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Covid II: Medical Info and Implications


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6 minutes ago, pogi said:

You mean that this guy (Daniel McCarthy) who ran for Senate and is a member of the Council for National Policy is tweeting reckless nonsense of life-threatening proportions:  

And his supporters are completely okay with being lied to.

Seriously, is there a way I can opt out of this?

 

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 I am wondering is this a religious discussion board anymore? Also it appears by page 2.5 - 3, that this topic has already become political.

 I miss the geography arguments. Or it least a Supreme Court decision that has religion as its nemesis. I mean I've got all this popcorn and nothing to entertain me. Must be a sign of the times (yes, a lazy catalyst for a funner discussion).

Thanks

Your mask wearing trouble starter, and yes I wear a mask 

Anijen

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16 minutes ago, Anijen said:

 I am wondering is this a religious discussion board anymore? Also it appears by page 2.5 - 3, that this topic has already become political.

 I miss the geography arguments. Or it least a Supreme Court decision that has religion as its nemesis. I mean I've got all this popcorn and nothing to entertain me. Must be a sign of the times (yes, a lazy catalyst for a funner discussion).

Thanks

Your mask wearing trouble starter, and yes I wear a mask 

Anijen

I would argue that the geography arguments are political, just of a more tame and petty variety.

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Can we drop the political stuff please?  I promise to look up more medical info.

Tacenda, if you need help answering FB comments of a more political nature or something full of memes rather than substances, maybe we can start a parallel thread for that...how to discuss Covid with others.  :)

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Try a google link:

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In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.

On Thursday, the United States recorded 45,604 new coronavirus cases, according to a database maintained by The Times. If the rates of contagiousness in Massachusetts and New York were to apply nationwide, then perhaps only 4,500 of those people may actually need to isolate and submit to contact tracing.

https://www.google.com/amp/s/www.nytimes.com/2020/08/29/health/coronavirus-testing.amp.html

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Highly sensitive PCR tests seemed like the best option for tracking the coronavirus at the start of the pandemic. But for the outbreaks raging now, he said, what’s needed are coronavirus tests that are fast, cheap and abundant enough to frequently test everyone who needs it — even if the tests are less sensitive.

“It might not catch every last one of the transmitting people, but it sure will catch the most transmissible people, including the superspreaders,” Dr. Mina said. “That alone would drive epidemics practically to zero.”

 

Edited by Calm
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https://abcnews.go.com/Health/nevada-lab-confirms-1st-coronavirus-reinfection-us/story?id=72691353
 

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Scientists say that although reinfection is likely possible, it's also extremely rare. This is the first documented reinfection among nearly 6 million COVID-19 cases to date...

At first, the researchers wondered if the virus had been hiding in his body the whole time -- mutating, changing and eventually developing into something that caused him to get sick with COVID-19 a second time. But they ultimately rejected this theory, saying that the two viruses were so different that it would have been nearly impossible for the virus to change that quickly inside his body. The only explanation was that he had been infected by a slightly different version of the coronavirus.

"There’s no invulnerability here," Pandori told ABC News. "Whether you’ve had this infection before or whether perhaps in the future vaccinated, there won’t be such a thing as invulnerability."

 

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EH:

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Flu shots are ready now to prevent a "twindemic." The Washington Post said that most major drug stores have this season’s flu shot in stock right now and they are ready to be administered. Public health officials are warning that hospitals could be overwhelmed in the fall by a “twindemic” of both influenza and novel coronavirus. Getting the inoculation early on may help avoid overburdening the healthcare system. The Centers for Disease Control and Prevention (CDC) recommends that people get a flu vaccine by the end of October.

Here is a link to the website, my quotes are from the app to save me time:

https://www.everydayhealth.com

Edited by Calm
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447530/
 

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Be aware of acute kidney injury in critically ill children with COVID-19

https://www.oregonlive.com/coronavirus/2020/08/doctors-see-unexpected-and-dramatic-kidney-damage-from-coronavirus.html
 

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Two studies of New York patients found that 68% to 76% of intensive care patients with COVID-19 had kidney damage. In one, a third of ICU patients needed dialysis, a process in which a machine performs the kidney’s blood-filtering work.

https://link.springer.com/article/10.1007/s42399-020-00482-y

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You would think somethings wouldn’t need to be pointed out as stupid:

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The FDA is cautioning against hand sanitizers packaged in food and drink containers. The FDA is warning consumers about alcohol-based hand sanitizers that are being packaged in containers that may appear as food or drinks and may put consumers at risk of serious injury or death if ingested. The agency has discovered that some hand sanitizers are being packaged in beer cans, children’s food pouches, water bottles, juice bottles, and vodka bottles. Additionally, the FDA has found hand sanitizers that contain food flavors, such as chocolate or raspberry.

