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Badger52
02-28-2020, 21:22
Why have islands in the Pacific like Johnson and Midway if we can’t quarantine people and airplanes for a month or longer? Should have never brought these people to the United States.[/COLOR] I wonder if the Ambassador that ok'd the transport of the infected ones back to CONUS and (apparently from many sources) against a direct order from Trump to the contrary has joined the unemployed ranks.
I wonder if the Ambassador that ok'd the transport of the infected ones back to CONUS and (apparently from many sources) against a direct order from Trump to the contrary has joined the unemployed ranks.
This is an interesting political quandary.
If 45 publicly stated he doesn't want American to return, the D's will use that as ax on the campaign trail,
nee: heartless, uncaring, un-Christian, un-American, ......
If 45 publicly states he wants Americans to return, and it causes a "pandemic" of cluster infections, the D's will have another ax on the campaign trail,
nee: bungling, sloppy, dangerous, inept, incompetent, ......
:munchin
UPDATE:
I grabbed this off Dan's Instagram feed..
Sound Strange and Stupid?
That's the way they think..
Let’s stop hating Trump so much that we would rather see our country fail than see the orange man in the White House succeed.
We'll we both know that there are many people out there who lives are running on hatred. They are so over the top that I firmly believe they would intentionally self-contaminate/infect themselves and others to achieve their goal.
I don't believe there is any hope for them, and there is only one cure for their kind.
I wonder if the Ambassador that ok'd the transport of the infected ones back to CONUS and (apparently from many sources) against a direct order from Trump to the contrary has joined the unemployed ranks.
And so many are now blaming Trump for allowing the passengers from the Diamond Princess back into the US and possibly infecting others who are label as infected through unknown origins.In addition the HHS is getting flak for lack of PPE when this Ambassador deemed that all were virus free. What I have yet to hear from anyone is possibly relationship those infected through unknown origins may have with a very porous border.
Old Dog New Trick
02-29-2020, 10:24
Excellent point! ETA: Well, except for the housing problem.
We are the best country in the world at building tent cities and don’t we have an abundance of inflatable hospitals laying around somewhere.
On top of that we are also the best country in the world at sending medical doctors, nurses and laboratory technicians on short notice anywhere needed. Be they active duty, NG, or reserve.
One would hope that these assets were briefed to POTUS at the earliest time? “Sir, we can mobilize the JBLM (Lewis/MacChord) and JBPH (Pearl Harbor) to Midway Island and establish a short term quarantine for up a thousand US and foreign citizens in 48 to 72 hours. I just need you to sign here.” (General Mark Milley CJCS - Sec Def Mark Esper)
Approved, and give the CDC a call and tell them to send their very best epidemiologist along.
We know how to do this shit! Hot zone, neutral decontamination areas and cold zones for non-infectious people. Three week to a couple months vacation in the Pacific the temperatures are great this time of year.
We are the best country in the world at building tent cities and don’t we have an abundance of inflatable hospitals laying around somewhere.
On top of that we are also the best country in the world at sending medical doctors, nurses and laboratory technicians on short notice anywhere needed. Be they active duty, NG, or reserve.
One would hope that these assets were briefed to POTUS at the earliest time? “Sir, we can mobilize the JBLM (Lewis/MacChord) and JBPH (Pearl Harbor) to Midway Island and establish a short term quarantine for up a thousand US and foreign citizens in 48 to 72 hours. I just need you to sign here.” (General Mark Milley CJCS - Sec Def Mark Esper)
Approved, and give the CDC a call and tell them to send their very best epidemiologist along.
We know how to do this shit! Hot zone, neutral decontamination areas and cold zones for non-infectious people. Three week to a couple months vacation in the Pacific the temperatures are great this time of year.
But why would they?? Most of them don't like Trump.
Old Dog New Trick
02-29-2020, 11:41
But why would they?? Most of them don't like Trump.
Right, there is a certain segment of our society (including military brass) that would rather see our country fail than to see Trump (doing well, making good decisions) win!
Obama got a free pass for everything he and his administration did wrong (illegal) and was celebrated in the streets for the few decisions his administration seemed to get right - by accident or otherwise. (Even by the RINOs in the Congress)
We're retired and were hit way harder than you and, even through we have only SS as income and can't really buy more, I know that what we have will rebound quickly. Especially after the next election. I don't panic. ;) Unfortunately some do.
If you have income investment focus it softens the blow.
I went full monty with shifting the retirement $$ that I have in accounts that I can self-manage into a diversified basket of high-yield securities. I'm totally focusing on income with capital growth being icing on the cake. Right now I don't need the income, so I'm plowing it right back into the account and am viewing this event like a giant fire-sale. I am in a much better place taking a 1 week 14% unrealized capital loss knowing that those investments are still spinning off real cash (9.8% yield on invested capital)... much of it on a a monthly basis that I can use to go bargain shopping.
Badger52
02-29-2020, 12:06
We know how to do this shit! Hot zone, neutral decontamination areas and cold zones for non-infectious people. Three week to a couple months vacation in the Pacific the temperatures are great this time of year.Hell, yeah. Place of our choosing; and without any black goo leeching up through the soil.
Old Dog New Trick
02-29-2020, 15:52
So it appears that a transgender woman has died of the Coronabeervirus in Jay Enslee’s Evergreen state. The “man” was a significant health risk with pre-existing conditions and may or may not have recently returned from South Korea. It is also reported (because Gov. Enslee knows more about science and Climate Change than VP Pence) that they sent the person to a local motel room so as not to infect the Evergreen Hospital staff.
[Note: there was one reported case of a 50 y/o female with underlying health issues who had actually returned from South Korea but, “she” is doing okay and is receiving treatment for a life threatening URI. The “mysterious man” was not ever previously reported to health officials or the CDC...he just showed up out of the blue and died from “unconfirmed COVID-19”.]
But there is no conspiracy here to cause panic and pandemonium as reported by CNN and USA Today.
tom kelly
02-29-2020, 19:49
So it appears that a transgender woman has died of the Coronabeervirus in Jay Enslee’s Evergreen state. The “man” was a significant health risk with pre-existing conditions and may or may not have recently returned from South Korea. It is also reported (because Gov. Enslee knows more about science and Climate Change than VP Pence) that they sent the person to a local motel room so as not to infect the Evergreen Hospital staff.
[Note: there was one reported case of a 50 y/o female with underlying health issues who had actually returned from South Korea but, “she” is doing okay and is receiving treatment for a life threatening URI. The “mysterious man” was not ever previously reported to health officials or the CDC...he just showed up out of the blue and died from “unconfirmed COVID-19”.]
But there is no conspiracy here to cause panic and pandemonium as reported by CNN and USA Today.
Named the Covid-19 by the WHO (World Health Organization) a worthless money pit that does nothing to improve the health of the world same as the United Nations is NOT united to promote world peace. China has 1 level 4 Biohazard Lab & it's in Wuhan China. The lab is THE NAVAL UNIVERSITY OF ENGINEERING & the head of the Lab is Dr. Chen Wi a Maj. General in the Chinese Army. She is China's top Bio weapons expert. Her lab was locked down on 2 Jan.2020 because of the virus & 21 days before Wuhan (pop.11 million) was quarantined. This is when China admitted to having an epidemic...Did the coronavirus-19 ordinate in Dr. Wi's lab or did it come from Wuhan's wet meat market as reported by the Chinese Gov.????
If you have income investment focus it softens the blow.
I went full monty with shifting the retirement $$ that I have in accounts that I can self-manage into a diversified basket of high-yield securities. I'm totally focusing on income with capital growth being icing on the cake. Right now I don't need the income, so I'm plowing it right back into the account and am viewing this event like a giant fire-sale. I am in a much better place taking a 1 week 14% unrealized capital loss knowing that those investments are still spinning off real cash (9.8% yield on invested capital)... much of it on a a monthly basis that I can use to go bargain shopping.
I've always been an aggressive investor, and still am. It bit me this time (and I knew it was coming) and a couple of other times. I guess I should slow down . . . after this recovery. :D
Yes, I know, I still have time left to recover what was lost in 2008 again and again but some people don’t...this hits recent retirees hard and it’s over BS!
Let’s stop hating Trump so much that we would rather see our country fail than see the orange man in the White House succeed.
And VFOG's,,
12 yrs from now I'll be in my mid 80t's :munchin
doctom54
03-01-2020, 18:22
And VFOG's,,
12 yrs from now I'll be in my mid 80t's :munchin
Just wondering.
What is the difference between a FOG and VFOG?
Just wondering.
What is the difference between a FOG and VFOG?
My personal definition
FOG - retired, Historically for civilians around 60+- but with the military 50? When you come back as a contractor on Range 37 or become a role-player for RS?
VFOG - 70
VVFOG - 80
doctom54
03-01-2020, 19:11
The medical community has done studies and your definition changes as you get older.
I think of myself as a FOG (retired military, still working, Medicare eligible); just wanted to make sure I wasn't a VFOG yet.;)
Badger52
03-01-2020, 19:14
By the way, it's for Vintage.
That's my story & I'm stickin' to it.
:cool:
Old Dog New Trick
03-01-2020, 20:13
My personal definition
FOG - retired, Historically for civilians around 60+- but with the military 50? When you come back as a contractor on Range 37 or become a role-player for RS?
VFOG - 70
VVFOG - 80
I guess that just still makes me a FAG then - retired >50 <60 :D
InTheBlack
03-01-2020, 20:14
Gonna be seeing these posters again pretty soon:
https://thumbs-prod.si-cdn.com/QwqUFVdAUr8aUI84GHsoaulo76Y=/fit-in/1072x0/https://public-media.si-cdn.com/filer/ec/b4/ecb47a49-b41e-4576-8015-d27ee3f36722/file-20180109-36028-cg8mlz.jpg
article:
https://www.smithsonianmag.com/history/ten-myths-about-1918-flu-pandemic-180967810/
It's probably time for states bordering CA to set up checkpoints to test for the virus. Once the homeless of LA and SF catch it, it will spread rapidly there. Not sure about SD's homeless population but it doesn't matter, it's CA in general. Hey, they check us for vegetables and fruit when we cross their border.
The Good side of COVID_19
An adviser to Iran's Supreme Leader Ayatollah Ali Khamenei has died from the new coronavirus, as other top officials in the country are confirmed to be infected, according to multiple reports on Monday.
The Good side of COVID_19
An adviser to Iran's Supreme Leader Ayatollah Ali Khamenei has died from the new coronavirus, as other top officials in the country are confirmed to be infected, according to multiple reports on Monday.
Can I surmise that 3rd World countries will see an exponential Corona V outbreak proportioned to the number of PRC Advisers in-bedded with said 3rd world countries??
:lifter Asking for a friend.. :D
Old Dog New Trick
03-02-2020, 12:56
For those wanting know:
100+ cleaning agents supposedly that will disinfect Coronavirus and 99.99% of all other germs:
https://abc13.com/health/100+-products-that-will-work-against-coronavirus-germs/5973798/
I'm thinking 25, 50 Megaton Tzar's should wipe most of it off the face of the earth, if they act quickly...
Bring on those EMP's!
Old Dog New Trick
03-02-2020, 15:05
Worst case scenario is unfolding in King County, WA., at Evergreen Medical Center and the Life Care Center in Kirkland, WA.
For anyone who’s been keeping tabs, the first known infected person in the US returned from Wuhan, China to SEATAC (likely through Beijing direct) and went about his life for about a week before seeing someone about the flu. He was admitted for a week or so then sent home to self isolate.
While the president and CDC were locking down International arrivals at SFO, LAX, ORD, NYC and some others I can’t remember off the top of my head...SEA was never on the list before or after the only known case had walked through customs and departed for home.
My ‘assumptions’ are a healthcare worker came into contact with this person or another person with contact and has returned to work in either one or both Evergreen Medical and/or Life Care Center and had been a walking host with nothing more than the “common cold” for symptoms.
It’s hard to say at this moment but they have all they need right now for a hazardous bio-containment process to move every infected person in the state of Washington to the Life Care Center as a hot zone and use the quarantined Police/EMS/FD that has already been exposed to carry out transporting other infected patients and medical staff from the medical care facilities reporting an infected person. Containment should be a 500’ area around the Life Care Center with decontamination zone and control points for destruction and resupply of disposable items. With another 500’ border of a neutral zone.
It’s too bad Washington is led by an incredibly inept governor but at least he’ll be able to deploy his National Guard like he wants to.
Badger52
03-02-2020, 15:41
It’s too bad Washington is led by an incredibly inept governor but at least he’ll be able to deploy his National Guard like he wants to.He actually might find some talent that would help him there but it has to be a duplex circuit. If he ain't listenin'...
No matter. All blame --> Trump
LongWire
03-02-2020, 16:38
Kids in my town in the NE Corner of WA state were given the day off due to scare.... not sure what jerked that reaction, some of those kids are all hanging out in town together, so what does this solve?..... sheesh
InTheBlack
03-02-2020, 17:38
For those wanting know:
100+ cleaning agents supposedly that will disinfect Coronavirus and 99.99% of all other germs:
https://abc13.com/health/100+-products-that-will-work-against-coronavirus-germs/5973798/
Stupid advice: "Don't: Forget to use the one-way wipe method. You never want to wipe in one direction and go back over it in the opposite direction because you will deposit germs you just cleaned up."
Um, you just KILLED the pathogen, if you did it right. Moving live ones around is counterproductive.
They say nothing about wet contact TIME. I would bet that most of these need 10 minutes for a coronavirus. Recall the January research I posted earlier, saying SARS & MERS need 78-80% ethanol to kill in 60 seconds. At only 70%, needs 10 minutes. Purell hand sanitizer is 62%.
InTheBlack
03-02-2020, 17:50
use the quarantined Police/EMS/FD that has already been exposed to carry out transporting other infected patients
If this little grey duck is quarantined, like hell I'm going to get close to known sickies. Working in full hazmat & SCBA ain't gonna happen. That kind of debilitating physical stress is contraindicated for people under quarantine because they are expected to get sick.
Here again is the case report for that first guy, up thru 30JAN20. Note that his pneumonia cleared up after taking remdesivir. So I am puzzled that this is not being named as the best chance drug to test. And what has happened to him since Jan 30 ?
https://sci-hub.tw/10.1056/NEJMoa2001191
If this little grey duck is quarantined, like hell I'm going to get close to known sickies. Working in full hazmat & SCBA ain't gonna happen. That kind of debilitating physical stress is contraindicated for people under quarantine because they are expected to get sick.
Here again is the case report for that first guy, up thru 30JAN20. Note that his pneumonia cleared up after taking remdesivir. So I am puzzled that this is not being named as the best chance drug to test. And what has happened to him since Jan 30 ?
https://sci-hub.tw/10.1056/NEJMoa2001191
Remdesivir (Gilead), chloroquine, and lopinavir/ritonavir. (Abbvie, HIV therapy) are all leading candidates for treatment. Remdesivir is investigational and is being manufactured in small research quantities. None could be made in quantity in the US, IMO. The latter 2 are made in quantities in China/India. I suspect there are serious discussions going on at high levels to gain access to supplies, but...
I suspect we have the best chance to get chloroquine as it’s made in ton quantities as an anti malarial. But diverted supply means Peter/Paul theft and increased malaria deaths.
Everything is a trade off, and outsourcing has bitten us.
Old Dog New Trick
03-02-2020, 19:40
If this little grey duck is quarantined, like hell I'm going to get close to known sickies. Working in full hazmat & SCBA ain't gonna happen. That kind of debilitating physical stress is contraindicated for people under quarantine because they are expected to get sick.
Here again is the case report for that first guy, up thru 30JAN20. Note that his pneumonia cleared up after taking remdesivir. So I am puzzled that this is not being named as the best chance drug to test. And what has happened to him since Jan 30 ?
https://sci-hub.tw/10.1056/NEJMoa2001191
Thanks that was good read. Although I departed the medical field a very long time ago I can understand and follow their thought processes and testing and treatments. Glad it turned out so well for him.
Now, as a federal emergency response professional, I would have no problem “asking” people (other trained professionals) who have already been exposed (by accident or performance of duty) to a pandemic illness with a high likelihood of survival to man the front lines of a battle where limiting the exposure and continued spread/transmission of that illness so that others can function free of exposure.
You see, if you have to send every emergency employee home to self quarantine after each one possible exposure you soon run out of trained emergency responders and the whole system breaks down soon after.
You did read where using Remdesivir is experimental and not FDA approved for the treatment of COVID-19 or any other Coronavirus and they used it with or without the patients approval. Right? (But, just think of the possibilities now that they know it helps...)
You did read where using Remdesivir is experimental and not FDA approved for the treatment of COVID-19 or any other Coronavirus and they used it with or without the patients approval. Right? (But, just think of the possibilities now that they know it helps...)
Would this fall under the new "right to try" law? In this case the patient wouldn't know if they were terminal or not.
Old Dog New Trick
03-02-2020, 19:55
Would this fall under the new "right to try" law? In this case the patient wouldn't know if they were terminal or not.
Yes, I believe it would. Knowing what was happening in China at the time. (They probably got his consent anyway once they told him he had the virus.)
Also probably why the president is saying we may have a cure as well as antivirals in the works.
ETA: I’m just a fly in the ointment. I don’t even have a wall to watch from. All JMOO.
5thgrp"C"
03-02-2020, 20:34
The further this progresses the more seriously it should be taken. We have been able to slow it down but "mitigation" was the word of the day during the Vice President's brief (3/2/2020).
Schools closing, that's the turning point.
If/when there is no day care, no schools, no work (other than essential pax), no anything. No money coming in for a large % of the population. No damn way anyone over 60, overweight, previous med history goes anywhere. That's when this goes beyond your run of the mill every quarter century bug into something bigger.
The further this progresses the closer this comes to being a generation defining moment.
Old Dog New Trick
03-02-2020, 23:10
It just occurred that I may have missed an important point to make about being in the “Hot Zone” once you’ve possibly been infected. As a professional that put you there in the first place, be that a doctor, nurse, EMT, police officer or firefighter or a civilian member of the government or epidemic scientists you were there because someone needed you to be there. That’s the choice we all make going into jobs that require you to rush in when everyone else is rushing out.
No one is asking you to put your health at risk but there is risk in what you do. The solution is to limit and mitigate it as much as possible and accept that there still remains risk. Do you want others to put themselves in the same position...no. Do you want to put your family at risk because you’re told to stay home? No!
In my current job I travel, a lot, domestically and internationally, my wife has already told me to ready myself to sleep in our RV or don’t come home don’t come in the house if you are sick. Neither her or my kid should be exposed to what I could possibly be exposed to at work. I do what I can to protect them from the hazards of my job.
If I knew I might have contracted something like this virus but felt healthy enough to help other possibly infected people I’d rather help them than sit around lonely wondering what to do. But maybe that’s just me...even if it meant zipping up a hazmat suit and wearing a mask and goggles all day and going through decontamination washes repeatedly. Done it before, would do it again.
It just occurred that I may have missed an important point to make about being in the “Hot Zone” once you’ve possibly been infected. As a professional that put you there in the first place, be that a doctor, nurse, EMT, police officer or firefighter or a civilian member of the government or epidemic scientists you were there because someone needed you to be there. That’s the choice we all make going into jobs that require you to rush in when everyone else is rushing out.
No one is asking you to put your health at risk but there is risk in what you do. The solution is to limit and mitigate it as much as possible and accept that there still remains risk. Do you want others to put themselves in the same position...no. Do you want to put your family at risk because you’re told to stay home? No!
In my current job I travel, a lot, domestically and internationally, my wife has already told me to ready myself to sleep in our RV or don’t come home don’t come in the house if you are sick. Neither her or my kid should be exposed to what I could possibly be exposed to at work. I do what I can to protect them from the hazards of my job.
If I knew I might have contracted something like this virus but felt healthy enough to help other possibly infected people I’d rather help them than sit around lonely wondering what to do. But maybe that’s just me...even if it meant zipping up a hazmat suit and wearing a mask and goggles all day and going through decontamination washes repeatedly. Done it before, would do it again.
If you haven't seen it, Chernobyl (HBO series) goes through the same thing with their first responders... guys going home and contaminating their families.
I modeled the small city, 250k population, my daughter lives in and works as an outpatient clinic pharmacist who they’re trying to drag back into a former role as ICU PharmD. They have 12 hospitals and multiple clinics. There are 147 ICU beds in the system and it’s one of the higher ICU/total beds ratios.
So the attack rate is projected to be 40%-70% of a population (Lipsitch, epidemiologist at Harvard public health) with 15%-20% requiring hospitalization with 15%-20% of those requiring an icu bed (NEJM, Lancet). (80%-85% mild disease.)
So using a 40% attack rate and low end estimates, i.e. 15% serious/ICU, that’s 15,000 hospitalizations and 2,250 requiring vent support in the ICU.
At the high end w 70% attack and 20%/20% it’s 35,000 hospitalizations and 7,000 icu beds.
These are patients, not patient days. Chinese reports indicate long vent stays up to 30 days and about 90% of vent patients die.
250k * 0.4 * .15 * .15 = 2250 icu
250k * 0.7 * .2 * .2 = 7000 icu
I’m betting on the lower end of the range (close to 2250 ICU patients) with a 1% CFR or 10 times the seasonal flu. I’m basing that using current Korean stats which represent 1st world care and aggressive testing, which we still don’t have.
These numbers represent totals over the course of the disease and won’t be happening all at once but regardless, the hospitals will be totally swamped even without factoring in sick staff, depleted PPE, and absent antibiotics and vasopressors needed during sepsis/vent support.
You can see why social distancing and other NPIs will be the key to flattening the infection curve to spread out the hospital impact.
I’d expect strong emphasis on staying home and avoiding infection. The financial impact on small business will be severe IMO.
As the chief said in McClintock, it will be a remembered fight.
InTheBlack
03-03-2020, 19:25
you were there because someone needed you to be there. That’s the choice we all make going into jobs that require you to
rush in when everyone else is rushing out.
