Coronavirus

[dhanson865]

This one is on wikipedia and hasn't been updated recently, does anyone feel like finding the updated copy from the Italian source?

 

[generalenthu]

Great info. I was starting to think it was going to be a slow day for actual science.

Detect COVID-19 in as Little as 5 Minutes

Did a quick hunt on what kind of test this is, and it is a point-of-care PCR test. They sensitivity and specificity for the SARS-CoV-2 virus and this test isn't published, but here is the link for that data for their Flu A/B test:
ID NOW Influenza A & B 2 - Alere is now Abbott

Should be a reliable test. Sadly, they are only stating a production capacity of 5 million tests per month in April.

I posted this earlier, but clearly folks missed it.
Coronavirus

In any case, I see you calling it a PCR test. But they say they use enzymes, rather than thermal cycling to let the rna stands multiply. Is it still considered a RT PCR? I do see they try to distinguish themselves from PCR. So questioning your assertion.

 

[UrsS]

@UrsS - you going to grow a pair and join in the conversation, or just keep armchair quarterbacking and clicking "disagree" ?

Asking for a friend.

Well, I'm so far back in reading the posts that my comments would be out of context; and this is not the "Which Health Care System Works Best" thread. But now that you ask:
First let me say that I do appreciate your medical knowledge (of which I have none) your information and your intellectual honesty.

About the US 'health care': There are large portions of the US population that are practically without any health care system. I personally know people who are not going to any doctor because they are too afraid of the cost of any treatment. It also should be clear that poor people in this country do not get any real health insurance, despite Obamacare efforts.
I have lived in other countries and had to use their systems. It is personally clear to me that those systems (the once I have experienced - Spain, Switzerland, Morocco) seem to work much easier for the patient and there is no fear of a crippling bill showing up later. - Example: I had to visit the local emergency room here not too long ago. The bill they sent to the insurance company was $ 17,500 and they did actually do nothing at all - a bunch of tests with no results and then 7 hours later, (which I spent mostly laying in a bed hurting like the dickins) they sent me back home. This kind of gouging is insane.
So, your defending the current 'health care' system seems to me based on a limited reality, the world you probably live in (my guess) but not the world of millions of not so fortunate Americans. Look at 'our' system from the point of view of somebody living in Watts (Los Angeles), or from a seasonal farm worker (legal, or without papers), or from somebody living on $7.25 per hour, or a restaurant worker getting $2.50 per hour + tips. There is no health insurance in that budget. And you stated yourself how the current Medicare system 'encourages' doctors and hospitals to really help those patients .

I would love to see some data collected based on income, education level, and geography on how this pandemic is evolving in the USA.

Please keep up the good work in this thread, I'm learning a lot form it and find the discussions very informative - and sometimes entertaining too; and it helps me make decisions on how to deal with this crisis - Thank you!

 

[renim]

They are probably kicking themselves for spending all their money on an arsenal large enough to invade a small country.
.

i can't speak for American's but it used to knowledge that bullets are the most compact source of nutrition available for explorers.

from 10:30 to about 13:00

 

[dhanson865]

Top 7 countries by deaths snapshot as I go to bed.

 

[renim]

Top 7 countries by deaths snapshot as I go to bed.

View attachment 526682

I really don't trust the Chinese numbers. Too many videos of Wuhan welding doors shut to trust Chinese numbers

there must be many many deaths in China not recorded because they occurred outside of a hospital facility.

 

[Daniel in SD]

I would love to see some data collected based on income, education level, and geography on how this pandemic is evolving in the USA.

I'm pretty sure right now the rich and well connected are disproportionately infected. Traveling all around the world and having a large social circle is not good if you're trying to avoid a novel virus.

 

[Buckminster]

Update from the UK. I have been WFH for 2 weeks. Kid sent home from school 1 week ago. Bonding with the neighbours more than ever before. Street traffic and pedestrians reduced by ~95%. We drive and walk in the country at the end of the day. Going to a supermarket once every 3 days is now a treat and our biggest risk of contracting COVID. We are buying food for our elderly neighbours who have been in self isolation for 3 weeks. Impossible to get a supermarket delivery now. Most are good at social distancing here now.