EH summary

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EH:

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The FDA has greenlighted a fast and inexpensive testing card. On Wednesday last week, the FDA granted emergency use authorization for a fast, five-dollar antigen test for the detection of COVID-19 infection. BinaxNOW COVID-19 Ag Card rapid test from Abbott is about the size of a credit card and is a similar design to some pregnancy tests.

A healthcare provider swabs the patient’s nose and applies that sample on a test card with a testing reagent added. After waiting 15 minutes, the healthcare provider reads the results directly from the testing card without the use of lab equipment. One line indicates a negative result; two lines indicate a positive result.

The FDA said that this test could be used at point-of-care settings, like a doctor’s office, emergency room, or some schools. In a press release, Abbott announced that the test comes along with a complementary app for mobile phones that “will allow people who test negative to display a temporary digital health pass that is renewed each time a person is tested through their healthcare provider together with the date of the test result.”

 

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From the article sniped quoted by @Calm:

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Additionally, the FDA has found hand sanitizers that contain food flavors, such as chocolate or raspberry.

Maybe this is what we should be getting for the priest's to use right before they prepare the sacrament. ;)

 

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I would like some feedback on this article:

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According to The New York Times, potentially 90 percent of those who have tested positive for COVID-19 have such insignificant amounts of the virus present in their bodies that such individuals do not need to isolate nor are they candidates for contact tracing. Leading public health experts are now concerned that overtesting is responsible for misdiagnosing a huge number of people with harmless amounts of the virus in their systems.”  (Townhall)

“‘Most of these people are not likely to be contagious…’ warns The Times.”

The issue appears to be the ballooning sensitivity of the PCR test.

Yes, that’s what the NY Times is confessing (8/29):

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“Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.  Most of these people are not likely to be contagious…”

“In three sets of testing data…compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.”

Let me break this down for you, because it’s a lot worse than the Times admits.  The rabbit hole goes much deeper—-and I’ve been reporting on the deeper facts for months.

The issue appears to be the ballooning sensitivity of the PCR test.  It’s so sensitive that it picks up inconsequential tiny, tiny amounts of virus that couldn’t harm a flea—-and it calls these amounts “positive.”

Therefore, millions of people are labeled “positive/infected” who carry so little virus that no harm would come to them or anyone they come in contact with.

That would be bad enough.  But the truth is, the PCR test is not able to produce ANY reliable number that reflects how much virus a person is carrying.  A lot, a little, it doesn’t matter.

The test has never been validated, in a large-scale study, for the ability to quantify the amount of virus a person is carrying.  I’ve proposed how that study should be done IN THE REAL WORLD, NOT IN THE LAB.

ALL the PCR tests being done on people all over the world reflect NOTHING about illness, infection, contagion, or transmission.

I always get leery about breathless "news" items like this (but then, I'm pretty skeptical about the objectivity and competency of a lot of the MSM as well).  This is particularly so when the author resorts to things like ALLCAPS and "let me break this down for you..."

I know a family who had a daughter test positive for COVID (she was asymptomatic).  She and the rest of her family quarantined themselves for two weeks.  The rest of the family members (7) were tested and the results came back negative for all.  

How big a role does "viral load" play?  Per this Lancet study:

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Viral load in COVID-19 might correlate with infectivity, disease phenotype, morbidity, and mortality. To date, no studies have assessed the association between viral load and mortality in a large patient cohort.

But then...

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Viral loads for symptomatic, hospitalised patients who tested positive for SARS-CoV-2 were measured on samples collected between March 13 and May 4, 2020, that tested positive on both platforms at diagnosis.
...
A Cox proportional hazards model adjusting for age, sex, asthma, atrial fibrillation, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, heart failure, hypertension, stroke, and race yielded a significant independent association between viral load and mortality (hazard ratio 1·07 [95% CI 1·03–1·11], p=0·0014; appendix p 3), with a 7% increase in hazard for each log transformed copy per mL. 
...
Early risk stratification in COVID-19 remains a challenge. Here, we show an independent relationship between high viral load and mortality. 

