard to say.

NY is definitely testing mostly sick people, but it is running a lot of tests. So I’m sure the numbers are inflated, but I’m not sure how much. And then there are the related deaths due to healthcare system overload...

 

I think the rate of dead/diagnoses could be low, because we aren't testing all the asymptomatic people, or high because we aren't testing the dead people, and because it takes time to die.

But I have no doubt that the dead/recovered ratio is high.  Because the number of people who were sick 3 weeks ago, was so much lower, and the recovered number only includes those people.  

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3 hours ago, Ausmumof3 said:

Anyone seen reliable info about Ecuador?  That situation looks bad

 

I'm praying hard for Ecuador. The first sponsored child who mentioned coronavirus in a letter to me (written at the end of January) lives in Guayaquil. I also have a 5 year old in Quito and a few more kids in Ecuador -- I hope the jungles at least are safe but when I saw people fled there I'm really worried.

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@Ausmumof3

🇦🇺 https://www.channelnewsasia.com/news/world/covid-19-australia-cruise-ships-crew-coronavirus-12601274

“SYDNEY: Australian police and military will soon begin helicoptering doctors to several cruise ships stranded near Sydney to assess nearly 9,000 crew for COVID-19, officials said on Thursday (Apr 2).

The military-style operation, due to begin by the weekend, is aimed at resolving a standoff between cruise line operators and authorities who fear a wave of new imported coronavirus cases would overwhelm local hospitals.

Australia ordered a ban on all cruise liners in mid-March, but later allowed Australian nationals to disembark from four ships in Sydney - a decision which led to more than 450 new COVID-19 cases in the country.

"I'm holding the line on this," said Police Commissioner Mick Fuller of New South Wales state, which includes Sydney and where most of the cruise ships are located.

"My fear is by bringing 9,000 people off the cruise ships into isolation, not knowing if they have the virus or they may develop symptoms, that would absolutely overload our hospital system," he said on Thursday.

"We will drop doctors across eight ships, 9,000 people - It's a big task in itself," he said.

Fuller said anyone found to need urgent medical care would be brought to facilities onshore, but the ships would be expected to head to their home ports with the rest of their crews.”

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