Coronavirus

[RobStark]

Sorry, but many of these conditions are ... in some cases, hereditary. Eventually, regardless of exercise and diet, people die of these diseases. That is not to say that some folks are too sedimentary and over eat and eat the wrong things which are not helpful. I suppose that you are one of the few that are not among the idiots. How arrogant to make such a statement.

 

[RobStark]

Trying to get a doctor to be less arrogant is like telling a crackwhore to stop smoking crack. It's a fools errand.
.

 

[Daniel in SD]

I think that one could argue that the rate of spread in NYC was so fast (compared to other US locations) that the virus was able to get deep into the highly vulnerable at nursing homes (patients and staff) and into elderly/sick home care (patients and staff). When many patients and staff have been infected (many asymptomatic, initially) the overall death rate is likely to be higher than spreads elsewhere. In addition the NY policy of sending COVID positive elderly back to nursing homes tilted the demographic age groups of those infected.

I think you'd have to break the data down into age groups with similar healthiness and comorbidity factors in order to properly compare different regions

New York State actually has one of the lowest percentage of deaths in nursing homes. Nursing homes are just really tough to isolate. You've got staff working at multiple homes who are often from communities with higher infection rates and residents share rooms and common areas.

One-Third of All U.S. Coronavirus Deaths Are Nursing Home Residents or Workers

 

[Norbert]

why would you assume the rest of the US is the same as NYC? Seems like a faulty assumption to draw any conclusions from.

More people infected, more chances for virus to make someone dead. Serology tests in NYC show ~25% people in NYC have coronavirus antibodies.

you said it yourself. The main difference between nyc and where I live in NY is the population density and public transportation. Not sure extrapolating from NYC to the rest of the country makes sense. Not to mention, at this point there is a lot more testing, tracing and isolation, and more awareness with social distancing and hygiene.

I never said the virus is more deadly in nyc than everywhere else. Just that you can’t assume it would spread as quickly as it did in NYC. If a vaccine never happens then I would expect it to eventually spread to about 80% of the population, but that would be over many years.

also, I am not claiming I know anything special.

I’m pretty sure that without mitigation the virus would spread to the point of herd immunity (which with overshoot might be as high as 80%) in places other than NYC within a few months. It spread to 20% of the NYC population in a matter of just a few weeks! I don’t think it would take years at all.

As I said, in the context of the discussion where the comment from @Norbert was made, we weren’t talking about the rate of spread anyway. The point was to illustrate the small percentage of the populace infected to date, and extrapolate the NYC mortality numbers to the nation. That does not have anything to do with the rate of spread.

Alan already answered this very well. The main point is that according to what we are told by epidemiologists, without vaccine and without mitigation, it will spread until herd immunity is reached. Herd immunity is generally assumed to be 60-70%, give or take. That's probably at least true for cities. The NYC subway may have contributed to a quick spread, but it is not a factor in the assumed herd immunity level. The 60%-70% number is not derived from NYC, but a general scientific estimate.

The main difference between NYC and other cities is that in NYC there already was a large outbreak in progress before mitigation became effective.

By the way, one estimate for the infection level (prevalence) in NYC was 25%, however an update later was slightly less than 20%. The difference seemed to be that the latter considered that different neighborhoods had different infection levels, and extrapolated the samples according to the neighborhood in which they were taken, and their population number.

So without mitigation, NYC could have gotten 3x or more worse. The specific conditions in NYC, such as high public transportation, is a reason to assume that the required level for herd immunity might be higher there, not that it would be lower elsewhere.

So the NYC numbers are perfectly well suited for estimating the potential danger for a spread in the rest of the US, without mitigation, considering how far away NYC is from reaching the general estimate for herd immunity.

 

[AlanSubie4Life]

In actual Tesla and Coronavirus news, SCCA is starting autocross (with many precautions!) again June 13th and we will finally determine whether @AlanSubie4Life's P3D is superior to my Exocet.
View attachment 545971

I will hope for a fast course, where you have to change to third gear. Gonna be tough (for me).

