Jump to content

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


Recommended Posts

16 minutes ago, K-9 said:

This is concerning. Do they know if it was brought in by a visitor or spread from a care giver at the hospital. I fear that soon we will reach a perfect storm of too many infected patients and too many infected care givers too sick to care for them. 

Not sure yet. Her boss called her at home and told her they had 2 inpatient cases and to stay home for now. Then they called her back a few mins later and said “never mind, we need you to come in”. So I’m guessing she will find out more details later. I’m not sure if they are new patients that maybe caught it before they came in, or if someone brought it in or what. 

 

She has has issues with her immune system, so not only is she worried for all the patients, she’s a bit worried about herself as well. I feel bad for her. I know she’s spooked. 

 

One thing I know is that they will take every precaution they can there. They already deal with a lot of high risk patients with compromised immune systems and have a lot of restrictions in place. I have confidence in the way they will handle it.

 

 

 

———————————————-

 

Felt this was worth sharing:

 

 

 

I cant tell you how grateful I am for all the healthcare workers on the front lines dealing with this around the world. They are heroes in my eyes.

Edited by BillsFan4
Accidentally combined posts
  • Awesome! (+1) 1
Link to comment
Share on other sites

1 hour ago, plenzmd1 said:

Interesting article..as someone mentioned upthread..might the cure be worse than the disease?

 

 

 

Economically, it might be. The data from outside of China (where we have limited confidence) will tell how serious this is across wider populations. To get that data, we need...Hapless? 

 

Nothing would be better than if people could say in June that they told you so and this was never going to be a big deal but areas ahead of us in time are showing it's a big deal. 

Edited by Sundancer
Link to comment
Share on other sites

1 hour ago, plenzmd1 said:

Interesting article..as someone mentioned upthread..might the cure be worse than the disease?

 

 

 

He makes good points, but I can easily dispute some of his contentions.  And here is a piece online which does so:

https://www.statnews.com/2020/03/18/we-know-enough-now-to-act-decisively-against-covid-19/

 

1. He is absolutely right we have no clue how many people are really infected, and that makes it impossible to assess where we really are.  We badly need more testing.

2. Please GTFO with this "3.4% case fatality rate meaningless".  and " Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%."  That is not based on expertise, it's complete surmise.  

It's time to stop dismissing evidence from countries that aren't us.   Really.  People act as though China is mud huts and acupuncture.  China has a very good modern medical system with all modern equipment and techniques in big cities like Wuhan and Shenzen and comparable beds/person to US cities.  I know a physician working in Shenzen and dozens of Chinese scientists.  They have everything we have, and they're just as smart at science - really.

Right now, globally, the case fatality rate is 4.0%.  That is a fact.  A lot of people are still critically ill on vents - a situation with 50% mortality so far - so while the deathrate may go down as more mildly ill people are tested, the death rate may also go up as more people who are still on vents pass away.

What we do know, is that countries with death rates <1% have contained the virus so as not to overwhelm their health care systems.  Don't take my word, go to the linked site and calculate the case fatality rate from countries with >1000 cases so data, but medical system not overwhelmed like S. Korea - 1%.  In China, the WHO joint commission found outside Wuhan, the case fatality rate was 0.7% and in Wuhan, 5.8%.  They attributed this to the health care system being overwhelmed in Wuhan (they euphemistically refer to this as "standard of care evolved")

US, by the way, currently stands at 1.8% case fatality rate.  So how can he argue  0.05% to 1% is a "reasonable estimate" when we already factually exceed that, with, yes, many undiagnosed mild cases, but also already many ill people on ventilators many of whom may yet die, and more coming every day? 

 

The economic shutdowns are ruinous. 

 

The societal cost of not shutting down and trying to "buy time" is also going to be horrific - decimated Health Care Workers (we may see this anyway, due to inadequate PPE), improvised ventilators 3 patients/vent, inadequate care because of HCW shortages and lack of coordinated distribution of supplies here, triage as they are already having to do in N. Italy.  (I know people recently back from Spain and Italy too). 