Of course. I'm just an old retired guy grousing. If you got exposed because the bosses did not protect you in the first place...
InTheBlack
03-03-2020, 19:42
So the attack rate is projected to be 40%-70% of a population (Lipsitch, epidemiologist at Harvard public health) with 15%-20% requiring hospitalization with 15%-20% of those requiring an icu bed (NEJM, Lancet). (80%-85% mild disease.)
Got the primary URL for Lipsitch? Its mentioned here:
https://www.wsj.com/articles/how-many-people-might-one-person-with-coronavirus-infect-11581676200
but dated 16FEB20 so is an old estimate, is it still a good number?:
"“I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year. What proportion of those will be symptomatic, I can’t give a good number.”"
And are you also presuming that all of those infected are in fact symptomatic enough to be counted as having it. But I suppose a higher asymptomatic number raises the R0... which might be a wash versus having a larger number of infected people to divide into the known number requiring hospital care (which would reduce the hospitalization percentage).
InTheBlack
03-03-2020, 19:56
https://news.harvard.edu/gazette/story/2020/02/key-coronavirus-question-how-are-children-affected/
27FEB20
>
Harvard GAZETTE: You’ve been quoted you as saying you expect between 40 percent and 70 percent of humanity to be infected with this virus within a year. Is that still the case?
LIPSITCH: It is, but an important qualifier is that I expect 40 to 70 percent of adults to be infected. We just don’t understand whether children are getting infected at low rates or just not showing very strong symptoms. So I don’t want to make assumptions about children until we know more. That number also assumes that we don’t put in place effective, long-term countermeasures, like social distancing for months at a time which, I think, is a fair assumption. It may be that a few places like China can sustain it, but even China is beginning to let up.
>
InTheBlack
03-03-2020, 19:58
https://www.medrxiv.org/content/10.1101/2020.02.12.20022467v1
17FEB20
The role of absolute humidity on transmission rates of the COVID-19 outbreak
Wei Luo, Maimuna S Majumder, Dianbo Liu, Canelle Poirier, Kenneth D Mandl
doi: https://doi.org/10.1101/2020.02.12.20022467
Abstract
A novel coronavirus (COVID-19) was identified in Wuhan, Hubei Province, China, in December 2019 and has caused over 40,000 cases worldwide to date. Previous studies have supported an epidemiological hypothesis that cold and dry (low absolute humidity) environments facilitate the survival and spread of droplet-mediated viral diseases, and warm and humid (high absolute humidity) environments see attenuated viral transmission (i.e., influenza).
However, the role of absolute humidity in transmission of COVID-19 has not yet been established. Here, we examine province-level variability of the basic reproductive numbers of COVID-19 across China and find that changes in weather alone (i.e., increase of temperature and humidity as spring and summer months arrive in the North Hemisphere) will not necessarily lead to declines in COVID-19 case counts without the implementation of extensive public health interventions.
*****
The first sentence in the abstract seems to contradict their conclusion. Maybe their bad English skills meant to say "we know of no previous research regarding transmission rates vs temperature?"
https://www.medrxiv.org/content/10.1101/2020.02.22.20025791v1
25FEB20
Temperature significant change COVID-19 Transmission in 429 cities
Mao Wang, Aili Jiang, Lijuan Gong, Lina Luo, Wenbin Guo, Chuyi Li, Jing Zheng, Chaoyong Li, Bixing Yang, Jietong Zeng, Youping Chen, Ke Zheng, Hongyan Li
doi: https://doi.org/10.1101/2020.02.22.20025791
Abstract
Background
There is no evidence supporting that temperature changes COVID-19 transmission.
Methods
We collected the cumulative number of confirmed cases of all cities and regions affected by COVID-19 in the world from January 20 to February 4, 2020, and calculated the daily means of the average, minimum and maximum temperatures in January. Then, restricted cubic spline function and generalized linear mixture model were used to analyze the relationships.
Results
There were in total 24,232 confirmed cases in China and 26 overseas countries. In total, 16,480 cases (68.01%) were from Hubei Province. The lgN rose as the average temperature went up to a peak of 8.72℃ and then slowly declined. The apexes of the minimum temperature and the maximum temperature were 6.70℃ and 12.42℃ respectively. The curves shared similar shapes. Under the circumstance of lower temperature, every 1℃ increase in average, minimum and maximum temperatures led to an increase of the cumulative number of cases by 0.83, 0.82 and 0.83 respectively. In the single-factor model of the higher-temperature group, every 1℃ increase in the minimum temperature led to a decrease of the cumulative number of cases by 0.86.
Conclusion
The study found that, to certain extent, temperature could significant change COVID-19 transmission, and there might be a best temperature for the viral transmission, which may partly explain why it first broke out in Wuhan. It is suggested that countries and regions with a lower temperature in the world adopt the strictest control measures to prevent future reversal.
InTheBlack
03-03-2020, 20:40
There are 147 ICU beds in the system and it’s one of the higher ICU/total beds ratios.
...
These are patients, not patient days.
...
250k * 0.4 * .15 * .15 = 2250 icu
2250/147 is 15 patients per bed.
365 days in a year divided by 15 patients...
if the cases are evenly spread out over a year, each patient can stay for 24 days. Over 6 months, 12 days.
Did I do that right? Knowing the algebraic equation will allow solving for any input data.
EDIT: did not account for beds being used by "normal" patients. So what is the excess or surge capacity? Will they delay transplant surgery to open an ICU bed for the possibility of a flu patient? What is the triage system for that?
What is the average number of icu beds per capita or 100,000 in urban areas in the USA?
InTheBlack
03-03-2020, 21:40
How soon until the punks figure out how to get all the cops off the streets?
https://www.officer.com/tactical/ems-hazmat/news/21127868/five-dallas-police-officers-watched-for-symptoms-of-coronavirus-following-arrest
Five Dallas Police Officers Watched for Symptoms of Coronavirus Following Arrest
Five Dallas police officers were told to stay home temporarily after arresting a man whom jail officers later reported had a “possible case of COVID-19” on Sunday.
David Tarrant
The Dallas Morning News
Mar 3rd, 2020
DALLAS -- Five Dallas police officers were told to stay home temporarily after arresting a man whom jail officers later reported had a “possible case of COVID-19” on Sunday.
Parkland Hospital officials also confirmed on Monday they were monitoring the 24-year-old “out of an abundance of caution.”
All five officers who came in contact with the person they arrested “were notified of the potential exposure and given a day off for precautionary reasons,” according to a Dallas police statement. The officers are expected to return to work at their next tour of duty, police said.
“Per our contagious disease policy, all five officers that came in contact with the arrested person were notified of the potential exposure and advised not to return to work until further notice,” the police statement said.
At about 9 a.m. Sunday, Dallas officers responded to a disturbance call at an East Dallas apartment. When officers arrived, Dallas Fire and Rescue had taken the 24-year-old man to a local hospital for injuries he sustained from an assault, according to a Dallas police statement.
Medical staff treated the man and released him back to Dallas officers, who drove him to jail and charged him with assault of a family member, police said.
At around 10:30 p.m., jail officers notified Dallas police of a possible case of COVID-19 involving the man, who was taken by private ambulance to Parkland Hospital.
A Parkland spokesperson confirmed that the 24-year-old suspect was taken to the hospital. “We are monitoring the person for symptoms out of an abundance of caution,” April Foran said. “We cannot offer comment beyond those facts.”
The Dallas County Sheriff’s Department, which oversees the jail, said in a statement that it has “an extensive intake screening process,” which was recently updated over concerns related to the virus outbreak.
“There has not been and are not currently any cases of the Coronavirus in the Dallas County Jail,” the sheriff’s department said.
Mike Mata, president of the Dallas Police Association, said Monday evening that the suspect knew he could stay out of jail by claiming to be sick.
When doctors examined him, Mata said, “the suspect had no indication of being ill. His claim had no merit.”
The squad cars involved in the man’s arrest were immediately removed from service for cleaning, police said.
Members of the department are currently working with medical professionals to draft a protocol to ensure officer safety.
2250/147 is 15 patients per bed.
365 days in a year divided by 15 patients...
if the cases are evenly spread out over a year, each patient can stay for 24 days. Over 6 months, 12 days.
Did I do that right? Knowing the algebraic equation will allow solving for any input data.
EDIT: did not account for beds being used by "normal" patients. So what is the excess or surge capacity? Will they delay transplant surgery to open an ICU bed for the possibility of a flu patient? What is the triage system for that?
What is the average number of icu beds per capita or 100,000 in urban areas in the USA?
I don’t know the average stay in the ICU.
There is zero surge capacity in many areas due to a brutal flu year.
No idea about icu beds/100k pop
WHO announced an average 3.4% case fatality rate, which seems way too high and influenced by Iranian and Italian stats. We still don’t know how many people are infected, so I can’t understand how they get that figure.
Korea is the gold standard for first world countries as far as testing, mitigation, and treatment and they are currently seeing 0.5%, or 5 x greater than seasonal flu.
https://news.harvard.edu/gazette/story/2020/02/key-coronavirus-question-how-are-children-affected/
27FEB20
>
Harvard GAZETTE: You’ve been quoted you as saying you expect between 40 percent and 70 percent of humanity to be infected with this virus within a year. Is that still the case?
LIPSITCH: It is, but an important qualifier is that I expect 40 to 70 percent of adults to be infected. We just don’t understand whether children are getting infected at low rates or just not showing very strong symptoms. So I don’t want to make assumptions about children until we know more. That number also assumes that we don’t put in place effective, long-term countermeasures, like social distancing for months at a time which, I think, is a fair assumption. It may be that a few places like China can sustain it, but even China is beginning to let up.
>
Yes, a critical caveat that I didn’t see with regards to age. This seems to cut his estimate by a third? in many areas. Depends on the age demographic.
His attack rate is being widely used by public health and it looks like he’s walking it back.
Using WA nursing home fatalities when estimating CFR is wrong IMO. It’s not common but also not unusual for up to 20% of residents in nursing homes to die of seasonal flu in a bad year. Makes you wonder, though, what Sun City, The Villages, etc. will experience in the coming months.
WHO's CFR of 3.4 is currently unsupported IMO. 1% is bad enough at 10x seasonal flu and what Fauci is predicting.
It's a fluent, continually moving number, but it has been fairly consistent globally OCONUS. The actual number won't be known till next year IMHO. CFR = Deaths ÷ Infected × 100.
Last count: 3254 ÷ 95173 = 0.0341903691 × 100 = 3.41903691% CFR. The Flu CFR is but 0.1%. Hopefully that number will change as testing becomes more available.
https://www.worldometers.info/coronavirus/
Keep in mind, the following is all hypothetical. May or may not happen. Better to be prepared than to be scared. So far the numbers are staying fairly consistent. The Global CFR is hovering around 3.4%. Projected viral attack rate per city (population centers thus far, OCONUS/via Lipsitch, epidemiologist at Harvard public health, is around 40-70%). Of those infected, 4-7% are critical and require mechanical ventilation in the ICU for 20-30 days. Do we have enough Ventilators? Enough Bipaps? Take Boone where I work for example. The population is around 20,000. If 40% of its residents become infected, 4% will likely require some kind of ventilatory support. In addition to our normal ICU patient load, that's roughly 8,000 patients that would require support in the ICU at our hospital. The question is, at what time frame could this occur if it actually happens? The numbers represent totals over the course of the disease and hopefully they won’t be happening all at once but regardless, our hospital will be totally swamped (if it happens), and as you said: "even without factoring in sick staff, depleted PPE, and absent antibiotics, and vasopressors needed during sepsis/vent support," it could get real sporty. I hope it won't come to that but it's better to be prepared to expect what's potentially coming and gaming the scenarios than not. That's my piece of mind. Good thing is that children aren't affected.
https://news.harvard.edu/gazette/story/2020/02/key-coronavirus-question-how-are-children-affected/
I don't think Washington state will be representative of the US or the rest of us. Nevertheless, in that state alone the CFR right now is 25.6% because of burning thru the rest home. 10 Deaths ÷ 39 positive cases × 100 = 25.6% CFR. (Numbers constantly move).
If anyone here are ZDogg fans, this video is well worth watching (my apologies for violating the ******* rule). They've confirmed pretty much what's been posted in this thread.
https://youtu.be/0f0GAuctVk8
Old Dog New Trick
03-04-2020, 17:48
Here’s a question for all you mathematicians on here.
According to the CDC/WHO how many people get influenza (of some known type) worldwide?
According to the CDC/WHO how many people die from influenza worldwide?
According to the CDC/WHO how many people worldwide see a doctor, go to a healthcare professional and get tested for influenza, and how many of those tests are reported to the CDC/WHO?
How many more people self medicate with OTC drugs or home remedies, actually have the flu and get better in under five days and infect their workplace, classmates and communities on a daily, weekly, monthly basis without anyone actually reporting their illness to the CDC/WHO?
Just asking for a friend.
P.S. I’m trying to imagine how many more people were either infected with COVID-19 or just exposed from the few carriers (hosts) that have returned from a source of this virus? What was the method of community transmission in the Life Care Center? Was it one to one or a single group function? I hope they are getting those questions asked and answered.
It ain't Influenza. Although I'm not a mathematician, just a "common Joe health care worker," your friend should probably know that out of the reported cases known, 2 - even up to 10 times the amount of those cases went unreported, which would change the numbers significantly into our favor, meaning less CFR's. That's probably what'll change when the numbers come out next year, exponentially, and everyone will be like, WOW, that whole SARsCov-2 thing was overblown (JMHO). Lol. This will probably be a little worse than the 1918 Spanish Flu Pandemic, but even then, during that whole time frame the whole thing was hyped up and overblown. I've resigned myself that I've had a fruitful life and eventually we can't defeat age and gravity. May as well help everyone we can, and contribute to the betterment of society, right? Came to that conclusion last weekend when I participated in the treatment of a patient who was on one of the notorious "Princess Cruise Lines." It's here, we just gotta deal with it rationally. (I'm symptom free BTW).
Mustang Man
03-04-2020, 21:38
Here’s a question for all you mathematicians on here.
According to the CDC/WHO how many people get influenza (of some known type) worldwide?
According to the CDC/WHO how many people die from influenza worldwide?
According to the CDC/WHO how many people worldwide see a doctor, go to a healthcare professional and get tested for influenza, and how many of those tests are reported to the CDC/WHO?
How many more people self medicate with OTC drugs or home remedies, actually have the flu and get better in under five days and infect their workplace, classmates and communities on a daily, weekly, monthly basis without anyone actually reporting their illness to the CDC/WHO?
Just asking for a friend.
P.S. I’m trying to imagine how many more people were either infected with COVID-19 or just exposed from the few carriers (hosts) that have returned from a source of this virus? What was the method of community transmission in the Life Care Center? Was it one to one or a single group function? I hope they are getting those questions asked and answered.
I can somewhat answer some of what you're asking. From a number of sources I've gathered 40% - 70% of global population will get this virus. The WHO just announced the mortality rate of COVID-19 being 3.4%, the seasonal flu in the U.S. is 0.1%. Let's round the mortality rate to 4% on account of China's shady numbers and let's be conservative and say 40% of the world gets this virus. If the infection rates continue we're looking at about 120 million dead world wide.
40-70 percent infection
https://thehill.com/changing-america/well-being/prevention-cures/482794-officials-say-the-cdc-is-preparing-for
3.4 percent mortality rate
https://www.sciencealert.com/covid-19-s-death-rate-is-higher-than-thought-but-it-should-drop
Seasonal flu mortality rate in the U.S.
https://www.livescience.com/new-coronavirus-compare-with-flu.html
I can somewhat answer some of what you're asking. From a number of sources I've gathered 40% - 70% of global population will get this virus. The WHO just announced the mortality rate of COVID-19 being 3.4%, the seasonal flu in the U.S. is 0.1%. Let's round the mortality rate to 4% on account of China's shady numbers and let's be conservative and say 40% of the world gets this virus. If the infection rates continue we're looking at about 120 million dead world wide.
40-70 percent infection
https://thehill.com/changing-america/well-being/prevention-cures/482794-officials-say-the-cdc-is-preparing-for
3.4 percent mortality rate
https://www.sciencealert.com/covid-19-s-death-rate-is-higher-than-thought-but-it-should-drop
Seasonal flu mortality rate in the U.S.
https://www.livescience.com/new-coronavirus-compare-with-flu.html
Random points:
Lipsitch walked back the 40-70% number, now says 40% max. He's tweeted the new numbers but no one seems interested in publishing a retraction, it ruins the “Trump/Pence are idiots, listen to the scientists” narrative.
Korean CFR is more like 0.6%, or six times worse than seasonal flu, and nowhere like 3.4%. Korea has gold-standard testing and a first world medical system. They have drive-through free testing with results texted to cellphones in 10 minutes. Their CFR denominator is considered reliable.
The WHO number of 3.4% CFR will likely be correct, possibly low, in places like Iran, India, and Africa. I’d expect a CFR OF <=1% in the US, or ten times worse than seasonal flu.
A 40% attack rate with 1% CFR will overwhelm the US healthcare system. No country can afford excess ICU beds and staff for “surge capacity” and Democrat statements otherwise are pure politics. That said, having 1% stockpile of necessary PPE for a moderate pandemic is governmental malpractice.
Nursing home death rates should not be extrapolated to the general population. It can be 20% with seasonal flu.
It’s going to be bad, but not Spanish flu bad, at least from what we’re seeing now.
My daughter reports today that she still has to get testing approval from the director of infectious disease and they’re still being stingy.
She now has two ER doctor friends at home very ill with respiratory disease and negative flu titers. Neither tested for covid.
So much for my theory that they’d take good care of medical staff.
Looks like we'll have a collapsing medical system in another few weeks.
Here's an interesting take...
https://twitter.com/clarewenham/status/1235546249681657857
Old Dog New Trick
03-05-2020, 10:11
You guys aren’t answering my questions, just regurgitating what’s recently being said. Said mostly by the “experts - speculating without facts” which is nothing more than a “Wild Ass Guess” which is what they are doing with COVID-19, making WAGs and assumptions based on different circumstances worldwide. You see, we really don’t know what happened in China (again speculation and assumptions based on hearsay and misinformation) and the Diamond Princess was a disaster! But even from that “Petri dish” only a small handful of people have died. Many not receiving more than symptomatic care, common remedies and recovering with rest.
Here, I’ll help you out with the influenza questions (these aren’t exact numbers but wildly known facts about influenza.) It is suspected that between 40 to 50 million ‘Americans’ get the flu every year and of that 16 to 34 thousand die from it every year in ‘America.’ And that’s just what’s reported for statistics. What if half the American population (170 million people) actually gets infected with the flu but self medicate and don’t report their illness to any ‘record keeper?’ Your 0.1% mortality rate gets skewed, doesn’t it? Almost enough so that we can continue to freak out over motor vehicle and gun deaths each year, but I digress. What is the world population percentage of influenza morbidity v. mortality and are certain places more likely to have a higher mortality rate than others? My guess is yes, we just don’t follow it unless it’s something new, like SARS, MERS, or something with a catchy name - Novel Coronavirus. Right now there is a worldwide issue with Dengue Fever but you wouldn’t know it from the news. Thankfully most people recover from it. Remember Zika?
Remember, some, if not all sources are biased of their own medical opinion or political bias (depends on which sideline you stand and what financial backers you receive support from - don’t cut the hand that feeds you. Or, “Don’t pick a fight with the President.”) It’s far too early to tell what kind of global death rate will be attributable to COVID-19 based on the known and unknown numbers of suspected cases of infected people. Right now the experts are guessing for whatever reasons they have (self aggrandizement or political ideology.) Most have caused panic and fear than calm and rational responses so far. I suspect that >~<50% of the elderly hospice patients in Washington will die from this but we will learn much from their sacrifice.
I'm convinced that part of the "Trump sucks" narrative--harping on him for 'failed' covid response--is a desperate attempt at distraction by the scientific community.
The "only trust the scientists" narrative is ridiculous. Those ivory tower researchers are hip-deep complicit in the release of this virus.
There are many more, and I assume even nastier, biologic agents just one slip away from release. The H5N1 virus, modified to add the last two minor mutations needed for full pandemic potential, could wipe out 20%-30% of the world population.
This 'pathogen enhancement' research has to stop. Immediately.
I'm convinced that part of the "Trump sucks"narrative --harping on him for 'failed' covid response--is a desperate attempt at distraction by the scientific community.
The "only trust the scientists" narrative is ridiculous. Those ivory tower researchers are hip-deep complicit in the release of this virus.
Well,, it is not getting better.
A county-level swamp critter in Washington State publically told everybody to stay home.
Washington county recommends all 2.2M residents to work from home, tells over 60's to stay indoors
https://www.foxnews.com/us/washington-king-county-coronavirus-residents-work-from-home
What's Up Next??:
Costco, McDonald's, KFC and other food sources close for the protection of their values employees.
NYC and LA permanently close US Customs warehouses pending complete incineration of all Fur'n Food in bio-isolation containment efforts.
How to start worldwide panic without really trying.
:mad::mad::mad:
You guys aren’t answering my questions, just regurgitating what’s recently being said. Said mostly by the “experts - speculating without facts” which is nothing more than a “Wild Ass Guess” which is what they are doing with COVID-19, making WAGs and assumptions based on different circumstances worldwide. You see, we really don’t know what happened in China (again speculation and assumptions based on hearsay and misinformation) and the Diamond Princess was a disaster! But even from that “Petri dish” only a small handful of people have died. Many not receiving more than symptomatic care, common remedies and recovering with rest.
Here, I’ll help you out with the influenza questions (these aren’t exact numbers but wildly known facts about influenza.) It is suspected that between 40 to 50 million ‘Americans’ get the flu every year and of that 16 to 34 thousand die from it every year in ‘America.’ And that’s just what’s reported for statistics. What if half the American population (170 million people) actually gets infected with the flu but self medicate and don’t report their illness to any ‘record keeper?’ Your 0.1% mortality rate gets skewed, doesn’t it? Almost enough so that we can continue to freak out over motor vehicle and gun deaths each year, but I digress. What is the world population percentage of influenza morbidity v. mortality and are certain places more likely to have a higher mortality rate than others? My guess is yes, we just don’t follow it unless it’s something new, like SARS, MERS, or something with a catchy name - Novel Coronavirus. Right now there is a worldwide issue with Dengue Fever but you wouldn’t know it from the news. Thankfully most people recover from it. Remember Zika?
