COVID-19 - Facts and Information Only Topic

[Hapless Bills Fan]

 

 

 

https://public.flourish.studio/visualisation/1812248/?fbclid=IwAR0MeiOoCAZc1hAEOxEu3P_oiVn0PsXbCUcsTRgEA0teZrFXYmA-ooO8fJo

 

This is a very vivid presentation.  I wish I could figure out how to paste it so it would play in here. 

For anyone who thinks this is overblown, please click on the link above.  For anyone who doesn't want to watch the visualization, beginning and end below.

March 15:

 

 

April 8:

[Hapless Bills Fan]

https://www.washingtonpost.com/nation/2020/04/05/youre-basically-right-next-nuclear-reactor/?arc404=true

 

Account of an anesthesiologist intubating patients in the ICU

Our team had a meeting on March 16th to figure out a staffing plan, once it was clear where this was going. Chicago’s becoming a hot spot now. Our ICU is almost full with covid patients. The pediatric ICU has been cleared out to handle overflow. The wave is just starting, and we need to limit our exposure or we’re going to run out of staff. Everyone basically agreed we should dedicate one person to covid intubations during the day and another at night, and I started thinking: I’m 33 years old. I don’t have any kids at home. I don’t live with older relatives. About an hour after the meeting, I emailed my supervisor. “I’m happy to do this. It should be me.”

Now my pager goes off throughout the night. Nine o’clock, midnight, 2, then again at 3:30. Most of the time I do several airways in a shift. By next week or the week after that, they’re saying it could be 10.

[ExiledInIllinois]

Just don't inhale your food... Very informative on how coronavirus is spread:

 

https://www.npr.org/sections/health-shots/2020/04/08/822903487/how-safe-is-it-to-eat-take-out

 

"Infectious disease and food safety experts we spoke to say they base their determination that takeout food is safe on decades of research on other coronaviruses, which were first identified in humans in the 1960s."

 

"While COVID-19 is new to us, coronaviruses are not, and with all the studies done on these viruses, there has never been any information to implicate food-borne transmission," says Dr. William Schaffner, a professor of medicine in the department of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tenn. ..."

[Sundancer]

Hapless has been quoting a geneticist (Bedford, also quoted often in this piece)  early in this thread. Turns out that most of the CV-19 cases we have here came from European travelers, according to two separate studies. 
 

https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html

 

A travel ban for Europe in Jan would have made a big difference but we didn’t know Europe was ahead of us by a few weeks. Amazing science here. 

Edited April 9, 2020 by Sundancer

[thebandit27]

Seems that Fauci is agreeing with the lower estimate from WSU’s model:

 

 

 

Which would be relatively excellent news

Edit: it would be good news, but note several caveats

1) The model ASSUMES CURRENT STAY AT HOME AND OTHER SOCIAL DISTANCING MEASURES REMAIN IN PLACE THROUGH MAY
2) Here is a figure from the website with the model.  Click to embiggen.   The shaded area represents the 95% confidence intervals in the model.  Note the substantial uncertainty.

Edited April 10, 2020 by Hapless Bills Fan
edited to add more info about model

[Hapless Bills Fan]

5 hours ago, ExiledInIllinois said:

Just don't inhale your food... Very informative on how coronavirus is spread:

 

https://www.npr.org/sections/health-shots/2020/04/08/822903487/how-safe-is-it-to-eat-take-out

 

"Infectious disease and food safety experts we spoke to say they base their determination that takeout food is safe on decades of research on other coronaviruses, which were first identified in humans in the 1960s."

 

"While COVID-19 is new to us, coronaviruses are not, and with all the studies done on these viruses, there has never been any information to implicate food-borne transmission," says Dr. William Schaffner, a professor of medicine in the department of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tenn. ..."

 

So one question to ask is: with all those other coronaviruses, do they enter cells through the same mechanism?  My understanding is no except for....

.....SARS-CoV, the virus that caused SARS, was thought to have spread in part through fecal-oral transmission...and it binds to ACE2.

 

-They are finding SARS-CoV-2 RNA in fecal samples.  Whether it is live virus capable of causing covid-19, is another question.

-Coronaviruses are typically acid-stable, which is why it is advised not to use vinegar as a disinfectant

-Sars-CoV2 is thought to bind to ACE2 as well

-There are a lot of ACE2 receptors in intestines

 

Yes, food workers should be safe, practice good hygiene, and not come to work when ill.  But they don't, always.

This sort of piece just bothers me.  The restaurant industry is getting killed, and I understand wanting to help it, but while there isn't evidence of food-borne transmission, there are a buttload of cases where the source of the disease is listed as "under investigation" or "unknown".

3 hours ago, Sundancer said:

Hapless has been quoting a geneticist (Bedford, also quoted often in this piece)  early in this thread. Turns out that most of the CV-19 cases we have here came from European travelers, according to two separate studies. 
 

https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html

 

A travel ban for Europe in Jan would have made a big difference but we didn’t know Europe was ahead of us by a few weeks. Amazing science here. 

 

It's linked in the article, but go here

https://www.gisaid.org/epiflu-applications/next-hcov-19-app/

scroll down, and hit "play"

[Hapless Bills Fan]

PSA: here is a link to a national project, asking people to self- report symptoms from various locations.  They are trying to get a handle on how many people staying at home have had symptoms that might be covid-19.   They send you daily reminders to report in, but you can opt out.

 

https://med.stanford.edu/covid19/covid-counter.html

If you have recovered from covid-19, consider becoming a plasma donor to help others fight the disease.  Here is a website:

https://ccpp19.org/donors/index.html

 

Here is an article about this:

https://www.usatoday.com/story/news/health/2020/04/01/coronavirus-plasma-therapy-5-us-patients-covid-19-donors/5090946002/

 

If you believe you have had covid-19 symptoms after mid- January, contact your doctor or your local covid-19 information phone number and ask if it would be possible for you to get a serology or antibody test to see if you've had covid-19, so that you may donate plasma if you qualify.

 

[Hapless Bills Fan]

Covid-19 and your heart

 

https://www.livescience.com/how-coronavirus-affects-heart.html

[K-9]

This Ohio PSA is one of the best depictions of the importance of social distancing I’ve seen. Very clever. 
 

 

 

 

 

 

[Hapless Bills Fan]

More on chloroquine.  If you wish to discuss, I ask that you copy the link to this post and discuss in the discussion thread, Please.

If you ask questions here, I'll quote your post and paste in the best answer I can find for you into this post.

 

I've followed this blogger, Derek Lowe, for years.  He knows his drug discovery/development stuff. 

Here's his assessment of two small, controlled studies on chloroquine out of China.

 

https://blogs.sciencemag.org/pipeline/archives/2020/03/31/comparing-chloroquine-trials

 

 

Bottom line: one study showed no effect.  One showed what appears to be a real effect. 

Neither showed the amazing miracle cure French doctor stuff. 

The best effect was 1 day difference in fever,  a nice effect on pneumonia assessed by CT scan.   PCR testing was not repeated in the study that showed an effect.

 

He notes:

(Both studies) excluded patients with any sort of cardiac arrhythmias, a wise precaution since one of the most acute worries with high doses of hydroxychloroquine is QT-interval prolongation, and you don’t want to do that to anyone with any underlying problems. So as long as such patients are excluded, for now hydroxychloroquine is in the “might do nothing, might do some good” category, which under the current conditions seems sufficient for treating patients, pending further data. You will notice that we are not exactly in the “total cure” category that the Marseilles group has been putting itself in, but frankly, these results from China are more like what I expect from the clinic (at best!) when using a repurposed drug against such a pathogen.

And also sounds a note of caution:

As Leonid Schneider has commented on PubPeer, the original trial as registered in China looks quite different from what we see here. Update: see this comment as well. The design was for 100 control patients, another 100 patients to receive one dose of hydroxychloroquine, and 100 more to receive a higher dose. What we have, though, are only two groups of 31 patients each, which suggests that there were problems with the inclusion criteria for the trial and/or with patient recruitment. The trial design also called for endpoints of negative results for viral RNA, and for “T cell recovery time”, to be collected by sputum and throat swabs and by blood samples, respectively, and none of this shows up in the preprint at all.
 

Now, it may be that the 100-patient size numbers were in there as a placeholder and meant “Up to this many depending on how many people we can enroll”. But the endpoints and sample collections seem to have changed pretty thoroughly, and it would be good to know more about that, why these decisions were made, whether any of these data were collected and what they were like. So my opinion of this latest study is “cautious approval”, and that probably sums up my feelings about hydroxychloroquine as a therapy in the Covid-19 epidemic in general. It’s a long way from “This is the cure and it’s unethical to disagree”, that’s for sure. More data will be coming, and we’ll revisit the topic then.

 

 

[Hapless Bills Fan]

OK, from the same source, blogger Derek Lowe, on hydroxychloroquine/azythromycin.  He does a nice job assessing a new French study and discussing clinical trials, effect size, and so forth.

 

First up, the study itself.  The title is "No  Evidence  of  Rapid  Antiviral  Clearance  or  Clinical  Benefit  with  the  Combination  of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection" and that pretty well sums it up.  "we  wished  to  assess  in  a prospective  study  virologic  and  clinical  outcomes  of  11  consecutive  patients  hospitalized  in our department who received hydroxychloroquine (600 mg/d for 10 days) and azithromycin (500 mg Day 1 and 250 mg days 2 to 5) using the same dosing regimen reported by Gautret et al. (3). ......At the time of treatment initiation, 10/11 had fever and received nasal oxygen therapy. Within 5 days, one patient died, two were transferred to the ICU. In one patient, hydroxychloroquine and azithromycin were discontinued after 4 days because of a prolongation of the QT interval from  405  ms  before  treatment  to  460  and  470  ms  under  the  combination.

 

Repeated  nasopharyngeal  swabs  in  10  patients  (not  done  in the  patient  who  died)  using  a qualitative  PCR  assay  (nucleic  acid  extraction  using  Nuclisens  Easy  Mag®,  Biomerieux  and amplification  with  RealStar  SARS  CoV-2®,  Altona),  were  still  positive  for  SARS-CoV2  RNA  in 8/10 patients (80%, 95% confidence interval: 49-94) at days 5 to 6 after treatment initiation.  These virologic results stand in contrast with those reported by Gautret et al. and cast doubts about the strong antiviral efficacy of this combination.

Furthermore, in their report Gautret et al also reported one death and three transfers to the ICU among the 26 patients who received hydroxychloroquine, also underlining the poor clinical outcome with this combination.

For the layperson, prolongation of QT interval is bad - it can signal fatal cardiac arrhythmias.  Occurring in 1 out of 11 patients is bad.

 

Lowe has this to say: "while this is a small study and not a perfect match, it provides no evidence to show that the HCQ/AZ combination had any benefit at all."

He goes on to point to an upcoming publication from a NYU team treating covid-19 patients with hydroxycholorquine/azithromycin: "While we’re on the subject of QT prolongation, there’s this preprint from a medical team at NYU that was also treating patients with the same combination of drugs. In 84 patients, they found notable QT prolongation in about 30% of them, and another 11% were to a level (>500 milliseconds) that put them at a high risk for arrhythmia. This group’s mean age was 63, 74% male. No cancer patients in this group, but 65% did have hypertension and 20% were diabetic (which from many reports is actually a reasonable look at the patients most likely to progress to severe disease). The strongest predictor of dangerous QT numbers was the development of renal trouble while on the drug combination.

 

In the discussion thread, @Nervous Guy correctly cited the incidence of cardiac-related adverse events in patients taking chloroquine or hydroxychloroquine for other conditions, and it's quite low.  I sounded a note of caution, that cardiac arrhythmias are apparently seen in covid-19 patients with a pretty high incidence in general, so one could not assume the same low incidence of side effects in a population of sick people.  At the time, I didn't know of the NYU preprint, but unfortunately the NYU study suggests this may be a concern.

An important point Lowe makes about the Gautret ("French physician") studies is that even taking the reduction in viral titer at face value, that's what could be considered a "surrogate endpoint" for what one really cares about when treating patients - how many treated patients got better,did the treated group recover more quickly than other patients by some patient-centered measure such as CT scan of lungs, fever, # of patients discharged vs ICU etc.

 

Anyway, Derek Lowe really understands the whole process of developing a drug and deciding whether or not it has a sufficient clinical effect to justify any risk, and his blog is well worth reading - give it a look.

 

He deconstructs the Gautret et al study as well and points to another publication that deconstructs it, but I already had a go at that myself up thread so I'll just link it. His conclusion: these new results are still not from randomized patients and still do not have any sort of control group for comparison. The sample is larger, but it’s still not possible to judge what’s going on. And on further reading, I have doubts about Dr. Raoult’s general approach to science and doubts about Dr. Raoult himself. Despite this second publication, I am actually less hopeful than I was before. Now the details. 

 

On 4/11/2020 at 5:02 AM, Nervous Guy said:

What I cited was the incidence of HCQ alone, not in combination with any other drug...whose to say the drug combination exacerbated a rare side effect and actually it looks like this is very likely.   Here is the warning for azithromycin, have to admit I did not know this:

QT prolongation

• Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been reported with macrolides, including azithromycin
• Elderly patients may be more susceptible to drug-associated effects on the QT interval

• Consider the risk of QT prolongation for at-risk groups including:

  • Patients with known prolongation of the QT interval, a history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias or uncompensated heart failure
  • Patients on drugs known to prolong the QT interval
  • Patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents

 

https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-azithromycin-zithromax-or-zmax-and-risk-potentially-fatal-heart

 

I did know that, but I don't think it's just the combo of drugs... just treating with chloroquine (which China has done extensively, it became their standard of care) they have seen cardiac side effects at incidents higher than one would expect given the drug's history....because it became the standard of care without blinded studies or controls, of course, it could be they are seeing the effects of the disease as well and there is some data on that.  That's the problem with uncontrolled studies. ?

EDIT: this just in.  https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1.full.pdf

Group reviewed medical record data from 6 countries looking for concurrent administration of hydroxychloroquine and azithromycin OR  hydroxychloroquine and ampicillin.
They found that while hydroxychloroquine alone (when compared to another rhumatoid arthritis drug) showed no excess adverse events, when combined with azithromycin they saw increased cardiac events and heart failure:
Conclusions  Short-term hydroxychloroquine treatment is safe, but addition of azithromycin may induce heart failure and cardiovascular mortality, potentially due to synergistic effects on QT length. We call for caution if such combination is to be used in the management of Covid-19

 

[Hapless Bills Fan]

More about serology testing, and a note of caution.  I will admit I did not "get" this myself initially, and had to consult a friend who is an expert in antibody-based testing to get my head straight but I "get it" now.

 

So we are hearing this:

https://currently.att.yahoo.com/news/antibody-test-allow-us-back-191110496.html

 

A major answer to the question of when — and how — Americans can return to public places like work and school could depend on something called an antibody test, a blood test that determines whether someone has ever been infected with the coronavirus.
 

People who are believed to be immune may be able to safely return to work. It would be especially important to know which health care workers are protected from getting infected and could continue to care for sick people.
 

The Centers for Disease Control and Prevention recently announced that it would begin using antibody tests to see what proportion of the population has already been infected.

“Within a period of a week or so, we are going to have a relatively large number of tests available,” Dr. Anthony Fauci, the leading infectious disease expert in the U.S., said Friday morning on CNN.
 

He said the White House coronavirus task force was discussing the idea of “certificates of immunity,” which could be issued to people who had previously been infected.

WHOA NELLIE! 

 

Let's work through whether or not that's a good idea for a second.  Bottom line: for people who have reason to believe they were infected (relevant symptoms, close contact with someone who tested positive for covid-19, someone who's symptoms are recent enough to be tested for SARS-Cov2 by RT-PCR and tests positive), sure.

 

For the general population?  Whether or not that means anything, depends entirely on how many people are actually infected.  If it's 50% of the population, or even 30%, yeah, it means something.  If it's 3 or 4% of the population, or less - BAD idea.  Very very BAD idea.  (Fauci is a smart dude and almost certainly know that - it is probably what he means when he says “As we get to the point of considering opening the country, it is very important to understand how much that virus has penetrated society.” Immunity certificates, he said, had “some merit under certain circumstances.”

 

The linked article gives a very good explanation of what the tests look for and their role - recommend as a read.  But there's an entire Mare's Nest, well-known to people who develop these tests (Where's @BillsFanNC?  This your lane, right? Weigh in here!) - the influence of population prevalance of false positives.

 

All tests have false positives, and false negatives.

Bottom line again: if the incidence of immunity is only 3 or 4% in the population, and the test is good - say, 95% specificity - IF YOU TEST POSITIVE, MEANING YOU'RE IMMUNE, there is a 50/50 chance that result is correct.  Read that again.  Wrap your mind around it.

https://twitter.com/zbinney_NFLinj/status/1245789672833417217?s=20

 

 

Again, my first reaction to this was "WTF?" and I rang up a friend whose "lane" this is and said "walk me through this, speak slowly, use small words".  Then we did the calculations independently and came up with the same answer.  Whether or not this is a good idea, depends entirely on how prevalant in a population covid-19 turns out to be.  If some people who posted here are correct and 50% or even 30% of the population have had the disease, Genius.
If it's actually only 2-4%, and you test broadly - BAD MOVE.  Millions of people would be incorrectly identified as immune, when they're not, even with a test that is 95% accurate.

Picture worth 1000 words so here are some pictures explaining this from the same guy, using a theoretical test for Diabetes as an example.  Click to embiggen.  Questions?  Ask.  If someone with a better lane here doesn't answer and I'm not sure, I will grab my friend (in a socially distant way) and shake more answers out of him.

 

 

20 minutes ago, OldTimeAFLGuy said:

 

....how is this affected in layman terms by those who have recovered, but have contracted the virus again?.........would this type of test subsequently show them as immune and NOT a candidate for re-infection?...thanks.............

 

People who are believed to be immune may be able to safely return to work. I

 

I would have to know what cases you're talking about "recovered then contracted the virus again"?

 

I know there are some cases especially in China and S. Korea, where patients have tested negative, then tested positive again some time later, but there is some question as to whether the negative result was essentially a "false negative" - the patient was actually still shedding virus when they tested negative, but not enough for the test to pick up.  The Chinese test may be ~30-40% false negatives, and the S. Korea test 10%-25%, for various reasons not all having to do with the test itself (eg swabbing procedure, whether or not the person has enough virus to test in their nasopharynx at that time)

 

If you know of documented cases where someone was 100% recovered, tested negative, then developed symptoms of the disease again, please link.  Thanks!!!

As far as a serology blood test is concerned, if you have a good antibody response on a blood test, you should be immune - but the problem is if testing broadly, even a small false positive rate will result in MANY MANY PEOPLE showing as immune on the blood test but actually NOT being immune - see pictures for explanation, visual is very good.

 

[Hapless Bills Fan]

The statement was made that patients  being treated with hydroxychloroquine do not get covid-19.

That statement would appear to be untrue.

 

We have a database: patients prescribed hydroxychloroquine for their rheumatoid arthritis, who generously participated

Early results from the patient experience survey (over 6000 responses):

• Primary rheumatic disease: 24% with rheumatoid arthritis, 15% with systemic lupus erythematosus, 6% with axial spondyloarthritis, 3% with psoriatic arthritis
• 309 (5%) reported COVID–19 infections.
• 142 (46%) were taking hydroxychloroquine at the time they were diagnosed with COVID–19.

[Hapless Bills Fan]

Another viral epidemiologist weighs in

 

 

I don't have a "threader" version, sorry - perhaps someone with a Twitter account could make one?

 

Key points of the thread:

 

 

 

 

[Hapless Bills Fan]

Pretty good Vox article, which points out that a right-leaning/conservative think tank, a left-leaning think tank, and two other sources have pretty much reached similar conclusions about what the "reopening" alternatives look like

 

https://www.vox.com/2020/4/10/21215494/coronavirus-plans-social-distancing-economy-recession-depression-unemployment
 

When scientists of vastly different political and socioeconomic perspectives reach pretty much the same conclusion, it's probably real.

[Hapless Bills Fan]

https://threadreaderapp.com/thread/1247609734896607232.html

 

Discussion by "my boi" virologist Trevor Bedford on estimating population prevalence of covid-19.  (I quote him a lot, because he kind of knows his stuff, and he puts it out there so that others can weigh in and correct if need be).

 

The "dream state" would be 50% of the population has actually had covid-19, in which case Jackpot! that's herd immunity.  Bottom line, Bedford doesn't think we're there, and here's why

 

Here's a report by the MRC estimating prevalence in Europe:

https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-13-europe-npi-impact/ (summary)
https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-03-30-COVID19-Report-13.pdf (full thing)

 

Table from the above (note the error estimates):

 

Currently, the US has 560,891 cases of covid-19.

Bedford estimates

(note he uses the words "I guess", but the guess of a trained epidemiologist on his topic of expertise is not the same as my guess or your guess.  It would be more like the trained eye of a football scout estimating the foot speed of a prospect by eye vs. me doing it)

 

So Bedford's estimate would mean between 5.6M and 11.2M people in the US are actually infected: 1.7 - 3.4% of the population.

 

That's way short of what's needed for herd immunity.

 

 

 

[Hapless Bills Fan]

55 minutes ago, OldTimeAFLGuy said:

...just a layperson's question.......would an in depth study of asymptomatic folks help to pinpoint the susceptibility and as to why they had it with no symptoms yet were fine?.....would or could that help in treating the more vulnerable versus evaluating 330 + mil people in the US?....I've done a lousy job of phrasing my question.... 

 

That's absolutely one of the things medical people would love to know......

 

...first a caveat, people mean different things by "asymptomatic".  Sometimes it means asymptomatic at the time of the test, in countries that are doing extensive contact tracing, but later develop symptoms.   Sometimes it depends upon the questions asked about symptoms.   Sometimes a follow-up interview indicates symptoms that weren't considered worth mentioning or relevant (eg GI symptoms, pink eye, etc).  That's why you see "asymptomatic" rates flying all over the place.

 

Be that as it may, it would be hella helpful to all if we understood why some people get no symptoms or mild symptoms, some people get a severe flu-like disease but recover (both considered "mild" cases) while ~20% need some form of significant, prolonged hospital care. 

Unfortunately, that's probably the sort of information that's going to take a while to sort out.

[Hapless Bills Fan]

7 hours ago, plenzmd1 said:

Not sure if this is the correct thread, but some anecdotaol evidence thet look like almost 20% could be asympatmatic

https://nypost.com/2020/04/14/pregnant-women-without-symptoms-are-getting-coronavirus-study/

 

Good place for it.  When you test a bunch of people, it's no longer anecdotal.

At this point, the preponderance of evidence seems to indicate that at least 20-25% of people infected with covid-19 are truly asymptomatic throughout the course of the disease, and that presymptomatic people are infectious for 24-48 hrs before they develop symptoms .  Some data say as many as 40-50% of people may be asymptomatically infected.

