Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[Hapless Bills Fan]

5 hours ago, May Day 10 said:

 

About 3-4 days ago, they started their most restrictive distancing rules, cant go like 90 feet away from your home or something, and they said it would be until March 25th.  Expert-level social distancing

 

 

I think that's the key.  Restrict everything for a week or 2.  Test the heck out of everything, contain it, then slowly allow pieces of the economy and society back into circulation.  Massive testing at borders for the foreseeable future.  

 

In China at present, I am told that if you are traveling into the country from anywhere with unchecked covid-19 it's a mandatory 2 week quarantine.

They escort you to a hotel room and bring meals to your door.  You don't leave the room unless you summon medical assistance.

 

3 minutes ago, K-9 said:

Except that I heard a certain someone at yesterday’s White House briefing make that comparison and using that same false equivalency in justifying policy moving forward. 

 

A friend of mine has an analogy:

 

We know that many more people die from vehicle crashes, than from playing Russian Roulette.

If from this, you conclude that it's safer to play Russian Roulette than to drive to work in the morning, you should probably defer to others on matters of epidemiology.

 

[SDS]

2 minutes ago, Hapless Bills Fan said:

 

In China at present, I am told that if you are traveling into the country from anywhere with unchecked covid-19 it's a mandatory 2 week quarantine.

They escort you to a hotel room and bring meals to your door.  You don't leave the room unless you summon medical assistance.

 

 Traveling to China from here seems to be almost impossible. We have an acquaintance from China who has been trying to get back for a week and the best she has been able to do is get to San Francisco. Today they pulled her off the plane because they said Japan would not allow foreigners to travel on to China. this is after she’s had at least a half dozen flights canceled on her.

[Hapless Bills Fan]

7 minutes ago, GoBills808 said:

It also doesn't have a vaccine

 

Correct, no vaccine along with no immunity from prior exposure are part of what's meant by "the lack of immunity"

 

2 minutes ago, SDS said:

Traveling to China from here seems to be almost impossible. We have an acquaintance from China who has been trying to get back for a week and the best she has been able to do is get to San Francisco. Today they pulled her off the plane because they said Japan would not allow foreigners to travel on to China. this is after she’s had at least a half dozen flights canceled on her.

 

I'm sorry.  It is having a big impact on business, also.

[BillsFan4]

https://www.vox.com/2020/3/23/21190033/coronavirus-covid-19-deaths-by-age

 

Quote

Young adults (20 to 29 years old)

The important stats on young adults:

• In Spain, out of 1,285 cases for people 20 to 29 (a much bigger sample size than we have for children), 183 of them have been hospitalized, a 14 percent rate; eight have ended up in intensive care, a 0.6 percent rate, and four people in this age range have died, a 0.3 percent fatality rate.
• Italy and South Korea have reported no fatalities for this group; China reports that 0.2 percent of cases for these young people end in death.
• The CDC covers a huge 20-44 age range in its data, but here’s what we know about that entire group: 14.3 percent hospitalized, 2 percent in the ICU, and 0.1 percent fatality rate.
• Bottom line: We are seeing a higher hospitalization rate among young adults compared to the teens directly behind them in age, and comparatively more of them wind up in the ICU. Fatality rates are still low, but deaths do happen. The trends that will carry through the rest of this article — the older you get, the higher the risk — are starting to show up.

 

Quote

Adults up to middle age (30 to 49 years old)

The important stats on this working-age population:

• In Spain, out of 5,127 cases from this cohort, 1,028 people have been hospitalized, a 20 percent rate; 55 went to the ICU, a 1.1 percent rate; and 12 people ages 30 to 49 have died, a 0.2 percent fatality rate.
• Italy (0.3 percent death rate), China (0.2 percent), and South Korea (0.1 percent) have reported deaths in this age range.
• As mentioned above, the CDC covers one huge 20-44 age range in its report, but here’s what we know about that group: 14.3 percent hospitalized, 2 percent in the ICU, and 0.1 percent fatality rate.
• For people 45 to 54, the CDC reports 21.2 percent have been hospitalized, 5.4 percent were put in the ICU, and 0.5 percent have died.

Bottom line: For this demographic, a significant number of people are being hospitalized, upward of one in five cases. And those final numbers from the CDC are a good example of how risk can vary within these age groups: Odds of hospitalization, intensive care, and death seem to increase from one’s early 40s to late 40s. We’ve seen the same trend in Spain: The rates of hospitalization jumped from 17 percent for ages 30 to 39 to 23 percent for ages 40 to 49.

