Coronavirus

[Daniel in SD]

Yep, of course. But the hysteria and the measures are still out of proportion to the number of deaths in relation to other health problems that most people give zero F about every year. And to be clear, I'm not advocating doing nothing at all. But instead of e.g. closing down factories and schools, the isolation measures could be targeted preferentially to the risk groups until the situation would calm down.

So, Italy is doing too much?
Your methodology for computing the number of deaths continues to be suspect.

 

[dhanson865]

That's not how it works. We have a finite supply of 87 year old diabetics. My apologies for being so cavalier, but this is getting absurd.

I was under the impression that Mississippi, Arkansas, and Alabama have a near endless supply of octogenarian diabetics. But if they run out I'm sure we have some in Tennessee as well.

 

[MC3OZ]

https://www.smh.com.au/world/north-...drugs-that-might-stop-it-20200323-p54d2x.html

New York: Nearly 70 drugs and experimental compounds may be effective in treating the coronavirus, a team of researchers reported on Sunday night.

 

[eevee-fan]

Bill Gates leaves Microsoft to focus on philanthropy.

 

[TheTalkingMule]

I was under the impression that Mississippi, Arkansas, and Alabama have a near endless supply of octogenarian diabetics.

Yes, there are a lot. 2.3M males 85+ in the US and probably 1/2 of them are compromised enough to make this very very dangerous. But then again, every day and every contact is very dangerous when you're 85+ and compromised.

We also have to remember that cv is picking off a LOT of people the flu would have gotten this year or next. 50k or so compromised seniors wiped out by flu in 2018, this will likely be worse.

Yes, my mom is over 75. And yes, I'm worried every day.

 

[tander]

A million coronavirus related deaths would be a nothing burger in the grand scheme of things. 100 fold increase in deaths from the present situation (~14000) would result in 1.4 million deaths. You haven't lost any sleep over the 1.2 million malaria related deaths over the last three years. I wouldn't lose sleep over 1.4 million coronavirus related deaths. 5-20 million would start to get more significant.

So you are missing some critical parts in your formula (and thinking). It is not just because there is a virus that has exponential growth. It's because if it grows too fast it overwhelms the already tightly budgeted healthcare systems (in terms of healthcare workers, ventilators, masks, gloves etc.). If that happens then you've not only got a virus problem, you've got a problem helping all the other people that might enter the healthcare system for non virus things. And then triaging begins which is no fun because they literally have to tag people who are most likely to live and die, and provide or not provide care based on that. And that means a whole bunch of people with normally treatable things, end up dying, not to mention medical mistakes start piling up. On top of all that fun stuff, you've probably heard about how far behind the testing has been in many places. That means there are a lot of asymptomatic healthcare workers that are going to get sent home to quarantine as soon as testing ramps up, leaving the healthcare system that much more overdrawn. So even if you don't care about diabetic old people, if you or someone you love gets badly injured in a car wreck and show up at the hospital, they might just say, welp he shouldn't have been driving his Tesla so fast because all the ventilators are already in use and we're already short 10 nurses anyway.

 

[Compton]

So you are missing some critical parts in your formula (and thinking). It is not just because there is a virus that has exponential growth. It's because if it grows too fast it overwhelms the already tightly budgeted healthcare systems (in terms of healthcare workers, ventilators, masks, gloves etc.). If that happens then you've not only got a virus problem, you've got a problem helping all the other people that might enter the healthcare system for non virus things. And then triaging begins which is no fun because they literally have to tag people who are most likely to live and die, and provide or not provide care based on that. And that means a whole bunch of people with normally treatable things, end up dying, not to mention medical mistakes start piling up. On top of all that fun stuff, you've probably heard about how far behind the testing has been in many places. That means there are a lot of asymptomatic healthcare workers that are going to get sent home to quarantine as soon as testing ramps up, leaving the healthcare system that much more overdrawn. So even if you don't care about diabetic old people, if you or someone you love gets badly injured in a car wreck and show up at the hospital, they might just say, welp he shouldn't have been driving his Tesla so fast because all the ventilators are already in use and we're already short 10 nurses anyway.

Thanks for the explanation. It's a good thing that shutting down the economy and the following recession do not have a serious detrimental effect on the population or our ability to prevent and treat other diseases. And too bad there's no compromise like letting the industry to operate (with e.g. the kind of preventative measures that Tesla applied in the China plant) while promoting working at home to the extent possible and isolating risk groups. Because everything is black or white.

 

[Singuy]

Man all this back and forth. The government just need to start mailing out masks to all people and then get people back to work under 50 yo. If you don't want to wear a mask, then don't go to work.

