Coronavirus

[dqd88]

Hmmm...



Speaking of snowflakes , look at this guy, having to have his leg amputated due to issues with the ECMO machine he had to be on due to coronavirus infection. Must just be a crazy exception or he has a pre-existing condition, as this is similar to a flu, amirite? /s

AK! ️ on Instagram: “My sweet husband needs your prayers please. Nick has been sick for awhile with what we were told last week was pneumonia. Unfortunately…”

View attachment 533875

Weird, doesn't seem like there is anything wrong with his lungs here?

@dqd88 do you think it was the lack of fitness, the poor diet, the old age (41 is basically normal life expectancy, right?), or what?

What else might have killed him this year if it hadn't been coronavirus (which hopefully does NOT actually kill him - he is off life support so that is good but ECMO cost him his leg), do you think?

My friend, you are taking an anecdote and sensationalizing it. You do see that right?

Of course I feel sorry for the guy. But I could put up a gruesome (actually many thousands of gruesome) pictures of people in car accidents. Then say something like "look at this person who became a parapalegic from this car crash"... or "look at this kid who lost his parents"... etc
So, maybe we should stop all car driving?

Yes, people will and do suffer. Does that mean we should not discuss facts and data?
Are you suggesting that we should destroy the economy to prevent Covid deaths? How can you possibly make that decision if you don't fully understand the full cost of destroying the economy (in both dollar and human suffering)?

I await you're reply

 

[dqd88]

That's exactly what you said by juxtaposing it with the spanish flu.

EDIT: And again, how old are you?

If you're gonna pry for my age you should prob have good manners and give yours first.
Do you think I'm young and don't care for the elderly? I have elderly parents and yes I care about them.
But you know what scares me the most?
I have a kid, and I'm scared as hell about the future he'll inherit. I'm scared as hell, when he's in his 20s, 30s, 40s... what the world will look like. There are many insanely big problems his generation will have to face; bigger problems than any generation before. Will they have the resources they need? Will they succeed? Will they feel emboldened to push forward or will they be shackled by crushing debt, social unrest, lack of opportunity, with the problems caving in all around them?
Maybe you don't have kids.

I side with Elon on this matter. He is looking at the big picture. He has 5 kids. I'm sure he worries about this mother too. But I'm sure it is of highest importance to peer into the future, and try to move things in the right direction, not just for his kids, but all of humanity. Because he sees the big problems. Far, far bigger than Coronavirus. Coronavirus, as serious as it is, is not an existential threat to humanity. Not even close. But there are existential threats to humanity out there. It is about perspective. No one has proper perspective it seems.

 

[Norbert]

So, maybe we should stop all car driving?

Yes, if we are drunk, for example. That's the situation we are in. We can't drive safely. I'm sure if we had involved the same level of expertise and effort into preventing deaths from this pandemic as we use for car safety, driver education and to prevent accidents, it would have never come to an outbreak like this. Building up a proper testing capacity, producing enough masks, a few thousand ventilators, is nothing compared to the research, development, engineering and support for traffic safety that we have engaged in for a hundred years. In that regard, we have a lot of catching up to do.

 

[Norbert]

If you're gonna pry for my age you should prob have good manners and give yours first.
Do you think I'm young and don't care for the elderly? I have elderly parents and yes I care for them.
But you know what scares me the most?
I have a kid, and I'm scared as hell about the future he'll inherit. I'm scared as hell, when he's in his 20s, 30s, 40s... what the world will look like. There are many insanely big problems his generation will have to face; bigger problems than any generation before. Will they have the resources they need? Will they succeed? Will they feel emboldened to push forward or will they be shackled by crushing debt, social unrest, lack of opportunity, with the problems caving in all around them?
Maybe you don't have kids.

You can't play one against the other. That's not how that works.

 

[RobStark]

So, how is Sweden doing?

Let's compare them to a handful of other countries - countries of Western Europe of similar size (Belgium, Netherlands, Switzerland, Austria, Portugal), as well as their Scadinavian neighbors (Denmark, Finland, Norway).

Total cases:

Belgium: 37,183
Netherlands: 31,589
Switzerland: 27,404
Portugal: 19,685
Austria: 14,671
Sweden: 13,822
Denmark: 7,242
Norway: 7,069
Finland: 3,681

Cases / million population:

Belgium: 3,208
Switzerland: 3,166
USA: 2,232 (for context)
Portugal: 1,931
Netherlands: 1,844
Austria: 1,629
Sweden: 1,369
Norway: 1,298
Denmark: 1,250
Finland: 664

We can see that Sweden, despite having somewhat relaxed measures, has not exploded in cases as some have predicted. Primary schools remain open. Shopping centers remain open. For now.

