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

[Hapless Bills Fan]

1 hour ago, Gugny said:

New York restaurants and bars have to cap their seating capacity at half.

 

This is going to have a significant impact on servers, bartenders and the owners of mom & pop diners, bars, etc.  Servers and bartenders don't get PTO and most of their earnings are tips.  

 

I'm not saying it's the wrong thing to do; just emphasizing how sad it is.

 

The problem that I have with measures like this and like the NJ 10 pm curfew is that I don't think there's any particular evidence they're effective epidemiological public health measures (especially the 10 pm curfew).  This is the problem with having a strategy that is piecemeal and driven by local ideas recently created in a room full of people who want to "do something",  instead of central decision making driven by "best practices".

Leaving aside the point that half-capacity for some restaurants is still more closely spaced than full-capacity for others.....

-a server who may be ill will still be leaning over diners placing plates and removing empties

-there is recently published study in NEJM that Covid19 may linger in the air as aerosol for 3 hrs and travel a bit further than previously thought (maybe 6-8 ft)

-patrons will all be in common space and touching common surfaces waiting for seating and using restrooms

 

It would probably be more effective to have a screener at the door asking if the employee or customer had taken fever medication or was coughing, checking for temperature, and barring those with fever and cough, asking them to return home and contact their physician.

 

 

 

[Gugny]

1 minute ago, Hapless Bills Fan said:

 

The problem that I have with measures like this and like the NJ 10 pm curfew is that I don't think there's any particular evidence they're effective epidemiological public health measures (especially the 10 pm curfew).

Leaving aside the point that half-capacity for some restaurants is still more closely spaced than full-capacity for others.....

-a server who may be ill will still be leaning over diners placing plates and removing empties

-there is recently published study in NEJM that Covid19 may linger in the air as aerosol for 3 hrs and travel a bit further than previously thought (maybe 6-8 ft)

 

It would probably be more effective to have a screener at the door asking if the employee or customer had taken fever medication or was coughing, checking for temperature, and barring those with fever and cough, asking them to return home and contact their physician.

 

 

 

 

I question the curfew method, too.  Most people are in by 10pm, anyway.  And if they make a curfew beginning earlier, say 5pm - then you've got gigantic masses of people out in the earlier hours trying to get stuff done.

 

[John in Jax]

44 minutes ago, Hapless Bills Fan said:

Since Fever is the single most common symptom of Covid-19 (~90%), it would help a lot if everyone with fever could be tested for Covid-19 and directed to self-quarantine if positive.  If a slow, limited throughput test is still being used, at least test what we can rapidly test for (strep, flu etc) and if negative - then test for Covid-19.  I'm dreaming?

 

OK, how about at least test people with two common symptoms (fever and dry cough, 68%), and quarantine/contact trace the positives?

I saw a female 30 something on a cable news network last night who tested positive, and she had zero symptoms! She said she had recently gone to a party with a lot of people in attendance. I’m not quite sure why / how she was tested.

 

I personally have had a slight sore throat, slight/intermittent dry cough, constant stuffy nose, and slight on/off headache since Thursday afternoon, but NO fever and no shortness of breath. I called my Dr, and I’ve been self medicating like crazy since then, and stayed home from work on Friday. Of course, I’ve scoured the internet for reliable info on symptoms of Covid-19 vs Flu vs Allergies vs a Cold. My conclusion is that I‘ve got a “regular” old cold, but I can’t be 100% sure of that. 
 

And to add: I haven’t been out of FL since November (was up in Buffalo), and I do not regularly come in contact with a lot of people, and my job has me driving around north/central FL 90% of the workday (about 1000 miles per week on my truck) doing inspections at various construction sites. And normally, I am always washing my hands and/or using hand sanitizer.

[Hapless Bills Fan]

46 minutes ago, BUFFALOKIE said:

Let me know when deaths begin outpacing births. Not that ther is anything wrong with that.

 

You know this has to happen eventually, right? 

 

OK, you know

 

https://worldbirthsanddeaths.com/

[Foxx]

1 hour ago, OldTimeAFLGuy said:

...not to worry Hap!......last call is 9:30 with guaranteed immunity................9:45 and you're on your own....

this is normally when panic buying sets in.

