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Covid-19 - Facts and Information Only thread

Hapless Bills Fan

[This is a general message.  If you see it, please don't take it personally]
To avoid creating another mega-thread, I am returning to edit previous posts:

-update them with current information as it emerges or to add better information, so check back to the same post.

-paste in comments from knowledgable people that were originally separate posts

-delete discussion

 

If you want to discuss, please use the other thread. On a computer, click on the post date-time in the upper left corner to obtain a direct link to the post in question, then copy a link to include in your post so people know what you're referencing.  On a mobile device, this can be done but instructions vary.

 

If you find updated info, feel free to post it - but your post may disappear as I merge your info into the relevant original post.  I try to quote and give credit.

 

Thanks, and again - please don't take it personally if your post is deleted, I'm trying to maintain a succinct thread for information and resources. The other thread is there for your Covid-19 discussions and ruminations.

Message added by Hapless Bills Fan

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I'm gonna take a try at putting links to covid-19 information here.  Please limit discussion to the other thread.  Thanks

 

Much of this discoverable by Google.  So is a bunch of "stuff" and links that will offer to infect your electronics for you.  In evaluating information, please be aware that trained scientists working closely with data tend to caveat with "I think" or "I believe" about stuff that has a whole lot of training and modeling behind it, vs. people who make definitive statements about things that are still unknowable - like the true case fatality rate with best treatment or if warm weather will cause it to diminish as do seasonal flu/colds.

Beautiful graphic explaining the impact of social distancing on epidemic spread:
Covid-19-Transmission-graphic-01.gif?fbc

CDC (Center for Disease Control) website, the US official source for info:

https://www.cdc.gov/coronavirus/2019-ncov/
 

WHO (World Health Organization) website
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

 

Edit: from @BillsFanNC, this is a fantastic resource (Singapore Saw Swee Hauk School of Public Health).  Absolutely top-notch.
https://sph.nus.edu.sg/covid-19/


When do symptoms appear after exposure?  From WHO-China Joint Report, based on 55,000 cases in China:
People with COVID-19 generally develop signs and symptoms,including mild respiratory symptoms and fever, on an average of 5-6 days after infection (mean incubation period 5-6 days, range 1-14 days).

Graphic Symptoms of Covid-19 (taken from Report of the WHO-China Joint Mission on Coronavirus Disease 2019)
89992007_10157112831390814_5532516733128

Please be aware that low-percentage symptoms may still be covid-19 - Concern has been expressed that GI tract symptoms may be overlooked as possible covid-19.

From WHO:

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

From CDC:

The following symptoms may appear 2-14 days after exposure.*

  • Fever
  • Cough
  • Shortness of breath

_______________________________________________

If you have a website that you find factual and a valuable resource about covid-19, please feel free to add it, but if the review of this "peer" disagrees, please don't get offended if it goes away.  Please keep discussion and share random news articles in the other Covid threads. 

If you wonder whether your link should be here, feel free to PM me and ask but be patient if I don't hit you back right away.

 

Other sites folks recommended:

On 3/20/2020 at 12:15 PM, Hardhatharry said:
On 3/20/2020 at 8:41 AM, BillsFanNC said:

Another resource that may not have been posted here yet is from the National University of Singapore, who have been publishing weekly digest updates on the latest published research.

 

https://sph.nus.edu.sg/covid-19/

 

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Posted (edited)

JHU website updated regularly, giving diagnosed cases, deaths, and recovered cases around the world.  Will give you info you need and not infect your electronics.  If you select the US, and mouse-over a red "infection" dot, a pop-up in the L corner will give you the data for that state.

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

 

EDIT: by popular demand, a site which gives Covid-19 cases by population:

https://www.worldometers.info/coronavirus/#countries

 

Really good, regularly updated article from Financial Times [BUT after the first couple views, you need to subscribe. 

Offer a trial 4 weeks for $1, but put it on your calendar - they'll hit you for $67/month subscription after that if you don't cancel.]
 image.thumb.png.c0c398cfb9395844634b78e47567c516.png

Data from the above link as of 29 March.  Click to embiggen.  The United States has now surpassed every other country's case total despite extraordinarly limited testing.   143,527 cases.
 

