Covid II: Medical Info and Implications

[bsjkki]

Just now, Tacenda said:

Awesome, hoping the spit test and results can be done in each of our homes one day too!!

The feds bought all the tests to distribute to nursing homes and institutions. The next batch will reach others.

[pogi]

10 hours ago, Calm said:

I am not sure there is enough consistency between areas on type of lock downs and cooperation or lack there of to draw conclusions myself either way. Throw in protests, young and dumb type of parties, variations on contact tracing and enforcement...

And if the lockdowns didn’t work, is it that they weren’t actually effective or more that they were sabotaged by lack of cooperation?  Or something else?

Comparing Sweden to the US or other countries without taking into account population density, percentage of population that is older, health care quality, and probably many other influences on Covid numbers is problematic imo.  At least as described, I wasn’t impressed. 
 

added:  as far as I can tell, they are only using the daily count of deaths for each country or state. Given the wide variation in many countries and states, I wonder how this impacts it. It is an interesting result of it is found to be accurate...that death growth rates fell to zero 20-40 days or so after 25 deaths were recorded...rather weird it would be consistent across such varied demographics. 
 

I will be interested to see the study reviewed by the experts, especially if confirmed to explain why the disease behaves this way (apparently some others do as well).

The other problem with the study is that the lock downs were also about keeping the healthcare system from being overrun and not as much about total death counts.  They don't address that at all, and kind of miss the point of the lock-downs.  Yes, they may have delayed the inevitable death, but that was largely the point to delay and spread out cases over time so they don't all happen at once and overwhelm the system. 

[pogi]

24 minutes ago, bsjkki said:

Redfield clarifies people had been exposed to covid positive people should quarantine for 2 weeks. A problem arose that people who had been exposed, would go get a test, it would be negative and they would not stay quarantined. Asymptomatic people who get tested after exposure would view it that they were clear even though they may have been tested before the viral load was developed in their system. Testing must be linked to an action (quarantine 2 weeks).

That is why contact tracers are important.  Whenever we put people on quarantine we always educate them about this.  We tell them that if they want to test, they should wait 5 to 7 days after exposure before testing to allow viral load to develop and avoid false negatives.  Often, we reach the person after they have already tested negative, we explain to them why it is still necessary to quarantine despite the negative test.  Even though they tested negative yesterday, doesn't mean they are negative today, or will be tomorrow. 

[Rain]

3 hours ago, bsjkki said:

Even after a vaccine is approved, it will take 6-9 months to get enough people vaccinated for it to help overall. Mitigation issues will need to continue. Approval for vaccine only requires a 50 percent efficacy rate but once it's approved...they want to distribute it within 24 hours so the distribution chains need to be set up. First responders will be first and then those who are most vulnerable.

Attempting this again without the detail.  (Got the error message)

After my preclampsia I learned Europe used something different than the US did to stop seizures.  I have wondered during covid what differences in testing, efficacy, sample size etc. the vaccine will have in other countries verses the US.

[Calm]

Quote

The Dakotas lead in virus growth. The Associated Press reported that coronavirus infections in the Dakotas are growing faster than anywhere else in the nation. North Dakota and South Dakota lead the country in new cases per capita over the last two weeks. Both states have rejected establishing mask-wearing requirements.

Dr. Fauci touted Vermont’s response as a "model for the country." Joining Vermont officials via Zoom on Tuesday, Anthony Fauci, MD, director of National Institute of Allergy and Infections Diseases (NIAID), congratulated the state for its success in slowing the spread of the coronavirus, according to WCAX in Burlington. For months, the state has consistently had the fewest cases, the lowest rate of spread, and the lowest positivity rate. Currently, only two people in the state are hospitalized with the virus and the positivity rate is at 0.2 percent. “Listening to the numbers that you said, I wonder if I could bottle that and take it with me when I go around talking to other parts of the country,” Fauci said

Same as I get on my app

https://www.everydayhealth.com/infectious-diseases/coronavirus-alert/

[Calm]

15 hours ago, pogi said:

The other problem with the study is that the lock downs were also about keeping the healthcare system from being overrun and not as much about total death counts.  They don't address that at all, and kind of miss the point of the lock-downs.  Yes, they may have delayed the inevitable death, but that was largely the point to delay and spread out cases over time so they don't all happen at once and overwhelm the system. 

Another thing is even if all the death rate changes are close to zero or less after 20-40 days post 25th death, the number of deaths themselves could be affected by quickness and type of lockdown. How fast and high is the spike in the 20-40 days after the 25 death?  If rigid lockdown tops the spike at 10 a day vs a loose lockdown at 1000 deaths a day, that both continue at those levels afterwards is highly significant, is it not?  
 

So did they look at what might send the spoke up fast and furious vs more sedate?

And are they saying there is no significant difference with countries that have dropped deaths down to close to or zero?  So many questions I am having a hard time understanding from the report. 

