Coronavirus

[Mr._Clark]

Thanks for posting TLS Guy. Your candid assessment is appreciated.

This is well outside my area of expertise.

 

[RedCharles]

Good post TLS, but I don't necessarily agree it will be worse than Spanish Flu; Spanish Flu was bad news. 10% CFR. Bi-Modal distribution. According to Chinese data, no one under 10 has died from Coronavirus. We'll soon see how deadly Coronavirus is without proper medical care. We've already seen that with overwhelmed medical care, the death rate is close to 5%.

According Los Alamos: Average 4.2 day incubation period. 11.2 days from symptoms until death. 11.5 days to discharge.

https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1.full.pdf

Which is to say, the people dying in Italy today probably got infected 16 days ago. Was anyone thinking Northern Italy is in danger Feb 10th? I highly doubt it. Wherever this is going to break out in the United States, it's already happened. It's time to prepare, because by the time you know, it's too late.

When 50% of people are infected that automatically cuts the transmission rate in half. Herd immunity. This is why estimates range form 40-60% of the world infected.

You know it's bad in Iran when the guy on TV telling everyone to be calm and it's just the flu, comes down with Coronavirus on TV.

Something I learned secondhand was that when an intubation is performed, the virus gets all over the place. Quite messy. Doctor said that if the virus comes here, he would retire, because he was certain that he would inevitability get it while performing intubations.

And apparently, the worst news I've read so far.

Western Japan woman tests positive for coronavirus again weeks after hospital release - The Mainichi

OSAKA -- A woman in her 40s from this western Japan city who was found infected with the new coronavirus in January and was released from hospital on

mainichi.jp

 

[herbu]

Local morning news just did 5 minutes on Coronavirus. No deaths here. Then they did a 5 second piece saying there were 8 deaths in NC last week from the flu. So...???

 

[kystorm]

Think I'll be buying some extra groceries today....Summer can't get here soon enough

 

[TLS Guy]

As more cases come in case fatality seems to be holding steady at the 3.5% mark.

The US now has its first case that is unexplained in California. That means no travel and no contact with an individual known to have Coronavirus. So that marks the first community spread of the virus in the US. So we have to regard the cat as out of the bag now.

One very concerning case has been reported from Japan. A female tour guide in her forties became ill in January and tested positive. She was discharged well February 1. She now has become ill again with typical symptoms and tested positive for the virus again. This is credible, as the common cold is a coronavirus and as you all know post infectious immunity is very short lived. I hope there is some other explanation for this, or for some reason why this woman is a massive outlier.

The bottom line is that everyone on the globe is going to get exposed to this virus sooner or later now.

So debate is starting about whether containment efforts are warranted, which will prolong the epidemic or just let things be and get the world herd immunity built up quicker and have a shorter epidemic. The problem with the latter is that there will no be enough hospital beds, let alone ICU beds for the seriously ill. So I would then expect the case fatality rate to be much higher. On the other hand attempts at containment may not make any difference and prove to be a waste of time.

On a slightly lighter note, all male medical personel in the NHS have been ordered to shave off beards, in order to make masks fit better.

 

[Midwesthonky]

On a slightly lighter note, all male medical personel in the NHS have been ordered to shave off beards, in order to make masks fit better.

Ah...good times! Nothing like a good pandemic to impact grooming standards and facial hair styles.

Well, in December, I was disappointed that I didn't get a deer but still ok because of the freezer full of venison from the last two deer. Now, I think that's a good thing.

 

[Verdinut]

For daily reports from the WHO, go to the following link: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

The virus seems to have been contained in China.

 

[TLS Guy]

For daily reports from the WHO, go to the following link: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

The virus seems to have been contained in China.

That remains to be seen. Even if it has, it comes at enormous cost of measures taken that probably could not be duplicated in open societies. I could not see any western country building a couple of 1000 bed hospitals in 10 days!

 

[Mr._Clark]

Ah...good times! Nothing like a good pandemic to impact grooming standards and facial hair styles.

Well, in December, I was disappointed that I didn't get a deer but still ok because of the freezer full of venison from the last two deer. Now, I think that's a good thing.

On the subject of fashion trends during a zombie apocalypse, I ordered some really cool black ninja style N99 masks on Amazon today. However, I couldn't help but notice that the masks are made in China, which means I will probably end up getting the virus from the masks.

Either that or I will get into a car accident trying to put my seat belt on in an effort to get the blasted beeper to stop.

Or, the venison I eat during the apocalypse is from a deer with CWD and I end up getting a prion (prions are possibly the strangest biological thing I have ever heard of).

 

[Old Onkyo]

Looks like China won the Trade War.

 

[TLS Guy]

On the subject of fashion trends during a zombie apocalypse, I ordered some really cool black ninja style N99 masks on Amazon today. However, I couldn't help but noticing that the masks are made in China, which means I will probably end up getting the virus from the masks.

