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

[pogi]

24 minutes ago, Meadowchik said:

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? 

I didn't actually diagnose her.  She reported to me that she went to the ER yesterday due to "heart problems" she described it as feeling like her heart kept skipping a beat.  When she said that, I initially thought heart palpitations - no big deal.  However, she stated that the EKG showed a "heart arrhythmia".  She didn't specify what kind of arrhythmia, but based on her description and condition I am assuming it could only be A-fib. She is currently on a heart monitor for a week and has an appointment with a cardiologist after that.  So, this is all preliminary, but if it truly is A-fib, then there is a good chance they will put her on blood thinners, as A-fib increases the risk of clotting and strokes. 

[pogi]

20 minutes ago, bsjkki said:

Flee the cities.

 

...and infect rural America so that we can close down all schools.  These high percentages are not limited to urban areas any more.  Large parts of rural America are seeing high positive percentage test rates.  

Edited August 5, 2020 by pogi

[The Nehor]

10 hours ago, bsjkki said:

https://www.google.com/amp/s/www.newsweek.com/fauci-sides-trump-reopening-schools-after-telling-teachers-theyll-part-experiment-1522023%3famp=1?espv=1

https://www.c-span.org/video/?c4896914/user-clip-cdc-it-public-health-interest-schools-back-open-face-face-learning

https://www.google.com/amp/s/nypost.com/2020/07/29/bill-gates-says-schools-should-reopen-despite-covid-19/amp/

this one has a multitude of studies and quotes the AAP and their opinion on opening schools.

https://www.google.com/amp/s/www.livescience.com/amp/coronavirus-should-schools-reopen-fall.html

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

https://www.google.com/amp/s/www.businessinsider.com/reopening-schools-covid-19-cases-caution-birx-2020-8%3famp

https://www.google.com/amp/s/www.nytimes.com/2020/07/15/health/coronavirus-schools-reopening.amp.html

From the UN. https://www.google.com/amp/s/www.nbcnews.com/news/amp/ncna1235788

 

Your first three are Fauci, Fauci and friends, and Bill Gates. Fauci works for an administration that presses for schools to be open at any cost and Bill Gates is not an expert.

The next one is about the losses from not doing in-person learning which is important to know but it is not a call to open schools. The AAP focuses on their field of expertise but are not epidemiologists.

Dr. Birx’s guidelines say most students in the US should not go to school. If we had done a better job at containment we probably could take the calculated risk of opening schools.

I admit I find a certain irony in you quoting the UN in support of your position. Again, it is talking about the potential loss (which is real) but why do none of your links talk about the odds of having to shut down?

[bsjkki]

28 minutes ago, The Nehor said:

Your first three are Fauci, Fauci and friends, and Bill Gates. Fauci works for an administration that presses for schools to be open at any cost and Bill Gates is not an expert.

The next one is about the losses from not doing in-person learning which is important to know but it is not a call to open schools. The AAP focuses on their field of expertise but are not epidemiologists.

Dr. Birx’s guidelines say most students in the US should not go to school. If we had done a better job at containment we probably could take the calculated risk of opening schools.

I admit I find a certain irony in you quoting the UN in support of your position. Again, it is talking about the potential loss (which is real) but why do none of your links talk about the odds of having to shut down?

I guess you are on record on for discounting the NIH and the CDC. You science denier!

[Ahab]

39 minutes ago, The Nehor said:

Your first three are Fauci, Fauci and friends, and Bill Gates. Fauci works for an administration that presses for schools to be open at any cost and Bill Gates is not an expert.

The next one is about the losses from not doing in-person learning which is important to know but it is not a call to open schools. The AAP focuses on their field of expertise but are not epidemiologists.

Dr. Birx’s guidelines say most students in the US should not go to school. If we had done a better job at containment we probably could take the calculated risk of opening schools.

I admit I find a certain irony in you quoting the UN in support of your position. Again, it is talking about the potential loss (which is real) but why do none of your links talk about the odds of having to shut down?

I picture in my mind children walking into school buildings, and the halls and classrooms in those school buildings, as if they are guinea pigs and we are all watching to see if COVID-19 will get them.

This is a very deadly virus and we should all be doing whatever we can to try to make sure that we and our children do not get it.  They likely don't understand the risks, without a vaccine, just as many adults don't.

The world, in general, is not acting intelligently.

Edited August 5, 2020 by Ahab

[Ahab]

1 hour 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.  

Nice to hear that he recovered the first time.  I hope he recovers from it again now that he has it again.  What percentage of repeat infection cases would you say have recovered or will usually recover?