[Calm]

This is from my med app, so hopefully the political commentary is minimal. This is politics but it deals with what information we should be believing about Covid and medical officials, so am including it. Please do not use it as a springboard to complain about anyone else’s handing of their job or such.  My intent is to encourage caution and looking at a variety of trustworthy sites for info rather than one individual or even organization. 
 

Quote

A top Trump health aide apologized for pushing false conspiracy theories. Michael R. Caputo, the assistant secretary of public affairs at the HHS, apologized to staffers on Tuesday after attacking government scientists with a series of falsehoods on Facebook, according to CNN. Caputo had told Facebook viewers that there is a “resistance unit” within the Centers for Disease Control and Prevention (CDC) and left-wing hit squads are being trained for insurrection. He accused scientists of “sedition” and said his “mental health has definitely failed.” Caputo is reportedly considering a leave of absence.

 

Edited September 17, 2020 by Calm

[The Nehor]

46 minutes ago, Calm said:

This is from my med app, so hopefully the political commentary is minimal. This is politics but it deals with what information we should be believing about Covid and medical officials, so am including it. Please do not use it as a springboard to complain about anyone else’s handing of their job or such.  My intent is to encourage caution and looking at a variety of trustworthy sites for info. 
 

 

Sounds like he needs a break.

[pogi]

6 hours ago, Calm said:

Another thing is even if all the death rate changes are close to zero or less after 20-40 days post 25th death, the number of deaths themselves could be affected by quickness and type of lockdown. How fast and high is the spike in the 20-40 days after the 25 death?  If rigid lockdown tops the spike at 10 a day vs a loose lockdown at 1000 deaths a day, that both continue at those levels afterwards is highly significant, is it not?  
 

So did they look at what might send the spoke up fast and furious vs more sedate?

And are they saying there is no significant difference with countries that have dropped deaths down to close to or zero?  So many questions I am having a hard time understanding from the report. 

Yep.  This report has an agenda, me thinks.

[bsjkki]

8 hours ago, Calm said:

This is from my med app, so hopefully the political commentary is minimal. This is politics but it deals with what information we should be believing about Covid and medical officials, so am including it. Please do not use it as a springboard to complain about anyone else’s handing of their job or such.  My intent is to encourage caution and looking at a variety of trustworthy sites for info. 
 

 

He did take a leave of absence. (Obviously needed) https://twitter.com/SpoxHHS/status/1306367589787074563?s=20

 

[Calm]

https://apnews.com/b62eacec9bd3fff89eeab1a8de72f819
 

Quote

Similar examples abound in other college towns across the nation. Among the 50 U.S. counties with the highest concentrations of students and overall populations of at least 50,000, 20 have consistently reported higher rates of new virus cases than their states have since Sept. 1, according to an Associated Press analysis. 

On average, infection rates in those 20 counties have been more than three times higher than their states’ overall rates.

At James Madison University in Virginia, which recently sent students home through September amid a surge in cases, the county is averaging a weekly infection rate of nearly 90 cases per 100,000 people, or more than eight times the statewide average.

Health officials fear that surges among college students will spread to more vulnerable people — older ones and those with underlying health problems — and trigger a new wave of cases and hospitalizations. Some worry that colleges could overwhelm hospitals already bracing for increasing cases of COVID-19 and flu this fall and winter.

 

It would be a very sad statement on the maturity of our young adults if there ends up to be less infection spread among elementary kids if it turns out they are better at listening to instructions on how to stay safe. 

[Tacenda]

I like that our Utah governor is not changing colors yet. He's stearn about people not taking health precautions, and worried specifically about his hometown Utah County, noting that they account for 40 percent of the numbers of covid cases. And are only 20 percent of the state's population. I hope people take heed! 

I'm so sick of this, and want to move! I know that sounds childish! But what is wrong with people?

[Ahab]

11 minutes ago, Tacenda said:

I like that our Utah governor is not changing colors yet. He's stearn about people not taking health precautions, and worried specifically about his hometown Utah County, noting that they account for 40 percent of the numbers of covid cases. And are only 20 percent of the state's population. I hope people take heed! 

I'm so sick of this, and want to move! I know that sounds childish! But what is wrong with people?

It doesn't bother some people to think about death, apparently.

[Calm]

16 minutes ago, Ahab said:

It doesn't bother some people to think about death, apparently.

More likely they aren’t actually thinking about it, at least realistically. 

[Tacenda]

Is this the party that gets mentioned on the news about parties? It's our own Kwaku himself who put this one on. Seems to think it's no big deal.

https://kutv.com/news/local/venue-owner-says-no-more-parties-after-viral-video-of-hundreds-without-masks-or-distancing

[Calm]

1 hour ago, Tacenda said:

Is this the party that gets mentioned on the news about parties? It's our own Kwaku himself who put this one on. Seems to think it's no big deal.

https://kutv.com/news/local/venue-owner-says-no-more-parties-after-viral-video-of-hundreds-without-masks-or-distancing

Yes, it demonstrates yet again one can be intelligent and reasonable in many ways and shortsighted and foolish in others. 

