wuhan - coronavirus

[TravelingChris]

On 4/20/2020 at 11:36 AM, Pen said:

@TravelingChris if your Rx Vitamin D says ergocalciferol then it is D2 — I would think it would say, or at least pharmacy would know

I know we all get D2

[Pen]

1 minute ago, TravelingChris said:

I know we all get D2

 

Then no sheep/lanolin involved afaik. Actually I don’t know how the synthetic D is made or from what. 

[sbgrace]

1 hour ago, Arctic Mama said:

https://www.thepublicdiscourse.com/2020/04/62572/
 

interesting discussion on lockdowns not being effective compared to other policy changes in response to the pandemic, especially compared with their deleterious impact on economic behavior, mental health, etc.

I thought this was interesting because he does NOT advocate not wearing masks, school closures, etc.  Separating out a full lockdown from other measures and comparing efficacy is an interesting policy discussion and I thought he addressed a lot of the objections pretty well. 

I'm not done reading...but he did not represent what I found in my research of lock down effectiveness in the 1918 pandemic. There is certainly evidence for lock down effectivness from that outbreak. San Francisco did great on the 1st round of disease, when they did extensively lock down, but they attributed the success to masks and had less lockdown, and much worse outcomes during the second wave. States that maintained lock down throughout did much better (Indiana is one I remember). My research was based on state historical records, not current representations of the data of that pandemic. 

[Pen]

30 minutes ago, Arctic Mama said:

See, I think if you aren’t seeing a big change from other measures, the drawbacks of a full lockdown as opposed to cautious social and illness measures already implemented (like group gathering size and school dismissal, hand washing, etc) aren’t enough to potentially justify it in every area.  Especially in the US, where the significance of the spread in a dense urban area with public transport like NY probably won’t ever be replicated in Denver or Baton Rouge, even if they do have their own spikes.

This strengthens the case for region specific policy and lifting lockdown while maintaining other phased restrictions, I think.  Something to consider as the economic pain increases, at least, in looking at how much more mileage one may or may not get out of a given policy.

 

I agree with region specific approach.  Aren’t we doing that? 

I would be concerned that though Baton Rouge is not New York City, it could easily follow New Orleans.  And that Denver could easily follow Gunnison.  (Or alternatively Denver could be severely affected as an airline hub city. And Baton Rouge sometimes is a satellite office city for some New York or other big city firm—there are many ways a place can be affected.  If all travel had to have a rapid test before being allowed that could help. But travel restrictions only by state?  So it is okay to take virus from badly affected urban centers in a state anywhere else in same state, but not to cross state line doesn’t sound helpful. )

Edited April 22, 2020 by Pen

[RootAnn]

6 minutes ago, square_25 said:

Ah, I didn't actually look that carefully, so I didn't see that. Thank you for the clarification. Do you know off the top of your head how many deaths the reclassification accounts for, or should I go dig deeper? 

I only saw Massachusetts reported 250 on Tuesday and 0 on Monday's data. Their numbers had been about 150/day so 100-150 were probably from the day before. I didn't check how many PA & Michigan reclassification added.

[EmseB]

6 minutes ago, Arctic Mama said:

See, I think if you aren’t seeing a big change from other measures, the drawbacks of a full lockdown as opposed to cautious social and illness measures already implemented (like group gathering size and school dismissal, hand washing, etc) aren’t enough to potentially justify it in every area.  Especially in the US, where the significance of the spread in a dense urban area with public transport like NY probably won’t ever be replicated in Denver or Baton Rouge, even if they do have their own spikes.

This strengthens the case for region specific policy and lifting lockdown while maintaining other phased restrictions, I think.  Something to consider as the economic pain increases, at least, in looking at how much more mileage one may or may not get out of a given policy.

Yes. I have read a couple papers that seem to indicate the subway in NYC is/was one of the biggest factors of why things got so bad there. And then refutations of those studies and why they aren't valid. Of course now I have to go look them up again because someone closed all my tabs on the desktop. I get it is essential, but also the MTA(?) screwed up big time by limiting cars and service and cramming people on even tighter. Plus, in reading just anecdotes, there seems to be an attitude from New Yorkers that using the subway is inevitable? Or just a problem that can't be addressed so oh well? Or there's defensiveness that it can't possibly be a factor in disease spread. I don't know how to describe the sentiment but it is strange. From the outside it looks like a huge problem that everyone in nyc just kind of accepts as necessary, but it seems like it would have to be a source of infecting thousands of people.

[Jean in Newcastle]

48 minutes ago, Arctic Mama said:

See, I think if you aren’t seeing a big change from other measures, the drawbacks of a full lockdown as opposed to cautious social and illness measures already implemented (like group gathering size and school dismissal, hand washing, etc) aren’t enough to potentially justify it in every area.  Especially in the US, where the significance of the spread in a dense urban area with public transport like NY probably won’t ever be replicated in Denver or Baton Rouge, even if they do have their own spikes.