The COVID-19 "lockdown" spare tire I've developed is going to slow me down, too. Going to need to go cycling every day.

 

[UncleHemi]

Doctors get very little nutrition schooling.
My kid's mom is a doc. She had a shockingly bad diet.
I've always been into nutrition.
She told me that avocadoes were bad for you. Meanwhile her cupboards were packed with processed foods. She ate what I'd consider a "trailor park" diet - lots of potato chips, ice cream, fries. Dating her, I gained weight and got cavities. After breaking up I regained my health.

Yeah, a doctor (a radiologist for a large hospital system). Doctors are weak on nutrition. It's not their thing. Their job isn't to prevent illness, it's to diagnose and treat illness. Literally. They don't get paid to prevent illness and to ensure people eat healthy. Their overall framework for health is that modern medicine essentially is the fix for whatever consequences arise from lifestyle.

Metabolism is a different subject.

Oh dear. The traps of generalisations: as an MD (actually an MBChB) I work extensively in disease prevention, which includes nutrition, have worked extensively on cardiovascular risk research critical appraisal, . What bkp_duke says is sensible and a nice summary of the nutritional issues in cardiovascular disease. As for what this has to do with Covid 19 I don't know. As a family physician, I have not seen a case yet.

 

[Doggydogworld]

More discussions now about Sweden in Europe: Todays press notice in the NZZ highlights a problem for them with the current efforts to open borders for the summer season (in German). Neighbouring and other countries are reluctant to accept Swedish guests as it is a country with a particularly high death rate. They are regarded as "not having the Coronavirus under control".

Die Schweden – Europas unwillkommene Sommergäste
Zypern öffnet demnächst die Grenzen für Touristen aus Staaten, die das Coronavirus «unter Kontrolle haben». Die Schweden werden nicht dazugehören. Selbst in der nordischen Nachbarschaft zögert man, Schweden einreisen zu lassen.

Sweden is now 8th in deaths per million and will pass France in the next few days. If we exclude countries of less than 100k people (e.g. Andorra and San Marino) then Sweden will be 5th behind Belgium, Spain, the UK and Italy. They're rapidly gaining on Spain and Italy, but Covid Projections estimates Sweden's death rate will decline quickly enough to avoid overtaking them. I'm not convinced their R(t) is as low as Covid Projections thinks, however, but it's hard to say with such noisy data.

In terms of travel, Covid Projections estimates 0.8% of Sweden's population is currently infected. That's not much worse than the UK at 0.6%. Most of the rest of Europe is at 0.1-0.2%, except Belgium and Italy at 0.4%.

 

[Papafox]

Covid-19 study on hydroxychloroquine use questioned by 120 researchers and medical professionals

Looks like the Lancet article that rang alarm bells about hydroxychloroquine potentially has some serious flaws. Over 120 researchers and doctors are now questioning the study.

 

[SageBrush]

In terms of travel, Covid Projections estimates 0.8% of Sweden's population is currently infected

I doubt that reassures other countries, in particular because I suspect that Stockholm should be the data behind the decision whether to open borders.

 

[SageBrush]

Covid-19 study on hydroxychloroquine use questioned by 120 researchers and medical professionals

Looks like the Lancet article that rang alarm bells about hydroxychloroquine potentially has some serious flaws. Over 120 researchers and doctors are now questioning the study.

Did you read the criticisms (presuming you have the ability to understand them) ?

I did. And overall they are laughable. The main objection was that individual center data was not published. They remind me of the data hounds who tried to smear the UK climate change research center.

Let me try to clue you in a bit: With utmost confidence I can say that some of the centers made therapeutic errors, dosing errors, treatment errors, and protocol errors. Sh1t happens. It is why it is almost uniformly true that 'real world' experience with a therapeutic is not as good as the initial data obtained at a top tier academic institution.

But guess what ? Those are the results you can expect from widespread use.

 

[Papafox]

Did you read the criticisms (presuming you have the ability to understand them) ?

I did. And overall they are laughable. The main objection was that individual center data was not published. They remind me of the data hounds who tried to smear the UK climate change research center.