S. Korea was leading at one point (due partly to massive testing) but now seems to have it locked down.  It can be done.  WE CAN DO THIS TOO! 
(Taiwan doesn't make the graph; being next door to China and having frequent travel .......they have not yet gotten to 100 cases through effective, proactive control measures.  We can do this!)

[Edit: There is some emerging controversy that China may not be counting asymptomatic cases.  If these are recovered patients shedding virus, they probably shouldn't since they've already been counted, but if they are new positive tests they should count ]


image.thumb.png.8f9fe1a53da777acb1d6c177be625948.png
We are close to China for death toll and are closing on Italy.  Currently 2,500 deaths and on the "doubling every 3 days" line.  If that trend continues, should be 20,000 deaths in a week.

Note that 19 days out from complete country-wide lockdown, Italy's case count looks as though it may be leveling off.  This is as expected given the incubation time of the disease, the possibility of presymptomatic and asymptomatic transmission, and of course, any violations of social distancing.  It would be expected to take at least 3 weeks post country-wide lockdown for it to flatten (the more violations, the longer).  There is also the possibility that it is flattening because they are limiting testing, as NYC is doing.

 

 

 

 

Edited by Hapless Bills Fan
Updated graph as of 30 March. Added access instructions for JHU state info. Added Deaths graph.

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From Hapless in the other thread:

 

Quote

This graph is the answer to everyone who posts somewhere about "why don't we just all accept that we're going to get the disease, accept the mild symptoms most of us will have, and get it over with?" 

This is the classic "contained vs uncontrolled transmission" epidemic graph.

 

If 80% have a mild disease, but ~15% are seriously ill and require medical intervention including oxygen and ~5% become severely ill and require intensive care, hospitals and HCW quickly become overwhelmed.  This is undoubtedly part of the high initial death rate in Wuhan - the healthcare system, despite redeployment of resources from other parts of the country, was simply too far above capacity.  (Oh, and be sure to schedule your heart attack or your meningitis so that it doesn't occur at the epidemic peak.)

 

D05BAD69-13B4-403F-9580-8EFCDAB9A2C5.jpeg

 

Edit: and on April 2, we see a similar graph presented by the White House, with some numbers on it.  Thank you @MJS
 

3 hours ago, MJS said:

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

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

 

The numbers on this version of the graph appear to come from the University of Washington's Institute for Health Metrics and Evaluation, or IHME as explained in this NPR report.

———————————————————————————————

 

 

WHO executive director Dr. Michael Ryan on what he’s learned from dealing with many previous outbreaks:

 

 

 

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From the previous COVID19 thread:

 

Quote

or if you don't speak Italian, it's translated here (scroll down past the picture)

 

https://www.mirror.co.uk/news/world-news/coronavirus-shocking-image-italian-patients-21663653

 

Key take home:

 

Francois Balloux of the University College London Genetics Institute said: “The trajectory in the UK is so far roughly comparable to the one in northern Italy, but with the epidemic [there] two to three weeks ahead of the situation [here].

“It is possible that a lockdown strategy similar to the one imposed in northern Italy may be adopted by the UK. The Covid-19 epidemic cannot be contained any more.”

 

Doctor-turned-author Adam Kay said it should be a stark warning for Britain. He said: “­Fourteen days ago, Italy had fewer coronavirus cases than we do today. They employed similar public health measures to us.

 

“Unless I’m missing something, this is us in a fortnight.”

The U.S. is on a similar timeline as the U.K.. The experts are saying that we are roughly 10-14 days behind Italy’s COVID19 timeline.

 

Quote

From the translation of Italian Physician Dr Daniele Macchini of Humanitas Gavazzeni hospital's Facebook post:

 

"There are no more surgeons, urologists, orthopaedists – we are only doctors who have become part of a single team to face this tsunami that has overwhelmed us.

"Cases are multiplying, with a rate of 15-20 admissions per day – all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the ER is collapsing. Reasons for admission are always the same: fever and breathing difficulties, fever and cough, respiratory failure.

"Radiology reports are always the same: bilateral interstitial pneumonia. All to be hospitalized.

 

"Some are already intubated go to intensive care. For others it’s too late. Ventilators are like gold dust: those in operating theatres that have suspended non-urgent activity become intensive care places that did not exist before.
(....)