Weather has been great for a week which helps. Starting to feel surprisingly sustainable - I will be WFH 1 day per week minimum after the crisis and would be amazed if my company doesn't throw us all out half the week soon enough. My team all seem to be coping fine - most live on the edge of London - I am a bit further out. Bought a powerline wifi extender - hoping to work in the garden a bit next week. Entertainment is not a problem - plenty of TV to stream.

I am lucky, this is not sustainable elsewhere however. Small flats with multiple kids will turn folk crazy.

 

[wdolson]

I’ve never participated in this forum before, so I apologize if I’m doing this wrong. I just wanted to say that this is the most cogent explanation have seen and if I had permission and the knowledge of how to post it on Facebook I would. And thank you.

I suppose that's OK if you think it would help.

and when you think of 1812 we can’t forget there’s no comparison to the level of medical care that we have now over back then and still how many deaths are anticipated from CV.

Going on 4 WFH weeks as of Monday and being in the higher risk group I can’t help but wonder about getting it despite all this time plus additional weeks that I see in our future once other areas intermingle earlier than they should. Without some vaccine (best 12-18 months away) or some possible antibody treatment can’t say I feel encouraged by what I’m seeing from State and Federal governments. The medical breakthrough will come when they do and not before.

Heck we still have yet to find paper goods in the store when my husband has gone out.

Do you mean 1918? Our ability to protect people from secondary infection and to treat it when it happens is much better than 1918. Most who died in the 1918 flu epidemic died of pneumonia. Some are getting pneumonia with this too, but COVID-19 kills people directly too.

I heard today that the local Grocery Outlet had a lot of TP. I was in Costco earlier this week and they had a mountain of paper towels.

Measles yes, Covid19 no. sooner or later group immunity will kick in, once 60% (or so) of the population is vaccinated or survived, it will be difficult for the Covid19

I've heard it's more like 70-80%, but the idea is that if enough of the population is immune, the spread of a disease will be drastically slowed down because each infection will find it difficult to find a new host who can get infected. That doesn't work if there is a community who has no immunity and the virus gets into that community. That's why we had measles outbreaks of measles among anti-vaxers over the last few years. There were enough non-vacinated kids that once one of them caught it, it spread quickly. Though measles is one of the most infectious diseases in the world, much higher than COVID-19.

 

[GlennNWWA]

As I am sure you know, you don't have to do very many random samples to extrapolate. However with the severe shortage of tests it is probably not adviseable to take any random samples, much less the 200 - 1,500 I assume would be needed for a well designed and well executed regional or even national test. We probably have no tests to spare for this yet as they are needed just to use on people with symptoms.

 

[eevee-fan]

I heard today that the local Grocery Outlet had a lot of TP. I was in Costco earlier this week and they had a mountain of paper towels.

Just did a web search of Walgreen locations near me (they show in store stock) and yep, 8 stores have TP in stock. I expected it'd take 2 weeks for things to normalize. Will see if I am right this weekend.

 

[Remus]

Don't put words into my mouth. Did I say I liked the current system? Did you forget to read the rest of this thread and see how much I LOATHE insurance companies?

Stop reading your personal preferences and prejudices into my post. If I want to say something, I'm always clear about it and don't mince words.


Single payer in this country would be a DISASTER for the following reasons:
1) you will see doctors retire in droves. This is not a guess on my part, this is well established given the insanely low reimbursement rates that Medicare currently pays for office visits.
2) you will see rationing of care because of #1 - Canada and the UK already have this and it's not called "rationing" it's called "extended wait times to see a specialist". Literally, costs are kept down because some of the sickest people in the system (that would use up the resources) cannot get the care they need in time before dying. This is evidenced by higher mortality rates in these countries for various diseases (see my post several pages back about cancers).
3) the US Government is HORRIBLY inefficient in everything it touches. So inefficient that the cost of care would probably go UP, instead of DOWN.
- When I was a medical student some of the WORST care I ever saw was in the VA medical system. That's 100% government run, and should be looked at CLOSELY as to how a bureaucratic system would run healthcare. I literally showed up for work one day at a VA facility and had a nurse look me square in the eyes and refuse to draw blood on a patient because she had "met her quota for the day".

