quote:

Originally posted by alteon180e:
italy is perplexing to me. i understand they are in severe deficit of ICU capacity. this is tragic, but let me ask, according to some reporting:
italy stats

are we talking about less than 1,200 people needing hospital care in all of italy? i may be wrong but out of the ~13K active cases, 11.6K or so are in "mild" condition. is mild considered hospital care? can they go home? even if double 1,200 "more" people needed respirators...is their lockdown not letting all of italy's medical facilities be used for their care? is there a high concentration of very sick people in too small of a region and its current hospital capacity? are they not leveraging their national capacity to treat people, due to mitigate the spread?

im lost on the idea that under 2000 "more" people need serious medical care in italy, but the whole country's medical system is collapsing, and going to into terminal triage mode. "letting people die". not an expert, but the dumb guy asking dumb questions i guess...

I wouldn't get too wrapped-up and deep into the statistics considering how fluid it is.
For some perspective, the vast majority of cases are in Northern Italy, which is the wealthier and better resourced part of the country, so a surge of 1200 patients, on top of the existing patients already admitted for other issues, is still a sizeable surge for just 3-4 provinces. The fearful danger and why Italy put the whole country on quarantine, is when the virus migrates to the Southern portion of the country, where resources and education are not comparable to the North, their numbers are going to grow much larger than they already are.

Italy has the oldest population in the Europe, like many elderly, they don't want to be a burden and want to be self-reliant so, reporting or, getting to a hospital can be a difficult if not resistant. I suspect in month or, so, cases of people having died in their own beds/homes/appts, is going to common there.

quote:

Originally posted by ensigmatic:

quote:

Originally posted by 12GA:
Both my children are teachers in city school districts and this is absolutely true. They’re both hoping their schools stay open so that their students will continue to get two meals a day.

I find this utterly appalling. They're supposed to be in school, the school systems for which I pay taxes, to feed their minds, not their bellies

Same here. Not only that, but people are actively rooting for schools to stay open, ensuring further spread of the disease among students who CAN afford to eat at home. Because poor kids. Yeah, that seems fair and logical.

quote:

Originally posted by Sigmanic:
Hope the Trumpster dodged this bullet....



Brazil's President Bolsonaro tests positive for coronavirus, further testing being done

This appears to be more BS from the media

quote:

Originally posted by pessimist:
I'm still going to the gym which is probably among the most dangerous activities right now.

I would think so, because of the number of surfaces you and others touch, many of those surfaces being the types of materials upon which SARS-CoV-2 has the longest persistence, and the fact few people wipe down.

That's why day-before-yesterday, the day following the first confirmed cases reported in my area, was my last day in the gym for a while.

quote:

Originally posted by pessimist:
I am, however, very concerned about my mother.

In my case it's my wife, who has compromised lungs and immune system. I would probably tolerate getting infected. Her: Not so much. So, were it just me, I'd probably not forgo the gym. For her I will. Gladly.

Hell, I've taken breaks for far less important reasons than my wife.

quote:

Originally posted by Balzé Halzé:

quote:

Originally posted by Sigmanic:
Hope the Trumpster dodged this bullet....



Brazil's President Bolsonaro tests positive for coronavirus, further testing being done

This appears to be more BS from the media

Safe to say, the media, if not hopeful, they're encouraging and leading with their headlines..

The most intelligent and useful report I've seen on Covid-19 yet. Unfortunately, it's only on Linkedin. I'll post the link, and then go back and try and post it as text.

Edit: posted the text, but the formatting didn't make it. The information is there. If you can get into Linkedin, it will be easier to read.

https://www.linkedin.com/pulse...-jordan-shlain-m-d-/

University of California, San Francisco BioHub Panel on COVID-19

March 10, 2020

Panelists
Joe DeRisi: UCSF’s top infectious disease researcher. Co-president of ChanZuckerberg BioHub (a JV involving UCSF / Berkeley / Stanford). Co-inventor of the chip used in SARS epidemic.
Emily Crawford: COVID task force director. Focused on diagnostics
Cristina Tato: Rapid Response Director. Immunologist.
Patrick Ayescue: Leading outbreak response and surveillance. Epidemiologist.
Chaz Langelier: UCSF Infectious Disease doc
What’s below are essentially direct quotes from the panelists. I bracketed the few things that are not quotes.

