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Co-vid 19: What Is and Isn't Known, Discussion and Debate


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59 minutes ago, pogi said:

I just think this is silly perception of what should be required.  Going to school in a pandemic naturally is a given presumed risk of exposure and infection, no need for a call every time a potential exposure happens.  Parents may be getting several calls a day when school opens.   What good will it serve to call about every single low-risk exposure? 

Here is what happens in those low risk calls - 

Contact Tracer: "Hi, I am calling to inform you that your child may have been exposed to someone infected with Covid while at school." 

Parent: "Who were they exposed to?" 

Contact tracer: "I can't tell you that because of HIPPA laws, but they are considered low-risk and don't need to quarantine or do anything different at this time." 

Parent: "Why are you calling me if you can't tell me anything useful?"

Contact tracer: "We are just calling to inform you of a potential exposure." 

Parent: "We are in a pandemic with wide-spread transmission.  They are in school with kids passing them all over the place in narrow hallways and stacked like sardines in classrooms, I am aware that they have likely ongoing exposures". 

Contact tracer: "Umm, ok, well watch for any signs of infection and get tested if any present themselves." 

Parent: "No kidding (with a sarcastic tone)?  Anything else?

Contact tracer: "Make sure they wear a mask and practice other preventive measures."

Parent: "Serious (said again with a sarcastic tone)?" 

Contact tracer: "Ok, well thank you, bye!"

10 minutes to 1 week later...same call happens from a different Contact tracer...and on and on... 

Total waste of time.  

Why waste our time making those individual calls, (which practically speaking do absolutely nothing other than potentially create anxiety and don't necessarily reduce any risk of transmission), when we could simply make a general announcement that all students should assume ongoing low risk exposures while at school and monitor for symptoms daily, and that they will be notified of any high-risk exposures.

If we have to call every low risk exposure, families will be getting calls on a weekly basis, and potentially multiple times a day, for different low risk exposures to different students/faculty.  It is a waste of time and resources, and families will quickly become annoyed at the number of calls.  Every student in the school will have a low risk exposure in a matter of weeks.  Those exposures will be ongoing throughout the year. 

Unless you can provide some CDC, or other Federal Government documentation about "close contact low risk" and "close contact high risk", because it really just sounds like a state government employee made something up. 

And if that is the dialogue, it sure appears to be specifically designed to not provide not ensure that a parent is informed. 

The phone should be like this.

"You are receiving this call because your student shares a classroom with an individual who tested positive for covid19. At this time there is no need to get tested. Watch for symptoms, contact your physician is symptoms develop"  or something like that."


 

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34 minutes ago, provoman said:

And if that is the dialogue, it sure appears to be specifically designed to not provide not ensure that a parent is informed. 

The phone should be like this.

"You are receiving this call because your student shares a classroom with an individual who tested positive for covid19. At this time there is no need to get tested. Watch for symptoms, contact your physician is symptoms develop"  or something like that."

I am not sure what you read, but Isn't that almost exactly what I said:

"Hi, I am calling to inform you that your child may have been exposed to someone infected with Covid while at school...watch for any signs of infection and get tested if any present themselves...Make sure they wear a mask and practice other preventive measures"...or something like that. 

34 minutes ago, provoman said:

Unless you can provide some CDC, or other Federal Government documentation about "close contact low risk" and "close contact high risk", because it really just sounds like a state government employee made something up. 

You are not understanding what I am saying.  There is no such thing as a "close contact low risk".  There are low risk contacts however.  They are not considered "close contacts".  

Quote

·         Low Risk Contacts

o   Being in the same indoor environment (e.g. classroom, hospital waiting room) as a person with symptomatic, confirmed infection for a prolonged period of time, but is not defined as a close contact (within 6 feet for 15 minutes or longer)

Your suggestion is that all low risk contacts should be contacted and informed of potential exposure.  I am simply suggesting that it serves no pragmatic purpose to do so.