Either that or I will get into a car accident trying to put my seat belt on in an effort to get the blasted beeper to stop.

Or, the venison I eat during the apocalypse is from a deer with CWD and I end up getting a prion (prions are possibly the strangest biological thing I have ever heard of).

The CDC do not want people buying masks. They will not stop you getting Coronavirus. They will stop you spreading it somewhat. So they want to conserve them fro people who are ill.

We have been dealt a bad hand by some stupid ICU doctors in California.

They have had a forty year old woman with respiratory failure from pneumonia on a ventilator for four days. Granted she had no travel or contacts with travelers. Anyhow it took them 4 days to test her for Coronavirus and its positive. So the exhalation valve of that ventilator was spewing Corona virus all over that ICU for days exposing the staff and visitors to the virus.

I was in ICU practice in the SARS epidemic. We tested all unusual pneumonia patients for SARS in that period. In fact I used to screen all unusual pneumonia cases in younger patients for novel viruses. I even used to keep serum for posterity. I had a young man in his twenties die of pneumonia once. No cause found, but I saved serum. When Hunta virus was first reported from the Four Corners states, I had some of his serum tested for that. It came back positive for Hunta virus. Over the years we had two further cases on my watch in a region where it is not supposed to occur. Those guys in California were not vigilant medical detectives.

So I think we are basically screwed now.

Trump is taking a leaf out of China's book and muzzling the CDC. They have to check with Spence before opening their mouths. I hope they disobey that order.

The UK are considering closing all schools for two months.

If the mortality is not to get out of hand, I think we will have to stop most travel, assembly, require work from home for all non essential personel and close the schools.

I think we really do have to stop large number needing ICU and especially ventilator care all at once. Everyone will get exposed, but I think we have to stop that happening all at once. I know only 17 people out of hundred will need ICU care, and nearly half of those will need a ventilator. If they can't get it they will be in the death column for sure. So it will only take a thousand or so cases to run a fairly large city out of ventilators. All except the largest hospitals would not carry more than 20 to 30 vents. So I reckon you would need 70 or so vents per thousand cases. We were just under a 300 bed hospital and we had around 20 vents to put into service. I think the largest number of ventilator patients I had to look after at one time, was 14 and of course that was over Christmas! I have to say I'm totally amazed how much ventilator care China is able to provide. I highly doubt we will do nearly as well.

 

[Mr._Clark]

Switching back to serious mode, the CDC criteria for Coronvirus testing is absolutely absurd:

>>>Already in deep distress, the patient was rushed last week to a hospital in Northern California, severely ill and unable to breathe on her own.

Doctors at the University of California, Davis Medical Center, near Sacramento, provided the woman with critical care but also considered an unlikely diagnosis: infection with the coronavirus.

Hospital administrators said they immediately requested diagnostic testing from the Centers for Disease Control and Prevention, but the procedure was not carried out because the case did not qualify under strict federal criteria: She had not traveled to China and had not been in contact with anyone known to be infected. . . .

“I think the diagnostic issue is the single most important thing that keeps me up at night right now,” said Lauren Sauer, director of operations at the Johns Hopkins Office of Critical Event Preparedness and Response. . . .

“The obvious observation is that many countries are capable of testing rather widely,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “Why can’t we?” . . .

The C.D.C. operates two laboratories that test for the coronavirus and can handle approximately 400 specimens per day. Agency officials say there is no testing backlog, but it is unclear whether the labs will be able to keep up with demand if the need — and eligibility — increases testing substantially. . . .

A criticism of the new criteria [instituted after the California case], however, is that doctors will have to wait until someone is extremely ill to test for the virus if that person did not travel to the affected regions or have contact with a known case. . . .

“If we could identify these people earlier who don’t specifically meet one of the two criteria, or some sort of broader travel criteria, we could get them tested,” Ms. Sauer said. “You have to wait until someone’s really sick to push that test now, even with this new criteria.<<<

Coronavirus Diagnosis in California Highlights Testing Flaws (Published 2020)

Doctors suspected infection with the virus, but the patient did not fit the federal criteria and was not tested for days.

www.nytimes.com

Why in the world would the CDC set the testing criteria so high? Also, it's amazing to me that the CDC has not ramped up it's testing capabilities. 400 per day seems WAY too low.

 

[TLS Guy]

Switching back to serious mode, the CDC criteria for Coronvirus testing is absolutely absurd:

>>>Already in deep distress, the patient was rushed last week to a hospital in Northern California, severely ill and unable to breathe on her own.

Doctors at the University of California, Davis Medical Center, near Sacramento, provided the woman with critical care but also considered an unlikely diagnosis: infection with the coronavirus.

Hospital administrators said they immediately requested diagnostic testing from the Centers for Disease Control and Prevention, but the procedure was not carried out because the case did not qualify under strict federal criteria: She had not traveled to China and had not been in contact with anyone known to be infected. . . .

