wuhan - coronavirus

[Ausmumof3]

14 minutes ago, TCB said:

I agree that the politicizing of this is coming from both sides of the great US divide. It amazes me and makes me extremely sad that even in a pandemic people feel they have to take sides - maybe I’m just naive - I have the impression that in previous times of hardship like the World Wars etc people pulled together - but maybe that’s just romantic nonsense.

It feels weird from here because it just doesn’t seem that politicised in Aus or maybe I’m missing it.  I’m trying to be more careful about what I share because I realise some of it is more loaded than I thought.

[Paige]

2 hours ago, Ausmumof3 said:

I started following a few Chinese news sources in the early days when I was trying to figure out what was going on.  There’s a fair bit of propaganda coming out now from there denigrating other countries responses and praising chinas which is a tad obnoxious given how it seems to have started.  So I think maybe it’s a pushback against that.  But yes overall focusing on our own response moving forward is going to be way more productive.

I doubt that's true here. I doubt anyone in the US who is pushing the blame China narrative is paying attention to what's going on in the Chinese media. You're giving the talking heads and talking points makers too much credit. If anything, I think it's more likely the Chinese are watching us and pushing back. 

I think China absolutely lied, is still lying, and is also making and has made mistakes with info that led to misleading info coming out that was unintentional. But that has nothing to do with the US response! We're supposed to have spies and intel people who are working for us and can bypass the Chinese propoganda! And we did. And they mostly sent the correct messages. And once the disease hit our shores, what happened next had absolutely nothing to do with Chinese failings and misinformation. I think we are focusing on blaming China because it's easier than admitting our response failed on multiple levels. I hope that's not too political- I think some of it is because of the current admin's mistakes, but some of it is not and reflects policy failures over decades. 

Back to China- I'm surprised China hasn't targeted a scapegoat yet who would come out, take all the blame, and quit their job, or be sent off to some nasty Chinese prison. Or maybe they've decided to double down on the lie that it came from the US gvmt and we're the scapegoat? 

[Ausmumof3]

1 minute ago, Paige said:

I doubt that's true here. I doubt anyone in the US who is pushing the blame China narrative is paying attention to what's going on in the Chinese media. You're giving the talking heads and talking points makers too much credit. If anything, I think it's more likely the Chinese are watching us and pushing back. 

I think China absolutely lied, is still lying, and is also making and has made mistakes with info that led to misleading info coming out that was unintentional. But that has nothing to do with the US response! We're supposed to have spies and intel people who are working for us and can bypass the Chinese propoganda! And we did. And they mostly sent the correct messages. And once the disease hit our shores, what happened next had absolutely nothing to do with Chinese failings and misinformation. I think we are focusing on blaming China because it's easier than admitting our response failed on multiple levels. I hope that's not too political- I think some of it is because of the current admin's mistakes, but some of it is not and reflects policy failures over decades. 

Back to China- I'm surprised China hasn't targeted a scapegoat yet who would come out, take all the blame, and quit their job, or be sent off to some nasty Chinese prison. Or maybe they've decided to double down on the lie that it came from the US gvmt and we're the scapegoat? 

They did sideline and replace some officials in Wuhan if that’s what you mean?

[EmseB]

4 hours ago, Ausmumof3 said:

 

 

I wonder if they are early in the infection and will later become symptomatic.  One thing that’s kind of positive with asymptomatic carriers I guess is it hugely lowers the case fatality rate.  But then it makes it harder to detect and contain.

I was trying to look at the dates but it's hard to tell when exactly all of them got tested off the ship and got into their own rooms since it happened over the course of several days or a week.

The high number of asymptotic, especially in that environment, is concerning. Even if you can quarantine people who are sick, you can't quarantine what you can't see.

[Pam in CT]

re asymptomatic carriers walking around Typhoid Mary-like, unwittingly transmitting to others

7 hours ago, EmseB said:

60% of the 600 positive cases on the USS Teddy Roosevelt are asymptomatic so far.

https://taskandpurpose.com/news/uss-theodore-roosevelt-sailors-coronavirus-asymptomatic

 

6 hours ago, ElizabethB said:

That is really high.  It is also a younger, thinner, and healthier population than average, but still a very high asymptomatic rate.  

 

Right --compared to the general population, these people are young and fit and active.  Were they not restricted to a boat -- even if they were only engaging in activities deemed as "essential," picking up groceries or home improvement products or seed supplies or whatever -- they would be transmitting.

In an accidental Eureka! mold-on-the-bread kind of circumstance, Columbia Presbyterian in NYC collected hard data on this phenomenon as well, which were recently reported by the obstetric doctors involved (as a letter to the editors, not a peer-reviewed study, so as to get the word out as quickly as possible -- the team is continuing to collect the data and is working on a fuly- vetted-article when they have a full month of data) in the NE Journal of Medicine.. All elective surgeries and non-essential procedures have been deferred in NYC for over a month, but the one sizable population segment that still has to come in are maternity patients.

After two delivering mothers who showed no signs of COVID/flu/respiratory problems upon admission (there were four others who DID present with fever or other symptoms and were isolated upon admission... but two did not), but developed them during delivery, were tested and turned out to be COVID-positive, the obstetric team realized with horror that the delivery team -- who had neither isolated the patients nor used COVID PPE -- had almost certainly transmitted the virus to other obstetric patients. So they implemented universal quick-result COVID testing of all obstetric patients upon admission, so that the positive ones could be isolated and (far-too-limited, le sigh) PPE could be allocated to managing those cases.

