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Message added by Hapless Bills Fan

[This is a general message.  If you see it, please don't take it personally]

 

Now that we’re READY FOR SOME FOOTBALL, We are trying to return to a FOCUS ON FOOTBALL at Two Bills Drive

 

Because people have indicated they find this thread a useful resource, we’ve decided to leave it here but lock it.

 

I will continue to curate.  If you find updated info you’d like to include, please PM me.   If it comes from a source rated “low” for factual and “extreme” for bias, it probably won’t make it out of my PM box unless I can find a more reliable source for it (I will search)

As I have time, I will probably tighten the focus on sourced, verifiable info and prune outdated stuff, to make it easier to find.

 

GO BILLS!

 

 

 

 

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Posted (edited)

Can I post this Dr. here:

 

 

 

He explains the mechanics of what happens... Not exactlty family hour, few swear words... But its down to earth. Informative... He shoots from the hip.

 

If I needed bariatric surgery... I'd want this guy! LoL..

 

 

Edited by ExiledInIllinois
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Posted

Dr. Anthony Fauci said on Tuesday that the US is starting to see "glimmers" that social distancing is having a dampening effect on the spread of the coronavirus. 

 

Fauci said that while people who survive the virus are likely to be immune, there won't be enough of them to provide "herd immunity" to prevent community spread. 

 

The US "will be much, much better prepared than we are right now" if the second wave of the virus comes again later this year. 

 

https://www.yahoo.com/news/top-infectious-disease-expert-us-151255400.html

Posted
7 hours ago, thebandit27 said:

 

Short answer: probably something to it.  Every pharma company in the USA probably has something similar, but note this in text:

What is the next step?

We are sending [the antibodies] to the military for confirmation testing and to Charles River Laboratories for safety and tox characterization. We’ve partnered with two different companies that will help us scale up large batches of the antibody for production. We're in discussions to start human phase one/two trials that would happen at the end of the summer.  Pending good results - [if] we see the drug is safe and helpful means we could start releasing it for compassionate use in September.

would be late summer.

OK so what this chap is talking about, is making a human antibody that has been specifically designed to bind tightly to the virus, neutralize it and keep it from entering cells, and flag it for "trash removal services" by the human immune system. Making a monoclonal antibody is a standard tool for new pharmaceutical candidates, these days, and you CAN safely bet the rent that every pharma company in the US is doing likewise.  (When I used to work for one of them, part of this development process was literally one of my lanes.)  Our standard timeline then for binding assays to clinical trials was 8 months.  Why so long?  Well, the slowest step is that the antibodies are made by mammalian cells - usually Chinese Hamster Ovary or CHO cells - which take 24 hrs to double if you watch 'em, and 24 hrs to double if you don't.  So a lot of the time is just waiting to grow enough cells to spit out enough antibody so that you can purify it and start doing toxicology studies in animals and then safety studies in people.  If you make it a top priority, might be able to knock a month or 6 weeks off by overlapping some things that are ordinarily done sequentially.

 

What this company has done that shortens the timeline to where he's saying maybe 4 months, is that they had pre-existing anti-SARS monclonal antibody drug candidates and they've tested them to see if any of them work against covid-19 in vitro, in the test tube, and found that they do.   Depending upon what they did with them before, they may already have a CHO cell line able to spit the antibodies out and a cell bank of little vials from which they can grow up bioreactors full of the stuff.  That would lop off a couple of months, 2 or 3.  I think he may be a tad over-optimistic and he's likely talking 6 months with supply chain burbles and so forth.

But keep in mind, when he proudly announces "potential cure", he's once again talking about something that works in a test tube, and has never been tested for safety in people or shown to treat patients.

Posted
1 minute ago, Hapless Bills Fan said:

OK, needs to be shared but, please bear in mind this does NOT mean drinking water is or will be contaminated.  Waste water normally has all kinds of viruses and bacteria in it that get chemically treated to kill them then removed by filtration

 

https://www.bloomberg.com/news/articles/2020-03-31/coronavirus-in-sewage-portended-covid-19-outbreak-in-dutch-city

 

"Dutch scientists were able to find the coronavirus in a city’s wastewater before Covid-19 cases were reported, demonstrating a novel early warning system for the pneumonia-causing disease.  ....The so-called SARS-CoV-2 coronavirus is often excreted in an infected person’s stool. Although it’s unlikely that sewage will become an important route of transmission, the pathogen’s increasing circulation in communities will increase the amount of it flowing into sewer systems, Gertjan Medema and colleagues at the KWR Water Research Institute in Nieuwegein said on Monday....They detected genetic material from the coronavirus at a wastewater treatment plant in Amersfoort on March 5, before any cases had been reported in the city, located about 50 kilometers (32 miles) southeast of Amsterdam."