“I think the diagnostic issue is the single most important thing that keeps me up at night right now,” said Lauren Sauer, director of operations at the Johns Hopkins Office of Critical Event Preparedness and Response. . . .

“The obvious observation is that many countries are capable of testing rather widely,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “Why can’t we?” . . .

The C.D.C. operates two laboratories that test for the coronavirus and can handle approximately 400 specimens per day. Agency officials say there is no testing backlog, but it is unclear whether the labs will be able to keep up with demand if the need — and eligibility — increases testing substantially. . . .

A criticism of the new criteria [instituted after the California case], however, is that doctors will have to wait until someone is extremely ill to test for the virus if that person did not travel to the affected regions or have contact with a known case. . . .

“If we could identify these people earlier who don’t specifically meet one of the two criteria, or some sort of broader travel criteria, we could get them tested,” Ms. Sauer said. “You have to wait until someone’s really sick to push that test now, even with this new criteria.<<<

Coronavirus Diagnosis in California Highlights Testing Flaws (Published 2020)

Doctors suspected infection with the virus, but the patient did not fit the federal criteria and was not tested for days.

www.nytimes.com

Why in the world would the CDC set the testing criteria so high? Also, it's amazing to me that the CDC has not ramped up it's testing capabilities. 400 per day seems WAY too low.

We need to be able to test 10,000 cases a day, and more as this infection ramps up. Anyone with upper or lower respiratory infection needs testing now.

 

[Kvn_Walker]

Local morning news just did 5 minutes on Coronavirus. No deaths here. Then they did a 5 second piece saying there were 8 deaths in NC last week from the flu. So...???

Yeah yeah, Rush said just take a couple aspirin, right?

 

[Kvn_Walker]

So stupid me though The Stand was fiction, not a documentary. Well hopefully it won't reach those proportions, but the way some of the world's government's are handling this gives me pause.

Since North Korea has a near impermeable communications barrier, we might never know if it's there and how bad it might be within its borders.

 

[pewternhrata]

The media is still just taking full advantage of this and stretching it. Take ohio for for example, they are pushing the impression that there are 212 cases of the virus in ohio which is completely false. This is state side and they swing the factual data, I cant imagine what is actually going on overseas but the US media is not giving anything seemingly relevant to the issue...I'll just wait for the inevitable; hopefully Milla has her bags packed.

 

[Swerd]

It's clear that Covid-19 is already breaking out here in North America, Europe, and elsewhere beyond China. We are witnessing it now. Efforts at containing spread of the virus did not succeed. I don't think this should surprise too many people.

The media is still just taking full advantage of this and stretching it. Take ohio for for example, they are pushing the impression that there are 212 cases of the virus in ohio which is completely false. This is state side and they swing the factual data, I cant imagine what is actually going on overseas but the US media is not giving anything seemingly relevant to the issue...I'll just wait for the inevitable; hopefully Milla has her bags packed.

The national news media usually get the facts correct, that they do report. While, at the same time, they can easily get the whole story wrong. It's like judging size of an iceberg based only on the 10% that shows above the water. We never see the other 90% of the iceberg, or the entire news story in proper context.

Any of us who have ever worked in a field or been personally close to something that also appeared in the national news may know what I mean. I think TLS Guy's story about his ICU experience during the SARS epidemic years ago is a good example. The whole story, in proper context, is always more complicated than even the impartial news media wants to take time to report.

Yeah yeah, Rush said just take a couple aspirin, right?

Right. I would listen to that guy's medical advice no sooner than I would listen to any of his other words.

 

[mtrycrafts]

...
Right. I would listen to that guy's medical advice no sooner than I would listen to any of his other words.

I just wish the medical facility that he might end up in will fulfill his remedy, give him 3 Aspirins.

 

[mtrycrafts]

I recently heard the author of this book https://dontknowmuch.com/books/more-deadly-than-war/

Some may be interested how the name came about and how much it was censored and held from the public, sent infected soldiers to Europe, and how authority, generals, didn't want to follow doctors recommendation even though they had no idea what it was how to fight it.
Spain was neutral during WW I so paper was not censored there and when the virus spread to Spain, published as Spanish flue.

 

[JerryLove]

We have been dealt a bad hand by some stupid ICU doctors in California.

So, you aren't referring to the people who couldn't get the CDC to test because it didn't meet the criteria?

They have had a forty year old woman with respiratory failure from pneumonia on a ventilator for four days. Granted she had no travel or contacts with travelers. Anyhow it took them 4 days to test her for Coronavirus and its positive. So the exhalation valve of that ventilator was spewing Corona virus all over that ICU for days exposing the staff and visitors to the virus.

I don't understand. Most people on a respirator have some combination of being immune-compromised and having a contagious disease.

Are you saying that respirators don't have hi-MIRV HEPA filters on their air channels? That makes it seem like the entire medical community is basically incompetent.