This is NOT a pulmonary or infectious disease team -- these are doctors who deliver babies -- but they quickly realized that their protocol amounted to what universal testing would look like if public health authorities had the tests and resources to do it, so they are moving to get the information out as quickly as possible. Because in a very short, fairly early point in NYC's ordeal:

Quote

...Between March 22 and April 4, 2020, a total of 215 pregnant women delivered infants at the New York–Presbyterian Allen Hospital and Columbia University Irving Medical Center . All the women were screened on admission for symptoms of Covid-19. Four women (1.9%) had fever or other symptoms of Covid-19 on admission, and all 4 women tested positive for SARS-CoV-2 (Figure 1). Of the 211 women without symptoms, all were afebrile on admission. Nasopharyngeal swabs were obtained from 210 of the 211 women (99.5%) who did not have symptoms of Covid-19; of these women, 29 (13.7%) were positive for SARS-CoV-2. Thus, 29 of the 33 patients who were positive for SARS-CoV-2 at admission (87.9%) had no symptoms of Covid-19 at presentation.

 

There are two critical, and dismaying, implications of this. First: of the 215 women who showed up in labor, 33 ((or 15.3%) were COVID positive.  Second: of the 33 who were positive, 29 (87.9%) showed no symptoms.  

Extrapolation to scale is difficult -- young women may on average be otherwise healthier/ more resistant than the general population and thus more likely to be asymptomatic if positive; secondary maternity patients = mothers may on average do more sallying forth for supplies/ taking their older kids out than the general population and thus more exposed; maternity patients are likely on average to have had more routine medical visits and thus more exposed; the general incidence between March 22-April 4 was certainly higher in NYC than it was, then, in other parts of the country. But the point about the invisibility, even to the carriers themselves, of transmission holds.  Every single person procuring real necessities at Costco or Lowes, let alone at church or yoga or the beach, could be an unwitting Typhoid Mary.

Any one of the 640+ people now linked to that single meat processing plant in South Dakota that is now the most concentrated hot spot in America could be, or have a household member who is, a maternity patient. Who upon (untested) admission to the maternity ward, could infect any doctor, nurse, aide, food delivery or cleaning person in the hospital. Who then continues on -- not only to the next patient/ room/ meal in the hospital, but also home to other household members, and also on to Costco or Lowes for essentials.  And thus transmits -- unwittingly, this is not about irresponsible folks taking their snotty hacking kids to social gatherings; 87.9% of Columbia Presbyterian mothers had no symptoms  -- on to the next concentric circle of infection. This is how exponential transmission works; this is how the number of cases has doubled every 3 (at NYC's worst) to 6 (now) days.  Not (mostly) because sick people are acting like jerks; because the disease transmits by folks who genuinely do not suspect they are transmitting.  The most dangerous reasons why is this virus different from all the other viruses are 1. the ease with which it transmits (compared to, say, HIV) and 2. that it evidently transmits both before symptoms appear in patients who do ultimately get sick and also by carriers who never do themselves get sick.  

Any person we encounter, indeed any one of us even if we feel just fine, could inadvertently be Typhoid Marys.  

 

Re nursing homes, and transparency -- my Governor is now releasing daily COVID information, which includes this:

Quote

Town	Nursing home	Licensed beds	Residents with COVID-19	COVID-19 associated deaths among residents
Bethel	Bethel Health Care Center	161	18	2
Bloomfield	Bloomfield Center for Nursing and Rehabilitation	120	11	4
Bloomfield	Caleb Hitchcock Health Center	60	2	1
Bloomfield	Touchpoints at Bloomfield	150	20	6
Branford	Branford Hills Health Care Center	190	20	3
Bridgeport	Jewish Senior Services	294	23	6
Bridgeport	Northbridge Healthcare Center	145	6	2
Bristol	Countryside Manor of Bristol	90	11	3
Bristol	Sheridan Woods Health Care Center	146	24	7
Canton	Cherry Brook Health Care Center	100	11	2
Cheshire	Elim Park Baptist Home	90	1	-
Chester	Aaron Manor Nursing and Rehabilitation	60	15	3
Cromwell	Apple Rehab Cromwell	85	2	-
Danbury	Glen Hill Center	100	2	1
Danbury	Saint John Paul II Center	141	23	9
Danbury	Western Rehabilitation Care Center	120	13	7
East Hartford	Riverside Health & Rehabilitation Center	345	38	10
East Haven	Apple Rehab Laurel Woods	120	14	3
East Haven	Whispering Pines	90	32	14
East Windsor	Fresh River Healthcare	140	3	-
Enfield	Parkway Pavilion Health and Rehabilitation Center	130	45	8
Fairfield	Cambridge Health and Rehabilitation Center	160	12	7
Fairfield	Carolton Chronic & Convalescent	229	21	3
Fairfield	Ludlowe Center for Health & Rehabilitation	144	12	3
Farmington	Touchpoints at Farmington	105	20	2
Glastonbury	Glastonbury Health Care Center	105	17	5
Glastonbury	Salmon Brook Rehab and Nursing	130	9	4
Greenwich	Greenwich Woods	217	13	4
Greenwich	Nathaniel Witherall	202	25	3
Greenwich	RegalCare at Greenwich	75	1	-
Guilford	Guilford House	75	1	-
Hamden	Arden House	360	16	2
Hamden	Hamden Rehabilitation & Health Care Center	153	13	4
Hamden	Whitney Rehabilitation Care Center	150	2	-
Hartford	Chelsea Place	234	16	5
Hartford	Trinity Hill Care Center	144	25	1
Manchester	Crestfield Rehabilitation Center	155	9	2
Manchester	Manchester Manor Health Care Center	126	8	-
Manchester	Touchpoints at Manchester	131	27	4
Manchester	Westside Care Center	162	1	-
Meriden	Curtis Home	60	6	1
Middletown	Middlesex Health Care Center	150	15	1
Middletown	Water's Edge Center for Health & Rehabilitation	150	8	1
Milford	Golden Hill Rehab Pavilion	120	67	9
Milford	Milford Health and Rehabilitation Center	120	13	1
Milford	West River Rehab Center	120	7	2
Naugatuck	Glendale Center	120	17	-
New Britain	Grandview Rehabilitation and Healthcare Center	160	18	4
New Canaan	Waveny Care Center	76	11	9
New Haven	Grimes Center	114	58	1
New Haven	RegalCare at New Haven	150	8	-
New Haven	The Mary Wade Home	94	8	1
New London	Harbor Village	128	5	1
New Milford	Village Crest Center for Health & Rehabilitation	95	4	-
Newington	Bel Air Manor	71	2	1
Newington	Newington Rapid Recovery Rehab Center	180	20	2
North Haven	Montowese Health & Rehabilitation Center	120	10	2
Norwalk	Autumn Lake Healthcare at Norwalk	150	13	8
Norwalk	Cassena Care at Norwalk	150	11	2
Plainville	Apple Rehab Farmington Valley	160	7	-
Portland	Portland Care and Rehabilitation	65	16	4
Ridgefield	Laurel Ridge Health care Center	126	12	1
Rocky Hill	60 West	95	4	-
Rocky Hill	Apple Rehab Rocky Hill	120	28	5
Rocky Hill	Maple View Health & Rehabilitation Center	120	4	1
Seymour	Shady Knoll Health Center	128	30	9
Sharon	Sharon Health Care Center	88	7	-
Shelton	Apple Shelton Lakes	106	40	13
Shelton	Bishop-Wicke Health and Rehabilitation	120	22	12
Shelton	Gardner Heights Health Care Center	130	42	15

