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Covid II: Medical Info and Implications


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An interesting article but I have not had time to backcheck much of the data.

https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/

A summary would be that less than 20% of those infected pass on the virus. The R factor is correct but it is an average and we have some people who spread it and many infected who did not. The guess is that some people shed the virus at a very high rate while others are much less infectious. This would explain a lot of the randomness of the pandemic outbreak. While mitigation efforts do lead to fewer cases there is a randomness as well as to how many people in each round will be “super spreaders” making predictions more difficult. This could show why Northern Italy was hit so hard in a pretty small area while surrounding areas had few cases. They rolled the dice badly on how many are super spreaders.

This also provides a different method of contact tracing. Instead of focusing primarily on who an infected person has possibly exposed (though that has value) there may be more value in backtracing to try to find what is likely the super spreader that infected the person and contact trace them.

It also means large gatherings are even more dangerous than we thought. There are suspected accounts of one case causing thousands in crowded venues.

The situation is similar to the SARS threat a few years back which spread in a similar way. The Western world largely treated it like a flu pandemic where contagiousness is much more predictable. This is understandable as the most likely threat for years has been a really nasty strain of influenza.

On the whole I would say this reinforces the need for masking. If someone happens to be a super spreaders wearing a mask could save hundreds or thousands from infection.

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This is what lockdowns/wearing masks/social distancing  were hoping to prevent again in terms of smoothing out the curve.  Speculation is that surging is a result of more socializing and school stuff moving indoors as it cools. Maybe this time the message that masks and social distancing needs to continue  will get across to not only this state, but others. But honestly if it hasn’t yet, why should we expect differently now?

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Wisconsin hospitals are overflowing. Severe coronavirus cases in Wisconsin are climbing so high that some hospitals in the state have put patients on waiting lists or are sending them to other facilities, according to the Milwaukee Journal Sentinel. The paper cites Green Bay, Wausau, and the Fox Valley as areas being hit especially hard. State health officials acknowledged this week that Wisconsin is closer than ever to opening a state-run field hospital to accommodate the deluge of patients. The state recently had its highest number of deaths per day since May.

Also:  https://www.jsonline.com/story/news/2020/10/01/wisconsin-reports-record-number-cases-hospitalizations-21-deaths/5880060002/

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Indeed, survey data collected by the polling firm Dynata in early July for the New York Times showed low rates of mask-wearing across much of Wisconsin some three months after the Centers for Disease Control and Prevention recommended their use in public places among all people.

Mask-wearing rates varied widely between Wisconsin communities in July, according to survey results based on self-reported behavior.

At the county level, the Madison area and summer home destinations like Door County and parts of the Northwoods had the state's highest rates of mask-wearing, with 62-64% of those surveyed saying they "always" wear a mask in public when other people are close at hand. Rural parts of central Wisconsin and suburban areas west and north of Milwaukee had among the lowest rates in the state, with the percent saying they ‘always' wear a mask in public ranging from roughly 21-36%.


(has political commentary, please ignore, just using for the thorough mask wearing behaviour info)

https://www.wiscontext.org/face-masks-wisconsins-pandemic-politics-and-limits-persuasion
 

Makes me wonder about what could be done to encourage mask wearing without ticking people off. I think radio stations could have some fun with promotions such as giving daily prizes for the best mask of the day selfie in a public place or having a local celebrity randomly stop people and give them prizes to local restaurants for take out (a way to advertise businesses and mask wearing). However those who have promoted mask wearing have reported being harassed in some places like Wisconsin, even family threatened, so this might discourage such things.

I have seen lots of promos about caring and respecting others by wearing masks...maybe it is time to appeal to the more childlike, childish, or even self-centered side of people to get them viewing masks differently.

If they could turn mask wearing into something fun, attention getting, or money making while avoiding shaming as that is more likely to backfire....

Edited by Calm
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I am posting this here for informational purposes and not to start a political discussion and it definitely relates to Covid.

The President of the United States and the First Lady have both tested positive for coronavirus and announced they are going to quarantine. The internet has gone wild running over his schedule to try to guess who could have caught it. It is unclear when he contracted it so it is unknown when he could have started spreading it. Neither of the candidates wore a mask at the debate (which was expected) but Trump’s family and some of his staff chose not to wear a mask in the audience even thought it was technically required. The suspected origin is Hope Hicks, former press secretary and current advisor to the President and Jared Kushner as she tested positive first.