It's not like they didn't invent this portable self isolation system called wearing a mask. It's ridiculous to social distancing without masks in which Americans really don't care and go to church and what not. Get everyone masked, done and done...like all the Asian countries. 3M, start pumping out millions. Postal service, start including them on every run. And president, maybe stop pointing fingers at China and have them ship you a few million masks....complete dumbass in control.

 

[MC3OZ]

Thanks for the explanation. It's a good thing that shutting down the economy and the following recession do not have a serious detrimental effect on the population or our ability to prevent and treat other diseases. And too bad there's no compromise like letting factories to operate while promoting working at home to the extent possible and isolating risk groups.

The solution is more testing and early treatment..

In particular:-

• Antibody based testing maybe cheaper and can be done to mass screen large groups of people.
• We may also have drugs may treat cases detected early enough well enough to keep the majority of cases out of ICU.
• As mentioned above, masks are a good idea when returning to work and when leaving the house to run errands.

If the shutdown buys time to get measures like this and other changes in place, it is a good thing..

So a reasonable aim initially is try to limit the peak shutdown to 2-4 weeks and use that time to get more testing, better safety procedures and better treatment in place.

In terms of unwinding the shutdown, pick the most sensible option...

We are not going to shutdown the economy forever, while ignoring the opportunity for better testing and treatment.

The shutdown is happening because earlier rounds of testing were woefully inadequate, we need to improve that as the top priority.

 

[alloverx]

C-Span has the daily Whitehouse & Gov Cuomo (amongst others) briefings available.

 

[tander]

Thanks for the explanation. It's a good thing that shutting down the economy and the following recession do not have a serious detrimental effect on the population or our ability to prevent and treat other diseases. And too bad there's no compromise like letting the industry to operate (with e.g. the kind of measures that Tesla applied in the China plant) while promoting working at home to the extent possible and isolating risk groups. Because everything is black or white.

It would be nice if there were better options, but they already have been compromising in many places, that's why in the US for example they are still allowing restaurants to do take out and some businesses to operate, but you do too much of that and you end up like Italy where they are triaging people right this minute. I'd much rather lose my job or paycheck for a while than get injured on the job and get no care or bad care when I get to the hospital, and I wouldn't want to be the ER doc or nurse that has to decide who lives or dies either.

Man all this back and forth. The government just need to start mailing out masks to all people and then get people back to work under 50 yo. If you don't want to wear a mask, then don't go to work.

It's not like they didn't invent this portable self isolation system called wearing a mask. It's ridiculous to social distancing without masks in which Americans really don't care and go to church and what not. Get everyone masked, done and done...like all the Asian countries. 3M, start pumping out millions. Postal service, start including them on every run. And president, maybe stop pointing fingers at China and have them ship you a few million masks....complete dumbass in control.

They heard you 3M to send 500,000 respirators to New York, Seattle
Seriously though yeah the back and forth is such a waste, and it would be interesting to see how much masks help I'm sure they do.

 

[Singuy]

It would be nice if there were better options, but they already have been compromising in many places, that's why in the US for example they are still allowing restaurants to do take out and some businesses to operate, but you do too much of that and you end up like Italy where they are triaging people right this minute. I'd much rather lose my job or paycheck for a while than get injured on the job and get no care or bad care when I get to the hospital, and I wouldn't want to be the ER doc or nurse that has to decide who lives or dies either.


They heard you 3M to send 500,000 respirators to New York, Seattle
Seriously though yeah the back and forth is such a waste, and it would be interesting to see how much masks help I'm sure they do.

Every country in which the majority of people out and about wearing mask has defeated this virus. They have conducted a study in China and found that the majority of people who got infected was from a family member(most likely they stop wearing a mask when they were at home). SK, HK, Taiwan and Singapore did not shut down their economy and yet virus flatten out way before overwhelming their healthcare system. Mask Mask Mask. It's the only common denominator and you have all these people working in high offices scratching their heads on how save the economy.

 

[tander]

Every country in which the majority of people out and about wearing mask has defeated this virus. They have conducted a study in China and found that the majority of people who got infected was from a family member(most likely they stop wearing a mask when they were at home). SK, HK, Taiwan and Singapore did not shut down their economy and yet virus flatten out before way before overwhelming their healthcare system. Mask Mask Mask. It's the only common denominator and you have all these people working in high offices scratching their heads on how save the economy.