I have no medical experience or qualifications.  But "independent relationship between high viral load and mortality" sounds like "having a high viral load is not a necessary component for dying from COVID."  Is that accurate?

Here's an article from early August:

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Asymptomatic COVID-19 carriers may have viral loads on par with patients with symptoms, though a slightly higher proportion of symptom-free individuals may test negative within a few weeks of diagnosis, according to a new study.

This sounds like "there is not a direct correlation between viral load and having COVID-related symptoms since asymptomatic people may have more or less equal viral loads and symptomatic people."  Is that accurate?

Here's an article from April:

Quote

Infectious respiratory diseases spread when a healthy person comes in contact with virus particles expelled by someone who is sick — usually through a cough or sneeze. The amount of particles a person is exposed to can affect how likely they are to become infected and, once infected, how severe the symptoms become.

The amount of virus necessary to make a person sick is called the infectious dose. Viruses with low infectious doses are especially contagious in populations without significant immunity.

The minimum infectious dose of SARS-CoV-2, the virus that causes Covid-19, is unknown so far, but researchers suspect it is low. “The virus is spread through very, very casual interpersonal contact,” W. David Hardy, a professor of infectious disease at Johns Hopkins University School of Medicine, told STAT.

A high infectious dose may lead to a higher viral load, which can impact the severity of Covid-19 symptoms.

In other words, someone can have a light "viral load" and still cause infections in others, though a higher viral load can cause more severe symptoms.

Going back to the NY Times article cited above:

Quote

Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time. But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.

Huh.

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Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

“The decision not to test asymptomatic people is just really backward,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, referring to the C.D.C. recommendation.

“In fact, we should be ramping up testing of all different people,” he said, “but we have to do it through whole different mechanisms.”

This is confusing.  The CDC is "suggesting" that we test less and/o skip testing asymptomatic people.  But if the current testing regiment is resulting in us "diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus," most of whom "are not likely to be contagious," such that the testing of such low-risk persons "may contribute to bottlenecks," then what is the purpose of Dr. Mina advocating for "ramping up testing?"  Won't that result in more diagnoses of low-risk persons?

The article goes on to suggest that yes/no testing for COVID needs to improve to account for viral load:

Quote

The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.

But similar PCR tests for other viruses do offer some sense of how contagious an infected patient may be: The results may include a rough estimate of the amount of virus in the patient’s body.

“We’ve been using one type of data for everything, and that is just plus or minus — that’s all,” Dr. Mina said. “We’re using that for clinical diagnostics, for public health, for policy decision-making.”

But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. “It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,” Dr. Mina said.

The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious.

"The greater the viral load, the more likely the patient is to be contagious."

Is that at odds with the Lancet study (showing a possible "independent relationship between high viral load and mortality")?

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One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus.

Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. Mina said.

Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said.

A more reasonable cutoff would be 30 to 35, she added. Dr. Mina said he would set the figure at 30, or even less. Those changes would mean the amount of genetic material in a patient’s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result — at least, one worth acting on.

Holy cow.  The difference between a current "positive" test result (which apparently is . . . any cycle figure?) and the useful/meaningful one proposed above seems huge.  

Put another way, testing based on a less sensitive viral load "threshold" analysis (30-40 cycles) would mean that a patient would need to have a substantially higher viral load ("100-fold to 1,000-fold" more than "the current standard") in order to qualify as testing "positive" for COVID.  Am I reading this correctly?

If so, then is it fair to surmise that deploying the above recommendation would result in significant numbers of those who have previously "tested positive" for COVID will be retroactively deemed to not be positive?  And if that happens, then won't that have huge policy implications for our response to COVID?

Thanks,

-Smac

Edited by smac97
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1 hour ago, smac97 said:

How big a role does "viral load" play?  Per this Lancet study:

But then...

I have no medical experience or qualifications.  But "independent relationship between high viral load and mortality" sounds like "having a high viral load is not a necessary component for dying from COVID."  Is that accurate?

The study is suggesting that there is a correlation between high viral load and increased mortality/morbidity risk.  I agree that the wording is confusing though.  The word "independent" kind of throws things off for me.

1 hour ago, smac97 said:

Holy cow.  The difference between a current "positive" test result (which apparently is . . . any cycle figure?) and the useful/meaningful one proposed aboveis huge.  