[bsjkki]

14 minutes ago, Ahab said:

I picture in my mind children walking into school buildings, and the halls and classrooms in those school buildings, as if they are guinea pigs and we are all watching to see if COVID-19 will get them.

This is a very deadly virus and we should all be doing whatever we can to try to make sure that we and our children do not get it.  They likely don't understand the risks, without a vaccine, just as many adults don't.

The world, in general, is not acting intelligently.

Under theses guidelines, children should never go to school. The flu kills children at much higher rates. We really should never leave our house. Then we will all be safe all the time.

[The Nehor]

1 hour ago, bsjkki said:

I guess you are on record on for discounting the NIH and the CDC. You science denier!

Not discounting. I read what they want. I disagree and I suspect that political objectives direct their statements on this matter.

43 minutes ago, bsjkki said:

Under theses guidelines, children should never go to school. The flu kills children at much higher rates. We really should never leave our house. Then we will all be safe all the time.

You believe the world will be perpetually in the middle of a pandemic? School are breeding grounds for disease. The new teacher being ill almost in perpetuity for their first year on the job is almost proverbial. Without a deadly disease it is the cost of doing business as, as you said, children are generally resilient to disease. This pandemic will lay out many of their teachers (check out teaching age demographics) and kids take it home and the flu does not kill more adults than Covid does. We also still have not figured out what the long term consequences of this disease are. We could be murdering the economy for decades for one semester of schooling that will, in many cases, last a few weeks.

Then again, you have won. Many schools are opening. We will find out who is right over the coming weeks and months. I am pretty sure I am right but I hope and pray you are right and it will be fine.

[bsjkki]

40 minutes ago, The Nehor said:

Not discounting. I read what they want. I disagree and I suspect that political objectives direct their statements on this matter.

You believe the world will be perpetually in the middle of a pandemic? School are breeding grounds for disease. The new teacher being ill almost in perpetuity for their first year on the job is almost proverbial. Without a deadly disease it is the cost of doing business as, as you said, children are generally resilient to disease. This pandemic will lay out many of their teachers (check out teaching age demographics) and kids take it home and the flu does not kill more adults than Covid does. We also still have not figured out what the long term consequences of this disease are. We could be murdering the economy for decades for one semester of schooling that will, in many cases, last a few weeks.

Then again, you have won. Many schools are opening. We will find out who is right over the coming weeks and months. I am pretty sure I am right but I hope and pray you are right and it will be fine.

It's not a matter of winning. I think cases will occur. But, it's not just one semester. We might have to learn how to live with this disease long term. I'm not sure our economy can take another 6 months of lockdown. I think it is beginning to fray. I think emotional well being is fraying. I think we have to look at the big picture and make some hard calls.

[pogi]

1 hour ago, Ahab said:

Nice to hear that he recovered the first time.  I hope he recovers from it again now that he has it again.  What percentage of repeat infection cases would you say have recovered or will usually recover?

If you are asking how many of my personal patients died after a repeat infection, the answer is zero.  I couldn't tell you how many have chronic complications like heart arrhythmia, permanent lung damage with shortness of breath, chronic fatigue, etc. from it though.  I don't track that information.  It would be interesting to see those numbers if we had them.    

Edited August 5, 2020 by pogi

[The Nehor]

8 minutes ago, bsjkki said:

It's not a matter of winning. I think cases will occur. But, it's not just one semester. We might have to learn how to live with this disease long term. I'm not sure our economy can take another 6 months of lockdown. I think it is beginning to fray. I think emotional well being is fraying. I think we have to look at the big picture and make some hard calls.

If we were capable of making hard calls we could have stopped this before it got anywhere. We could still get down to contact tracing local outbreaks and rooting out the last of this in two months if we are willing to take drastic action. Instead we have taken the middle way of taking action but not anything that is too disruptive and ended up with the worst of both worlds. We trashed the economy without containing the disease while also not containing the disease at the cost of the economy. Opening schools seems like the next item on the list of "How else can we make this worse" that we have been checking off.

[Calm]

3 hours ago, bsjkki said:

This is the great unknown and your observation makes the chance of a viable vaccine less likely, correct?

In an article that got pulled (I suspect the Church didn’t want to look like it was endorsing a particular vaccine), one of the researchers said if the vaccine targets what is shared commonly among the different strands, it could be much more effective...iirc he was talking about the hook part of the virus, the key that gets the virus into the cell. Its structure is one of the reasons Covid is so infectious and I got the impression it is one of the more consistent, non evolving parts of the virus...the key can’t change much and still work the same way. 
 