 

a level of transparency which to me is MASSIVELY important -- to patients, to patients' families, to all employees in the respective places as well as medical service providers going into them, to public health officials and municipal leaders in the affected towns... and also to folks whose loved ones are not in those facilities, but are in others.

Facts are our friends. Without data everybody is flying without instruments.

[sassenach]

1 hour ago, Matryoshka said:

Huh. Do you have a citation for that?  I find that really odd, especially since other countries (especially Italy, as cited above) are seeing practically a doubling of deaths over the past year.  Do we normally have so many auto deaths vs Italy?  That seems unlikely - they drive like maniacs there. 😉  Also doesn't seem like suicide deaths or things like that would be down - everyone's been predicting those would go up with stay-at-home...  I saw that NYC has had something like 4x the rate of fatal 911 calls recently over past years data.  That also doesn't seem to indicated that overall deaths are down, but the very much the opposite.  Maybe this reflects parts of the country where Covid hasn't really hit yet???  That might make more sense... if Covid isn't spreading (yet) in many areas so it isn't increasing deaths there, then other deaths would be down and make the overall number lower?

Go to the cdc Covid site and they have a page for death rates with a bunch of data tables. 
 

This isn’t based on any statistical analysis, just me eyeballing the data and spinning hypotheses. I imagine this will all be analyzed at some point in the future.

Considering that auto death is a major killer in the US, it makes perfect sense to me. Kind of like the reverse of the 9/11 effect. 

[kbutton]

9 minutes ago, Pam in CT said:

After two delivering mothers who showed no signs of COVID/flu/respiratory problems upon admission (there were four others who DID present with fever or other symptoms and were isolated upon admission... but two did not), but developed them during delivery, were tested and turned out to be COVID-positive, the obstetric team realized with horror that the delivery team -- who had neither isolated the patients nor used COVID PPE -- had almost certainly transmitted the virus to other obstetric patients.

Are the practitioners spreading COVID because they are not using COVID PPE, or because they were also infected? I am reading this as being the result of PPE rationing (and lack of patient isolation). 

[Laura Corin]

1 minute ago, Seasider too said:

 

Is this the remdisivir (sp)?

 

That's the one treatment they will not be testing, according to the article, because they can't get drug supplies to do it.  They are testing five or six other options.

[Matryoshka]

38 minutes ago, sassenach said:

Go to the cdc Covid site and they have a page for death rates with a bunch of data tables. 

This isn’t based on any statistical analysis, just me eyeballing the data and spinning hypotheses. I imagine this will all be analyzed at some point in the future.

Considering that auto death is a major killer in the US, it makes perfect sense to me. Kind of like the reverse of the 9/11 effect. 

Welp, apparently it's not auto deaths leading the decline... just watching a spot on CBS This Morning. .. rather than going down, auto deaths are actually spiking now in spite of lower traffic, due to increased speeding. Traffic speeds are up 30% in CA; in Minnesota,  traffic deaths have doubled. 

Edited April 17, 2020 by Matryoshka

[Jean in Newcastle]

1 minute ago, Matryoshka said:

Welp, apparently it's not auto deaths leading the decline... just watching a spot on CBS This Morning. .. rather than going down, auto deaths are actually spiking now in spite of lower traffic, due to increased speeding. Traffic speeds are up 30% in CA; in Minnesota,  traffic deaths have doubled. 

That must be state specific. Our auto company sent out emails that auto accidents in Washington state are down 30%. Thus we will be getting a refund on premiums. 

[Pam in CT]

re medical practitioners spreading COVID:

14 minutes ago, kbutton said:

Are the practitioners spreading COVID because they are not using COVID PPE, or because they were also infected? I am reading this as being the result of PPE rationing (and lack of patient isolation). 

 

I listened to an interview of one of the Columbia Presbyterian doctors, who referenced two interlinked factors:

1. Prior to March 22, the obstetric ward didn't have *any* tests -- the emergency rooms and pulmonary wards didn't have nearly adequate tests!! -- they were separating and isolating patients solely on the basis of self-reported symptoms and temperature tests; and
2. (Even now, certainly then) all NYC hospitals have severe PPE shortages, and have been rationing to known or suspected COVID-facing practitioners.

