Coronavirus

[Cosmacelf]

In terms of Tesla returning to auto manufacture, we probably need to see CA (if not the whole US) get growth factors down below 1.05 and keep it there for 2 weeks. Easily this is a 6-week delay.

And actually you probably shouldn't look at CA as a whole - metro areas are what count. And unfortunately the worst area in CA is the bay area, SF in particular. With Fremont just across the bay, I doubt it'll open up soon.

 

[eevee-fan]

[Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia]. - PubMed - NCBI

View attachment 524862

same thing, just a shorter name

still don't recommend ingesting aquarium cleaner, thats like comparing methylated spirits to vodka.

The biggest problem is that this drug is not meant to be taken without consulting a physician. Who knows what other meds the couple were on... I am sure zero Medicine Reconciliation done.

 

[EinSV]

Letting the virus spread would a complete breach of the social contract: a "State" that let his citizens die like that would be a major shock in all democratic countries. That would be chaos, as even minor injuries wouldn't be cured, and the body count would duplicate. Imagine having a civil war with no hospitals.
US is the country with most guns per capita, I'll let you imagine how it goes.
In this sense, lockdown is the most sensible thing to do.

This false choice between health and the economy that is heating up is very frustrating. Korea, China, Japan and Singapore all seem to be able to get their economy back on track without sacrificing health. And mass unemployment and poverty are not exactly a recipe for good health.

Also, since the countries that have been successful in beating this all use masks, we should get over ourselves and start using them in North America and Europe. (Limited availability argument is a joke -- if we can ramp production of ventilators we can ramp production of 50c surgical masks).

 

[linux-works]

why is it that, still, there are no masks to be bought, pretty much world wide?

a friend in germany tells me she can't get a mask there, no one can.

in the US, its not possible to buy them unless you have 'connections'.

what the holy hell is going on? its really not that specialized. its not a new silicon chip or anything - its friggin fabric! (I know, a bit more than that, but still, not rocket science).

china bought up all the masks they could, even ones not meant or destined for their country. and they are limiting sales to outside of china. so, basically, they are not going to be the ones to help us, here.

can no one produce simple PPE?

people are not staying home - we have people thinking its a 'liberal plot'. you can't convince them; at least legally require them to wear a mask when out in public or fine their asses big-time.

but there are NO MASKS.

and no plans, either.

 

[deonb]

but there are NO MASKS.

and no plans, either.

Mukilteo furniture maker converts factory for ‘100 Million Mask Challenge’ to fight coronavirus

 

[X Fan]

Just go this message from one of my American suppliers (ingredients for food supplements), who provides an important natural ingredient from India that we urgently need or we will soon run out of stock.

---

The situation as it stands:

• More than 1/3 of the population of the US under “Stay at home” lockdown orders, including California
  • We are classified as an essential business as far as we understand, so we will continue operating in California with essential team members and needs only. Our responses will therefore be prioritized to more immediate needs
• Most states and all major cities in India also have imposed lockdown measures until April 1, 2020. That includes manufacturing sites
• Most ground cargo transportation has been ordered stopped. That affects our botanical shipments from farm to factory, and cargo shipments from the factory
• All passenger (pax) international and domestic flights in India have been stopped for the week of March 23rd, heading into at least April 1st. This is the latest as of today, but may change or extend
  • Pax flights are how a majority of the air freight is moved around the world
• US Customs and FDA are facing staff shortages/backlogs at LAX, so there could likely be delays in clearance

How this affects us:

• Stricter lockdown controls in India closes our factory, and movement of all cargoes until April 1st
• With pax travel drastically reduced and international flight bans out of India, we are unable to get our shipments out of India. This could be the case for the remainder of March 2020
  • We are trying to see if the heavily limited space in cargo flights can be an option
  • The Indian government is restricting that cargo to essential products only, and we are checking to see how we can fit in

---

Conclusion: we are f***ed.

And this probably is what hundreds of thousands of companies around the world are facing the next few months. I'm afraid we are only seeing the tip of the iceberg when it comes to the economic impact of interrupted supply lines.