[Gray Beard]

@Hapless Bills Fan

 

Stupid question, perhaps already discussed upstream...

 

There are many anecdotal stories of people who say they have had flu-like symptoms in recent months, yet they tested negative for the flu. Their claim is that Covid-19 has been around longer than people might think.   I doubt that this is the case, but I have nothing other than a gut feel.  What say you?

[Hapless Bills Fan]

2 minutes ago, John in Jax said:

I saw a female 30 something on a cable news network last night who tested positive, and she had zero symptoms! She said she had recently gone to a party with a lot of people in attendance. I’m not quite sure why / how she was tested.

 

I personally have had a slight sore throat, slight/intermittent dry cough, constant stuffy nose, and slight on/off headache since Thursday afternoon, but NO fever and no shortness of breath. I called my Dr, and I’ve been self medicating like crazy since then, and stayed home from work on Friday. Of course, I’ve scoured the internet for reliable info on symptoms of Covid-19 vs Flu vs Allergies vs a Cold. My conclusion is that I‘ve got a “regular” old cold, but I can’t be 100% sure of that. 
 

And to add: I haven’t been out of FL since November (was up in Buffalo), and I do not regularly come in contact with a lot of people, and my job has me driving around north/central FL 90% of the workday (about 1000 miles per week on my truck) doing inspections at various construction sites. And normally, I am always washing my hands and/or using hand sanitizer.

 

WHO-China Joint Commission (largest data on symptoms): "Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%),and conjunctival congestion (0.8%)."

What did your doctor say?  The symptom probabilities suggest that a stuffy nose and no fever means high probability of cold/other virus and not Covid-19, but that's just playing the probabilities.  Remember of course that if you are taking anti-fever medication or cold meds that contain same, it will mask fever.

 

This is where a readily available test would be extremely helpful, so well-intentioned persons such as yourself could be told "yes, you have it, self-quarantine" or "just a cold, As you Were". 

[Gugny]

 

It's people like this who are running our country.  God help us all.

[John in Jax]

6 minutes ago, Hapless Bills Fan said:

 

WHO-China Joint Commission (largest data on symptoms): "Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%),and conjunctival congestion (0.8%)."

What did your doctor say?  The symptom probabilities suggest that a stuffy nose and no fever means high probability of cold/other virus and not Covid-19, but that's just playing the probabilities.  Remember of course that if you are taking anti-fever medication or cold meds that contain same, it will mask fever.

 

This is where a readily available test would be extremely helpful, so well-intentioned persons such as yourself could be told "yes, you have it, self-quarantine" or "just a cold, As you Were". 

Dr said to self medicate, wait it out til tomorrow morning, and if I’m worse, go in for a visit. And yes, I’d like to be tested ASAP. I have not quarantined myself, but I have been extremely careful when I’ve been out so as to not cough/sneeze on my hands, and then touch a surface. To add, I am rarely sneezing, and only coughing about 2-3x an hour, some hours with no cough at all. I’m not severely fatigued either; went for a motorcycle ride yesterday, as well as cut the grass/did yard work (it’s 80 degrees down here).

[Gugny]

For those wondering if they should cancel/postpone travel plans:

 

Airbnb is offering 100% refunds.  It took me less than a minute to cancel and get the refund going.

 

I just spoke to my travel agent about canceling my trip to Puerto Rico (scheduled for 4/10 - 4/16).  If I cancel now, I will get vouchers for my flights that I can use anytime within a year.

 

My rental car will be refunded.

 

If travel is restricted, airlines will be giving refunds.  My cutoff to cancel is 48 hours prior, so I'm going to wait it out with hopes that I can get a refund.

 

[BUFFALOKIE]

19 minutes ago, Gray Beard said:

@Hapless Bills Fan

 

Stupid question, perhaps already discussed upstream...

 

There are many anecdotal stories of people who say they have had flu-like symptoms in recent months, yet they tested negative for the flu. Their claim is that Covid-19 has been around longer than people might think.   I doubt that this is the case, but I have nothing other than a gut feel.  What say you?

Since you asked, yes. I missed three days of work three weeks ago tomorrow. Flu like cold sweats, achy body and stomach pain. Low fever. Dad had same and his dr. Said no flu. I didn't go to dr.

