Coronavirus

[AlanSubie4Life]

With "hundreds or maybe even thousands" of young people dying, the math states they must be essentially immunocompromised outliers.

No, it doesn't follow that the people who die have to be immunocompromised individuals. I suspect the distribution is similar to what happens for all respiratory illnesses - immunocompromised individuals are at higher risk, but if you get unlucky, you die.

Far too many millions of young people have been infected for the math to state otherwise. We'd have 1M+ dead young people if that were the case.

That's not true. COVID-19 is not that deadly to the young, as I said. That's how the numbers work out. This isn't complicated. It can kill you if you're young, but it's not that common. But it's common enough to raise excess mortality (because young people don't typically die from respiratory diseases)

so far, many more Americans under 35 died in the Swine Flu pandemic of 2009.

Do we really have to revisit these numbers? They're elsewhere in this thread, so please refer to those well-researched numbers. Again, I'd like you to be correct, but this is just false.

From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus.

This epidemiological data supports laboratory serology studies that indicate that older people may have pre-existing immunity to the novel H1N1 flu virus. This age distribution is very different from what is normally seen for seasonal flu, where older people are more heavily impacted.

CDC Novel H1N1 Flu | 2009 H1N1 Early Outbreak and Disease Characteristics

There's no question that swine flu tended to be more deadly to young people RELATIVE to COVID-19 (see above: likely due to attack rate) but the claim that more people under 35 died in the swine flu pandemic does not stand up to a look at the evidence. And as mentioned above, part of the reason for the distribution is because young people dominated the swine flu infections! So that was likely due to 50 million infections in the young (80% of the infections were below age 49, alone)! That's a lot, and much higher than the attack rate for COVID-19 in the young.

For the charts below, these are CONFIRMED deaths, so they don't add to 12000 (best estimate of swine flu death total in US), of course, but it allows extrapolation. Implies: 2000 deaths below age 24, with about 40 million infections, for swine flu.

I can't directly compare to below 35 with this data, but I would estimate it was about 4000 estimated swine flu deaths in that age bracket. (Just from the charts below, estimating.). Compare to 2500 confirmed deaths with COVID-19, with substantially fewer infections. (Probably 45-50 million for swine flu vs. 35 million for COVID-19.)

Conclusion: that's likely less deadly than COVID-19 - we already have 500-600 confirmed deaths below age 24,with 2500 confirmed deaths below age 35, and we know there have not been 40 million infections in those age groups (best estimates are 70 million infections in all age groups in the US, total, for COVID-19 - and in this case many are in older people). And remember, we just have the official numbers from the CDC of deaths - these do not include uncounted COVID-19 deaths, which you can see likely exist, and are substantial, from the excess mortality data (see link below). There are a few unlucky young individuals who are dropping dead of COVID-19 (likely due to clotting/stroke/cardiovascular side effects). Some of these are not counted. You have to compare apples to apples: we have ESTIMATES of swine flu deaths, and you're comparing to CONFIRMED COVID-19 deaths. Look at excess mortality by age group for 2020 to fill in the picture....

https://jamanetwork.com/journals/jama/fullarticle/2774445

"Only 38% of all-cause excess deaths in adults aged 25 to 44 years recorded during the pandemic were attributed directly to COVID-19. Although the remaining excess deaths are unexplained, inadequate testing in this otherwise healthy demographic likely contributed. These results suggest that COVID-19–related mortality may have been underdetected in this population."

So, I would say there have likely been at least 5000 deaths from COVID-19 for age 35 and below. Probably out of about 35 million infections.

So you can see with the above data, it supports my hypothesis:

COVID-19 will prove to be more deadly (per infection, AND on an absolute basis) than 2009 swine flu to the young (though it's not a huge difference - probably by at most a factor of 2 per infection- substantially more dangerous, as I originally said).

This is a deadly disease to young people! That's the message! It's worse than swine flu (which was bad!).

For anyone following my personal saga...

I wish you both the best, and that your wife turns the corner shortly with no long-term effects. Interesting that they are still prescribing hydroxychloroquine; I thought that ship had long since sailed. Anyway. From what I have read, the monoclonal antibody treatment can only be given to non-hospitalized patients, so it seems worth it to ask for it early before things get worse (seems like it would be past that point for your wife, tbh, but I am not a doctor). My layperson's understanding is that it has to be given before any significant damage is done. Of course it's probably not available unless you're a VIP; this is America after all. Anyway, hopefully all of this is unnecessary for you and your wife, in any case.

 

[Tiger]

I am still asymptomatic, and would expect to show symptoms about now if my wife got me infected at the end of last week when she was coming down with it and we didn't know. I just took a PCR test, should have results by Friday.