 

"There are no more shifts, no more hours. Social life is suspended. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.  "Some infected colleagues have infected relatives, some of whom are already fighting for their lives.

 

"So be patient – you can’t go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate. 

"We try to make ourselves useful. You should, too. We influence the life and death of a few dozen people. You, many more. Please share this."

 

 

Full twitter thread for above story -

 

There are 20+ tweets so click on the tweet to see the whole thread.

 

 

Over the last 48 hours in Italy there have been roughly 700 deaths from COVID19.

 

350+ new deaths in a 24 hour span 2 days in a row. 

 

Hospitals are at 200+% capacity. Doctors are telling heart breaking stories of choosing which patients to let die.

 

 

What we are currently trying to accomplish with these social distancing rules is avoiding what is happening in Italy. There are already stories of hospitals here dangerously short on supplies and beds. Doctors forced to work after being exposed to COVID19. Having to reuse masks for 2 weeks.

 

It is crucial that we do everything we can to flatten the curve now.

21848DAD-DB2F-4E68-9740-8A9BD1E75FC4.jpeg

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I like this video

 

 

[mod notes:

I love much of the graphic presentation - clear, catchy, and easy for a layperson to understand.

Areas where the info it presents has been filled in:

1) There's enough data from countries that have contained the epidemic at this point to say with some confidence that the death rate is >4% in areas/countries where the health care system is overwhelmed, and <1% in areas/countries where the spread is slowed enough that the health care system can handle it

2) The info about the primary spread being through person to person aerosol transmission (breathing or coughing) is likely correct but transmission from touching surfaces then touching face is also thought to occur.  A new study has  shown the virus can live on porous surfaces (paper, cardboard, hair, cloth) for ~3 hrs, and hard surfaces for 1-2 days. 

3) The video presents secondary bacterial pneumonia/sepsis as a cause of death in serious cases.  Increasing evidence suggests that cytokine storm may be involved - the immune system gets excessively triggered by the virus and goes into overdrive.  [Remember this phrase when speaking to the physician of a loved one with high fever/difficulty breathing: "did you request a serum ferritin test to screen for cytokine storm?"].  If known to be occurring, there are specific pharmaceutical treatments for cytokine storm.

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Hapless post from other thread:

 

Quote

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

 

This is by far the best article about the coronavirus.  It is factual, it is matter of fact, and it is correct.

 

If you read nothing else, read this.  It explains the different disease outcomes in Hunan vs rest of China, in Korea vs Hunan, and in Italy.

 

It explains the difference between known and actual cases and the reason for mitigation factors like social distancing and cordons.

 

Read it.

 

Ive attached a graph from the 1918 influenza pandemic showing the difference between Philadelphia and St. Louis. (st. Louis put aggressive social distancing measures in place)

B71462E2-577A-4130-ACB2-736411B8F160.jpeg

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https://www.nebraskamed.com/COVID/a-message-from-one-of-our-doctors-to-his-family-about-covid-19?fbclid=IwAR3rCHLYtrd3yHJc2P41Y35OrhwDSiPeJtDZzA4S_OqD4Hn2HCt3u_42J1A

I'm a doctor at Nebraska Medicine. Here's what I'm telling my family about COVID-19.

 

‘This is an email from Nebraska Medicine critical care anesthesiologist Dan Johnson, MD, to his friends and family about the seriousness of COVID-19. It is shared with permission from Dr. Johnson.’

 

Quote

Dear Family,

 

Quote

The COVID-19 pandemic will be a challenge to the USA unlike any we have experienced in our lifetime. For the last several weeks, I have been involved in multiple meetings each day where I get to hear the thoughts of experts in the field of pandemics, specifically about this pandemic, and what we need to do.

If anyone hears from family or friends who think this is “no big deal,” or that the USA’s response has been excessive, please know that they are very wrong. I’m sure you have all read about the many reasons that this is NOT “just like flu.” The numbers of infected, worldwide and in the USA, are extreme underestimates (because many infected have not been tested). The best metric to use, right now, is talking with hospital workers in the hotbeds, and asking them what their situation is.