Top takeaways
At this point, we are past containment. Containment is basically futile. Our containment efforts won’t reduce the number who get infected in the US.
Now we’re just trying to slow the spread, to help healthcare providers deal with the demand peak. In other words, the goal of containment is to "flatten the curve", to lower the peak of the surge of demand that will hit healthcare providers. And to buy time, in hopes a drug can be developed.
How many in the community already have the virus? No one knows.
We are moving from containment to care.
We in the US are currently where at where Italy was a week ago. We see nothing to say we will be substantially different.
40-70% of the US population will be infected over the next 12-18 months. After that level you can start to get herd immunity. Unlike flu this is entirely novel to humans, so there is no latent immunity in the global population.
[We used their numbers to work out a guesstimate of deaths— indicating about 1.5 million Americans may die. The panelists did not disagree with our estimate. This compares to seasonal flu’s average of 50K Americans per year. Assume 50% of US population, that’s 160M people infected. With 1% mortality rate that's 1.6M Americans die over the next 12-18 months.]
The fatality rate is in the range of 10X flu.
This assumes no drug is found effective and made available.
The death rate varies hugely by age. Over age 80 the mortality rate could be 10-15%. [See chart by age Signe found online, attached at bottom.]
Don’t know whether COVID-19 is seasonal but if is and subsides over the summer, it is likely to roar back in fall as the 1918 flu did
I can only tell you two things definitively. Definitively it’s going to get worse before it gets better. And we'll be dealing with this for the next year at least. Our lives are going to look different for the next year.
What should we do now? What are you doing for your family?
Appears one can be infectious before being symptomatic. We don’t know how infectious before symptomatic, but know that highest level of virus prevalence coincides with symptoms. We currently think folks are infectious 2 days before through 14 days after onset of symptoms (T-2 to T+14 onset).
How long does the virus last?
On surfaces, best guess is 4-20 hours depending on surface type (maybe a few days) but still no consensus on this
The virus is very susceptible to common anti-bacterial cleaning agents: bleach, hydrogen peroxide, alcohol-based.
Avoid concerts, movies, crowded places.
We have cancelled business travel.
Do the basic hygiene, eg hand washing and avoiding touching face.
Stockpile your critical prescription medications. Many pharma supply chains run through China. Pharma companies usually hold 2-3 months of raw materials, so may run out given the disruption in China’s manufacturing.
Pneumonia shot might be helpful. Not preventative of COVID-19, but reduces your chance of being weakened, which makes COVID-19 more dangerous.
Get a flu shot next fall. Not preventative of COVID-19, but reduces your chance of being weakened, which makes COVID-19 more dangerous.
We would say “Anyone over 60 stay at home unless it’s critical”. CDC toyed with idea of saying anyone over 60 not travel on commercial airlines.
We at UCSF are moving our “at-risk” parents back from nursing homes, etc. to their own homes. Then are not letting them out of the house. The other members of the family are washing hands the moment they come in.
Three routes of infection
Hand to mouth / face
Aerosol transmission
Fecal oral route
What if someone is sick?
If someone gets sick, have them stay home and socially isolate. There is very little you can do at a hospital that you couldn’t do at home. Most cases are mild. But if they are old or have lung or cardio-vascular problems, read on.
If someone gets quite sick who is old (70+) or with lung or cardio-vascular problems, take them to the ER.
There is no accepted treatment for COVID-19. The hospital will give supportive care (eg IV fluids, oxygen) to help you stay alive while your body fights the disease. ie to prevent sepsis.
If someone gets sick who is high risk (eg is both old and has lung/cardio-vascular problems), you can try to get them enrolled for “compassionate use" of Remdesivir, a drug that is in clinical trial at San Francisco General and UCSF, and in China. Need to find a doc there in order to ask to enroll. Remdesivir is an anti-viral from Gilead that showed effectiveness against MERS in primates and is being tried against COVID-19. If the trials succeed it might be available for next winter as production scales up far faster for drugs than for vaccines. [More I found online.]
Why is the fatality rate much higher for older adults?
Your immune system declines past age 50
Fatality rate tracks closely with “co-morbidity”, ie the presence of other conditions that compromise the patient’s hearth, especially respiratory or cardio-vascular illness. These conditions are higher in older adults.
Risk of pneumonia is higher in older adults.
What about testing to know if someone has COVID-19?
Bottom line, there is not enough testing capacity to be broadly useful. Here’s why.
Currently, there is no way to determine what a person has other than a PCR test. No other test can yet distinguish "COVID-19 from flu or from the other dozen respiratory bugs that are circulating”.
A Polymerase Chain Reaction (PCR) test can detect COVID-19’s RNA. However they still don’t have confidence in the test’s specificity, ie they don’t know the rate of false negatives.
The PCR test requires kits with reagents and requires clinical labs to process the kits.
While the kits are becoming available, the lab capacity is not growing.
The leading clinical lab firms, Quest and Labcore have capacity to process 1000 kits per day. For the nation.
Expanding processing capacity takes “time, space, and equipment.” And certification. ie it won’t happen soon.
UCSF and UCBerkeley have donated their research labs to process kits. But each has capacity to process only 20-40 kits per day. And are not clinically certified.
Novel test methods are on the horizon, but not here now and won’t be at any scale to be useful for the present danger.
How well is society preparing for the impact?
Local hospitals are adding capacity as we speak. UCSF’s Parnassus campus has erected “triage tents” in a parking lot. They have converted a ward to “negative pressure” which is needed to contain the virus. They are considering re-opening the shuttered Mt Zion facility.
If COVID-19 affected children then we would be seeing mass departures of families from cities. But thankfully now we know that kids are not affected.
School closures are one the biggest societal impacts. We need to be thoughtful before we close schools, especially elementary schools because of the knock-on effects. If elementary kids are not in school then some hospital staff can’t come to work, which decreases hospital capacity at a time of surging demand for hospital services.
Public Health systems are prepared to deal with short-term outbreaks that last for weeks, like an outbreak of meningitis. They do not have the capacity to sustain for outbreaks that last for months. Other solutions will have to be found.
What will we do to handle behavior changes that can last for months?
Many employees will need to make accommodations for elderly parents and those with underlying conditions and immune-suppressed.
Kids home due to school closures
[Dr. DeRisi had to leave the meeting for a call with the governor’s office. When he returned we asked what the call covered.] The epidemiological models the state is using to track and trigger action. The state is planning at what point they will take certain actions. ie what will trigger an order to cease any gatherings of over 1000 people.
Where do you find reliable news?
The John Hopkins Center for Health Security site. Which posts daily updates. The site says you can sign up to receive a daily newsletter on COVID-19 by email. [I tried and the page times out due to high demand. After three more tries I was successful in registering for the newsletter.]
The New York Times is good on scientific accuracy.

