bkp_duke
Well-Known Member
https://jamanetwork.com/journals/jama/fullarticle/2770279
Steroids continue to be the go to drugs to improve morbidity and mortality.
Steroids continue to be the go to drugs to improve morbidity and mortality.
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Coronavirus
- Thread starter Wenche
- Start date
AlanSubie4Life
Efficiency Obsessed Member
Meanwhile locally things are falling apart at Cornell:
Cornell notches rise in COVID-19 cases, most linked to student athletes flouting anti-virus guidelines
“To be clear, however—all is not well,” Kotlikoff scolded. “Far from it. There is potential for just a few small student gatherings to destroy all our plans for an in-person semester.”
Gee, ya think?We've had very low rates in the area until Cornell decided to bring back the students. Ithaca College had enough sense to stay with remote learning.
Shocking! Students are going to party and gather and if you are going to bring them back; you have to assume that is going to happen and plan for success with that activity going on. You can’t say “it’s the students’ fault!!!” It’s not - they should be fine partying and carrying on as usual if they are back at school with any working plan. (Their brains aren’t fully developed anyway so that’s another reason they are blameless.)
You need a plan that is modeled and shows that disease is completely crushed under worst case assumptions (wild parties, normal student behavior, minimal compliance with social distancing). You can’t just hope and pray.
It’ll be interesting to see how the schools that actually follow that sort of strategy do. It’s still a really tough problem no matter what you do (at least with current resourcing). Obviously if we wanted to bring everyone back to school and keep the virus crushed we probably could - but requires a LOT of resources, ingenuity, and a good plan for efficiently deploying them.
Daniel in SD
(supervised)
A coworker's kid goes to Brandeis and they are testing everyone twice a week (students, professors, staff). That seems like it might be enough.
Another coworker's kid goes to Utah State and they're testing sewage from the dorms. They've already quarantined 4 residence halls with 287 students.
Really the plan for many colleges and universities is to collect tuition, blame students for outbreaks, and then switch to remote learning.
Chest X-rays could provide 'rapid, cost-effective' COVID-19 diagnosis when 'adequate testing is lacking'
"Several American drug companies are trying to allay the public's fears about the mad dash for a coronavirus vaccine, The Wall Street Journal reports.
In a draft of a joint statement reviewed by the Journal, multiple companies developing and testing COVID-19 vaccines — including Pfizer, Johnson & Johnson, and Moderna — pledged not to seek government approval for their products until they have been proven safe and effective. The statement is still being finalized, but could reportedly be made public as soon as next week."
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There are probably ways to convince them otherwise...
And there are vaccines developed outside of the US.
And with the good connections between the WH and Vladimir Putin the Russian vaccine should also be an option.
"Several American drug companies are trying to allay the public's fears about the mad dash for a coronavirus vaccine, The Wall Street Journal reports.
In a draft of a joint statement reviewed by the Journal, multiple companies developing and testing COVID-19 vaccines — including Pfizer, Johnson & Johnson, and Moderna — pledged not to seek government approval for their products until they have been proven safe and effective. The statement is still being finalized, but could reportedly be made public as soon as next week."
-------------------------------
There are probably ways to convince them otherwise...
And there are vaccines developed outside of the US.
And with the good connections between the WH and Vladimir Putin the Russian vaccine should also be an option.
AlanSubie4Life
Efficiency Obsessed Member
Seems likely to be enough as a basic first step of surveillance. Obviously a lot of other modeling and procedures need to be in place for containment of the positive cases and outbreaks as they arise, too. I assume they are allowing partying and such and won't be blaming the students for that. Students should be allowed to gather! It's normal and in a relatively closed and well tested community with an appropriate action plan, it should be totally possible. I'm not advocating recklessness, but a few parties with some hangovers and such seems totally fine. Just need to limit the size so the inevitable outbreaks can be contained adequately. They likely do need restrictions (and strongly encourage compliance) on outside visitors from outside the VPB (virtual private bubble). I'd think maybe set up a system where such outside visitors can get tested for free prior to interaction with the community (at a party or whatever).
Definitely good to not blame students - just encourage responsible behavior as much as possible. Need to keep them on board for contact tracing, etc. It's not their fault they went to a party and got infected - and if you make it seem that way they'll get a lot less co-operation.