[Hapless Bills Fan]

26 minutes ago, Gray Beard said:

@Hapless Bills Fan

 

Stupid question, perhaps already discussed upstream...

 

There are many anecdotal stories of people who say they have had flu-like symptoms in recent months, yet they tested negative for the flu. Their claim is that Covid-19 has been around longer than people might think.   I doubt that this is the case, but I have nothing other than a gut feel.  What say you?

 

The answer is up thread in a couple places, but I'll try to summarize here. 

 

For starters, please bear in mind that ALL clinical tests for disease have a known false negative rate, and there are several different strains of flu and some other viruses known to cause flu-like symptoms.  So a negative for one type of flu, may still be flu if other types weren't tested, and may still be the type tested for (but a false negative for several reasons, not all having to do with the test itself).  They may still have had flu.

 

That said:

 

Taiwan has been taking measures since 31 December: "On December 31, 2019, when the World Health Organization was notified of pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. As early as January 5, 2020, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry"

 

-When did the US start taking measures?  Not until recently, and not as extensively, right?  People who have traveled through international airports (but not to level 3 countries, or to level 3 countries but before that declaration was made) still can't get tested even if they have relevant symptoms (fever, cough, difficulty breathing).

-There is a community transmission cluster in Washington State apparently initiated by a traveler returning from Wuhan on or about 15 January (before the city locked down, at a point where Wuhan had perhaps 500 actual cases of Covid19).

 

My take is that it's probable that at least a handful of travelers returning from China between late December and late January probably had Covid19, and started clusters of the virus all over the country.  Some of them probably died away, and some of them have probably been quietly spreading communally and are at a point where they will start to "bloom" and be seen as excess numbers of serious pneumonias or deaths among susceptible populations.

 

FWIW, this isn't just my take.  I quote the guy so much people are going to start to think I'm his publicist, but here you go from my Fred Hutch guy Trevor Bedford.  Keep in mind that back-of-the-envelope calculations by a trained epidemiologist who does it for a living are a bit different than "guesses" or "making up numbers" by Joe Public - experience and education matters.  Just as a trained scout can estimate 40 time pretty accurately by watching a guy, a trained epidemiologist can guess what's going on pretty accurately by taking a few facts and synthesizing.

(edit: he means it's a bit sooner than he predicted, 8 wks vs 10)

[he's saying he believes that because of limited testing and contact tracking, there may be ~10 covid-19 cases for every reported infection]

 

 

 

 

[BUFFALOKIE]

28 minutes ago, Hapless Bills Fan said:

 

OK, you know

 

https://worldbirthsanddeaths.com/

That is a very interesting link Hap. Thank you.

 

If that tracker is true, oh boy. Really puts some things in perspective. How can the world continue at a 4 births to 1.5 deaths per second rate?

 

I dont predict when, but that ratio will turn eventually, guaranteed.

 

[K-9]

1 hour ago, Hapless Bills Fan said:

Interesting article in JAMA (Journal of American Medical Association) about measures taken by Taiwan to contain Covid-19 (it focuses on strategy and omits some description of tactics).  Taiwan was widely expected to develop a severe epidemic:

 

Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China.¹ The country has 23 million citizens of which 850 000 reside in and 404 000 work in China.^2,3 In 2019, 2.71 million visitors from the mainland traveled to Taiwan.  COVID-19 [emerged] just before the Lunar New Year during which time millions of Chinese and Taiwanese were expected to travel for the holidays.
Basically public health experts around the world fully expected Taiwan to be pulverized by Covid19.  Taiwan collectively said "Nope, not THIS island!"

 

First of all, Taiwan had a clear command and control structure to handle epidemics, with plans in place.  This saves time and helps protect against in-fighting between agencies:

In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC). The NHCC is part of a disaster management center that focuses on large-outbreak response and acts as the operational command point for direct communications among central, regional, and local authorities. The NHCC unified a central command system that includes the Central Epidemic Command Center (CECC), the Biological Pathogen Disaster Command Center, the Counter-Bioterrorism Command Center, and the Central Medical Emergency Operations Center.