Observations on China
Unlike during SARS, China’s scientists are publishing openly and accurately on COVID-19.
While China’s early reports on incidence were clearly low, that seems to trace to their data management systems being overwhelmed, not to any bad intent.
Wuhan has 4.3 beds per thousand while US has 2.8 beds per thousand. Wuhan built 2 additional hospitals in 2 weeks. Even so, most patients were sent to gymnasiums to sleep on cots.
Early on no one had info on COVID-19. So China reacted in a way unique modern history, except in wartime.
Every few years there seems another: SARS, Ebola, MERS, H1N1, COVID-19. Growing strains of antibiotic resistant bacteria. Are we in the twilight of a century of medicine’s great triumph over infectious disease?
"We’ve been in a back and forth battle against viruses for a million years."
But it would sure help if every country would shut down their wet markets.
As with many things, the worst impact of COVID-19 will likely be in the countries with the least resources, eg Africa. See article on Wired magazine on sequencing of virus from Cambodia.

quote:

Originally posted by pessimist:
I've been popping in from time to time to read bits and pieces of this thread. All i can say is that this ridiculous thread should be preserved and studied by psychologists and their students for years to come.

Over 100 pages that reek of fear while most participants claim not to be the least bit concerned. Yet it's filled with spreadsheets, statistics, pouring over numbers and looking for reassurance from others in the herd who claim to be equally unperturbed. Let me give you a clue, if you're spending time pouring over numbers, you're shitting your britches.

Well... thank you for the clue.
Why do you keep "popping in from time to time to read bits and pieces" if no one here but you has a clue?

Hang on, guys. Stop everythimg. pessimist is presenting his lecture. He can save your life. Just listen to him. Kinda hard to hear him from his lofty perch, but that, too, is your fault.