Let me try to clue you in a bit: With utmost confidence I can say that some of the centers made therapeutic errors, dosing errors, treatment errors, and protocol errors. Sh1t happens. It is why it is almost uniformly true that 'real world' experience with a therapeutic is not as good as the initial data obtained at a top tier academic institution.

But guess what ? Those are the results you can expect from widespread use.

Let's see how this shakes out. Obviously France was swayed by the Lancet article.

Meanwhile, this NYU Medical School study of HCQ that I've been linking to shows profoundly different results when the treatment is begun before the patient enters the ICU and zinc is added.to the equation. Seriously, take a look at table 4 and tell me with a straight face that HCQ+azithromycin+zinc shows no benefits when given before the patient enters the ICU. Use the data, though, not your opinion.

Most of us agree that HCQ's use as a COVID19 treatment began with more hype than knowledge. Pretty quickly on we learned from a doctor in New York that HCQ plus azithromycin was not doing much good when treatment began on a patient who was already in the midst of a severe battle within the lungs.

What if the treatment included zinc (as was done in many Asian countries) and begun soon after symptoms appeared? I had been running with anecdotal evidence that HCQ+azithromycinj+zinc worked well when delivered early, and when the NYU study confirmed a massive benefit to the treatment when begun early and with zinc included (compared to the treatment without zinc), the study backed up my hunch.

So that's the real question right now, how well does HCQ+zinc work when given early in the disease? Since azithromycin adds to the heart arrhythmia problem, perhaps a test can be done with HCQ+zinc alone as one arm of the study. Also, what if quercetin is substituted for HCQ as a vehicle for giving the zinc access to cells? Both quercetin and zinc are safe substances when given at proper doses. That would be a really useful arm of a controlled study.

Where I disagree with you @SageBrush , is that I am looking to neither kill HCQ as a treatment nor give it a thumbs up for widespread use. Rather, I see the need to differentiate when the treatment works (combined with zinc and given early) from when it does not.

The Lancet article (if it is not too flawed) suggests that HCQ+azithromycin is not the silver bullet. We all get that. I really hope that hospitals drop efforts to treat with HCQ after the patient has already entered the ICU. So let's move on. Right now we have one serious study showing HCQ + zinc given early shows a 44% decrease in morbidity when compared to the treatment given early without zinc. That's HUGE.

I suggest we learn from all these studies. The Lancet article confirms that the treatment without zinc produces negative results when treatment is begun at unspecified times. The NYU study shows promise when HCQ is used with zinc and the treatment is begun early. Let's go from there.

 

[SageBrush]

HCQ is used with zinc and the treatment is begun early. Let's go from there.

Ain't gonna happen. For one, research physicians for the most part think that Zinc is a fool's errand if they review the entirety of the zinc in viral illness literature instead of cherry pick outliers like your pet NYU study; and second, as you include less ill patients in your study group the adverse effects become a more prominent trade-off for the benefit gained.

It's time for you to move on, and latch on to something else. Vitamins are in vogue amongst the foolish.

Or, be SMART and
attend to your personal hygiene,
Socially distance,
and WEAR A MASK

Are you smart ?

 

[Papafox]

Ain't gonna happen. For one, research physicians for the most part think that Zinc is a fool's errand; and second, as you include less ill patients in your study group the adverse effects become a more prominent trade-off for the benefit gained.

It's time for you to move on, and latch on to something else. Vitamins are in vogue amongst the foolish.

Or, be SMART and
attend to your personal hygiene,
Socially distance,
and WEAR A MASK

Are you smart ?

Not going to happen? If a reputable study shows that a treatment has 44% less morbidity once zinc is added, you're absolutely sure no one in the country is going to be curious and want to see if the results can be reproduced? Really? Let's see what happens.

 

[SageBrush]

Really? Let's see what happens

Really, but dream on. In the meantime,

Are you SMART ?

 

[dhanson865]

Brazil moves ahead of Spain today. France tomorrow, Italy next week.