As soon as they learned of the problem, Taiwan acted:
On December 31, 2019, when the World Health Organization was notified of pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. January 5, 2020, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry; suspected cases were screened for 26 viruses including SARS and Middle East respiratory syndrome (MERS). Passengers displaying symptoms of fever and coughing were quarantined at home and assessed whether medical attention at a hospital was necessary. 

Note that these steps were taken without a test.  Quarantine at home is both enforced using cell phone tracking, and supported by regular wellness checks and provision of food. 

 

On January 20, while sporadic cases were reported from China, the Taiwan Centers for Disease Control (CDC) officially activated the CECC for severe special infectious pneumonia under NHCC, with the minister of health and welfare as the designated commander. The CECC coordinated efforts by various ministries, including the ministries of transportation, economics, labor, and education and the Environmental Protection Administration, among others, in a comprehensive effort to counteract the emerging public health crisis. 

For the past 5 weeks (January 20-February 24), the CECC has rapidly produced and implemented a list of at least 124 action items including (...) case identification (using new data and technology), quarantine of suspicious cases, proactive case finding, resource allocation (assessing and managing capacity), reassurance and education of the public.....

 

On January 27, the National Health Insurance Administration (NHIA) and the National Immigration Agency integrated patients’ past 14-day travel history with their NHI identification card data from the NHIA; this was accomplished in 1 day. Taiwan citizens’ household registration system and the foreigners’ entry card allowed the government to track individuals at high risk because of recent travel history in affected areas. Those identified as high risk (under home quarantine) were monitored electronically through their mobile phones. On January 30, the NHIA database was expanded to cover the past 14-day travel history for patients from China, Hong Kong, and Macau.

On February 14, the Entry Quarantine System was launched, so travelers can complete the health declaration form by scanning a QR code that leads to an online form, either prior to departure from or upon arrival at a Taiwan airport. A mobile health declaration pass was then sent via SMS to phones using a local telecom operator, which allowed for faster immigration clearance for those with minimal risk. [Persons with low risk (no travel to level 3 alert areas) were sent a health declaration border pass via SMS (short message service) messaging to their phones for faster immigration clearance; those with higher risk (recent travel to level 3 alert areas) were quarantined at home and tracked through their mobile phone to ensure that they remained at home during the incubation period.]  This system was created within a 72-hour period. On February 18, the government announced that all hospitals, clinics, and pharmacies in Taiwan would have access to patients’ travel histories.  (In other words, if you had traveled during the past 14 days and went to the clinic with fever or cough, or even the pharmacy to get cough or fever medicine, the doctor or pharmacist got an alert to treat this as a potential Covid-19 case. )

Again, none of these measures require a test.  They do require centralized command and control and rapid decision making, but a lot of the strategies and tactics had been thought out and planned in advance and were simply implemented.

We could do (or have done) a lot of the stuff Taiwan did using big data, with questions, but they have to be better questions than "have you traveled to China?" at a point where the disease was popping up all over Europe or "have you traveled to a level 3 alert area in the last month?" which requires someone to know WTF that means. 

Fundamentally, we have lacked a centralized, nimble response - it has been left piecemeal to local governments, individual health care providers and businesses to process information and react appropriately, which takes longer and is less efficient.  And bluntly: If you don't track quarantine, some people won't comply.  If you don't support quarantine with food and health checks, people can't comply.
 

 

Well, in response to the Ebola scare, we actually created and put in place a uniform pandemic response strategy with a clear chain of command across several inter-agency departments, including the NSC, DHS, NIH, and CDC. In 2018, that was ended. For whatever reason. 
 

That is all I’m gonna say. 

[Chandler#81]

 

 

 

[Hapless Bills Fan]

[BillsFan4]

2 hours ago, Gugny said:

 

It's people like this who are running our country.  God help us all.

I see people bragging about being out in crowded places all over social media. 

 

 

 

[Gugny]

1 minute ago, BillsFan4 said:

I see people bragging about being out in crowded places all over social media. 

 

***** morons.  Absolute ***** morons.

 

#oklaignorant

 

 

 

Edited March 15, 2020 by Gugny

[Lurker]

11 minutes ago, Hapless Bills Fan said:

 

Is this another one of those Ed Orgeron PSAs?...

[BillsFan4]

Just now, Gugny said:

 

***** morons.  Absolute ***** morons.

And that was a governor! ?‍♂️