Coronavirus

[TheTalkingMule]

This idea of warping reality to increase panic and supposedly create a more effective lockdown is a great indicator of why the US response was so ineffective.

Half of NYC has now been infected and there are ~4k deaths. For the sake of being conservative, let's say only 20% of the city ends up infected and they'll land at 9k deaths. That's a mortality rate of .24%.

A plan should be based on reality rather than one guy's apocalyptic wet dream. We already had clear evidence of mortality rate and the best way to deal....we went the other direction with our hair on fire.

Countries that took this seriously from the outset and followed guidelines of testing, tracing contact, and isolation did great. Everyone else is in varying degrees of chaos with the US probably doing the worst job of minimizing spread and deaths.

We didn't need 6 more weeks of notice, we HAD 6 weeks of notice. Plenty of time to plan and coordinate testing/resources.

 

[SageBrush]

Some musings on how Italy would need to contain this after lock down is lifted:
How Italy is Preparing for Phase 2 - Leaders League

That looks like a pretty good plan.

Good for them, and good luck !!

 

[traxila]

So, SARS and MERS have significantly different infection profiles:
1) The data we have on them show they do not have viral shedding till symptoms occur. This makes containment far easier since you don't have the "silent spreaders"
2) Both viruses have a substantially higher mortality rate. It's high enough that there is a significant degree of the virus "burning itself out" before it can spread further.

My point was if THIS novel virus, this previously unknown pathogen, was slightly more lethal but otherwise the same. Never said anything about SARS and MERS.

 

[EVNow]

~80% of people put on ventilators die. Nobody every goes on a ventilator (apart from a handful of surgical cases) has a good prognosis for survival. As much effort as needs to be placed on adequacy of ventilator access, that is for the most critically ill patients.

Here's something new from frontline doctors in NYC.

Covid-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome : COVID19

It's bizarre. 'Hypoxia without dyspnea,' is the catchphrase at my hospital. People have crazy low oxygen sats and just don't feel it - at all.​

After they're intubated, they don't seem like typical ARDS at all, either. The lungs have a very different feel- almost normal, and not stiff and diseased like ARDS lungs usually feel.
​

So, apparently some ICUs are treating this like altitude sickness rather than ARDS.

 

[SageBrush]

For the armchair arithmeticians amongst us --
I was staring at my Log normal daily mortality per capita graph I post daily and realized that the curve is kinda sorta an ellipse.
Since the area of an ellipse is A*B*Pi, it is easy to calculate total expected mortality once the peak is evident.

 

[Daniel in SD]

This idea of warping reality to increase panic and supposedly create a more effective lockdown is a great indicator of why the US response was so ineffective.

Half of NYC has now been infected and there are ~4k deaths. For the sake of being conservative, let's say only 20% of the city ends up infected and they'll land at 9k deaths. That's a mortality rate of .24%.

A plan should be based on reality rather than one guy's apocalyptic wet dream. We already had clear evidence of mortality rate and the best way to deal....we went the other direction with our hair on fire.

Countries that took this seriously from the outset and followed guidelines of testing, tracing contact, and isolation did great. Everyone else is in varying degrees of chaos with the US probably doing the worst job of minimizing spread and deaths.

We didn't need 6 more weeks of notice, we HAD 6 weeks of notice. Plenty of time to plan and coordinate testing/resources.

Unfortunately we can't change the past. I don't think incoherent ramblings are the solution either. I think you're going to have to show your work on those numbers...

 

[TheTalkingMule]

My point was if THIS novel virus, this previously unknown pathogen, was slightly more lethal but otherwise the same. Never said anything about SARS and MERS.

It's not really possible for a new virus to have all these same traits AND be highly lethal. SARS2 spreads super easily and incubates for up to 13 days. Combine that with a modern day mortality rate over 2% and you're describing something that would have ended human civilization long ago. Unless of course you want to believe this is some new type of virus that don't play by the rules.

 

[EVNow]

There are a lot of excess deaths … how much of this is Covid ?