Also today, the stricter lockdown which the Italian government imposed is halting deliveries of postal packages to about 40% of the country (including Rome and Milan), killing a large part of that very important market for us for at least the next few weeks.

Well, there's always TSLA stock to fall back on. Some day.

Thanks for the update. This is bad news for the world’s drug supply as India is a huge generic producer.

 

[X Fan]

why is it that, still, there are no masks to be bought, pretty much world wide?

a friend in germany tells me she can't get a mask there, no one can.

in the US, its not possible to buy them unless you have 'connections'.

what the holy hell is going on? its really not that specialized. its not a new silicon chip or anything - its friggin fabric! (I know, a bit more than that, but still, not rocket science).

china bought up all the masks they could, even ones not meant or destined for their country. and they are limiting sales to outside of china. so, basically, they are not going to be the ones to help us, here.

can no one produce simple PPE?

people are not staying home - we have people thinking its a 'liberal plot'. you can't convince them; at least legally require them to wear a mask when out in public or fine their asses big-time.

but there are NO MASKS.

and no plans, either.

You are correct re: China and how they instructed their producers to only ship internally.

However, I believe they are finally loosening the strings since a face mask order for 50 that i placed via amazon a couple of months ago has finally shipped (and via China post).

My son is urging me to donate to a local hospital (even though only 3-ply).

 

[dhrivnak]

But the point remains:
Chloroquine is NOT a very nice drug. We use it for some things because we don't have a better alternative.

Now I agree one should not take drugs freely, but I have taken Chloroquine twice for mission trips to central America as has my wife. The doctors suggested we take them prophylactically as a guard against Malaria. As with most drugs there were side effects listed, but we took them with no ill effects. This drug has been around a long time and many of us who go on mission trips have taken it without ill effects. I think most people would consider this a low risk drug.

 

[eevee-fan]

Now I agree one should not take drugs freely, but I have taken Chloroquine twice for mission trips to central America as has my wife. The doctors suggested we take them prophylactically as a guard against Malaria. As with most drugs there were side effects listed, but we took them with no ill effects. This drug has been around a long time and many of us who go on mission trips have taken it without ill effects. I think most people would consider this a low risk drug.

Big difference:
You took the pills as directed by a physician.
They are probably concerned due to age and comorbidity. But instead of going to the doctor, they went ordered from a pet shop.

 

[bkp_duke]

Now I agree one should not take drugs freely, but I have taken Chloroquine twice for mission trips to central America as has my wife. The doctors suggested we take them prophylactically as a guard against Malaria. As with most drugs there were side effects listed, but we took them with no ill effects. This drug has been around a long time and many of us who go on mission trips have taken it without ill effects. I think most people would consider this a low risk drug.

And we use it, because we don't have better.

People never seem to understand that the N=1 argument (i.e. "I took it and didn't get sick") is a really poor argument. You look at side effect profiles over thousands to millions of people. That's how you determine if the drug has a low side-effect profile, or a high one.

This one, is closer to the higher side. Especially if you have a heart condition.

 

[AlanSubie4Life]

'm not talking about it being floating around for months, just a few extra weeks. The testing in the US was initially very poor and it could have been growing in mostly low risk populations for those weeks unnoticed. The company I work for in the Bay Area said they had a big flu outbreak in the office just before COVID-19 became big in the news. Most of the people who work there are in their 30s and 40s and generally healthy. Only a few are above 50.

This just does not square with the data or the epidemiological evidence. If you go look at Trevor Bedford's Twitter or any number of other sources, you'd know that it's simply not possible to have a big flu outbreak in January in the United States West Coast and have that be coronavirus (it is not clear to me what was the timeline of introduction into New York but based on current case numbers it had lots of different starts, or it started earlier than Washington State - it also has a higher growth rate due to higher density, of course...these are all factors and I'll just put New York aside for this discussion until that becomes more clear from the data).

