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

[MJS]

4 hours ago, BillsFan4 said:

That’s not the only difference though.

 

For example, another difference is the hospitalization rates that we’ve seen so far.

 

for H1N1, it looks like it was something like 22 per every 100,000 people.

From 2009-10  on h1n1 hospitalization rates: https://www.cdc.gov/H1N1flu/hosp_deaths_ahdra.htm

 

For covid-19 it’s something like 1 in every 5-7 people. So far, 15+% of people in all age groups 20 and over have needed hospitalization (closer to 15% for younger, and more like 30+% for older patients). If this keeps spreading at the rate it is right now, our hospitals aren’t going to be able to handle it and a lot more people are going to die because they can’t get the proper care. 

 

we never saw swine flu do what covid19 is doing in 1st world countries like Italy, Spain and the U.S.

 

Here’s quick chart showing some of the differences between influenza and covid-19:

 

 

Those are all things that we can't measure till afterward because we don't know how many actual cases there are. There is a bias to more severe cases because those people are seeking medical help, whereas those who aren't exhibiting severe symptoms likely are not, and even if they are they have not been given tests unless they have some connection to an existing case. So we don't know the true hospitalization rate and won't for quite some time.

[Sundancer]

The most frustrating thing here is that there is still no national plan in place for how long this lasts and how to come out of this. 

 

Even this would be ok to me:

 

1. We need to have this stockpile in place at hospitals: # ppe. # tests. # beds. 

 

2. We need this on hand as national stockpile to move as needed. # of this and that including ventilators. Also treatment drugs. 
 

3. We need quarantine centers set up in regions that have clear rules about intake and how to use them. 
 

4. We need testing centers separate from 1 and 3 with # tests. 
 

5. We need everyone to get on board with tracking contacts for a time and here’s our system for doing that. 
 

Once  we have 1-5, we will *start* to reopen the economy sector by sector while encouraging as much distancing as possible. 
 

There will be outbreaks. People will end up back in quarantine In clusters. But this is the plan to both reopen and stay on this. 
 

This has to be centralized and it needs to be out there soon so we know what the timing is. The above is the Korea plan. It’s not novel. 
 

Healthcare workers, the economy, patients. We all need this plan. If we just reopen in two weeks in a kind of free for all, the last few weeks bought us time only to do #1 and maybe a little of the others but not in an organized way so it was a sacrifice without much purpose. That would be tragic. This shutdown should be for a definitive reason with clear goals. 

Edited March 26, 2020 by Sundancer

[Pine Barrens Mafia]

[Halloween Land]

1 hour ago, Sundancer said:

The most frustrating thing here is that there is still no national plan in place for how long this lasts and how to come out of this. 

 

Even this would be ok to me:

 

1. We need to have this stockpile in place at hospitals: # ppe. # tests. # beds. 

 

2. We need this on hand as national stockpile to move as needed. # of this and that including ventilators. Also treatment drugs. 
 

3. We need quarantine centers set up in regions that have clear rules about intake and how to use them. 
 

4. We need testing centers separate from 1 and 3 with # tests. 
 

5. We need everyone to get on board with tracking contacts for a time and here’s our system for doing that. 
 

Once  we have 1-5, we will *start* to reopen the economy sector by sector while encouraging as much distancing as possible. 
 

There will be outbreaks. People will end up back in quarantine In clusters. But this is the plan to both reopen and stay on this. 
 

This has to be centralized and it needs to be out there soon so we know what the timing is. The above is the Korea plan. It’s not novel. 
 

Healthcare workers, the economy, patients. We all need this plan. If we just reopen in two weeks in a kind of free for all, the last few weeks bought us time only to do #1 and maybe a little of the others but not in an organized way so it was a sacrifice without much purpose. That would be tragic. This shutdown should be for a definitive reason with clear goals. 

This is the right plan, but it will be a long ongoing process to get there unfortunately. It seems that NY State is getting hit the most, meaning that it is entering it's peak. Meaning that we will be on the better side of it hopefully. 