I have been in communication with a friend who is a critical care physician from the Lombardy region of Italy. The health care workers there are living in a nightmare, having to decide who lives and who dies from lack of oxygen because their health care system is overwhelmed.

In the USA, we have three pathways for COVID-19:

  1. The country views this challenge like WWI and WWII, and almost everyone does the right things, and we will be harmed but okay.
  2. Many people do the right things, and many don’t, and we will have the same struggles that Italy is enduring.
  3. People blow this disease off as no big deal, and our health care system (and life as we know it) will be crippled.

You have all probably seen the concept of “flatten the curve.” If we fail to flatten the curve, and we fail to eliminate the portion of yellow above that line, there will be dire consequences:

  1. More people, including some of our friends and family, will die.
  2. Health care workers like me, Rachel, and several of you are at higher risk of dying.
  3. All health care workers will have to witness the needless deaths of patients who could have survived.

In the SARS-1 outbreak, critical care doctors and nurses in Asia and Canada acquired life-long PTSD from watching patients gasp for air and die because they did not have enough ventilators. SARS-1 was nothing compared to COVID-19. If we do not flatten the curve, Rachel, Bridget, and I will have to witness many of these types of deaths.

In the absence of a vaccine or an anti-viral in the immediate future, our best chance to avoid overwhelming our hospitals is non-pharmaceutical interventions. The two best ways to do that are (1) social distancing, and (2) excellent hygiene.

Please check out these simulations from the Washington Post, and share this article.

The best ways for you to achieve social distancing are pretty simple:

  1. You and your kids should stay home. This includes not going to church, not going to the gym, not going anywhere.
  2. Do not travel for enjoyment until this is done. Do not travel for work unless your work truly requires it.
  3. Avoid groups of people. Not just crowds, groups. Just be around your immediate family. I think kids should just play with siblings at this point – no play dates, etc.
  4. When you must leave your home (to get groceries, to go to work), maintain a distance of six feet from people. REALLY stay away from people with a cough or who look sick.
  5. When you do get groceries, etc., buy twice as much as you normally do so that you can go to the store half as often. Use hand sanitizer immediately after your transaction, and immediately after you unload the groceries.

I’m not saying people should not go to work. Just don’t leave the house for anything unnecessary, and if you can work from home, do it.

 

Everyone on this email, besides Mom and Dad, are at low risk for severe disease if/when they contract COVID-19. While this is great, that is not the main point. When young, well people fail to do social distancing and hygiene, they pick up the virus and transmit it to older people who are at higher risk for critical illness or death. So everyone needs to stay home. Even young people.

 

Tell every person over 60, and every person with significant medical conditions, to avoid being around people. Please do not have your kids visit their grandparents if you can avoid it. FaceTime them.

 

Our nation is the strongest one in the world. We have been through other extreme challenges and succeeded many times before. We WILL return to normal life. Please take these measures now to flatten the curve, so that we can avoid catastrophe.

 

Love,

Dan

 

Also, this is worth reading too:

 

https://god.dailydot.com/high-risk-coronavirus-pandemic/

24 High-Risk People You Should Practice Social Distancing For During The Coronavirus Pandemic

 

While many may not be in the high risk categories, almost everyone has some friends or family that are probably at higher risk. Also, Things you may not necessarily think about - like being overweight, having diabetes, (both very high in America), or high blood pressure (hypertension), put you at higher risk. 

 

Also things like coronary artery disease or any cardiac issues/disease, digestive diseases, or people with compromised immune systems or on drugs (for rheumatoid arthritis, etc) that suppress their immune system.

 

https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30076-5/fulltext

 

https://www.health.com/condition/infectious-diseases/coronavirus/coronavirus-preexisting-conditions

 

we have to try and protect our more vulnerable citizens.

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Posted (edited)

To give an idea of the impact it’s already having on NYC hospitals (in a matter of days):

 

 

 

(the sending food part was a joke)

 

They also need blood donations. Red Cross is calling for the same in all of NY state.