I guess people like to paint the government as inefficient, for good reasons. However the big companies are not better and many cases worse.

I used to work for Accenture. There are many smarty-pants in that company charges the clients a week's time for something I can do in 4 hours. It's super easy to charge whatever you want when the patient doesn't have much choice or don't know much about what you do.

And couple of years ago I fell from by bike and broke my collar bone. They took me to the ER, in a private hospital, where after talking the X Ray, they said everything is ok and I can go home. I had to yell to them that it was broken and I can feel the broken bone with my fingers! How the hell can't they see it from x Ray?!

And I have met peditricians who can't even diagnose a simple ear infection when even I can see the fluid with an otoscope.

There's another time my daughter fell on her elbow, and the doctor we went to said she needed cast after seeing the X Ray. Luckily my dad was visiting us and he is a surgeon. After grandpa read the picture and cursed couple of times we went home with no cast and she recovered in several days.

Yeah those people are happily employed in private hospitals and clinics.

And who are we fooling that we don't have death panel here in the u.s.? For many of us the death panel is our employer. If you lose your job while having a chronicle condition, what do you do?

 

[Causalien]

I really don't trust the Chinese numbers. Too many videos of Wuhan welding doors shut to trust Chinese numbers

there must be many many deaths in China not recorded because they occurred outside of a hospital facility.

The last number I got from my contacts (before the greatest chinese firewall kicks in and everyone went dark) was that the actual numbers are 10x the infected and 6x the death.

To be honest, I've been steadily losing my Chinese contacts over the years as less and less of them want to risk having their social credit decrease. Many of them have lost their access to travel outside the country or to the more "special" places like Canada or the western nations. I've had to fly to some of the more far away countries that are easier for them to get approval for in order to meet them.

I think after this, I won't be able to get in touch with any of them.

 

[bkp_duke]

I posted this earlier, but clearly folks missed it.
Coronavirus

In any case, I see you calling it a PCR test. But they say they use enzymes, rather than thermal cycling to let the rna stands multiply. Is it still considered a RT PCR? I do see they try to distinguish themselves from PCR. So questioning your assertion.

View attachment 526681

My understanding, from reading the product descriptions, is that it is a PCR (not a RT PCR), just a different variant PCR (Polymerase Chain Reactcion). Otherwise it would not be able to obtain such a high sensitivity and specificity.

 

[bkp_duke]

What about those who are asymptomatic carriers (or the SARS survivors)? Would they not be considered "immune", since Norbert's question wasn't about transmitting the virus?

We don't have any data for true "carrier" states. I.e. that term specifically refers to those that NEVER clear the virus.

We do, however, have data that show some people take a lot longer to clear the data (just over 30 days is the number I have read in a few, limited papers). Most likely those people had what we refer to as a "subclinical" infection. I.e. they got infected, didn't so any or just the most mildest of symptoms, and then built up an immune response. They did not come to the part immune, they just built up a nice response without getting very sick like other people.

 

[bkp_duke]

The last number I got from my contacts (before the greatest chinese firewall kicks in and everyone went dark) was that the actual numbers are 10x the infected and 6x the death.

To be honest, I've been steadily losing my Chinese contacts over the years as less and less of them want to risk having their social credit decrease. Many of them have lost their access to travel outside the country or to the more "special" places like Canada or the western nations. I've had to fly to some of the more far away countries that are easier for them to get approval for in order to meet them.

I think after this, I won't be able to get in touch with any of them.

Wow. Thanks for the info.

Communism . . . sucks.