The list of people who could have caught it is large tracking Hope Hicks and the President and Melania. Prominent names of people who were potentially exposed include Pelosi, McConnell, some of the Republican Senate leaders, some of the Cabinet, the new Supreme Court Nominee, a lot of Trump’s advisors including Jared Kushner and Steven Miller, and Trump’s family. The campaign stops of the last few days and the rallies are also potential spread events. The one unknown that I have not tracked any solid information on is whether the Vice President was potentially exposed. This information is still preliminary but every name I gave seems well substantiated. I apologize in advance if it turns out to be false.

There were worries it was a hoax or prank or a strange dodge at first as it started with a tweet but the President’s physician also issued a statement and the military launched planes to coordinate defense in case of attack while the President could potentially be disabled (this is standard procedure and basically puts enemies on notice not to screw with the nation right now). I thought it was likely true but the military response convinced me. 

The President does have several comorbidities that increase the chances of the disease being serious or fatal but the odds are definitely still in favor of survival.

2020 is certainly a wild ride.

Edit: There is now a debate about whether the aircraft spotted are business as usual with the military or in reaction to the illness. I am not familiar enough with current operations to know who is right and who is wrong but we have hordes of “experts” arguing the point. It may not mean anything at all.

Edited by The Nehor
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My husband just started having symptoms yesterday.  He is going in for a test this morning.  He is now sleeping in our office/guest room.  

This has had me really thinking about ventilation much more than I have been. Likely my daughter and I already had or have it if he does since he is the one who leaves the house the least, but just in case we are trying to do what we can in case he has it  and we don't. 

We have 2 AC systems in the house - one with the bedrooms and one with the common areas.  (We are in Phoenix and it is still hot).  So my daughter and I are limiting our times in the bedrooms.  My husband opened the window in the office so the air can be pushed out there.  

I found this article on vox that may be helpful.  I don't know anything about vox and how reliable it is, but at least it can give you a starting point of what to look for.

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2 hours ago, Rain said:

My husband just started having symptoms yesterday.  He is going in for a test this morning.  He is now sleeping in our office/guest room.  

This has had me really thinking about ventilation much more than I have been. Likely my daughter and I already had or have it if he does since he is the one who leaves the house the least, but just in case we are trying to do what we can in case he has it  and we don't. 

We have 2 AC systems in the house - one with the bedrooms and one with the common areas.  (We are in Phoenix and it is still hot).  So my daughter and I are limiting our times in the bedrooms.  My husband opened the window in the office so the air can be pushed out there.  

I found this article on vox that may be helpful.  I don't know anything about vox and how reliable it is, but at least it can give you a starting point of what to look for.

While definitely take precautions the current data suggests that a lot of people are not spreading it but those who do spread it a lot so there is a decent chance he will not infect anyone. I hope it turns out not to be Covid though. :( 

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A new player has joined the game!!!!

Second recorded case of a new virus currently being called Alaskapox.

https://www.newsweek.com/second-ever-case-new-alaskapox-virus-strain-recorded-us-1535863

Serious note: This will probably be nothing. Most of these go nowhere. Then again Covid was greeted with a yawn in the early days until it started to spread. Still, almost certainly nothing.

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1 hour ago, The Nehor said:

A new player has joined the game!!!!

Second recorded case of a new virus currently being called Alaskapox.

https://www.newsweek.com/second-ever-case-new-alaskapox-virus-strain-recorded-us-1535863

Serious note: This will probably be nothing. Most of these go nowhere. Then again Covid was greeted with a yawn in the early days until it started to spread. Still, almost certainly nothing.

If it gets big, they need to rethink the name so as easier to say. (I was going to say something political, but that is for the other thread :P )

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6 minutes ago, Calm said:

If it gets big, they need to rethink the name so as easier to say. (I was going to say something political, but that is for the other thread :P )

It already has a scientific name. It is from a family of viruses we do not see much from. If I remember it has been decades since anyone has caught one. Unless it is or becomes transmissible from human to human it will not go anywhere. Incidentally this is why the WHO was hesitant to say coronavirus was going from person to person before they could be sure. Not sure I agree with the reasoning but that is probably what it was.

Two cases close together is worrying but I have not heard of any contact where the two were close enough to transmit it. Again, probably nothing.

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3 minutes ago, Rain said:

Hey @pogi - have you heard anything about the inside of your nose burning sometimes?

I have heard that reported by several people, actually. 

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Just now, pogi said:

I have heard that reported by several people, actually. 

Thanks.  My husband hasn't experienced the loss of smell or taste, but did have the burning.  First time I've heard something about it.  I've actually had something similar to burning, but it just didn't register with me.  Will be interesting to see what his test says.

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7 minutes ago, Rain said:

Thanks.  My husband hasn't experienced the loss of smell or taste, but did have the burning.  First time I've heard something about it.  I've actually had something similar to burning, but it just didn't register with me.  Will be interesting to see what his test says.