This strengthens the case for region specific policy and lifting lockdown while maintaining other phased restrictions, I think.  Something to consider as the economic pain increases, at least, in looking at how much more mileage one may or may not get out of a given policy.

Since we've had a regional approach from the start, I fail to see your point. 

[Arcadia]

People are tired of sheltering in place though 

https://www.sfgate.com/bayarea/article/Cops-order-900-off-San-Mateo-County-beaches-15216038.php

“BEACHGOERS VIOLATE SHELTER-IN-PLACE: "Most families encountered had packed their family vehicle with bags of toys, food and items for a full day at the beach," the San Mateo County Sheriff's Office  said.

...

The county Sheriff’s Department issued 650 warnings over the weekend and four formal citations along the coast.

“We had hundreds of people on the beach and practically anywhere they could find a place to sit along the coast line,” Lt. Stephanie Josephson said in a written statement. “Most families encountered had packed their family vehicle with bags of toys, food and items for a full day at the beach. Most people seemed to be aware of the health orders but decided to take the chance in coming out to the beaches and complied with the verbal warnings.””

[Arcadia]

Japan https://www.straitstimes.com/asia/east-asia/japanese-childrens-home-reports-8-babies-with-coronavirus

“TOKYO (REUTERS) - A Japanese care home for infants said on Wednesday (April 22) that it has found eight cases of coronavirus infection among its children.

One staff member tested positive for the virus on April 16, and tests were subsequently conducted on its 29 children, a spokesman at Saiseikai Central Hospital, which runs the institution, said.

None of the eight children were showing major symptoms such as fever, but they had been hospitalised, she said.

Children who cannot live at home for reasons such as abuse, neglect or their parents' divorce are usually cared for at residential-care facilities in Japan.”

[SoCal_Bear]

Was the merits of this study discussed already on this board? 

The following is the text of a study by Prof Isaac Ben-Israel, first published on April 16, 2020. (Ben-Israel discussed his research on Israeli TV on April 13, saying that simple statistics show the spread of the coronavirus declines to almost zero after 70 days — no matter where it strikes, and no matter what measures governments impose to try to thwart it.)

https://www.timesofisrael.com/the-end-of-exponential-growth-the-decline-in-the-spread-of-coronavirus/

[Arcadia]

Japan https://www.japantimes.co.jp/news/2020/04/22/national/nagasaki-coronavirus-cruise/#.XqCJ_CVlCaM

“An Italian cruise ship docked in Nagasaki for repairs with 623 crew members aboard has become the latest host of a COVID-19 cluster, with the confirmation of at least 33 infections on Wednesday.

Nagasaki Prefecture confirmed the spike in infections on the Costa Atlantica, currently docked at the Mitsubishi Shipbuilding Co. facility in Nagasaki's Koyagi district. Gov. Hodo Nakamura said Wednesday he would request assistance from the Self-Defense Forces to deal with the outbreak. A committee of Health Ministry experts said it appeared a cluster of infections had occurred aboard the ship.

Those who show symptoms of ill health will be transferred to medical facilities in the area, while those who test negative will be returned to their home countries. As of Wednesday, 57 crew members had been tested.

The Costa Atlantica was not carrying any passengers, local media reported.”

[Jean in Newcastle]

9 minutes ago, Arcadia said:

Japan https://www.straitstimes.com/asia/east-asia/japanese-childrens-home-reports-8-babies-with-coronavirus

“TOKYO (REUTERS) - A Japanese care home for infants said on Wednesday (April 22) that it has found eight cases of coronavirus infection among its children.

One staff member tested positive for the virus on April 16, and tests were subsequently conducted on its 29 children, a spokesman at Saiseikai Central Hospital, which runs the institution, said.

None of the eight children were showing major symptoms such as fever, but they had been hospitalised, she said.

Children who cannot live at home for reasons such as abuse, neglect or their parents' divorce are usually cared for at residential-care facilities in Japan.”

A lot of these residential care facilities are actually wings in specialized hospitals.  (Many hospitals in Japan are specialized to certain diseases in conditions.  For example, I got my appendix out at a hospital that only did appendectomies.) 

[EmseB]

37 minutes ago, square_25 said:

I think everyone accepts it's a factor in disease spread, at least ever since it became clear it's airborne. 

Do you have a suggestions about what to do about it, though? The most subway-heavy borough is Manhattan, which is actually less affected than other boroughs. So I doubt the solution is cramming most people into buses. Most people don't have cars and can't afford taxis and yet they still have to go to work, or the place grinds to a halt. So what do you do? 

Manhattan is less affected, yes, but outer boroughs where people have to spend more time on the subway to get into Manhattan or other parts of the city are more affected, right? I wish I could find where I read that.

Do I have a suggestion? No. I am not a mayor or public health or disaster expert expert in charge of a major city. 😉 I have very little familiarity with NYC. It seems odd to me, really super strange in fact, that there isn't some kind of disaster or contingency plan in place for a situation where the subway should not or cannot be used. Pandemic aside, the subway is not impervious to disasters...so there's no disaster planning for any kind of event that disables the subway? I'm not saying it wouldn't be a major problem, but this whole thing is a major problem.