 

[bkp_duke]

I saw a paper on detection of covid-19 virus. The problem apparently is not the PCR test - but sample collection method. Not conclusive - but indicative of problems with virus detection.

https://jamanetwork.com/journals/jama/fullarticle/2762997

There were 1070 specimens collected from 205 patients with COVID-19 who were a mean age of 44 years (range, 5-67 years) and 68% male. Most of the patients presented with fever, dry cough, and fatigue; 19% of patients had severe illness. Bronchoalveolar lavage fluid specimens showed the highest positive rates (14 of 15; 93%), followed by sputum (72 of 104; 72%), nasal swabs (5 of 8; 63%), fibrobronchoscope brush biopsy (6 of 13; 46%), pharyngeal swabs (126 of 398; 32%), feces (44 of 153; 29%), and blood (3 of 307; 1%). None of the 72 urine specimens tested positive (Table).​

That was a PCR test. The Methods section of the paper specifically describes that they used RT-PCR for detection.

"RNA was extracted from clinical specimens and determined by rRT-PCR targeting the open reading frame 1ab gene of SARS-CoV-2 as previously described."

 

[wdolson]

Just did a web search of Walgreen locations near me (they show in store stock) and yep, 8 stores have TP in stock. I expected it'd take 2 weeks for things to normalize. Will see if I am right this weekend.

We were fairly well stocked for TP when all this started so I haven't been too concerned on that front. I expect there will probably be some sales in a few weeks. At this point the people who wanted to hoard TP probably can't get into their spare bedrooms and probably aren't going to be buying much more for a while.

My SO found this today
Thousands of spring breakers traveled from one Florida beach to cities across the US. Mapping their phone data shows the importance of social distancing amid the coronavirus outbreak.

Down a ways is a video from Tectonix where they anonymously tracked cell phone signals that were near the beach at Ft Lauderdale the first couple of weeks of this month. Those phones are now scattered all over the eastern US.

Some of those hot spots on the map have sprung up as problem areas in the last week like Michigan and Atlanta

 

[Norbert]

As I am sure you know, you don't have to do very many random samples to extrapolate. However with the severe shortage of tests it is probably not adviseable to take any random samples, much less the 200 - 1,500 I assume would be needed for a well designed and well executed regional or even national test. We probably have no tests to spare for this yet as they are needed just to use on people with symptoms.

Yes, unfortunately we don't have enough testing capacity for even the most necessary, which is to diagnose everyone who is symptomatic.

So I don't know when they expect to catch up with that primary demand. Yet I think it is also very important to test all health care workers, and everyone else who comes into contact with many people due to doing their job. Then perhaps some limited random sampling in order to better understand the epidemic character of COVID-19, so as to be able to adjust the general strategy accordingly.

So my point would be that we have a strong need for even much more testing capacity than that. But some keep saying "we just want to test symptomatic people". They may mean that they don't want everyone to keep asking to be tested themselves at this point in time, unless they really have symptoms. But it also sounds a bit like they are not sufficiently recognizing the need for much more than that.

Currently the need for "ventilators" is emphasized, as if doing the best in this regard already consumes all available resources, or doesn't even get all the required resources. I would think bringing up more testing capacity does not have to distract from ventilators, because it can be organized by different people and companies.

EDIT: And I think we really are going to need lots of ventilators.

 

[Causalien]

Wow. Thanks for the info.

Communism . . . sucks.

I don't know if it's communism, or just having power concentrate on one person or one group.

There was a period, I distinctively remember, when China was on the up and up. Their society was modernizing, becoming capitalist and turning more and more free. I could almost see a prosperous future as China turns into a society much like USA.

Then a year or two before Xi got crowned forever emperor, things started reverting. Slowly at first so it didn't seem alarming, but got really bad recently. Mind you, it is still way better than the earliest days where a foreign businessman risk getting killed and having their buisiness taken over if they didn't bribe the right gov official. But numerous example recently shows that it is reverting to something similar. Where businesses were forced to have their shares signed away to communist party members, but they still kept their lives at least.