 

Quote

People nearing retirement age (50 to 69 years old)

The important stats on the people entering their golden years:

• In Spain, out of 6,045 cases from this cohort, 2,166 people have been hospitalized, a 36 percent hospitalization rate; 221 went to the ICU, a 3.7 percent rate; and 83 people ages 50 to 69 have died, a 1.4 percent fatality rate.
• Taken collectively, Italy, China, and South Korea have reported fatality rates from 0.4 percent up to 3.6 percent for people in this group.
• For people 45 to 54, the CDC reports 21.2 percent have been hospitalized, 5.4 percent were put in the ICU, and 0.5 percent have died. For people 55 to 64, 20.5 percent have been hospitalized, 4.7 percent ended up in the ICU, and 1.4 percent died. For the oldest folks in this group, ages 65 to 74, hospitalizations (28.6 percent), ICU stays (8.1 percent) and deaths (2.7 percent) continue to trend upward.

Bottom line: All of these folks are in the high-risk category. A substantial minority are being hospitalized, and a handful of people out of every 100 have died. The dangers increase if they have heart or lung problems, or if they have diabetes or a cancer diagnosis.

Quote

Almost half of Americans ages 55 to 64 have at least one preexisting condition, according to the Kaiser Family Foundation.

 

More info in link.

 

the flu has a hospitalization rate of about 1%, for comparison.

Edited March 24, 2020 by Hapless Bills Fan
formatting

[Hapless Bills Fan]

34 minutes ago, John in Jax said:

It actually is the ONLY thing that you can compare it to, since, you know, it’s a respiratory issue. I mean we can’t compare it to our nations #1 killer (heart disease) or to vehicle crashes or to suicides or to poison deaths.

 

The thing that amazes me is that all those people die from influenza even though there are specific drugs to treat it.

 

ETA re the post two above this: Apparently, a LOT of people have Covid-19, and they don’t know it/nobody knows it, so those numbers are way skewed. Put another way, if all the people who have it but don’t know it are added to the mix, the hospital/death numbers are a lot lower.

 

John,

Let's take this step by step.  Though the personalized breakdown and explanation of information that is already explained a couple of times upthread will not continue indefinitely.

 

1) R0 number is well known from flu.  R0 number can be calculated with good accuracy for covid-19 from data where contact tracing and testing of all contacts has been performed in China (as the crisis waned and testing became more widespread in Wuhan; outside Hubei province), in S. Korea, and in Singapore and Taiwan.  Not way skewed

2) Incubation time - again, well known at this point by contact tracing and quarantining or isolating people, and observing how long it takes them to become ill as well as by case histories asking patients "when did you first feel symptoms?".  Average of 5.6 days, range 1 - 14 for covid-19.  Not way skewed

3) Hospitalization rate - again, there are countries including China, or if you don't like their data S. Korea, Singapore, Taiwan, where a huge amount of testing and contact tracing has been done, so they know with a good degree of accuracy how many of the people who test positive, become ill enough to require hospitalization.  15% severely ill and 2-5% critically ill does not seem to be an overestimate.  It does seem to be affected by the age of the population, but it's not way skewed because many people <54 still require hospitalization (see @BillsFan4's post)

4) Case fatality rate - again, a lot of data.  In China outside Wuhan, where the disease didn't exceed capacity, the case fatality rate was 0.7-0.9%.  In countries where the health care system gets swamped, like Italy, it is currently running 9.8%. 

 

So if we want a realistic estimate for our situation if we don't continue measures to mitigate disease spread, and institute measures to contain disease once we relax social distancing constraints, I agree with you that 1-3.4% is a skewed number and that 9.8% case fatality rate as in Italy is likely to be closer to what we see.

 

 

 

 

[Hapless Bills Fan]

2 hours ago, Hardhatharry said:

The government isn't allowed to err on the side of public safety b.c it will hurt votes when election comes if people decide "it was no big deal"

 

You know, it's just possible that a big-ass body count in the face of Federal public health inaction might be just as politically costly.

I should add that a lot of the body-count is likely to be in the rural Heartland where hospitals are scarce, the demographics trend older, smoking and co-morbid conditions are common, and ICU beds non-existent.