Put another way, testing based on a less sensitive viral load "threshold" analysis (30-40 cycles) would mean that a patient would need to have a substantially higher viral load ("100-fold to 1,000-fold" more than "the current standard") in order to qualify as testing positive for COVID.

Am I reading this correctly?

If so, then is it fair to surmise that deploying the above recommendation would result in significant numbers of those who have previously "tested positive" for COVID will be retroactively deemed to not be positive?  And if that happens, then won't that have huge policy implications for our response to COVID?

Thanks,

-Smac

The New York Times article is bringing into question the threshold for Positive results.  I don't think it has been answered yet, however, what level of viral load is considered "safe".  At this point, I think any level of viral load should be considered potentially infectious.  A person with a low viral load may be low risk to the general public (especially if they are wearing a mask), but if that person is swapping spit with their girlfriend...  Is it fair to the girlfriend if we consider him "negative", when in fact he may be infectious to her?   Furthermore, detecting a low viral load may simply mean that the patient is in the early stages (or late stages) of infection.  After a few days, they may have a much higher viral load. 

If we could determine what level of viral load is considered "safe" to not isolate, then that might influence implications for response to Covid.  But we would still have to grapple with the fact that a test is a frozen picture in time of a disease that may have a fluctuating viral load over time.  For example, a test which shows a low viral load today, will not tell us if this person will have a low viral tomorrow, or the next day, or the next day...  We can't just assume that a person who tests positive with a low viral load will remain safe throughout the duration of their infection. 

Edited by pogi
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https://www.axios.com/countries-with-highest-coronavirus-death-rates-5dd89c65-bdb7-4ba7-ad87-3737520911cd.html

Current top 10 countries with covid deaths. Peru now takes the top spot even though they locked down in March.

Peru's coronavirus death rate is now the highest in the world, surpassing Belgium and exceeding even Brazil (7th) and the U.S. (8th).

Why it matters: Peru and Belgium illustrate the divergence between the world's two hardest-hit regions since the eye of the storm shifted from Europe to Latin America in the spring.

Zoom in: Belgium saw an incredibly sharp spike over a single month, from its first death on March 11 to a daily high of 321 deaths on April 9.

  • The post-lockdown descent was nearly as sharp. It has now been three months since Belgium last recorded more than 15 deaths in one day.
  • The trend is similar in other European countries, like Italy: a terrifying spike, a steady decline and consistently low death tolls even after the lifting of lockdowns.

The flipside: Peru was hit later than Belgium, and it imposed a lockdown in March before recording a single death. Death tolls climbed much more slowly, but over nearly three months rather than one.

  • On April 27, Peru’s daily death toll crossed 150 for the first time.
  • Since then, Peru (pop. 33 million) has recorded over 150 deaths nearly every day for four months.
 

Daily avg., last 7 days

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It is important not to assume lockdowns are identical in each country.  Even though Peru has strict rules, it may not matter if the people among most vulnerable can’t follow them. 
 

https://www.google.com/amp/s/time.com/5844768/peru-coronavirus/%3famp=true

Quote

But public health experts say living and working conditions in the country of 33 million—where a fifth of people live on only around $100 a month—has made it near impossible for many Peruvians to comply with quarantine measures. Meanwhile, some government measures have backfired, inadvertently leading to bigger gatherings of people. Here’s what to know about how COVID-19 spread in Peru, despite quarantine measures....

The government’s [quarantine] strategy works for the 30% of Peru that is employed in the formal sector, that’s been growing economically,” he says. “But there’s another 70% of Peru, which is informal, that doesn’t have access to basic services of health, education, nutrition, or to pensions and financial safety nets.”

Staying home for long periods of time is impossible for the 44% of households that do not have a refrigerator, according to a 2018 government survey, with families needing to leave the house regularly to access food. As a result, busy food markets have become a hub of infection. In late April, when authorities shut down one of Lima’s more than 1,200 food markets and performed rapid discard tests on traders, 163 of 842 came back positive....

The government has given poorer families grants of around $220 each to help them weather the crisis—part of a massive economic response package that will cost 12% of Peru’s GDP. But critics say the distribution of that aid has contributed to spreading the virus. Most poorer Peruvians don’t have bank accounts, so recipients have needed to go to banks in person to collect their money. “This generated queues at the banks since dawn, without any respect for physical distancing,” Nora Espiritu, a doctor and health researcher wrote in The BMJ, a British medical journal,

I don’t know what other options there besides lockdown are workable unless perhaps massive aid from better off countries (but then there is still the corruption issues often present in areas with extensive poverty), so I am not sure there is a realistic solution to situations like this that could put them close to on par with well developed countries.