Remember, some, if not all sources are biased of their own medical opinion or political bias (depends on which sideline you stand and what financial backers you receive support from - don’t cut the hand that feeds you. Or, “Don’t pick a fight with the President.”) It’s far too early to tell what kind of global death rate will be attributable to COVID-19 based on the known and unknown numbers of suspected cases of infected people. Right now the experts are guessing for whatever reasons they have (self aggrandizement or political ideology.) Most have caused panic and fear than calm and rational responses so far. I suspect that >~<50% of the elderly hospice patients in Washington will die from this but we will learn much from their sacrifice.
I agree this isn't going to be the end of the world but it is going to be very significant. I think it's wrong to dismiss the entire scientific community as partisan hacks, because that's what you've done above. Many are on the front lines, like my daughter, and they're desperately trying to plan for this. It's glib to imply these people don't care about their patients and communities and are presenting estimates based upon their political biases.
Every time I see someone equate covid to seasonal flu, I ask myself "Why did the Chinese crash their economy?" Because they DID crash it with potentially fatal consequences for the CCP regime. Why would they risk their Silk Road initiative, their South Seas power grab, and their 2025 tech dominance goals? Because they've risked all of those with their aggressive containment strategy and the subsequent massive hit on businesses, many which aren't expected to survive.
Riddle me this: Someone with seasonal flu gets on a cruise ship in Hong Kong. How many infections would you expect to be produced from that one patient? The answer is six. Over 700 on that ship came down with covid.
How many deaths would you expect if it was the flu? Zero. There are six covid deaths to date and over 20 remain in serious/critical condition, many on ventilator support. Most, as you say, just had the sniffles.
In seasonal flu, 19% are asymptomatic and are considered non-infectious. With covid that percentage is assumed much higher (still unknown, but I hope it's true) and they are infectious. Some are highly infectious--the so-called super spreaders.
In the 2017-2018 flu season (worst in the last 10 years that we have stats for, this year was baaaad but no data tabulated yet) there were 45M infections (estimated, not confirmed), 810K hospitalizations, and 61k deaths.
While total cases of Covid including asymptomatic/mild may be a WAG, hospitalization numbers are not. Current NEJM and Lancet studies cite 15%-20% of hospitalized covid cases going serious/critical and requiring respiratory support and 90% of those dying. So in equal numbers of hospitalized covid patients (810k x 15% x 90%) that's 109k projected deaths.
Assuming the same 45M covid patients as 2017-18 seasonal flu, and 20% need hospitalization (currently a WAG but based upon optimistic Chinese stats) and 20% of those need ventilator support (not a WAG) that's 1.8M patients needing an ICU bed and if 90% mortality (not a WAG) that's 1.6M deaths.
So, 61K flu deaths vs 1.6M covid deaths in the same 45M patients. The WAG in that number is the number of expected hospitalizations. We're still awaiting the disease to peak in Korea before we can get an accurate number.
I don't know for sure, but this feels like a middlin' pandemic in the 1st world, about 10x worse than seasonal flu. I hope I'm wrong because that will crash our health system.
Old Dog New Trick
03-05-2020, 11:56
I’m not taking this “lightly” and respect those in the medical field tasked with identifying and treating this, but I’m not jumping overboard because a communist regime unleashed a virus on the world. This is the 21st century not the 19th or early 20th centuries. (Those still living there may find this more difficult to control.)
The best thing some of these modern medical cities could do is identify and use one treatment facility per 100,000 or use an existing structure to isolate and treat the disease without continuing to infect places and people that haven’t yet been exposed.
I’m not seeing that. I didn’t see that in Washington. They now have hospitals throughout King County that have all been exposed to one patient or a carrier. Not good management.
Again, I’m not busting your chops over this and I’m not trying to correlate a connection between influenza and COVID-19. Only that one we are not afraid of because we know much about it and the other is causing mass hysteria and panic.
This article discusses by using scientific process instead of media hyperbole.
COVID-19 isn't as deadly as we think (https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html)
My daughter reports today that she still has to get testing approval from the director of infectious disease and they’re still being stingy.*
I'm not so sure they're being stingy. I think it's because we just don't have the capability to do widespread testing yet. Last weekend our hospital didn't have the capacity to do testing and CDC guidelines were way too narrow. All that is beginning to change. Currently 67 Public Health labs in 45 states now have verified testing of SARsCov-2/COVID19. This is a huge improvement from just 8 weeks ago. Good news is, Quest Diagnostics now offering tests on demand for hospitals and clinics in its labs across the country. Buy stock in Quest. Lol
https://newsroom.questdiagnostics.com/2020-03-05-Quest-Diagnostics-to-Launch-Coronavirus-Disease-2019-COVID-19-Test
Edited to add:
More good news. As of 6pm today, LabCorp has the capacity to test for SARsCov-2/COVID19.
https://ir.labcorp.com/news-releases/news-release-details/labcorp-launches-test-coronavirus-disease-2019-covid-19
Old Dog New Trick
03-05-2020, 14:23
This article discusses by using scientific process instead of media hyperbole.
COVID-19 isn't as deadly as we think (https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html)
Good overall analysis and I agree with the findings from the “known” Petrie dish that was the Diamond Princess cruise ship.
Rumsfeld quip: things we know, things we don’t know, and things we don’t know we don’t know. (I think Chinese data is something we don’t know and know not to believe it.)
InTheBlack
03-05-2020, 14:31
This article discusses by using scientific process instead of media hyperbole.
COVID-19 isn't as deadly as we think (https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html)
>
This is where the Diamond Princess data provides important insight. Of the 3,711 people on board, at least 705 have tested positive for the virus (which, considering the confines, conditions, and how contagious this virus appears to be, is surprisingly low).
>
Vs Mugwump saying seasonal flu should have produced 6. OTOH if they were confined as on that ship, maybe more ?
It was not an internal quarantine -- what are the details? Did people stay in their rooms & get served meals? & what about linen service? Were the crew the only transmission source? Was the "guest service" crew isolated from the other crew?
Why does this article assert that 705 is low?
***
I want to separate the "quantitative" aspect from the "qualitative" for COVID-19. How much more infectious is it than seasonal flu - the end result being more cases that enter the health care system at the lowest level? Is "infectious" simply the R0? What is the seasonal flu R0 range for past years?
>
In the 2017-2018 flu season (worst in the last 10 years that we have stats for, this year was baaaad but no data tabulated yet) there were 45M infections (estimated, not confirmed), 810K hospitalizations, and 61k deaths.
While total cases of Covid including asymptomatic/mild may be a WAG, hospitalization numbers are not. Current NEJM and Lancet studies cite 15%-20% of hospitalized covid cases going serious/critical and requiring respiratory support and 90% of those dying.
So in equal numbers of hospitalized covid patients (810k x 15% x 90%) that's 109k projected deaths.
Assuming the same 45M covid patients as 2017-18 seasonal flu, and
20% need hospitalization (currently a WAG but based upon optimistic Chinese stats) and
20% of those need ventilator support (not a WAG)
that's 1.8M patients needing an ICU bed and
if 90% mortality (not a WAG)
that's 1.6M deaths.
So, 61K flu deaths vs 1.6M covid deaths in the same 45M patients.
The WAG in that number is the number of expected hospitalizations.
>
Ro for seasonal flu is slightly over 1. Meaning 1 flu case produces slightly more than q additional case. Covid Ro estimates are all over the map. If you’re using shrine lickers in Iran, it can be 20. In Korea its still estimated to be 2.2, numbers double about every 3.4 days, which is actually not happening, they’re doubling faster.
I’d say Korea is the lab, not that cruise ship. The ship's demographics are too skewed and the situation too artificial. I don’t understand that Slate article. Seasonal flu is rampant in winter when folks are cruising. How many times have you heard of 700 people coming down with the flu on a single ship? I have a friend who cruises continuously post retirement, a 30 day jaunt across the pacific is nothing to him. He’s never heard of more that 2-3 people being treated for the flu. Anecdotal, but smells right.
Folks were terrified of Covid on the Princess and were isolating themselves in their rooms. Food was delivered. Fewer cases should’ve occurred, 700 is a lot. Food borne (fecal) is speculated as well as airborne via some vent shafts.
Korea are testing like mad and finding scads of subclinical cases. Interestingly many have pneumonia on CAT scan but no cough or SOB. Their CFR just edged up from 0.6 to 0.7. Note their med system is overwhelmed now with 2300 waiting for a hospital room or ICU bed.
Fauci is going with <=1 CFR in the US based on Korea. It’d be higher if he was basing estimates on Italy IMO but I guess we’ll see.
Italy looks different from Korea with less testing (but proportionately more than us) and higher deaths and reports of younger ICU patients without underlying disease.
Interesting case descriptions below for the medics.
36231
Chinese trolls are flooding Taiwanese social media giving incorrect advice on handling the outbreak and sowing social discord. At home in Hubei province, Wuhan ants welded into their anthills shout abuse down on the vice prime minister. There are 760 million still under varying degrees of lockdown.
The CCP has to be worried about losing control and the possibility of a Hong Kong-style general strike and uprising. When we’re well and truly in the teeth of this infection here in the US, I’d watch out for Chinese adventurism. Nothing unites the base like a good war. If it’s fast, and they’re all fast at first.
There are Several vids in the linked twitter thread. Tap a vid for audio.
Today vice prime minister Sun Chunlan #孙春兰 visited Wuhan Qingshan Kaiyuan residential community. It’s meant to be a PR show. Residents were not allowed to come out, but things went out of control. They started shouting, “Fake! Everything is fake!” #假的 #全都是假的
https://twitter.com/yaxuecao/status/1235581128582598664?s=21
Drugs in shortage/absent
https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm
Minneapolis-Madison-Milwaukee hospitals have balanced PPE among themselves but all have 5-10 day supply with no incoming inventory. They’re planning on using ineffective measures (Surgical masks instead of N95) for frontline staff.
They’re buggered.
2250/147 is 15 patients per bed.
365 days in a year divided by 15 patients...
if the cases are evenly spread out over a year, each patient can stay for 24 days. Over 6 months, 12 days.
Did I do that right? Knowing the algebraic equation will allow solving for any input data.
EDIT: did not account for beds being used by "normal" patients. So what is the excess or surge capacity? Will they delay transplant surgery to open an ICU bed for the possibility of a flu patient? What is the triage system for that?
What is the average number of icu beds per capita or 100,000 in urban areas in the USA?
No.
147 icu beds x 15 days per covid stay (which is a WAG but seems reasonable-low) is a capacity of 2,205 icu days.
2,250 projected icu patients x 15 days = 33,750 projected icu days
So, 2205 days capacity vs 33,750 need.
Excess patients beyond capacity die, but 90% in China died at that point anyway.
but I’m not jumping overboard because a communist regime unleashed a virus on the world.
Source or speculation? I'm not seeing any reliable reporting on this. Bonus if you have high side to discuss.
Key areas to watch are Milan & Lombardy, Italy. They're not a third world country. 10% of their Doctors & Health Care workers are infected and under quarantine. That's huge, and could be detrimental to our Health Care system if a scenario like that happened here. If infection rates exceed 15% of frontline health care workers, staff will eventually be depleted. The cruise ship "Grand Princess," is now quarantined off the coast of the "Peoples Republic of Kalifornia." One of my patients was on that cruise. If the patient turns up positive, no telling how many people have been affected. One lady who was on that cruise tested positive in Canada. The CDC are tracking down all patients who have had respiratory symptoms from the "Grand Princess" starting from February 11, after a patient died, and several cases turned positive.
https://apnews.com/837274f1bab9af1aab12f1b9481b2d62?fbclid=IwAR3ahd5t irWMmaJ0KfsKJ4nd6AgerqamdNe3TbXseOzP_AH010uU2-4Sws8
https://calgaryherald.com/news/local-news/alberta-reports-first-presumptive-coronavirus-case-as-province-ramps-up-testing
Edited to add:
https://www.mercurynews.com/2020/03/05/timeline-coronavirus-concerns-aboard-the-grand-princess/
https://mobile.twitter.com/BNODesk/status/1235745673582129153?s=20
https://twitter.com/DrMCecconi/status/1235652849759137798
InTheBlack
03-06-2020, 09:46
I would bet cruise ships stock lots of Tamiflu and hand it out like breath mints to anyone the crew notices with symptoms.
This clinical trial says that surgical masks are just as good as N95 for health workers for seasonal flu / colds : - about 8% got sick for both groups:
https://jamanetwork.com/journals/jama/articlepdf/2749214/jama_radonovich_2019_oi_190087.pdf
N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel A Randomized Clinical Trial
Lewis J. Radonovich Jr, MD;
IMPORTANCE Clinical studies have been inconclusive about the effectiveness of N95
respirators and medical masks in preventing health care personnel (HCP) from acquiring
workplace viral respiratory infections.
OBJECTIVE To compare the effect of N95 respirators vs medical masks for prevention of
influenza and other viral respiratory infections among HCP.
DESIGN, SETTING, AND PARTICIPANTS A cluster randomized pragmatic effectiveness study
conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and
May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period
of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were
matched and randomly assigned to the N95 respirator or medical mask groups.
INTERVENTIONS Overall, 1993 participants in 189 clusterswere randomly assigned towear N95
respirators (2512 HCP-seasons of observation) and 2058 in 191 clusterswere randomly assigned
towear medical masks (2668 HCP-seasons) when near patients with respiratory illness.
MAIN OUTCOMES AND MEASURES The primary outcomewas the incidence of
laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory
illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness,
and influenzalike illness. Adherence to interventions was assessed.
RESULTS
Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369
[82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons.
There were 207 laboratory-confirmed influenza infection events (8.2%of HCP-seasons) in the N95
respirator group and 193 (7.2%of HCP-seasons) in the medical mask group (difference, 1.0%,
[95%CI, −0.5%to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95%CI, 0.95-1.45]).
There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group
(difference, −21.9 per 1000 HCP-seasons [95%CI, −48.2 to 4.4]; P = .10); 679
laboratory-detected respiratory infections in the respirator group vs 745 in the mask group
(difference, −8.9 per 1000 HCP-seasons, [95%CI, −33.3 to 15.4]; P = .47); 371
laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask
group (difference, −8.6 per 1000 HCP-seasons [95%CI, −28.2 to 10.9]; P = .39); and 128
influenzalike illness events in the respirator group vs 166 in the mask group (difference, −11.3
per 1000 HCP-seasons [95%CI, −23.8 to 1.3]; P = .08).
In the respirator group, 89.4%of participants reported “always” or “sometimes” wearing their assigned devices vs 90.2%in the mask group.
CONCLUSIONS AND RELEVANCE
Among outpatient health care personnel, N95 respirators vs
medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01249625
JAMA. 2019;322(9):824-833. doi:10.1001/jama.2019.11645
This disease is very infectious. I would posit that in one year, almost everyone will test positive. People with healthy immune systems, children, and people under the age of 70, will be asymptomatic and/or most likely recover without incident. People with pre-existing chronic conditions and the elderly will more likely die. Current cases are not consistently and reliably reported. As the sample size of verified cases increases, the fatality rates will be smaller if current death profiles remain the same.
All of this is assuming that a vaccine is not found. Polio was deadly once too.
Wash your hands, don’t hoard, and take care of the elderly.
This is just MHO. Your mileage may vary.
Old Dog New Trick
03-06-2020, 16:19
Source or speculation? I'm not seeing any reliable reporting on this. Bonus if you have high side to discuss.
Speculation, but assumptions based on known history. If 100,000 Chinese peasants died in a flood and no one was there to report it you wouldn’t know.
“If a tree falls in the woods and no one is around to hear it does it make a sound?”
This disease is very infectious. I would posit that in one year, almost everyone will test positive. People with healthy immune systems, children, and people under the age of 70, will be asymptomatic and/or most likely recover without incident. People with pre-existing chronic conditions and the elderly will more likely die. Current cases are not consistently and reliably reported. As the sample size of verified cases increases, the fatality rates will be smaller if current death profiles remain the same.
All of this is assuming that a vaccine is not found. Polio was deadly once too.
Wash your hands, don’t hoard, and take care of the elderly.
This is just MHO. Your mileage may vary.
40% of US males and females are obese vs 5% in China. Obesity is a comorbidity considered on par with heart disease, which many of the obese also have...plus type 2 diabetes.
Don’t assume what you saw in Wuhan will carry over to the US population.
Overweight males of ages down to 30 are dying in Italy. Women, not so much.
twistedsquid
03-06-2020, 19:20
Heard this from an 82 year old client today..." All the bad stuff comes from China." I couldn't respond.
40% of US males and females are obese vs 5% in China. Obesity is a comorbidity considered on par with heart disease, which many of the obese also have...plus type 2 diabetes.
Don’t assume what you saw in Wuhan will carry over to the US population.
Overweight males of ages down to 30 are dying in Italy. Women, not so much.
I am assuming nothing based on China. I consider obesity a pre-existing chronic condition. I am pointing out that the reliable sample is still small. Time will tell.
InTheBlack
03-06-2020, 20:13
Why no plan to use our hospital ships to isolate cases?
InTheBlack
03-06-2020, 20:22
Is the South Korea's capacity to do what they are doing due to being ready to respond to biowarfare unleashed by North Korea? Are they revealing a previously secret capability?
40% of US males and females are obese vs 5% in China. Obesity is a comorbidity considered on par with heart disease, which many of the obese also have...plus type 2 diabetes.
Don’t assume what you saw in Wuhan will carry over to the US population.
Overweight males of ages down to 30 are dying in Italy. Women, not so much.
What about smokers? Chinese males smoke way more than Americans. And this is a respiratory problem.
InTheBlack
03-06-2020, 23:05
I need information on oxygen concentrators. Useful in preventing a breathing difficulty from progressing? ARDS patients seem to need ventilators pretty quickly, which is a completely different technology. OTOH might it buy a couple days until maybe the patient will be admitted to a hospital?
Is "bush medicine" but safe usage to turn it up until the pulse oximeter says 95%? What max liters/min capacity might be needed? If things are bad a few months from now, there will probably be a way to get medical advice remotely and use it more effectively.
A good one is a big ticket item; less so with lower liters/min at 90%. But probably not too hard to sell if not needed after a year.
InTheBlack
03-07-2020, 00:06
https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463
Accepted manuscript
On the origin and continuing evolution of SARS-CoV-2
Xiaolu Tang, Changcheng Wu, Xiang Li, Yuhe Song, Xinmin Yao, Xinkai Wu, Yuange Duan, Hong Zhang, Yirong Wang, Zhaohui Qian ... Show more
Author Notes
National Science Review, nwaa036, https://doi.org/10.1093/nsr/nwaa036
Published: 03 March 2020
ABSTRACT
The SARS-CoV-2 epidemic started in late December 2019 in Wuhan, China, and has since impacted a large portion of China and raised major global concern. Herein, we investigated the extent of molecular divergence between SARS-CoV-2 and other related coronaviruses. Although we found only 4% variability in genomic nucleotides between SARS-CoV-2 and a bat SARS-related coronavirus (SARSr-CoV; RaTG13), the difference at neutral sites was 17%, suggesting the divergence between the two viruses is much larger than previously estimated.
Our results suggest that the development of new variations in functional sites in the receptor-binding domain (RBD) of the spike seen in SARS-CoV-2 and viruses from pangolin SARSr-CoVs are likely caused by mutations and natural selection besides recombination.
Population genetic analyses of 103 SARS-CoV-2 genomes indicated that these viruses evolved into two major types (designated L and S), that are well defined by two different SNPs that show nearly complete linkage across the viral strains sequenced to date.
Although the L type (∼70%) is more prevalent than the S type (∼30%), the S type was found to be the ancestral version.
Whereas the L type was more prevalent in the early stages of the outbreak in Wuhan, the frequency of the L type decreased after early January 2020.
Human intervention may have placed more severe selective pressure on the L type, which might be more aggressive and spread more quickly.
On the other hand, the S type, which is evolutionarily older and less aggressive, might have increased in relative frequency due to relatively weaker selective pressure.
These findings strongly support an urgent need for further immediate, comprehensive studies that combine genomic data, epidemiological data, and chart records of the clinical symptoms of patients with coronavirus disease 2019 (COVID-19).
I'm not so sure simple oxygen delivery devices (masks/nasal cannula's, etc.) will be sufficient. The following is a letter circulating among the European Society of Intensive Care Medicine*.
".....Milan, 4 March 2020
*
*
Dear friends,
*
At this moment in time, we believe it is important to share our first impressions and what we have learned in the first ten days of the COVID-19 outbreak.
*
We have seen a very high number of ICU admissions, almost entirely due to severe hypoxic respiratory failure requiring mechanical ventilation.
*
The surge can be important during an outbreak and cluster containment*has to be in place*to slow down virus transmission.
*
We are seeing a high percentage of positive cases being admitted to our Intensive Care Units, in the range of*10% of all positive patients.
*
We wish to convey a strong message: Get ready!
*
We also want to share with you some key points from our experience:
*
Get ready now - with your ICU’s networks - to define your*contingency plan*in the event of an outbreak in your community
Don’t work “in silo”. Coordinate with your hospital management and other healthcare professionals to prepare your response
Make sure your hospital management and procurement office have a*protocol*in place about*which personal protection equipment (PPE) to stock and re-stock
Make sure your staff is trained in*donning and doffing procedures
Use*education, training and simulation*as much as possible
Identify early hospitals*that can manage the initial surge in a safe way
Increase your total ICU capacity
Get ready to*prepare ICU areas*where to cohort COVID-19 + patients -*in every hospital if necessary
Put in place a*triage protocol*to identify suspected cases, test them and direct them to the right cohort
Make sure you*set clear goals*for care with the patients and their families early on
*
*
With our best regards
*
Prof. Maurizio Cecconi********** Prof. Antonio Pesenti************ Prof. Giacomo Grasselli
President elect, ESICM********** University of Milan*************** University of Milan
Humanitas University, Milan........"