[Sundancer]

33 minutes ago, Halloween Land said:

This is the right plan, but it will be a long ongoing process to get there unfortunately. It seems that NY State is getting hit the most, meaning that it is entering it's peak. Meaning that we will be on the better side of it hopefully. 

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

[K-9]

16 minutes ago, Sundancer said:

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

We have needed this national plan for over two months. If it hasn’t happened by now with all we know and see, I have no illusions it’s gonna happen at all. This is up to 50 governors to implement; 50 separate entities. 
 

Shameful.

[Cripple Creek]

Sorry if already posted.

 

ER Doc's quick account of his normal day.

https://threadreaderapp.com/thread/1242302400762908685.html

 

 

Evidence that we're working in a vacuum:

https://www.cnn.com/2020/03/25/politics/us-military-coronavirus-tests/index.html

Edited March 26, 2020 by Cripple Creek

[TigerJ]

11 hours ago, Doc Brown said:

Pry not.  I'm also hoping the warmer weather cities like LA and Miami don't see as wide of an outbreak.

The main way that warm weather affects the spread of disease is through human behavior changes.  In cold weather, people will tend to gather in groups in contained spaces.  Personal space increases out doors where there is so much more space available.  People need to understand that the virus doesn't automatically become less virulent because the temperature goes up.  Social  distancing and good hygiene are still critically important.

Edited March 26, 2020 by TigerJ

[Bob in Mich]

11 minutes ago, TigerJ said:

The main way that warm weather affects the spread of disease is through human behavior changes.  In cold weather, people will tend to gather in groups in contained spaces in cold weather.  Personal space increases out doors where there is so much more space available.  People need to understand that the virus doesn't automatically become less virulent because the temperature goes up.  Social  distancing and good hygiene are still critically important.

 

True, it is not the warmer weather so much as open windows and less time indoors close with others. 

 

Given those reasons though, I wonder about hot weather and using the AC.  On hot days, people go inside to the cooler temps....and they keep the windows shut to keep out the outside air.  Doesn't that sort of replicate the cold weather situation of crowding indoors?

[plenzmd1]

 

 

Interesting Twitter thread here...maybe some hope for optimism? I have no clue as the the veracity of the authors or SME

 

 

[Hapless Bills Fan]

10 hours ago, MJS said:

I think it's totally fine to take this seriously, but mark my words (and I'll own up to it if I'm wrong): this disease will pass with fewer cases and fewer deaths than the H1N1 (swine flu) did about a decade ago that infected more than 60 million Americans and killed over 12,000.

 

Part of that might be because of the extreme measures the country is taking. If so, good for us. We seem to have gotten the drop on this disease far quicker than we did with H1N1. But it makes me wonder why we didn't take such extreme measures then. Was it simply because it had already spread so much by the time we really knew about it and so there was no stopping it?

 

Well, some people are impossible to convince. 

 

Several things that make covid-19 more of a problem than H1N1 or any seasonal flu.

1) basic reproduction number - how many people get sick from contact with an infected person.  Flu, 1.3.  Covid-19, 2.0-2.4.  In terms of disease spread, that means about 45 people ill with flu for the same number of infection cycles that give ~500 Covid-19 patients.  H1N1 was a bit higher - 1.46-1.48, still way lower than covid-19

2) Incubation time for the disease - 3 days vs up to 14 days.  That means people who are sick, but don't know it yet, circulate in society and spread the disease

3) Higher morbidity, including in 20-54 age group: far larger number of people get seriously ill and require prolonged hospitalization or critical care. ~15-20%, hospitalized, 3-5% critical.   H1N1 estimate 0.4%  That's a key piece of information you're omitting about H1N1: 240,000 people hospitalized.

4) Higher mortality, maybe 1% (0.7-1.4) given widespread surveillance testing and contact tracing (China, Taiwan, S. Korea) and excellent hospital care that is not overwhelmed.  But because of the very high transmissivity and morbidity, the hospitals where it is unchecked ARE becoming overwhelmed.  In Italy, death rate running 10%.  Wuhan initially, >5%.