Are they doing great? Not exactly. Are they doing horribly? No
Somewhere in the middle. Which I would consider a success since they did not incur near the cost as most other countries.

Of course, the final chapter has not yet been written. They could still see numbers "take off". We will see.

How about deaths per 1M populations so far?

Sweden 150
Norway 30

IMHE says it has been 12 since peak for Norway and 12 days til peak for Sweden.

 

[OPRCE]

I am curious what it will do if given earlier at the first sign of exposure/symptoms...

Remdesivir works by preferentially mimicking ATP to arrest the action of RdRp, the viral enzyme responsible for RNA viral replication inside the cell, so the earlier it is administered should be the better, to prevent the buildup of viral load. It has been suggested as a prophylactic for frontline healthcare workers but I think it has not seen such use thus far.

The bio-molecular mechanisms are well explained in these 2 videos:

RNA virus replication

Action of Remdesivir

 

[cwerdna]

Controversial Louisiana pastor hosts Easter Sunday service for almost 1,500 people happened over Easter, in defiance of that state's law prohibiting gatherings of more than 10 people.

If one cares, I caught part of the interview CNN did with him before Easter. Skip to 0:48 of

.
Right now, Louisana per United States Coronavirus: 587,173 Cases and 23,644 Deaths - Worldometer is at 190 deaths from COVID-19 per 1 million population. That ranks them #3 after NY and NJ. I wonder how much worse it's going to get there over the next few weeks? Will they pass NY and NJ in terms of that metric?

He was on CNN again.

Louisiana pastor holding services during pandemic asks people to donate stimulus checks to evangelists
Defiant Central pastor's attorney hospitalized, church member dies from COVID-19

 

[davepsilon]

Sadly, you missed the point due to your emotional reaction, which blinds you to facts and reason.
It's important to view the problem in it's entirety, not just one part. I.e. no one wants to believe that the cost matters, but that would be disingenuous of you and everyone, because we make choices about cost and life/death all the time. It's just that it's become taboo to discuss in the fog of overly dramatic rhetoric which makes it hard to find a holistic approach to solving this problem. Very sad state of affairs.

Dr. Jay Bhattacharya puts it best - the decisions/policy we make depends on the death rate. E.g. If it's true that 1/1000 die we would not do a shut down, but if it's 3/100 then we would. Everyone assumed it's 3/100. But we don't have enough data. So he's trying to get it. His study is criticized, but he's not claiming it to be perfect, but it's something, it adds to insights that we did not have before.

The study you are referencing seems to add none of the new insights you claim. As has been pointed out many times the conclusions appear flawed based on the properties of the blood test. If I had to guess I would say you want it to be true and that is clouding your consideration of it within the broader story.

For a brand new, highly contagious pathogen it is not just the death rate but also the hospitalization rate that must be considered. I don’t agree with your assessment that no shut down is warranted for 1/1000 death rate with hospital support. But even if I did think about what happens when ventilators and even oxygen therapy run out.

The hallmark of a successful shutdown is that it feels unnecessary because the virus is contained.

A shutdown is a huge cost and should be moderated whenever possible. But there has to be feedback and testing to make sure the disease stays on a track that it doesn’t overwhelm the healthcare system. If everyone goes back to riding the subway and all their other daily interactions maybe with masks and forgoing handshakes and the general attention to hygiene we have all adopted the disease trend stays down. But maybe it goes back to exponential. With 30k cases a day you can’t do contact tracing due to volume. And you have very limited margin in the healthcare system if the cases start trending up.

 

[sparcs]

rt.live

Rt Covid-19
These are up-to-date values for Rt, a key measure of how fast the virus is growing. It’s the average number of people who become infected by an infectious person. If Rt is above 1.0, the virus will spread quickly. When Rt is below 1.0, the virus will stop spreading.

Instagram founders launch COVID-19 spread tracker Rt.live – TechCrunch

 

[heltok]

So, how is Sweden doing?

Let's compare them to a handful of other countries - countries of Western Europe of similar size (Belgium, Netherlands, Switzerland, Austria, Portugal), as well as their Scadinavian neighbors (Denmark, Finland, Norway).