So prior to the mandatory universal testing protocol instituted starting March 22, the ward was only isolating admissions who either presented with flu-like symptoms, or presented with a temperature.  But then two non-isolated, wholly asymptomatic mothers developed severe respiratory complications during delivery, were tested, and were found to be COVID positive... which then resulted in instant horror to the practitioners  OMG none of us have been using COVID-level PPE or protocol precautions with these patients for the last __x__ hours, we have very likely transmitted already, if we do not immediately institute different protocols we will be spreading throughout the ward. 

It is to their great credit that not only did they immediately institute different testing/isolation procedures, but also that they have moved forcefully -- outside their field -- to get the word out.

[Matryoshka]

2 minutes ago, Jean in Newcastle said:

That must be state specific. Our auto company sent out emails that auto accidents in Washington state are down 30%. Thus we will be getting a refund on premiums. 

The spot said the trend was happening nationwide, and quoted stats from lots of different states, so WA might be an exception - perhaps exhibiting the same rationality that led to the state not being ovrerun with Covid in spite of it having gotten there so early! It's not just what the govt demands, but what the people actually do...

[Sneezyone]

2 minutes ago, Matryoshka said:

The spot said the trend was happening nationwide, and quoted stats from lots of different states, so WA might be an exception - perhaps exhibiting the same rationality that led to the state not being ovrerun with Covid in spite of it having gotten there so early! It's not just what the govt demands, but what the people actually do...

Our insurer is nationwide although we live in VA and we are also getting a 20% discount/refund on our auto insurance.

[Sneezyone]

2 hours ago, kdsuomi said:

It's fine if you think it was bungled in February. However, we were also basing our early response off of flat out lies. If you only look at one side of that, you're still being very partisan. 

Arctic is talking about now. Everything bad has to be the fault of one party or one person and everything good is attributed to one party. It happens all the time. As I've said, I think my governor is a crackpot, but I think he's done a decent job with this situation. Would I vote for him? Absolutely not. Will I blame everything on him and not give him credit for anything because of that? Absolutely not. 

So, our own national advisors were lying in late January/early February when they issued rather stark warnings to the PTB? Partisans were lying to their own leader?

I think most people here have done a remarkable job of praising leadership, on both sides of the aisle, that has gone above and beyond to appreciate, recognize, save and protect lives. There are some notable exceptions among our leaders who have not prioritized the lives of citizens and health care workers, who have not acted swiftly based on changing information/realities. Some, demonstrably, had solid information earlier than others and still chose not to act. Acknowledging that isn’t a partisan issue. The evidence WRT the consequences of inaction is plentiful.

Edited April 17, 2020 by Sneezyone

[TracyP]

10 minutes ago, Matryoshka said:

Welp, apparently it's not auto deaths leading the decline... just watching a spot on CBS This Morning. .. rather than going down, auto deaths are actually spiking now in spite of lower traffic, due to increased speeding. Traffic speeds are up 30% in CA; in Minnesota,  traffic deaths have doubled. 

Hmm, not what I've heard in MN... I think you meant speed related traffic deaths - I believe they went from 3 in March '19 to 7 in March '20. That would be doubled. Fatal crashes overall have stayed about flat. There were 17 fatal crashes in March of this year, down just a bit from 21 last March.

[Jean in Newcastle]

I see most of what is going on at a federal level as “noise”. It hasn’t really impacted what is going on in my state in any meaningful way. 
 

I see the advances in treatments (which are being worked out by doctors on the ground around the world) promising. One of the scariest things initially was the lack of informed treatment options for moderate to severe cases. And despite the initial focus on ventilators, that is treatment with a very poor outcome. (Btw- now that they are trying other therapies with better success, I hope they take that into consideration and don’t keep cranking out ventilators with no thought on whether they are still needed). 
 

I wish that we had better reporting on WHY there aren’t more tests. The federal government has closed testing sites here so we shouldn’t rely in them. I don’t care who sets up testing but we need it. And antibody testing if they can find a reliable way to do it. 

[Matryoshka]

1 minute ago, Sneezyone said:

Our insurer is nationwide although we live in VA and we are also getting a 20% discount/refund on our auto insurance.

Wonder if they're only giving the discount to people rated 'safe drivers'... Apparently this trend is being led by idiots drag racing around at 100+mph. I'm kind of assuming those idiots already have at least one speeding ticket dinging their records. .. sane drivers, I think, are still being sane.. 

[prairiewindmomma]

Have we seen any evidence about how we are going to climb out of the PPE shortage or testing swab and reagent shortage?

I appreciate the discussions about reopening the economy because I think it refocuses back on the key problems that led to the lockdown in the first place.

I think we are in a longer term problem but we aren’t having needed discussions about handling the intermediate issues. How do we reopen healthcare so people can get chemo, surgeries, needed dental and eye care, etc. while so many things realistically can’t reopen yet? I think those are the discussions I wish we were having as a nation.

[Sneezyone]

1 hour ago, Paige said:

I doubt that's true here. I doubt anyone in the US who is pushing the blame China narrative is paying attention to what's going on in the Chinese media. You're giving the talking heads and talking points makers too much credit. If anything, I think it's more likely the Chinese are watching us and pushing back. 

I think China absolutely lied, is still lying, and is also making and has made mistakes with info that led to misleading info coming out that was unintentional. But that has nothing to do with the US response! We're supposed to have spies and intel people who are working for us and can bypass the Chinese propoganda! And we did. And they mostly sent the correct messages. And once the disease hit our shores, what happened next had absolutely nothing to do with Chinese failings and misinformation. I think we are focusing on blaming China because it's easier than admitting our response failed on multiple levels. I hope that's not too political- I think some of it is because of the current admin's mistakes, but some of it is not and reflects policy failures over decades. 