Thanks for the update and best whishes for getting better soon.

I have a question, as I am curious if in such situation, do you try use PPE at home to try to prevent yourself from contracting the virus (in case you have not yet contracted it at some point, before or after)? If you did not have immunity, this would probably contribute to your ability to take care of your family (and yourself)? What are the general recommendations in such situation?

 

[AlanSubie4Life]

https://twitter.com/trvrb/status/1351785352793493505?s=20

Looks like convalescent sera (not the vaccine, though presumably there will be a correlation) doesn't work as well (perhaps 8x less well or more, which is the threshold for updating the flu vaccine) against the strain in South Africa.

Fortunately the vaccine is very powerful (likely more powerful than infection-induced immunity from what I understand) so it may be enough to overcome this reduced efficacy.

Probably need to update the vaccine in Fall 2021 to stay on top of whatever shows up by then (this is something that can be done very rapidly for mRNA vaccines but likely needs to immediately become a focus).

All the more reason to bring cases to near zero worldwide ASAP! And get that vaccine rolled out worldwide! Need to slow down this process of evolution...

 

[TheTalkingMule]

There's no question that swine flu tended to be more deadly to young people RELATIVE to COVID-19 (see above: likely due to attack rate) but the claim that more people under 35 died in the swine flu pandemic does not stand up to a look at the evidence. And as mentioned above, part of the reason for the distribution is because young people dominated the swine flu infections! So that was likely due to 50 million infections in the young (80% of the infections were below age 49, alone)! That's a lot, and much higher than the attack rate for COVID-19 in the young.

For the charts below, these are CONFIRMED deaths, so they don't add to 12000 (best estimate of swine flu death total in US), of course, but it allows extrapolation. Implies: 2000 deaths below age 24, with about 40 million infections, for swine flu.

I can't directly compare to below 35 with this data, but I would estimate it was about 4000 estimated swine flu deaths in that age bracket. (Just from the charts below, estimating.). Compare to 2500 confirmed deaths with COVID-19, with substantially fewer infections. (Probably 45-50 million for swine flu vs. 35 million for COVID-19.)

That's been my point all along in brining up the Swine Flu outbreak. In 2009/10, even when the outbreak was concluded, the presumed case totals were far less than half what it turned out to be when a full survey was done in mid-2010. For whatever human nature reason, we have problems with estimating denominators based on just using our eyeballs and logic.

Yes, eventually the "CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus", however by this point in that pandemic, the assumption was about 4-5% of the population not 20-21% as it turned out.

Looking for citation, will provide after breakfast! Still unclear why I'm beating this dead horse.

 

[AlanSubie4Life]

however by this point in that pandemic, the assumption was about 4-5% of the population not 20-21% as it turned out.

A lot more focused on this number now, though. I think the estimate of 70 million (or a bit more now) is probably pretty good. Nobody really was paying attention to how many people got swine flu since the overall mortality was so low (though it was still more dangerous to the young than most were probably aware!).

Still unclear why I'm beating this dead horse.

Yes it is. COVID is more deadly than swine flu, except possibly for children. That seems very clear at this point. So we should not be telling adolescents and young adults that it is no big deal. It’s totally the wrong message. These age groups should ALSO be concerned about a disease which will substantially raise their chance of death, as is clearly evident from the all cause mortality data. Not to mention they can easily spread it to older people where the risk is 10x to 100x higher.

 

[ZeApelido]

Just got first dose of Moderna vaccine.

Has not mutated my DNA. Yet...

 

[TEG]

Thanks for the update and best whishes for getting better soon.
I have a question, as I am curious if in such situation, do you try use PPE at home to try to prevent yourself from contracting the virus (in case you have not yet contracted it at some point, before or after)? If you did not have immunity, this would probably contribute to your ability to take care of your family (and yourself)? What are the general recommendations in such situation?

We considered our house as our "safe bubble". We would not wear PPE inside or do anything special to avoid exposing each other. "We are in this together" basically. So I was likely exposed to COVID for some days very directly before realizing that our bubble was broken.

Once she got symptoms I switched to wearing a mask at home and trying to stay out of the same room as much as possible, but it maybe pointless now (I still don't have my test results back.)
I will continue to wear a mask all the time for the next 2 weeks just to reduce the amount of particles I might be spreading around, and also in the off chance that I somehow didn't already get infected.
My wife continues to have symptoms and is going to the hospital for some further tests today. She has been too uncomfortable to wear a mask much anymore, so I assume our house is a real hot zone right now.

Also, for what it is worth, the experience of actually being exposed and in a COVID household feels a lot different than what I was trying to imagine beforehand just from reading data and anecdotes. With all the study and "just in case" prep-work it still just becomes somewhat of an "along for the ride" type situation.
There end up being logistical issues such as I am supposed to go to the pharmacy to get meds for my wife but quarantined at home now. So have to enlist friends/relatives to help get things to us that aren't available for delivery.

 

[madodel]

Just watching the new Press Secretary give her first briefing. She was asked about Biden's COVID policy and she brought up that not only are masks required but N95 masks are required in the White House now. Hopefully they extend availability of these to all Americans.
Incoming White House plans extraordinary steps to protect Biden from COVID-19 now

Edit for clarity.

 

[TEG]

So my wife got admitted to ER with breathing difficulty and low oxygen sats now.
No visitors in the COVID ward, so I am stuck at home watching for news of what they do next over there.
They mentioned making a decision soon if to start Remdesivir & Baricitnib.
I had to look that up as I hadn't heard of that 2nd drug before.
COVID-19 (coronavirus) drugs: Are there any that work?

 

[scottf200]

In terms of actual prescribed medicines, they only one she has been given so far is hydroxychloroquine.
No mention (yet) of Dexamethasone, Remdesivir, or Regeneron. I am going to ask her doctor about those.

So my wife got admitted to ER with breathing difficulty and low oxygen sats now.
No visitors in the COVID ward, so I am stuck at home watching for news of what they do next over there.
They mentioned making a decision soon if to start Remdesivir & Baricitnib.
I had to look that up as I hadn't heard of that 2nd drug before.
COVID-19 (coronavirus) drugs: Are there any that work?

So sorry for what you are going thru. Your previous post about hydroxychloroquine was a surprise considering everything.

As an example from the link you just posted. COVID-19 (coronavirus) drugs: Are there any that work?

Hydroxychloroquine and chloroquine.These malaria drugs were authorized for emergency use by the FDA during the COVID-19 pandemic.
However, the FDA withdrew that authorization when data analysis showed that the drugs are not effective for treating COVID-19. They can also cause serious heart problems.

 

[madodel]

So my wife got admitted to ER with breathing difficulty and low oxygen sats now.
No visitors in the COVID ward, so I am stuck at home watching for news of what they do next over there.
They mentioned making a decision soon if to start Remdesivir & Baricitnib.
I had to look that up as I hadn't heard of that 2nd drug before.
COVID-19 (coronavirus) drugs: Are there any that work?

I'm so sorry to hear that. I haven't asked my wife about Standard of Care for COVID in a while. I was surprised at HCQ was given. Have they started dexamethasone since her breathing has worsened? The last I heard from her was they were using Dex, Remdesivir and high flow O2. I've never heard of Baricitnib either.

 

[Ocelot]

Just want to wish your family strength and your wife a complete recovery.

So my wife got admitted to ER with breathing difficulty and low oxygen sats now.
No visitors in the COVID ward, so I am stuck at home watching for news of what they do next over there.
They mentioned making a decision soon if to start Remdesivir & Baricitnib.
I had to look that up as I hadn't heard of that 2nd drug before.
COVID-19 (coronavirus) drugs: Are there any that work?

 

[TEG]

Hopefully it helps...

 

[NikolaACDC]

Biden inheriting nonexistent coronavirus vaccine distribution plan and must start 'from scratch,' sources say - CNNPolitics

"...one of the biggest shocks that the Biden team had to digest during the transition period was what they saw as a complete lack of a vaccine distribution strategy under former President Donald Trump, even weeks after multiple vaccines were approved for use in the United States.
"There is nothing for us to rework. We are going to have to build everything from scratch," one source said."
-----------------------------------
Let's hope it does get better from here.

Onwards and upwards.

To immunity and beyond!

 

[uujjj2]

Mrs. Uujjj reports that the COVID situation in California is still bad, but better than two weeks ago.

 

[TEG]

My COVID test came back negative. I am not sure how I could have avoided it given the time spent with my infected wife.
At the end of the day, there are really only two main points I hoped to get from the test...
#1: When does my "get out of quarantine" clock start? If I showed a positive then I could be getting out of lock down in ~2 weeks after. With a negative I have to consider when I last was near anyone infected.
#2: How eager am I to get vaccine? With a positive I would be "well, I guess I have natural immunities now", but since it is negative I am still looking forward to getting vaccinated as soon as a possible.

One way I could have avoided catching it now is if I already had it before. Maybe I should try to get an antigen test to see what that says.

 

[JRP3]

Since some people get reinfected I think I'd get the vaccine no matter what.