 

We need to buy some time to get our ***** together. 

 

Yes, John Ioannidis is a smart guy, but he seems to be working from a strange set of assumptions that are out-of-tune with current facts.

 

20 minutes ago, K-9 said:

This is concerning. Do they know if it was brought in by a visitor or spread from a care giver at the hospital. I fear that soon we will reach a perfect storm of too many infected patients and too many infected care givers too sick to care for them. 

 

That is exactly the concern.

  • Thank you (+1) 1
Link to comment
Share on other sites

5 minutes ago, Foxx said:

Cuomo holding press conference right now. Mandating all non essential work places can not have more than 50% of workforce reporting for duty outside home.

 

That's an interesting approach. We have to keep the economy going. I have no solution to that but something like this has to happen where people get back to work. Shutting it all down is not actually a thing that can last. 

 

Picking up this idea as interesting:

Quote

 

With President Trump proposing to send $1,000 checks to every American and industries, like the airlines, lining up for bailouts, there is a better way to arrest the panic.

 

I chronicled the 2008 financial crisis and spent the past week on back-to-back telephone calls with many of the experts who crafted that bailout, as well as the programs put in place after 9/11, Katrina, the BP oil spill and other crises. Now here is a thought experiment that could prevent what is quickly looking like the next Great Recession or even, dare it be mentioned, depression.

 

The fix: The government could offer every American business, large and small, and every self-employed — and gig — worker a no-interest “bridge loan” guaranteed for the duration of the crisis to be paid back over a 5-year period. The only condition of the loan to businesses would be that companies continue to employ at least 90 percent of their work force at the same wage that they did before the crisis. And it would be retroactive, so any workers that have been laid off in the past two weeks because of the crisis would be reinstated.

 

 

Apologies if this is tending to politics and not science but I'm trying to avoid the critiques of party and discuss alternatives to problems in the air. 

Edited by Sundancer
Link to comment
Share on other sites

 

They are officially invoking the defense production act. Was announced today. 

Very happy to hear that. Hopefully production of ventilators, masks etc will be ramped up. About a week ago I saw a company that produces ventilators saying that they have the capability to ramp up production 5 x. So hopefully that will happen now.

 

edit - here’s the article I was referring to:

 

Edited by BillsFan4
Link to comment
Share on other sites

10 hours ago, BillsFan4 said:

Testing numbers as of today. The U.S. is still lagging way behind every other country in testing. I’m still reading all sorts of stories on social media of people with symptoms who can’t get wasted.

 

I know some think MJ is cure all but MJ will not solve virus issues although you might enjoy them more. :devil:

  • Haha (+1) 1
Link to comment
Share on other sites

9 hours ago, K-9 said:

From a VOX report dated 3/8:

 

 

For weeks we’ve heard empty promises of the imminent shipments of millions of test kits. For weeks we’ve heard from the scientists how critical it is to have this testing done ASAP.  And for weeks we’ve heard story after story of how people with symptoms have been denied the test and/or given the bureaucratic run around when trying to obtain one. Sure looks like a deliberate plan to keep the numbers low from where I sit. 
 

Like I said, we all know why that is. And it should piss us off to no end. 

 

When I worked for US Census saw same thing - attempt to get numbers to match what WH leadership wanted.  They invested a lot of money to ramp up to support doing Census online, it was tested and then when number crunchers at WH did not like potential results cancelled it.  Money just thrown away.

Link to comment
Share on other sites

39 minutes ago, CountDorkula said:

 

Just talked to my buddy who does this. That is for HUD/ low income only.

 

Private lending still not suspended.

Heard the CEO of BoA say in an interview on Sunday that if you’ve been impacted by the crisis all,you have to do is call the bank, explain that, and your payment due will be suspended. This needs to happen across the board for all mortgages, all loans, all rents, all utilities, etc. It’s our moral imperative. 
 