Need to encourage testing! Tell people to get instant tested prior to having a party, encourage all participants to get a test prior to the gathering, etc. Encourage students to time the parties with respect to testing. Make it a celebratory event celebrating clean test results! We all know testing is not a guarantee of catching all infections, I know, but encouraging responsible behavior is still a good idea. Maybe coordinate with students and sample sewage from the house where the party took place the evening of, or something? Just to get ahead of things. If you make the parties more of a well coordinated event with university health authorities, it's easier to minimize risk and track outbreaks (rather than prohibiting them outright). The information on the party location/etc. could be kept firewalled from other university authorities to encourage compliance.
Lots of ideas here, I'm sure the universities have been through them. They have a lot of resources so a few with the best plans should be able to pull it off (unlike public schools). It's just important to plan for a "normal" return and "normal" student behavior (but encourage behavior changes of course to make it easier), and make sure it will work within those parameters.
AlanSubie4Life
Efficiency Obsessed Member
I guess Dr. Jay has the unique quality of being wrong about everything pandemic related. Clearly not the brightest bulb in the chandelier when it comes to ID! Guess you have to give him a break; he’s an economist so is not a real scientist. Credit Dr. Topol for the highlights.
Bad look to use that word and Cornell in the same sentence! (too obscure?)
What's the latest evidence / opinions on reinfections and transmissibility?
We are interviewing nannies and one of them lives with 10 people (10?!) and I guess not surprisingly has already been infected with Covid19.
Hearing she lives with 10 people would normally make us toss her out right away, but what is the possibility that she is currently actually a safe choice?
We are interviewing nannies and one of them lives with 10 people (10?!) and I guess not surprisingly has already been infected with Covid19.
Hearing she lives with 10 people would normally make us toss her out right away, but what is the possibility that she is currently actually a safe choice?
AlanSubie4Life
Efficiency Obsessed Member
My OPINION is that it’s rare. I would definitely make sure to get evidence of a positive PCR AND positive antibody test *with* titer number before hiring though. (Everyone thinks they have had it back in January.)
Seems like if reinfection were common we would have heard about it a lot of this point. But we have only heard of a couple cases.
Who knows longer term, though. No one knows how the immune memory will behave, and it seems pretty unlikely it will be lifelong sterilizing immunity.
That’s a lot of people to live with though. Maybe hold out for one who has had it already, can prove it, and doesn’t routinely get exposed?
AlanSubie4Life
Efficiency Obsessed Member
Like my car when it phantom brakes, I see dead people. (To be clear, all joking aside, this is horrible and irresponsible and likely tragic, but I hope that all works out well. Not every event is a superspreader event - sometimes (most of the time?) they are fine (depends on local disease burden and number of participants!).)
I wonder what that guy in the background with a mask on is thinking (he's the only one I could see)?
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Maybe I had a different college experience than you, but I would have guessed half the people at any given party weren't supposed to be there (underage, not a member of the group putting on the party, whatever). I can't see "normal party behavior" being compatible with authorities (of any kind) monitoring exactly who goes to what parties. And counting on "responsible behavior" when underage kids are drinking themselves into inappropriate behavior of every possible kind and even unconsciousness... seems, um, unlikely. If nothing else, plenty of party attendance was unplanned -- you walk past, see the party or hear the band or whatever, "hey let's check that out!"
Though while "get tested before gathering" or "party safely" or whatever seems unlikely to work, testing everyone all the time, especially same-day tests on Fridays, seems like a good move. And if positive test leads to quarantine, maybe that helps parties be safer. (You know, for some value of safer.)
AlanSubie4Life
Efficiency Obsessed Member
Probably, yeah.
I would tend to agree. But extraordinary times call for extraordinary measures and a degree of flexibility that is beyond what would normally be extended by authorities.
My point is that making things punitive is kind of pointless. Just need to encourage responsible behavior, recognize that parties are going to happen, and plan for the worst case - and make sure your models for that worst case scenario indicate nothing but complete success in containment.
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JRP3
Hyperactive Member
If you look at the number of reported cases from testing people it suffers quite a bit from how much who is getting tested changes over time.