An upbeat Fauci in today's press briefing, talking candidly, discussed some concern with new variants in Africa and Brazil that may be slightly more resistant to the vaccine, but feels vaccines can be tweaked if needed.

 

[AlanSubie4Life]

@TEG, I am sorry to hear about your wife and I hope she recovers rapidly now that she is receiving medical care. And I hope you remain well.

How eager am I to get vaccine? With a positive I would be "well, I guess I have natural immunities now", but since it is negative I am still looking forward to getting vaccinated as soon as a possible.

Remember the vaccine seems to induce much stronger (or at least more consistent) antibody response than a natural infection, in most people, so is likely to be superior to a natural infection for many people. There's still research to be done on this, but after the second dose the antibody levels (and other immune cell response measures) are very high. It's worth getting even if you have been sick, though probably you should de-prioritize if you've had it recently so someone else can get the vaccine.

Probably fine to wait a couple months after a natural infection, but definitely worth getting the vaccine regardless ASAP assuming there is ample vaccine available.

When does my "get out of quarantine" clock start? If I showed a positive then I could be getting out of lock down in ~2 weeks after. With a negative I have to consider when I last was near anyone infected.

Seems like you probably have to wait 10 days to 2 weeks from yesterday, when your wife was admitted (and do a good deep clean of the house ASAP, to get that clock ticking).

an antigen test

I think you meant antibody test.

An antibody test sort of makes sense, but even if it were positive you should probably not assume you have had the virus in the past. So somewhat pointless. Just probably have to wait it out.

but feels vaccines can be tweaked if needed.

I wish there had been follow up on this to describe the timeline of such a tweak. I understand that technically it is super easy - but what about getting approval - how is it ok to bypass all the trials? It's a different protein so you'd still have to at least attempt to demonstrate safety and efficacy. But are there shortcuts built into the system?

Instead, the press spent the time asking whether Fauci was happy under Biden, and why Biden didn't wear a mask when speaking (at a great distance from others) at the Lincoln Memorial last night given that they are now allegedly required on federal property. Meanwhile, this isn't even what is required by the order:

"require compliance with CDC guidelines with respect to wearing masks, maintaining physical distance, and other public health measures by: on-duty or on-site Federal employees; on-site Federal contractors; and all persons in Federal buildings or on Federal lands."

Clearly, the order requires compliance with CDC guidelines - which do not require wearing a mask at all times. Clearly you don't have to wear a mask if you're out backpacking alone in a national park. Nor do you have to if you're President Biden and you're outside and you're more than 12 feet away from others who are not members of your household. CDC guidelines do not require it. (Jen Psaki screwed up this answer though.)

I do think the CDC guidelines should be updated, though. They're kind of silly and should spell out the risks better - many people think that wearing a mask makes you safe - and it doesn't.

 

[bkp_duke]

Biden inheriting nonexistent coronavirus vaccine distribution plan and must start 'from scratch,' sources say - CNNPolitics

"...one of the biggest shocks that the Biden team had to digest during the transition period was what they saw as a complete lack of a vaccine distribution strategy under former President Donald Trump, even weeks after multiple vaccines were approved for use in the United States.
"There is nothing for us to rework. We are going to have to build everything from scratch," one source said."
-----------------------------------
Let's hope it does get better from here.

Onwards and upwards.

To immunity and beyond!

Sam Stein from Politico says this CNN story is basically false:
https://twitter.com/samstein/status/1352321872009064449

https://twitter.com/samstein/status/1352324257641099265

https://www.hhs.gov/sites/default/files/strategy-for-distributing-covid-19-vaccine.pdf

 

[AlanSubie4Life]

Sam Stein from Politico says this CNN story is basically false:
https://twitter.com/samstein/status/1352321872009064449

https://twitter.com/samstein/status/1352324257641099265

https://www.hhs.gov/sites/default/files/strategy-for-distributing-covid-19-vaccine.pdf

Yes, it's such a silly story, that even the Biden administration didn't actually say this! Apparently CNN just ran with it. Strange. (Note that the source was not necessarily the Biden administration - just someone with direct knowledge of the work.)

I'm pretty confident that the Biden administration is aware the program needs improvement, but they obviously didn't say it didn't exist. To be clear, the story didn't exactly say this either. It relayed someone's impressions about the strategy of the vaccine distribution program, as near as I can tell. And that strategy was alleged to not exist - not the program itself. That seems like a bit of an overstatement too - obviously there was a strategy, it just didn't work as well as the Trump administration stated:

I guess now that there is a bit more methodical administration in charge, the media has gone back to creating stories out of hearsay. I'm sure it'll settle out in the next couple weeks.