If it had been the virus in mid-January, we would have many, many more cases. The doubling time for unconstrained cases is about 5 days, so a start with those numbers in January (you said big outbreak at the office you mentioned, so let's say 20 vectors) would likely lead to numbers about 20x what we're seeing now in Washington State. If there were "lots" of people, in mid-January, we'd see numbers like the Washington State numbers (they probably have about 4-5k circulating or resolved cases now, 2k of which have been identified by test), roughly multiplied by the number of people in your postulated outbreak.

Why? Because the Washington outbreak of 4-5k cases, today, was (with very high probability based on the genetic sequence of the virus) started by a single person, the "WA-1" case, who returned to Washington on January 15th. Only recently in the Washington sampling have they identified other virus strains from separate introductions - the growth has been driven by that single person and whoever he infected. Crudely, without constraints, we've been through 13 doubling times, so we'd expect about 8000 cases from this introduction at this point.

Here is the analysis from Trevor:

https://bedford.io/blog/ncov-cryptic-transmission/

So, my point is that to fit the numbers we see today, there simply is no way the virus could have been in wide circulation, or even modest circulation, in mid-January. Period.

However, for you specifically, given your location, it's clearly possible (can't remember whether you said that you received a positive diagnosis) that if you were sick in the late January/ early Feb timeframe that you did pick it up somehow from that early WA-1 patient via community transmission.

I'm just saying widespread circulation at that time is not possible, not that you specifically did not have the disease.

 

[dhrivnak]

Big difference: You took the pills as directed by a physician. They went to the pet shop.

That I FULLY agree with. Taking something bought in a pet store borders on insanity. Sorry I thought people were against the taking of Chloroquine, the pharmaceutical grade.

 

[johnm6875]

Yes, good video. He basically says that looking at country wide or even state wide figures isn't useful. It must be done on a metro basis with an eye to ICU bed capacity to know if the metro area's hospitals are going to be overrun.

But did I miss his conclusion for NYC? He gave this great run up on positing what's the best case scenario, ie. no one else from here on out gets infected, but then doesn't say what that does to ICU bed capacity? In general I guess he is saying that NYC, and NYC alone looks screwed under realistic assumptions.

It appears Dr. Attia has suggested anybody at risk (oldsters), that can travel, should get out of the city as soon as they get sick. If I’m one of those in NY I’d be pouring over community/demographic info looking for good facilities with young populations and booking a hotel room nearby. I wonder if Dr. Attia will evaluate surrounding jurisdictions for their ability to handle these transients and the impact these sick people will have on the spread of the disease.

 

[X Fan]

It appears Dr. Attia has suggested anybody at risk (oldsters), that can travel, should get out of the city as soon as they get sick. If I’m one of those in NY I’d be pouring over community/demographic info looking for good facilities with young populations and booking a hotel room nearby. I wonder if Dr. Attia will evaluate surrounding jurisdictions for their ability to handle these transients and the impact these sick people will have on the spread of the disease.

sigh...Florida & NC due for a wave accelerator.

 

[MC3OZ]

It appears Dr. Attia has suggested anybody at risk (oldsters), that can travel, should get out of the city as soon as they get sick. If I’m one of those in NY I’d be pouring over community/demographic info looking for good facilities with young populations and booking a hotel room nearby. I wonder if Dr. Attia will evaluate surrounding jurisdictions for their ability to handle these transients and the impact these sick people will have on the spread of the disease.

Advice in Australia is discouraging city dwellers from travel to regional areas...
This seems like a weird recommendation by Dr Attia, all it could be is trying to spread the patient load more widely.

 

[Daniel in SD]

It appears Dr. Attia has suggested anybody at risk (oldsters), that can travel, should get out of the city as soon as they get sick.

He actually said they should leave now before they get sick because the hospitals will probably be overrun in 2 weeks.

 

[eevee-fan]

Interesting info on the Spanish Flu... might have been an avian flu.

Thawing Permafrost Is Giving Scientists The Chance To Study Long-Dead Diseases (Prepare For The Next Pandemic) | CleanTechnica

 

[Unpilot]

He actually said they should leave now before they get sick because the hospitals will probably be overrun in 2 weeks.

And I have to go and spend two day's in NY starting tomorrow...Yay.
At least I am allowed to wear a mask in the cockpit...O wait there are no mask's.

 

[bhzmark]

here's a WSJ article talking about hydroxychloroquine and how it seems to be working. Opinion | These Drugs Are Helping Our Coronavirus Patients

a good opinion piece written by doctors. It is worth quoting the doctors:

"we are using hydroxychloroquine in two ways: to treat patients and as prophylaxis to protect health-care workers from infection.

We had been using the protocol outlined in the research from China, but we’ve switched to the combination prescribed in the French study. Our patients appear to be showing fewer symptoms.

Our experience suggests that hydroxychloroquine, with or without a Z-Pak, should be a first-line treatment.
. . .
As a matter of clinical practice, hydroxychloroquine should be given early to patients who test positive, and perhaps if Covid-19 is presumed—in the case of ill household contacts, for instance. It may be especially useful to treat mild cases and young patients, which would significantly decrease viral transmission and, as they say, “flatten the curve.”

Emergency rooms run the risk of one patient exposing a dozen nurses and doctors. Instead of exposed health workers getting placed on 14-day quarantine, they could receive hydroxychloroquine for five days, then test for the virus. That would allow health-care workers to return to work sooner if they test negative."

Who are these crazy doctors? "We have decades of experience in treating infectious diseases and dealing with epidemics, and we believe in safety and efficacy." Dr. Colyer is a practicing physician and chairman of the National Advisory Commission on Rural Health. Dr. Hinthorn is director of the Division of Infectious Disease at the University of Kansas Medical Center.

Are they just doing this in Kansas? No.

At NYU and U of Washington also -- two of the hardest hit areas. And likely there are many other places with intelligent doctors who know how to make intelligent decisions with limited available information and don't let their pedantry about trusting RCTs in Nature paralyze them from intelligent decision making under uncertainty.

David Lat Undergoing 'Experimental' Drug Therapy, His Husband Says | New York Law Journal

Arun Sridhar on Twitter

 

[Cosmacelf]

Useful information. It is worth quoting the doctors actually having to make decisions with the available information.

"we are using hydroxychloroquine in two ways: to treat patients and as prophylaxis to protect health-care workers from infection.

We had been using the protocol outlined in the research from China, but we’ve switched to the combination prescribed in the French study. Our patients appear to be showing fewer symptoms.

Our experience suggests that hydroxychloroquine, with or without a Z-Pak, should be a first-line treatment.
. . .
As a matter of clinical practice, hydroxychloroquine should be given early to patients who test positive, and perhaps if Covid-19 is presumed—in the case of ill household contacts, for instance. It may be especially useful to treat mild cases and young patients, which would significantly decrease viral transmission and, as they say, “flatten the curve.”

Emergency rooms run the risk of one patient exposing a dozen nurses and doctors. Instead of exposed health workers getting placed on 14-day quarantine, they could receive hydroxychloroquine for five days, then test for the virus. That would allow health-care workers to return to work sooner if they test negative."

Who are these crazy doctors? "We have decades of experience in treating infectious diseases and dealing with epidemics, and we believe in safety and efficacy." Dr. Colyer is a practicing physician and chairman of the National Advisory Commission on Rural Health. Dr. Hinthorn is director of the Division of Infectious Disease at the University of Kansas Medical Center.

Are they just doing this in Kansas? No. At NYU and U of Washington also. And likely many other places with intelligent doctors who know how to make intelligent decisions with limited available information.

David Lat Undergoing 'Experimental' Drug Therapy, His Husband Says | New York Law Journal
View attachment 524877

Arun Sridhar on Twitter

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Thanks for sharing. If you click through and read the protocol they are using, it does a lot of monitoring and adjusting of dose based on EKG results. So, not recommended unless you are being monitored!