Back to China- I'm surprised China hasn't targeted a scapegoat yet who would come out, take all the blame, and quit their job, or be sent off to some nasty Chinese prison. Or maybe they've decided to double down on the lie that it came from the US gvmt and we're the scapegoat? 

They have...African immigrants. Mostly students.

[Sneezyone]

1 minute ago, Matryoshka said:

Wonder if they're only giving the discount to people rated 'safe drivers'... Apparently this trend is being led by idiots drag racing around at 100+mph. I'm kind of assuming those idiots already have at least one speeding ticket dinging their records. .. sane drivers, I think, are still being sane.. 

Maybe, I dunno. They just said it would be a blanket 20% cut due to people driving less.

[Matryoshka]

3 minutes ago, TracyP said:

Hmm, not what I've heard in MN... I think you meant speed related traffic deaths - I believe they went from 3 in March '19 to 7 in March '20. That would be doubled. Fatal crashes overall have stayed about flat. There were 17 fatal crashes in March of this year, down just a bit from 21 last March.

The spot didn't specify, but that does sound accurate.  It was focusing on these idiots driving around at 130-150 mph.

[Arcadia]

5 minutes ago, Sneezyone said:

Our insurer is nationwide although we live in VA and we are also getting a 20% discount/refund on our auto insurance.

 

19 minutes ago, Matryoshka said:

Welp, apparently it's not auto deaths leading the decline... just watching a spot on CBS This Morning. .. rather than going down, auto deaths are actually spiking now in spite of lower traffic, due to increased speeding. Traffic speeds are up 30% in CA; in Minnesota,  traffic deaths have doubled. 

The auto insurance discount is due to people driving less due to shelter in place orders. Think it’s more or less nationwide.

California has sideshows where you have crowds. People are speeding because of less commuter traffic on freeways.

[prairiewindmomma]

We are having street racing fatalities also. It is a huge problem—lots of people getting clocked at 120+ mph.

[TracyP]

1 minute ago, Matryoshka said:

The spot didn't specify, but that does sound accurate.  It was focusing on these idiots driving around at 130-150 mph.

I could definitely see that. 

[EmseB]

Did anyone post this already? (Pre-print study) https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1

These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases. Conclusions The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases. Population prevalence estimates can now be used to calibrate epidemic and mortality projections.

[prairiewindmomma]

15 minutes ago, square_25 said:

I'd guess there are shortages of equipment? Swabs, reagents, etc. 

There are shortages of supply, but we also still have capacity problems.  A couple of our local hospitals have set up their own labs, but they only have capacity to run 500-800 tests a day, which is nowhere near what we need for the population being funneled into those systems.  

Honestly, the plan about mobile testing in Target and Wal-Mart parking lots isn't a bad one. But I don't think any of that is happening, anywhere in the US. It's all still tied to hospital locations, afaik. 

My Danish friend's kid had a cough....worrisome since school started back up this week for them.  Her entire family was tested, and once they were shown to be covid-19 negative, then she same day had a doctor appointment to rule out asthma and other issues.  That kind of immediate responsitivity is what is needed but lacking in my stomping grounds. Even if we got to that point for people who have insurance, we still have a lot of people who avoid the doctor because of the expense of going. 

[OH_Homeschooler]

This is something that I've found particularly distressing. A town in Iowa-Columbus Junction. 2010 census said it had 1,899 residents. It's home to a Tyson pork plant, which of course is the town's largest employer. A week ago 24 workers tested positive. Two have died. Last I heard, 186 workers have tested positive: https://www.desmoinesregister.com/story/news/2020/04/14/testing-rural-iowa-covid-19-coronavirus-tyson-food-pork-processing/2989203001/

That doesn't even include the family members, and the town has a 10% infection rate. 

Now I am hearing on FB/underground sources that out-of-work employees from that plant are being sent to another local plant. It's just mind-boggling. That small, rural town is not going to survive this. How is that plant going to replace all the workers that die? How are the families going to survive? How is THIS better for the economy than if things had just been shut down in the first place?

Why isn't this getting more attention? 

Edited April 17, 2020 by OH_Homeschooler

[ElizabethB]

Boston homeless shelter, "Of the 397 people tested, 146 people tested positive. Not a single one had any symptoms."

https://www.krmg.com/news/national/coronavirus-cdc-reviewing-stunning-universal-testing-results-from-boston-homeless-shelter/tPL2WCG42CXensDpmDhqCO/

Homeless more likely to have enough vitamin D?  

Everyone, please forward at least this poster, preferably the whole study as well, to your friends in health care.  The poster recommends testing, tracking, and treating vitamin D levels in all coronavirus patients.

Study:

https://www.dropbox.com/s/ka7h4fbi7xdz9s9/Covid-19 and Vitamin D Information.pdf?dl=0

Poster:

https://docs.google.com/document/d/1ROn9Si3jXQzfgAwijH4JMv-n7wYJwrAMAefIM4kULkg/edit

The one doctor that I know of that is tracking D levels, Dr. Erik Hermstad, said on twitter, "I haven't seen any vitamin D levels in the 40's or higher yet on ANY patient I've admitted with it [COVID-19]."

Edited April 17, 2020 by ElizabethB

[EmseB]

6 minutes ago, square_25 said:

That seem way too high given the 65 deaths and the credible estimates of the IFR being about 0.5 to 1%. I would be VERY curious how good their antibody test is. 

I don't know enough about antibody tests to know if serology(?) tests are reliable or not. But I think the point is that it is high, higher than we thought, and since we're only testing the sickest people in most parts of the world this study is trying to find the true IFR as best they can. But this does seem to really bottom out the IFR.