[John in Jax]

37 minutes ago, Hapless Bills Fan said:

 

John,

Let's take this step by step.  Though the personalized breakdown and explanation of information that is already explained a couple of times upthread will not continue indefinitely.

 

1) R0 number is well known from flu.  R0 number can be calculated with good accuracy for covid-19 from data where contact tracing and testing of all contacts has been performed in China (as the crisis waned and testing became more widespread in Wuhan; outside Hubei province), in S. Korea, and in Singapore and Taiwan.  Not way skewed

2) Incubation time - again, well known at this point by contact tracing and quarantining or isolating people, and observing how long it takes them to become ill as well as by case histories asking patients "when did you first feel symptoms?".  Average of 5.6 days, range 1 - 14 for covid-19.  Not way skewed

3) Hospitalization rate - again, there are countries including China, or if you don't like their data S. Korea, Singapore, Taiwan, where a huge amount of testing and contact tracing has been done, so they know with a good degree of accuracy how many of the people who test positive, become ill enough to require hospitalization.  15% severely ill and 2-5% critically ill does not seem to be an overestimate.  It does seem to be affected by the age of the population, but it's not way skewed because many people <54 still require hospitalization (see @BillsFan4's post)

4) Case fatality rate - again, a lot of data.  In China outside Wuhan, where the disease didn't exceed capacity, the case fatality rate was 0.7-0.9%.  In countries where the health care system gets swamped, like Italy, it is currently running 9.8%. 

 

So if we want a realistic estimate for our situation if we don't continue measures to mitigate disease spread, and institute measures to contain disease once we relax social distancing constraints, I agree with you that 1-3.4% is a skewed number and that 9.8% case fatality rate as in Italy is likely to be closer to what we see.

 

 

 

 

Thank you for all the time and effort you put into these posts. I’m learning a lot, as I’m sure many others are too.

[K-9]

58 minutes ago, Hapless Bills Fan said:

 

In China at present, I am told that if you are traveling into the country from anywhere with unchecked covid-19 it's a mandatory 2 week quarantine.

They escort you to a hotel room and bring meals to your door.  You don't leave the room unless you summon medical assistance.

 

 

A friend of mine has an analogy:

 

We know that many more people die from vehicle crashes, than from playing Russian Roulette.

If from this, you conclude that it's safer to play Russian Roulette than to drive to work in the morning, you should probably defer to others on matters of epidemiology.

 

Outstanding! 

[BillsFan4]

Yes, same here. Thank you Hapless! 

 

 

————————————————————

 

 

 

 

This twitter thread is definitely worth reading (click on tweet to see whole thread). This is a doctor in NYC.

Edited March 24, 2020 by BillsFan4

[Hapless Bills Fan]

19 minutes ago, BillsFan4 said:

Yes, same here. Thank you Hapless! 

 

 

————————————————————

 

 

 

 

This twitter thread is definitely worth reading (click on tweet to see whole thread)

 

I'd like to point a few things out.

 

1) The doctor in question mentions "masking up" and walking in, then leaving and "masking out".

Hopefully that means he is issued a properly-fitting N95 ventilator mask - the minimum standard of PPE for seeing ill patients.

 

But deep in the FDA website is the following statement: "If properly fitted, the filtration capabilities of N95 respirators exceed those of face masks. However, even a properly fitted N95 respirator does not completely eliminate the risk of illness or death."

 

Why? It's called an "N95" mask because it is certified to block 95% of particulates.  It will not block viruses or smaller aerosols.  And look at the odds - if 5% of virus-carrying particulates get through, and a HCW is seeing ill patients 12 hrs a day, 6 or 7 days a week - well, sooner or later he's gonna get sick.  "It Just Bees that Way"

 

The higher level of protection is called a PAPR - a "powered air purifying respirator".  Example:

 

2) The CDC's current official guidance as of 10 March does not even mandate the use of OSHA-minimum N95 face masks.  It states:
Updated PPE recommendations for the care of patients with known or suspected COVID-19:

• Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand.  During this time, available respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to HCP.
  • Facemasks protect the wearer from splashes and sprays.
  • Respirators, which filter inspired air, offer respiratory protection.

Unfortunately, the covid-19 virus did not get the memo.  Facemasks, even surgical ones, only protect the wearer from splashes and sprays.  The best have been studied to offer protection against about 44% particulate transmission.