ETA: I also was still thinking this was droplets spread and not airborne? I am way behind I guess. 😕

Edited April 22, 2020 by EmseB

[Corraleno]

58 minutes ago, square_25 said:

The Sweden comparison also seems wrongheaded. Sweden is doing worse than the other Scandinavian countries. It makes no sense, given density and length of outbreak, to compare it to Italy.

Yeah, this guy (from the American Enterprise Institute, BTW) is clearly cherry-picking countries that not only have vastly different levels of infection, they also have huge cultural and demographic differences, and then claiming that lockdowns don't work because Italy and Spain are worse off than Sweden and the Netherlands. In reality, Sweden and the Netherlands are doing MUCH worse than comparable countries that did lock down. In fact, their deaths per capita are even worse than the US rate of 139 — the Netherlands is 237 deaths per million and Sweden is 192. Compare those to Denmark at 66 and Norway at 34. If you look at the three Scandinavian countries with very similar cultures and demographics, that started with similar levels of cases, there is a VERY clear progression from the country with the strictest lockdown (Norway), to a moderate lockdown (Denmark), to no lockdown (Sweden): 34—> 66 —> 192.

His main argument is that it's the other measures (closing schools, reducing gatherings, etc.) that work, and lock downs have no effect on the number of deaths at all (or even increase them). But the only proof he offers are his own statistics — and, like you, I have no idea what he is comparing, or where he got his numbers from, or what fudge factors he has plugged in. He argues that since the decline in deaths began a few days before the 20-day minimum that he claims is necessary before the lockdown could affect the death rate, the beginning of the decline was caused by other factors and therefore the lockdown itself has no effect on deaths.

Even if one agrees with the premise that the lockdown could not possibly have any impact on the death rate before 20 days, and that deaths were beginning to be slowed by all the other measures, in no way do either of those things "prove" that a continued decline in deaths since the lockdown is 100% attributable to previous measures and the lockdown has no effect. That's like telling someone who started losing a few pounds by exercising, and then started dieting as well, that their continued weight loss is 100% attributable to exercise, since their weight was already declining before they started the diet, so diet has no effect on weight loss. That is not a logical or justifiable conclusion.

 

 

[Arcadia]

7 minutes ago, calbear said:

Was the merits of this study discussed already on this board? 

The following is the text of a study by Prof Isaac Ben-Israel, first published on April 16, 2020. (Ben-Israel discussed his research on Israeli TV on April 13, saying that simple statistics show the spread of the coronavirus declines to almost zero after 70 days — no matter where it strikes, and no matter what measures governments impose to try to thwart it.)

No idea but Singapore is past 70 days and spiking in cases due to increased testing. Their first case was 21st January, 93 days ago (GMT+8).

https://co.vid19.sg/singapore/

[Jean in Newcastle]

3 minutes ago, square_25 said:

Maybe I’m using the words wrong. What’s the difference between droplet spread and airborne? This is really not my area.

I’m not sure what kind of contingency plan you’re envisioning. When train lines are closed, they use buses. I doubt that’s a big improvement. Ultimately, the issue is that you need to transport a large volume of people in a high density place. I do not see how to solve this without crowding people together.

It's both.  Droplet spread can be aerosolized.  Though droplets are airborne for a time, aerosolized drops hang in the air for longer. 

 

[Corraleno]

55 minutes ago, calbear said:

Was the merits of this study discussed already on this board? 

The following is the text of a study by Prof Isaac Ben-Israel, first published on April 16, 2020. (Ben-Israel discussed his research on Israeli TV on April 13, saying that simple statistics show the spread of the coronavirus declines to almost zero after 70 days — no matter where it strikes, and no matter what measures governments impose to try to thwart it.)

https://www.timesofisrael.com/the-end-of-exponential-growth-the-decline-in-the-spread-of-coronavirus/

There are several problems with that article. First, the graph showing a steep downward curve is actually showing the ratio of new daily cases to total cases (i.e. the larger the number of total diagnosed cases the smaller the percentage of that number that will be new cases); this shows that the rate of increase is being slowed, not that the number of active cases is declining. He does not present any evidence whatsoever that the number of new cases in every country will reduce to zero after 70 days, even with mitigation measures, let alone that they will decline to zero without any measures.

His argument that it doesn't matter what measures countries take is entirely dependent on comparing Sweden to countries that have some level of lockdown, and he offers no other proof that the mitigation measures taken in all those other countries have not contributed to slowing their rates of increase. He ignores the fact that Sweden is doing very little testing, as a matter of policy (they are not really trying to slow the spread, they are going for herd immunity), so their case numbers are not very reliable. The author's graphs end on Easter weekend, where you can see a drastic dip in the number of deaths reported, but if you look at the number of daily deaths up to today, that curve is still on an upward trend:

 

Edited April 22, 2020 by Corraleno

[EmseB]

9 minutes ago, square_25 said:

Maybe I’m using the words wrong. What’s the difference between droplet spread and airborne? This is really not my area.