This would actually be a pretty test-effective screening tool for public health officials in anyplace without a known covid-19 outbreak and with a municipal wastewater system.  If you find the virus in the wastewater, then you KNOW it's in the community and social distancing precautions MUST be taken, as well as putting a push on to ask anyone with fever or other symptoms to stay home and perhaps get them testing and isolate their contacts. (if you don't find it, doesn't prove it is not there, might be below detection limits)

 


Now this one I can speak to...currently the only concern is leakage from septic tanks into an active aquifer.

 

NY State issued an order to start WW disinfection season now, so at most you’re looking at year-round disinfection as opposed to the typical April-October or May-November season.

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Posted

A couple of good videos

 

Not sure how well the first will work - might need a Facebook account?

Really good interview with Dr Sam Fink, MD.  He treated one of the first covid-19 disease clusters in LA: a group of 13 returning from a ski trip in Northern Italy

-13/13 became ill

-4/13 wound up in ICU

-3 of the 4 ICU patients were previously healthy YOUNG people with no pre-existing conditions.

He said right away when he saw that cluster of patients "this is really different".  Why?  Usually with flu, not THAT contagious - not 100% group infected; not THAT serious - not 1/4 of infected group require ICU and of those, most of them are previously healthy young people.

-Straight talk about maintaining the need for physical distancing over the next 2-3 months.

-Talks about IgM and IgG response, developing immunity

-Talks about serology vs RT-PCR testing and their different uses - need to find out if someone with RT-PCR positive is still infectious

-Testing results still being delayed - 10 days!!!! hoping to get down to 48-72 hrs

-Talks about caution with testing,  China false negative 30%, US believed 10% negative rate from RT-PCR testing, "false sense of security"

-Miss 1 out of 10 people - that's a huge number!!!!!!

-Is it necessary to disinfect groceries etc?  No proven transmission by that means, don't be crazy but extra precautions can't hurt.

-Masks - supplies must go to protect HCW first but if you have a mask, USE IT.  When he goes out, he wears a mask.  "I'm going with S. Korea on this"

-He does NOT trust numbers from China, Vietnam, Iran (communist and totalitarian states), their first priority is to protect the government.  Trusts numbers from S. Korea, Japan, Singapore etc.

 

Looooooong video from Dr David Fink of Weill Cornell Medical Center

Apologies to whomever posted this originally from Fox, which was generating some controversy, I'd like to credit you but don't remember who it was

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Posted

Comment from an epidemiologist on the effect of small breaches in social distancing.  Emphasis mine.
_______________________________________________________________________________________________________

 

A Short Explanation by Jonathan Smith, Yale University

Hey everybody, as an infectious disease epidemiologist (although a lowly one), at this point I feel morally obligated to provide some information on what we are seeing from a transmission dynamic perspective and how they apply to the social distancing measures. Like any good scientist I have noticed two things that are either not articulated or not present in the “literature” of social media.

Specifically, I want to make two aspects of these measures very clear and unambiguous.

First, we are in the very infancy of this epidemic’s trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn’t have to. This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. You will feel discouraged. You should. This is normal in chaos. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying around you. You may feel like giving in. Don’t.

Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with. This sounds silly, it’s not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain.

In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they about societies working in unison. These measures also take a long time to see the results. It is hard (even for me) to conceptualize how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

Until we get a viable vaccine, this unprecedented outbreak will not be overcome in a grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months. This virus is unforgiving to unwise choices. My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn’t working and become paralyzed by fear, or to ‘cheat’ a little bit in the coming weeks. By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty

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Posted

Bill Gates gets it.  Key point he misses, assuring supplies of PPE and other needed medical supplies by:

1) immediately blocking all overseas sales and shipments

2) invoking DPA to allow federal government to set price caps and using Defense Logistics Agency to manage distribution

 

https://www.washingtonpost.com/opinions/bill-gates-heres-how-to-make-up-for-lost-time-on-covid-19/2020/03/31/ab5c3cf2-738c-11ea-85cb-8670579b863d_story.html

 

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Posted

How to “coronavirus-proof” your home:

 

https://www.cnn.com/interactive/2020/03/health/coronavirus-tipsheets/coronavirus-proof-your-home/index.html

 

Quote

Make a game plan

  • Designate one person to be your errand-runner to limit your outside exposures
  • Set up a disinfecting station — an area outside your home or in a room with low foot traffic where you can disinfect packaged food

