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Covid II: Medical Info and Implications


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1 hour ago, The Nehor said:

That is very strange. Almost all quarantine restrictions in nations had emergency provisions for lifesaving medical care though in the stricter nations it also involved quarantines.

I’m hoping there is more to this story. How could anyone let babies die instead of breaking quarantine rules to get them life saving treatment?

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https://www.npr.org/2020/10/21/925794511/were-the-risks-of-reopening-schools-exaggerated

"Despite widespread concerns, two new international studies show no consistent relationship between in-person K-12 schooling and the spread of the coronavirus. And a third study from the United States shows no elevated risk to childcare workers who stayed on the job.

Combined with anecdotal reports from a number of U.S. states where schools are open, as well as a crowdsourced dashboard of around 2,000 U.S. schools, some medical experts are saying it's time to shift the discussion from the risks of opening K-12 schools to the risks of keeping them closed.

"As a pediatrician, I am really seeing the negative impacts of these school closures on children," Dr. Danielle Dooley, a medical director at Children's National Hospital in Washington, D.C., told NPR. She ticked off mental health problems, hunger, obesity due to inactivity, missing routine medical care and the risk of child abuse — on top of the loss of education. "Going to school is really vital for children. They get their meals in school, their physical activity, their health care, their education, of course."

 

The whole thing is very informative.

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On 10/21/2020 at 5:41 PM, bsjkki said:

Going to school is really vital for children. They get their meals in school, their physical activity, their health care, their education, of course."

While I agree with this, I think it is a sad statement on our communities that it is this way for so many...schools expected to provide what families should be able to...

But that is another topic and I am just in a mopey mood or I would do better at not derailing my own thread.

I am very much hoping this is true. 
 

It seems rather strange though that it is safe for K-12 while we have seen major outbreaks with college kids. 

Edited by Calm
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1 minute ago, Calm said:

While I agree with this, I think it is a sad statement on our communities that it is this way for so many...schools expected to provide what families should be able to...

But that is another topic and I am just in a mopey mood or I would do better at not detailing my own thread.

I am very much hoping this is true. 
 

It seems rather strange though that it is safe for K-12 while we have seen major outbreaks with college kids. 

It is spreading through campuses. My sons fraternity has all but 5 members who have had covid. They tested every student on arrival to campus. They send all covid positive patients to a special dorm until they are negative. It still spread quickly. I heard today about my neighbors parents who both had covid at 89 and one was diabetic. They are fine now. Not long timers. Their other son is pulmonologist and he told my neighbor he gave them lots of antibiotics. I thought that was interesting.

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4 minutes ago, bsjkki said:

They are fine now. Not long timers. Their other son is pulmonologist and he told my neighbor he gave them lots of antibiotics. I thought that was interesting.

Preventing secondary infections sounds intelligent. 

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"The Centers for Disease Control and Prevention (CDC) on Wednesday expanded its definition of “close contact” of someone with coronavirus, now saying that multiple brief encounters can also lead to transmission of the virus. The previous definition of close contact, which is used for determining who should quarantine, was being within 6 feet of an infected person for at least 15 minutes. 

The new standard now defines close contact as being within 6 feet of an infected person for at least 15 minutes over a 24-hour period, making clear that multiple separate encounters that add up to more than 15 minutes also count. "

https://thehill.com/policy/healthcare/522117-cdc-expands-definition-of-close-contact-after-spread-from-multiple-brief

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Rather than “transmission of the virus”, don’t they mean the virus taking root as it has enough numbers to overcome defensive measures the body attempts?  It has been transmitted multiple times, but with enough additions to its numbers can make a foothold that sticks and spreads  

Too tired tonight to think of correct terminology, hopefully that conveys the idea. 

Edited by Calm
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Moderna is first to enroll 30,000 vaccine trial participants. Moderna announced Thursday that it had completed enrollment of 30,000 participants for its phase 3 study of mRNA-1273, its vaccine candidate against COVID-19, being conducted in collaboration with the NIAID. More than one-third of the volunteers (37 percent) are minorities. To date, more than 25,650 participants have received their second vaccination.