My cynicism says, “good luck with that.” 

Link to comment
Share on other sites

2 minutes ago, K-9 said:

Heard the CEO of BoA say in an interview on Sunday that if you’ve been impacted by the crisis all,you have to do is call the bank, explain that, and your payment due will be suspended. This needs to happen across the board for all mortgages, all loans, all rents, all utilities, etc. It’s our moral imperative. 
 

My cynicism says, “good luck with that.” 

 

People need to keep paying if they can. If they can't, the last thing anyone will do is evict. It's the reality of the situation that we need capital flowing through the system. If you don't pay the bank, the bank can't loan the restaurant that closed money. If the bank doesn't make that loan, the waiter living paycheck to paycheck who is still getting something gets $0. Imagine that times 100000 permutations of downstream effects. $$ has to keep moving. 

Link to comment
Share on other sites

1 hour ago, BillsFan4 said:

 

They are officially invoking the defense production act. Was announced today. 

Very happy to hear that. Hopefully production of ventilators, masks etc will be ramped up. About a week ago I saw a company that produces ventilators saying that they have the capability to ramp up production 5 x. So hopefully that will happen now.

 

edit - here’s the article I was referring to:

 

Another example of what health care providers have been warning us about for over a month would happen and we are just now getting around to it. 
 

Let’s hope that any new thing they warn us about today doesn’t take a month to heed.

  • Like (+1) 1
Link to comment
Share on other sites

2 minutes ago, Sundancer said:

 

People need to keep paying if they can. If they can't, the last thing anyone will do is evict. It's the reality of the situation that we need capital flowing through the system. If you don't pay the bank, the bank can't loan the restaurant that closed money. If the bank doesn't make that loan, the waiter living paycheck to paycheck who is still getting something gets $0. Imagine that times 100000 permutations of downstream effects. $$ has to keep moving. 

I understand the dollar velocity argument here and it’s more than valid. But the sad fact is that nearly half the country isn’t prepared to meet a $400 unforeseen emergency with no disruption to their working lives. 
 

The trillion dollar + infusion of liquidity into the markets will help. 

Link to comment
Share on other sites

2 minutes ago, K-9 said:

I understand the dollar velocity argument here and it’s more than valid. But the sad fact is that nearly half the country isn’t prepared to meet a $400 unforeseen emergency with no disruption to their working lives. 
 

 

Agreed. 

 

2 minutes ago, K-9 said:

The trillion dollar + infusion of liquidity into the markets will help. 

 

That's nothing to the large number of people not getting checks. Almost literally $0. 

 

In 2008, people were not about to have $0 in the bank and mouths to feed. That is where we are now. So it's find to send out cash but we need to get back to work, very very soon. 

  • Like (+1) 1
Link to comment
Share on other sites

2 minutes ago, Sundancer said:

 

Agreed. 

 

 

That's nothing to the large number of people not getting checks. Almost literally $0. 

 

In 2008, people were not about to have $0 in the bank and mouths to feed. That is where we are now. So it's find to send out cash but we need to get back to work, very very soon. 

 

$2k/citizen will buy a couple weeks max

  • Like (+1) 1
Link to comment
Share on other sites

On 3/17/2020 at 12:17 PM, Hapless Bills Fan said:

 

If you look at the linked stories I gave, it is not clear at all that the problem was a "contaminated negative control".  That would actually not fit with the data that 5 state health labs were able to run tests from the kits successfully.  I don't want to go into it too deep here, but if you want to say that's what the problem is, provide sources and let's see how they stack up for cred with what I provided.  The sources I gave say the problem was the CDC ignored the WHO standard, and decided they wanted to design a test that would test simultaneously for several coronaviruses including SARS and MERS.  The result was susceptibility to picking up environmental contamination with a wide range of harmless viruses in their negative control.  That's not a 'contaminated negative control', that's a testing design flaw that rendered the test unusable except to the highest standards of operation.