Yeah I'm sure that's part of it, I also think a lot of those countries tend to have better hygiene in general too, for example they often have bidets instead of us heathens hoarding toilet paper and using our hands. And as I understand it they were quick to jump on testing.

 

[skivi]

New Cases in Switzerland already declined from saturday to sunday about 50 %!

 

[AlanSubie4Life]

Exactly. Deaths trail infections. Korea just report 7 daily deaths, the same number they had when their new cases peaked 3 weeks ago.
View attachment 524611 View attachment 524612

Yep, sucks to be on a ventilator for weeks, to no avail.

 

[wdolson]

Well that number was worldwide for 122,247 closed cases, but yes the number of asymptomatic and mild cases must be much larger. However that means for the actual percentage to be around 1%, there would have to have been more than 1,000,000 actual infections already a few weeks ago.

EDIT: With "that number" I am referring to the one in my own post, 13%.

I think there were significantly more infections weeks ago. There's a fair amount of evidence that quite a few people who are infected have no symptoms and more have cases so mild the people who had it thought it was something else. Some of the early deaths were attributed to normal pneumonia. The symptoms of this can be mistaken for a lot of other health problems so when nobody is looking for it and the serious cases are small, they get lost in the noise.

This assumption is not correct, and is being propagated as fact, when it is not true. Yes, old school teaching made an assumption that DNA was more robust than RNA, because it is one strand versus two. If that were the only consideration, yes it would be true. But when you take into account the types of replication mechanisms involved and if they were subject to proofreading by the polymerases during the process, the assumption breaks down.

Replication FIDELITY is not just determined by single vs. double strandedness (and RNA in some instances is doublestranded, FYI), but is also determined by whether or not a viral replication has a robust proofreading mechanism built into it and the efficiency of that proofreading mechanism in the polymerase reading the DNA. SARS-CoV-2 has a LOWER MUTATION rate than influenza (which trends to about one major antigenic shift per year) because it actually has a proofreading mechanism built into it's polymerase. Influenza, by contrast, does not.

Relevant articles:
Coronaviruses: an RNA proofreading machine regulates replication fidelity and diversity. - PubMed - NCBI
Mutations can reveal how the coronavirus moves—but they’re easy to overinterpret | Science | AAAS (this is an editorial, not original data, but the references are sound).

End result:
SARS-CoV-2 is seeing slow antigenic drift (i.e. random mutations) at a rate about 1/4 that of Influenza (which doesn't have proofreading built into it's replication mechanism). It's not quickly mutating.

Why is this important? Because it means if we can get a vaccine out there, we have an excellent chance of wiping this virus out of the population.

There seem to be quite a bit out there from reputable sites about the higher mutation rate of RNA viruses including these:
Complexities of Viral Mutation Rates

Why are RNA virus mutation rates so damn high?

But even if you're right and the virus is not mutating fast, any given infection chain can die out if it doesn't find fertile ground. ie it stops finding new hosts.

 

[SMAlset]

The news today was talking about men and women and how men were fairing worse than women and why that might be. Maybe some protection from estrogen and that women tend to out live males of the same age. They also mentioned that more men than women were smokers putting them at higher risk for CV. I don’t know what the statistics were/are for vaping by gender but while I’ve seen an occasional woman vaping, the majority have been young males.

The coronavirus is killing far more men than women. But why? | Boston.com

Another thing that was being discussed was that more infected people have been reporting that they have lost their sense of smell and/or taste. This seemed to be a precursor to some who hadn’t shown symptoms early on. This loss could help diagnosis people earlier.

 

[sparcs]

Texas Gov. Abbott says he has no plans of issuing statewide ‘shelter-in-place’ order

During a press conference Sunday evening, Texas Gov. Greg Abbott said he has no plans at the moment of issuing a “shelter-in-place” order that would require the state’s residents to remain in their homes unless there is a strong need to leave.

Abbott’s press conference came hours after Louisiana Gov. John Bel Edwards issued a statewide stay-at-home order that will go into effect at 5 p.m. on Monday.

 

[JRP3]

Air quality and its effects on health we track closely. The others, we do not.

If you meant this as a "gotcha" I don't appreciate the reply. We're just trying to get better data.

Back to air quality - the research replicates well. Bad air is really bad for people. Especially the poor (for logical reasons).

It seemed as if you were missing some important data in your model, and you were. If you want to ignore that fact it's up to you but would seem to conflict with "trying to get better data".

 

[SO16]

Those other diseases are nowhere as deadly in terms of spread, and also have vaccines usually - enabling the general public and health staff to operate as normal.

We still don’t know the mortality rate of this virus.