Coronavirus

[highfigh]

Oh, horse and buggy and whips. Now I remember.

If he means it the same as I would if I were to say that about Milwaukee, it would refer to extremely bad roads and people acting like it's the Wild West.

 

[Mr._Clark]

Reuters ran an article today about the government response in Britain.

>>>LONDON (Reuters) - A piece of research that helped convince the British government to impose more stringent measures to contain COVID-19 painted a worst case picture of hundreds of thousands of deaths and a health service overwhelmed with severely sick patients. . . .

The projection study, by a team led by Neil Ferguson, a professor of mathematical biology at Imperial College London, used new data gathered from Italy, where the infectious disease epidemic has surged in recent weeks.

Comparing the potential impact of the COVID-19 disease epidemic with the devastating flu outbreak of 1918, Ferguson’s team said that with no mitigating measures at all, the outbreak could have caused more than half a million deaths in Britain and 2.2 million in the United States.<<<

Sobering COVID-19 study prompted Britain to toughen its approach

A crucial projection study that helped convince the British government to impose more stringent measures to contain COVID-19 painted a worst case picture of hundreds of thousands of deaths and a health service overwhelmed with severely sick patients.

www.reuters.com

 

[highfigh]

I would like to know if the medical community has a specific stance on this- I went to see a doctor yesterday and during the exam, he coughed several times. At first, I put my hands out as if to block anything coming toward me and said 'Corona?". He coughed again and I asked for his take on the whole thing- he said that he doesn't think most people will have a serious problem with it and that it is very contagious, but that the reaction is stronger than necessary with the exception of trying to avoid transmitting it to those who are vulnerable.

With its communicability- while I don't like the damage the shutdowns are doing to people and small businesses that can't survive loss of patronage, I think that shutting down en masse will cut down on the time needed to deeply clean everything where the virus may reside, even if its lifetime has been exceeded for contagion.

 

[Swerd]

Vaccination has a long history. Small pox epidemics used to take a huge toll on communities. It took a terrible toll on Native American populations and wiped out the Mandan Indians of North Dakota.

The account of the Lewis & Clark Expedition contained sobering reports of the fates of entire Mandan towns located along the Missouri River. As Lewis & Clark traveled west, they wintered over at one large & thriving town. As they returned east, that town and others nearby were wiped out and abandoned. Only the isolated and more hostile Sioux seemed to survive.

Wikipedia publishes this graph that estimates the effect of small pox and other epidemics on the population of Mexico during the early Spanish colonial period. Apparently enough surviving written accounts have been discovered to support this shocking estimate.

According to Noble David Cook, a community of scholars has recently, albeit slowly, "been quietly accumulating piece by piece data on early epidemics in the Americas and their relation to the subjugation of native peoples." They now believe that widespread epidemic disease, to which the natives had no prior exposure or resistance, was the primary cause of the massive population decline of the Native Americans.

Cocoliztli is a term used for unidentified diseases characterized by high fevers and bleeding that ravaged Mexico. Subsequent outbreaks baffled both Spanish and native doctors, with little consensus among modern researchers on the pathogenesis. Recent bacterial genomic studies have suggested that Salmonella, specifically a serotype of Salmonella enterica known as Paratyphi C, was at least partially responsible for this initial outbreak. It might have also been an indigenous viral hemorrhagic fever, perhaps exacerbated by the worst droughts to affect that region in 500 years, as well as living conditions for indigenous peoples of Mexico in the wake of the Spanish conquest of 1519.

In 1796 an English physician, Dr Bruce Jenner had noted that you only got small pox once. He reasoned that Cowpox was a milder form of small pox. So he did and experiment that any ethics committee would nix now and forbid.

Was that Edward Jenner? Bruce Jenner, the former Olympic Decathlon champion, has more recent fame and notoriety.

If I remember my virology from grad school, Cowpox was suspected and sometimes used to prevent small pox for some time before 1796. It was Jenner who first clearly demonstrated it worked.

The controlled trial goes back longer than you think. Scurvy at sea was a huge problem. In 1747 the Royal Navy charged a young naval surgeon to research a cure. This is regarded as the first example of careful didactic research curing a disease.