 

 

 

 

Edited by BillsFan4
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Posted (edited)
-Major source of transmission is thought to be close person-to person contact via small droplets exhaled or coughed out by the person with covid-19
-Droplets can also settle on surfaces and be transferred when another person touches the surfaces and then touches their mouth, nose, or eyes
-An NIH study showed that active virus is detectable for up to 24 hours on cardboard and two or three days on plastic and steel. 
-The same study showed that aerosolized droplets containing live virus (finer than normal droplets we exhale) may stay in the air for up to 3 hrs. 
(this would be more of a concern for medical professionals and dentists conducting procedures that may aerosolize larger numbers of particles; most virus particles in droplets shed by a person breathing or coughing are larger, and will fall out of the air more rapidly)
-Live virus is shed in feces, so in theory fecal-oral transmission is possible; it is not known how much this contributes.  Yuck in general.  Wash your hands.

Washing hands and avoiding touching your face protects you from surface transmission, but not from transmission via inhaling droplets shed by an infected person
(as from being packed into a crowd as at a bar, social event, or sitting/standing close to someone for hours.).  This is why Social Distancing is important.  You can scrub your hands until they're raw, but if you don't stay away from most people and limit the people with whom you have contact, you're still gonna get sick.

It is increasingly believed that transmission from asymptomatic or mildly symptomatic people may play a large role in disease transmission.  (This is why widespread testing will be needed to allow normal daily activities to resume without causing new disease spikes)

-----

From WHO Website: How does COVID-19 spread?

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.  WHO is assessing ongoing research on the ways COVID-19 is spread and will continue to share updated findings.    

From CDC Website:
https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html
How COVID-19  Spreads

Person-to-person spread

The virus is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Can someone spread the virus without being sick?

  • People are thought to be most contagious when they are most symptomatic (the sickest).
  • Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
    [Edit: current evidence is suggesting asymptomatic or presymptomatic spread may play a much larger role. There are a number of large disease clusters in several states where reportedly no one attending the meeting or social gathering showed symptoms]

Spread from contact with contaminated surfaces or objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

How easily the virus spreads

The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas.

Edited by Hapless Bills Fan
edited to add updated CDC information. edited to add link about asymptomatic spread

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Quotes from NIAID director Dr. Fauci:

 

Quote

He discussed three reasons why coronavirus is different from other ailments like the flu.

 

“One, it’s brand new so we don’t have any prior experience about what it’s gonna do, what it’s dynamic’s gonna be,” he said. “Number 2, it spreads very easily, there’s no doubt about that. It isn’t like some of the other outbreaks that we had that just didn’t adapt itself to spread among humans. And Number 3, it’s very serious in the sense of morbidity and mortality, particularly among – and very heavily weighted -- towards individuals who are more susceptible – the elderly and those with underlying conditions.”

 

When asked if its contagiousness and lethality are worse than the flu, Fauci emphatically said, “Well yes, I mean it just is, and we’ve gotta face that fact.”

 

Fauci also repeated his prediction that things “will get worse before they get better.” He remained optimistic that the impact can be mitigated, but only if people take precautions.

 

“To think that right now everything is going to be okay if we don’t do anything, that’s absolutely incorrect,” he said.

 

 

Quote

Despite the morbidity and mortality with influenza, there's a certainty … of seasonal flu," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a White House press conference on Jan. 31. "I can tell you all, guaranteed, that as we get into March and April, the flu cases are going to go down. You could predict pretty accurately what the range of the mortality is and the hospitalizations [will be]," Fauci said. "The issue now with [COVID-19] is that there's a lot of unknowns." 

 

So far they are finding that up to 20% of COVID19 patients need hospitalization. If this spreads quickly (as we’ve seen it do) it could easily completely overwhelm out medical facilities and cause needless deaths because there’s not enough ventilators and other needed equipment.

 

https://www.statnews.com/2020/03/18/coronavirus-new-age-analysis-of-risk-confirms-young-adults-not-invincible/

 

Quote

In general, the U.S. experience largely mimics China’s, with the risk for serious disease and death from Covid-19 rising with age. But in an important qualification, an analysis by the Centers for Disease Control and Prevention reported on Wednesday underlines a message that infectious disease experts have been emphasizing: Millennials are not invincible.

 

The new data show that up to one-fifth of infected people ages 20-44 have been hospitalized, including 2%-4% who required treatment in an intensive care unit.