So maybe there is still hope that a vaccine will be broadly applicable. 

[strappinglad]

Guidelines: wash your hands for 20 seconds

Random Human( RH ) : will 15 seconds do?

Guidelines: wear a mask

RH: How about just over my mouth

Guidelines: maintain 6 ft. distancing

RH : I think 4 ft is fine

The virus is like the Japan tsunami and the people are lined up on the coast holding signs saying STOP .

I went to the ER a couple of days ago. There was a nurse there at the door taking temps and handing out masks and asking the usual questions. I sat down alone in the waiting area and observed the nurse. As she sat and visited she pushed and pulled on her mask and at times put her fingers under the mask. 

We think kids are going to mask up properly when trained adults have a hard time .

[The Nehor]

Russia announced they will begin mass vaccinations in October. There are still reports that Russian elite got this vaccine as early as April but Russia denies those rumors.

They have released almost nothing about this vaccine and are puffing their chests about it being like Sputnik. The only information I can find is that it is based on a preexisting vaccine which means (assuming they are not lying) it is unlikely to use one of the new experimental methods being researched. No data on the clinical trials has been released. They are technically doing Phase 3 trials starting soon at the same time they start giving the vaccine to health care workers.

The only overt indication of nervousness is that Putin has not been front and center talking about this. Presumably he wants political cover and scapegoats if it goes bad.

[The Nehor]

They got pricing on that drug Remdesivir is currently being experimented for its benefits in treating Covid patients. Range is $2,300 to $3,100 per dose. Cost of manufacturing is about $1 a dose. There is hope that since its development was aided directly by federal dollars that there will be an exemption on that price for Covid.

[The Nehor]

48 minutes ago, strappinglad said:

Guidelines: wash your hands for 20 seconds

Random Human( RH ) : will 15 seconds do?

Guidelines: wear a mask

RH: How about just over my mouth

Guidelines: maintain 6 ft. distancing

RH : I think 4 ft is fine

The virus is like the Japan tsunami and the people are lined up on the coast holding signs saying STOP .

I went to the ER a couple of days ago. There was a nurse there at the door taking temps and handing out masks and asking the usual questions. I sat down alone in the waiting area and observed the nurse. As she sat and visited she pushed and pulled on her mask and at times put her fingers under the mask. 

We think kids are going to mask up properly when trained adults have a hard time .

[Tacenda]

8 minutes ago, The Nehor said:

Oh my!! 😂 I saw someone post this on FB and only saw the title and thought it was promoting no masks, glad I read this!

Edited August 5, 2020 by Tacenda

[Calm]

Pogi (or anyone else tracking Utah numbers), has there been any change in reporting Utah stats to the public over time?  I know that some other states have made changes a few times and if I understand correctly the change to no longer reporting to the CDC delayed some hospital stats in some states. 

Just wondering if Utah has been consistent or if there is context that should be used to interpret what the stats off the UT government case counts mean overtime  

I am looking for context for someone who is taking three districts and using their stats and calculating current active cases to say the risk is the same or lessening while from what I have read, cases are less concentrated now so even if numbers were the same, you would be at higher risk than before if you were not in one of the previous clustered areas.  

They have decided the studies are all too politicized so they are only going to depend on the numbers for where they live and mostly shop, using active cases only (assuming active are resolved at two weeks).  They are assuming the percentage of non tested Covid cases is consistent over time. 

Edited August 6, 2020 by Calm

[Calm]

Day care center cases....since they only need to report, some close and others do not.  Nothing is said about unlicensed day care...I assume definitely not reporting, but who knows about closing or other precautions.

https://www.sltrib.com/news/politics/2020/08/03/data-shows-inconsistent/
 

What concerns me somewhat is the day care center are reporting the numbers in the state database don’t match their actual experience in all cases. A certain amount of error is to be expected in days collecting even when operations are smooth, more in the middle of a crisis...so I am not accusing the state of blowing it, just wondering how much that should affect how we view other numbers coming from the state. 

Edited August 6, 2020 by Calm

[Calm]

Quote

The number of people tested also remained on the low side, with an increase of 3,466. Still, the percentage of tests with positive results for the past week was at 9.8%, just over a week after the average dipped to 9.1%.

“We are doing some analysis to try to determine if there are specific geographic areas experiencing a bigger [testing] decline than others,” said Tom Hudachko, UDOH spokesman. “So far, the decline appears to be statewide.”...