It still took a number of decades before this became widely accepted within the Royal Navy. The accounts of Capt. James Cook, from his 3 Pacific exploration voyages during the 1770s and 80s, contain numerous references to scurvy and his various attempts to supplement the diets of his sailors.

Calling and Englishman a Limey has come to be regarded as a term of abuse. Personally I have never regarded it as such, but a mark of distinction and honor. This was really the first use of a clinical trial to bring a cure to a terrible and serious disease.

When I was in the US Navy (1971-75) it was considered okay to call a Royal Navy sailor a limey, but calling them lime suckers was to be avoided, as it was considered an insult – fighting words.

 

[TLS Guy]

The account of the Lewis & Clark Expedition contained sobering reports of the fates of entire Mandan towns located along the Missouri River. As Lewis & Clark traveled west, they wintered over at one large & thriving town. As they returned east, that town and others nearby were wiped out and abandoned. Only the isolated and more hostile Sioux seemed to survive.

Wikipedia publishes this graph that estimates the effect of small pox and other epidemics on the population of Mexico during the early Spanish colonial period. Apparently enough surviving written accounts have been discovered to support this estimate.

View attachment 34711

According to Noble David Cook, a community of scholars has recently, albeit slowly, "been quietly accumulating piece by piece data on early epidemics in the Americas and their relation to the subjugation of native peoples." They now believe that widespread epidemic disease, to which the natives had no prior exposure or resistance, was the primary cause of the massive population decline of the Native Americans.

Cocoliztli is a term used for unidentified diseases characterized by high fevers and bleeding that ravaged Mexico. Subsequent outbreaks baffled both Spanish and native doctors, with little consensus among modern researchers on the pathogenesis. Recent bacterial genomic studies have suggested that Salmonella, specifically a serotype of Salmonella enterica known as Paratyphi C, was at least partially responsible for this initial outbreak. It might have also been an indigenous viral hemorrhagic fever, perhaps exacerbated by the worst droughts to affect that region in 500 years, as well as living conditions for indigenous peoples of Mexico in the wake of the Spanish conquest of 1519.
Was that Edward Jenner? Bruce Jenner, the former Olympic Decathlon champion, has more recent fame and notoriety.

If I remember my virology from grad school, Cowpox was suspected and sometimes used to prevent small pox for some time before 1796. It was Jenner who first clearly demonstrated it worked.
It still took a number of decades before this became widely accepted within the Royal Navy. The accounts of Capt. James Cook, from his 3 Pacific exploration voyages during the 1770s and 80s, contain numerous references to scurvy and his various attempts to supplement the diets of his sailors.
When I was in the US Navy (1971-75) it was considered okay to call a Royal Navy sailor a limey, but calling them lime suckers was to be avoided, as it was considered an insult – fighting words.

 

[TLS Guy]

SWERD said [Was that Edward Jenner? Bruce Jenner, the former Olympic Decathlon champion, has more recent fame and notoriety.] Quote

Yes! my brain seems a bit foggy lately.

 

[Dan]

I would like to know if the medical community has a specific stance on this- I went to see a doctor yesterday and during the exam, he coughed several times. At first, I put my hands out as if to block anything coming toward me and said 'Corona?". He coughed again and I asked for his take on the whole thing- he said that he doesn't think most people will have a serious problem with it and that it is very contagious, but that the reaction is stronger than necessary with the exception of trying to avoid transmitting it to those who are vulnerable.

With its communicability- while I don't like the damage the shutdowns are doing to people and small businesses that can't survive loss of patronage, I think that shutting down en masse will cut down on the time needed to deeply clean everything where the virus may reside, even if its lifetime has been exceeded for contagion.

Well here is this MD's take. I have a cough from allergies that is chronic. I'm not worried about it but I tell people what it is to alleviate concern.. If I had ANY symptoms of a cold I'd be home in a second. I just did a thyroid biopsy on someone which is a very low risk procedure not unlike a blood draw, but I am in the person's face by necessity much like a dentist. I never wore a mask for such a minor procedure before- until today, purely a precaution. Healthcare workers are of course the most exposed and we have to be careful we don't spread it further. There is some data to suggest that healthcare workers get more sick than their age matched cohorts in the general population cause unknown. I think what your doc did is unconscionable and unprofessional. He is also wrong about transmitting it to the less vulnerable.