 

Surveillance testing means you are able to screen a section of the population (test on a mass scale) not limit testing to people who are critically ill.  In the past, the CDC has developed and rolled out large numbers of novel tests for other potentially epidemic diseases quite quickly.

China and at least one other country (I think Korea, might be Taiwan) are now rolling out two different versions of a true screening kit that provides 15 minute results.  One is based upon detecting covid-19 antibodies, the other is based on detecting an early antibody response that covid-19 seems to trigger more than flu.

Testing every American is stupid, but we should at this point be able to test everyone who has symptoms (fever most common) and everyone who has known contact with a Covid19 positive person.

 


Early on I had read that the problem was with false positives in patient samples which would indicate a problem with primer design that might result in a test that lacked adequate specificity as you suggest.  Later on I had read this article:

 

https://www.technologyreview.com/s/615323/why-the-cdc-botched-its-coronavirus-testing/

 

Quote

On February 5 the CDC began to send out coronavirus test kits, but many of the kits were soon found to have faulty negative controls (what shows up when coronavirus is absent), caused by contaminated reagents. This was probably a side effect of a rushed job to put the kits together. Labs with failed negative controls had to ship their samples to the CDC itself for testing.

 

As someone who has done a fair amount of PCR that suggested to me that the kits suffered from a negative control that had been contaminated with target sequence amplicons, something that can happen quite easily if routine PCR guidelines aren't followed.  Without seeing the data we can only guess what the true failure was, but it was indeed a major failure by the CDC no matter how you slice it.

 

22 hours ago, Hapless Bills Fan said:

 

I think you should probably stop posting on this, because this demonstrates lack of understanding of the process of test design, the meaning of surveillance testing, the process of validating a clinical test etc and thus is not helping clarity here.

Validating a test that is fully developed and in use elsewhere is a standard process that should take a scientist who knows their ***** a small amount of time - weeks or even a week, if a team is assigned to the task, equipment is fully available (both of which could have been done).

The regulations that were partially lifted were a rather ponderous bureaucratic process that the current FDA had imposed to qualify tests developed OUTSIDE the FDA under "emergency use authorization".  Because their own test development was struggling, the CDC finally took the step of allowing state and university laboratories to validate and use their own tests and clearing some of the hurdles to validating them under EUA - but it's not entirely clear that they've lifted enough of them (see above)

The problem is if the validation requirements are unreasonable or pose an undue burden beyond the necessary science of "does this test detect what it should, does it not detect what it shouldn't, and what are the error estimates?"  Example: Alexander Greninger, an assistant professor in laboratory medicine at the University of Washington Medical Center, said after he submitted his COVID-19 test, which copies the CDC protocol, to the FDA, a reviewer asked him to prove that his test would not show a positive result for someone infected with the SARS coronavirus or the MERS coronavirus — an almost ridiculous challenge. The SARS virus, which appeared in November 2002, affected 26 countries, disappeared in mid-2003 and hasn’t been seen since. The MERS coronavirus primarily affects the Middle East, and the only two cases that have been recorded in the U.S., in 2014, were both imported.  There are labs that can create parts of a SARS virus, but the FDA’s recommended supplier of such materials said it would need one to two months to provide a sample, Greninger said. He spent two days on the phone making dozens of calls, scrambling to find a lab that would provide what he needed.

Greninger said the FDA was treating labs as if they were trying to make a commercially distributed product. “I think it makes sense to have this regulation,’’ he said, when “you’re going to sell 100,000 widgets across the U.S. That’s not who we are.”

