COVID-19 - Facts and Information Only Topic

[Punching Bag]

[Edit: I'm leaving the data here, but please check the thread to see if the links are already there rather than replicating - that will make the thread unwieldy.  The site has been there, and I just added the link to this specific page on the site.  Thanks.]

Most sites fail to include population.  US is #20 per population including some small countries were any deaths skyrockets percentage.

 

Data as of March 31, 2020

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

 

Country, Other	Total Cases	New Cases	Total Deaths	New Deaths	Total Recovered	Active Cases	Serious, Critical	Tot Cases/ 1M pop	Deaths/ 1M pop	Reported 1st case
San Marino	236	+6	26	+1	13	197	16	6,955	766	Feb 26
Italy	105,792	+4,053	12,428	+837	15,729	77,635	4,023	1,750	206	Jan 29
Spain	95,923	+7,967	8,464	+748	19,259	68,200	5,607	2,052	181	Jan 30
Andorra	376	+6	12	+4	10	354	12	4,866	155	Mar 01
Belgium	12,775	+876	705	+192	1,696	10,374	1,021	1,102	61	Feb 03
Netherlands	12,595	+845	1,039	+175	250	11,306	1,053	735	61	Feb 26
France	52,128	+7,578	3,523	+499	9,444	39,161	5,565	799	54	Jan 23
Switzerland	16,605	+683	433	+74	1,823	14,349	301	1,919	50	Feb 24
Luxembourg	2,178	+190	23	+1	80	2,075	31	3,479	37	Feb 28
Iran	44,605	+3,110	2,898	+141	14,656	27,051	3,703	531	35	Feb 18
UK	25,150	+3,009	1,789	+381	135	23,226	163	370	26	Jan 30
Saint Martin	15		1		2	12		388	26	Feb 29
Monaco	52	+3	1		2	49		1,325	25	Feb 27
Sweden	4,435	+407	180	+34	16	4,239	358	439	18	Jan 30
Channel Islands	141		3	+1		138		811	17	Mar 08
Portugal	7,443	+1,035	160	+20	43	7,240	188	730	16	Mar 01
Denmark	2,860	+283	90	+13	1	2,769	145	494	16	Feb 26
Cayman Islands	12		1			11		183	15	Mar 12
Austria	10,180	+562	128	+20	1,095	8,957	198	1,130	14	Feb 24
Ireland	3,235	+325	71	+17	5	3,159	103	655	14	Feb 28
USA	186,046	+22,258	3,807	+666	6,347	175,892	3,981	562	12	Jan 20

Edited March 31, 2020 by Limeaid

[Hapless Bills Fan]

9 hours ago, GoBills808 said:

@Hapless Bills Fan

Are these the false negatives they keep talking about re: tests? Or something else? Either way, seems like really bad news:

https://www.npr.org/sections/goatsandsoda/2020/03/27/822407626/mystery-in-wuhan-recovered-coronavirus-patients-test-negative-then-positive

 

I don't think these are the false negatives on initial tests.  The initial false negatives may have to do with China initially doing throat swabs and not nose (naseopharangeal) swabs or not doing an RNA extraction step in their test.  The CDC test uses an RNA extraction step to the best of my knowledge; it's a double-edged sword as not every health lab has an RNA extraction machine, or enough of them.  We're requiring nasopharangeal swabs (another double edged sword since they require a special flexible little sample brush)  I want to emphasize I am not factually 100% certain on this.  It's what I understood, but I could have understood wrong - I need to dig into it deeper.  If anyone has more info please PM me.

 

What I think this is, is that several countries including China have observed that cured covid-19 patients may shed virus for a prolonged time after their symptoms resolve, thus could presumably still infect people.  For this reason, China requires continued quarantine then a repeat test at 14 and 28 days .  What I think is going on may be the limit of detection of the test - the virus is still there but below the limit of detection, then the next swab gets a bit more virus thus detects it.    Shedding virus (that can infect others) is not unusual virus behavior - polio virus shedding after administration of live attenuated vaccine is well known.  If you look at Figure 59.3 in this article,  picture the tail extending out further - it is very low, and variability in the amount of virus captured by the swab or the test itself become important. (I'll paste the figure in at the bottom)

 

This is where if the French study is proven out in larger numbers and  hydroxychloroquine/azythromycin clear virus, it would be Big even if they don't effectively treat disease.  Being able to clear someone from being a carrier if they're only mildly infected or asymptomatic, or if they're recovering, would be big.  University of Minnesota has started a clinical trial on this.

 

8 hours ago, ExiledInIllinois said:

It's a swab.  Like strep swabs... Can be notoriously inaccurate with false negatives.  Why the quick swabs are taken FWIW...