We have moved our workstations in radiology into small offices, increased spacing and wotking from home where possible. We now sit at the same workstation every day instead of moving around. All conferences are teleconferences. When I teach the resident stands well behind me while I point out the findings on the images. Usually we are side by side very close.

 

[Matthew J Poes]

@TLS Guy you mention something I've heard too, which is that the virus is highly variable, possibly mutating into different forms. If, like other similar viruses, an immunization is not possible, how could heard immunity be possible?

Also, given the projected mortality rate, wouldn't achieving a 70% immunity rate also require a significant loss of life? Like on the order of 200 million plus? It seems like that is not the right approach, at least not until such time that we can reduce the peak cases to a manageable level.

I understood the UK take, they were projecting a really prolonged peak in the cases, but it seems like their approach was also risking their medical system seriously.

 

[Matthew J Poes]

So, which came first... the chicken or the egg?

I think the media is blowing this up for two reasons:
1) Ratings
2) An opportunity to poke Trump. Before this virus, the Left/media had nothing to poke Trump leading up to the election. Yeh, I know some will say, "Oh, we had this and that to poke him". But it was just fluff. The huge majority of measurable indicators were positive. And your top candidate is a joke. All you really had was that you didn't like him. So while I'm not saying libs want this virus or want people to get it, Corona is an answered prayer to libs looking for something to key on during the election. And they are certainly taking advantage of it. Now they can condemn every action he takes, and no one can really prove them wrong.

While I'm sure the media is sensationalizing some of this, how would this view really explain the government responses around the world? Are you suggesting that the media is causing state and federal governments to make decisions they wouldn't otherwise? Do you believe that California is ordering the very costly "Shelter-in-place" to some how make Trump look bad?

My opinion is that those who hold the view that this virus is normal, no big deal, and that the responses are an over-reaction do not understand what is going on and are letting themselves be blinded to reality in dangerous ways. There is a legitimate problem that requires people take these measures seriously. If the media over-reacts a little, that isn't going to be a big deal here. If people under-react, that is. Under-reactions are what got us here.

 

[highfigh]

Well here is this MD's take. I have a cough from allergies that is chronic. I'm not worried about it but I tell people what it is to alleviate concern.. If I had ANY symptoms of a cold I'd be home in a second. I just did a thyroid biopsy on someone which is a very low risk procedure not unlike a blood draw, but I am in the person's face by necessity much like a dentist. I never wore a mask for such a minor procedure before- until today, purely a precaution. Healthcare workers are of course the most exposed and we have to be careful we don't spread it further. There is some data to suggest that healthcare workers get more sick than their age matched cohorts in the general population cause unknown. I think what your doc did is unconscionable and unprofessional. He is also wrong about transmitting it to the less vulnerable.

We have moved our workstations in radiology into small offices, increased spacing and wotking from home where possible. We now sit at the same workstation every day instead of moving around. All conferences are teleconferences. When I teach the resident stands well behind me while I point out the findings on the images. Usually we are side by side very close.

One of the most ironic things about going to that clinic is the fact that so many of the people working there are overweight or very overweight, including the doctors I have seen and both told me that I need to lower my A1C, cholesterol and BP. They're not large and muscular-looking, they just look pudgy, at best. I probably have far less body fat than they do and because I changed my diet as soon as I found out about my levels last Thursday, I have dropped almost 10 pounds and at the beginning of yesterday's appointment, my BP was lower.

 

[Verdinut]

Healthcare workers are of course the most exposed and we have to be careful we don't spread it further. There is some data to suggest that healthcare workers get more sick than their age matched cohorts in the general population cause unknown.

Yesterday, I was near the entrance of the Emergency of a general hospital. I met a taxi driver who was wearing a mask as he drives healthy and ill people to that department.

I did realize that those cab drivers are also most exposed just sitting at less than 3 feet from the people in the back seat. I'm sure that quite a few of them will catch the virus and the situation will eventually be reported in the news. Also, people who take a cab in which a person suffering from a Covid-19 attack sat a little while before are also much at risk. The question arises about the safety of taking a cab nowadays.