 When you’re out

  • Avoid coming within less than six feet of others
  • Wipe handles on carts or baskets while shopping
  • wash your hands frequently while you’re out and avoid touching your face 
  • (I would add: use InstaCart or other services offered by stores. Walmart is offering free home delivery. Tops offers InstaCart. Avoid going in the store if possible)

 When you get back

  • Wash your hands with soap and water for (at least a minimum of) 20 seconds (use surgical scrubbing technique or similar making sure you wash thoroughly)
  • Disinfect takeout boxes and packaged foods at your disinfecting station
  • Thoroughly wash produce before putting it in your kitchen

 Disinfect

  • Disinfect everything you touch — doorknobs, light switches, keys, phone, keyboards, remotes, etc.
  • Use EPA-approved disinfectants (these include Clorox Disinfecting Wipes and certain Lysol sprays) and leave surfaces wet for 3-5 minutes

 Delivery

  • Ask workers to drop deliveries off on your doorstep or an area of your complex
  • If they need you to come to the door, keep six feet of distance (if signing for a package, I ask them to leave clipboard, step back and then I use my own pen to sign. No face to face contact)
  • Pay and tip online when possible
  • After you pick up mail from your mailbox, wash your hands (I also leave mail in a bag for 24hrs after retrieving it from the mailbox before reading, just to be safe)

 Laundry

  • Wash clothes, towels and linens regularly on the warmest setting
  • Disinfect your laundry hamper, too, or place a removable liner inside it
  • Don’t shake dirty laundry to avoid dispersing the virus in the air

 Guests

  • You shouldn’t allow guests over right now (you know what precautions you’re taking. You Don’t know what precautions others are. Even those that say they’re taking it serious may not be. Their idea of “taking it serious” could be much different than yours)
  • If you need to house a family member or friend, avoid shared living spaces as much as you can
  • If they need to enter shared living spaces, ask them to keep six feet of distance 
  • (I’d add: wipe down/disinfect any shared surfaces frequently)

 If someone in your home gets sick

  • First, consult your doctor
  • Isolate them in another room and ask them to use a separate restroom
  • Disinfect frequently touched surfaces every day 
  • Avoid sharing items with them 
  • Wear gloves when washing their laundry
  • Continue to wash your hands frequently
  • Ask them to wear a face mask if they have one

 Supplies you’ll need

  • EPA-approved disinfectants
  • If you don’t have disinfectants, make a bleach solution:
    • Mix four teaspoons bleach per quart of water; or
    • Use a 70% alcohol solution
  • Laundry detergent
  • Trash bags 
  • Prescription medicines (you can mail order these) (I’d add: or use free delivery where available. Just ask delivery driver to step back when signing for meds, use your own pen then wash hands) 
  • Canned foods — fruits, veggies, beans
  • Dry goods — breads, pastas, nut butters
  • Frozen foods — meats, veggies, fruits
  • (I would add: disposable gloves, if available)

 Pets

  • Supervise your pet in your backyard
  • It’s OK to play with them outside — just keep your distance from other humans
  • If you’re sick, ask someone you live with to take care of them while you recover
  • If you must care for them while you’re sick, wash your hands frequently

I thought this was a pretty good list. I added the stuff in the parentheses+italics

Posted (edited)

This NYT site has really good numbers by state and county (with a click cases per 100K). The disparity between NYC and anywhere but the populous Italy Lombardy region is striking. 40% of America’s fatalities so far are in NYC. 
 

https://www.nytimes.com/interactive/2020/us/new-york-coronavirus-cases.html

 

It is too early to say if other big cities are lagging in time and will spike or if they are just different but PA was an early outbreak center and its deaths per day has been steady around 12 for 5 days running compared to NYC at 400 yesterday (Pa shut down a week before NY). 

 

NYC: 1374 (a few hundred more in nearest burbs)

Philadelphia: 74 (Tens more in nearest burbs)

Seattle: 166 (first major outbreak)

SF: 7

LA: 65

Miami: 11

Chicago: 95 (Tens more in nearest burbs)

Boston: 13

Edited by Sundancer
Posted

I'm intimately familiar with both companies. Great partnership.

 

FRANKLIN LAKES, N.J. MORRISVILLE, N.C., March 31, 2020 /PRNewswire/ -- BD (Becton, Dickinson and Company) (NYSE: BDX), a leading global medical technology company, and BioMedomics, a privately held, North Carolina-based clinical diagnostics company, today announced the release of a new point-of-care test that can detect antibodies in blood to confirm current or past exposure to COVID-19 in as little as 15 minutes.