Total cases:

Belgium: 37,183
Netherlands: 31,589
Switzerland: 27,404
Portugal: 19,685
Austria: 14,671
Sweden: 13,822
Denmark: 7,242
Norway: 7,069
Finland: 3,681

Cases / million population:

Belgium: 3,208
Switzerland: 3,166
USA: 2,232 (for context)
Portugal: 1,931
Netherlands: 1,844
Austria: 1,629
Sweden: 1,369
Norway: 1,298
Denmark: 1,250
Finland: 664

We can see that Sweden, despite having somewhat relaxed measures, has not exploded in cases as some have predicted. Primary schools remain open. Shopping centers remain open. For now.

Are they doing great? Not exactly. Are they doing horribly? No
Somewhere in the middle. Which I would consider a success since they did not incur near the cost as most other countries.

Of course, the final chapter has not yet been written. They could still see numbers "take off". We will see.

Just got back to Sweden from being in lockdown in Singapore. It’s surreal to go from one place with strict limitations, ~100% masks and everyone being fully alert about the virus to a place where life is pretty much normal, people sitting out in sun enjoying a beer etc and like 1% masks. So far Sweden seems to do okay, deaths are high but not exploding, confirmed cases seems stable even with slowly improving testing and number of patients in ICU is slowly falling.

Testing in Sweden has been very bad, close to zero contact tracing and only testing people in hospitals with symptoms. Compared to for example Singapore, Sweden has ~1500 deaths and 15000 confirmed cases (1:10 ratio), Singapore 10deaths and 6000 confirmed cases(1:600 ratio). Norway has decent testing compared to Sweden. Expect testing to improve a lot in May the antibody tests becoming more available.

Cases in Sweden are mostly around Stockholm area, lots of people in Stockholm went to the Alps and brought it home. It seems a lot of the people in ICU are first/second gen immigrants outside of the capital, often from Somali and Syrian familys who may live closer together, have different sources of information and some socioeconomic and maybe genetic factors(lack of vitamin D?!).

From what I hear many people in other countrys seem to view Sweden’s policy more positive this week than they did previous week.

 

[BornToFly]

View attachment 533877

I hate charts like this one, because we know from antibody testing that 90%+ of people infected have little to no symptoms. The idea that you have to have fever + other symptoms means that people will continue to spread it because they think they don't have it.

 

[bkp_duke]

I didn't say that having an underlying condition means you'll die soon.

Many people with underlying conditions will not die soon. True statement.

Also,
Young, healthy people have virtually zero chance of dying from Covid. True statement.
Young, healthy people who got Spanish Flu had a relatively high chance of dying from it. True

Most people who die from Covid have underlying conditions. True

These are all true statements.

How about this statement:
The "closer you are" to dying from an underlying condition, the more susceptible you are to dying of Covid if you get Coronavirus.

True? Probably
E.g., Someone with stage 4 cancer is much more likely to die of Covid than if they are in stage 1.
The more obese one is, the more likely they are to die of Covid.
If one has an advanced/severe stage of diabetes or kidney disease, probably more susceptible (from the data I've seen).

(we should be able to talk about this factually, without fear of being labeled insensitive.)

I find it odd to ask for my age; I'm Gen X, probably about average age of the posters on this forum.

An Olympic Athlete disagrees with you:
Olympian Cameron van der Burgh Says COVID-19 Is 'By Far the Worst Virus'

Arguably, this would be one of the healthiest people in the world in terms of body conditioning, and for him to say that being sick with COVID-19 effectively drained what we as physicians call the "biological reserve" is noteworthy.

 

[winfield100]

Sadly, you missed the point due to your emotional reaction, which blinds you to facts and reason.....Very sad state of affairs.

Dr. Jay Bhattacharya puts it best - the decisions/policy we make depends on the death rate. E.g. If it's true that 1/1000 die we would not do a shut down, but if it's 3/100 then we would. Everyone assumed it's 3/100. But we don't have enough data. So he's trying to get it. His study is criticized, but he's not claiming it to be perfect, but it's something, it adds to insights that we did not have before.

@dqd88
Here is some data for you ~5.3% mortality for entire US

 

[bkp_duke]

It would have been helpful know if this patient in the ABC7 news story on skin rashes had tested positive for COVID19 or not. But worth mentioning skin rashes or measles like spots may be another possible symptom of the disease based on what has been observed with patients in Europe.

Coronavirus news: Skin rashes emerge as possible symptom of COVID-19, dermatologists say

This has been reported in the pediatric physician circles. Note that it is really only consistent in children, and only on the soles of the feet, not over the entire body.

Sadly, that presentation is a lot like Hand Foot and Mouth, so it's NOT UNIQUE to SARS-CoV-2.