 

https://www.usatoday.com/story/news/health/2020/03/18/coronavirus-ventilators-us-hospitals-johns-hopkins-mayo-clinic/5032523002/

 

Quote

Overrun by critically ill coronavirus patients, Italy’s hospitals are choosing who gets  lifesaving breathing machines and who does not.

It’s a scenario that could soon repeat in the United States, experts warn.

 

“The capacity in northern Italy hospitals is a preview of a movie that is about to play in the United States,” said Marty Makary, a Johns Hopkins University surgeon and health policy expert. “The best two indicators of what things will be like in the U.S. are the number of COVID-related deaths in Italy and the number of ICU beds.”

 

U.S. hospitals are on the cusp of too many severely ill patients without enough intensive care unit beds and ventilators to keep those patients breathing. It’s why states, municipalities and businesses are desperately trying to delay new infections through social distancing measures such as school closings and work-from-home mandates.

 

 

https://www.webmd.com/lung/news/20200318/us-may-not-have-enough-ventilators-for-covid19

 

Quote

March 18, 2020 -- There may not be enough ventilators in the United States to cope with the number of coronavirus patients who will require them due to pneumonia and other serious respiratory problems, experts say.


About 960,000 coronavirus patients may need to be put on ventilators at some point but the United States has only about 200,000 machines, according to the Society of Critical Care Medicine, the Associated Press reported.


The organization also said that about half of the ventilators are older models that may not be optimal for the most severely ill patients, and added that many ventilators are already in use by other patients with serious health conditions not associated with the coronavirus.


Ventilator manufacturers have boosted production, but it's not clear if that will meet the demand in the United States and other countries.

 

Why covid19 is worse than the flu n 1 chart: (1 to 3.4% fatality rate may not sound like a lot, but that is 10 to 34 times more deadly than the flu, and this spreads much faster, none of us have any immunity and we have no treatments yet)

A063C520-ED95-42B2-A3F0-FC76F39FC49B.jpeg

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Q:  I'm a young macho stud-muffin with six pack abs, oozing health and charm from every pore.  Fatalities by age say 0.2% chance I die from this covid-19 thing

Why shouldn't I party and mingle?  Pandemics are Boring.

 

A:  True, you're less likely to die.  But "not die" doesn't mean not get hella, miserably, debilitating sick.  "Data released Wednesday night by the CDC shows that of the 508 patients known to have been hospitalized in the U.S. for COVID-19, about 20% of those were ages 20 to 44 and another 18% were between the ages of 45 and 54."

Being sick enough to be hospitalized could mean 2-4 weeks flat on your back, struggling to breathe on oxygen, maybe even being paralyzed and placed on a ventilator.  Leaving aside the altruism aspect that your favorite teacher, coach, or your gran might need that ventilator, your six pack abs will not emerge intact and you may spend months working your way back to normal health, let alone peak condition.

Is that extra night bar hopping worth the risk?  Netflix and Chill!  Keep your Distance!

 

 

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Posted (edited)

How do I disinfect this covid-19 virus thing? 

 

Fortunately, coronaviri (covid-19 is a coronavirus) are not that hard to kill. 

What will work:

Soap and water (scrub >20 seconds and dry)

>60% alcohol (pref 70%) (rub hands 20 seconds until it all evaporates)

Disinfectant wipes - Chlorox, Lysol, etc - try to wet the surface you're wiping and allow it to dry, don't wipe

Dilute household bleach (will discolor) - see here for dilution instructions

Most disinfectant sprays or household cleaners.

Time.  The virus will die on a surface if you just leave it alone long enough.  About 10x the time it's been studied to live on that kind of surface will do.

 

What won't work:

Vinegar

Salt water (especially when sprayed in the mouths of a congregation of people using the same nozzle)

 

If you're picky and you want an (incomplete) list of products:

https://www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf

General advice on how to keep your home covid-19 free
https://www.seattletimes.com/seattle-news/health/cleaning-disinfecting-tips-to-keep-your-home-free-of-coronavirus/

 

Update: if you're disinfecting with bleach that has been stored for a while, look at the dates and adjust your dilution.

Stored bleach degrades over time
https://multimedia.3m.com/mws/media/735976O/disinfection-with-bleach-tech-talk.pdf

 

 

Edited by Hapless Bills Fan
added bleach degradation info

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This is a good resource for coronavirus case numbers in every state.