 

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Moderna will determine whether to submit a dossier to FDA requesting emergency use authorization after completing two months of median safety follow-up, which could be by the third week of November.

EDH update 

I don’t like the collapsing of quotes. Going to cut the quote into two parts. 

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EDH update

Given issues with mask breath, I see this as win win. If it helps, great. If not, my breath isn’t killing me.

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Mouthwash may inactivate the virus — but scientists warn that it’s not an antiviral. A study from Penn State College of Medicine released this week has found that certain oral antiseptics and mouthwashes may have the ability to inactivate the coronavirus. The results suggest that some of these products might be useful for reducing the viral load (amount of virus) in the mouth after infection and may help to reduce the spread of infection. “While we wait for a vaccine to be developed, methods to reduce transmission are needed,” said Craig Meyers, PhD, professor of microbiology and immunology and obstetrics and gynecology at Penn State. “The products we tested are readily available and often already part of people’s daily routines.”

 

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The 1% baby shampoo solution, which is often used by head and neck doctors to rinse the sinuses, inactivated greater than 99.9% of human coronavirus after a two-minute contact time. Several of the mouthwash and gargle products also were effective at inactivating the infectious virus. Many inactivated greater than 99.9% of virus after only 30 seconds of contact time and some inactivated 99.99% of the virus after 30 seconds.   

https://news.psu.edu/story/635101/2020/10/19/research/mouthwashes-oral-rinses-may-inactivate-human-coronaviruses

Original study with results:

https://onlinelibrary.wiley.com/doi/10.1002/jmv.26514
 

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A 1% baby shampoo nasal rinse solution inactivated HCoV greater than 99.9% with a 2‐min contact time. Several over‐the‐counter mouthwash/gargle products including Listerine and Listerine‐like products were highly effective at inactivating infectious virus with greater than 99.9% even with a 30‐s contact time. In the current manuscript we have demonstrated that several commonly available healthcare products have significant virucidal properties with respect to HCoV.

Stampede time. I predict Listerine stock will go up and it will be bare on the shelves for awhile. Hopefully people will not assume drinking it will help even more than rinsing.  
 

However, researchers are cautious:

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In The New York Times, scientists cautioned the public not to overinterpret the results. They suggested that the findings may have limited value because they were based on lab tests and did not include human volunteers

EDH

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More...

BTW, please read whole quotes if you intend to use the info as there may be crucial info in the part you cannot see, such as here the usual saline solutions I sometimes use to help with allergies (doesn’t make much difference, if any but that may be because of inconsistency) are useless for this. 

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With contact times of 1 and 2 min, the 1% baby shampoo solution was able to inactivate more than 99% and more than 99.9% or more of the virus, respectively. A contact time of 30 s had a variable effect.....In comparison, the over‐the‐counter saline nasal rinse, Neti Pot, had no effect on the infectivity of the virus at any incubation time tested.

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We initially tested Peroxide Sore Mouth (CVS), Orajel Antiseptic Rinse (Church & Dwight Co, Inc), 1.5% H2O2 (Cumberland‐Swan, Inc), Crest Pro‐Health (Proctor & Gamble), and Listerine Antiseptic (Johnson & Johnson Consumer Inc). The first three, Peroxide Sore Mouth, Orajel Antiseptic Rinse, and 1.5% H2O2, all have H2O2 as their active ingredient (Table 1). Crest Pro‐Health lists cetylpyridium chloride as its active ingredient (Table 1). Listerine lists four active ingredients (Table 1), eucalyptol, menthol, methyl salicylate, and thymol..... Crest Pro‐Health decreased infectious virus by at least 3 log10 to greater than 4 log10, or 99.9% to more than 99.99%; again, the contact times used made little difference. Listerine Antiseptic was able to decreases the infectious virus levels by greater than 4 log10, or greater than 99.99%. After incubation times of 1 and 2 min, we were unable to detect any remaining infectious virus (Table 3).

 

Edited by Calm
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Can’t edit...if I am reading correctly, the Listerine mouthwashes are most effective, the Peroxide rinses are more variable. Saline solutions have no effective. If you don’t like the stinging, you might make your own 1% baby shampoo solution (I am not recommending though)...not sure about taste with that. 
 

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After observing the results of Listerine Antiseptic, we wanted to see if products with similar composition would have the same efficacy. We decided to test Listerine Ultra (Johnson & Johnson Consumer Inc), Equate (Wal‐Mart Company Inc), and Antiseptic Mouthwash (CVS). While the results obtained with these three products were similar to those of Listerine Antiseptic, there were some interesting differences even though they all list exactly the same active ingredients and similar inactive ingredients (Table 1). All showed slightly lower efficacy, particularly at the shorter contact times, and Equate showed the greatest variability (Table 3). However, the Listerine‐like mouthwashes/gargles decreased infectious virus titers by greater than 99%.

Povidone‐Iodine (PVP‐I) formulations are common antiseptics used before and after surgery. PVP‐I formulations are also commonly used in over‐the‐counter skin cleansers and mouthwashes/gargles. Previous studies have demonstrated the efficacy of various PVP‐I formulations at inactivating HCoV.28-31 For comparison to these products we tested Betadine 5% (Alcon Laboratories, Inc). The results we obtained were similar to what others found with PVP‐I formulations (Table 3).28-31

 

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Why we need to be cautious:

EDH update

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All residents in a Kansas nursing home have COVID-10 and 10 have died. The North County Health Department in Kansas confirmed this week that an outbreak at a nursing home in Norton has infected all 62 residents and left 10 dead. In a statement, the health department said, “Steps are being taken to prevent any further outbreak including quarantining residents in their rooms and not allowing outside visitors into the facility.”

I am not sure how there can be a further outbreak when all residents are already infected, but perhaps they mean spreading back into the community. 

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https://m.facebook.com/story.php?story_fbid=184214143201243&id=110965280526130
 

I know it has been confusing how masks can be considered effective when they let aerosols through, this Facebook post by an epidemiologist makes it easily understood. 
 

Basically the more virus you get, the sicker you get.  Large droplets can carry lots more virus than aerosols will. So to keep your infection to the minimal, wear masks and get people to wear them around you if you can. You may still get infected, even sick....but less likely to end up in the hospital. 
 

Think of it like alcohol. Imbibing a tablespoon breaks the word of wisdom (if a Saint), but downing a bottle is going to make you stinking drunk and an idiot and might kill you, so it is stupid to justify that bottle on the grounds you already had a tablespoon.

 

Please wear masks. 
 

PS:  people wearing masks and therefore getting smaller viral loads may explain in part the dropping death rate for hospitalizations, along with better treatments.

https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-big-drop-in-covid-19-death-rates?fbclid=IwAR2Ua9Nj0wEXomfvfY_cNdi2P5-k-r_Olo8M2UcStEd-kcwvl4vCsRN3KcU

Edited by Calm
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6 hours ago, Calm said:

https://m.facebook.com/story.php?story_fbid=184214143201243&id=110965280526130
 

I know it has been confusing how masks can be considered effective when they let aerosols through, this Facebook post by an epidemiologist makes it easily understood. 
 

Basically the more virus you get, the sicker you get.  Large droplets can carry lots more virus than aerosols will. So to keep your infection to the minimal, wear masks and get people to wear them around you if you can. You may still get infected, even sick....but less likely to end up in the hospital. 
 

Think of it like alcohol. Imbibing a tablespoon breaks the word of wisdom (if a Saint), but downing a bottle is going to make you stinking drunk and an idiot and might kill you, so it is stupid to justify that bottle on the grounds you already had a tablespoon.

 

Please wear masks. 
 