Covid_Biomedomics_4steps-3.jpg
BD BioMedomics COVID-19 Test Procedures
BD, BioMedomics announce the launch of a rapid serology test to detect exposure to COVID-19 at the point of care in 15 minutes. The test is completed in four, simple steps and will be available in April.

The new test, developed and manufactured by BioMedomics, will be available through BD and distributed exclusively by Henry Schein, Inc. to health care providers throughout the United States.

 

 

https://www.bd.com/en-us/company/news-and-media/press-releases/bd-biomedomics-announce-launch-of-rapid-serology-test-to-detect-exposure-to-covid-19

[Edit: this test is one of those described upthread as utilized widely in China and seeking FDA EUA in US, so Good that they've received permission to use it in USA.  There is another company in CA, Bodysphere, that has just received FDA EUA for their test (it is a lateral flow immunoassay, also reacts with both IgM and IgG, 2-10 min)
http://mybodysphere.com/sars2covid19.html

https://www.businesswire.com/news/home/20200331005420/en/FDA-Authorizes-New-Two-Minute-Serological-Test-Kit

 

To all, bear in mind the double-edged sword of serology testing:

-It will react if you are far enough into an infection, usually 7-14 days, to produce antibodies against it.  You can be infected and either not yet producing antibodies, or not producing enough to detect, so a negative test doesn't mean you're disease-free. 

-It also can't tell you if you're still INFECTIOUS - you could feel great (asymptomatic) or be recovered physically, but still be shedding virus from your nose and digestive track, and potentially able to infect others.]

-What it can do is identify people who have had the disease, and are therefore at low risk for infection and also able to donate plasma to treat others

 

 

 

 

 

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Posted (edited)

Interesting graph presented by the White House. I'm sure we are somewhere in between the two extremes as far as our level of intervention is concerned

 

COVID-19-projections-graph-WH-1200x675.j

 

[Edit: please see up-thread for similar graph without numbers.  The numbers in this graph appear to be based upon a model produced by the University of Washington's Institute for Health Metrics and Evaluation (IHME) which was requested to provide a model to the government.  Some key assumptions of this model are described in this news report:
-The president's guidelines are not what makes the difference because the president's recommendations are not binding. In states where governors haven't imposed strict social distancing rules of their own, it's not clear to what extent people are following the White House call to stay home as much as possible

-Governors who haven't issued statewide social distancing rules will do so in a week (that's a week from the original announcement of extended guidelines)

-States will keep the social distancing rules in place through June 1  By contrast, Trump's presidential guidelines apply through April 30 only.

-Technically, not an assumption of the model but a prediction:  If and when the current wave of infections is suppressed, the U.S. will remain vulnerable.  "Our rough guess is that come June, at least 95% of the U.S. will still be susceptible," says IHME's Murray. "That means, of course, it can come right back. And so then we really need to have a robust strategy in place to not have a second wave."]

Please note that the other Covid-19 thread is at your service for your opinions and discussion.  Posts from this thread may be linked in as a starting point.  Thanks!!!

Edited by Hapless Bills Fan
remove personal opining
Posted (edited)

Information on the therapeutic front.

 

https://www.drugtargetreview.com/news/58838/fda-and-barda-to-collaborate-with-grifols-on-covid-19-therapeutics/

 

"Grifols stated that it will use its network of FDA-approved plasma donor centres to test and qualify donors and collect their plasma; then process the plasma into hyperimmune globulin at its purpose-built facility in Clayton, North Carolina, US, and support pre-clinical and clinical studies to determine whether hyperimmune globulin made from the plasma of convalescent donors could be viable treatment for COVID-19 disease and as a platform for the treatment of future emerging infectious diseases."

Edit: Convalescent plasma is old therapy, but probably the surest-bet to work on severe cases.

Edited by Hapless Bills Fan
insert quote
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Posted
13 hours ago, Hapless Bills Fan said:

Not covid-19 per se, but if this is a factual guide to Federal programs helping small businesses, it deserves as broad distribution as can be.

If anyone has a better, I'll delete this and replace it with yours

 

https://www.schatz.senate.gov/press-releases/schatz-releases-coronavirus-federal-resource-guide-to-help-hawaii-small-businesses-access-new-funding-programs

the actual SBA website  https://www.sba.gov/funding-programs/disaster-assistance

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Posted (edited)

More about blood pressure medicines and covid-19.  DO NOT stop taking BP meds if you're on them except under an MD's advice!!!!!!!!  No hard evidence they harm; they may help.