*** * ** * * * * * * * * * * * * * * * * *
*
https://mailchi.mp/esicm/the-future-of-haemodynamic-monitoring-first-webinar-of-the-year-1009715
InTheBlack
03-07-2020, 00:48
>
We have seen a very high number of ICU admissions, almost entirely due to severe hypoxic respiratory failure requiring mechanical ventilation.
>
Have these patients been struggling to breath for days & exhausted themselves, prior to going to the hospital? If so, a home oxygen unit sounds useful. Or were they in less-intensive care & on oxygen?
InTheBlack
03-07-2020, 00:50
Wonder if Kirkland was negligent under-response, or not?
https://kuow.org/stories/the-days-leading-up-to-the-outbreak-at-life-care-center-in-kirkland
SNIPPED MOST OF STORY - READ IT
In January, firefighters responded seven times to the Life Care facility. In February, and the first five days of March, they responded 33 times.
Firefighters are now grappling with the idea that coronavirus may have already been circulating at Life Care for weeks and that they, and Life Care workers, residents and visitors, had not been warned to take precautions, And that they may have inadvertently helped spread the virus farther.
In the days leading up to last Friday, Life Care staff and first responders were using nebulizers and CPAP machines to treat patients. “We essentially aerosolized it,” one first responder said, because before last Friday, that was standard protocol to treat patients.
“We made it worse,” he said.
I can't seem to find the study from the PrePrint or the New England Journal of Medicine but I'll look for it (case studies with CT/CXR results). IIRC, the take away points were that patients were clocking along just fine until week 2-3 and that was when they fell off the curve hard and fast (The 10% the European Society of Intensive Care Medicine were speaking of?). Full blown ARDS in a matter of hours. If that's the case, O2 would only buy a little time prior to intubation, and of those intubated, they didn't fair so well.
If Emergency Services responded 7 times in January, spread the virus to others and the virus has a three week cook time until you fall off the cliff time ...........
There should be people dropping in the streets by now.......
But there ain't.
Why no plan to use our hospital ships to isolate cases?
Who says there is no plans? Got a quote? source?
There are two US Navy dedicated hospital ships, the USNS Mercy (T-AH-19). and the USNS Comfort (T-AH-20). Normally, the ships are kept in a reduced operating status in Norfolk, VA, and San Diego, CA, by a small crew of civil service mariners and active-duty Navy medical and support personnel. Each ship can be fully activated and crewed within five days.
Here is an article on the Ebola outbreak of 2014. Hospital ships are not a front line tool for infectious diseases. That does not mean they are not in the plan..
There is one other flaw of a hospital ship: it cannot be protected from the infectious disease it has been deployed to fight. And if there is one thing that ship captains fear, it's an outbreak. Military ships are cramped for space and residents share bathrooms and other facilities. Even though the Ebola virus is not airborne, having the infected on board is a massive risk.
https://www.huffpost.com/entry/navy-hospital-ships-ebola_n_5998968
As of this story the death rate in South Korea is around .625%
"SEOUL (AFP, THE KOREA HERALD/ASIA NEWS NETWORK) - Two South Korean apartment buildings heavily occupied by members of a sect linked to most of the country's coronavirus cases have been quarantined after dozens of residents tested positive for the disease, an official said on Saturday (March 7).
The move comes as the country, which has the highest number of confirmed Covid-19 cases in the world outside China, reported 448 new infections, taking its total to 7,041.
Another two deaths were reported by the Korea Centres for Disease Control and Prevention, bringing the toll to 44......"
https://www.straitstimes.com/asia/east-asia/two-apartment-buildings-in-south-korea-quarantined-over-coronavirus
As of this story the death rate in South Korea is around .625%
"SEOUL (AFP, THE KOREA HERALD/ASIA NEWS NETWORK) - Two South Korean apartment buildings heavily occupied by members of a sect linked to most of the country's coronavirus cases have been quarantined after dozens of residents tested positive for the disease, an official said on Saturday (March 7).
The move comes as the country, which has the highest number of confirmed Covid-19 cases in the world outside China, reported 448 new infections, taking its total to 7,041.
The only land bridge between China and South Korea is thru the little fat kid's backyard. NK has to be hurting? :mad:
Could not find the link - it's one of those rolling headline sites.
New numbers coming out for Iran is showing a death rate of 2.5%. Big difference compared to Korea.
If Emergency Services responded 7 times in January, spread the virus to others and the virus has a three week cook time until you fall off the cliff time ...........
There should be people dropping in the streets by now.......
But there ain't.
Saw a good documentary on the Spanish Flu of 1918... Healthy dudes in their 20s were diagnosed at 10am and dead by 4pm... after the first symptoms appeared.
Old Dog New Trick
03-07-2020, 08:34
Not comparing but just found this, I had asked earlier if someone knew.
The figure of infections dwarfs other major outbreaks such as SARS, MERS and Ebola. The virus is still much less widespread than annual flu epidemics, which cause up to 5 million severe cases around the world and 290,000 to 650,000 deaths annually, according to the World Health Organization. (USA Today)
We are a long way from those kinds of numbers and I understand that those are ‘annual’ numbers and we’re only into this a ‘quarter’ already. Time will tell.
Also, a 360,000 spread sounds more of a WAG!
I'm not an alarmist, just a realist. I tweak ventilator knobs for a living, pass out nebulizers for bronchospasms, and manage patient airways during code blues. I'm a Jack of all trades when the shit hits the fan in a hospital, but a master of none. Whatever I've posted in this thread should be taken with a "huge" grain of salt. I'm guilty of reading into things way too much. However, if the high tower IQ talking heads are correct, we're gonna face a shitstorm in the coming months. May as well be prepared, even if they're wrong. Protecting your family, loved ones, and ensuring you're protected won't hurt at all. Below is what a PhD Assoc. Director of Science & Technology, ChemBE posted based on the numbers coming out of Italy (Lombardy/Milan). I'll post what was said below and the link if you're inclined to read it.
https://twitter.com/LizSpecht/status/1236095180459003909?s=20
"I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math."
"Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate."
"We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts."
"We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go."
"As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population."
"What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted."
Saw a good documentary on the Spanish Flu of 1918... Healthy dudes in their 20s were diagnosed at 10am and dead by 4pm... after the first symptoms appeared.
It was a few years back and I don't remember the details but it was an article on how hard it was to find a sample of the Spanish Flu. Something about a National Guard(?) unit stationed in the middle of nowhere above the arctic circle and a number of troops who died from the flue where buried in a small cemetery.
The article was focused on if it would be ethical to dig them up to study the flue.
"The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc)."
"Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients)."
"By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.)"
"If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd."
"If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption."
"As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now."
"Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing)."
"There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.)"
"As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day."
"One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused."
"How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas... again, predominantly from China."
"Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor."
"Now consider how these 2 factors – bed and mask shortages – compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix."
"HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above."
"We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going."
"Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naďve population works."
"Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease."
"I’m an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan."
"Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong."
"But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”."
"These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system."
"And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared?"
"Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out."
"One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year."
"Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population."
"
Hopefully they're wrong :D
But if not, best be prepared. Lol.
Edited to add:
It's a moving target and the true numbers won't come out till next year, but the trend hasn't really changed too much.
3526 Deaths ÷ 104,144 confirmed cases x 100 = CFR.
Unless the reported numbers are wrong (more than likely will be a year from now), we're still looking at a 3.3856967276% mortality rate, roughly 333 times more deadly than the Flu.
https://www.worldometers.info/coronavirus/
InTheBlack
03-07-2020, 10:09
It was a few years back and I don't remember the details but it was an article on how hard it was to find a sample of the Spanish Flu. Something about a National Guard(?) unit stationed in the middle of nowhere above the arctic circle and a number of troops who died from the flue where buried in a small cemetery.
The article was focused on if it would be ethical to dig them up to study the flue.
They did & it was quite a while ago.
InTheBlack
03-07-2020, 10:40
Happy to see the stats on hospital beds, use rate, etc from Liz Specht. Still would like to see her sources though.
Another numbers run:
Seasonal flu so far this season:
https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
34,000,000 – 49,000,000 illnesses
16,000,000 – 23,000,000 medical visits
350,000 – 620,000 medical stays
20,000 – 52,000 deaths
And my browser says "The United States is the third most populous country in the world, with an estimated population of 330,149,796 as of December 16, 2019. "
If COVAN-19 is like seasonal only 10x as deadly (Of course, mostly in the older cohort) then 200,000 to 500,000 deaths. Assuming 80% cases trivial, then maybe not so much load on the overall system for visits & non-fatal hospital stays.
Not sure what to think about infectivity. Less than seasonal or several times? Slower rate is better.
OTOH if 40% get it & the ratio of fatalities is the same as seasonal, then
330M x 40% = cases x (pick % fatal)
say .001 fatal, just like seasonal flu.
then 132,000 fatalities.
But very overloaded system due to admissions.
Which will increase the fatalities by some % (or multiplier) due to lack of medical care.
EDIT:
"As of this story the death rate in South Korea is around .625%"
Say that this is culling the weakest first & true rate is half that:
So 0.003125 x 40% x 330M = 412,500.
Old Dog New Trick
03-07-2020, 10:54
China is just having a tough go on this. Must be bad karma for all that intellectual property theft over the years.
Hotel converted to Coronavirus quarantine collapsed.
https://apple.news/AiysF4Ri-Rp6sj7sMw8NKGA
InTheBlack
03-07-2020, 11:16
Fascinating article:
https://bedford.io/blog/ncov-cryptic-transmission
Cryptic transmission of novel coronavirus revealed by genomic epidemiology
2 Mar 2020 by Trevor Bedford
...
Knowing that transmission was initiated on Jan 15 allows us to estimate the total number of infections that exist in this cluster today. Our preliminary analysis puts this at 570 with an 90% uncertainty interval of between 80 and 1500 infections.
...
We know that Wuhan went from an index case in ~Nov-Dec 2019 to several thousand cases by mid-Jan 2020, thus going from initial seeding event to widespread local transmission in the span of ~9-10 weeks. We now believe that the Seattle area seeding event was ~Jan 15 and we're now ~7 weeks later.
I expect Seattle now to look like Wuhan around ~1 Jan, when they were reporting the first clusters of patients with unexplained viral pneumonia.
We are currently estimating ~600 infections in Seattle, this matches my phylodynamic estimate of the number of infections in Wuhan on Jan 1. Three weeks later, Wuhan had thousands of infections and was put on large-scale lock-down.
However, these large-scale non-pharmaceutical interventions to create social distancing had a huge impact on the resulting epidemic. China averted many millions of infections through these intervention measures and cases there have declined substantially.
You can follow updates that "Trevor Bedford" posts in the link below. He's from Seattle Washington and a no knee jerk reactionary. He's with these folks:
https://bedford.io/team/
And they have done some awesome research genetically mapping SARSCov-2, and he usually posts their teams findings on his Twitter page, although I don't twit, nor have a twit page. He's a scientist, and "hopefully" unbiased:
https://mobile.twitter.com/trvrb . Read his page regularly.
InTheBlack
03-07-2020, 13:52
https://www.medrxiv.org/content/10.1101/2020.03.01.20029819v2
Posted March 05, 2020.
COVID-19 Epidemic Outside China: 34 Founders and Exponential Growth
Yi Li, Meng Liang, Xianhong Yin, Xiaoyu Liu, Meng Hao, Zixin Hu, Yi Wang, Li Jin
doi: https://doi.org/10.1101/2020.03.01.20029819
This article is a preprint and has not been peer-reviewed
Abstract
Background: In December 2019, pneumonia infected with a novel coronavirus burst in Wuhan, China. Now the situation is almost controlled in China but is worse outside China. We aimed to build a mathematical model to capture the global trend of epidemics outside China.
Methods: In this retrospective, outside-China diagnosis number reported from Jan 21 to Feb 28, 2020 was downloaded from WHO website. We develop a simple regression model on these numbers: log10 (Nt+34)=0.0515*t+2.075 where Nt is the total diagnosed patient till the ith day, t=1 at Feb 1.
Findings: Based on this model, we estimate that there have been about 34 unobserved founder patients at the beginning of spread outside China. The global trend is approximately exponential, with the rate of 10 folds every 19 days.
InTheBlack
03-07-2020, 13:58
https://www.medrxiv.org/content/10.1101/2020.02.20.20025866v2
Posted March 06, 2020.
Estimating the Asymptomatic Proportion of 2019 Novel Coronavirus onboard the Princess Cruises Ship, 2020
Kenji Mizumoto, Katsushi Kagaya, Alexander Zarebski, Gerardo Chowell
doi: https://doi.org/10.1101/2020.02.20.20025866
This article is a preprint and has not been peer-reviewed
Abstract
The potential infectiousness of asymptomatic COVID-19 cases together with a substantial fraction of asymptomatic infections among all infections, have been highlighted in clinical studies.
We conducted statistical modeling analysis to derive the delay-adjusted asymptomatic proportion of the positive COVID-19 infections onboard the Princess Cruises ship along with the timeline of infections.
We estimated the asymptomatic proportion at 17.9% (95% CrI: 15.5%-20.2%), with most of the infections occurring before the start of the 2-week quarantine.
...
the asymptomatic proportion, which is broadly
defined as the proportion of asymptomatic infections among all the infections of the
disease. Indeed, the asymptomatic proportion is a useful quantity to gauge the true
burden of the disease and better interpret estimates of the transmission potential. This
proportion varies widely across infectious diseases, ranging from 8% for measles and
32% for norovirus up to 90-95% for polio [4-6]. Most importantly, it is well established
that asymptomatic individuals are frequently able to transmit the virus to others [7-8].
...
Out of the 634 confirmed cases, a total of 306 and 328 were reported to be
symptomatic and asymptomatic, respectively. The proportion of asymptomatic
individuals appears to be
16.1 % (35/218) before February 13,
25.6 % (73/285) on February 15,
31.2 % (111/355) on February 16,
39.9% (181/454) on February 17,
45.4% (246/542) on February 18,
51.9% (322/621) on February 19 and
51.7% (328/634) on February 20 (Table 1)
...
The reported asymptomatic cases consists of both true asymptomatic infections and
symptomatic cases that had not yet developed symptoms at the time of data collection,
i.e., the data is right-censored.
...
Our estimated asymptomatic proportion is at 17.9% (95% CrI: 15.5%–20.2%),
which overlaps with a recently derived estimate of 33.3% (95% CI: 8.3%–58.3%) from
data of Japanese citizens evacuated from Wuhan [13].
...
Our study is not free from limitations.
First, laboratory tests by PCR were
conducted focusing on symptomatic cases especially at the early phase of the quarantine.
If asymptomatic cases where missed as a result of this, it would mean we have
underestimated the asymptomatic proportion.
Second, it is worth noting that the data of
passengers and crews employed in our analysis is not a random sample from the general
population. Considering that most of the passengers are 60 years and older, the nature of
this age distribution may lead to underestimation if older individuals tend to experience
more symptoms. An age standardized asymptomatic proportion would be more
appropriate in that case.
Third, the presence of symptoms in cases with COVID-19 may
correlate with other factors unrelated to age including prior health conditions such as
cardiovascular disease, diabetes, immunosuppression. Therefore, more detailed data
documenting the baseline health of the individuals including the presence of underlying
diseases or comorbidities would be useful to remove the bias in estimates of the
asymptomatic proportion.
Badger52
03-07-2020, 14:20
Local/regional outlets have it also, this is from the AP (https://apnews.com/6a15879ffff522207f29c630e835833f). Some other scattered reports indicate that facility or area has upwards of 30 healthcare folks out on self-quarantine now as well.
MSM will be along in awhile to cover it after they sort out their Clown Show 2020 "March to Milwaukee!"™ coverage for the weekend. (What to tell you, when, by who, etc.)
Screw it; headed out to enjoy the day, kinda like yesterday.
InTheBlack
03-07-2020, 14:32
That's amusing. We put the cruise ship people into the super-duper quarantine facility with expertly trained staff... and some local yokel on vacation comes back with it.
Badger52
03-07-2020, 14:50
That's amusing. We put the cruise ship people into the super-duper quarantine facility with expertly trained staff... and some local yokel on vacation comes back with it.Heh, yeah. If I was sitting pretty at the station in Antarctica my message to HQ would be that "every swingin' dude/dudette on the relief shift better be in quarantine for 24 days, and you're gonna deep-clean that frickin' bird. Otherwise, we're good, just need a resupply while y'all sort this shit out."
InTheBlack
03-07-2020, 14:54
calculating doubling time -- My brain hurts... used to be able to do this with logarithm formula, but stumped on the phrasing; growth at "the rate of 10 folds every 19 days."
How do you turn that into a % growth rate to plug into a D.T. formula?
EDIT: it has a 10x time of 19. What is the 2x time?
EDIT: by brute force, x^y is 1.129^19 days = 10.03 fold increase
So "rate" is 12.9% per day
using that rate is a doubling time of 5.71 days
https://miniwebtool.com/doubling-time-calculator/?r=19
***
BETTER:
2 = e^rt
ln(2) = ln (e^rt)
ln(2) = rt
( ln(2) / t ) = r
except use ln(10) for 10x instead of 2x.
rate is 12.1%
DT is 6.07 days
The moral of this is that really small changes in exponent values make big changes in the final result, so its probably between 5.5 and 6.5 days...
Surf n Turf
03-07-2020, 15:06
You can follow updates that "Trevor Bedford" posts in the link below. He's from Seattle Washington and a no knee jerk reactionary. He's with these folks:
https://bedford.io/team/
And they have done some awesome research genetically mapping SARSCov-2, and he usually posts their teams findings on his Twitter page, although I don't twit, nor have a twit page. He's a scientist, and "hopefully" unbiased:
https://mobile.twitter.com/trvrb . Read his page regularly.
Thanks, for the link
I think I understand their process.
Not sure I could compete in today’s world with these (wonder) kids with obvious IQ's north of 145
SnT
Badger52
03-07-2020, 15:07
That bottled water, Ramen noodles, and Clorox are walkin' out of the Walmarts in the corn belt shortly. Saw a bit of that up here when that one subject was in Madison, (by appearances) folks who don't think about such things till it's in their face on the affiliate's 6pm news while they shovel in their take-out from the noodle palace. Then she finished her quarantine, good to go, walked, and everything calmed down in the area.
I bet cbtengr will have intel on shelf stockages.
I think the "Keep it Out" and "Keep it Contained" plans are pretty much out the window now.
All the individual cases have been out walking around with it before it was found out they had it - and now the race is on to track down who they had come in contact with. Missed will be the customers at Dollar Tree - might get the workers if the person remembered they went there.
The US population is not the kind of folks to stay home if told to do so.
So it will spread. Now the question is how bad will it be.
I'm going with similar to a very bad seasonal flu.
Going to be funny when this is all over watching folks try and return 40 cases of Ramen Noodles.
Pete, if you’re ready for mid-term isolation, it doesn’t make any real difference. You’ll wait and see if this turns out to be simply a bad flu year. But that possibility is disappearing fast, IMO.
The best case scenario is Korea's 0.7% fatality rate, the lowest in the world. CFR of 0.7 is seven times worse that a bad seasonal flu year. Note that their cigarette use runs about 20% of the population and obesity is about 5%. Ours is 17% smokers and 40% obese. They already have hundreds who need hospitalization with no beds available.
WHO's official CFR is 3.6%, 36 times that of flu, and is what Iran and Italy are currently seeing. I’d expect that to go down in Italy as more asymptomatic cases are identified but Iran looks to hold steady at 3.6. They are getting absolutely hammered.
CFR varies by locale and population. There have been two variants, or clades, of COVID19 identified and there are emerging worries that the more dangerous type, the same one that circulated initially in Wuhan, is attacking Iran.
The factor that is overlooked in these discussions is the exponential doubling of cases. This is the source of those “showering without rubber ducky decals is more dangerous that COVID19” posts you might have seen.
It’s true. Right now, at the very early stages of this pandemic in the US, we are seeing few hospitalizations and deaths. But note that Italy was in the same place just one week ago and today they have the most deaths outside of China and they're planning a complete one-month lockdown of 1/4 of their population with no travel allowed into or out of northern Italy.
See the link below for a clear discussion of the issue of exponential case growth and the implications for our health system and the availability of masks/gowns/IV/etc. (Pro tip: they won’t last one day). The author is very cautious to use the most optimistic of all projections and to bracket every assumption with +/- adjustments.
If you can find a hole in her logic let me know. I can’t. Click on the black bar to see the entire thread.
https://twitter.com/threadreaderapp/status/1236117572321501185?s=21
Here's a interesting video on the tube that must not be mentioned regarding Vit D...
https://www.xxxxxxx.com/watch?v=gmqgGwT6bw0
I've had positive results with a number of issues with this doing soft gel caps of D3. Doing 2000 IU of it could improve your immune system. Some people take 5000 IU or more
Ideally you should get your blood tested to fine tune the dose. here's an article on what happens if it's too much.
https://www.lifeextension.com/Magazine/2012/5/New-Study-Warns-Against-Excessive-Vitamin-D-Intake
We get Vitamin D by sunlight as well as diet. Taking it is good for older people who's skin doesn't process sunlight as well any more.
Badger52
03-07-2020, 19:59
See the link below....Thanks for that.
Plagues were feared in antiquity for the war, famine, and political unrest they brought as much as the direct deaths they produced.
OPEC collapsed as a functioning cartel on Friday as the Russians refused to cut production in an attempt to prop oil prices gutted by the pandemic consumption slump in China. Basically, Russia declared economic war on Saudi Arabia and US frackers.
Today the House of Saud fired back and announced deep discounts on oil—$8/bbl to the US and $10/bbl to the EU—in their own assault on the Russians and US frackers.
It’s a move based on desperation.