 

[dhanson865]

Tennessee governor's free 'sock masks' treated with registered pesticide

NASHVILLE, Tenn. (WTVF) — Hundreds of thousands of Tennesseans have picked up free face masks provided by the state, never suspecting that those masks might carry their own health risk.

But an exclusive NewsChannel 5 investigation has discovered that those face masks - meant to slow the spread of COVID-19 - were treated with a controversial substance that is registered as a pesticide.

That substance is an antimicrobial designed to ward off odors.

"I wouldn't wear one," said Dr. Warren Porter, a professor of environmental toxicology at the University of Wisconsin at Madison and a board member for the environmental group Beyond Pesticides.

"Nobody wants to breathe in COVID, but I wouldn't want to be breathing in something that I also knew could be poisoning my body in a relatively short period of time and might be having multi-year effects on my health."

As part of Gov. Bill Lee's push to re-open Tennessee's economy, the state ordered five million nose-and-mouth coverings from the Renfro Corporation, a North Carolina-based sock maker.

Cost to taxpayers: $8.2 million dollars.

The governor's team boasted that the sock masks, as they came to be known, are "washable, reusable, and treated with Silvadur, a non-toxic silver antimicrobial good for 25 industrial washes."

But a search of the web reveals filings with the U.S. Environmental Protection Agency where Silvadur is registered as a pesticide that is "harmful if inhaled" and "toxic to fish."

Silvadur is a DuPont product that uses silver technology that is supposed to keep fabrics fresh.

 

[davepsilon]

@Papafox

Is there a name for latching onto an initial view and then refusing to change even in the face of increasing evidence to the contrary?

Honestly if you were to start fresh what is in favor of HQC as opposed to just not against it? If it were a good drug with all the HQC evangelists taking it only on faith there should be a giant mountain of evidence in favor of it by now. Seems like a dead end and I thought you would have abandoned it by now.

 

[madodel]

Really, but dream on. In the meantime,

Are you SMART ?

Yes @Papafox is actually very smart and successful at technical stock analysis. I have no idea what his medical or laboratory research background is. I love reading his financial posts. He just can't move on from HCQ. Maybe he is right, but at this point I don't see anyone putting up millions to finance an initial study of HCQ with zinc for early treatment, with a substantial well documented major risk.

I find it very difficult to know what to believe here sometimes because it takes time to figure out who actually knows what they are saying. Maybe it would be helpful if in this medical oriented technical thread if people posted their experience. I'm not smart enough to be a doctor, but I managed to work as a critical care nurse for about 5 years in Philly in the early 80's, got an MBA and moved into healthcare clinical information systems programming and development (COBOL, 360 Assembler and IBM PCS-ADS). I've been retired for 19 years now (married well and made a really excellent investment). Since I'm married to a non-interventional Cardiologist who has been in practice for 30 years, I'm still tuned in to what is going on in our local medical community. But I have no knowledge of epidemiology or infectious disease beyond what I experienced 40 years ago as an RN.

I spent the past 5 years watching the investors-roundtable thread but lately I've given up on that. Most of the people I respected left the thread and it just isn't interesting any more. This thread teaches me new things everyday now. Non-medical people don't understand that opinions don't guide medical practice, but established guidelines based on years of research and findings do. Varying significantly from those guidelines will eventually get you sued or your license pulled in the US. Having been married to a physician for almost 4 decades I can say that doctors tend to not tolerate opinions or at least be skeptical of people who only know half the story, especially if it is based on some news story or a TV ad or some hucksters blog post. My wife frequently calls me an idiot, unless she needs help with her computer.

 

[SageBrush]

Is there a name for latching onto an initial view and then refusing to change even in the face of increasing evidence to the contrary?

Many

 

[SageBrush]

Yes @Papafox is actually very smart

I'm not talking about IQ. By SMART I mean:

Does he
Socially distance ?
Practice careful personal hygiene ?
Wear a face mask that covers his mouth and nose outside his home ?

Time to petition the Mods for a thread for those who do not. I suggest "Covid Cures for Morans" as a title to attract them.