Waste water testing seems to be an interesting avenue for surveillance testing. There is a large project conducting this testing near Boston MWRA - Wastewater COVID-19 Tracking The conditions surrounding the test have likely been more consistent ... though I don't know that for sure.
If we assume that. Then prevalence in the Boston area has been growing since early July. Slowly, not exponentially. So implied R_t must be just barely above 1. I have previously praised rt.live for being some of the best modeling available. But I must point out that they currently model Massachusetts as the US state with the lowest R_t at 0.86. Their model seems to think the recent rise in reported cases is due to more widespread testing. Only one of these two datasets is right. I think rt.live is way off base here. Highlighting just how hard it is to get this modeling right. Massachusetts Rt
Covidactnow is also a website I generally think worth consulting but also disagrees with the sewage trends putting R_t in MA below 0.95. America’s COVID warning system
I will be following this with great interest to see what is the better tracker. Patient tests and % testing adjustments or Sewage. My gut thinks the poo. I'm sure if the cases continue to grow the return to school will be the preferred narrative for a catalyst. People are always grasping for a convenient why. But school didn't start returning in July. It must be a more fundamental catalyst.
Waste water testing seems to be an interesting avenue for surveillance testing. There is a large project conducting this testing near Boston MWRA - Wastewater COVID-19 Tracking The conditions surrounding the test have likely been more consistent ... though I don't know that for sure.
If we assume that. Then prevalence in the Boston area has been growing since early July. Slowly, not exponentially. So implied R_t must be just barely above 1. I have previously praised rt.live for being some of the best modeling available. But I must point out that they currently model Massachusetts as the US state with the lowest R_t at 0.86. Their model seems to think the recent rise in reported cases is due to more widespread testing. Only one of these two datasets is right. I think rt.live is way off base here. Highlighting just how hard it is to get this modeling right. Massachusetts Rt
Covidactnow is also a website I generally think worth consulting but also disagrees with the sewage trends putting R_t in MA below 0.95. America’s COVID warning system
I will be following this with great interest to see what is the better tracker. Patient tests and % testing adjustments or Sewage. My gut thinks the poo. I'm sure if the cases continue to grow the return to school will be the preferred narrative for a catalyst. People are always grasping for a convenient why. But school didn't start returning in July. It must be a more fundamental catalyst.
Is that consistent with a bradykinin hypothesis for the disease, that steroids would help?
bkp_duke
Well-Known Member
Because the bradykinin pathways (and I'm not expert, just reading up on this stuff) overlap significantly with many of the pathways with cytokine storm to cause a large inflammatory response, yes it does fit well with that hypothesis.
scottf200
Well-Known Member
Great overview article that popped up on my alerts.
Title: Here’s how the U.S. could release a COVID-19 vaccine before the election—and why that scares some (Aug. 28, 2020) -- Question with a paragraph or two answers.
* What’s the traditional vaccine approval pathway?
* How does an EUA work?
* What safety and efficacy evidence would FDA require before issuing an EUA?
* What harm could an EUA do?
* What if the vaccine doesn’t work well or causes harm?
* Has an EUA ever been used for a vaccine?
* What’s the difference between FDA’s expanded access program and an EUA?
* If FDA decides not to grant an EUA or expanded access for a COVID-19, are there other approval pathways?
* Does Europe have a similar emergency approval process?
* How did China and Russia speed approval of their COVID-19 vaccines?
* Many countries do not have strong regulatory agencies. How do they decide whether to use a COVID-19 vaccine that is not licensed?
Here’s how the U.S. could release a COVID-19 vaccine before the election—and why that scares some
What's Up With That Russian Vaccine? | SciShow News
dhanson865
Well-Known Member
What do you think about the risk of me going to a dental cleaning (6 month style)? I could totally reschedule for some time after the vaccine comes out and just keep brushing and such until then. So I'm going to say this is elective not required. Is it worth the risk going in and having contact with all those surfaces and proximity to all those staff members?
WHO Is Now Asking People to Avoid Routine Dental Work. Here's Why
I think I'll just cancel my appointment.
WHO Is Now Asking People to Avoid Routine Dental Work. Here's Why
I think I'll just cancel my appointment.
bkp_duke
Well-Known Member
Each to his own, but my dental cleanings are all postponed till post-vaccine.
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