Edited by pogi
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2 hours ago, pogi said:

I am not sure what you read, but Isn't that almost exactly what I said:

"Hi, I am calling to inform you that your child may have been exposed to someone infected with Covid while at school...watch for any signs of infection and get tested if any present themselves...Make sure they wear a mask and practice other preventive measures"...or something like that. 

You are not understanding what I am saying.  There is no such thing as a "close contact low risk".  There are low risk contacts however.  They are not considered "close contacts".  

Your suggestion is that all low risk contacts should be contacted and informed of potential exposure.  I am simply suggesting that it serves no pragmatic purpose to do so.

I apologize for any miscommunication. 

There is trepidation in hearing that being in the same room but not withing "close contact" is a low risk for infection. I think if more people accepted or understood that, there would be less push back about schools opening, I would not sit in the foyer during the monthly in person sacrament meeting. 

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19 hours ago, Tacenda said:

I was pro school for a bit, thinking that it would be an impossible situation to figure out how their working parents can find suitable places for them. But wonder if we need to do as a whole people what's right to save lives. But hopefully that in turn won't take lives or harm lives in other ways. It's truly the scariest and bleakest thing to have happen all around.

Somehow we made it through summer and most parents do not have seasonal jobs. I also think the whiplash will be worse as schools are open for three weeks and then get shut down again. Parents think they can work full-time and make plans around it and then it falls apart. This sums up a lot of my expectations:

https://www.theatlantic.com/ideas/archive/2020/08/push-reopen-schools-fail/614869/

19 hours ago, pogi said:

I hear you, but I have a hard time thinking of an acceptable alternative.  We have to think long-term here as this virus is not going away any time soon.  If kids are not in school, many will simply replace daycare for school, which will not be much of a help in controlling spread.  With working parents, many don't have other alternatives.  I think the best solution is to do a hybrid system of on-line learning and in-class school where we could cut attendance by 1/3 if we have 2 days on-line and 1 day in-class.  

There really is no good answer to this problem.  Every solution seem to creates more problems. 

I still think the hybrid system will end up going to pure online after several spreads. I agree with you that contact tracing in schools are a fool’s errand. While it goes against the fiscal conservative in me I think we need to subsidize in a way a parent can be around. This is hardest with single parent homes of course. While I am worried about schools I think the rash of incoming evictions and homelessness will be the biggest hit to controlling the virus. Homeless shelters are not ideal for preventing virus transmission and we do not have enough of them in any case.

Congress claims it is close to a deal to extend the federal moratorium but that would only cover about a third of renters without a state level moratorium. I also read locally that landlords with federally backed mortgages are filing illegal evictions and the courts have no good verification mechanism.

The other looming threat is overloaded hospitals to the point that people who could be saved die due to lack of resources. This is hard to track as the federal administration moved reporting from the CDC to HHS which mysteriously does not report the metrics that would make things look bad. Their data is also more out of date than the CDC reports and too much of the data they did report was found to be inaccurate.

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This article really struck me. We do, as a nation and world, need to look at the risk/reward statistics. The cure, in this case, may well be worse than the disease. The ramifications of widespread economic collapse is devastating on the weakest and poorest.

"All around the world, the coronavirus and its restrictions are pushing already hungry communities over the edge, cutting off meager farms from markets and isolating villages from food and medical aid. Virus-linked hunger is leading to the deaths of 10,000 more children a month over the first year of the pandemic, according to an urgent call to action from the United Nations shared with The Associated Press ahead of its publication in the Lancet medical journal.

More on the Pandemic:

Further, more than 550,000 additional children each month are being struck by what is called wasting, according to the U.N. — malnutrition that manifests in spindly limbs and distended bellies. Over a year, that’s up 6.7 million from last year’s total of 47 million. Wasting and stunting can permanently damage children physically and mentally, transforming individual tragedies into a generational catastrophe."

"Even more than the money, restrictions on movement need to be eased so that families can seek treatment, said Victor Aguayo, the head of UNICEF’s nutrition program.