As the saying goes, this is big if true.

[TracyP]

8 minutes ago, square_25 said:

That seem way too high given the 65 deaths and the credible estimates of the IFR being about 0.5 to 1%. I would be VERY curious how good their antibody test is. 

Factor in that Santa Clara county has a median age of 37 and I don't think that's so out there.

Plus Californians in general are pretty healthy and would have decent levels of vit d in that region of the state. 

[EmseB]

I don't know who this guy is, but this seems a decent explainer (again, if study is accurate)

https://mobile.twitter.com/justin_hart/status/1251163873039626244

[EmseB]

2 minutes ago, square_25 said:

I just mean we've had other antibody tests that didn't give anything like this for the IFR. The antibody tests seem to not be super reliable from what I read, and they have trouble distinguishing immunity from small reactions from immunity to OTHER coronaviruses. 

If you assume half of New York state is infected (!), you already get an IFR of 0.16%. That's with all the deaths so far, never mind the ones coming up!! And the median age is 38. And I very much doubt we really have 10 million infected. 

The IFR calculated in the Germany study was 0.37%. 

This doesn't compute. 

well, it could vary by region, no? I mean, don't a lot of illnesses have varying factors that would make ifrs different in different places?

Eta: I have also read this about some antibody tests, but then read that some are 97% accurate. I don't know which tests are which, but I wouldn't think they would pre-publish this on a low accuracy test if that is the whole point of the study itself?

Edited April 17, 2020 by EmseB

[prairiewindmomma]

RE: Smithfield pork plants....just because someone is testing positive doesn't mean that they are needing interventionary healthcare.  They will, statistically, recover and move on.  It's really inconvenient now for that small town, but it's a blip and life will carry on.  I expect that these kinds of things will be happening for the next couple of years and why we will continue to have supply and logistical gaps on and off.

Most meat packing towns are small and rural, not close to major medical facilities.  They also tend to have a higher percentage of immigrant labor, and lower access to quality medical care.  They are good paying jobs for those communities, but not something most urban families would consider a living wage.

[Pam in CT]

re NY Columbia Presbyterian maternity ward data (to be clear, the doctors are definitely *not* presenting this as a full-scale peer-reviewed study; only as raw data that they've collected)...

... and how extrapolate-able it might be:

14 minutes ago, square_25 said:

 

Oh, super interesting, and thank you. I've read the study of pregnant women but didn't hear this. 

I wonder if you'd expect the rate of asymptomatic people to be higher or lower during pregnancy? I know there's immune system suppression during pregnancy... 

 

So (as noted above) the rate of COVID-positve, but asymptomatic, people in that all-female, all-young, all-pregnant, sample of 215 who showed up because they were in labor (and not because of extreme, or any, flu-like symptoms)... First: of the 215 women who showed up in labor, 33 ((or 15.3%) were COVID positive.  Second: of the 33 who were positive, 29 (87.9%) showed no symptoms at the time of admission.

Reasons why that 15.3% incidence might be higher than elsewhere:

• The data was from a cohort in New York City in late March, where the disease was already spreading, so their baseline population was higher than the nation's
• That cohort likely went to more pre-natal appointments in late Feb-early March than the typical NYC person, in medical offices or hospitals where the disease may (?) have already been spreading; or with medical personnel who may (?) have inadvertently been carrying, so they may (?) have been exposed at higher rates than the general NYC population
• That cohort includes second- and third-time mothers, who may (?) have been exposed at rates higher than the general NYC population  through their asymptomatic toddlers and schoolchildren
• That cohort includes women/morthers, who may (?) have sallied out to get groceries/other essentials at higher rates than the general NYC population
• That cohort was all pregnant, which is generally associated with immune suppression, so they may (?) have contracted at higher rates than the general NYC population

Reasons why that 15.3% incidence might be lower than elsewhere:

• Pregnant women may (?) be more conscious/cautious about both germs and unnecessary risk, and thus more avoidant of potentially infectious places and conditions in the run-up to March 22 (during which time New Yorkers, if not other places, were *very conscious* that COVID was coming) than the general NYC population

Reasons why that 87.9% asymptomatic rate might be higher among pregnant women than among other cohorts:

• Pregnant women may (?) eat better, take more vitamins, and thus be in comparatively better baseline health than the general NYC population;
• There may (?) be something about hormone or other factors associated with pregnancy that inhibits COVID's expression.

 

All of which to say -- as the obstetric doctors themselves do say -- that the takeaway here is not so much the particular percentages down to the decimal, but rather the Big Picture insight about the invisibility of transmission.  This is an enemy we cannot see.  

Until we have *ubiquitous and repeated* testing we simply will not know where the enemy is lurking. That is neither a political, nor a scaremongering, nor a scapegoating statement: it's just how the virus transmits. Through carriers who genuinely have no idea they're carrying.

[Arcadia]

10 minutes ago, TracyP said:

Factor in that Santa Clara county has a median age of 37 and I don't think that's so out there.

Plus Californians in general are pretty healthy and would have decent levels of vit d in that region of the state. 

We do have a lot of foreign born here as in lots of relatives visiting during the period of Christmas up to Chinese New Year. 

The weather has been rather gloomy lately. Ironically there was more sunshine in my area in February/March before the shelter in place kick in. 

[prairiewindmomma]

https://www.bbc.com/news/world-europe-52291326

Some news pieces about how Europe is slowly reopening.

The article from BBC I linked said kids aren't wearing masks. From Facebook photos of her kids at school, I'd say some people are. I'd also say some people are keeping their kids home. They still have Danish tv going---with singing time, exercise time, etc.  Like, the community attitude towards making a common sacrifice and staying at home is less contentious than here in my community. I haven't heard what the plan is for older students. Both of my friend's kids are in elementary.