I’m not sure what kind of contingency plan you’re envisioning. When train lines are closed, they use buses. I doubt that’s a big improvement. Ultimately, the issue is that you need to transport a large volume of people in a high density place. I do not see how to solve this without crowding people together.

I'm not envisioning a contingency plan. Like I said, I'm not an expert here, nor am I responsible for managing a major city during a disaster. I would say, off the top of my head more buses, more subway cars so people could at least sit further apart. A lot of cities in other countries limit who can travel on which days in order to limit things like pollution or traffic congestion. But this sentiment that you're expressing above is common with what I've been seeing from NY'ers on my social feeds. That is, there's no way for people in NY to social distance and also go anywhere, so whatareyagonnado? Nothing, I guess, is the current answer. Just keep packing people in train cars, sadly enough. Which, as @Arctic Mama was talking about above, presents a unique problem in NYC lifting SIP and lockdown precautions that other cities do not have to consider. Not that other cities don't have other issues to contend with, but not the same apparently unsolvable problem of the subway.

[TravelingChris]

On 4/20/2020 at 11:43 AM, Pen said:

 

Thank you! I think I need to look into this possibility in our family!!!  There’s been unexplained elevated bilirubin which may have been dismissed as Gilbert’s and “nothing to worry about”.   Well, it was dismissed as nothing to worry about for sure, but can’t recall if “Gilbert’s” was referred to.  

Oh definitely.  When Dh was diagnosed by donating blood, he was told by both the blood officials and by all doctors following this - a number since he was in the military and kept getting new doctors- that it was totally benign.  It is- in the fact that it doesn't kill you.  But you still need to modify your medical treatment.  For dh, it means that many, many medicines have to be in half dosages including anesthesia.  The second to the last time he had anesthesia, he stopped breathing twice in the recovery room and his anesthesia wore off very, very late, It was a colonoscopy and with me, I was worn off mine in a few hours- and I only needed to spend about an hour and a half in the recovery room area and part of that was just waiting for them to write up orders, etc.  But by the afternoon, I was totally fine-  I have a genetic condition where I more quickly go through many medications- like I need higher dosages at dentist office or with paon meds.  But the pain meds issues is nothing like my very large- 6"3/5 former center in college football son in law who has addiction tendencies also-- he needs a lot more than I do. Mine just wear off much too quickly so if I am supposed to take one every 8 hours, I will be in pain in 5 or 6.  I do better by taking smaller doses much more frequently- like 5mg Norco every 4 hours and not 10mg every 8 hours.  

[mathnerd]

2 hours ago, Arcadia said:

@Ausmumof3 @mathnerd press release https://www.sccgov.org/sites/covid19/Pages/press-release-04-21-20-early.aspx

“County of Santa Clara Identifies Three Additional Early COVID-19 Deaths

FOR IMMEDIATE RELEASE

April 21, 2020

Three individuals who died at home in February and March were positive for SARS-CoV-2

Santa Clara County, CA – The County of Santa Clara Medical Examiner-Coroner has identified three individuals who died with COVID-19 in Santa Clara County before the COVID-19 associated death on March 9, 2020, originally thought to be the first death associated with COVID-19 in the county. 

The Medical Examiner-Coroner performed autopsies on two individuals who died at home on February 6, 2020 and February 17, 2020. Samples from the two individuals were sent to the Centers for Disease Control and Prevention.  Today, the Medical Examiner-Coroner received confirmation from the CDC that tissue samples from both cases are positive for SARS-CoV-2 (the virus that causes COVID-19).  

Additionally, the Medical Examiner-Coroner has also confirmed that an individual who died in the county on March 6 died of COVID-19.

These three individuals died at home during a time when very limited testing was available only through the CDC.  Testing criteria set by the CDC at the time restricted testing to only individuals with a known travel history and who sought medical care for specific symptoms.  As the Medical Examiner-Coroner continues to carefully investigate deaths throughout the county, we anticipate additional deaths from COVID-19 will be identified.”

@Arcadiathis is consistent with word on the street that the bay area imported COVID19 after the December vacation that involved residents going back to visit Hubei province. I am convinced that people who were in crowded locations like workplaces, movie theaters, concerts, malls, classrooms, sports events etc got exposed from what I experienced in Jan/Feb. I believe that NorCal will be early in the curve for acquiring herd immunity based on anecdotes I am hearing.

[mathnerd]

7 minutes ago, square_25 said:

 

How is herd immunity consistent with a 3% antibody rate and a very low number of deaths? I guess you could argue that the low death numbers are as a result of a totally different virus mutation? That's not supported but at least it's vaguely plausible. But what about the antibody rate? 

I think that antibody rate far exceeds 3% in reality. If all the mega employers of the bay area able to implement onsite antibody testing when SIP is lifted, we will see a much different number.