I had one guy say that out of all his symptoms, it was the most difficult to endure.  He said it was like a fire that he couldn’t put out.  Hopefully it isn’t that bad for your husband!  There can be all sorts of skin inflammation, rashes and irritation with this virus, that is just a very sensitive place for that to happen.

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Here are the updated CDC guidelines.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

COVID-19 can sometimes be spread by airborne transmission

  • Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space.
  • This kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis, measles, and chicken pox are spread.
  • There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.
    • Under these circumstances, scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left.
  • Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through airborne transmission. [1]

 

 

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This study, based on the new CDC guidelines, should be highlighted. Proper surgical masks are readily available at this point, and should be the preferred mask. If you're at high risk and  going to wear a mask, wear the one that will protect you and others the best. Indoor transmission by aerosol does happen. Ventilation is key. A surgical mask will protect you and not just others. Evaluate your risk and make decisions on your activities appropriately. 

https://www.medrxiv.org/content/10.1101/2020.07.16.20155119v1.full.pdf

Of these 19 masks, only two were effective for the whole range of aerosol. Cloth masks were found to be 20 ineffective for the assigned task.

...From the 221 aerosol science point of view, real aerosol was tested in our experiments, representative of a 222 naturally ventilated typical indoor environment. Only surgical masks of known origin, displayed 223 an acceptable efficiency across the aerosol range. Specifically, since the size of the airborne 224 SARS-CoV-2 virus displays a large number concentration around 100-350 nm before its 225 atmospheric aging, i.e. accumulation and coagulation, it was established that masks should be 226 highly efficient at this aerosol nanoscale range. Furthermore, the instrumental sampling face 227 velocity for the masks tested was similar to the “face velocity” of air entering the mask at a 228 typical human breathing rate. This ensured that our experiments were not biased or erroneous 229 because of “different/varying” face velocity parameter that affects the separation number (Ns) of 230 aerosol for a target (mask material) efficiency. The M6, a KN95 mask was the most efficient 231 across the examined range. Market available cloth masks were inefficient at any aerosol size 232 range.

 

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So anyone know how to translate that into "shopping jargon" given there are many masks claiming to be KN95, etc?

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Here is a screenshot of the masks they used, left off some ofthe no name versions:

 

IMG_0098.PNG

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Looking back on the South Korea Starbucks episode, I had a few questions. What kind of masks do they wear in South Korea? It turns out the most popular is the KF94 face mask. https://www.statista.com/statistics/1103510/south-korea-types-face-mask-used-due-to-coronavirus/

This is what those look like. https://www.amazon.com/kf94-mask/s?k=kf94+mask

So, if I was high risk, I would not wear a cloth face mask. I would at least wear a 3 ply surgical mask. If you're going to wear it, you might as well use one that works.

Personally, based on case counts and deaths/hospitalizations and knowing what we now know, I think we should open up and protect the high risk. We know so much more now.

Colorado numbers are showing, even with school open, case positive rates are low and deaths are low. The 2nd wave brought many cases but not very many deaths.

https://www.9news.com/article/news/health/coronavirus/coronavirus-numbers/colorado-coronavirus-latest-numbers-oct-5/73-b2334176-e440-47c9-a299-d24db2391d1a

This graphic makes it very clear.

Image

Edited by bsjkki
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10 minutes ago, bsjkki said:

Stats on campus outbreaks.

How long have they been opened?

My mother's assisted living place got reinfected by a student worker.  

I think the outbreak info here is interesting, but needs both a timeline and a flowchart or whatever that might be called that shows their contact circles...how many live with parents, work in medical environments, etc.

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2 hours ago, bsjkki said:

Stats on campus outbreaks.

In Salt Lake County, from the 21st of September through yesterday there have been 130 people hospitalized with Covid.  25 of those are under 39 years old (that is 19.2% of all hospitalizations).  11 hospitalizations are under 29 years old (that is 8.4% of all hospitalizations in Utah).   Close to 10% of all ICU cases are under 40 in Utah from September 21 through yesterday.  12% of deaths.

These are not trivial numbers

What these numbers don't show is how many of these young people are index cases for older, more vulnerable people through direct contact or community spread.  That is what is most concerning and is not reflected at all in your graph.  We all know that young people are less vulnerable then older people.   What we also know is that they are really good at transmitting the virus through community spread. 

 

 

Edited by pogi
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If you have to eat indoors probably good idea...but touching one’smask a lot isn’t a great thing either, though surface contact is low risk apparently.  I would take my food back to my work space if finding a place by an open window wasn’t possible. 
 

Makes more sense to do takeout imo if you are having a party. You can laugh and get noisy and steal each others’ food without worry or restraint. 

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