 

[bkp_duke]

Remdesivir works by preferentially mimicking ATP to arrest the action of RdRp, the viral enzyme responsible for RNA viral replication inside the cell, so the earlier it is administered should be the better, to prevent the buildup of viral load. It has been suggested as a prophylactic for frontline healthcare workers but I think it has not seen such use thus far.

The bio-molecular mechanisms are well explained in these 2 videos:

RNA virus replication

Action of Remdesivir

Not possible. See my prior posts. Remdesivir is an IV only mediation, and due to production, stability, and transportation issues you can expect it to be in relatively short supply.

This medication will be given ONLY to those hospitalized. No exceptions, even healthcare workers.

 

[winfield100]

Oops wrong Link @dqd88
~5.3% mortality in US a few actual data point numbers
ArcGIS Dashboards

 

[OPRCE]

Not possible. See my prior posts. Remdesivir is an IV only mediation, and due to production, stability, and transportation issues you can expect it to be in relatively short supply.

This medication will be given ONLY to those hospitalized. No exceptions, even healthcare workers.

I'm unsure which part of my post (which is unrelated to how the drug is administered) you say is impossible?

Obviously Remdesivir is in exceedingly short supply, since FDA has yet to grant approval for generalised use against COVID-19 (or indeed anything else). My understanding is that Phase III clinical trials (on large groups of humans) are ongoing in China and elsewhere atm, and that compassionate use exceptions may be granted in individually justified cases.

 

[N5329K]

“The hallmark of a successful shutdown is that it feels unnecessary because the virus is contained.“

This sounds exactly right.
Robin

 

[bkp_duke]

I'm unsure which part of my post (which is unrelated to how the drug is administered) you say is impossible?

Obviously Remdesivir is in exceedingly short supply, since FDA has yet to grant approval for generalised use against COVID-19 (or indeed anything else). My understanding is that Phase III clinical trials (on large groups of humans) are ongoing in China and elsewhere atm, and that compassionate use exceptions may be granted in individually justified cases.

No, compassionate use exemptions have been removed (the way they work is you have to apply for one for EACH patient you want to use it on, directly to the manufacturer). Gilead was being overwhelmed by these, so compassionate use was removed and the drug moved to an "off label" designation by the FDA so that physicians could obtain it from selected hospital (not retail) pharmacies for hospital only usage.

Your point, specifically that I was replying to (at least how I read it), was to suggest that Remdesivir be moved to a preventative / prophylactic usage model. That is never going to happen. It does not have a completely benign side-effect profile.

 

[jbcarioca]

To those who imagine that SARS-CoV-19 only thrives in cool weather I offer the following:
Manaus, Amazonas, Brazil 1459 total cases/124 deaths. March low 73F high 91F
Fortaleza, Ceará, Brazil. 2588. 141 73F. 90F

I chose these two cities because they are both quite consistent in temperatures, although Manaus is very humid, and Fortaleza has constant trade winds and low average humidity. Both are fairly large, but both have been far less involved in international travel during the last few months than have been the majority of infected places. Both are a mixture of ~15% prosperous people and ~75% impoverished ones. Nearly all the Southern hemisphere potential equivalents are deeply internationalized so Singapore, as an example, cannot work due to it's globalism, small size and wealth. Others have so little established infrastructure that their reports are unreliable. With rare exceptions there is very weak testing either living or dead so data is inconclusive. My two examples are unusual in that the two cities have fairly decent public health facilities in the cities, even though their two States definitely haven't much rural medical care.

Both Manaus and Fortaleza have very good municipal data and support:
Novo Coronavírus - Informações da Prefeitura de Fortaleza
Covid-19 Archives - Prefeitura Municipal de Manaus
The two sites are in Portuguese, but a quick glance shows how well they serve the internauts, anyway. FWIW, near illeterates tend to have internet access via mobile phones, even though they often cannot afford replenishment of their prepaid plans.

All this is only to show that these two cities, both with substantial local transmission, and climates that are always summer year around, have quite obvious significant SARS-CoV-2 problems.

Lesson: This virus does NOT limit itself to cold weather., Sub-Lesson: This is NOT the flu.
Very sadly the Presidents of Brazil and the US are joined attitudinally so are doing a great job of making containment harder and solutions more distant. I hope Governors in both countries can do better, but both are severely hampered by anti-scientific bias from the top.

Of course, if the world is lucky social distancing coupled with extensive testing will suffice until effective treatment or even cures can be found, followed by effective vaccine(s).

BTW: I did not link to the data sources. They're easily found, up to date, by searching by: [city name] Covid-19