PS:  people wearing masks and therefore getting smaller viral loads may explain in part the dropping death rate for hospitalizations, along with better treatments.

https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-big-drop-in-covid-19-death-rates?fbclid=IwAR2Ua9Nj0wEXomfvfY_cNdi2P5-k-r_Olo8M2UcStEd-kcwvl4vCsRN3KcU

This CDC study showed that it is close contact that leads to sars cov 2 spread, regardless of whether masks are worn.  https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf  So, whether or not masks slow the spread, if you are in contact with a person who has it, chances are that you are going to get it.  The good news is that there is a 99.9% survival rate and most have mild to no symptoms.

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34 minutes ago, Robert J Anderson said:

This CDC study showed that it is close contact that leads to sars cov 2 spread, regardless of whether masks are worn.  https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf So, whether or not masks slow the spread, if you are in contact with a person who has it, chances are that you are going to get it.  The good news is that there is a 99.9% survival rate and most have mild to no symptoms.

CFR for the 99.9% survival rate.

The study simply demonstrates what we already know - close contact is a risk factor for transmission.   It did not say it is the only risk factor.  In fact it made the case that not wearing a mask is a risk factor.  

Nowhere in the study does it say "regardless of whether masks are worn".  Nor does it even come close to suggesting anything like unto it.  In fact, it suggested that restaurants likely spread it better then other places because masks are not worn while eating.  The study very clearly and explicitly still recommends wearing masks as a preventive measure. 

Edited by pogi
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47 minutes ago, Robert J Anderson said:

So, whether or not masks slow the spread, if you are in contact with a person who has it, chances are that you are going to get it. 

Possibly (I am thinking of the Starbucks event where masked waiters did not get it, but customers did), but how bad you get it may depend on whether or not you wear a mask since that looks to be dependent on how much virus you take in.  Like going out in a downpour with or without an umbrella, you are going to get wet (wind blowing, car splashes), but the better the umbrella, the less wet and therefore the less uncomfortable you will be.

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The good news is that there is a 99.9% survival rate and most have mild to no symptoms.

Do you mean if exposed or if infected and if infected, where is your data coming from please?  When posting stats, if you could quote rather than just give a full study, that would be appreciated...especially since I am reading on my old tech which is turning your link all black after the first page...no clue why, just happens.

Edited by Calm
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14 minutes ago, pogi said:

CFR for the 99.9% survival rate.

The study simply demonstrates what we already know - close contact is a risk factor for transmission.   It did not say it is the only risk factor.  In fact it made the case that not wearing a mask is a risk factor.  

Nowhere in the study does it say "regardless of whether masks are worn".  Nor does it even come close to suggesting anything like unto it.  In fact, it suggested that restaurants likely spread it better then other places because masks are not worn while eating.  The study very clearly and explicitly still recommends wearing masks as a preventive measure. 

It's simple math based on what the WHO said recently about 10% of the world population already having been exposed as of early October, 2020 and using the latest death count.

https://www.usnews.com/news/health-news/articles/2020-10-05/who-estimates-coronavirus-has-infected-10-of-global-population

https://www.realclearpolitics.com/coronavirus/

1,156,521 deaths as of today / 760,000,000 exposures based on estimates from the WHO = 0.0015217381578947.  Then, 0.0015217381578947 X 100% = 0.15% deaths per exposure.

But, by all means, continue to wear masks if you wish.  Perhaps, though, realize that maybe there is a little over-reaction going on?

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19 minutes ago, Calm said:

Possibly (I am thinking of the Starbucks event where masked waiters did not get it, but customers did), but how bad you get it may depend on whether or not you wear a mask since that looks to be dependent on how much virus you take in.  Like going out in a downpour with or without an umbrella, you are going to get wet (wind blowing, car splashes), but the better the umbrella, the less wet and therefore the less uncomfortable you will be.

I get it.  It seems logical that a mask will slow exposure down.  My point is that because supposedly the asymptomatic - https://www.nbcnews.com/health/health-news/new-research-adds-growing-evidence-asymptomatic-spread-covid-19-n1240708 - will pass on the virus, we may be exposed by someone we know right now and/or are spreading it ourselves to others, regardless of whether or not we wear masks.  Who knows who really has it or not as a vast majority don't show symptoms and can still pass it on.  It looks like we will all be exposed at some point and so, should we continue to force unneeded misery on people whose businesses are shut down?  Is slowing the spread a pointless exercise given how we will all be exposed at some point prior to a vaccine being developed?