James Tozer on Twitter

THREAD: Might the death toll from covid-19 be higher than the official fatalities attributed to it so far? Data emerging from the worst-hit places in Europe suggest so. (1/9)​

A common way to quantify deaths in a severe health crisis is to look at “excess mortality”: the total number of people who have passed away in an area, compared to usual. Journalists in Italy, Spain and France have started doing this. (2/9)​

 

[Daniel in SD]

It's not really possible for a new virus to have all these same traits AND be highly lethal. SARS2 spreads super easily and incubates for up to 13 days. Combine that with a modern day mortality rate over 2% and you're describing something that would have ended human civilization long ago. Unless of course you want to believe this is some new type of virus that don't play by the rules.

This is your most bizarre argument. There have been many epidemics in human history far more deadly than COVID-19. Modern travel just allows it to spread everywhere at once.

 

[AZRI11]

Here's something new from frontline doctors in NYC.

Covid-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome : COVID19

It's bizarre. 'Hypoxia without dyspnea,' is the catchphrase at my hospital. People have crazy low oxygen sats and just don't feel it - at all.​

After they're intubated, they don't seem like typical ARDS at all, either. The lungs have a very different feel- almost normal, and not stiff and diseased like ARDS lungs usually feel.
​

So, apparently some ICUs are treating this like altitude sickness rather than ARDS.

This needs to be verified. Scary if true

 

[ggr]

For the armchair arithmeticians amongst us --
I was staring at my Log normal daily mortality per capita graph I post daily and realized that the curve is kinda sorta an ellipse.
Since the area of an ellipse is A*B*Pi, it is easy to calculate total expected mortality once the peak is evident.

That doesn't take into account that because it's a log scale, the "density" of deaths at the top of the ellipse is greater than near the major axis. Of course, if it truly approximates an ellipse, the deaths to come at the peak is equal to the deaths to get there.

 

[N5329K]

Real death rates, and a few more rays of light:

Robin

 

[EV-lutioin]

The polymerase for SARS-CoV-2 has a proof-reading function built into it, influenza does not.

https://www.researchgate.net/figure...mplex-SARS-Pol-and-exonuclease_fig7_322075142
Structure of the SARS-CoV nsp12 polymerase bound to nsp7 and nsp8 co-factors

DNA vs. RNA has ZERO impact upon REPLICATION FIDELITY (i.e. mutation rate).

DNA vs. RNA has a LARGE impact upon stability of the virus genome when packaged and put into the virus particle.

Thanks, the great information! It was my understanding that, in general, RNA viruses mutate more readily than DNA viruses. So far, it appears that SARS-CoV-2 has only developed a small number of mutations and does not have a segmented genome like influenza.
Mechanisms of viral mutation

 

[EVNow]

SARS2 spreads super easily and incubates for up to 13 days. Combine that with a modern day mortality rate over 2%

What is Sars2 ? What is "modern day" ?

 

[traxila]

It's not really possible for a new virus to have all these same traits AND be highly lethal. SARS2 spreads super easily and incubates for up to 13 days. Combine that with a modern day mortality rate over 2% and you're describing something that would have ended human civilization long ago. Unless of course you want to believe this is some new type of virus that don't play by the rules.

So the difference between the 1 to 2 % death rate that we claim to be seeing now with COVID-19, and a 3 to 4% death rate is the difference between the current situation and the end of human civilization?

Do I have to describe a new type of virus that doesn't play by the rules for a slight increase in mortality rate? It is not possible that this same virus we are dealing with could have been slightly more deadly without giving it a completely new set of traits? Anything over 2% is highly lethal?

Sorry for all the questions, but obviously I am confused.

 

[Papafox]

Regarding the white house debate, Peter Navarro discussed the matter on CNN, for those who want another viewpoint.
Peter Navarro defends hydroxychloroquine use in heated CNN interview

In many ways, the debate in the situation room between Peter Navarro and Anthony Fauci is the same one we've been having between @Papafox and @bkp_duke , with Papafox taking Navarro's position that the evidence in favor of HCQ so far is just too great to ignore at this point and bkp_duke taking Fauci's position that current studies and data cannot be relied upon and what we need are results of carefully-conducted studies with control groups. I would argue once again that my position on HCQ is more than just wishful thinking because it is based upon significant reports from the field on the value of the drug. I also respect the positions taken by bkp_duke and Fauci, but disagree with the conclusion regarding how to act between now and the time the careful studies are released.