[mommyoffive]

https://www.msn.com/en-us/news/us/coronavirus-at-meat-packing-plants-worse-than-first-thought-usa-today-investigation-finds/ar-BB132K8d?ocid=spartandhp

 

https://www.msn.com/en-us/health/medical/us-govt-experts-warn-against-virus-drug-combo-promoted-by-trump/ar-BB132Uip?ocid=spartandhp

 

https://www.msn.com/en-us/health/health-news/a-disaster-roche-ceos-verdict-on-some-covid-19-antibody-tests/ar-BB1328cG?ocid=spartandhp

 

https://www.msn.com/en-us/news/us/we-must-do-the-impossible-cuomo-says-michael-bloomberg-will-fund-dollar10m-coronavirus-tracking-program/ar-BB1336Xl?ocid=spartandhp

 

https://www.msn.com/en-us/news/factcheck/fact-check-trump-claims-coronavirus-tests-are-widely-available-they-are-not/ar-BB130NVO?ocid=spartandhp

[Matryoshka]

12 minutes ago, mathnerd said:

I think that antibody rate far exceeds 3% in reality. If all the mega employers of the bay area able to implement onsite antibody testing when SIP is lifted, we will see a much different number.

What would lead you to think that other than wishful thinking? A similar survey in Chelsea, MA came up with a 30% antibody rate.

[Arcadia]

13 minutes ago, mathnerd said:

I think that antibody rate far exceeds 3% in reality. If all the mega employers of the bay area able to implement onsite antibody testing when SIP is lifted, we will see a much different number.

Just the tech buildings between NASA Ames and Lockheed Martin would be interesting enough since those two locations were among the earliest cases. 

My oncologist was already warning in January. Not surprised since we do have a high Chinese population in my local area and also lots of business trips to China as well. 

[Pen]

I find Hawaii rather interesting.  Apparently low rates, or at least low sickness and death that got a person tested — perhaps we will learn it has had higher rates that are asymptomatic.

Lots of people (including personal family) in Hawaii have Asian family connections and a lot of travel takes place between various Asian countries, including China, and Hawaii.

A “prepare to shelter in place” directive,  buy supplies for two weeks,  was issued in Hawaii earlier then where I am on West coast, and I think even before the California Bay Area counties issued SIP orders.  

But the restrictions that my Hawaii relatives report are lesser than what most areas of the 3 contiguous Pacific states are doing—yet afaik confirmed cases and deaths per 1000 population have been way less in Hawaii. 

 

Edited April 22, 2020 by Pen

[mlktwins]

I can't even go on some of the other threads (ex. should states open back up) on this forum anymore.  So discouraging and people talking about level of risks and just wanting to get it and be done with it.  There is still so much unknown about this virus - even for people in the lower risk categories.

https://www.yahoo.com/news/coronavirus-patient-thought-recovering-then-173800979.html

I'm just going to stay holed up in my house for awhile until the powers that be have more time to figure out what the he!! this virus is all about.  

 

[Arcadia]

27 minutes ago, Pen said:

I find Hawaii rather interesting.  Apparently low rates, or at least low sickness and death that got a person tested — perhaps we will learn it has had higher rates that are asymptomatic.

Lots of people (including personal family) in Hawaii have Asian family connections and a lot of travel takes place between various Asian countries, including China, and Hawaii.

A “prepare to shelter in place” directive,  buy supplies for two weeks,  was issued in Hawaii earlier then where I am on West coast, and I think even before the California Bay Area counties issued SIP orders.  

But the restrictions that my Hawaii relatives report are lesser than what most areas of the 3 contiguous Pacific states are doing—yet afaik confirmed cases and deaths per 1000 population have been way less in Hawaii. 

 

How is the weather and population density in Hawaii? 

For example, my region had relatively hot weather in February/March during lunch hours and the zipcode with the most cases in SF is in densely populated Mission District. 

[Arcadia]

@mathnerd@square_25@Pen

April 19th https://www.ucsf.edu/news/2020/04/417206/covid-19-testing-mission-district-bolinas-inform-next-steps-fight-against

"In the new testing effort, UCSF researchers have partnered closely with community organizations aiming to comprehensively test all residents of a densely populated tract of San Francisco’s Mission District as well as residents of Bolinas, a small, rural town in western Marin County.

...

The new study aims to counteract the lack of data about the community spread of SARS-CoV-2 that has made the virus so challenging to combat – in part because many people who become infected never show symptoms but can still spread the illness, and many who experience symptoms but recover without hospitalization have never been tested.

“All our public health decisions, including when it will be possible to relax regional and statewide shelter-in-place orders, are driven by rough assumptions about how this virus behaves based on very limited data,” said Greenhouse, an associate professor of medicine at UCSF and a CZ Biohub Investigator. “Studying in detail how the virus has spread in these two distinctive communities will give us crucial data points that we can extrapolate to better predict how to control the virus in similar communities nationwide.”

Standard Nasal Swabs, Antibody Testing for Thousands

At pop-up testing sites located in neighborhood community centers, the researchers will collect samples using nasal swabs for diagnostic tests of active COVID-19 infection, as well as finger-prick blood samples for antibody testing, which can reveal past exposure to the virus in both children and adults. Because diagnostic tests cannot detect the presence of the virus once it is cleared from the body (which can happen whether a person was asymptomatic or recovered on their own), both types of test are essential to understanding how widely the disease has already spread in these communities.