 

[Mr._Clark]

I ran across an article (link below) regarding the immune system response in a non-severe COVID-19 case. For those who have a background in this (eg TLS Guy), are there any conclusions (or best guesses for that matter) that can be drawn from this? I realize this is only one case, but it is at least some information.

If I'm following the article, it seems to suggest that if a vaccine can be developed that triggers a similar response as in the patient studied it's likely to be effective.

Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19 - Nature Medicine

www.nature.com

 

[TLS Guy]

I ran across an article (link below) regarding the immune system response in a non-severe COVID-19 case. For those who have a background in these field (eg TLS Guy), are there any conclusions (or best guesses for that matter) that can be drawn from this? I realize this is only one case, but it is at least some information.

If I'm following the article, it seems to suggest that if a vaccine can be developed that triggers a similar response as in the patient studied it's likely to be effective.

Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19 - Nature Medicine

www.nature.com

So that is a report of a case of a patient who got a mild bilateral pneumonia from Covid 19. That shows a pretty typical immune response to viral infection. It also shows the cytokine mechanism was not activated in this case. However you can go to the bank that it will be activated in severe cases. The severe cases are associated with a cytokine storm. However this is well known. The problem is that we do not know why some patients get a cytokine storm from severe and even not such severe insults.

Despite enormous research since the Vietnam war, we do not understand the clear chain of events, here and certainly not how to reliably terminate it. That is the kernel of the issue.

 

[TLS Guy]

Well here is this MD's take. I have a cough from allergies that is chronic. I'm not worried about it but I tell people what it is to alleviate concern.. If I had ANY symptoms of a cold I'd be home in a second. I just did a thyroid biopsy on someone which is a very low risk procedure not unlike a blood draw, but I am in the person's face by necessity much like a dentist. I never wore a mask for such a minor procedure before- until today, purely a precaution. Healthcare workers are of course the most exposed and we have to be careful we don't spread it further. There is some data to suggest that healthcare workers get more sick than their age matched cohorts in the general population cause unknown. I think what your doc did is unconscionable and unprofessional. He is also wrong about transmitting it to the less vulnerable.

We have moved our workstations in radiology into small offices, increased spacing and wotking from home where possible. We now sit at the same workstation every day instead of moving around. All conferences are teleconferences. When I teach the resident stands well behind me while I point out the findings on the images. Usually we are side by side very close.

I think Hi-Fi needs to search for another medical practitioner!

 

[ryanosaur]

Wine Country/North Bay Area, CA

Until last week, we were experiencing a very light touch from the Virus. 3 people, former cruise ship travelers, were being cared for in local facilities. Other than their presence here, there were no signs of anything going on at all...
One guy freaked out in a Coffee Shop because he had to touch an iPad to complete his credit card transaction: "I can't believe you want me to touch that. People are sick. They're dying! Everyone's going to be sick in two weeks!!!"
That was over a week ago.
There were the random people wearing 'SARS masks' despite the the fact that they weren't gong to help them, much less the advice to not wear such masks at all. I only saw two until this week
*sighs
I am a long time Service Industry guy. The highpoint in my previous career was Executive Chef at a local Premier Winery. Like many, I burned out from the excessive hours (80-hour work weeks, anyone?) and chose to pursue my own health and wellness, rather than race to the ER from a Heart Attack or Stroke. I've spent the past few years doing my Private Chef work, working at a local Bar, and becoming a Barista. (Why? Because I can. )
That Coffee shop where the guy freaked out was the one I work in. Our management started paying attention to this almost two weeks ago. We have been sanitizing those iPads HOURLY (even before Apple said it was OK to use disinfectant on these devices! ). Likewise, for us, it has been general practice to clean the "dining room" pretty much every hour which includes wiping things down with Sanitizer, too. In general, it is a clean and pretty safe environment.
With our locally confirmed second case of community transmission since Saturday, the guidance of the Governor, and the common sense humanism of our management (as well as their eye on dropping sales, to be certain), we locked up yesterday. 100+ local employees on indefinite leave.
Or, as the hourly alarm sanitation reminder in our iPads read: "It's Corona Time."