 



https://www.propublica.org/article/how-south-korea-scaled-coronavirus-testing-while-the-us-fell-dangerously-behind
 

 

 

 

I agree with the bolded, but my response in terms of IVD validation was based on my experience in dealing with both the CDC and FDA in the past.   Having dealt with them specifically in developing a surveillance test for antiviral resistance, albeit when we weren't in the middle of a global pandemic, still gave me no reason to expect that they would react in a manner or with the appropriate speed that this situation required.

 

21 hours ago, Hapless Bills Fan said:

 

Thanks for info on flu surveillance testing.  I believe in 2009 for H1N1, a more massive scale was done, but I'd have to go look it up to be sure.

Certainly 2000 tests per day in 5 cities is way more than got done for Covid19 (I think even, more than is being done now), right?  It would have helped, you must admit....


To my understanding, I believe surveillance testing in the public health sense means what public health officials decide it needs to mean.  In the case of flu, they know it's out there and spreading, so they're interested in subtypes and lineages to see how well it matches the year's vaccine and to pick up any strains that might be particularly problematic.   Here's a link to an article about Active Surveillance Testing for MRSA.

In the case of a novel disease such as Covid-10, public health officials are more interested in "where is it, and how widespread is it?".  Surveillance testing could mean testing everyone who returns from a country or set of countries, or everyone who reports a certain symptom (fever, say; or contact with an infected person).  Or it could mean random screening of a sample population, though I feel that would be of less use at present.

The distinction (again as I understand it) is that you're testing widely, not just limiting to people who traveled to specific countries AND report specific symptoms.

 

But I'd love to hear more about flu surveillance testing with regard to how it might or might not help here.

 

With flu the the overall umbrella of surveillance is two pronged, diagnostic results (Flu A/B) are gathered from clinical labs in all states and territories to monitor how much flu is out there and where it is.  These diagnostic data can be collected from rapid tests (both antigen and molecular based) and from traditional PCR.  The rapid molecular and antigen based tests are something we did not have for covid19, although the Roche isothermal PCR test that was granted approval under the EUA should help in this regard.  A smaller subset of samples are tested at public health laboratories for subtype (A/H1N1, A/H3N2, B) and lineage, which as you stated is primarily for identifying circulating strains to assess vaccine efficacy.  And yes, they certainly do ramp up surveillance efforts when a novel strain appears such as in 2009.

 

I think we are largely in agreement here that the CDC/FDA failed on both technical and bureaucratic levels in a big way.  They clearly failed in rolling out enough tests that would have helped in giving an earlier picture on the spread of covid19.  You can be certain that there will be congressional inquiries into this when all is said and done.

  • Awesome! (+1) 1
Link to comment
Share on other sites

40 minutes ago, Sundancer said:

 

Agreed. 

 

 

That's nothing to the large number of people not getting checks. Almost literally $0. 

 

In 2008, people were not about to have $0 in the bank and mouths to feed. That is where we are now. So it's find to send out cash but we need to get back to work, very very soon. 

Of course, but I think that infusion it will help the banks and other institutions. 

Link to comment
Share on other sites

6 minutes ago, K-9 said:

Of course, but I think that infusion it will help the banks and other institutions. 

It should not be looked at as anything but an emergency bandaid. Certainly not as financial lubrication.

 

Printing money to increase liquidity in the markets, as proven, is not a long term solution. 

Link to comment
Share on other sites

11 hours ago, K-9 said:

From a VOX report dated 3/8:

 

 

For weeks we’ve heard empty promises of the imminent shipments of millions of test kits. For weeks we’ve heard from the scientists how critical it is to have this testing done ASAP.  And for weeks we’ve heard story after story of how people with symptoms have been denied the test and/or given the bureaucratic run around when trying to obtain one. Sure looks like a deliberate plan to keep the numbers low from where I sit. 
 

Like I said, we all know why that is. And it should piss us off to no end. 

I guess I’m not as smart as everybody else in here, because I don’t know “why that is.” Maybe you can be more specific, and explain it more thoroughly. Maybe if it gets explained, I’ll be pissed off too. Thanks.