“By having schools closed, by having primary health care services disrupted, by having nutritional programs dysfunctional, we are also creating harm,” Aguayo said. He cited as an example the near-global suspension of Vitamin A supplements, which are a crucial way to bolster developing immune systems.

In Afghanistan, restrictions on movement prevent many families from bringing their malnourished children to hospitals for food and aid just when they need it most. The Indira Gandhi hospital in the capital, Kabul, has seen only three or four malnourished children, said specialist Nematullah Amiri."

https://apnews.com/5cbee9693c52728a3808f4e7b4965cbd?fbclid=IwAR1BjrKceQ9JNA43ygyxYeeSnVKfeqP_3uWMzFQKljRrGFx31efBlUbyK_w

Edited by bsjkki
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9 minutes ago, bsjkki said:

This article really struck me. We do, as a nation and world, need to look at the risk/reward statistics. The cure, in this case, may well be worse than the disease. The ramifications of widespread economic collapse is devastating on the weakest and poorest.

"All around the world, the coronavirus and its restrictions are pushing already hungry communities over the edge, cutting off meager farms from markets and isolating villages from food and medical aid. Virus-linked hunger is leading to the deaths of 10,000 more children a month over the first year of the pandemic, according to an urgent call to action from the United Nations shared with The Associated Press ahead of its publication in the Lancet medical journal.

More on the Pandemic:

Further, more than 550,000 additional children each month are being struck by what is called wasting, according to the U.N. — malnutrition that manifests in spindly limbs and distended bellies. Over a year, that’s up 6.7 million from last year’s total of 47 million. Wasting and stunting can permanently damage children physically and mentally, transforming individual tragedies into a generational catastrophe."

"Even more than the money, restrictions on movement need to be eased so that families can seek treatment, said Victor Aguayo, the head of UNICEF’s nutrition program.

“By having schools closed, by having primary health care services disrupted, by having nutritional programs dysfunctional, we are also creating harm,” Aguayo said. He cited as an example the near-global suspension of Vitamin A supplements, which are a crucial way to bolster developing immune systems.

In Afghanistan, restrictions on movement prevent many families from bringing their malnourished children to hospitals for food and aid just when they need it most. The Indira Gandhi hospital in the capital, Kabul, has seen only three or four malnourished children, said specialist Nematullah Amiri."

While horrible the US is not currently suffering from food shortages nor is anyone under travel restrictions preventing them from going to a hospital. In fact when schools were shut down most school districts I am aware of that had them kept their meal programs going to make sure vulnerable kids could eat. I condemn some of the measures used in other nations but I am not willing to use them as an analogy to argue the US needs to reopen restaurants and schools. If our system cannot prevent societal collapse when we have plenty of food and enough housing for everyone but need people to do a little less to keep alive maybe the problem is with the system itself and not the restrictions meant to preserve life?

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4 minutes ago, The Nehor said:

While horrible the US is not currently suffering from food shortages nor is anyone under travel restrictions preventing them from going to a hospital. In fact when schools were shut down most school districts I am aware of that had them kept their meal programs going to make sure vulnerable kids could eat. I condemn some of the measures used in other nations but I am not willing to use them as an analogy to argue the US needs to reopen restaurants and schools. If our system cannot prevent societal collapse when we have plenty of food and enough housing for everyone but need people to do a little less to keep alive maybe the problem is with the system itself and not the restrictions meant to preserve life?

So you disagree with the scientists and experts about the importance of going to back to school and opening up and the problems that are just beginning?

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45 minutes ago, bsjkki said:

So you disagree with the scientists and experts about the importance of going to back to school and opening up and the problems that are just beginning?

Haven't read the article you linked, but based on what you did post, I did not see anything related to the importance of opening schools. AND if opening schools is about nutrition, as Nehor posted, US schools provided meals during the schools months when schools were closed.  So in viewed in proper context of the Country and the restrictions in place, I would disagree with someone using the harm in villages of the mountains of Afghanistan as a basis to push school in the US to open.