The state also has been collecting data on the percentage of clinic and hospital patients who arrive with symptoms consistent with COVID-19, Hudachko said, and those numbers also have been decreasing for a few weeks.

“It could be that there are fewer sick people out there,” he said, “and that could explain some of it.”...

The decline in testing has occurred at Intermountain facilities statewide, with about 15% fewer tests being conducted since Pioneer Day, Wallin said....

Many factors may affect how many tests are administered in a day, said Dr. Jonathan Genzen, chief operating officer for ARUP Laboratories. They include the number of people with symptoms in need of testing for contact tracing, how many people a collection site can handle, and the level of public awareness for how to get tested. There also are factors that affect whether a patient can get to a test site, such as weather, holidays, schedules and transportation, he said.

https://www.sltrib.com/news/2020/08/03/utah-reports-new-covid/

[Meadowchik]

On 8/6/2020 at 12:09 AM, strappinglad said:

Guidelines: wash your hands for 20 seconds

Random Human( RH ) : will 15 seconds do?

Guidelines: wear a mask

RH: How about just over my mouth

Guidelines: maintain 6 ft. distancing

RH : I think 4 ft is fine

The virus is like the Japan tsunami and the people are lined up on the coast holding signs saying STOP .

I went to the ER a couple of days ago. There was a nurse there at the door taking temps and handing out masks and asking the usual questions. I sat down alone in the waiting area and observed the nurse. As she sat and visited she pushed and pulled on her mask and at times put her fingers under the mask. 

We think kids are going to mask up properly when trained adults have a hard time .

Logically, masks worn over the mouth and nose are an overall advantage against Covid infection rates. I remember people posting about touching the mask as negating all its benefits, but since surface transmission is different from air transmission, that's incorrect. 

[The Nehor]

2 hours ago, Meadowchik said:

Logically, masks worn over the mouth and nose are an overall advantage against Covid infection rates. I remember people posting about touching the mask as negating all its benefits, but since surface transmission is different from air transmission, that's incorrect. 

Yeah, it is not true. The exterior of the mask is unlikely to be carrying much more virus than your shirt. It mitigates longer range dispersal By the wearer and provides a minor benefit to the wearer in screening out some virus from the air.

When I had a snack a few hours ago it seemed kind of tasteless. Now the hypochondriac in me thinks I have Covid. I hope I am just tired. I devised a taste test I can use tomorrow.

[Calm]

Hot sauce on a cracker?

[Calm]

Summer camps previews of schools?

https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w

Quote

The findings in this report are subject to at least three limitations. First, attack rates presented are likely an underestimate because cases might have been missed among persons not tested or whose test results were not reported. Second, given the increasing incidence of COVID-19 in Georgia in June and July, some cases might have resulted from transmission occurring before or after camp attendance.†† Finally, it was not possible to assess individual adherence to COVID-19 prevention measures at camp A, including physical distancing between, and within, cabin cohorts and use of cloth masks, which were not required for campers.

These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight setting, resulting in high attack rates among persons in all age groups, despite efforts by camp officials to implement most recommended strategies to prevent transmission. Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported (1–4). This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection (1–3) and, contrary to early reports (5,6), might play an important role in transmission (7,8). The multiple measures adopted by the camp were not sufficient to prevent an outbreak in the context of substantial community transmission. Relatively large cohorts sleeping in the same cabin and engaging in regular singing and cheering likely contributed to transmission (9). Use of cloth masks, which has been shown to reduce the risk for infection (10), was not universal. An ongoing investigation will further characterize specific exposures associated with infection, illness course, and any secondary transmission to household members. Physical distancing and consistent and correct use of cloth masks should be emphasized as important strategies for mitigating transmission in congregate settings.

From Everyday Health alerts:

Quote

Other camps have been encountering similar problems. Central Michigan District Health Department officials have traced dozens of recent coronavirus cases to a Gladwin-area summer camp, according to the Detroit Free Press. KGW8 in Oregon said that 11 campers and 14 staff members — all age 20 or younger — tested positive at a Bible camp in Multnomah County. The Rapid City Journal found that 93 South Dakota residents and three out-of-state residents have COVID-19 after attending Camp Judson. Those infected at this church camp range in age from 5 to 74.

 

Edited August 7, 2020 by Calm

[Hamba Tuhan]

1 hour ago, Calm said:

Summer camps previews of schools?

Is anyone able to explain to me why Americans are holding summer camps in the middle of a pandemic?