Link to comment
Share on other sites

19 minutes ago, GoBills808 said:

It should not be looked at as anything but an emergency bandaid. Certainly not as financial lubrication.

 

Printing money to increase liquidity in the markets, as proven, is not a long term solution. 

I agree. There is no panacea. But in the short term a trillion dollars of capital infusion into the markets should help to offset those liquidity concerns, even if just a little, and help lenders when needing to postpone payments from some of their customers. 
 

Question: since those receivables are still assets, can’t lenders borrow against those future payments to further offset liquidity issues? I’m really not sure. 

29 minutes ago, John in Jax said:

I guess I’m not as smart as everybody else in here, because I don’t know “why that is.” Maybe you can be more specific, and explain it more thoroughly. Maybe if it gets explained, I’ll be pissed off too. Thanks.

I think I’ve had enough posts get deleted for one day as they attracted this kind of trolling element. Go troll a different pond. 

  • Like (+1) 1
  • Haha (+1) 1
Link to comment
Share on other sites

Just now, K-9 said:

I agree. There is no panacea. But in the short term a trillion dollars of capital infusion into the markets should help to offset those liquidity concerns, even if just a little, and help lenders when needing to postpone payments from some of their customers. 
 

Question: since those receivables are still assets, can’t lenders borrow against those future payments to further offset liquidity issues? I’m really not sure. 

I'm not an expert, but my understanding is yes. I mean under normal conditions you can find equity in basically anything provided there's credit available lol...the issue being now lending's basically frozen as Fed moved to cut interest to zero...normally you'd find someone willing to take on the risk of backing those loans in anticipation of climbing out of this but as of right now not seeing it.

  • Thank you (+1) 1
Link to comment
Share on other sites

17 minutes ago, GoBills808 said:

I'm not an expert, but my understanding is yes. I mean under normal conditions you can find equity in basically anything provided there's credit available lol...the issue being now lending's basically frozen as Fed moved to cut interest to zero...normally you'd find someone willing to take on the risk of backing those loans in anticipation of climbing out of this but as of right now not seeing it.

Good points, all. I’m afraid that until we see the first report of a reduction in CoVID-19 cases, the markets will lack the kind of confidence required in the meantime. 

Link to comment
Share on other sites

 4207 new cases and 475 new deaths in Italy. 1084 new recoveries were also reported today. Is this the peak? Seems like the worst day so far for them, so many health workers contracting it, couple of the older doctors have also died. 

 

 

http://www.ansa.it/canale_saluteebenessere/notizie/sanita/2020/03/18/coronavirus-morto-il-segretario-della-federazione-dei-medici-di-lodi_9c0a5f1e-e938-4308-bd05-01486266df84.html

 

Link to comment
Share on other sites

2 hours ago, K-9 said:

Heard the CEO of BoA say in an interview on Sunday that if you’ve been impacted by the crisis all,you have to do is call the bank, explain that, and your payment due will be suspended. This needs to happen across the board for all mortgages, all loans, all rents, all utilities, etc. It’s our moral imperative. 
 

My cynicism says, “good luck with that.” 

 

 

...imagine if they pursued foreclosures under these circumstances and the explosion of bank owned properties in a depressed real estate market?...makes perfect sense (COUGH).......

Link to comment
Share on other sites

I would like to see statistical compilations in more detail by age that do not include China's numbers in a week. I see glimpses of these now but not tabled. 

 

Anyone who thinks they can draw conclusions from China's numbers, especially their decreasing cases and apply them elsewhere, may not have their thinking hat on straight. 

- We are not China and lockdowns there are not the same as in the west

- China has a very loose relationship with the truth. 15000 to 15 patients does not ring true with what the rest of the world is experiencing.  

 

Edited by Sundancer
  • Like (+1) 1
Link to comment
Share on other sites

Guest
This topic is now closed to further replies.
×
×
  • Create New...