Edited by Calm
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6 hours ago, smac97 said:

I would like some feedback on this article:

I always get leery about breathless "news" items like this (but then, I'm pretty skeptical about the objectivity and competency of a lot of the MSM as well).  This is particularly so when the author resorts to things like ALLCAPS and "let me break this down for you..."

I know a family who had a daughter test positive for COVID (she was asymptomatic).  She and the rest of her family quarantined themselves for two weeks.  The rest of the family members (7) were tested and the results came back negative for all.  

How big a role does "viral load" play?  Per this Lancet study:

But then...

I have no medical experience or qualifications.  But "independent relationship between high viral load and mortality" sounds like "having a high viral load is not a necessary component for dying from COVID."  Is that accurate?

Here's an article from early August:

This sounds like "there is not a direct correlation between viral load and having COVID-related symptoms since asymptomatic people may have more or less equal viral loads and symptomatic people."  Is that accurate?

Here's an article from April:

In other words, someone can have a light "viral load" and still cause infections in others, though a higher viral load can cause more severe symptoms.

Going back to the NY Times article cited above:

Huh.

This is confusing.  The CDC is "suggesting" that we test less and/o skip testing asymptomatic people.  But if the current testing regiment is resulting in us "diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus," most of whom "are not likely to be contagious," such that the testing of such low-risk persons "may contribute to bottlenecks," then what is the purpose of Dr. Mina advocating for "ramping up testing?"  Won't that result in more diagnoses of low-risk persons?

The article goes on to suggest that yes/no testing for COVID needs to improve to account for viral load:

"The greater the viral load, the more likely the patient is to be contagious."

Is that at odds with the Lancet study (showing a possible "independent relationship between high viral load and mortality")?

Holy cow.  The difference between a current "positive" test result (which apparently is . . . any cycle figure?) and the useful/meaningful one proposed above seems huge.  

Put another way, testing based on a less sensitive viral load "threshold" analysis (30-40 cycles) would mean that a patient would need to have a substantially higher viral load ("100-fold to 1,000-fold" more than "the current standard") in order to qualify as testing "positive" for COVID.  Am I reading this correctly?

If so, then is it fair to surmise that deploying the above recommendation would result in significant numbers of those who have previously "tested positive" for COVID will be retroactively deemed to not be positive?  And if that happens, then won't that have huge policy implications for our response to COVID?

Thanks,

-Smac

https://zdoggmd.com/covid-death-stats/?fbclid=IwAR0xKCIPO8QrA-m88_Nms0my9VTiMPaf7m922wHy_iH7WqjAG9XmtMA03a0

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8 hours ago, smac97 said:

I know a family who had a daughter test positive for COVID (she was asymptomatic).  She and the rest of her family quarantined themselves for two weeks.  The rest of the family members (7) were tested and the results came back negative for all.  

This happened to my granddaughter Princesca. She woke up one morning not being able to taste or smell. Testing verified she was positive, but her patents, brother, two sisters, and uncle and aunt who were living in the home all tested negative and none of them became ill. The library where she worked was closed for two weeks. Her family was quarantined for almost a month. 

Edited by Bernard Gui
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We have a dilemma.

Sister Gui has been preparing to teach her kindergarten class on-line from her classroom. Today she learned that our school district may open classrooms to students on September 23 because our county infection rate has been dropping. 

We are both over 65. Should we be concerned? We can’t find reliable and consistent information. 

Edited by Bernard Gui
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On 9/1/2020 at 7:25 AM, Amulek said:

From the article sniped quoted by @Calm:

 

 

I think you should quit sniping at poor @Calm.  I don't think she deserves it! 😀  Sorry!  Couldn't resist!

Edited by Kenngo1969
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6 hours ago, Bernard Gui said:

We have a dilemma.

Sister Gui has been preparing to teach her kindergarten class on-line from her classroom. Today she learned that our school district may open classrooms to students on September 23 because our county infection rate has been dropping. 

We are both over 65. Should we be concerned? We can’t find reliable and consistent information. 

How is your over all health?  Any chronic problems?

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