Edited by provoman
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Everyone should ignore for the purpose of this thread the bottom line as political, if you can find a source with just the numbers that would be better, Tacenda.

Edited by Calm
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7 hours ago, bsjkki said:

So you disagree with the scientists and experts about the importance of going to back to school and opening up and the problems that are just beginning?

You mean the concerns about kids not having socialization and being a bit behind on education? No, I agree with them that those are problem. It is a terrible problem. I just doubt it will be worse than the mass infections opening the schools will inevitably cause. Israel was doing better than the US in regards to the pandemic in general. They opened their schools back up in May when they thought they had a lid on it. Hundreds of schools had to shut back down and tens of thousands and students and staff were quarantined. There are no good options. There are just less bad options. 

If we had taken our medicine and contained the spread earlier we might be able to open schools but the virus is too widespread and we do not have it anywhere close to contact tracing. It will get into almost every school and the way schools are set up they will have a lot of spread.

As to the problems that are just beginning some will probably be worse than large-scale spread in schools. The impending mass evictions for example. Nothing like becoming homeless in the middle of a pandemic.

1 hour ago, Tacenda said:

Not sure how accurate, but if it is, this is terribly shocking how bad the US is doing compared to the rest of the world.

Pretty accurate. The chart left out most of the nations that are likely concealing cases on a large-scale basis except possibly the USA in the last few weeks. I am worried about the recent reporting shift causing our data to be incorrect.

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7 hours ago, provoman said:

Haven't read the article you linked, but based on what you did post, I did not see anything related to the importance of opening schools. AND if opening schools is about nutrition, as Nehor posted, US schools provided meals during the schools months when schools were closed.  So in viewed in proper context of the Country and the restrictions in place, I would disagree with someone using the harm in villages of the mountains of Afghanistan as a basis to push school in the US to open.

Yeah, Nehor brought up the schools. I posted an article showing the complete and utter disaster this virus is on 3rd world countries. More children will die from this virus due to starvation than die from covid. I don't even want to estimate what that ratio will look like.

I did not use this as a basis to push to open schools. I did not connect the article to anything US centric. I was reacting to Nehor's comment. I happen to agree with the experts that getting kids back in school is important and should happen. He seems to disagree with the scientists and experts on this. I guess it is okay to disagree with scientists now?

I will post the whole article about starvation and death in other countries when it is released in the Lancet. I found this article through a friend of mine on Facebook who happens to live in Guatemala who has documented the wide spread food shortages that have happened around him due to the shutdowns in the country. 

 

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12 minutes ago, bsjkki said:

Yeah, Nehor brought up the schools. I posted an article showing the complete and utter disaster this virus is on 3rd world countries. More children will die from this virus due to starvation than die from covid. I don't even want to estimate what that ratio will look like.

I did not use this as a basis to push to open schools. I did not connect the article to anything US centric. I was reacting to Nehor's comment. I happen to agree with the experts that getting kids back in school is important and should happen. He seems to disagree with the scientists and experts on this. I guess it is okay to disagree with scientists now?

I will post the whole article about starvation and death in other countries when it is released in the Lancet. I found this article through a friend of mine on Facebook who happens to live in Guatemala who has documented the wide spread food shortages that have happened around him due to the shutdowns in the country. 

 

You reading an article by someone who said we should reopen schools does not constitute a consensus I am Ignorantly defying.  Some educators have pointed out the dangers of not having school. More importantly some social scientists have pointed out the even greater danger that this leaves man of the nation’s most vulnerable children without critical support. These are all valid and real concerns but they do not justify ignoring the warnings of epidemiologists and medical experts who say it will spread and the schools will shut down. Is a week or two of in-person schooling going to prevent the problems? No. Will planning to open and then shutting down A few weeks in mess with the plans of parents, force teachers to transition with no planning, and prevent planning for how to support the most vulnerable because you assume you will not need it? Yes. Will people die because we opened schools? Yes.