NE Journal of Medicine article and Fig 1 from that source.

https://www.nejm.org/doi/full/10.1056/NEJMsr2005760

image.thumb.png.6363b0b799a5eb37471caeca88c7c4d5.png

 

The blood pressure medicine Losartan is going to have clinical trials to see if it can reduce the severity of mild/moderate covid-19 infections:

https://www.startribune.com/university-of-minnesota-to-test-three-drugs-for-covid-patients/568766632/?refresh=true

"The second randomized trial will test the high blood pressure drug losartan on patients who test positive for the virus but whose symptoms are mild enough that they’re told to go home and recover instead of going to the hospital, Tolar said.

Some doctors theorize that the use of losartan will reduce how aggressive and deadly a COVID-19 infection is, by disrupting how the virus binds to the body at the molecular level."
 

6 hours ago, Nervous Guy said:

I've been following these studies for a few weeks since I take telmisartan, another ACE antagonist.  Intuitively, they may work...or make it worse,  I'll chose to be optimistic.  Incidentally, while both ACE inhibitors and ACE antagonists have excellent efficacy in treating high blood pressure, ACE inhibitors have a common side effect of a dry cough, ACE antagonists don't...coincidence or not?

https://onlinelibrary.wiley.com/doi/full/10.1002/ddr.21656

 

1 hour ago, OldTimeAFLGuy said:

...interesting and thank you for sharing friend....I'm on Lisinopril which is shown as another ACE antagonist....will follow you updates closely.....:thumbsup:

Edited by Hapless Bills Fan
add follow-ups from others
Posted (edited)

Hapless posted about the BCG vaccine before (the vaccine for TB). Sounds like there is some correlation between countries that still give it and lower infection rates of CV-19. 

 

Something to keep watching. I do keep wondering why the cases in India are not just exploding. 

 

https://www.bloomberg.com/news/articles/2020-04-02/fewer-coronavirus-deaths-seen-in-countries-that-mandate-tb-vaccine

Quote

 

The preliminary study posted on medRxiv, a site for unpublished medical research, finds a correlation between countries that require citizens to get the bacillus Calmette-Guerin (BCG) vaccine and those showing fewer number of confirmed cases and deaths from Covid-19. Though only a correlation, clinicians in at least six countries are running trials that involve giving frontline health workers and elderly people the BCG vaccine to see whether it can indeed provide some level of protection against the new coronavirus.

 

Gonzalo Otazu, assistant professor at the New York Institute of Technology and lead author of the study, started working on the analysis after noticing the low number of cases in Japan. The country had reported some of the earliest confirmed cases of coronavirus outside of China and it hadn’t instituted lockdown measures like so many other countries have done.

 

Otazu said he knew about studies showing the BCG vaccine provided protection against not just tuberculosis bacteria but also other types of contagions. So his team put together the data on what countries had universal BCG vaccine policies and when they were put in place. They then compared the number of confirmed cases and deaths from Covid-19 to find a strong correlation.

 

 

 

Here is Hapless's post. 

 

 

[Edit: Interesting find, Sundancer.  It seems worth pointing out that many of the countries with high BCG vaccination rates and early covid-19 exposure so that we get a better feel for how the epidemic is progressing there (eg Singapore, Taiwan, S. Korea, Japan) are also countries that have a strong tradition of public mask-wearing, and which advised citizens to wear masks early on in the outbreak.   There's the old "correlation is not causation" thing. 

Here's the actual article in .pdf form: https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1.full.pdf
Here's the data on which countries have BCG vaccination policies: http://www.bcgatlas.org/

Keep in mind the disease originated and had quite a play in China, which does have mandatory BCG vaccination, and that Spain (stopped 1981), UK (stopped 2005) and France (stopped 2007) are quite hard-hit.  But certainly Italy and the US have never had widespread BCG vaccination.
image.thumb.png.46c78dcc2a7943046560851a0c680038.png

India really doesn't have much in the way of testing and not necessarily much in the way of public health tracking and data collection, either.  I'm not sure what's going on.  If the "warm weather stops it" theory is correct, that might be in play. Or it might be simmering and have not blown up yet.]

Edited by Hapless Bills Fan
add links to article and BCG vaccination data
Posted (edited)

Really good resource for metro data in the US

 

https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-metro-area-tracker.html?action=click&module=Spotlight&pgtype=Homepage
 

I will discuss this in the discussion thread when I have time. Looks like Detroit, Atlanta, and NO are the places to watch now. 

[Edit: promising that NY cases have gone from doubling every 6 days to doubling every 3, but I wish I felt confident that isn't an artifact of inadequate testing.  Deaths, on the other hand, are on the "doubling every 3 days" trajectory]

Edited by Hapless Bills Fan
comment on NYC trajectory
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