Expect Houthi rebels to gain access to even more sophisticated drones in the coming weeks. Maybe made by Raytheon, maybe made by ZALA Aero, maybe by an Iranian proxy. One distribution hub in flames and problem solved for the US.
The US junk bond market and banks, gutted by a collapsing bond rates, cannot bail out the US oil patch like they did in 2015, especially if we're economically fighting both Russia and Arabia.
Interesting times.
Thanks for that.
Yep. UW Health has 147 ICU beds across their whole system, in 12 hospitals/clinics big and small. Most beds are in Madison. Yesterday they were all filled. Still the flu, along with their usual strokes, heart attacks, etc. Makes you go hmmm.
I saw a panicky infectious disease guy from U of Minn Health on the CNBC business channel last week and he said they had 5-10 days of PPE and expected zero chance of resupply.
Sometimes you have to just cover up and take a beating.
InTheBlack
03-07-2020, 23:20
The best case scenario is Korea's 0.7% fatality rate, the lowest in the world. CFR of 0.7 is seven times worse that a bad seasonal flu year.
Multiplying fatality factor by seasonal flu deaths seems the best way to me.
Trying to use doubling times then seriousness on a spreadsheet, I can't make it match the China progression of numbers.
How does doubling time change when cases are very low? The few infected in a small zone will be exposing the same set of people multiple times, so the R0 would be skewed.
Then with very large numbers you get herd immunity starting and again exposing the same people multiple times.
Wonder if the way doubling time changes is a Logistic Curve sort of equation?
InTheBlack
03-07-2020, 23:26
Going back to seasonal flu numbers, this year says 40M per season get sick, that's 40/330 = 12%. If COVID-19 affects 36% that's three times 50k deaths = 150,000 deaths at seasonal death rates.
Seven times that death rate is a million.
Even half a million is ten times the seasonal death numbers.
InTheBlack
03-08-2020, 02:00
I recall China's capacity as 200M per... day?
No info on 3Ms capacity to produce domestically.
Who's responsible for our current stock being so much less than what could have been foreseen as needed?
https://www.medscape.com/viewarticle/926295
snip
"Since we have this regional manufacturing model, many of our items are coming regionally. And we're working with our supply partners very closely to monitor the situation," McCullough told Reuters.
The company is not currently under contract to produce the masks and is preparing to respond to the government's request, 3M spokeswoman Jennifer Ehrlich said.
Demand for masks like the ones produced by 3M has outpaced supply as the coronavirus outbreak, which originated in China, has spread. The outbreak has riled markets and disrupted global supply chains, largely in export-dependent China.
"The demand is outstripping capacity right now, and we're working 24/7 to ramp up and be able to meet as much of that demand as we can," CEO Michael Roman told investors at an industry conference last month.
The U.S. Department of Health and Human Services intends to buy 500 million N95 respirators over the next 18 months for the Strategic National Stockpile (SNS), the nation's supply of pharmaceuticals and medical supplies.
One thing is for sure - in about three weeks everybody who goes to a Doc's office with a case of the sniffles will demand to be tested.
They had better be cranking up production of those test kits.
Near as I can gather depending on the source one test kit has something like 500 to 600 individual test units in it. The news is doing a poor job on educating the public on that. The hear one test kit and think one test.
The U.S. Department of Health and Human Services intends to buy 500 million N95 respirators over the next 18 months for the Strategic National Stockpile (SNS), the nation's supply of pharmaceuticals and medical supplies.
Yeah, buy from whom? China won’t sell and they make the raw materials, the intermediate fabric, and the finished masks.
And spread over 18 months? So none over the next 4 months I’m guessing.
From the thread I referenced: “There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.)”
So 500M new masks / 6M HCWs = 83 days with 1 mask per day. Standard practice dictates a mask change every time you leave a room with an infected patient for about 20 masks per day on average. That’s 83/20=4 days of masks.
And none for cops, food staff, cleaning staff, local nursing home staff, etc.
We need a billion masks today.
If HCWs never eat or drink and go with 1 mask per day expect many more HCW infections and deaths.
I don't read nor speak Italian but one of my co-workers does, she's an Italian from near Milan. I sent the article below to her early this morning, and her reply is quoted below, along with the link to the article. If the numbers she said are correct then they haven't been reported yet. Looks like they're in for a Wuhan experience. Anyone here read Italian? The article was published yesterday:
https://www.corriere.it/cronache/20_marzo_07/coronavirus-stiamo-creando-terapie-intensive-anche-corridoi-cb01190a-60be-11ea-8d61-438e0a276fc4.shtml
"This is so crazy! 18k infected, 3k needing intensive respiratory care. They've been forced to create critical protocols and revamp policies in the wards, operating suites and ICUs. The system of one of the best medical institutions in the world is critically stressed and has to compromise by transferring out the sickest to protect those who can possibly survive and those who care for them. ....there's so much more, but I have to get ready to come in."
Edited to add:
I gave report this morning to my Italian friend & co-worker, who took my assignment that I had last night. We discussed the above article and the difficulties they're experiencing in Milan. If what's happening in Milan, and the northern region of Italy (Lombardy), happens in or around our location, our system would be overwhelmed within a week or two. Time will tell. We may very well experience the most epic medical event of our lifetime. I pray we don't, fingers crossed......
Italy Locks Down the Country’s North to Fight Coronavirus
https://www.wsj.com/articles/italy-plans-large-scale-lockdown-in-countrys-north-to-fight-coronavirus-11583613874
"MILAN—The Italian government is locking down 17 million people—more than a quarter of its population—including in Milan, the surrounding Lombardy region and 14 neighboring provinces, in the most sweeping steps any European country has prepared to take against the coronavirus epidemic...."
Right now they are running 3.9% - 233 of 5,883.
Travel chaos erupts as Italy quarantines north to halt virus
https://apnews.com/f3be69cc2cf55f74a35118c557ad8461
This article shows some of the problems with trying to lock down an area to prevent the virus from spreading. Would probably be very difficult to lock down any large area in the US.
"...Students at the University of Padua in northern Italy who had been out at bars on a Saturday night saw the reports on their phones and rushed back to grab their belongings and head to the train station. Hundreds of passengers, some wearing face masks and rubber gloves, crammed onto the last local train leaving Padua at 11:30 p.m, sitting on their suitcases in the aisles. No conductor came by to check tickets.
“I read two hours ago that they may be putting out an urgent decree putting Padua in the red zone ... so I decided to go earlier,” said student Roberto Pagliara, heading to his hometown of Puglia in southern Italy. ..."
Just a random thought for the MD types or the Brainiacs that are numerous on this board (PedOncoDoc/Trapper John, et al). All throughout the 90's & early 2000's while doing neonatal transport/NICU, we frequently set up SPAG's to deliver "Ribavirin" to our intubated preemies with RSV. We also delivered it aerosolized to non intubated patients as well, who met the criteria back in the day. Since "Ribavirin" is a*guanosine*(ribonucleic)*analog use to stop viral RNA synthesis and viral mRNA capping, could it be used as a treatment for SARS-COV-2, since it is an RNA virus? Remdesivir seems to work and show better outcomes according to some studies, but curious if Ribavirin" could do the same, or even better? Is anyone looking at this drug (antiviral) for the treatment of SARS-COV-2 since it attacks the lungs?
Ret10Echo
03-08-2020, 10:21
Travel chaos erupts as Italy quarantines north to halt virus
https://apnews.com/f3be69cc2cf55f74a35118c557ad8461
This article shows some of the problems with trying to lock down an area to prevent the virus from spreading. Would probably be very difficult to lock down any large area in the US.
"...Students at the University of Padua in northern Italy who had been out at bars on a Saturday night saw the reports on their phones and rushed back to grab their belongings and head to the train station. Hundreds of passengers, some wearing face masks and rubber gloves, crammed onto the last local train leaving Padua at 11:30 p.m, sitting on their suitcases in the aisles. No conductor came by to check tickets.
“I read two hours ago that they may be putting out an urgent decree putting Padua in the red zone ... so I decided to go earlier,” said student Roberto Pagliara, heading to his hometown of Puglia in southern Italy. ..."
I watched the first 20 minutes of the 1994 miniseries "The Stand" loosely based upon Steven King's book.
Really eery parallels
This in the opening credits:
This is the way the world ends, not with a bang, but a whimper.
T. S. Eliot
I watched the first 20 minutes of the 1994 miniseries "The Stand" loosely based upon Steven King's book.
Really eery parallels
This in the opening credits:
It’s not going to end, and 98% will survive, but it’s going to be a wild ride
I don't read nor speak Italian but one of my co-workers does, she's an Italian from near Milan. I sent the article below to her early this morning, and her reply is quoted below, along with the link to the article. If the numbers she said are correct then they haven't been reported yet. Looks like they're in for a Wuhan experience. Anyone here read Italian? The article was published yesterday:
https://www.corriere.it/cronache/20_marzo_07/coronavirus-stiamo-creando-terapie-intensive-anche-corridoi-cb01190a-60be-11ea-8d61-438e0a276fc4.shtml
Edited to add:
I gave report this morning to my Italian friend & co-worker, who took my assignment that I had last night. We discussed the above article and the difficulties they're experiencing in Milan. If what's happening in Milan, and the northern region of Italy (Lombardy), happens in or around our location, our system would be overwhelmed within a week or two. Time will tell. We may very well experience the most epic medical event of our lifetime. I pray we don't, fingers crossed......
The Italians are triaging elderly out of ICU to focus on the younger patients. A logical and appropriate step IMO. But a hard, hard choice and one that’ll cause screaming if we do it here and leave the old white guys who run out govt in ICU beds.
Badger52
03-08-2020, 15:37
...screaming if we do it here and leave the old white guys who run out govt in ICU beds.The double-standard would, at least, be consistent.
Monsoon65
03-08-2020, 15:53
Saw a good documentary on the Spanish Flu of 1918... Healthy dudes in their 20s were diagnosed at 10am and dead by 4pm... after the first symptoms appeared.
That's not bad. In the book, "The Great Influenza" by John Barry, he has anecdotes of people showing no signs of being sick dropping dead in the street.
Flu seems to kick old folks and the little ones in the ass. Spanish flu seemed to hit the younger folks. One theory is that they were malnourished and not as healthy due to the war going on in Europe. Another is that the old weren't hit so hard because they may have had some immunity due to the Russian flu of 1889-90.
That's not bad. In the book, "The Great Influenza" by John Barry, he has anecdotes of people showing no signs of being sick dropping dead in the street.
Flu seems to kick old folks and the little ones in the ass. Spanish flu seemed to hit the younger folks. One theory is that they were malnourished and not as healthy due to the war going on in Europe. Another is that the old weren't hit so hard because they may have had some immunity due to the Russian flu of 1889-90.
Flu in the 1918-19 pandemic killed quickly via cytokine storm. The stronger the immune system the more ravaging the response. Young adults and pregnant women were particularly vulnerable.
COVID19 kills by attrition, over weeks and weeks, patients finally dying of exhaustion if at home and from sepsis and organ failure if intubated or on cardiopulmonary bypass.
The hero physician of Wuhan who was arrested and interrogated for warning of covid took 3.5 weeks to die. He selfied a week before he died. It’s a long slow insidious slide and it absolutely eats resources. An ICU nightmare.
InTheBlack
03-08-2020, 18:41
I'm guessing that its feasible to make more masks by showing home based women how to sew them together; so can they make enough of the raw materials?
I would guess that in a short while industrial sheet-goods machinery could be converted to sew together the layers in big sheets and slice to size, so the edges might be raggedy.
SUN 8MAR20
I searched term "china's production capacity for masks per day"
results indicate the production was 20 million /day before the crisis, and intent to ramp up to 180 million per day by end FEB 2020.
https://news.cgtn.com/news/2020-03-02/China-produces-over-110-million-face-masks-a-day-amid-COVID-19-Ox4nmbVjMI/index.html
China is now producing over 110 million face masks a day, official data showed Monday.
www.xinhuanet.com/english/2020-03/02/c_138835152.htm
In south China's economic powerhouse Guangdong Province, Guangzhou Xingshi Equipments Co., Ltd, a manufacturer of diapers and sanitary napkins, converted one of its lines for fully-automated mask production. With a capacity of assembling 1,000 medical masks per minute, or 1.4 million per day running non-stop, the ultra-fast line is believed to ...
https://news.cgtn.com/news/2020-03-05/China-advances-production-line-to-meet-surging-face-mask-demand-OC7D4R8t8c/index.html
China advances production line to meet surging face mask demand
By Huo Li
Supply catching up with the demand
Despite the rapid increase in production capacity, experts warn about the subsistence mismatch between supply and demand.
"As more people return to work, the demand for face masks should reach two to three million per day, so there's still a huge gap between supply and demand," Dr. Liu Chunsheng, associate professor from the Central University of Finance and Economics told CGTN.
Liu predicts more supply shortages will appear as the epidemic goes global. China might gradually meet overseas demand for face masks as the epidemic in the country subside.
"China has not reached the point of meeting the overseas demand yet, as the country enters the final battle against the coronavirus. It has to put domestic demand first," Liu added.
Vlog: China's mask factories in high gear to meet demand
Tianjin Teda Filters Co., Ltd. produces the air filtration material for face masks. The company's director of research and development Yang Wenjuan said that the melt-blown mask filter is still in short supply. It has export plans in the future and seek to expand from producing mask filter materials when the epidemic subsides, she added.
China's effort in prompt up production
Face masks are held as the most essential tool to stop potential infection via droplets. Most face mask producers have canceled their holidays and worked at full capacity.
Measures were introduced to support technological upgrading in the sector, some firms have retooled their manufacturer lines for the volume production of the much-needed protective gear.
Guangzhou Xingshi Equipment Co., Ltd. converted one of its diapers and sanitary napkins manufacturer lines for fully-automated mask production. With a capacity of assembling 1,000 medical masks per minute, or 1.4 million per day running non-stop, the ultra-fast line is believed to be among the world's fastest, according to local authorities.
Video: Chinese manufacturers shift from diaper to mask-making machines
Zhong Tian Smart Equipment Co., Ltd, a company that manufactures cables and smart workshop equipment, designed fully-automated mask production line from scratch, and managed to get hold of more than 700 required components within a week. The company is in the process of assembling two types of upgraded production lines, among which, one has the capacity of producing more than 6,000 disposable flat mask per hour, another will make around 5,000 N95 masks per hour. The company has received 82 orders by Tuesday, including 10 from a company in Japan.
InTheBlack
03-08-2020, 20:09
I think this paper is bunk. The case fatality numbers are way too high, IMO - 2%, 2.5%, and 3%. I don't think this will be true for economically productive aged people. And its dated "February" with no precise day.
See pg 11 Table 2; I can't paste tabular data:
https://anu.prezly.com/coronavirus-is-highly-uncertain-and-the-costs-could-be-high?asset_type=attachment&asset_id=171409#attachment-171409
The Global Macroeconomic Impacts of COVID-19 Seven Scenarios.pdf
2 MB pdf
Family of Missouri's first coronavirus patient broke self quarantine, St. Louis County officials say
https://www.stltoday.com/lifestyles/health-med-fit/coronavirus/family-of-missouri-s-first-coronavirus-patient-broke-self-quarantine/article_94fe6bf6-f679-5b88-870c-18c5f79d019b.html
Rules are for thee - not for me.
"Villa Duchesne and Oak Hill School will close Monday after administrators learned that a St. Louis County woman infected with the coronavirus is the older sister of a Villa Duchesne student.
Moreover, a message from the schools to parents, circulating on social media, warns that the father and sister of the infected patient attended a school father-daughter dance Saturday night at the Ritz-Carlton in Clayton. They also apparently attended a pre-dance gathering at the house of a Villa student.
St. Louis County Executive Sam Page said Sunday that the patient’s family had been told on Thursday to self quarantine at their home in Ladue. Page said the patient’s father had not followed health department instructions. Page spoke at a news conference Sunday evening...."
Italy Locks Down the Country’s North to Fight Coronavirus
https://www.wsj.com/articles/italy-plans-large-scale-lockdown-in-countrys-north-to-fight-coronavirus-11583613874
"MILAN—The Italian government is locking down 17 million people—more than a quarter of its population—including in Milan, the surrounding Lombardy region and 14 neighboring provinces, in the most sweeping steps any European country has prepared to take against the coronavirus epidemic...."
Right now they are running 3.9% - 233 of 5,883.
This might be of interest, re: Italy:
https://raconteurreport.blogspot.com/2020/03/reality-alert.html
Further from Raconteur Report:
https://raconteurreport.blogspot.com/2020/03/embrace-suck.html
I'm not saying "Panic!"; but it wouldn't hurt for us to get our minds around this before we are blind-sided.
Didn't copy the link but I was reading somewhere that one of the problems with Italy was it had a much older population compared to others.
Could be a partial explanation on why their death rate was so much higher.
Didn't copy the link but I was reading somewhere that one of the problems with Italy was it had a much older population compared to others.
Could be a partial explanation on why their death rate was so much higher.
We, too have an older population, to which many of us belong. It will also suck for those with auto-immune disorders (such as Rheumatoid Arthritis) who, in order to remain functional, are on immuno-suppressant drugs, as well as those with heart and/or respiratory issues. The best advice: don't get sick. Avoid crowds, wash your hands often, use alcohol or alcohol gel when needing to go out (shopping, banking) - and keep your hands away from your face! (An issue for which I am constantly guilty: itchy eyes, etc.)
As per the attached link
Italy comes in at # 5 with a median age of 46.5.
We are # 61 with a median age of 38.5.
https://www.cia.gov/library/publications/resources/the-world-factbook/fields/343rank.html
Priest in D.C. (Georgetown) gave communion and shook hands with parishioners (approx 500 at the service) on March 1st has tested positive.
Don't blame the Catholics. This was Episcopal.
and in other news... several schools are closing in Fulton County, GA (Atlanta) due to an teacher who has tested positive.
This flu will get real. Fast.
Priest in D.C. (Georgetown) gave communion and shook hands with parishioners (approx 500 at the service) on March 1st has tested positive.
Don't blame the Catholics. This was Episcopal.
and in other news... several schools are closing in Fulton County, GA (Atlanta) due to an teacher who has tested positive.
This flu will get real. Fast.
That's what has me worried. I'm in the especially "at risk" category. So I guess no more shaking hands. It's gonna have to be the "elbow-bump" from now on. ;)
Badger52
03-09-2020, 20:02
A brief glance at the Johns-Hopkins GIS tool can be an eye opener. Livin' large up in deplorable land along with those wonderful lines of General Eisenhower's baby criss-crossing the country, I only need to look at a blip in Iowa City, another couple in Mogadishu-North (MN), and a half-dozen in Chicongo to know that it can happen in einen Augenblick.
How many people make a hospital visit for some routine stuff (PT in the rehab/wellness clinic, blood test, or a quick bag of iron, etc.) and - as would be expected - are sharing the air circulated by a giant HVAC setup?
And, yeah, I read recently (someone keeps track of such things) that we tend to touch our faces approx 23 times an hour. Let's not do that, m'kay?
:cool:
A summary of all COVID-19 research and the recent WHO data dump from Oxford University.
Doubling time for global # of cases (incl China): 19 days
Global (excl. China): 5 days
Global CFR: 3.5%
China CFR: 3.9%
Global (excl. China): 2.4%
https://ourworldindata.org/coronavirus
InTheBlack
03-10-2020, 04:30
http://www.cidrap.umn.edu/news-perspective/2020/03/study-highlights-ease-spread-covid-19-viruses
Study highlights ease of spread of COVID-19 viruses
Mar 09, 2020
COVID-19 can be spread before it causes symptoms, when it produces symptoms like those of the common cold, and as many as 12 days after recovery, according to a virologic analysis of nine infected patients published today on the preprint server medRxiv.
Also, in a study published in today's Annals of Internal Medicine, researchers at Johns Hopkins found a median incubation period for COVID-19 of 5.1 days—similar to that of severe acute respiratory syndrome (SARS).
Virus concentrates quickly, sheds efficiently
Led by researchers in Germany, the virologic study, which has not yet been peer-reviewed, found that the novel coronavirus quickly begins producing high viral loads, sheds efficiently, and grows well in the upper respiratory tract (nose, mouth, nasal cavity, and throat).
"Shedding of viral RNA from sputum outlasted the end of symptoms," the authors wrote. "These findings suggest adjustments of current case definitions and re-evaluation of the prospects of outbreak containment."
The nine patients, who were admitted to the same Munich hospital, were studied because they had had close contact with an index case. Cell cultures and real-time polymerase chain reaction (RT-PCR) were done on throat swabs and samples of sputum, stool, blood, and urine. Throat swabs showed very high viral shedding during the first week of symptoms.
The findings contrasted starkly with those from the 2003 outbreak of SARS in terms of viral load. "In SARS, it took 7 to 10 days after onset until peak RNA concentrations (of up to 5x105 copies per swab) were reached," the researchers wrote. "In the present study, peak concentrations were reached before day 5, and were more than 1,000 times higher."
...
Social distancing to prevent infection
Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, which publishes CIDRAP News, said that the results challenge the World Health Organization's assertion that COVID-19 can be contained.
The findings confirm that COVID-19 is spread simply through breathing, even without coughing, he said. They also challenge the idea that contact with contaminated surfaces is a primary means of spread, Osterholm said.
"Don't forget about hand washing, but at the same time we've got to get people to understand that if you don't want to get infected, you can't be in crowds," he said. "Social distancing is the most effective tool we have right now."
Here's a study published in the Lancet that details some of the things they found throughout the course of the disease process. Lancet maps out the clinical factors for survival and major clinical courses of symptoms. Also noteworthy: viral shedding lasted 8-37 days......
"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study"
Link: https://www.thelancet.com/lancet/article/s0140-6736(20)30566-3
Badger52
03-10-2020, 04:57
Over the last 24 hours I've noticed a major change in the way the Johns-Hopkins tool (https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6) displays its information. Previously, the blips (cumulative confirmed or active) were on the map relatively close to where they actually were. Now, it's as if one blip for a state (maybe 2 for the big populations) is sufficient to indicate that "Yep, we've got (or had) the virus here."