Beginning on April 20, the researchers hope to provide tests over the course of four days for as many as possible of Bolinas’s nearly 2,000 residents, and then, during a four-day testing period beginning on April 25, to the 5,700 residents of a particularly densely populated Mission District census tract.

Study participants who test positive for active COVID-19 infection will get immediate follow-up calls from UCSF infectious disease experts, working hand-in-hand with regional public health departments and community groups, to assist with the process of facilitating isolation and quarantine (for contacts), and to connect persons with active disease to medical support through partnerships with local healthcare networks.

Those who test negative will be expected to continue abiding by shelter-in-place and social-distancing mandates because of the possibility of false negative test results and a general lack of information about the potential for reinfection with the disease."

[SoCal_Bear]

The Gov of Hawaii did order 14 day quarantine for anyone flying into Hawaii on 3/21.

 

[Pen]

Just now, Arcadia said:

How is the weather and population density in Hawaii? 

 

Weather is of course generally warm (except up mountain/ volcano tops where it can snow) with substantial outdoor lifestyle.

population density in places like Honolulu is probably on a par with Los Angeles, or even with San Francisco in most dense areas—similarly  dominated by apartments rather than houses.  

 

Just now, Arcadia said:

For example, my region had relatively hot weather in February/March during lunch hours and the zipcode with the most cases in SF is in densely populated Mission District. 

 

[Sneezyone]

6 minutes ago, calbear said:

The Gov of Hawaii did order 14 day quarantine for anyone flying into Hawaii on 3/21.

 

 

This. It substantially reduced the flight traffic since no-one wants to spend their 2-week vacation in a hotel room unable to leave.

[mathnerd]

7 minutes ago, square_25 said:

 

So.... you think they just measured wrong? They had quite a lot of people. This was a self-selected study, which means it was likely to be skewed towards people who were worried about exposure. 

Do you have any reason for your belief other than gut instinct? I would have also guessed numbers above the 3% until the deaths stayed low and the antibody tests showed small numbers. But right now, I don't see how it could be much higher. If anything, I figure it's lower. 

There will probably eventually be an actually random study, anyway. Would you accept the results of that? 

If you mean the Stanford study of Santa Clara county cases, I think that study is not meant to be taken as a definitive statement on immunity in the local community. They targeted specific demographics when they recruited volunteers, made up numbers to compensate for underrepresented demographics and used a test from a Minnesota company the accuracy of which is unknown. It was a hastily done paper and is loaded with many biases.

Large employers in the Santa Clara county (with more than 10,000 employees) are directly working with manufacturers of antibody tests trying to procure tests so that they can start allowing those with immunity into the workplace. If they can secure reliable tests and their data comes out, then, we can see the true nature of the infection in the bay area. 

[EmseB]

1 hour ago, square_25 said:

Subway ridership is way down, I think. Or do you mean what we’re going to do once the shelter in place is lifted? It’s a good question. As a sad kind of cynical answer, I’ll guess that a lot of poorer neighborhoods in NYC are going to be pretty close to herd immunity by the end of this ordeal, anyway. We’ll see after the antibody testing, I guess, and those results will be out soon.

As for more subway cars, I really have no idea how feasible this is. Perhaps they can run both buses and trains along the same routes? I have no idea what the limitations of the system are.

As far as I have read subway ridership is down but cars have been removed from trains and service has been cut so the actual cars are just as packed as ever if not more so. Maybe that's not the case?

This makes me more acutely aware that I've lived in suburbia most of my life and have never had to solely rely on mass transit to get around. I admit I can't relate to the idea that there are no other options for transportation other than mass transit. Even in DC people generally seemed to be able to get around without the metro if they needed to. I remember my DH had to get to work when it was shut down for a week for snow and it sucked but it wasn't the only option for transportation. 😕 It does make me wonder what would happen in a different kind of natural disaster in nyc. Anyway, I'm getting more and more off topic.

[ElizabethB]

1 hour ago, Pen said:

I find Hawaii rather interesting.  Apparently low rates, or at least low sickness and death that got a person tested — perhaps we will learn it has had higher rates that are asymptomatic.

Lots of people (including personal family) in Hawaii have Asian family connections and a lot of travel takes place between various Asian countries, including China, and Hawaii.

A “prepare to shelter in place” directive,  buy supplies for two weeks,  was issued in Hawaii earlier then where I am on West coast, and I think even before the California Bay Area counties issued SIP orders.  

But the restrictions that my Hawaii relatives report are lesser than what most areas of the 3 contiguous Pacific states are doing—yet afaik confirmed cases and deaths per 1000 population have been way less in Hawaii. 

 

Yes, they get a lot of travel, too.  You would think their rates would be as high as the ski counties.  Maybe vitamin D?  Hawaii is unique in many ways.

[Ausmumof3]

2 hours ago, mathnerd said:

@Arcadiathis is consistent with word on the street that the bay area imported COVID19 after the December vacation that involved residents going back to visit Hubei province. I am convinced that people who were in crowded locations like workplaces, movie theaters, concerts, malls, classrooms, sports events etc got exposed from what I experienced in Jan/Feb. I believe that NorCal will be early in the curve for acquiring herd immunity based on anecdotes I am hearing.

I thought herd immunity required like 70pc infection?

[Pen]

2 minutes ago, ElizabethB said:

Yes, they get a lot of travel, too.  You would think their rates would be as high as the ski counties.  Maybe vitamin D?  Hawaii is unique in many ways.

 

Yes, lots of travel.  

Maybe sunshine, vitamin D, lots of fresh foods, fish, fruits... 

I think how they have an 8 deaths per thousand population deserves some study. 

[Ausmumof3]

2 hours ago, Matryoshka said:

What would lead you to think that other than wishful thinking? A similar survey in Chelsea, MA came up with a 30% antibody rate.

Wow that seems high

[mlktwins]

https://www.yahoo.com/news/alarmed-covid-patients-blood-thickened-181831259.html

 

[Arcadia]

@Pen@Plum@square_25 Can't find the results of this study

April 7th https://www.indystar.com/story/news/health/2020/04/07/eli-lilly-co-testing-asymptomatic-coronavirus-infections/2965166001/

"If you have been wondering whether you have the coronavirus but have no symptoms, here is your chance to get tested for free: Eli Lilly and Co. is seeking volunteers for a study of how many people in Indianapolis fall into this category.

People interested in participating must be over age 18, residents of Central Indiana, and cannot have undergone testing for the SARS-CoV-2 virus or experienced any symptoms associated with COVID, the disease the virus causes.

“The importance of asymptomatic carriers as transmitters for viral spread remains uncertain,” Lilly officials said in a news release. “As a first step towards understanding this better, this study will track the prevalence of asymptomatic infection in the Indianapolis area over time.”

Studies have suggested that not everyone who has the virus will develop symptoms. Centers for Disease Control and Prevention Director Dr. Robert Redfield told NPR last week that as many as 25% of people who are infected may never develop symptoms. 

Lilly plans to enroll 3,000 people in the study, which will run for a limited time."

[Rosie_0801]

6 hours ago, Pen said:

 

Sorry!!!

It’s only you who checks these?   

I thought you were one of several moderators!!!!!

 

 

Not for the last few weeks. I'm not sure where the other one went, but I know she sleeps too sometimes. 😛

[Wheres Toto]

3 hours ago, EmseB said:

I'm not envisioning a contingency plan. Like I said, I'm not an expert here, nor am I responsible for managing a major city during a disaster. I would say, off the top of my head more buses, more subway cars so people could at least sit further apart. A lot of cities in other countries limit who can travel on which days in order to limit things like pollution or traffic congestion. But this sentiment that you're expressing above is common with what I've been seeing from NY'ers on my social feeds. That is, there's no way for people in NY to social distance and also go anywhere, so whatareyagonnado? Nothing, I guess, is the current answer. Just keep packing people in train cars, sadly enough. Which, as @Arctic Mama was talking about above, presents a unique problem in NYC lifting SIP and lockdown precautions that other cities do not have to consider. Not that other cities don't have other issues to contend with, but not the same apparently unsolvable problem of the subway.

I don't know about now when they reduced the number of trains and routes because they thought less people would be using them because businesses were supposed to be closed, but at normal times, certain routes have trains hitting the stations every 5 minutes.   I don't see how they can safely add trains when they are already traveling so close together.    You can only have the number of cars that fit on the station platforms.

[Matryoshka]

32 minutes ago, Ausmumof3 said:

Wow that seems high

Yep.  They have the highest per capita cases in MA.  Here's a link to the data and more background - apparently 32% people randomly tested had antibodies.  The official case rate at the time was only 2%.  As of the 14th, it was 189 cases per 10K population, total 712, which is about the time of the study? - it's 977 now.  It's a low-income town and about 80% of the working population is considered 'essential', so not a lot of sheltering at home possible.

 

Edited April 22, 2020 by Matryoshka

[Ausmumof3]

5 minutes ago, Matryoshka said:

Yep.  They have the highest per capita cases in MA.  Here's a link to the data and more background - apparently 32% people randomly tested had antibodies.  The official case rate at the time was only 2%.  As of the 14th, it was 189 cases per 10K population, total 712, which is about the time of the study? - it's 977 now.

 

They were volunteers though so we still don’t have an account for the bias that those with previous symptoms might be now likely to opt in.  I’ll have to see if i can find the original study, because they might have controlled for that but it’s not in the article?  

[Pen]

48 minutes ago, ElizabethB said:

Yes, they get a lot of travel, too.  You would think their rates would be as high as the ski counties.  Maybe vitamin D?  Hawaii is unique in many ways.

 

The travel quarantine rule was well after Chinese New Year type travel would probably have already taken place.

and at least one death seemed to be from someone who had traveled to Washington state.

 

[Matryoshka]

19 minutes ago, Ausmumof3 said:

They were volunteers though so we still don’t have an account for the bias that those with previous symptoms might be now likely to opt in.  I’ll have to see if i can find the original study, because they might have controlled for that but it’s not in the article?  

Well, it was volunteers off the street - apparently they set up shop in a square and it was volunteers from passersby, not people who opted in by coming to a hospital or signing up on a website.  They also excluded anyone who had tested positive in the past - and MA has some of the highest per capita testing in the country, so I'd hope there wasn't that huge a backlog of people who had symptoms and couldn't get tested, and just happened to be walking by the testing station during the relatively short time it was there.  One of the articles below does say that about half of the people tested (so, even more than tested positive) did report at least one coronavirus symptom, but not enough for them to feel that sick or bother looking for testing, or I'm guessing stay at home from work, since so many are 'essential workers' and can't call out unless they really feel sick.  

More articles https://www.bostonherald.com/2020/04/15/massachusetts-researchers-turning-to-passersby-for-coronavirus-antibody-test/

https://www.dailywire.com/news/massachusetts-researchers-tested-people-on-the-street-for-coronavirus-antibodies-one-third-had-them

 

But anyway, if it was that high in Chelsea, and only 3% in the CA study, I'm thinking it's a bad idea to think that somehow the 3% is woefully undercounted and there's magic herd immunity hiding somewhere in the other 97%...

 

Edited April 22, 2020 by Matryoshka

[mommyoffive]

6 minutes ago, Ordinary Shoes said:

My daughter has an orthodontist appointment in 2 weeks. What do you guys think? I think I'm okay with it. Everyone there will wear masks. We'll wear masks but of course DD will need to remove it for the appointment. The appointment is her annual visit. She had an expander last year and now wears a retainer. She'll need braces in several years. So they won't be doing anything. Just checking to see if everything is going according to plan. 

 

Wow, your area is doing them?  Did they never shut down or did they just reopen?  We have had dental, ortho, and oral surgery cancelled.  Only emergency cases seen. 

[Matryoshka]

2 minutes ago, mommyoffive said:

Wow, your area is doing them?  Did they never shut down or did they just reopen?  We have had dental, ortho, and oral surgery cancelled.  Only emergency cases seen. 

Yeah, dental is supposed to be quite a big transmission risk - although I think the vector is more patient -> dentist than the other way around.  But that's why emergencies only.  Are cases super-low where you are @Ordinary Shoes?

[EmseB]

1 hour ago, Where's Toto? said:

I don't know about now when they reduced the number of trains and routes because they thought less people would be using them because businesses were supposed to be closed, but at normal times, certain routes have trains hitting the stations every 5 minutes.   I don't see how they can safely add trains when they are already traveling so close together.    You can only have the number of cars that fit on the station platforms.

Right. Metro in DC runs variable numbers of cars on their trains based on peak and non peak hours. I was thinking of something like that. Obviously not extending cars beyond the platform. My point was to run max number of cars on each train despite decreased ridership in order to give people more space between each other.

Edited April 23, 2020 by EmseB

[mathnerd]

3 hours ago, Matryoshka said:

What would lead you to think that other than wishful thinking? A similar survey in Chelsea, MA came up with a 30% antibody rate.

not wishful thinking. Northern California has very intimate ties to China that any epidemic over there would immediately show up here (there are tens of thousands of immigrant chinese living here, tourists on several daily flights from China and most of the local semiconductor tech sector setting up shop in china involving travel of employees on a day to day basis back and forth between the 2 countries).

There was a big wave of serious and "weird" respiratory disease here in January (coincided with people returning from China after visiting relatives during winter break), second wave in Feb coinciding with people returning after Chinese New Year celebrations with their family in China. Community spread is predicted to have happened in January and February with the first death due to community spread reported on Feb 6. This is earlier than the first death in Seattle. The local counties are trying to do autopsies to trace how far back deaths due to Covid19 could have occurred. They think that they have uncovered only the tip of the iceberg so far. If so, these deaths happened to people who went to regular places like grocery stores, mall, hospitals, schools and got the virus from there, as early as January. So, the rates of ~2-3% for the presence of antibodies are on the low side for the local population  We need more reliable antibody tests and mass testing for there to be enough data to make a good prediction about herd immunity. Since my area was one of the first to get the disease and it spread for several weeks before SIP directive, I guess that this area will be one of the first to achieve herd immunity whenever that happens (of course a reliable vaccine can do that also).

[Ausmumof3]

https://www.9news.com.au/world/coronavirus-causing-stroke-in-young-people-doctors-report/7890c285-fee7-4296-bec1-2ded051cd535
 

COVID 19 appears to be affecting the way blood clots and causing small strokes in younger patients

this could also be possibly related to the language thing the professor was asking about 

“Our report shows a seven-fold increase in incidence of sudden stroke in young patients during the past two weeks. Most of these patients have no past medical history and were at home with either mild symptoms (or in two cases, no symptoms) of COVID-19," he added.

Edited April 23, 2020 by Ausmumof3