Of the 9 counties that comprise the Bay Area proper, 6 are under Shelter-In-Place restriction. We, currently, are not one of those; a neighboring County is. Most of our local businesses are adhering to the spirit of the local and state guidance. Dining rooms are closed. Restaurants remaining open are take out only. If there was a gathering place for people, they are mostly closed off, or have only 4 tables instead of 12.

As a trained Chef and Service Industry professional, I do kind of wish my current employer had decided to remain open and lead from the front lines. I do agree that the restrictions being put in place are for the greater good. I also believe that we have a vital roll in the community as well: with great care, we are a place where people can actually practice Human-ing: to get that all important cup of coffee and scratch the itch of both Chemical and Social ritual. We serve as a point of contact where our friends and guests can at least blow off a little steam with some banter or social advice (being a Barista and a Bar Tender are just about the same role).
One of our competitors in town is still open, and I am grateful to them for that decision. They have vowed to continue serving until such a time as a lockdown is put in place.

For myself, I'm on vacation for lack of a better word. I went grocery shopping yesterday after I was told to not come in for my closing shift. I did so responsibly. I bought fresh food only for the next several days and did not hoard anything.

To all our friends here at AH: Stay Well!

@gene: I am glad to have seen your update and hope your recovery continues. Likewise, I hope that your family stays well and healthy while you recover. Thank you for this place to blow off steam, and thank you for being a leader in this trying time!

 

[Kvn_Walker]

My opinion is that those who hold the view that this virus is normal, no big deal, and that the responses are an over-reaction do not understand what is going on and are letting themselves be blinded to reality in dangerous ways. There is a legitimate problem that requires people take these measures seriously. If the media over-reacts a little, that isn't going to be a big deal here. If people under-react, that is. Under-reactions are what got us here.

This is the dangerous gambit with such a large segment of the population not taking it seriously. You're in a no-win situation.

IF the containment and isolation measures work well enough and we dodge a bullet, then they will feel justified that it was never a problem in the first place. "I told you so!" They won't recognize the effectiveness of the preventative measures.

The other option is a severe loss of life and societal/economic disruption. Italy^3. That's the price we'd have to pay to "prove" the severity of it.

 

[Swerd]

Weeks ago when people started panic buying TP, I bought ammo

 

[John Parks]

View attachment 34715

Well, that was a crappy idea!

 

[Matthew J Poes]

This is the dangerous gambit with such a large segment of the population not taking it seriously. You're in a no-win situation.

IF the containment and isolation measures work well enough and we dodge a bullet, then they will feel justified that it was never a problem in the first place. "I told you so!" They won't recognize the effectiveness of the preventative measures.

The other option is a severe loss of life and societal/economic disruption. Italy^3. That's the price we'd have to pay to "prove" the severity of it.

Well, I would much rather be in the position of having known that lives were saved and disliked by the stubborn, than know I've been proven right at the expense of lives.

I specifically work with prevention services so we constantly battle the belief that we are trying to fix a problem that doesn't exist. We are trying to prevent a problem before it exists, not fix an existing one. If my programs work, you won't even know it. It's when they don't work that you see the problem. We have rigorous scientifically valid ways of proving they work, but unfortunately there are a lot of people who don't understand that kind of science, they want to see proof in a more obvious way. For the kind of work I do, that kind of proof means I've failed and it is not too late.

 

[ryanosaur]

Well, I would much rather be in the position of having known that lives were saved and disliked by the stubborn, than know I've been proven right at the expense of lives.

I specifically work with prevention services so we constantly battle the belief that we are trying to fix a problem that doesn't exist. We are trying to prevent a problem before it exists, not fix an existing one. If my programs work, you won't even know it. It's when they don't work that you see the problem. We have rigorous scientifically valid ways of proving they work, but unfortunately there are a lot of people who don't understand that kind of science, they want to see proof in a more obvious way. For the kind of work I do, that kind of proof means I've failed and it is not too late.

In light of what I shared above... this would be best exemplified by the 50 some-odd bikers gathered at a local bar. Social distancing is apparently a reason for them to go hang out. *sighs-and-shrugs