Now, be quiet, be humble, and draw nigh for the clues which will save your life.

quote:

Originally posted by alteon180e:
italy is perplexing to me. i understand they are in severe deficit of ICU capacity. this is tragic, but let me ask, according to some reporting:
italy stats

are we talking about less than 1,200 people needing hospital care in all of italy? i may be wrong but out of the ~13K active cases, 11.6K or so are in "mild" condition. is mild considered hospital care? can they go home? even if double 1,200 "more" people needed respirators...is their lockdown not letting all of italy's medical facilities be used for their care? is there a high concentration of very sick people in too small of a region and its current hospital capacity? are they not leveraging their national capacity to treat people, due to mitigate the spread?

im lost on the idea that under 2000 "more" people need serious medical care in italy, but the whole country's medical system is collapsing, and going to into terminal triage mode. "letting people die". not an expert, but the dumb guy asking dumb questions i guess...

The current estimate that keeps getting quoted is that around 20% of cases warrant hospitalization and around 5% of cases warrant ICU care.

Right now the issue is not the number of cases spread all across Italy, it's the number of cases concentrated in a specific area in northern Italy (Lombardy). As I understand it, the rest of Italy is currently doing OK, but could face the same issues if the virus spreads a lot in other areas of Italy.

Hospitals operate fairly close to capacity because to do otherwise costs a lot of money, and hospitals usually do not have a lot of ICU beds.

Looking around online, I see estimates between 50,000 and 100,000 ICU beds in the entire United States, and it keeps getting quoted that there are about 77,000 ventilators in the entire United States. That sounds like a lot - if the 5% number is accurate, it means that if we could perfectly distribute them, it would take 1-2 million active cases in the US to fill them all up.

There are a couple problems with that, though.

First, we can't perfectly distribute them. There will be areas with more active cases and fewer ICU beds.

Second, all of them aren't available - many are currently in use for people with problems other than coronavirus, and other health problems requiring ICU care aren't going to just disappear because coronavirus is here.

Third, based on what has happened so far in other countries, we can't rule out the possibility of having MORE than 1-2 million active cases at once if we don't successfully control spread of the disease.

Mount Everest is now closed. There goes my spring break.

quote:

Originally posted by parabellum:
Hang on, guys. Stop everythimg. pessimist is presenting his lecture. He can save your life. Just listen to him. Kinda hard to hear him from his lofty perch, but that, too, is your fault.

Now, be quiet, be humble, and draw nigh for the clues which will save your life.

Trying to take notes but, the contradictions are confusing, wish there was a Clif Notes version or a summery..

POTUS is apparently holding a presser at 1500 EST where a national state of emergency will be declared including controls on interstate travel and increased LE powers.

quote:

Originally posted by trapper189:
Mount Everest is now closed. There goes my spring break.

Well shit.

Probably the safest place on the planet, and some idiot closes it.

I'll shift over to K2. There are 3 other 8000 meter peaks nearby.

Well crap. I was considering taking advantage of the cheap airfare prices and going to visit my boy Green Boots and his beautiful “cave”.

quote:

Originally posted by PGT:
POTUS is apparently holding a presser at 1500 EST where a national state of emergency will be declared including controls on interstate travel and increased LE powers.

Holy Executive Decisions, Batman!

quote:

Originally posted by PGT:
POTUS is apparently holding a presser at 1500 EST where a national state of emergency will be declared including controls on interstate travel and increased LE powers.

Its EDT now.

If that's accurate, surprised he's not waiting until market closes.

quote:

Originally posted by RHINOWSO:

Its EDT now.

if only people knew what I meant by that...

quote:

Originally posted by Georgeair:
If that's accurate, surprised he's not waiting until market closes.

100% it is. Major news outlets are running the story now.

What I want to know is if you get a mild case, is it called the Coronita virus?

quote:

Originally posted by RHINOWSO:

quote:

Originally posted by WaterburyBob:

quote:

Originally posted by RHINOWSO:
People are obviously rookies, you can wipe your ass just fine with Kleenex.

True, but flushing Kleenex can cause problems, as it doesn't dissolve as well as toilet paper.

That's the cities problem, eh?

Not if it causes a blockage in your house/yard (we're responsible for repairs all the way to the street connection here).