Wuhan Coronavirus

[mugwump]

Originally Posted by InTheBlack

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.

[T-Rock]

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_...0a276fc4.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......

[Pete]

Italy Locks Down the Country’s North to Fight Coronavirus

https://www.wsj.com/articles/italy-p...us-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.

[Pete]

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. ..."

[T-Rock]

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]

Originally Posted by Pete

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

[mugwump]

Originally Posted by Ret10Echo

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

[mugwump]

Originally Posted by T-Rock

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_...0a276fc4.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]

Originally Posted by mugwump

...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]

Originally Posted by grog18b

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.

[mugwump]

Originally Posted by Monsoon65

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]

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/2020-03-0...jMI/index.html
China is now producing over 110 million face masks a day, official data showed Monday.

http://www.xinhuanet.com/english/202..._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/2020-03-0...t8c/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]

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-i...achment-171409

The Global Macroeconomic Impacts of COVID-19 Seven Scenarios.pdf
2 MB pdf

[Pete]

Family of Missouri's first coronavirus patient broke self quarantine, St. Louis County officials say

https://www.stltoday.com/lifestyles/...5f79d019b.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...."

[Stobey]

Originally Posted by Pete

Italy Locks Down the Country’s North to Fight Coronavirus

https://www.wsj.com/articles/italy-p...us-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...ity-alert.html

Further from Raconteur Report:

https://raconteurreport.blogspot.com...race-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.