 

 

 

[Hapless Bills Fan]

Welp then

 

 

[DrDawkinstein]

10 hours ago, Sundancer said:

I know Hapless's feelings (!) but just as an FYI, TED's Chris Anderson is hosting a TED Talk with Bill Gates today at 12pm on Facebook.

 

 

 

Speaking of Bill Gates...

 

https://www.vox.com/recode/2020/3/24/21192638/coronavirus-bill-gates-trump-reopen-business

 

Bill Gates says we can’t restart the economy soon and simply “ignore that pile of bodies over in the corner”
 

Quote

“There really is no middle ground, and it’s very tough to say to people, ‘Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts,’” Gates said in an interview with TED Tuesday. “It’s very irresponsible for somebody to suggest that we can have the best of both worlds.”

 

“The economic effect of this is really dramatic. Nothing like this has ever happened to the economy in our lifetimes,” Gates said. “But bringing the economy back ... that’s more of a reversible thing than bringing people back to life...

 

“It’s disastrous for the economy,” Gates said. But “the sooner you do it in a tough way, the sooner you can undo it and go back to normal.”

 

[GaryPinC]

1 hour ago, Hapless Bills Fan said:

 

John,

Let's take this step by step.  Though the personalized breakdown and explanation of information that is already explained a couple of times upthread will not continue indefinitely.

 

1) R0 number is well known from flu.  R0 number can be calculated with good accuracy for covid-19 from data where contact tracing and testing of all contacts has been performed in China (as the crisis waned and testing became more widespread in Wuhan; outside Hubei province), in S. Korea, and in Singapore and Taiwan.  Not way skewed

2) Incubation time - again, well known at this point by contact tracing and quarantining or isolating people, and observing how long it takes them to become ill as well as by case histories asking patients "when did you first feel symptoms?".  Average of 5.6 days, range 1 - 14 for covid-19.  Not way skewed

3) Hospitalization rate - again, there are countries including China, or if you don't like their data S. Korea, Singapore, Taiwan, where a huge amount of testing and contact tracing has been done, so they know with a good degree of accuracy how many of the people who test positive, become ill enough to require hospitalization.  15% severely ill and 2-5% critically ill does not seem to be an overestimate.  It does seem to be affected by the age of the population, but it's not way skewed because many people <54 still require hospitalization (see @BillsFan4's post)

4) Case fatality rate - again, a lot of data.  In China outside Wuhan, where the disease didn't exceed capacity, the case fatality rate was 0.7-0.9%.  In countries where the health care system gets swamped, like Italy, it is currently running 9.8%. 

 

So if we want a realistic estimate for our situation if we don't continue measures to mitigate disease spread, and institute measures to contain disease once we relax social distancing constraints, I agree with you that 1-3.4% is a skewed number and that 9.8% case fatality rate as in Italy is likely to be closer to what we see.

 

 

 

 

 

It seems to me very important the fact that the flu statistics are taken from a full year's worth of stats of an endemic virus compared to a novel one which is only now spreading across the world and has not completely peaked.  It's why the comparisons make me bristle.  Let alone the extreme measures being taken to control covid-19 compared to the flu.

 

Hapless, thanks for doing all this and you are doing a yeoman's job at it.  Great info and discussion.  ? ?

[BillsFan4]

Another thread from Dr. Spencer. He’s a good follow on Twitter.

 

(once again click on tweet to see whole thread. I don’t know how to do that thread unroll thing)

 

wanted to to share this one:

 

“There’s been lots of young people put on life support”

 

 

that caught my eye.

Edited March 24, 2020 by BillsFan4

[BillsFan4]

 

[Jrb1979]

What upsets me more then anything else about what's going on is how much the government has to babysit us. If people would have followed what was suggested and did social distancing from the beginning and avoided crowds we wouldn't have had to resort to this. If people just stayed home except to go to work or get essentials we would have been better off. Of course people can't help themselves and have to go the beach or the bar. Too many of us didn't take this seriously including me, til they started closing things. 

[BillsFan4]

 

[BillsFan4]

 

[DrDawkinstein]

10 minutes ago, BillsFan4 said:

 

 

Yep, we're up to 32 deaths and over 1000 cases in GA. City has been shut down since last week. But Gov Kemp still giving indecisive messaging...

 

edit: with only 5000 tests done to date in GA.

Edited March 24, 2020 by DrDawkinstein

[Hapless Bills Fan]

a note of humor: