The Next Pandemic: SARS-CoV-2/COVID-19

[123719bwiqrb]

Just now, shoshin said:

 

Do you follow the progress in medical treatments for Covid? If you don't you can find plenty of sources. I'm not going to google a ton of articles on point for you. Pretty basic knowledge at this point that we've gotten a lot better at treating a novel disease over the 6 months we've been treating it. The early ventilator panic was based on a lack of understanding that more critical patients needed more oxygen than just plain inhalation support.

 

And ventilators have been found to do more damage than good in many cases.  There are other ways of boosting a patient's blood oxygen levels, and those have been used more often now.

[shoshin]

9 minutes ago, SoCal Deek said:

So isn’t this exactly why the President and his task force built so many thousands of ventilators? The point was to be able to move them where they are needed....no? 

 

There's unlikely to be any ventilator shortage anywhere. Cuomo and Trump made political decisions on what they knew at the time. Turns out we shouldn't see a ventilator shortage or put it this way, if we do, things have gotten really, really, really bad and we shouldn't be excited about scoring a political point over it.

 

The ICU bed measure is one that is more than just "a bed." It's a human measure of HCW capacity too because ICU patients need a lot of human care. 

Edited June 19, 2020 by shoshin

[SoCal Deek]

Just now, shoshin said:

 

There's unlikely to be any ventilator shortage anywhere. Cuomo and Trump made political decisions on what they knew at the time. Turns out we shouldn't see a ventilator shortage or put it this way, if we do, things have gotten really, really, really bad and we shouldn't be excited about scoring a political point over it. 

I’m not sure what political point you believe the President made. He was asked to use the power of the federal government to manufacture ventilators and he did. He doesn’t deploy them. He just got companies to make them. I’m really not trying to bring politics into this but your comment made me wonder. 

[Magox]

13 minutes ago, shoshin said:

 

ICU covid usage went up by 130 beds in 4 days. There is a total operational capacity of 200 ICU beds free and 450 nonoperational more across the entirety of Texas. That's not panic porn: That's "pay attention to these numbers."

 

Ventilator usage is down everywhere because we are much better at treating this with other modalities. I don't see that as a limiting resource and don't really track it. 

 

And I agree about that site. I wish every state had that exact chart. 

 

 

You and I can differ on our opinions, I think it is panic porn.  This whole issue is way overblown, and it doesn't really matter anyway because there is no turning back, unless you have some paternalistic government official that indicates otherwise and even then that would be an outlier and the public wouldn't effectively comply anyway. 

 

The only reason why I'm commenting on it is because I'm a data nerd and I love following these sort of things.

[shoshin]

3 minutes ago, SoCal Deek said:

I’m not sure what political point you believe the President made. He was asked to use the power of the federal government to manufacture ventilators and he did. He doesn’t deploy them. He just got companies to make them. I’m really not trying to bring politics into this but your comment made me wonder. 

 

Sorry, I maybe didn't phrase it well. I think Trump and Cuomo did the right thing in the moment in pushing for more capacity as they saw exponential rises and lack of projected ventilator capacity. What I'm saying about "not scoring political points" was a doomsday scenario (that I don't think we will see) where we find our current ventilator usage maxed out. If we get to that point, it will be very bad news and I'd hope we had all hands on deck in unity, not prodding each other about politics. 

Edited June 19, 2020 by shoshin

[SoCal Deek]

2 minutes ago, shoshin said:

 

Sorry, I maybe didn't phrase it well. I think Trump and Cuomo did the right thing in the moment in pushing for more capacity as they saw exponential rises and lack of projected ventilator capacity. What I'm saying about "not scoring political points" was a doomsday scenario (that I don't think we will see) where we find our current ventilator usage maxed out. If we get to that point, it will be very bad news and I'd hope we had all hands on deck in unity, not prodding each other about politics. 

I don’t blame either one of them and didn’t at the time. It was panic time for sure. We may differ here, but looking back, the two infamous doctors....especially Teflon Fauchi are the ones in my opinion that set this whole thing on fire. 

[shoshin]

5 minutes ago, Magox said:

 

 

You and I can differ on our opinions, I think it is panic porn. 

 

Making conversation here: At what point would you think they should be worried in TX?

 

Using up 1/3 of the currently available ICU beds in the last 4 days doesn't concern you much so I'm genuinely curious. 

[FireChans]

21 minutes ago, shoshin said:

 

Do you follow the progress in medical treatments for Covid? If you don't you can find plenty of sources. I'm not going to google a ton of articles on point for you. Pretty basic knowledge at this point that we've gotten a lot better at treating a novel disease over the 6 months we've been treating it. The early ventilator panic was based on a lack of understanding that more critical patients needed more oxygen than just plain inhalation support.

Early ventilation has been pulled back a bit in the last few months, but when patients are in full on ARDS, ventilators are required. I don’t have the data in front of me but I would bet there’s a pretty decent correlation between mortality and ventilator requirements.

 

If you aren’t worried about ventilators, why are you worried about ICU admissions? Folks can be managed on the medical floors with HFNC. What are the indications for ICU admission?

 

 

Edited June 19, 2020 by FireChans

[shoshin]

9 minutes ago, FireChans said:

Early ventilation has been pulled back a bit in the last few months, but when patients are in full on ARDS, ventilators are required. I don’t have the data in front of me but I would bet there’s a pretty decent correlation between mortality and ventilator requirements.

 

If you aren’t worried about ventilators, why are you worried about ICU admissions? Folks can be managed on the medical floors with HFNC. What are the indications for ICU admission?

 

 

 

I worry about HCW/other healthcare resource limitations, which are well-represented by ICU bed capacity. It's purely an economics approach to it. 

 

HFNC is just one treatment modality. I have not heard (and admittedly don't have any idea) if there's a shortage there. I doubt it because those machines are pretty simple. 

Edited June 19, 2020 by shoshin

[BillStime]

This is so sad.  This poor family.  Just heartbreaking.

 

'There are no words': Family devastated over Covid-19 deaths of mother, 2 daughters

 

@GG - this is why I post stats.  I know reality pisses you off but COVID needs to be taken seriously. It's not going away until we get a vaccine.

[Magox]

14 minutes ago, shoshin said:

 

Making conversation here: At what point would you think they should be worried in TX?

 

Using up 1/3 of the currently available ICU beds in the last 4 days doesn't concern you much so I'm genuinely curious. 

 

No, it doesn't concern me.  When I look at the average age of the people who are being infected and that a good portion of the people who are being hospitalized are much younger than before and the fact that ventilator use is not going up.   This tells me that the average person who is being hospitalized now is a completely different and less at risk demographic than before.

 

[FireChans]

4 minutes ago, shoshin said:

 

I worry about HCW/other healthcare resource limitations, which are well-represented by ICU bed capacity. It's purely an economics approach to it. 

 

HFNC is just one treatment modality. I have not heard (and admittedly don't have any idea) if there's a shortage there. I doubt it because those machines are pretty simple. 

There are lots of treatment modalities for poor oxygenation. HFNC, BiPap, nonrebreather, and of course ventilation.

 

From a healthcare standpoint, if ICU patients don’t require intubation, their length of stay in the ICU is likely less than someone who does. Unless they require pressors or some other indication to remain in the ICU.

 

Basically, I would argue we may see a large fluctuation of icu numbers up and down over the next few weeks.

[shoshin]

12 minutes ago, FireChans said:

 

 

Basically, I would argue we may see a large fluctuation of icu numbers up and down over the next few weeks.

 

Right now at least in Texas, ICU usage is exponentially up, which is why it's worth watching. And in AZ, theirs is also continuing to rise and this is not just ICU new patients, which I agree could be OK if they are in ICU for short periods of time, but total ICU patients currently in the hospital--that's the rising statistic and it's only the covid cases that are contributing to the rise--not others. 

 

If it levels out where we are in Texas, it's manageable. AZ needs it to decline. FL is fine for now. 

Edited June 19, 2020 by shoshin

[Tiberius]

Coronavirus traces found in northern Italian wastewater collected in December 2019

A new study co-led by scientists with the Italian National Institute of Health has found that the first traces of the coronavirus emerged in wastewater in several northern Italian cities as early as December 2019.

Traces of the coronavirus were found in samples collected that month in Turin and Milan, the researchers said.

Similar projects focusing on wastewater are underway in other parts of the continent to determine when exactly the virus arrived in Europe. Cases of the then-unidentified disease were first reported in late December in the Chinese city of Wuhan.

But subsequent research found that the virus must have already been present in France in late December, according to retested samples.

The new Italian research similarly suggests that the virus was spreading in northern Italy — the country’s most affected region — earlier than previously thought. Several towns around Milan confirmed their first major clusters only in late February.

“This research may help us understand the beginning of virus circulation in Italy,” Giuseppina La Rosa, a researcher for the institute, was quoted as saying by the Reuters news agency.

[Westside]

16 minutes ago, shoshin said:

 

Right now at least in Texas, ICU usage is exponentially up, which is why it's worth watching. And in AZ, theirs is also continuing to rise and this is not just ICU new patients, which I agree could be OK if they are in ICU for short periods of time, but total ICU patients currently in the hospital--that's the rising statistic and it's only the covid cases that are contributing to the rise--not others. 

 

If it levels out where we are in Texas, it's manageable. AZ needs it to decline. FL is fine for now. 

Is the increase in ICU due to covid? Just curious. 

[spartacus]

1 minute ago, westside2 said:

Is the increase in ICU due to covid? Just curious. 

ABSOLUTELY

 

no chance hospitals are actually using their facilities to treat non-covid patints after being forced to stop all voluntary treatment

everyone knows time should stop while we wait for the vaccine

[shoshin]

19 minutes ago, spartacus said:

ABSOLUTELY

 

no chance hospitals are actually using their facilities to treat non-covid patints after being forced to stop all voluntary treatment

everyone knows time should stop while we wait for the vaccine

 

You need to look at the data in the link and not stick to your preferred narrative.

 

Yes, using up 130 of the remaining 300 ICU beds available in TX in the last 4 days was all due to covid-positive patients. Some upwards change in non-Covid but that data is separately identified.

 

 

Edited June 19, 2020 by shoshin

[shoshin]

23 minutes ago, westside2 said:

Is the increase in ICU due to covid? Just curious. 

 

Yes. There's a slight uptick in non-Covid but that's been pretty level. 

[B-Man]

 

 

 

PUBLIC HEALTH: 

 

Parkview Medical Center in Pueblo laying off 22 staffers due to financial impact of COVID-19.

 

 

 

 

 

[shoshin]

4000 new FL cases today. This is ~700 more than the 3300 record set yesterday.

 

We can keep trying to spin these giant case jumps as good news but they are not. 

[plenzmd1]

2 hours ago, BillStime said:

This is so sad.  This poor family.  Just heartbreaking.

 

'There are no words': Family devastated over Covid-19 deaths of mother, 2 daughters

 

@GG - this is why I post stats.  I know reality pisses you off but COVID needs to be taken seriously. It's not going away until we get a vaccine.

It is indeed tragic, and ones heart goes out to the family.

 

But this is also in the same paper

 

https://buffalonews.com/2020/06/18/buffalo-niagara-regions-private-sector-jobs-fall-21/

10 minutes ago, shoshin said:

4000 new FL cases today. This is ~700 more than the 3300 record set yesterday.

 

We can keep trying to spin these giant case jumps as good news but they are not. 

Certainly the best news would be for cases going down, no doubt, and these numbers are troubling. 

 

Having said that..i know you dismissed this yesterday but if i understand contact tracing correctly, if it is being done in Florida..we will continue to see higher cases and higher positives based on contact tracing working...am i missing something there?

 

Certainly i have no insight into these numbers you are reporting..but are they concentrated again in the migrant farming community? Mostly younger people ? How many asymptomatic?

 

So much more data needed that just positive test numbers

[Kangaxx]

https://calmatters.org/commentary/its-time-to-end-the-state-of-emergency-over-covid-19/

“These infection fatality rates are remarkably low and are similar to the fatality rate for the seasonal flu.”

“The virus is 10 times less fatal than we first thought.”

[GG]

2 hours ago, BillStime said:

This is so sad.  This poor family.  Just heartbreaking.

 

'There are no words': Family devastated over Covid-19 deaths of mother, 2 daughters

 

@GG - this is why I post stats.  I know reality pisses you off but COVID needs to be taken seriously. It's not going away until we get a vaccine.

 

Is that why you were posting stats during NYC peak, when bodies were piling up in Hart Island and UHauls and families couldn't grieve their loved ones, at the same time that King Andrew & Fredo were yukking it up on CNN?

 

Perspective is a wonderful trait to have in a crisis.

[3rdnlng]

17 minutes ago, shoshin said:

4000 new FL cases today. This is ~700 more than the 3300 record set yesterday.

 

We can keep trying to spin these giant case jumps as good news but they are not. 

What doesn't kill you makes you stronger. Each non lethal case that doesn't use up facilities/equipment for the seriously ill simply helps out the overall situation. 

[Westside]

10 minutes ago, 3rdnlng said:

What doesn't kill you makes you stronger. Each non lethal case that doesn't use up facilities/equipment for the seriously ill simply helps out the overall situation. 

No! We must keep everything closed if we want to survive this terrible pandemic! Or until November if biden wins, then it will be safe to go out!

[shoshin]

20 minutes ago, plenzmd1 said:

 

 

Having said that..i know you dismissed this yesterday but if i understand contact tracing correctly, if it is being done in Florida..we will continue to see higher cases and higher positives based on contact tracing working...am i missing something there?

 

It can play a role but we didn't invent contact tracing in the last 7 days. 

 

20 minutes ago, plenzmd1 said:

Certainly i have no insight into these numbers you are reporting..but are they concentrated again in the migrant farming community? Mostly younger people ? How many asymptomatic?

 

So much more data needed that just positive test numbers

 

Cases presage hospitalizations and deaths everywhere else. It will be great if FL is the first place that doesn't see that. 

[spartacus]

30 minutes ago, plenzmd1 said:

It is indeed tragic, and ones heart goes out to the family.

 

But this is also in the same paper

 

https://buffalonews.com/2020/06/18/buffalo-niagara-regions-private-sector-jobs-fall-21/

Certainly the best news would be for cases going down, no doubt, and these numbers are troubling. 

 

Having said that..i know you dismissed this yesterday but if i understand contact tracing correctly, if it is being done in Florida..we will continue to see higher cases and higher positives based on contact tracing working...am i missing something there?

 

Certainly i have no insight into these numbers you are reporting..but are they concentrated again in the migrant farming community? Mostly younger people ? How many asymptomatic?

 

So much more data needed that just positive test numbers

The governor explained the numbers in a press conf earlier in the week.

https://threadreaderapp.com/thread/1273256643556454400.html

 

the high numbers are actually very good  for achieving herd immunity

as almost all of them are not sick

Testing has gone up as people go back to work and start to travel

 

2 examples

1. 2 people at Orlando airport had mild symptoms

they broadly tested other travelers in the airport and had 500 positives

none of them had symptoms- not sick , not a load on the hospital system

 

2. migrant workers

staying and traveling to the fields in close proximity

1 example - 1 worker had symptoms

tested remainder of work group - 99 tested postive - none had symptoms- not sick, not in hospital

 

confirmed that hospitals have plenty of capacity

 

also important that the median age of cases has PLUNGED, from 65 to 37.

Young people are not at risk.

 

Daily deaths have trended down for months..

Florida has comparable population as NYS, yet the daily deaths have been around 20 for the whole state for weeks

The virus is a non-issue

 

Edited June 19, 2020 by spartacus

[plenzmd1]

3 minutes ago, shoshin said:

 

It can play a role but we didn't invent contact tracing in the last 7 days. 

 

 

Cases presage hospitalizations and deaths everywhere else. It will be great if FL is the first place that doesn't see that. 

Not saying all of it can be explained away by that, but i certainly think it can play a role.

 

And yes,hospitalizations and deaths certainly followed case counts before, but my counter to that would be only the very sick were getting tests , and the most vulnerable to the virus. 

 

If these positive cases are skewing younger and more asymptomatic, does it not logically follow that while we will see a rise in both, it may not be at the same rate as even a month ago?

[spartacus]

 

10 minutes ago, shoshin said:

 

It can play a role but we didn't invent contact tracing in the last 7 days. 

 

 

Cases presage hospitalizations and deaths everywhere else. It will be great if FL is the first place that doesn't see that. 

watch the video from Desantis

the opposite of fear porn

https://threadreaderapp.com/thread/1273256643556454400.html

[meazza]

35 minutes ago, GG said:

 

Is that why you were posting stats during NYC peak, when bodies were piling up in Hart Island and UHauls and families couldn't grieve their loved ones, at the same time that King Andrew & Fredo were yukking it up on CNN?

 

Perspective is a wonderful trait to have in a crisis.

 

Uh oh.

[shoshin]

9 minutes ago, spartacus said:

 

watch the video from Desantis

the opposite of fear porn

https://threadreaderapp.com/thread/1273256643556454400.html

I have seen it. And there’s no way that he believes that today with 4000 and that being 20% of the nation’s recent case totals is good news. 
 

He was bragging about low case counts for months. If hospitalizations and deaths stay low, it will be great news. We can only wait on the data because he’s not going to take steps to mitigate.  

Edited June 19, 2020 by shoshin

[Reality Check]

https://www.zerohedge.com/technology/how-check-if-your-iphone-secretly-coronavirus-tracker

6 minutes ago, meazza said:

 

Uh oh.

https://www.zerohedge.com/geopolitical/china-officially-charges-two-detained-canadians-espionage

[spartacus]

14 minutes ago, shoshin said:

I have seen it. And there’s no way that he believes that today with 4000 and that being 20% of the nation’s recent case totals is good news. 
 

He was bragging about low case counts for months. If hospitalizations and deaths stay low, it will be great news. We can only wait on the data because he’s not going to take steps to mitigate.  

keep pushing the fear porn

 

The Florida count is proof that this virus as a threat is dead.

4000 cases ( which is hardly high in a state of 20 mil) with hardly any sick people.

Herd immunity

 

[Deranged Rhino]

 

[SoCal Deek]

I’ve got a great idea. Let’s round up all the Florida Covid patients and park them in nursing homes! That’ll work for sure. 

[shoshin]

7 minutes ago, spartacus said:

keep pushing the fear porn

 

The Florida count is proof that this virus as a threat is dead.

4000 cases ( which is hardly high in a state of 20 mil) with hardly any sick people.

Herd immunity

 

AZ just broke their record high set yesterday in a 25+% jump over yesterday’s count. 
 

If you don’t like the numbers, don’t read them. When higher cases mean fewer hospitalizations and deaths, that will be a good day. Now we wait and see where the exponential case growth in these states takes us. Are they just finally getting hit or are they showing what happens when you reopen, ie, it takes a while to see the exponential rise in the same way it took some time to go from case 0 in December to 100000 dead by June? Some contribution is young people needing to get tested and some is contact tracing but these were happening before these leaps. 
 

 We have to wait it out now but I really was hoping the cases would level. 

Edited June 19, 2020 by shoshin

[SoCal Deek]

9 minutes ago, shoshin said:

AZ just broke their record high set yesterday in a 25+% jump over yesterday’s count. 
 

If you don’t like the numbers, don’t read them. When higher cases mean fewer hospitalizations and deaths, that will be a good day. Now we wait and see where the exponential case growth in these states takes us. Are they just finally getting hit or are they showing what happens when you reopen, ie, it takes a while to see the exponential rise in the same way it took some time to go from case 0 in December to 100000 dead by June? Some contribution is young people needing to get tested and some is contact tracing but these were happening before these leaps. 
 

 We have to wait it out now but I really was hoping the cases would level. 

Shosin

With all the respect I can muster....you simply cannot keep an entire society locked up and shut down forever just to keep a few people from dying! We never have and never will. If the experts haven’t learned more about this virus since January shame on them. I actually think they have and what you’re seeing now is nothing more than the next evolution in this long sad saga. Enough already!

[Magox]

47 minutes ago, plenzmd1 said:

Not saying all of it can be explained away by that, but i certainly think it can play a role.

 

And yes,hospitalizations and deaths certainly followed case counts before, but my counter to that would be only the very sick were getting tests , and the most vulnerable to the virus. 

 

If these positive cases are skewing younger and more asymptomatic, does it not logically follow that while we will see a rise in both, it may not be at the same rate as even a month ago?

 

It certainly is playing a part but isn't painting the entire picture.  I think it's coming from a variety of places, contact tracing, some companies paying for employees before they enter into the workplace, prisons, migrant agricultural worker testing etc.   

 

I was listening to DeSantis presser today and there were some interesting factual tidbits, such as:

 

1) That ICU usage has not been increasing and in fact roughly about 50% lower than it's peak. 

2) That the majority of deaths now are coming from Long-term facilities. 

3) That less people are testing positive in the long-term facilities than before and is trending lower.  

4) That overall deaths are still trending lower

5) That ventilator usage is trending lower

6) That 80% of the people who have tested positive over the past week are under the age of 45

7) That hospital bed capacity is 50% higher now than it was in Late March and that is including all the elective surgeries and hospital usage

8 ) That the vast majority of the people who have tested positive are asymptomatic and not people who suspected they had the virus but rather done through targeted sweeps and contact tracing.

10 minutes ago, SoCal Deek said:

Shosin

With all the respect I can muster....you simply cannot keep an entire society locked up and shut down forever just to keep a few people from dying! We never have and never will. If the experts haven’t learned more about this virus since January shame on them. I actually think they have and what you’re seeing now is nothing more than the next evolution in this long sad saga. Enough already!

 

Yeah,

 

This isn't even an option.  I only keep up with the data because it's something I enjoy tracking.  There is no going back.  If there is it will only be on a very limited targeted basis and even then the compliance will be terrible.

[BillStime]

1 hour ago, GG said:

 

Is that why you were posting stats during NYC peak, when bodies were piling up in Hart Island and UHauls and families couldn't grieve their loved ones, at the same time that King Andrew & Fredo were yukking it up on CNN?

 

Perspective is a wonderful trait to have in a crisis.

if only Trump did more when he found out in November. So sad. 

[Deranged Rhino]