Don't they send a more exhaustive throat culture to the lab after a strep quick swab.

 

The strep swab is a throat swab.  The nasopharangeal swab used for coronavirus is this little flexible bristle brush they shove up your nose and push through to the back of your throat.  That's usually not how the strep swabs I've had are done.

 

No, they don't usually do a more exhaustive throat culture for strep, unless you seem to be seriously ill.

This figure is for the SARS coronavirus, not covid-19, but it nicely illustrates a couple of points:

 

[Hapless Bills Fan]

Good news front: extending ventilators

 

Fitting designed to use one ventilator for 4 patients.  Simple and practical:

https://www.greenvilleonline.com/story/news/2020/03/25/coronavirus-prisma-health-says-its-developed-way-make-one-ventilator-work-four-patients/5083304002

Let's pray that our doctors and nurses and RT's get the PPE they need to stay healthy, because a patient on a ventilator needs intensive nursing care and RT oversight.

 

Update: this doctor says 1 ventilator can be stretched to use with 4 patients using common hospital fittings
https://onlinelibrary.wiley.com/doi/pdf/10.1197/j.aem.2006.05.009

 

And finally, Elon Muskhas purchased and donated "100s of ventilators from approved manufacturers" and has had them shipped to the City of New York:

https://www.bbc.com/news/technology-52071314

He also plans to reopen the Buffalo "Gigafactory" to build ventilators.

 

James Dyson (of Dyson vaccum and Dyson airblade fame) has designed a ventilator, the CoVent:
https://www.cnn.com/2020/03/26/tech/dyson-ventilators-coronavirus/index.html?fbclid=IwAR2FldNKt2KwDFUYm-A8v6-mb-8C4xh4dZhcp3EeoNYXpivej90NoELMFBs
 

On 3/24/2020 at 12:53 AM, Hapless Bills Fan said:

Now this is a really cool opensource project!

https://www.forbes.com/sites/alexandrasternlicht/2020/03/18/theres-a-shortage-of-ventilators-for-coronavirus-patients-so-this-international-group-invented-an-open-source-alternative-thats-being-tested-next-week/?utm_source=fark&utm_medium=website&utm_content=link&ICID=ref_fark&fbclid=IwAR3Po8wwmDx65JeYDEFNjRO14npk3IQ82FWq0jJCuI-n9dyUdRwNR76ozGo#322547563ba0

 

Mind, so many unknowns - reliability, durability....but it would surely be better to have an Opensource ventilator of minimal use-testing than no ventilator

Another Opensource ventilator project, using hardware store parts, this one from University of Florida:

 

MIT gets into the act with a ventilator that mechanically compresses an ambu-bag, the bag used to ventilate during CPR.  Estimated cost $100.  I wonder if people will now be buying up their parts?

https://scitechdaily.com/mit-posts-free-plans-online-for-an-emergency-ventilator-that-can-be-built-for-100/?fbclid=IwAR2aKr13Yu1EH5BozSh5PNbNio3q_aAoB_idJ8DcEg51r4RD1gCGPt54QAA
 

One concern I have about all these open-source and jury-rig ventilator strategies is that they will not multiply the number of trained critical-care RTs and RNs (in fact the number of these will decrease, as they fall ill), and asking people who are short on sleep and overworked to superintend patient care on jury-rigged devices ..."what could go wrong?".  But I know every one of them would rather have something to offer, than make an agonizing choice who dies.

[The Dean]

On the ventilator topic, it seems there can be some use for cpap/bipap machines as an emergency, short term non invasive ventilator. It is NOT a substiture for areal ventilator for those in really bad shape. But unless I'm misunderstanding, they can be used as a short-term solution for some patients. Here are few sources for your perusal:

 

https://www.precisionvaccinations.com/continuous-positive-airway-pressure-cpap-machines-enhance-people-respiratory-challenges
 

https://www.bioworld.com/articles/433966-noninvasive-ventilation-options-explored-for-covid-19-as-fda-eases-with-guidance

 

Here is a Reddit thread with some commentary by a respiratory therapist, for what it's worth:

 

Not sure if this is pie in the sky thinking, or something that can really help relieve the pressure on the ventilators for the most serious patients. I'll leave it to Hapless to decide if it belongs in this thread. 

 

Have a great night, everyone.