[EmseB]

8 minutes ago, square_25 said:

What exactly is he explaining here? That if you adjust the denominator way up, the IFR goes way down? I think most people know that already. The question is rather "Is this a reasonable estimate of the denominator?" 

I think yes? I'm still reading and trying to digest. Do you know anything about the antibody test they were using? Or sero prevalence tests in general? Or the larger MLB study he mentions?

I mean, this seems to good to be true, but good news would be...good...right now.

Edited April 17, 2020 by EmseB

[EmseB]

1 minute ago, square_25 said:

I'm not a biologist, so only what I've read in the last month :-P. But it's easy to overestimate immunity for the reasons I said: you can catch small reactions that aren't enough to cause immunity and you can catch reactions to other viruses in the same family. 

This is actually something I've been wondering about for a long time and these antibody tests make me wonder even more. We know everyone is naive to Sars2, but definitely not naive to other coronaviruses. If some other cv's are so closely related to Sars2 that they pop up on a highly specific antibody test, would that also mean they confer some immunity or protection to someone who gets sars2?

[Carrie12345]

Listening to NJ’s briefing and I was taken aback by the numbers they’ve released on care centers. 
In my grandmother’s county, 51 facilities report 1,831 cases. 
 

[Pam in CT]

 

re rural area hotspots like Smithfield

32 minutes ago, prairiewindmomma said:

RE: Smithfield pork plants....just because someone is testing positive doesn't mean that they are needing interventionary healthcare.  They will, statistically, recover and move on.  It's really inconvenient now for that small town, but it's a blip and life will carry on.  I expect that these kinds of things will be happening for the next couple of years and why we will continue to have supply and logistical gaps on and off....

Right -- most COVID positive will, statistically, not need significantly interventionary healthcare. A sizable segment will not show any symptoms ever. Of those that get sick, a sizable segment will recover without requiring hospitalization. 

They will, statistically, infect others, recover if they even get sick, and move on.  

The "infect others" part is key, though.

 

32 minutes ago, prairiewindmomma said:

...Most meat packing towns are small and rural, not close to major medical facilities.  They also tend to have a higher percentage of immigrant labor, and lower access to quality medical care.  They are good paying jobs for those communities, but not something most urban families would consider a living wage.

Which is why both the treatment and the transmission in rural areas will play out differently than in NY.

My father-in-law was in first a hospital, then step-down rehab, in NYC throughout January and February for issues wholly unrelated to COVID. And we were *panicked* that he would contract COVID *at those medical facilities.*  The writing was on the wall already and we all -- the family, the patients, the rehab center medical workers, anybody paying attention -- KNEW that the protocols and PPE were vastly inadequate to stop transmission. By mid-February all visitors were prohibited.  Everyone *knew* that transmission was occurring in medical centers... there just were insufficient supplies of necessary equipment to stop it.  It was absolutely a slow-mo train wreck that everyone saw coming but were powerless to stop.  (FIL was released in early April and is now home, still recovering but still COVID-free.) 

 

Rural transmission will be different.  Even though the handful of Smithfield employees who do require hospitalization will show up in the major medical facilities... as will the maternity patients and the cardiac arrests... so there *will* be *some* risk there... hospitals by now have FAR better information about what protocols are necessary to tamp down transmission; and while PPE shortages still exist hospitals are in far better shape now than NY was in February and March.  So the bulk of rural transmission will not occur in medical centers. It will start with workers in too-closely-packed conditions with lousy safety and sanitation processes that close too late and re-open too soon without sufficient cleaning; and will transmit at places like Walmart, and schools if they re-open, and church gatherings.

 

Edited April 17, 2020 by Pam in CT
formatting error

[prairiewindmomma]

Right, likely those small towns will have herd immunity earlier.

Of the meat packing town I am familiar with, most of those families do not really leave those communities either. They are too distant from other towns, and they may be without a vehicle. (Meat packing towns smell BAD---the scent can carry for 15-20 miles on strong wind days.)  Typically they get their groceries from a small wal-mart or from Dollar General in town.  

[SKL]

2 hours ago, Matryoshka said:

The spot said the trend was happening nationwide, and quoted stats from lots of different states, so WA might be an exception - perhaps exhibiting the same rationality that led to the state not being ovrerun with Covid in spite of it having gotten there so early! It's not just what the govt demands, but what the people actually do...

I'm in the midwest and my auto insurer is giving me a rebate also.

[Pam in CT]

24 minutes ago, prairiewindmomma said:

Right, likely those small towns will have herd immunity earlier.

Of the meat packing town I am familiar with, most of those families do not really leave those communities either. They are too distant from other towns, and they may be without a vehicle. (Meat packing towns smell BAD---the scent can carry for 15-20 miles on strong wind days.)  Typically they get their groceries from a small wal-mart or from Dollar General in town.  

I have high hopes that COVID immunity will turn out to "hold" over time, and that herd immunity will ultimately protect us.

If so, that will many months out, *after* either widespread infection (whether "widespread" turns out ex post to be a 4% infections-requiring-hospitalization rate/ 0.5% fatality rate... or a 20% infections-requiring-hospitalization rate/ 2% fatality rate, or something in between); or *after* a vaccine is not just developed but is also actually deployed at the 70++% rates required for herd immunity.  

That is: EITHER after a whole lot more life-threatening/ personally bankrupting/ macro economically- and supply-chain disruptive illness and death, OR the development and near-universal deployment of a vaccine. Either one is many months out.  Neither can be achieved without a whole lot more disruption to health, happiness and the economy.  In the interim until we get there: isolation, more and more efficient procurement of PPE and testing to separate the COVID-positive, develop treatments so more of those who do get infected can recover, faster.