 

It's one of the most crucial questions for public health officials trying to make good decisions about the epidemic to have good information about: how many people are asymptomatic, how long are they infectious?  How long are presymptomatic people infectious?  The initial assumptions here were "not many" and "not very", and increasing evidence says that both those assumptions were wrong. 

 

https://www.newsday.com/news/health/coronavirus/asymptomatic-coronavirus-1.43629598

"As many as 25% of people with the virus are asymptomatic and will remain so, Dr. Robert Redfield, the director of the U.S. Centers for Disease Control and Prevention, said in an interview broadcast Tuesday on National Public Radio. Those who get sick from COVID-19 may be capable of transmitting the virus for up to 48 hours before they have symptoms, he said. Both groups help explain why the virus has spread so quickly, he added."

Data from different countries:
China now seems to be saying 18-19%, with variation by age (highest % in children and >70 years old) [initial estimates were <1%]
https://www.medrxiv.org/content/10.1101/2020.03.16.20037259v1

 

S. Korea, which has done extensive testing and also monitoring of positive-test cases to detect any symptoms, is saying 20% asymptomatic
 

Iceland, which has done very high per-capita testing, is saying 50% asymptomatic

https://www.bloomberg.com/news/articles/2020-03-22/one-third-of-coronavirus-cases-may-show-no-symptom-scmp-reports
 

Italy
Tests of the entire town of Vo, 3000 people, showed 90 infected people, 6 asymptomatic:
https://www.theguardian.com/world/2020/mar/18/scientists-say-mass-tests-in-italian-town-have-halted-covid-19
Per this report on Vo, even higher (50-76%) but I have heard that as "asymptomatic at time of testing" and some later developed symptoms:
https://www.bmj.com/content/368/bmj.m1165

If anyone else has good sourced data on this, put it up - I'll quote it and fold it in here.
 

6 hours ago, snafu said:

From the quoted part of you post, are they saying that if someone has asymptomatic Covid-19, then they’re not infectious?

Only people who eventually develop symptoms are infections before they exhibit symptoms?

Thats strange to me, unless I’m mis-reading.

 

I think you're misreading.  From the same quote: "Both groups help explain why the virus has spread so quickly, he added", eg the current thinking is that asymptomatic infected people are indeed infectious, at the point where they have enough virus to be tested positive.

This is one of the things that makes covid-19 such a grizzly bear to fight from the epidemiological viewpoint.  Many other viruses, you're not infectious until you have symptoms, and almost everyone has symptoms, so telling people "stay home if you feel symptoms" is a reasonably good way to contain and control.

 

[Scraps]

This is a somewhat useful fact checker.  Its a bit annoying that it doesn't give you the newest information first, by default.  Also, it seems limited on topics.  I was able to find information on PPE and chloroquine but when I looked for remdesivir, it returned nothing.

 

https://www.poynter.org/ifcn-covid-19-misinformation/page/2/?search_terms=chloroquine

Edited April 14, 2020 by Scraps

[Saxum]

Wyoming reports first death, last of the 50 states.

https://www.usatoday.com/story/news/nation/2020/04/13/coronavirus-wyoming-first-death-last-state-mark-gordon/2987542001/

Quote

 The Cowboy State had been the only in the U.S. without a death since Hawaii reported the first of its now nine fatalities March 31.. Coronavirus has killed at least one person in all 50 states.

 

Quote

 

While Wyoming is one of just eight states that hasn’t issued a stay-at-home or shelter-in-place order, Gordon has prohibited gatherings of 10 or more people and closed schools and many businesses until April 30. He has often used the hashtag #StaySafeStayHome on Twitter.

The other states that haven’t mandated their residents to stay home: Arkansas, Iowa, Nebraska, North Dakota, Oklahoma, South Dakota and Utah.

 

Edited April 14, 2020 by Limeaid
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