 

Here's my bottom line: doctor after doctor involved in outbreak areas are saying "this is not flu; we are seeing many more patients who are much sicker than with flu, and many of them are younger." 

 

I believe doctors.

 

1 hour ago, K-9 said:

We have needed this national plan for over two months. If it hasn’t happened by now with all we know and see, I have no illusions it’s gonna happen at all. This is up to 50 governors to implement; 50 separate entities. 
 

Shameful.

 

Yes.  And they are in a situation where they are bidding against each other (and the federal gov't) for critical supplies like N95 masks and throat swabs, and there appears to be no central planning and command and control effectively overseeing distribution of the National Stockpile and backup ventilators etc.

[Sundancer]

58 minutes ago, plenzmd1 said:

 

 

Interesting Twitter thread here...maybe some hope for optimism? I have no clue as the the veracity of the authors or SME

 

 

 

 I have been following the "1/2 to 2/3 of the UK already has it or already had it and got over it" movement.

 

I have a simple pin to prick that bubble: If half the UK had it or has it, why are we suddenly seeing an uptick in hospitalizations right now? Were all the other cases non-hospitalized cases? And now we are just seeing a random spike?  

 

Ferguson's actual remarks, by the way, suggest continued social distancing and increased testing to follow Korea's model. He is not saying that we are 2-3 weeks away from this being over as the Tweeter Berenson suggests.

 

I would LOOOOOOOVE to be wrong. 

Edited March 26, 2020 by Sundancer

[MJS]

30 minutes ago, Hapless Bills Fan said:

 

Well, some people are impossible to convince. 

 

Several things that make covid-19 more of a problem than H1N1 or any seasonal flu.

1) basic reproduction number - how many people get sick from contact with an infected person.  Flu, 1.3.  Covid-19, 2.0-2.4.  In terms of disease spread, that means about 45 people ill with flu for the same number of infection cycles that give ~500 Covid-19 patients.  H1N1 was a bit higher - 1.46-1.48, still way lower than covid-19

2) Incubation time for the disease - 3 days vs up to 14 days.  That means people who are sick, but don't know it yet, circulate in society and spread the disease

3) Higher morbidity, including in 20-54 age group: far larger number of people get seriously ill and require prolonged hospitalization or critical care. ~15-20%, hospitalized, 3-5% critical.   H1N1 estimate 0.4%  That's a key piece of information you're omitting about H1N1: 240,000 people hospitalized.

4) Higher mortality, maybe 1% (0.7-1.4) given widespread surveillance testing and contact tracing (China, Taiwan, S. Korea) and excellent hospital care that is not overwhelmed.  But because of the very high transmissivity and morbidity, the hospitals where it is unchecked ARE becoming overwhelmed.  In Italy, death rate running 10%.  Wuhan initially, >5%.

 

Here's my bottom line: doctor after doctor involved in outbreak areas are saying "this is not flu; we are seeing many more patients who are much sicker than with flu, and many of them are younger." 

 

I believe doctors.

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

I'm not saying that this disease is not serious or that the measures taken are not right. I'm saying most of the numbers quoted are not real because they are all based on a guess of the number of cases which can't actually be determined until after the outbreak is over. I've also seen that these things have been well overestimated in the past, and don't see a reason why this disease would be any different.

[Sundancer]

3 minutes ago, MJS said:

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

 

Let's stick with #3 (hospitalizations) for a moment. Setting aside that the exact % who require it may be unknown, which I agree with, we can all agree that letting this thing loose without distancing, testing, and quarantining will obliterate our health care workers and system. Even with distancing, it already is in places where it's gotten a little loose. 

Edited March 26, 2020 by Sundancer

[Hapless Bills Fan]

4 minutes ago, MJS said:

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

I'm not saying that this disease is not serious or that the measures taken are not right. I'm saying most of the numbers quoted are not real because they are all based on a guess of the number of cases which can't actually be determined until after the outbreak is over. I've also seen that these things have been well overestimated in the past, and don't see a reason why this disease would be any different.