 

[Edit: Dean and anyone else, this is legit, but it was my understanding that HCW were advised against the use of CPAP machines as ventilators because their design means they aerosolize potentially infectious particles from the patients' lungs.  Do you (or anyone else) know how this is being mitigated?  PM me and I'll add to post]

[BillsFan4]

49 minutes ago, OldTimeAFLGuy said:

...ok Hap, have to draw upon your expertise and anointing you Governor of NY.......based on what appears to be a huge difference between Upstate NY and the NYC metro area relative to cases and control, would you as Governor draw an arbitrary "line of demarcation" relative to current restrictions in place? .....I am not saying a complete "back to business as normal" for Upstate NY, but somewhat relaxation of the more extreme restrictions....I would think a PARTIAL functioning NYS economy with again, appropriate restrictions would be beneficial versus the current statewide stranglehold precipitated by NYC and their population density....

@Hapless Bills Fan is much more qualified to answer this than me (though I already know what his answer will be), but going by what all the experts are saying, no. It would only make things worse (and potentially much worse).

 

Here, give this a read:

https://www.livescience.com/social-distancing-coronavirus-end.html

 

 

Edited March 28, 2020 by BillsFan4

[Gray Beard]

4 hours ago, BillsFan4 said:

@Hapless Bills Fan is much more qualified to answer this than me (though I already know what his answer will be), but going by what all the experts are saying, no. It would only make things worse (and potentially much worse).

 

Here, give this a read:

https://www.livescience.com/social-distancing-coronavirus-end.html

 

 

@Hapless Bills Fan     ...   this may not be worthy.  I’m just trying to address the question of relaxing social distancing rules in places that haven’t been hit... yet.
 

to add a few statistics...   there aren’t many cases in Central NY, but the trend is up.   I have a feeling it’s going to get much worse in a couple weeks. 

 

https://www.syracuse.com/coronavirus/2020/03/the-latest-coronavirus-numbers-for-syracuse-area-counties-list.html

 

Central New York counties have updated their numbers for coronavirus cases today (see link)

[BillsFan4]

1 hour ago, OldTimeAFLGuy said:

 

 

...thanks....appreciate your comments and insight.......was just thinking about somewhat striking an intermediary yet "still vigilant stay safe" balance to get portions of the NYS economy rolling again.....Upstate NY (where I am) is paying a HUGE price for his leadership ineptitude, particularly with having a major metro NYC population of 7-8 million (density as in on top of each other??) unprepared for ANY SLIGHTEST  "out of the ordinary hiccup" yet alone for the COVID-19 calamity.......

Yeah I'm in upstate NY too. My work has been crushed by this, so I feel your pain.

 

But the experts are saying that we don’t determine the timeline, the virus does.

IMO if we lift restrictions now, infection rates are only going to skyrocket and the economy could end up being shut down worse and probably for longer. The way I see it - the economy actually requires that we suppress this virus. We can’t just go on with daily life and ignore everything happening (hospitals being overwhelmed, tons of people getting severely ill, dying, etc). People aren’t going to go back to shopping/spending like normal while everyone around them is getting sick.

 

From what I’m reading, the experts say we need to have a national stay at home order to get the virus under control, and during that time we need to play catch up - produce tons of hospital equipment and safety gear (masks, gowns, gloves, etc) for our healthcare workers and massively expand testing and tracing programs (see places like South Korea and what they’ve done). Right now, we simply don’t have anywhere close to the requirements in place to be discussing re-opening. 

 

In the coming weeks, people that don’t even know they are sick yet are going to be getting sick. We won’t even start to see the effects of our social distancing measures for a bit yet, let alone be ready to open back up. Look at the countries that went into full, true lockdown. Their cases continued to spike for weeks afterwards.

 

 

Anyway... just my opinion from what I’ve read and discussions I’ve had with people much more knowledgeable than me. But I am no expert, so I don’t want to pretend to have any definitive answers.

Edited March 28, 2020 by BillsFan4

[BillsFan4]

 

[Hapless Bills Fan]

2 hours ago, BillsFan4 said:

@Hapless Bills Fan is much more qualified to answer this than me (though I already know what his answer will be), but going by what all the experts are saying, no. It would only make things worse (and potentially much worse).

 

Here, give this a read:

https://www.livescience.com/social-distancing-coronavirus-end.html

 

2 hours ago, OldTimeAFLGuy said:

...thanks....appreciate your comments and insight.......was just thinking about somewhat striking an intermediary yet "still vigilant stay safe" balance to get portions of the NYS economy rolling again.....Upstate NY (where I am) is paying a HUGE price for his leadership ineptitude, particularly with having a major metro NYC population of 7-8 million (density as in on top of each other??) unprepared for ANY SLIGHTEST  "out of the ordinary hiccup" yet alone for the COVID-19 calamity.......