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1 minute ago, Robert J Anderson said:

It's simple math based on what the WHO said recently about 10% of the world population already having been exposed as of early October, 2020 and using the latest death count.

https://www.usnews.com/news/health-news/articles/2020-10-05/who-estimates-coronavirus-has-infected-10-of-global-population

https://www.realclearpolitics.com/coronavirus/

1,156,521 deaths as of today / 760,000,000 exposures based on estimates from the WHO = 0.0015217381578947.  Then, 0.0015217381578947 X 100% = 0.15% deaths per exposure.

But, by all means, continue to wear masks if you wish.  Perhaps, though, realize that maybe there is a little over-reaction going on?

The WHO disagrees with your math And would suggest your 99.9% figure is false and has a different estimate, so using the WHO as a reference doesn’t answer your CFR - because they disagree with you. (manipulating numbers doesn’t count).  The problem is that you are calculating estimated infections (not just confirmed cases) with confirmed reported deaths (not total estimates).  That will not give you an accurate rate.  Deaths are under reported worldwide.  
 

No over reaction.  They work.  In Utah our health care system is being strained and flu season is just beginning.  Holidays are coming up, and people are spending more time indoors due to cold weather.  We also are at record high numbers with almost 2,000 cases on Friday.   The ICU at U of U hospital is at 99% capacity.  Others are exhausted and fatigued with hospitalizations increasing and optimal care giving decreasing.  I am afraid hard times may be ahead in Utah if people like you don’t start taking this seriously.

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14 minutes ago, Robert J Anderson said:

looks like we will all be exposed at some point and so, should we continue to force unneeded misery on people whose businesses are shut down? 

Equating wearing masks with shutting down businesses is ridiculous.  No one is making that argument here, please don't waste our time and space with shifting the comments to lockdowns.  If we are talking masks,stick to masks.

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1 minute ago, pogi said:

The WHO disagrees with your math And would suggest your 99.9% figure is false and has a different estimate, so using the WHO as a reference doesn’t answer your CFR - because they disagree with you. (manipulating numbers doesn’t count).  The problem is that you are calculating estimated infections (not just confirmed cases) with confirmed reported deaths (not total estimates).  That will not give you an accurate rate.  Deaths are under reported worldwide.  
 

No over reaction.  They work.  In Utah our health care system is being strained and flu season is just beginning.  Holidays are coming up, and people are spending more time indoors due to cold weather.  We also are at record high numbers with almost 2,000 cases on Friday.   The ICU at U of U hospital is at 99% capacity.  Others are exhausted and fatigued with hospitalizations increasing and optimal care giving decreasing.  I am afraid hard times may be ahead in Utah if people like you don’t start taking this seriously.

Where does the WHO disagree with my math?  How do you know that the deaths are under-reported worldwide?  How do you know if they aren't being over-reported given the financial incentives there are to report covid cases in hospitals?

The ICU at the UofU may be full but aren't there other hospitals that could take these cases if the UofU can't?  Surely, LDS Hospital or Salt Lake Regional Medical Center would take these patients?  Don't you think it is over-hyping to focus on the UofU when other hospitals have excess capacity?  

Is it possible to over-react to something?

I socially distance and wear masks.  So, what else should I do to supposedly take this seriously?  Is the nebulous statement "not taking it seriously" a talking point given out by the Utah government?  It seems to be a thing to tell people that are questioning our leaders on this one.

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Is the nebulous statement "not taking it seriously" a talking point given out by the Utah government?  It seems to be a thing to tell people that are questioning our leaders on this one.

If you want to take the thread in a political direction, please start another thread instead.

Don't have a problem with questioning medical info in here, debating government tactics is out of bounds while using them to support medical claims is not (success or lack of success of government direct shows support or not for ______, a medical claim).....know it is a fine line. 

Edited by Calm
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