 

Like I said, some people are impossible to convince.

 

Like I also said, and you cut: Doctor after doctor working in outbreak areas is saying "this is not like flu.  We are seeing many more people who are sicker, including healthy young people".

 

I believe doctors when they tell me what they're seeing.  This ain't their first rodeo.

 

Find me evidence that any flu epidemic since 1918 had a country-wide, during outbeak, case fatality rate of 10% during the epidemic (Italy now).  You're correct that the true numbers will only be known when the dust settles, but in the meantime look at the numbers we have.  Find me evidence that any flu epidemic since 1918, had a world wide case fatality rate of 4.5% during the epidemic - regardless of those numbers changing afterwards.

 

How does the fact that things are overestimated in the past, and will change, vitiate what the data in front of you says?  Nevermind.  I know.  Some people are impossible to convince.

 

 

[MJS]

6 minutes ago, Hapless Bills Fan said:

 

Like I said, some people are impossible to convince.

 

Like I also said, and you cut: Doctor after doctor working in outbreak areas is saying "this is not like flu.  We are seeing many more people who are sicker, including healthy young people".

 

I believe doctors when they tell me what they're seeing.  This ain't their first rodeo.

 

Find me evidence that any flu epidemic since 1918 had a country-wide, during outbeak, case fatality rate of 10% during the epidemic (Italy now).  You're correct that the true numbers will only be known when the dust settles, but in the meantime look at the numbers we have.  Find me evidence that any flu epidemic since 1918, had a world wide case fatality rate of 4.5% during the epidemic - regardless of those numbers changing afterwards.

 

How does the fact that things are overestimated in the past, and will change, vitiate what the data in front of you says?  Nevermind.  I know.  Some people are impossible to convince.

Convince of what, exactly? And I made no claim that Coronavirus is anything like the flu. I used H1N1 as an example of a disease that, while it was still happening, experts estimated an impact that was much higher than reality. Their projections were incorrect. What exactly are you thinking I need to be convinced of?

15 minutes ago, Sundancer said:

 

Let's stick with #3 (hospitalizations) for a moment. Setting aside that the exact % who require it may be unknown, which I agree with, we can all agree that letting this thing loose without distancing, testing, and quarantining will obliterate our health care workers and system. Even with distancing, it already is in places where it's gotten a little loose. 

 

I agree with that completely. I think these are smart measures to take and part of me wonders if these measures were taken with past pandemics if there would have been fewer cases and fewer deaths.

[Hapless Bills Fan]

3 hours ago, Sundancer said:

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

 

Yes.  We are at least 3 weeks short of peak in NYC, and that is if:

1) everyone there is doing what they're supposed to do

2) we don't see a surge of HCW working with insufficient PPE falling ill

 

[Cripple Creek]

Latest from Italy, 5210 new cases yesterday.

 

https://www.statista.com/chart/21099/coronavirus-in-italy/

 

Spain 5553 confirmed new cases yesterday.

 

https://www.statista.com/chart/21195/coronavirus-in-spain/

 

 

What Americans are worried about:

 

https://www.statista.com/chart/21193/worries-of-americans-covid-19/

Edited March 26, 2020 by Cripple Creek

[Hapless Bills Fan]

6 minutes ago, Cripple Creek said:

What Americans are worried about:

https://www.statista.com/chart/21193/worries-of-americans-covid-19/

 

I'm surprised only 30% are worried about having to go to work while sick.

 

A lot of people are rightly worried about the impact on their financial situation; I wonder if some of our leaders translate that to "therefore they all want to go back to work ASAP"?  Most of the small business owners I've been in contact with are scared of the impact on their businesses and sick about the impact on their employees, but they don't want to reopen because then they're scared about their employees getting sick or about spreading illness.  They recognize it's a "damned if you do, damned if you don't" situation.

[BillsFan4]