 

It is updated daily with new totals for each state. They stared doing this because the CDC wasn’t reporting complete testing data. But it looks like the CDC website may have finally started reporting more accurate full testing/infected data because they are currently showing more positive COVID19 cases than the covid tracking project.

It’s still a good resource though. 

 

Here’s the CDC site:

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

 

 

The reason for the testing ramp in New York is that we now have the capability to make our own COVID19 tests. They have a lab producing test kits for NYS. They should soon be able to test at least 7000 people per day.

 

Its actually quite impressive how quickly NYS has been able to move.

 

They asked for FDA permission to make their own tests on February 28th:

https://www.reuters.com/article/us-china-health-usa-testing/new-york-scrambles-to-replace-u-s-governments-faulty-coronavirus-test-kits-idUSKCN20N00J

 

They were given permission 7 days ago:

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-gives-flexibility-new-york-state-department-health-fda-issues

 

And now can test roughly 7000 people per day.

 

https://www.lohud.com/story/news/health/2020/03/18/why-new-yorks-local-coronavirus-testing-key-covid-19-fight/5068837002/

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https://www.healthline.com/health/how-to-make-hand-sanitizer#how-to-make

 

Hand sanitizer recipe

What you’ll need:

  • 3/4 cup of isopropyl or rubbing alcohol (99 percent)
  • 1/4 cup of aloe vera gel (to help keep your hands smooth and to counteract the harshness of alcohol)
  • 10 drops of essential oil, such as lavender oil, or you can use lemon juice instead

Directions:

  • Pour all ingredients into a bowl, ideally one with a pouring spout like a glass measuring container.
  • Mix with a spoon and then beat with a whisk to turn the sanitizer into a gel.
  • Pour the ingredients into an empty bottle for easy use, and label it “hand sanitizer.”
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And on the subject of testing:
 

Q: are enough tests available in the USA?  are we testing enough people?

A: No.  We are lagging behind pretty much every other developed country
https://www.vox.com/science-and-health/2020/3/12/21175034/coronavirus-covid-19-testing-usa
image.thumb.png.52c2228ef1786de79372e590a2588e34.png

The picture has improved recently.  The FDA gave permission to develop tests Feb 28.

University of Washington has been running  >1000 tests per day since theirs was approved March 2 (they had filed for EUA in early Feb).

NYS Dep't of Health just had their test, developed starting Feb 28, approved.

Roche had a higher-throughput test approved March 13: they have a machine that can run 4000 tests per day and there are 110 of these machines in the USA

Thermo-Fisher had their test approved March 16.

Q: doesn't it just take time to develop a test, manufacture it, and roll it out.

A: No, not if you make it a priority.  The Korean CDC held a meeting on January 27, 3 days after China released the covid-19 genome sequence, and asked several testing companies to develop a test ASAP and promised to fast-track approval. One company had a test approved a week later  Seegene had a high-throughput test in 3 weeks with a fancy-schmancy Super computer, but while it wasn't fancy-schmancy and can't run 10,000 tests per day, the U of Washington Virology guys developed their test and submited the EUA to the US FDA in the same interval and were able to test 1,000 patients/day as soon as they got approval.

Don't let anyone tell you there were scientific or technical reasons the USA wasn't testing more people, more quickly.

 

Q: Why does testing matter?  We're using social distancing, won't that stop the spread?

A: No, it only buys us time.  Our economy is taking a huge kick in the willies.  Once we start back up, we'll still inevitably have some cases, and a largely un-immune population. Unless containment measures are taken, the disease will bloom again and seriously ill patients will threaten to overwhelm hospitals - again. Containment measures include covid-19 testing of anyone with any symptoms including just fever, mandatory quarantine, and contact tracking/testing that exploits technology (not just imperfect human memory).  Ideally, we should conduct widespread serology testing to find people who are already immune and can safely circulate. 

Then with the disease contained, we can wait for a treatment/vaccine

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Posted (edited)

Good News Front - Testing division!

Several alternatives for rapid testing exist or are being developed. 