 

I dunno about "much more qualified" but here's the thing I do know: Upstate NY is still only testing patients who meet restrictive criteria.  You have to have specific symptoms and/or contact with a known covid-19 patient to be tested at this time, due to shortages in test swabs and PPE.  It's no longer quite as bad as "you have to have flown back from China or Italy where you affirm that you licked a pneumonia patient" as my sarcastic friend says, but it's still very restrictive.

BillsFan4 is exactly correct, based on the experience of people who have dealt with and managed epidemics and who know how to model them.

 

A picture is worth 1000 words, so let me again put in this graphic from the OP of this thread.  NYC shut down when they were 5 or 6 transmission cycles (25 or 30 days) into the epidemic.  A lot of WNY and upstate right now, may be only 2 or 3 transmission cycles in.  Clearly you can visualize that the time to "prune the shrubbery" is early on, before 4 cases become 2656 cases or 5843 cases

 

Right now, the only "pruning tool" we have is to say to people,  STFH (stay home).

 

The "pruning tool" we need, is to be able to test broadly, not everyone but everyone with symptoms - then contact trace, isolate and test everyone they've come in contact with.  If we have that tool, we can contain the disease - not prevent it, as with a vaccine, but contain it - and keep it within the bounds the health care system can treat effectively.  We also need to have ample PPE in place for our HCW, so they don't get sick.

A proven therapeutic regime to shorten the course of the disease and avert its most debilitating symptoms and a vaccine to prevent it, will be of fantastic public health assistance, but containment can be achieved without them.

There truly is no "intermediate balance" in this situation.  We're already seeing the "small uptick" in almost every county in the country.  If you relax restrictions in places that are not yet slammed, experience of prior epidemics predicts they will be slammed in 3-4 weeks (it takes that long because of the relatively long incubation time for this disease vs. flu).  Many communities in upstate NY simply don't have the hospital beds, the ICU beds, the staff, or the PPE.  Their operating plan has been to Medivac sick patients to Syracuse or Rochester or Albany or Buffalo (whatever nearest big city).  Well and good, until those cities are slammed and lack capacity.

The "rats fleeing NYC" aren't the problem.  Will they make it worse, sure, but Covid-19 is already circulating in almost every community  What the Governor of Florida doesn't "get", and what is equally true in upstate New York, is that many people traveled on business to hotspots between early February and mid-March....many families traveled for Spring Break starting at the end of February to mid-March where they mixed and mingled with people who were infected and didn't know it from current hotspots, then flew home.  Florida is telling "rats fleeing NYC" since March 26 to quarantine for 2 weeks, which is helpful, but doesn't recognize that all the visitors from the end of February until the bars were closed (March 21?) very likely infected enough Floridians for community spread.  

That is also true, of all the business travelers and Spring Break travelers returning to WNY and Upstate.  Lots of sparks.  Some will burn out.  Some will spread.  Relax social distancing, and those sparks will grow into fires in 3-4 weeks.  (See above)

[Hapless Bills Fan]

5 hours ago, OldTimeAFLGuy said:

...ok Hap, have to draw upon your expertise and anointing you Governor of NY.......based on what appears to be a huge difference between Upstate NY and the NYC metro area relative to cases and control, would you as Governor draw an arbitrary "line of demarcation" relative to current restrictions in place? .....I am not saying a complete "back to business as normal" for Upstate NY, but somewhat relaxation of the more extreme restrictions....I would think a PARTIAL functioning NYS economy with again, appropriate restrictions would be beneficial versus the current statewide stranglehold precipitated by NYC and their population density....

 

I missed this early, but no, I would not.  See above for rationale.  We have no control, and no real idea how many cases there are. 

 

I want to bring in a twitter thread here from my man Scott Gottleib.  He's an MD, a former FDA commissioner, a former professor at NYU School of Medicine, and a director at Pfizer.  Oh, and a political/economic Conservative - American Enterprise Institute guy.  Click on "Show This Thread".

 

He draws the usual number of un- or under-informed followups on Twitter so reader beware - for example, the reader who proposes testing everyone in the household and giving them some sort of token "I tested negative" is pointless, since in a contagious disease testing negative is a snapshot in time - you might test positive tomorrow or in 2 days if you've been exposed but haven't developed disease yet, or in 6 days if you walk out the door to do (whatever) and are unknowingly exposed.

 

But read his stuff.  And BillsFan4 crystal ball on my take right on point:

 

4 hours ago, BillsFan4 said:

@Hapless Bills Fan is much more qualified to answer this than me (though I already know what his answer will be), but going by what all the experts are saying, no. It would only make things worse (and potentially much worse).