Some US schools have already opened. Some are already shutting down. The most disgusting part are some people acting like it s a stroke of unforseeable bad luck. I really want to opt out of this death cult.

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The experts are saying the default should be to open. If you have widespread community outbreak...maybe not. It’s a big country. Here is the tale of 3 counties. One of them was locked down a shorter time than the others. Has been open longer and with less restrictions. Interesting, huh. 

Take precautions, follow the guidance, protect the most vulnerable.

*mask wearing compliance was highest too. 

https://data.tchd.org/covid19/

Edited by bsjkki
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9 hours ago, bsjkki said:

Dr. Birx encourages only those with under a 5 percent positive test rate to open. 

We are hoovering around 10% in Utah.  Many states are over 20%.  The US, as a whole, is at 7.6 %

https://slco.org/health/COVID-19/data/

There are probably only a handful of states nationwide that have under 5% (Alaska and Montana, for example).  You can see rates for each individual state here (you have to select the state you want to view from the drop down menu):

https://coronavirus.jhu.edu/testing/individual-states

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On 8/3/2020 at 4:18 PM, MiserereNobis said:

From the University of California: We thought it was just a respiratory virus. We were wrong.

It's a long but good read. It covers the history of understanding the virus, its symptoms, and how it works in the body.

I have never seen a virus affect so many different systems. It is truly remarkable.  Just this morning I learned that one of my patients (in her 40's) went to the hospital yesterday with new-onset heart arrhythmia problems.  She may have to be on blood-thinners the rest of her life thanks to Covid.  

This article also talks about the unknowns of immunity.  This morning has been really interesting already.  I just barely received a call (no kidding) from one of my patients who fully recovered and who' s case I closed on 7/23.  Well, he just had new onset symptoms begin yesterday with fever, cough, muscle aches, fatigue, and loss of smell and taste.  He didn't have loss of smell and taste with his initial bout of symptoms.  Clearly it is Covid...again, only 12 days after recovering from his first infection!  His father lived with him and unfortunately died from Covid only a couple weeks ago.  His extended family (7 in total) came to Utah for his Father's funeral and are living with him.  They are all positive for Covid and were symptomatic before my case started showing new symptoms.  My best guess is that he was infected by a different strain of Covid that his extended family brought with them and infected him with.  Covid has devastated his family with the loss of his father, and now he has to battle his enemy for a second time now in only a couple short weeks.  I have never seen Covid relapse like this, I can only assume it is a new infection.  Over and over and over again, I am seeing cases of repeat infections, but this is the shortest interval I have seen yet.  Immunity doesn't seem to be much of a thing at all from my limited observations.  Every week  it seems, I am thrown a curve ball by this virus - showing me new things that I never expected to see.  

Edited by pogi
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28 minutes ago, pogi said:

We are hoovering around 10% in Utah.  Many states are over 20%.  The US, as a whole, is at 7.6 %

https://slco.org/health/COVID-19/data/

There are probably only a handful of states nationwide that have under 5% (Alaska and Montana, for example).  You can see rates for each individual state here (you have to select the state you want to view from the drop down menu):

https://coronavirus.jhu.edu/testing/individual-states

I think you have to go more local than state. Denver rules Colorado and the Salt Lake area rules Utah. Let the local jurisdictions make the call. My county is under 5% but our neighboring counties are not. If we continue the trend for 2 weeks, we should be able to open. Will there by a spike? Undoubtedly. When we opened up in late May, (I did not factor in large scale crowds nationwide) I expected a spike too. Every year when kids go back to school, people get sick. I hope due to the mitigating factors of masks, temp checks every morning, hand washing stations and spread out desks, schools will be successful in mitigating the disease. I hope they add in ventilation too.

Everyone says this is a tricky balance. I agree with that. Interesting article on transmission studies and children. https://www.nytimes.com/2020/07/18/health/coronavirus-children-schools.html

Edited by bsjkki
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15 minutes ago, pogi said:

I have never seen a virus affect so many different systems. It is truly remarkable.  Just this morning I learned that one of my patients (in her 40's) went to the hospital yesterday with new-onset heart arrhythmia problems.  She may have to be on blood-thinners the rest of her life thanks to Covid.  

This article also talks about the unknowns of immunity.  This morning has been really interesting already.  I just barely received a call from one of my patients who fully recovered and who' s case I closed on 7/23.  Well, he just had new onset symptoms begin yesterday with fever, cough, muscle aches, fatigue, and loss of smell and taste.  He didn't have loss of smell and taste with his last bout of symptoms.  Clearly it is Covid...again, only 12 days after recovering from his first infection!  His father lived with him and died from Covid only a couple weeks ago.  His extended family (7 in total) came to Utah for his Father's funeral and are living with him.  They are all positive for Covid and were symptomatic before my case started showing new symptoms.  My best guess is that he was infected by a different strain of Covid that his extended family brought with them and infected him with.  Covid has devastated his family with the loss of his father, and now he has to battle his enemy for a second time now.  I have never seen Covid relapse like this, I can only assume it is a new infection.  Over and over and over again, I am seeing cases of repeat infections, but this is the shortest interval I have seen yet.  Immunity doesn't seem to be much of a thing at all from my limited observations. 

Wow, that is something! So horrible for your patient.

The heart patient reminds me of concerns I personally had. Can you talk about how she was diagnosed for a condition that requires blood thinner? Did you find superficial clots, or DVTs with ultrasound? Or did you have to use an MRI to find clotting? 

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7 minutes ago, bsjkki said:

I think you have to go more local than state. Denver rules Colorado and the Salt Lake area rules Utah. Let the local jurisdictions make the call. My county is under 5% but our neighboring counties are not.

I agree it should be by county.  These numbers suggest that most of the population should remain closed, according to these guidelines.

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18 minutes ago, pogi said:

I have never seen a virus affect so many different systems. It is truly remarkable.  Just this morning I learned that one of my patients (in her 40's) went to the hospital yesterday with new-onset heart arrhythmia problems.  She may have to be on blood-thinners the rest of her life thanks to Covid.  

This article also talks about the unknowns of immunity.  This morning has been really interesting already.  I just barely received a call (no kidding) from one of my patients who fully recovered and who' s case I closed on 7/23.  Well, he just had new onset symptoms begin yesterday with fever, cough, muscle aches, fatigue, and loss of smell and taste.  He didn't have loss of smell and taste with his initial bout of symptoms.  Clearly it is Covid...again, only 12 days after recovering from his first infection!  His father lived with him and unfortunately died from Covid only a couple weeks ago.  His extended family (7 in total) came to Utah for his Father's funeral and are living with him.  They are all positive for Covid and were symptomatic before my case started showing new symptoms.  My best guess is that he was infected by a different strain of Covid that his extended family brought with them and infected him with.  Covid has devastated his family with the loss of his father, and now he has to battle his enemy for a second time now in only a couple short weeks.  I have never seen Covid relapse like this, I can only assume it is a new infection.  Over and over and over again, I am seeing cases of repeat infections, but this is the shortest interval I have seen yet.  Immunity doesn't seem to be much of a thing at all from my limited observations.  Every week  it seems, I am thrown a curve ball by this virus - showing me new things that I never expected to see.  

This is the great unknown and your observation makes the chance of a viable vaccine less likely, correct? How do we learn to live with this disease if reinfection occurs easily and there are multiple strains. At some point, the entire society could collapse due to this disease and lockdowns decimating the economy.

Interesting study on reinfection. https://www.forbes.com/sites/brucelee/2020/07/19/can-you-get-covid-19-coronavirus-twice-here-is-an-update-on-reinfection/#11a29d847cbf

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