It makes the number of dots less (by design?), and may also be misleading & alarming to some when those that are there suddenly pop up in the wrong location.
InTheBlack
03-10-2020, 05:18
total of 62,000 ventilators in the USA, (as of several years ago?)
- NBC news medical guy, Today Show, 7:15AM TUE 10MAR20
I see now why their whole country is now under quarantine.....
From Jason Van Schoor, Registrar in Anaesthesia & ICM | NIHR UCL Academic Clinical Fellow. London, England:
"...
From a well respected friend and intensivist/A&E consultant who is currently in northern Italy:
1/*‘I feel the pressure to give you a quick personal update about what is happening in Italy, and also give some quick direct advice about what you should do.*
2/*First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.*
3/*The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity*
4/*We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.*
5/*Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.*
6/*My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.*
7/*We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere, this is the pattern:*..."
https://threadreaderapp.com/thread/1237142891077697538.html
https://www.cochranelibrary.com/search
Jason Van Schoor from the Cochrane Library link:
Division of Surgery & Interventional Science, Royal Free NHS Trust Hospital, University College London, London, UK
"...8/*1)A few positive cases, first mild measures, people are told to avoid ED but still hang out in groups, everyone says not to panick
2)Some moderate resp failures and a few severe ones that need tube, but regular access to ED is significantly reduced so everything looks great*
9/*3)Tons of patients with moderate resp failure, that overtime deteriorate to saturate ICUs first, then NIVs, then CPAP hoods, then even O2.
4)Staff gets sick so it gets difficult to cover for shifts, mortality spikes also from all other causes that can’t be treated properly.*
10/*Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe,*
11/*if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.*
12/*Another typical attitude is read and listen to people saying things like this and think “that’s bad dude” and then go out for dinner because you think you’ll be safe.*
13/*We have seen it, you won’t be if you don’t take it seriously. I really hope it won’t be as bad as here but prepare.*..."
https://threadreaderapp.com/thread/1237142891077697538.html
InTheBlack
03-10-2020, 07:11
So this Italian is writing in English. I don't understand the last sentence at all. Sounds like he's saying to stay away from your family, but teach them how to intubate each other?
>
11/ if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.
>
The first big news out of WA State was the 29th of February based on info from the 28th.
11 days so far.
doctom54
03-10-2020, 19:38
Here's a study published in the Lancet that details some of the things they found throughout the course of the disease process. Lancet maps out the clinical factors for survival and major clinical courses of symptoms. Also noteworthy: viral shedding lasted 8-37 days......
"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study"
Link: https://www.thelancet.com/lancet/article/s0140-6736(20)30566-3
Thanks for the link.
The interesting part to me is the median of 20 days of detectable virus in the survivors.
Thanks for the link.
The interesting part to me is the median of 20 days of detectable virus in the survivors.
Lymphopenia and v slow/weak immune response. Doesn’t bode well for vaccine efforts.
DOCTOM54
The interesting part to me is the median of 20 days of detectable virus in the survivors.
If that is not a weapon grade Bio virus, what is? A 20 day after life of contagion, chernobyl in a petri dish.
PedOncoDoc
03-11-2020, 07:49
DOCTOM54
If that is not a weapon grade Bio virus, what is? A 20 day after life of contagion, chernobyl in a petri dish.
Persistent viral shedding after recovery from an acute infection is not all that uncommon.
InTheBlack
03-11-2020, 08:14
Does "shedding after recovery" imply continued contagiousness?
And the other article said the highest viral load was reached in under 5 days, with an incubation period of 5.1 days. What is the definition of "incubation period?" Is it basically time to highest viral load? Or is COVID-19 unusual in this respect?
How do the above compare with seasonal flu or common cold?
What is "IQR" as a statistical term?
https://www.thelancet.com/lancet/article/s0140-6736(20)30566-3
>
For survivors, the median duration of viral shedding
was 20·0 days (IQR 17·0–24·0) from illness onset, but the
virus was continuously detectable until death in nonsurvivors
(table 2; figure 1).
The shortest observed duration
of viral shedding among survivors was 8 days, whereas the
longest was 37 days.
Among 29 patients who received lopinavir/ritonavir and were discharged,
the median time from illness onset to initiation of antiviral treatment was
14·0 days (IQR 10·0–17·0) and
the median duration of viral shedding was 22·0 days (18·0–24·0).
The median duration of viral shedding was
19·0 days (17·0–22·0) in patients with severe disease status and
24·0 days (22·0–30·0) in patients with critical disease status.
>
http://www.cidrap.umn.edu/news-perspective/2020/03/study-highlights-ease-spread-covid-19-viruses
Study highlights ease of spread of COVID-19 viruses
Mar 09, 2020
COVID-19 can be spread before it causes symptoms, when it produces symptoms like those of the common cold, and as many as 12 days after recovery, according to a virologic analysis of nine infected patients published today on the preprint server medRxiv.
EDIT ADD LINK:
https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf
Virological assessment of hospitalized cases of coronavirus disease 2019 Wolfel
Also, in a study published in today's Annals of Internal Medicine, researchers at Johns Hopkins found a median incubation period for COVID-19 of 5.1 days—similar to that of severe acute respiratory syndrome (SARS).
https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application Free
Lauer2020
...
in terms of viral load. "In SARS, it took 7 to 10 days after onset until peak RNA concentrations (of up to 5x105 copies per swab) were reached," the researchers wrote. "In the present study, peak concentrations were reached before day 5, and were more than 1,000 times higher."
InTheBlack
03-11-2020, 09:44
What is the seasonal flu death rate by age bracket, and between healthy people & those with risk indicators?
For example, as of a few days ago, a CDC graph for COVID-19 says 3.6% death rate for ages 60-69. Maybe assume its only 0.36% for "healthy" people.
-- what is the seasonal flu death rate for healthy people, vs 0.1% for all people?
0.36% : 0.1% is 3.6 times as deadly, but apples to oranges.
Maybe its really 0.36% healthy : 0.05% healthy so 7.2 times greater than seasonal, for healthy people.
EDIT: I seem to recall an early report saying 40-50% of deaths had co-morbidity factors.
Golf1echo
03-11-2020, 09:55
Another aspect of this situation is rapidly approaching based on recent news across the country-Containment...looks like choices will need to be made for those with interests in multiple locations. Logistics, security and supply relating to being in the right location, the one where you end up being contained in.
InTheBlack
03-11-2020, 09:58
The news had a clip from a lady coming off the last ship into home quarantine, saying she was happy to be going back with her family.
None of the newscasters mentioned that quarantine means alone, unless her family is going to stay home all the time as well...
Supposedly researchers have identified microscopic features including a unique furin cleavage site that could make the pathogen more infectious than the SARS virus.
"....The new virus spreads much more readily than the one that caused severe acute respiratory syndrome, or SARS (also a coronavirus), and has infected more than ten times the number of people who contracted SARS......"
"....To infect a cell, coronaviruses use a ‘spike’ protein that binds to the cell membrane, a process that's activated by specific cell enzymes. Genomic analyses of the new coronavirus have revealed that its spike protein differs from those of close relatives, and suggest that the protein has a site on it which is activated by a host-cell enzyme called furin.
This is significant because furin is found in lots of human tissues, including the lungs, liver and small intestines, which means that the virus has the potential to attack multiple organs, says Li Hua, a structural biologist at Huazhong University of Science and Technology in Wuhan, China, where the outbreak began. The finding could explain some of the symptoms observed in people with the coronavirus, such as liver failure, says Li, who co-authored a genetic analysis of the virus that was posted on the ChinaXiv preprint server on 23 February2. SARS and other coronaviruses in the same genus as the new virus don't have furin activation sites, he says......"
More here:
https://www.nature.com/articles/d41586-020-00660-x
Edited to add:
"....the flu virus that caused the deadliest recorded pandemic, the 1918 Spanish flu pandemic, doesn’t even have a furin activation site, says Lijun Rong, a virologist at the University of Illinois in Chicago...."
Lots of “gain of function” research going on everywhere. And synthetic biology is all the rage! It’s fun! It’s easy!
The emerging porcine epidemic diarrhea virus (PEDV) requires trypsin supplementation to activate its S protein for membrane fusion and virus propagation in cell culture. By substitution of a single amino acid in the S protein we created a recombinant PEDV (PEDV-S(FCS)) with an artificial furin protease cleavage site N-terminal of the putative fusion peptide. PEDV-S(FCS) exhibited trypsin-independent cell-cell fusion and was able to replicate in culture cells independent of trypsin, though to low titer.
Emphasis mine.
Adding furin cleavage sites is easy and undetectable, contrary to what some are saying.
https://www.researchgate.net/publication/276359777_A_Single_Point_Mutation_Creating_a_Furin _Cleavage_Site_in_the_Spike_Protein_Renders_Porcin e_Epidemic_Diarrhea_Coronavirus_Trypsin_Independen t_for_Cell_Entry_and_Fusion
Scientists in general, and the Chinese propaganda machine in particular, are stomping on the questions surrounding gain of function in the COVID-19 virus.
The Chinese motivation is obvious. Virologists don’t want anything to interfere with their “let no crisis go to waste” message that more research needs to be funded.
So much sciencing.
And while PragerU is demonetized on ******* for promoting the radical philosophy of responsibility and self improvement, Chinese trolls are flooding the site with posts claiming the virus is a US bioweapon.
We have met the enemy and he is us.
TOMAHAWK9521
03-11-2020, 11:48
Welcome to the Pandemic days
https://www.foxnews.com/health/who-declares-coronavirus-global-pandemic
https://www.breitbart.com/politics/2020/03/11/world-health-organization-declares-coronavirus-outbreak-a-global-pandemic/
https://www.usatoday.com/story/news/health/2020/03/11/coronavirus-live-updates-washington-ban-michigan-cases-us-death/5011587002/
Golf1echo
03-11-2020, 12:21
Interesting pod cast from The War Room, Army War College a stand off view point, much of the context I was not aware of.
https://warroom.armywarcollege.edu/podcasts/spanish-flu/
Badger52
03-11-2020, 12:40
Frankly, I think they've done a fair to middlin' job on emphasizing the hand-washing. And I think people get it, RE provisions. (Whether they've done it or not is another matter.)
However, I see a major obstacle in people willing to acknowledge the depth & duration of what is meant by "social distancing." You can look them in the eyes & tell 'em, and you'll get a north-south all day, but they will still be in denial. "Oh, we're a small town (at the confluence of 2 interstates), and it's little Janie's last Spring concert at the HS auditorium, it'll be Ok." Or...
"Let's hold a convention and we'll only invite the "key" 50,000 people to this major metro area and I'm sure the public transport will be fine - we only do it every 4 years... c'mon, what could go wrong?"
It's time to have The Conversation with people who are closest to you & branch out from there. There will come a time when the front porch sign won't say "No Solicitors" - it'll say "Eintritt Verboten." When the schools close and the parent still has to work, it can't mean "Oh, come down to visit with (COPD) Grandma for the day."
Medical insurers get it, and they are known to reli$$h only one thing. Got notified last night that my secondary (who was primary while I worked for our green machine) waives all testing co-pays, telemed visit charges, charges for delivery of Rx's, etc. should the situation warrant. And that industry is the last one to give something away. (There's probably a chunk of that $8.3B carved out for that on the backend but you gotta be alive first to collect, right?)
Well, the Food Lion closest to us still has everything to include TP - everything except for hand sanitizer.
One long empty section where they all used to be.
InTheBlack
03-11-2020, 14:25
[QUOTE=TOMAHAWK9521;656320]Welcome to the Pandemic days
Cue Ronald Reagan... Today on
Death
Valley
Days
Badger52
03-11-2020, 15:02
Well, the Food Lion closest to us still has everything to include TP - everything except for hand sanitizer.Heh, shared a couple words with a gent the other day on that TP issue. 1st case in Madison, since cleared, caused 3-cart purchases of the stuff initially. Supply chain no problem; pulp industry & actual makers of the stuff just east of us and it does come direct. The issue will not be whether it's on the shelves; the issue will be if we're at a stage where one wants to venture out to get it. Sporty times ahead. Cards, board games, Scrabble®, heads-up "Hold 'Em" are staples.
:munchin
Thinking about remedies to counter COVID-19 once an individual has become seriously infected, based on information in the article below, why not create a Cather type of instrument that could be inserted via a breathing tube into the lungs and flash a UVC pulse to counter the virus.
https://www.genengnews.com/topics/translational-medicine/uv-light-that-is-safe-for-humans-but-bad-for-bacteria-and-viruses/
tom kelly
03-11-2020, 15:51
Sunlight exposure also works a killer of microbes.
InTheBlack
03-11-2020, 16:42
Thinking about remedies to counter COVID-19 once an individual has become seriously infected, based on information in the article below, why not create a Cather type of instrument that could be inserted via a breathing tube into the lungs and flash a UVC pulse to counter the virus.
https://www.genengnews.com/topics/translational-medicine/uv-light-that-is-safe-for-humans-but-bad-for-bacteria-and-viruses/
Can't thread into the small tubules. Would only reach a tiny fraction of the surface area. Probably also blocked by the fluid that is exuded by the infected tissue.
InTheBlack
03-11-2020, 16:44
Is the ratio of death:recovered a good measure of morbidity? Can you plot it over time and see the trend, if not the actual percentage? The weakest die first, so I would think the trend would be accurate if not precise.
Five hours ago Russian bombers were intercepted off of Alaska by USAF and CAF. One can only assume maximum pressure is being exerted by Russia in this crisis. Why the increase in pressure, what is the advantage Russia is seeking to negoatate, whats is Russia's short term goal in using the virus to gather advantage or relief?
https://www.statista.com/statistics/1102303/coronavirus-new-cases-development-russia/
Five hours ago Russian bombers were intercepted off of Alaska by USAF and CAF. One can only assume maximum pressure is being exerted by Russia in this crisis. Why the increase in pressure, what is the advantage Russia is seeking to negoatate, whats is Russia's short term goal in using the virus to gather advantage or relief?
https://www.statista.com/statistics/1102303/coronavirus-new-cases-development-russia/
Crash the American shale oil industry
Noted in a prior post, the tension is palpable. It would be interesting if a drone controlled F/18 ram/crash into one of their bombers in a airmanship error. What Russia would do, calling the buff.
sfshooter
03-11-2020, 20:06
Russian bombers near the Alaska border is not new. I was there a year ago working in the Arctic and it happened then. US jets scrambled from Alaska for intercept.
I think the panic of this virus has gone to the extreme. Nobody panics about the 30,000 plus deaths every year, in the US, caused by automobiles. This thing has been going for what, 3 months or so, and has killed worldwide a yearly violence toll of Chicago? And we intentionally expose ourselves to automobiles!
https://visionlaunch.com/many-people-die-malnutrition-year/
No one seems to panic about this figure every year either.
How about we quit panicking and killing our economy. Take measures to protect against the spread of course, but quit making everyone believe that they are going to die if they get this.
And buy kleenex not TP. Went to Albertsons last night and picked up some groceries. TP was on my list. When I got to the TP isle there were two ladies standing in front of mostly empty shelves. The one was telling the other that her daughter could not get any in Denver and was coming up and for her to pack some suitcases full. She said she had been to most stores in town (100K people) and there was none anywhere. Right next to the TP section was the kleenex section. It was about 3/4 full. I ended up buying a six pack of off brand. Maybe people are thinking of those Venezuela stories:D
Badger52
03-11-2020, 20:30
Russian bombers near the Alaska border is not new.+1 This is just Bears doing what Bears have been doing for a very long time. And at this particular time, it's just likely a case of "in the midst of this current thing, can the Main Adversary still do "xyz."
Nothingburger imo.
+1 This is just Bears doing what Bears have been doing for a very long time. And at this particular time, it's just likely a case of "in the midst of this current thing, can the Main Adversary still do "xyz."
Nothingburger imo.
Concur!
InTheBlack
03-11-2020, 23:25
And associated reagents. But it seems that private labs are not short, yet...
https://www.scmp.com/economy/global-economy/article/3074805/coronavirus-testing-us-could-face-huge-disruption-due
The CDC issued interim guidelines on Monday that minimise the number of tests required for a diagnosis. The agency says labs can combine a patient’s nose and throat samples into one test, a move experts say will cut in half the amount of supplies used to test each person.
...
Mandy Cohen, North Carolina’s secretary of health, said that a shortage of extraction kits and other chemicals had hampered testing in her state. “Folks were saying, ‘We are sending you the [test] kits,’ and I don’t think they understood at first what exact part of the supply chain we needed,” she said. “We needed extraction kits.”
A spokesperson for the US Food and Drug Administration (FDA) said that the agency is contacting labs that are testing for the coronavirus “to understand their supply issues and assist where we can.”
...
The FDA has also approved a change to the CDC diagnostic test that allows labs to switch from Qiagen’s RNA extraction method to another manufactured by Roche, says Denny Russell, who leads the coronavirus response at Washington state’s public health lab. But getting his lab ready to use the Roche method could take a week in part because technicians will need training to use it.
Commercial labs, which have recently started running coronavirus tests, have not experienced any supply shortages, according to a spokesperson for the American Clinical Laboratory Association.
In the meantime, Qiagen has told customers that it may not be able to fill large standing orders, because it is trying to provide smaller numbers of kits to as many labs as possible, said spokesperson Robert Reitze. The company is ramping up production of RNA extraction kits at manufacturing sites in Hilden, Germany; Barcelona, Spain; and Germantown in the state of Maryland.
InTheBlack
03-12-2020, 01:24
Should we start trying to drink Canada dry?
https://www.jwatch.org/na50889/2020/03/03/remdesivir-promising-antiviral-against-coronaviruses
March 3, 2020
Remdesivir: A Promising Antiviral Against Coronaviruses
George Sakoulas, MD reviewing Sheahan TP et al. Nat Commun 2020 Jan 10 de Wit E et al. Proc Natl Acad Sci U S A 2020 Feb 13 Wang M et al. Cell Res 2020 Feb 4
snip
The efficacy of prophylactic and therapeutic remdesivir was also examined by de Wit and colleagues in a rhesus macaque model of MERS-CoV.
Remdesivir prophylaxis initiated 24 hours before inoculation with MERS-CoV caused significantly lower viral loads than control treatment in the lungs and prevented clinical infection in this model.
Remdesivir therapy initiated 12 hours after inoculation significantly reduced MERS-CoV loads in other respiratory tissues, decreased lung disease, and strongly attenuated clinical signs of infection compared with control treatment.
Wang and colleagues show that remdesivir and chloroquine can each inhibit SARS-CoV-2 in vitro. Chloroquine, an old antimalarial drug, exerts its antiviral activity in part by interfering with cell fusion by increasing endosomal pH.
Comment
Remdesivir is an investigational broad-spectrum antiviral agent with in vitro activity against multiple RNA viruses, including Ebola and CoV. It is a nucleotide-analog inhibitor of RNA-dependent RNA polymerases. These studies add further evidence that remdesivir may play an important role in the treatment and prophylaxis of emerging COVID-19, which is showing signs of being perhaps a less fatal but more contagious CoV compared with its recent predecessors as it spreads worldwide (https://www.worldometers.info/coronavirus/#repro).
The data show that timing of antiviral initiation may be critical, as administration of remdesivir with high viral loads seen after peak viral titer failed to reduce lung damage despite reducing viral loads in the Sheahan study.
In addition to clinical trials, the manufacturer of remdesivir also has a compassionate-use remdesivir program.
InTheBlack
03-12-2020, 01:30
Can't find anything yet...
https://www.jwatch.org/fw116370/2020/02/21/continued-decline-new-covid-19-cases-china
21FEB20
snip
The WHO expects preliminary results from clinical trials of two potential treatments — the HIV therapy lopinavir/ritonavir and the antiviral remdesivir — in about 3 weeks.
InTheBlack
03-12-2020, 02:17
Advertisement for an arthitis drug. Woman waking up, her device reads "take your child to work day" & shows her able to move easily; they go into her workplace in a high rise...
I think we should start SENDING our kids to work; they aren't affected by the virus.
Betcha we can talk Trump into suspending the child labor laws...
Anyone speak Italian? The following video is supposedly from an Anesthesiologist from Italy, Dr Barbara Balanzoni.
> https://video.corriere.it/cronaca/coronavirus-appello-rianimatrice-state-casa/d95e652e-5fca-11ea-96d2-d1c7db9c0ec3
InTheBlack
03-12-2020, 06:10
You have to scrub away organic dirt so it does not use up the oxidizer & to expose the bacteria.
But for a virus, in wet or dried nasal or mouth excretions -- does alcohol penetrate, even if dry?
If you don't really need to "wipe" then you are less exposed.
The hard part is actually standing behind the shopping cart looking at your watch for 30-60 seconds. The people behind you will be pissed off.
We own a small scarf company and have our scarves made in Milan, we have attempted to contact texting/email our sales rep's and several others, nada.
/\ Not surprising. All I've read thus far says they're getting hammered.
Here's another study that will lead me to protect myself above and beyond our protocols:
"We found that viable virus could be detected in aerosols up to 3 hours post aerosolization,...."
https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v1
Just received a reply from our friends at http://www.tgmtessuti.it They are located in Corbetta, just outside of Milan,
Hi Dennis. yes I m speaking daily to my family in a Milan, they are at home locked down, it’s going to be very important 10days, it hopefully things will turn around in a couple of weeks thanks to the hard measures they are taking. Speaking with Federica as well, that are still operational but with low capacity, that does those time bw office and home, but they are all fine. I let her know you reached out
some ground truth
I's like to share one of my favorite of Aesop's Fables - tweaked just a tad to reflect current events....
This is a tale about an entire industry that repeatedly tricks the population into thinking that the world is ending because of some random zombie apocalypse…
When the zombie apocalypse really DOES materialize, the entire industry sounds the alarm. Much of the population believe that it is another bout of fake news and thousands of people die because they refuse to acknowledge the threat. Eventually, the zombie apocalypse even consumes the industry that has spent so much time and effort misleading the population through hysterics and misdirection.
The moral of this story shows how liars are rewarded: even if they tell the truth, no one believes them
InTheBlack
03-12-2020, 13:31
I want to see the experimental protocol for the 3 hour hang time. It depends totally on the particle size & density, and how that changes with evaporation.
I want proof that their aerosol generator actually replicates the size distribution for sneezing/coughing.
EDIT:
Seems like a really small droplet size, anyone know offhand? Anyone remember the "P10 particle size" healthy & safety issue from some years ago?
https://doi.org/10.1101/2020.03.09.20033217
Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1
In short, aerosols (<5 μm) 69 containing HCoV-19 (105.25
70 TCID50/mL) or SARS-CoV-1 (106.75-7 TCID50/mL) were generated using a 3-jet Collison nebulizer and
71 fed into a Goldberg drum to create an aerosolized environment. Aerosols were maintained in the
72 Goldberg drum and samples were collected at 0, 30, 60, 120 and 180 minutes post-aerosolization on a
73 47mm gelatin filter (Sartorius).
doctom54
03-12-2020, 17:14
We own a small scarf company and have our scarves made in Milan, we have attempted to contact texting/email our sales rep's and several others, nada.
Italy is getting slammed and the entire medical community is now doing triage.
Truly amazing!
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/
I hope it turns out well!
I realize that this Covid-19 is no laughing matter; and it's going to get a lot worse before it gets better, not just in the human/healthcare realm, but in the economic realm. That being said, aside from taking sensible precautions, sometimes ...
Well, I've taken this from the bayourennaissanceman blogspot - because it is humorous. Stay safe out there all of you QPs, and all on this site!
Post #86 of this Thread
Hell of a test run for an antidote, by the very same people who created the killer virus and then, lets save the world.
And Now China shows it real intent, who still thinks this was an accident?
This reinforces imo as noted in the poll that this was deliberately released.
China hints at denying Americans life-saving coronavirus drugs
https://www.foxnews.com/world/chinese-deny-americans-coronavirus-drugs
As the rest of the world scrambles to contain the virus and protect its citizens, China has been busy casting itself in the role of global hero going so far as to demand a thank you for containing the virus as long as it did.
"We should say righteously that the U.S. owes China an apology, the world owes China a thank you," an editorial in Xinhua read.
cat in the hat
03-13-2020, 10:26
I realize that this Covid-19 is no laughing matter; and it's going to get a lot worse before it gets better, not just in the human/healthcare realm, but in the economic realm. That being said, aside from taking sensible precautions, sometimes ...
Well, I've taken this from the bayourennaissanceman blogspot - because it is humorous. Stay safe out there all of you QPs, and all on this site!
At least someone made fun of it before Southpark or Simpson's
Post #86 of this Thread
And Now China shows it real intent, who still thinks this was an accident?
This reinforces imo as noted in the poll that this was deliberately released.
China hints at denying Americans life-saving coronavirus drugs
https://www.foxnews.com/world/chinese-deny-americans-coronavirus-drugs
I don't follow the deliberate release into their own population to somehow make it spread to other places and then the US. WHy not just release it here if that's the case?
InTheBlack
03-13-2020, 11:17
DEF: Isopropyl alcohol (IUPAC name propan-2-ol; commonly called isopropanol or 2-propanol)
I'm still tracking the trail of primary reference sources. But I now think that the advice to use 60% alcohol became separated from the requirement to apply it for 3 minutes, and the requirement to use 1 Propanol. This is from a European standard for a surgeon to wash his hands. If he does not have soap & water, then use a specified type of alcohol & % -- but whether soap or alcohol, SCRUB FOR THREE MINUTES.
Then WHO created a paper teaching local/regional government how to produce alternative "hand rub formulations". They had "formulation I" and "formulation II" - one for 80% v/v Ethanol, the other for 75% v/v 2 Propanol aka Isopropanol. Note that they differ by 5%.
Then someone tested them, and found they did not meet the Euro standard, which is 1-Propanol 60%. They failed the 3-hours-later part of the standard.
So they suggested, and eventually WHO concurred, on a Modified formula. The difference is using w/v instead of v/v, but the confusing thing is it adds up to the same "percentage" number. And to extend the wet contact scrubbing from 3 to 5 minutes. And to omit or reduce the glycerol (glycerin).
There is another issue I am tracking down, related to exactly what was being tested. The early or original tests did not include SARS or MERS (done prior to those outbreaks). I have a paper mentioning that but have not digested it yet.
Also note that the study below shows Log10 reductions only on the order of 2 or 3. I'd like to see 4 or 5.
BOTTOM LINE: I have not yet found any primary reference that says 60% alcohol of any kind for a few seconds - ie Purel etc - is effective on SARS-CoV-2 (unofficially, HCoV-19). Especially since these "gel" formulations contain huge amounts "gunk" of various kinds as emoluents. Even 1.45% glycerin made the WHO formula fail.
https://www.researchgate.net/publica...d_Preparations
Modified World Health Organization Hand Rub Formulations Comply with European Efficacy Requirements for Preoperative Surgical Hand Preparations
Article (PDF Available) in Infection Control and Hospital Epidemiology 34(3):245-50
March 2013
DOI: 10.1086/669528
Source: PubMed
Miranda Suchomel primary author
Abstract
Background. The World Health Organization (WHO) has published "Guidelines on Hand Hygiene in Health Care" recommending 2 hand rub formulations based on 80% vol/vol ethanol or 75% vol/vol isopropanol for local production in healthcare settings where commercial products are not available or are too expensive.
Previous investigations have shown that neither formulation meets the efficacy requirements of European norm (EN) 12791, which is the most stringent available norm for surgical hand rub preparations.
Even when modified with approximately 5% higher alcohol content, the formulations proved to be inferior to the reference of the norm when measured after 3 hours.
Objective.
Because the high glycerol content of the formulations was suspected to negatively influence their efficacy, additional investigations were performed with varying glycerol content.
Methods.
Modified formulations with higher alcohol concentration (mass instead of volume percentage) and lower glycerol concentration (0.725% instead of 1.45%) or without the addition of glycerol were evaluated for their conformity with the efficacy requirements of EN 12791, which demands noninferiority in comparison with a reference hand antisepsis procedure immediately and 3 hours after treatment on volunteers' hands.
Design.
Randomized Latin-square design.
Setting.
Microbiology laboratory of the Medical University of Vienna, Vienna, Austria.
Participants.
Twenty-five healthy volunteers.
Results.
Reducing the concentration of glycerol or omitting it completely rendered both WHO formulations noninferior to the reference, both immediately and 3 hours after surgical hand antisepsis.
Conclusions. Both WHO-recommended formulations meet the efficacy requirements of EN 12791 by increasing their alcohol concentrations by 5%, prolonging their application to 5 minutes and reducing the glycerol concentration to 0.725%.
InTheBlack
03-13-2020, 11:19
So now I need the math to turn 75% v/v 2 Propanol aka Isopropanol, into 75% w/v.
What is 75% w/v expressed as % v/v, since weighing the liquid would be very tedious & most do not have an accurate enough scale?
InTheBlack
03-13-2020, 11:26
Q: Why is there a shortage of toilet paper?
A: Because every time one person sneezes, 50 people sh*t their pants.
Q: Why is there a shortage of toilet paper?
A: Because every time one person sneezes, 50 people sh*t their pants.
A: Bear's are waking up from hybridization and we all know what they do in the woods.
Astronomy
03-13-2020, 17:47
I don't follow the deliberate release into their own population to somehow make it spread to other places and then the US. WHy not just release it here if that's the case?
One plausible line of thought... they didn't intend to target the world; just their own folks. But they simply fucked up and vastly under-estimated the potential for global contagion.
As late as early February 2020, China was still racked by "viral" anti-government protests. Of the like not seen since the days of the Cultural Revolution. The lion's share of media coverage focused on events in Hong Kong, but the movement had spread to something like 20 other major cities. So you had a regime in desperate straights vis-a-vis its perceived legitimacy with the citizenry, combined with unfavorable world news coverage, international opprobrium for its handling of dissenters, and (oh yeah) a burgeoning Islamic minority movement about to jump on the same protest bandwagon. The current Emperor & Mandarins were shitting themselves about four months ago. Worried about personal survival in the event of a likely near term Populist revolution (sometime later in 2020).
That worry (and it's previously round the clock world news cycle coverage) has abated. Nobody is paying any attention to it. It's done.
Some bright and nefarious actors might have looked for a solution to decisively end such a problem on the streets of China. One that didn't involve a hard military application of violence nationwide. One that could plausibly quash massed gatherings... and even make the government look good as it "responded". An ability to "disappear" certain targets during the widespread "natural" lethality may have just looked like icing on the cake. Bonus points. A solution to their problem that would appear to be natural in origin and (hopefully) disappear after the advent of spring/summer and warmer weather.
Enter an engineered bug that seemed to fit the bill and probably briefed well on Power Point. Probably sounded brilliant to some select and tiny group of Deciders desperately looking for a cure for their regime security woes.
What previously dire political protest movement is apparently not happening in China today? Rhetorical question.
Since the critter got released into the wild, everything else is just collateral damage. Including a self-inflicted major hit to China's economy and subsequent world-wide pandemic. The not-too-bright, but ruthless fuckers that would kill a percentage of their own population without a second's hesitation, probably didn't anticipate all the branches and sequels. But they were likely more concerned, back during the November/December time frame, with being eventually hung from lamp posts (Mussolini style).
As far as they are concerned, the positive outcomes for executing such a plot readily outweigh the bad:
1. Nationwide anti-regime protest growth stopped dead in its tracks.
2. Increased population control measures implemented/enforced without much bad press or incitement to open revolt. For as long as they deem necessary.
3. A winnowing of population that they can afford to lose (elderly, dissidents, Uighurs, etc.).
4. The means of delivery is operationally friendly to a clandestine release with little danger of ever being politically/legally/technically traceable. Very few witting participants in the actual physical part of the release (and those few loose ends easy to dispose of). No major logistical hurdles that couldn't be handled. The entire operation would theoretically need involve only a handful of people, at least one of whom had security access to a vial from a major bio lab... like the one in Wuhan. Plausible Deniability. No living witnesses to the deed. :rolleyes:
5. A major electoral torpedo delivered to the Trump Administration in the form of a Black Swan social/economic crisis event. Something that might fortuitously dispose of their least favorite geo-political nemesis. Probably not anticipated, but nevertheless advantageous.
6. Opportunity to extort certain nations (in terms of strategic deliveries of crucial exports like pharmaceutical precursors, rare earths, just-in-time finished medical export products, etc.). Quid Pro Quo concessions.
7. Opportunity to exploit economic/political fissures between other global alliances. Or to opportunistically destabilize certain regimes worldwide (from Africa to the EU). Never allow a good crisis to go to waste.
Numbers 1-4 would represent the Main Effort (regime survival), while numbers 5-7 would emerge as 2nd or 3rd order effects, predictable or not.
In aggregate, one way to look at possible origins for this bug, based upon a Cui Bono examination of events & outcomes.
-------------
Alternatively, the virus could have developed out of natural mutations (IMHO highly unlikely). The Wet Meat Market Theory. The whole world's salad getting tossed by a bowl of bat soup in Wuhan.
Or it could have escaped from a lab setting through simple human carelessness (or financial greed). Lazy lab protocols, careless employees, or just someone selling leftover lab animal carcasses at the market across the river. For a few extra Yuan to augment their paycheck. Never attribute to Malice that which can be readily explained by Human Stupidity. Maybe as likely as a nefarious plan. But after flipping a quarter between unintentional lab escape... or deliberate release...
I'm going with Chinese Regime Hail Mary Pass for $200 Alex.
ABC123
Russian, China, and Iran in less than a week present a direct threat, arguably coordinated, while also holding a duplicity of deniability. Two of the actions include the acceptance for the loss of life. Those incidents where loss of life is recorded occur in china as a deniable byproduct of zoonotic transfer in an outdoor market, covering the actual intent of releasing a 2nd novel virus with pandemic potential.
The 2nd virus corrected the deficiencies that the 1st SARS virus lacked. Released in Wuhan, layers the plausible denial for China’s leaders to argue, and later to lay elsewhere. The concept of state sponsored genocide is unthinkable for the West, but not for China. The strategy embraces the risk of unimageable loss of life, the goal to humble and hallow out America’s ability to defend/react, while China holds hostage the entire American/world financial system, offering the opportunity to complete China’s long term goal of reincorporating its ancestral rouge territories: Hong Kong Taiwan; consolidate influence and expansion in SEA locally and the whole of the Pacific generally.
Russia has similar interest looking west, where Russia goal is to control all of western & Central Europe via energy. While Iran plays the linchpin where Russia, China and Iran engage America in a war of attrition in the unresolvable ME, impacting the political situation in America’s primary Presidential election year.
Maximum pressure campaign by three ideologically aligned state actors. All possess mutual interest and seek Regional hegemony.
Their actions taken separately and together, painted with a broad-brush stroke, engage the Trump Administration by capitalizing on and encouraging through surrogates, the continued domestic political discord.
This is not a product of happenstance or coincidence. It is not by chance that Russia decides to up the ante to gauge response by flying a routine mission into AM/CA airspace, while the Administration is confronting pandemic hysteria and the accusation by China that America is responsible for the virus, mixed that opaque color with the MSM Propaganda charging incompetence and uncertainty, while Iran reenters the mix by attacking and killing Americans, a Red line crossed, confirming Iran also is willingly prepared for the loss of life in pursuit of its Regional ambition, is not accidentals.
Imo, this is not by chance, but by mutual interest that China, Russia, and Iran act, if not by formal verbal mutual consent and agreement, (Obama/Putin) but by understanding political opportunity, these three have capitalized with the understand that the enemy of my enemy is my friend philosophy.
Further, I suspect and have no faith that Kerry on his trip to Iran, acted in America’s best interest. Possibly encouraging these events, by explaining the possible outcome that would be mutually beneficial if Trump was not reelected in 2020.
Astronomy, I missed that, great assessment, thank you for the insightful lesson.
Edit to add: Thinking about this further, you are stating intent combined with unforeseen consequences. So the release was intentional and the release of the virus was a domestic solution that unraveled adversely.
TOMAHAWK9521
03-13-2020, 21:57
If I missed someone else already mentioning this, I'll go ahead and apologize ahead of time. These articles provide a little insight as to how the Wu Flu showed up in Italy. The timeline for the Wu Flu emergence in Europe can be traced to the Chinese workforce returning from the home country after the lunar new year.
https://www.businessinsider.com/chinese-take-over-italys-garment-workshops-2013-12?op=1
https://www.ecnmy.org/engage/prato-chinese-stuff-look-around/
https://www.nytimes.com/2019/12/05/business/italy-china-far-right.html
https://fashionista.com/2013/02/as-more-chinese-factories-pop-up-in-italy-what-does-it-mean-for-the-made-in-italy-label https://www.bloomberg.com/news/articles/2011-11-03/italian-jobs-chinese-illegals
https://www.english-online.at/news-articles/business-economy/chinese-clothes-made-in-italy.htm
Working nights so far this weekend has been, well, interesting. Now we have the ability to test but it's a 3 day turn around through LabCorp. Our facility is now taking it seriously. We're allowing only one visitor per patient and our director has purchased disposable Ventilators. I think we have 15 on hand now in addition to our current fleet with possibly more on order. Our department is responsible for all our PAPRs and we're in the process of obtaining more. They seem to be more effective than N95s. MAXAIR-systems are the ones we're using. All I can say is in three days we'll know what we're up against. Flatten the curve!
InTheBlack
03-14-2020, 01:47
our director has purchased disposable Ventilators. I think we have 15 on hand now in addition to our current fleet with possibly more on order. Our department is responsible for all our PAPRs ...
I see that disposable ventilators seem to be for short term use. Is there a strategy for choosing these or are they the only kind available? My very short reading about ARDS has me believing that patients are on them for a long time. The article talked about optimizing the ventilator settings -- not too deep a breath so you don't tear the tissue, etc.
InTheBlack
03-14-2020, 01:50
My order with Graingers, made some time ago, was cancelled today for that reason.
My wife is upset that the things I have been talking about have happened.
InTheBlack
03-14-2020, 02:10
The following is linked to in the 13MAR20 daily situation report from Johns Hopkins:
http://www.centerforhealthsecurity.org/resources/COVID-19/
Clinicians' Biosecurity News 3/13/20
http://www.centerforhealthsecurity.org/cbn/2020/cbnreport-03132020.html
Get Ready for a 1918-like Scenario
Eric Toner, MD | March 13, 2020
My colleagues and I just submitted to medRxiv a paper on what a Wuhan-like epidemic would do to US ICUs.
https://medrxiv.org/cgi/content/short/2020.03.09.20033241v1
The bottom line is that demand would far exceed capacity, and some people in need of critical care would not be able to get it. But it is not just Wuhan; Italy is currently in the midst of a similar outbreak, and critical care services are overwhelmed there, too.
The encouraging news, however, is that it seems that community mitigation strategies—such as isolating the sick, home quarantining the exposed, canceling mass gatherings, and social distancing—have worked to tamp down the height of the epidemic wave and therefore have kept the healthcare systems functional in other parts of China, Hong Kong, Singapore, South Korea, and Japan. But to be effective, these measures need to be vigorously implemented several weeks before hospitals become overwhelmed.
Applying Wuhan data to the average US city
SNIP
EDIT: FROM THE PREPRINT ITSELF:
...secondary transmission in the community continued as patients and their household contacts
moved between hospitals seeking care.
Exceeding healthcare capacity may also lead to decreased quality of care, such as not being
able to get access to a ventilator, which would lead to an increased case fatality ratio. By the
end of February, Wuhan’s case fatality ratio was 4.5%, 3.2% for the rest of Hubei province, and
for the rest of China, where healthcare capacity was not exceeded due to strong social
distancing and contact quarantine measures in the early phase of the epidemic (such as
Guangzhou), 0.8%.
In both Wuhan and Guangzhou, the lockdowns did not lead to immediate downturns in the
demand for hospitalization or the number of serious cases; rather, the peak in these measures
occurred approximately a month after the lockdown in Wuhan, and two weeks after the
lockdown in Guangzhou. This delay reflects the potentially long time from infection to severe
and critical conditions as many COVID-19 patients who eventually require ICU care present
initially as having only mild symptoms,14 and even longer time to discharge or death,15 resulting
in the accumulation of hospitalized cases long after the downturns in the community spread. In
Wuhan, the longer delay may also reflect the ongoing transmission after the lockdown described
above, which itself resulted from the overloading of the healthcare system.
see that disposable ventilators seem to be for short term use. Is there a strategy for choosing these or are they the only kind available? My very short reading about ARDS has me believing that patients are on them for a long time. The article talked about optimizing the ventilator settings -- not too deep a breath so you don't tear the tissue, etc.
It's my understanding that fortunately ventilation (co2) isn't the issue, it's just profound hypoxemic respiratory failure. The ones who require ventilatory support are on for at least 20-30 days. At ~100 bucks a pop and readily available, it's a simple procedure to take the patient off the vent and bag them with a peep valve while changing out the disposable vent. Shouldn't be an issue. If you happen to have access to a Facebook account, below is a link to a Doctor in Italy who is sharing the strategies that seem to be working for Ventilator patients. It appears proning seems to work well. His page is public.
Edited to add:
According to the Doc in Italy, the lung compliance never really gets that bad as it does with typical ARDS. That's a good thing because it won't take too high a pressure (if using pressure control ventilation) or too high a volume (SIMV or volume modes) to ventilate a patient. The lower the pressure, or volume, the less tissue damage.
https://m.facebook.com/story.php?story_fbid=3556124411128163&id=100001919188234&fs=0&focus_composer=0&ref=bookmarks
Trapper John
03-14-2020, 08:15
So now I need the math to turn 75% v/v 2 Propanol aka Isopropanol, into 75% w/v.
What is 75% w/v expressed as % v/v, since weighing the liquid would be very tedious & most do not have an accurate enough scale?
All you need is the density of IPA. If density is 1.0 g/ml then 75% IPA (v/v) is 75% w/v. If the density is 0.8g/ml then 75% IPA (v/v) is 60% IPA (w/v) and is the recommended concentration for use as a disinfectant. I guessed the density of IPA is 0.8 g/ml, but you can look that up to be exact. :p
All you need is the density of IPA. :p
Had me for about 30sec :munchin
Trapper John
03-14-2020, 11:58
Had me for about 30sec :munchin
You funny Petason! :D
ABC123
Russian, China, and Iran in less than a week present a direct threat, arguably coordinated, while also holding a duplicity of deniability. Two of the actions include the acceptance for the loss of life. Those incidents where loss of life is recorded occur in china as a deniable byproduct of zoonotic transfer in an outdoor market, covering the actual intent of releasing a 2nd novel virus with pandemic potential.
The 2nd virus corrected the deficiencies that the 1st SARS virus lacked. Released in Wuhan, layers the plausible denial for China’s leaders to argue, and later to lay elsewhere. The concept of state sponsored genocide is unthinkable for the West, but not for China. The strategy embraces the risk of unimageable loss of life, the goal to humble and hallow out America’s ability to defend/react, while China holds hostage the entire American/world financial system, offering the opportunity to complete China’s long term goal of reincorporating its ancestral rouge territories: Hong Kong Taiwan; consolidate influence and expansion in SEA locally and the whole of the Pacific generally.
Russia has similar interest looking west, where Russia goal is to control all of western & Central Europe via energy. While Iran plays the linchpin where Russia, China and Iran engage America in a war of attrition in the unresolvable ME, impacting the political situation in America’s primary Presidential election year.
Maximum pressure campaign by three ideologically aligned state actors. All possess mutual interest and seek Regional hegemony.
Their actions taken separately and together, painted with a broad-brush stroke, engage the Trump Administration by capitalizing on and encouraging through surrogates, the continued domestic political discord.
This is not a product of happenstance or coincidence. It is not by chance that Russia decides to up the ante to gauge response by flying a routine mission into AM/CA airspace, while the Administration is confronting pandemic hysteria and the accusation by China that America is responsible for the virus, mixed that opaque color with the MSM Propaganda charging incompetence and uncertainty, while Iran reenters the mix by attacking and killing Americans, a Red line crossed, confirming Iran also is willingly prepared for the loss of life in pursuit of its Regional ambition, is not accidentals.
Imo, this is not by chance, but by mutual interest that China, Russia, and Iran act, if not by formal verbal mutual consent and agreement, (Obama/Putin) but by understanding political opportunity, these three have capitalized with the understand that the enemy of my enemy is my friend philosophy.
Further, I suspect and have no faith that Kerry on his trip to Iran, acted in America’s best interest. Possibly encouraging these events, by explaining the possible outcome that would be mutually beneficial if Trump was not reelected in 2020.
While I strongly agree with the premise that Russia wants to control Western Europe with energy(based on the following):
Early 80’s energy pipeline deal smashed by Reagan
Western Europe pushing hard for Libya intervention to diversify supply
Russia/Turkey nexus(unthinkable years ago) to monopolise EU access to energy out of Central Asia.
BUT, the implosion of OPEC and collapse of energy prices puts Russia at risk in the same way the Oil Glut of the 80’s directly contributed to the collapse of the Soviet Union a few years later.
Russia is utterly dependent on oil export revenue(higher energy prices) to maintain power.
The same applies to Iran.
China wants/needs cheap energy to keep the machine going.
I think that’s where their key economic interests diverge significantly.
If China lost a few hundred million old folks it would rebalance the artificial lump of old people in the demographic chart from long term one-child policy.
But it would eliminate a lot of energy consumers as well.
Common enemies align, but incongruent economic interests disrupt.
Perhaps there is another “only Nixon could go to China” moment in the next few years.
A: Bear's are waking up from hybridization and we all know what they do in the woods.
Lol Sir!
Hope this the the spot to put this thought, but am going to give a huge Thank You right now to all QP's over the years here for the incredible wisdom in threads like Be Prepared!
While other's are fighting at the stores and in panic mode over Covid19, those of us fortunate enough to have access to this site are prepared and have plenty of gloves, sanitizers, paper goods, canned good, batteries, hydration etc... (Alcoholic beverages included for some.);)
Shout Out to PS for allowing us regular folks to have access to your intelligence to learn from.
Know am not the only one who feels this way.:lifter
Ok, back to the Wuhan Virus latest..
Holly
InTheBlack
03-14-2020, 15:58
It's my understanding that fortunately ventilation (co2) isn't the issue, it's just profound hypoxemic respiratory failure. The ones who require ventilatory support are on for at least 20-30 days.
I want to learn more about the topic of ventilation. I take it that a ventilator is a device that uses a source of pressurized air (possibly oxygen enriched) and either a trach tube or close fitting mask to reduce the effort of breathing.
In the worst case situation of no hospital available, can a "disposable" ventilator be hooked up to something like a high-enough pressure oxygen concentrator to do the job? Obviously the pump must be oil-free & filtered; you can't hook up to your Craftsman air tool compressor.
I want to learn more about the topic of ventilation.
Probably the most widely read book by Therapists. It covers the vent questions you have and the aerosol questions earlier in the thread that you had:
> https://www.amazon.com/Egans-Fundamentals-Respiratory-Robert-Kacmarek/dp/0323341365
Sorry for the sidetrack......
InTheBlack
03-15-2020, 01:26
Article lists several independant observations:
https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html
One calculates 2-3 days before symptoms show.
Also France urges not to use anti-inflammatory type fever reducers. Recommends Acetaminophen.
If you work with Vents, here's some good info if your facility gets overrun. How to ventilate multiple patients with one ventilator, good stuff:
https://youtu.be/uClq978oohY
Lol Sir!
Hope this the the spot to put this thought, but am going to give a huge Thank You right now to all QP's over the years here for the incredible wisdom in threads like Be Prepared!
While other's are fighting at the stores and in panic mode over Covid19, those of us fortunate enough to have access to this site are prepared and have plenty of gloves, sanitizers, paper goods, canned good, batteries, hydration etc... (Alcoholic beverages included for some.);)
Shout Out to PS for allowing us regular folks to have access to your intelligence to learn from.
Know am not the only one who feels this way.:lifter
Ok, back to the Wuhan Virus latest..
Holly
Kind of you holly,
Most of us regulars on the forum take for granted being prepared for most situations because it is a way of life. We have built in resistance to mental and physical discomfort or coming up with novel solutions to a problem because we have had to deal with life in other countries that do not have convenience of shopping anytime you want or even clean water like here in the USA.
Unfortunately that is not the norm for the rest of the population, Any disruption turns into madness and stress.
Simple things to lower that stress, are planting a garden like our grandparents did even a very small one.
Air 3 min, hypothermia 3 hours, water 2-3 days, food 3 weeks, Most emergencies pass or civilization has fallen apart in 3 months. general rules but not always the case.
3 months is ironically about the time it takes for a major food crop to be available from sowing in the ground to store front for world populations in the right circumstances.
MOD's feel free to move this post to Field craft
Kind of you holly,
Most of us regulars on the forum take for granted being prepared for most situations because it is a way of life. We have built in resistance to mental and physical discomfort or coming up with novel solutions to a problem because we have had to deal with life in other countries that do not have convenience of shopping anytime you want or even clean water like here in the USA.
Unfortunately that is not the norm for the rest of the population, Any disruption turns into madness and stress.
Simple things to lower that stress, are planting a garden like our grandparents did even a very small one.
Air 3 min, hypothermia 3 hours, water 2-3 days, food 3 weeks, Most emergencies pass or civilization has fallen apart in 3 months. general rules but not always the case.
3 months is ironically about the time it takes for a major food crop to be available from sowing in the ground to store front for world populations in the right circumstances.
MOD's feel free to move this post to Field craft
QP's are resiliency in action, IMHO. :)
This Wuhan virus thread contains many course corrections in it, as it is a very fluid situation right now IMHO???
Heck, my bro just flew in from a pre planned trip from Egypt via London, Canada, MN, on Friday night.
Should we still have our family gathering here at the house with steaks and Ham?
We are saying yes. We are prepared. Not fearful.
Edit to add: The government is saying to trust in them for treating and results via a telephone call...from them. Hmmmm. Just does not seem very amenable.
Holly:munchin
Badger52
03-15-2020, 16:18
Should we still have our family gathering here at the house with steaks and Ham?
Shouldn't that be in pink font?
:munchin
InTheBlack
03-15-2020, 18:47
Should we still have our family gathering here at the house with steaks and Ham?
We are saying yes. We are prepared. Not fearful.
No, he should self quarantine. And everyone he has had close contact with. How exactly are you prepared to avoid infection if he is in that 2-3 day period when he may be infectious before being symptomatic?
InTheBlack
03-15-2020, 20:18
Pre-emptive low cost social distancing and enhanced hygiene implemented before local COVID-19 transmission could decrease the number and severity of cases.
Dalton 5MAR20
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3549276
The use of masks outside of health settings is controversial and it is important that masks not be diverted from health care supplies.
However, surgical masks are protective of large droplet spread and have approximately half the effectiveness of N95 mask for small droplet transmission, and are suggested to be cost saving in some modelled pandemic influenza scenarios. NOTE 20
They may have a limited role in the community setting prior to widespread transmission if there are adequate supplies and should be considered for use in households caring for COVID-19 cases at home. NOTE 16
16. Wein LM, Atkinson MP. Assessing infection control measures for pandemic influenza. Risk Anal. 2009;29:949–962.
20. Mukerji S, MacIntyre CR, Newall AT. Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission. BMC Infect Dis. 2015;15:413. Published 2015 Oct 13. doi:10.1186/s12879-015-1167-6.
doctom54
03-15-2020, 20:31
Italy is getting slammed and the entire medical community is now doing triage.
Truly amazing!
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/
I hope it turns out well!
Now at 25,000 cases and 1,800 deaths in Italy.
Now at 25,000 cases and 1,800 deaths in Italy.
on the flip... :mad:
Ohio governor destroys 10,000,000 jobs for 37 sick people.
Most of which are not covered by unemployment insurance.
Food riots to start next week. :mad:
Gov. DeWine announces closure of Ohio bars, dine-in restaurants
Published: 03/15/20 03:27 pm EDT
Updated: 03/15/20 09:16 pm EDT
COLUMBUS, Ohio - Ohio Gov. Mike DeWine will be issuing an order to close all bars and restaurants Sunday night at 9 p.m. to help prevent the spread of the coronavirus.
https://www.10tv.com/article/gov-dewine-announces-closure-ohio-bars-dine-restaurants-2020-mar
bblhead672
03-16-2020, 08:42
Extreme government over-reaction seems to be the uniform of the day...followed by sheeple over-reaction.
Meanwhile..this is such a major event that the CDC takes the weekends off from posting updated numbers of cases/deaths. Seems to me that if it were really as bad as it's being made out to be that updates would be posted more frequently than noon on Monday-Friday.
Badger52
03-16-2020, 10:22
Extreme government over-reaction seems to be the uniform of the day...followed by sheeple over-reaction.
Meanwhile..this is such a major event that the CDC takes the weekends off from posting updated numbers of cases/deaths. Seems to me that if it were really as bad as it's being made out to be that updates would be posted more frequently than noon on Monday-Friday.Yes, typically local sources are actually more timely I don't even live there & heard about WY's 3rd case from a friend overnight.
Also, CDC is located in Atlanta. Wonder how much "telework" is going on there.
Ret10Echo
03-16-2020, 10:27
on the flip... :mad:
Ohio governor destroys 10,000,000 jobs for 37 sick people.
Most of which are not covered by unemployment insurance.
Food riots to start next week. :mad:
Maryland Governor followed suite on the closure of restaurants, bars and theaters effective 17:00 Eastern today.
Is it better to "force" closure or to ban movement where restaurants are on the fence about whether to stay open or not?
I know there are restaurant owners on here (Penn)
Does the government bail out the hospitality industry as it did the banking industry? This is not an event of their (hospitality and service industry) making.
bblhead672
03-16-2020, 10:31
Governor of Indiana decides to jump on the train...
Indiana to close bars, restaurants to in-person patrons in response to coronavirus pandemic (https://www.theindychannel.com/coronavirus/indiana-to-close-bars-restaurants-to-in-person-patrons-in-response-to-coronavirus-pandemic)
Indiana has 12 confirmed cases.
rsdengler
03-16-2020, 11:03
Maryland Governor followed suite on the closure of restaurants, bars and theaters effective 17:00 Eastern today.
Is it better to "force" closure or to ban movement where restaurants are on the fence about whether to stay open or not?
Yep, just heard that as well. I think carry out and delivery are the only places that are allowed to stay open. Oh, and gyms are closed as well. Glad I have one in my basement. I'm still at work though, Baltimore County Government is open unless you want to work from home. Who knows, they may decide to close up, I know they restricted visitors to our County Court Buildings, and closed Senior and Rec Centers.
Old Dog New Trick
03-16-2020, 11:10
I was skiing in Colorado up until the governor closed all ski resorts in the state yesterday morning. Enjoying the great outdoors closest I ever came to the few other thousand people skiing was a lift line where six feet of separation is pretty normal with everyone wearing six feet of skis or three foot long snowboards. Most people wore a ski mask or something to keep face warm and everyone wore gloves.
While the governor closed the great outdoors, all the shops and restaurants were open for business. “Confused?”
Service industry is going to tank. Sad!
How many infected people in Colorado? Shrug?
Old Dog New Trick
03-16-2020, 11:12
Yep, just heard that as well. I think carry out and delivery are the only places that are allowed to stay open. Oh, and gyms are closed as well. Glad I have one in my basement. I'm still at work though, Baltimore County Government is open unless you want to work from home. Who knows, they may decide to close up, I know they restricted visitors to our County Court Buildings, and closed Senior and Rec Centers.
Yes, I absolutely trust the Grubhub or UberEats driver to wash their hands before driving from house to business to house over and over one house at a time.
What could go wrong?
ETA: the governors closing bars at time X because before time X you cannot get the virus. (Face palm)
rsdengler
03-16-2020, 11:23
Yes, I absolutely trust the Grubhub or UberEats driver to wash their hands before driving from house to business to house over and over one house at a time.
What could go wrong?
ETA: the governors closing bars at time X because before time X you cannot get the virus. (Face palm)
Lol, no I don't trust them at all to wash their hands. I rather just fix my own stuff anyway, unless I have a craving for a med rare cheeseburger. Then I'd just pick it up myself.
Ret10Echo
03-16-2020, 13:04
Yep, just heard that as well. I think carry out and delivery are the only places that are allowed to stay open. Oh, and gyms are closed as well. Glad I have one in my basement. I'm still at work though, Baltimore County Government is open unless you want to work from home. Who knows, they may decide to close up, I know they restricted visitors to our County Court Buildings, and closed Senior and Rec Centers.
Seems Like B-more is urging people to stay home... Just not city employees??
InTheBlack
03-16-2020, 13:07
37 known cases is how many actual? say 370. Doubling time 6 days. 30 days = 11,840 cases. If actual is 3700, then 118,400.
What number overloads the hospitals, affecting other critical care cases? Pick your number & work backwards to see the number of actual cases today which cross the threshold. Is that a reasonable number to believe exist?
InTheBlack
03-16-2020, 13:09
Baltimore closed the impound lot. But fines are frozen. Don't get towed, or looks like you are SOL for the duration. Stupid.
rsdengler
03-16-2020, 13:42
Seems Like B-more is urging people to stay home... Just not city employees??
I don't know about Baltimore City Government, I work for Baltimore County which is different. This is from our main Website:
County Employees
Non-Essential Employee Telework: Baltimore County has instituted telework for all non-essential employees who are able to do so.
I work in a satellite office 20 mins from Towson, so we are not at full capacity here. I know that if anyone here shows symptoms, we will be closing down; we have this "emergency plan" if that happens. As far as I know, there has been no one w/symptoms, etc. at this location or in our other facilities. But they do state if someone feels "sick" in anyway to stay home.
GratefulCitizen
03-16-2020, 13:59
Schools closed, large events cancelled, sports seasons suspended, workers directed to telecommute, etc.
Meanwhile, the hours of service rules for truck drivers are being suspended.
Most are being told to stay home and stay safe.
Truckers are being told to travel more and work more.
A link posted in another thread detailed what would happen if the trucks stopped moving.
The pdf it was linked to has been taken down, and similar documents are difficult to find with an Internet search.
The supply chain is more fragile than people realize.
Ret10Echo
03-16-2020, 14:19
The supply chain is more fragile than people realize.
The efficiency and lowered-cost of consumer goods is dependent upon a Just-in-Time supply chain mechanism. WalMart is expert in that. Problem is that companies did not have the algorithm in place or the intel to account for the surge on paper products and certain other goods. The replacements just don't exist and if they do somehow surge manufacturing or shipping on one end, the last mile delivery is scaled to handle the 'norm' not the surge.
I'm waiting as well on the next surge. Internet capacity and bandwidth demands (fixed fiber // wireless). Spring Break is providing a false lull but with an estimated 3 Million college students plus (potentially) state and local school districts expecting to transition to online environments how does that compete with business demands on network capacity during peak hours....not to mention all of the laid-off service industry workers that will most likely be doing something online whether streaming services or social media.
Ret10Echo
03-16-2020, 14:39
Mein Gott
HARRISBURG, Pa. (WJAC) — All Pennsylvania liquor stores have been ordered to close as COVID-19 mitigation efforts continue, the Liquor and Control Board announced Monday.
All Fine Wine & Good Spirits stores, licensee service centers and e-commerce sales will be closed indefinitely beginning at 9 p.m. Tuesday.
InTheBlack
03-16-2020, 15:13
as part of overall social distancing & going out in public less often.:
https://www.medrxiv.org/content/10.1101/2020.03.12.20034660v1
Impact assessment of non-pharmaceutical interventions against COVID-19 and influenza in Hong Kong: an observational study
Benjamin J Cowling, Sheikh Taslim Ali, Tiffany W. Y. Ng, Tim K Tsang, Julian C. M Li, Min Whui Fong, Qiuyan Liao, Mike YW Kwan, So Lun Lee, Susan S. Chiu, Joseph T. Wu, Peng Wu, Gabriel M. Leung
doi: https://doi.org/10.1101/2020.03.12.20034660
Abstract
Background: A range of public health measures have been implemented to delay and reduce local transmission of COVID-19 in Hong Kong, and there have been major changes in behaviours of the general public. We examined the effect of these interventions and behavioral changes on the incidence of COVID-19 as well as on influenza virus infections which may share some aspects of transmission dynamics with COVID-19.
Methods:
We reviewed policy interventions and measured changes in population behaviours through two telephone surveys, on January 20-23 and February 11-14. We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (R_t), for COVID-19 and influenza A(H1N1).
Findings:
COVID-19 transmissibility has remained at or below 1, indicating successful containment to date. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% confidence interval, CI: 34% to 53%) reduction in transmissibility in the community, and a 33% (95% CI: 24% to 43%) reduction in transmissibility based on paediatric hospitalization rates.
In the two surveys we estimated that 74.5% and 97.5% of the general adult population wore masks when going out, and 61.3% and 90.2% avoided going to crowded places, respectively.
Implications:
Containment measures, social distancing measures and changes in population behaviour have successfully prevented spread of COVID-19.
The social distancing measures and behavioural changes led to a substantial reduction in influenza transmission in early February 2020.
However, it may be challenging to avoid fatigue and sustain these measures and population behaviours as COVID-19 continues to spread globally.
Badger52
03-16-2020, 15:15
Mein GottFor some, das Ende.
InTheBlack
03-16-2020, 15:31
https://www.medscape.com/viewarticle/926893
A Million COVID-19 Cases Already, Global Estimates Suggest
Ricki Lewis, PhD
March 16, 2020
Spread of the novel coronavirus SARS-CoV-2 from Hubei Province, China prior to travel restrictions imposed on January 23 likely seeded a million cases worldwide so far, many so mild that people might not have realized they were infected, according to findings published online today in the journal Science.
Researchers discussed the findings of the new study and a previously posted study on the effect of travel restrictions during a news conference today.
In the Science article, Ruiyun Li, PhD, from the MRC Centre for Global Infectious Disease Analysis, Imperial College London, UK, and colleagues used mathematical modeling that combined data on people's movements among 375 Chinese cities with reported infection data, using statistical inference techniques.
The analysis suggests that before travel restrictions were instituted in Wuhan, 86% of cases were undocumented. The model also estimates that these undetected cases were 55% as contagious as were documented infections.
"Six out of seven cases are undocumented. The majority of cases are mild, with few or no symptoms, so most people may think they have a cold or not recognize that they're ill. If globally 150,000 are confirmed, then it's not unreasonable to project that we're approaching close to a million infections globally," said senior author Jeffrey Shaman, PhD, from the Mailman School of Public Health at Columbia University, New York City.
That also means that the 3500 or so documented cases in the United States are likely the tip of an iceberg.
The travel restrictions imposed in late January might have had only a limited effect, said Elizabeth Halloran, MD, DSc, director of the Center for Inference and Dynamics of Infectious Diseases at the Fred Hutchinson Cancer Research Center in Seattle, Washington and a coauthor of the earlier study, posted on medRxiv preprint server. (Articles posted on the medRxiv server, including the one on travel restrictions, have not been peer-reviewed.)
"Travel restrictions alone do not do much to delay the spread of the disease. Reducing transmissibility is really the key," she said.
Other speakers concurred.
SNIP
I don't know about Baltimore City Government, I work for Baltimore County which is different. This is from our main Website:
County Employees
Non-Essential Employee Telework: Baltimore County has instituted telework for all non-essential employees who are able to do so.
Does the "non-essentials" include the un-employment & welfare office, cause that's where those 100k service industry X-employees are headed for food stamps?
RIOTS @ 11pm news.. :mad:
They will never know the true count right now unless they take a small suburb of an area near the rest home - maybe 5,000 folks and just test everybody.
That will give a count of the "unknowns" running through a population.
Comrade De Blasio says the key is to nationalize affected industries to fix the Corona-V problem.
You can bet The Bern and Fumbling Joe(if he remembers) will quote De Blasio until the elections.
2 for 1,, get the Left happy and scare the shit out of the uninformed populace..
New York City Mayor Bill de Blasio on Saturday said he believes the Wuhan coronavirus is a prime example of why it's important for the federal government to nationalize "crucial factories and industries."
According to the Big Apple's mayor, people can get tested for the virus, but it's being done on a "priority structure" due to the limited number of tests that are available.
"Here’s the reality. This is a war-like situation. We’re in a wartime scenario with a Mar-a-Lago attitude being used by the federal government. It’s so laid back, and I don’t understand it," he told MSNBC's Joy Reid. "By the way, testing. How about ventilators? Where is the federal government making sure our hospitals have the ventilators we’re going to need? Where is the federal government when it comes to surgical masks, getting them distributed? This is a case for a nationalization of crucial factories and industries – literally a nationalization – that could produce the medical supplies to prepare this country for what we need."
https://townhall.com/tipsheet/bethbaumann/2020/03/14/de-blasio-wuhan-virus-is-an-example-of-why-the-feds-need-to-take-over-crucial-f-n2564945
Where's that ammo truck when you need it? :munchin
Remember Bill Maher, he prayed for a recession, the D卐M☭CRAT's want to crush the economy.
On closing a restaurant due to COVID-19.
We were open this week end, operated at 80% capacity. We removed a table to allow for some distance between clients. They noticed that consideration. Everyone, including the staff were nervous, you could see it, how people stood apart, or waited until the door way was clear to enter/exit. Once seated they were cool.
Impact of closing is simple, everyone gets hurt. We will take care of our staff financially and with sharing our inventory.
That said, I'm content that we have closed before being ordered to do so. Staying open presents risks that are not worth the return on reputation. imho