 

(Again: neither political, nor scaremongering, nor scapegoating. It's just the reality of how this invisible enemy is operating. Among us all.) 

[Corraleno]

1 hour ago, square_25 said:

I just mean we've had other antibody tests that didn't give anything like this for the IFR. The antibody tests seem to not be super reliable from what I read, and they have trouble distinguishing immunity from small reactions from immunity to OTHER coronaviruses. 

This is what I'm concerned about. There was another thread about how unreliable these antibody tests are, that they will show a positive result if the person had any of several coronaviruses, not just CV19.

Also, it should be noted that this is the study that's connected to/promoted by the Hoover Institute.  Bhattacharya isn't just a professor in the med school, he is a research associate at the National Bureau of Economic Research and a senior fellow at the Stanford Institute for Economic Policy Research, and he has been saying since day 1 that shut downs are not worth the economic damage. He is not some disinterested medical researcher looking for infection numbers, he is specifically looking for stats that will justify his preferred economic policies.  I would love to find out that vastly more people than we think have already had it and we are much closer to herd immunity, but so far Bhattacharya's own study seems to be the only one that supports his theory.

[EmseB]

19 minutes ago, Corraleno said:

This is what I'm concerned about. There was another thread about how unreliable these antibody tests are, that they will show a positive result if the person had any of several coronaviruses, not just CV19.

Also, it should be noted that this is the study that's connected to/promoted by the Hoover Institute.  Bhattacharya isn't just a professor in the med school, he is a research associate at the National Bureau of Economic Research and a senior fellow at the Stanford Institute for Economic Policy Research, and he has been saying since day 1 that shut downs are not worth the economic damage. He is not some disinterested medical researcher looking for infection numbers, he is specifically looking for stats that will justify his preferred economic policies.  I would love to find out that vastly more people than we think have already had it and we are much closer to herd immunity, but so far Bhattacharya's own study seems to be the only one that supports his theory.

I was the person who brought that up in the other thread because the company itself said that was tru of their test. The test used for this study seems to be a different type of test with higher accuracy and tends to give false negatives more often than false positives (if I'm reading the caveats correctly). That said, there seem to be concerns for this study with how subjects were selected (i.e. people volunteered because they had a bug in Feb/March and wanted to know if it was covid or not).

Do you know if the 10 other authors listed are similarly aligned? Do you think they would fudge the numbers to get results they want?

I actually have been wondering about the inverse..if the ifr is lower than current thinking and asymptomatic/super mild cases are much higher because we don't have testing resources available, what is the blowback on that?

Edited April 17, 2020 by EmseB

[EmseB]

14 minutes ago, square_25 said:

Ah, thank you for the context. 

Also, these percentages are very small. So we’re multiplying by numbers like 0.02, which means even a teeeeny false positive rate will make a huge difference in the eventual denominator. It’s not like messing up 15 percent by a percent or two!! False positives could literally be the majority of your universe. 

Isn't that caveated in the paper itself? I'm trying to find the quote.

It says they adjusted for test performance characteristics as far as I can tell. I can't copy and paste from my phone because it's a weird pdf.

Edited April 17, 2020 by EmseB

[EmseB]

6 minutes ago, square_25 said:

Wait. Wait. They selected for people with respiratory symptoms?? Please tell me they didn’t scale all those up to the whole population.

This is why peer review is so crucial. Even with peer review, people mess up statistics all the time. Right now, I literally can’t tell what percentage of the studies are even remotely useful. I don’t have enough information!!

No they didn't select for symptoms. Did you read the paper?

[Garga]

4 hours ago, TCB said:

I agree that the politicizing of this is coming from both sides of the great US divide. It amazes me and makes me extremely sad that even in a pandemic people feel they have to take sides - maybe I’m just naive - I have the impression that in previous times of hardship like the World Wars etc people pulled together - but maybe that’s just romantic nonsense.

I’ve been saddened, too.  Like, I feel like if it was WWII and we were told to give up our stockings, we all would, and we’d feel patriotic for doing so. 

On some various FB groups I belong to, people are flipping out about their rights being infringed and they Will Not wear a mask. Meanwhile, on other groups people are encouraging each other to wear masks and sharing sewing patterns.  (My state, PA, and the one next to me, MD, have some sort of rulings in place that you can’t enter businesses without a mask or you face fines and jail.)

One group believes X (overblown hype and power grabs) about this pandemic and the other believes Y (a world-wide crisis that requires extreme action), often based on what news media they watch.  And each group believes the other is filled with unthinking lemmings.  

And that’s painful.  We’re sooo divided in what we believe about this thing, based on what news source we listen to.  And the news sources are based on what side politically they fall.  

So it’s all political and I have no idea how we can unite.

Edited April 17, 2020 by Garga

[Paige]

3 minutes ago, square_25 said:

Nope, I was just going off your comment. I’ll read when my kiddo gives me my computer back.

But you said that it was people who had had a cold. That is not representative. Am I misunderstanding?

I didn’t read it yet either, but it seems the sample is self selected. (Based on comments here) 

Edited April 17, 2020 by Paige

[ElizabethB]

7 hours ago, TravelingChris said:

I was at a Church women's conference last year and the speaker was talking about a lot of things but mentioned saving our planet and using reusable bottles all the time, reusable bags for groceries, etc.  I had to explain to people that I can't use reusable bags for groceries because of my immune issues. I also mentioned that I use plastic water bottles too again because of health.  There were some people who derided me for not caring about the environment--- and I didn't really defend myself - although I do the responsible things for the environment that I can- not litter, if i have disposable gloves around-  pick up other's litter, recycle, and support various environmental groups through donations.

I am worse when I drink local water, as well.  I use a Berkey at home and have also had people deride me for my use of water bottles.