Summary from Singapore Saw Swee Hauk School of Public Health (as of March 13th)

 

Update 27 March: FDA has just authorized (EUA) Abbott's 12 minute test for covid-19 that runs on its proprietary ID-now machine.  No info on how widespread the machine is. (It's 5 minutes for a positive, but 12 minutes for a negative result)


Update 21 March: FDA has just authorized (EUA) 45 minute test for covid-19. &nbsp;The test was developed by Cepheid in California and will roll out 30 March.

It is designed to run on their GeneXpert Systems machines, of which there are said to be 23,000 worldwide, only 5,000 in the United states..  This will be helpful, but it is not (as some videos and media have incorrectly described it) a true "Point of Care" test as it requires Cepheid's special machine [I guess that may seem like semantics since their machine is small and portable, but the point is - you gotta purchase the machine, it's not like a Pg test or something]
It is a PCR based test.

 

https://www.biomedomics.com/products/infectious-disease/covid-19-rt/

Plus: Test that looks like a PG test and works in 15 minutes.  It detects antibody response in infected patients.  China is using it as a contact-tracing tool; it gives results in the field.  Preprint of their accepted publication can be found at this link.

Minus: 12% false negative rate, a 10% false positive rate, and questions about specificity.  Could have uses in cutting down the number of RT-PCR tests contact tracing teams must do - if you're positive, quarantine - if you're negative - give a swab for the more sensitive test to be sure.  Company may be seeking an EUA in this context.

Several other companies are now offering this including Pinnacle Labs (claims 90% accuracy).  Again, NOT FDA approved, and that 10% may give false confidence at home.

Scanwell is working on an at-home test that can be mailed to the patient and involves a Smartphone consultation with a medical professional (they say Dr or Nurse Practitioner).  Like the Biomedomics test, it depends upon detecting IgM and IgG antibodies in the blood.  They say they have applied for EUA and it will be available 6-8 weeks after receiving it.

New test from a Brit company.  It's an inexpensive, 6-test-at-a-time device that may be deployable in small health centers, based on existing techology. .....developed by U.K. researchers from the Brunel University London, Lancaster University and the University of Surrey can provide COVID-19 detection in as little as 30 minutes using hand-held hardware that costs as little as £100 (around $120 USD) with individual swab sample kits that cost around $5 per person. The test is based on existing technology that has been used in the Philippines for testing viral spread in chickens, but it’s been adapted by researchers for use with COVID-19 in humans. The team is now working on ramping mass production.

 

Other companies/universities are working on much more specific viral tests:

http://www.ox.ac.uk/news/2020-03-18-oxford-scientists-develop-rapid-testing-technology-covid-19 specifically recognise SARS-CoV-2 (COVID-19) RNA and RNA fragments.  Currently a tube in a heat block, they're working to develop a device (hopefully find an industrial partner ASAP).  [I didn't see a test result timeframe, just rapid]

 

https://www.psychologytoday.com/us/blog/the-future-brain/202003/mit-spinout-creates-rapid-covid-19-diagnostic-test
https://news.mit.edu/2020/covid-19-diagnostic-test-prevention-0312
"MIT spinout E25Bio, is preparing to submit to the U.S. Food and Drug Administration (FDA) for Emergency Use Authorization a cost-effective COVID-19 test that can deliver rapid results in less than 30 minutes."  Sounds like a specific anti-Covid19 antibody that binds to a viral protein.  Test is a paper strip that develops color.  YES!  This company has previously developed tests for Ebola, Dengue fever, and Zika.  30 minutes, field-usable, that would be such a boon.  The E25Bio folks say they're submitting an EUA so we'll see what the FDA thinks of their data.

Comments from a chap with experience below:

On 3/20/2020 at 8:41 AM, BillsFanNC said:

I have done some consulting work for [Biomedomics] in the past for a different application based on the same technology.  This test will give results for both early immune response (IgM) and later response (IgG). 

Lateral flow immunodiagnostics [as used in the MIT E25Bio paper-strip test] typically have lower sensitivity than molecular assays and therefore a higher false negative rate.

Edited by Hapless Bills Fan
updated to add Saw Swee Hauk report. updated to add Cepheid and Scanwell info. Updated to add UK test info. Updated to add Abbot test info.
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