The two sides in the situation room did agree, however, that some of the stockpile of 29 million doses of HCQ should be moved to locations where they will be most needed, and both sides agreed that the decision of whether to take HCQ continues to be placed in the doctor-patient relationship.

Here is yet one more piece of data to throw into the discussion:

Here's the daily deaths chart for Malaysia from worldometers.info . Malaysia is the one country that has been most adamant about using chloroquin for COVID-19 patients since the beginning of the first wave. Look at the numbers on the left side of the chart. Those are not in hundreds or in thousands of patients. Those are numbers ranging from 1 to 8 patients per day being lost to COVID-19. I would agree with the critics that this chart does not "prove" that chloroquine and HCQ are the silver bullet to deal with COVID-19, but it's yet another important piece of data that suggests we're going to see efficacy in treating COVID-19 when those additional tests come out this month.

 

[Sean Wagner]

With some degree of irony, I'd like to present a chart I put together this morning. It is a scatter plot of naïve CFR vs tests per confirmed case. The idea is to help us understand a little better what role higher frequency testing plays in uncovering lower mortality cases.

Thank you.

Just picking out KY, OR, and UT, all with similar (small) populations and near identical testing rates is quite revelatory.

 

[Prunesquallor]

For the armchair arithmeticians amongst us --
I was staring at my Log normal daily mortality per capita graph I post daily and realized that the curve is kinda sorta an ellipse.
Since the area of an ellipse is A*B*Pi, it is easy to calculate total expected mortality once the peak is evident.

Uh, uh. Log plot.

 

[SO16]

Regarding the white house debate, Peter Navarro discussed the matter on CNN, for those who want another viewpoint.
Peter Navarro defends hydroxychloroquine use in heated CNN interview

In many ways, the debate in the situation room between Peter Navarro and Anthony Fauci is the same one we've been having between @Papafox and @bkp_duke , with Papafox taking Navarro's position that the evidence in favor of HCQ so far is just too great to ignore at this point and bkp_duke taking Fauci's position that current studies and data cannot be relied upon and what we need are results of carefully-conducted studies with control groups. I would argue once again that my position on HCQ is more than just wishful thinking because it is based upon significant reports from the field on the value of the drug. I also respect the positions taken by bkp_duke and Fauci, but disagree with the conclusion regarding how to act between now and the time the careful studies are released.

The two sides in the situation room did agree, however, that some of the stockpile of 29 million doses of HCQ should be moved to locations where they will be most needed, and both sides agreed that the decision of whether to take HCQ continues to be placed in the doctor-patient relationship.

Here is yet one more piece of data to throw into the discussion:

View attachment 529784

Here's the daily deaths chart for Malaysia from worldometers.info . Malaysia is the one country that has been most adamant about using chloroquin for COVID-19 patients since the beginning of the first wave. Look at the numbers on the left side of the chart. Those are not in hundreds or in thousands of patients. Those are numbers ranging from 1 to 8 patients per day being lost to COVID-19. I would agree with the critics that this chart does not "prove" that chloroquine and HCQ are the silver bullet to deal with COVID-19, but it's yet another important piece of data that suggests we're going to see efficacy in treating COVID-19 when those additional tests come out this month.

If it looked like a patient was going to die from COVID, then might as well have them try HCQ. Of course don’t market it as a cure or sure thing. Just market it as it “may” help and you “may” have side effects. I’d take that chance over the side effect of certain death from COVID.

 

[jerry33]

If it looked like a patient was going to die from COVID, then might as well have them try HCQ. Of course don’t market it as a cure or sure thing. Just market it as it “may” help and you “may” have side effects. I’d take that chance over the side effect of certain death from COVID.

The issue is that it's supposed to work best on those who are not very sick.