[bsjkki]

Aerosols. https://elemental.medium.com/the-most-likely-way-youll-get-infected-with-covid-19-30430384e5a5

"It wasn’t until a public outcry from over 200 scientists that the WHO finally conceded in July that aerosol transmission was possible.

So if the novel coronavirus is airborne, why isn’t it as contagious as measles? One reason could be that measles is a heartier virus (remember that SARS-CoV-2 is relatively fragile) and can survive longer in those tiny aerosols. Another potential difference is the infectious dose — the amount of virus required to start an infection. Scientists still don’t know exactly how much of the novel coronavirus is needed to make someone sick, but it’s likely higher than conventional airborne viruses.

“What’s the infectious dose via the respiratory route is really probably the last piece of this that isn’t completely answered yet,” says Joshua Santarpia, PhD, an associate professor in the department of pathology and microbiology at the University of Nebraska. “I think people have this preconceived notion that if it’s airborne it’s like the measles or like smallpox where it only takes one viral particle to infect you, and this is almost certainly not the case with this coronavirus. Most coronaviruses are probably in the hundreds.”

Another question that needed to be answered before many public health experts could accept that SARS-CoV-2 was airborne was whether it could even survive in those smaller aerosol particles. Some viruses can’t because they dry up too quickly without a larger liquid droplet to support them. However, many scientists feel this issue has been put to rest with two recent papers (which have yet to be peer-reviewed) that provide what some have called the “smoking gun” for aerosol transmission: live, replicating virus collected from the air of Covid-19 patient hospital rooms.

“Confidently, what you can say is that things that we consider aerosols, not droplets, have both [viral] RNA and [live] virus in them that is capable of replication in cell culture,” says Santarpia, who led one of the studies. “I think that between the two of [our studies], you can say that aerosols are infectious… meaning that probably we’re looking at something that’s airborne.”

The whole article is very interesting with some links to interesting studies.

Edited September 18, 2020 by bsjkki

[bsjkki]

Here is the WHO study on Covid transmission routes.

https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

The scientists:

"We appeal to the medical community and to the relevant national and international bodies to recognize the potential for airborne spread of COVID-19. There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission...

This problem is especially acute in indoor or enclosed environments, particularly those that are crowded and have inadequate ventilation [17] relative to the number of occupants and extended exposure periods (as graphically depicted in Figure 1). For example, airborne transmission appears to be the only plausible explanation for several superspreading events investigated which occurred under such conditions e.g. [10], and others where recommended precautions related to direct droplet transmissions were followed.

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa939/5867798 

Edited September 18, 2020 by bsjkki

[bsjkki]

Utah info. CLI index - which the % of visits to emergency departments reporting "COVID-like-illness" Utah is at its lowest low point.

[strappinglad]

that graph has several numerical errors.The %ge points don't line up with the vertical axis.

[pogi]

25 minutes ago, bsjkki said:

Utah info. CLI index - which the % of visits to emergency departments reporting "COVID-like-illness" Utah is at its lowest low point.

These numbers reflect the low case counts we were seeing just a few weeks ago.  

Brace yourself!  The tides are turning.  Record high numbers today with 911 cases.  Up from around 200-300 cases a couple weeks ago.  Mostly college aged kids. High school kids are the next highest age group.  Hospital rates will shoot up in a couple/few weeks time.  It will shoot up even higher once these college kids start spreading it to their more vulnerable family and community members.  There will be a little lag there.   1 to 2 months and death rates are going to spike again.  School is open, college is in session, and flu season is coming, adding to hospital strain.  

Things could get ugly fairly quickly here in Utah.  Now is not the time to get lax, be safe out there people.
 

 

Edited September 18, 2020 by pogi

[bsjkki]

6 minutes ago, strappinglad said:

that graph has several numerical errors.The %ge points don't line up with the vertical axis.

You are correct the numbers seem off. Bottom graph. The top does show positive test rates spiking. This should show up in the CLI in a week or two...if it's mostly college students, probably not.

Here is another representation.

Edited September 18, 2020 by bsjkki

[bsjkki]

@pogi I talked with a doctor who said the flu shot is even more important this year than past years. When investigating younger covid deaths with no commodities, he said they found the patients had covid plus the flu and it was a very dangerous combination. Have you seen this at all. This was from a emergency room resident.

[pogi]

15 minutes ago, bsjkki said:

@pogi I talked with a doctor who said the flu shot is even more important this year than past years. When investigating younger covid deaths with no commodities, he said they found the patients had covid plus the flu and it was a very dangerous combination. Have you seen this at all. This was from a emergency room resident.

I have never personally seen a double infection.  That is a scary thought.  Very good advice about the vaccine though.  I hope it is an effective one this year.

[pogi]

27 minutes ago, bsjkki said:

This should show up in the CLI in a week or two...if it's mostly college students, probably not.

Even with it mostly being college aged kids, it will show up as sure as the sun rises in the east.   College aged kids may not be as high risk for death, but they are known to fill the hospitals.  People have a misconception that morbidity cannot be severe for young people.   I can’t tell you how many 20 year olds I see ending up in the ER.