 

Here, give this a read:

https://www.livescience.com/social-distancing-coronavirus-end.html

 

Good article, btw.  "You can not fight what you can not see" - Roger Klein.  A diagnostic test is our eyes.

[Hapless Bills Fan]

This article has cases per population data that a number of folks have been asking for:

https://www.nytimes.com/interactive/2020/03/27/upshot/coronavirus-new-york-comparison.html

 

"The number of confirmed cases is an imperfect measure of what we really care about: the prevalence of the virus in the population, and therefore — if it is early in the epidemic — how many people are sick or may be contagious. The limited availability of testing in some places means that many people with coronavirus won’t be counted among the confirmed cases. And the varying rates of testing across states and countries make it hard to compare the number of confirmed cases in different regions. "

 

Note that since 20 March (only 4 days after relaxing testing criteria), testing in NYC area per order of Dep't of Health has been limited to "patients who are sick enough to require immediate hospitalization" (this is due to shortage of swabs and PPE)

 

 

[Hapless Bills Fan]

Covid-19 avoidance advice from an immunocompromised patient - good advice with myths at the end:

https://medium.com/@amcarter/i-had-no-immune-system-for-months-after-my-bone-marrow-transplant-1b097f16040c

 

[He explains the practical rules he, the recipient of an immune transplant, followed to avoid becoming ill]

Below is a long list of crazy rules I’ve heard people suggest as safety precautions against COVID-19.

As someone who had the mighty responsibility of preventing herself from contracting all manner of illness for a long time, I can tell you that none of these things are useful.

(If someone you know is advocating any of these, please tell them to read this article, or, better yet, get their preventative advice directly from the CDC, and stop giving credence to random lists of things on Facebook that supposedly come from an unnamed “friend of a colleague who works at a hospital.”)

• You cannot kill novel coronavirus by heating up your nasal passages with a hair dryer, sauna, steam from your tea or soup, etc. This is probably the most hilarious suggestion I’ve heard. The flawed reasoning goes like this… “Coronavirus dies at 133 F, and it enters through the nose, so if I heat up my nose to 133 F, that will kill coronavirus.”

There are so many issues with this, but here are two major ones:

Novel coronavirus doesn’t confine itself to your nose, waiting for you to blast yourself in the face with a hair dryer. When your mucus membranes (eyes, mouth, nose) are exposed to it, it enters your cells. It populates your lungs and may live throughout your GI tract. You can’t “catch it” before it reaches your lungs.
Pro-tip: If the inside of your nose reaches 133 F, you is burning ??  133 degrees Fahrenheit is the temperature of scalding water. The inside of your nose is a watery mucus membrane, so if it ever got that hot, you would need medical attention.

• Drinking hot liquids does nothing to prevent viral infection (but they do warm you up and make you feel good, so enjoy!)
• “Keeping the mouth moist” and drinking frequently to “wash the virus into your stomach, where the gastric juices will kill it” is completely ridiculous. Novel coronavirus is present in stool samples. It survives in the GI tract. For other reasons why this is silly, read this: No, drinking water doesn’t kill coronavirus — BBC Future
• Gargling with “vinegar, salt, garlic, or lemon” does not kill the millions of microscopic virions that invade the cells of your mucus membranes when you become infected with novel coronavirus. Vinegar, salt, garlic, and lemon have mostly antibacterial properties — they are not sufficiently antiviral to be useful in this case.
• “The virus can live on hair and clothes.” This falls into the realm of technically true, but not meaningfully true (healthcare providers excepted). If someone literally coughs directly onto your hair or clothes, go take a shower and wash your clothes. Otherwise, shower daily, wear clean clothes, and wash your clothes regularly, like a normal human person who is clean. The virus infects when it comes in contact with your eyes, nose or mouth. The likelihood of transferring a critical mass of virions to your face because you went to the grocery store and your sleeve touched the checkout counter is very low (assuming you don’t go home and eat your dirty clothes).
• “Avoiding cold foods” has no effect on viral infection or transmission (but if you feel cold, drink or eat something warm! Duh.)
• The virus doesn’t “live in your throat” for three days before “moving” to your lungs. Again, when you are infected, you are infected. (...) There are stages of symptom progression as your body ramps up its immune response to the virus, but you can’t prevent virions from invading your lungs by gargling something when you have a sore throat (especially not with mild antibacterial agents like vinegar/salt/garlic/lemon). Viruses do not work like bacteria.

As a brilliant emergency medicine physician (and collaborator on this article) said,

“You can’t disinfect the entire inside of your body unless you are dead and embalmed.”

[Hapless Bills Fan]

First county in US to test all residents! 

 

https://tellmed.org/news/2020/3/19/united-biomedical-groups-c19-company-partners-with-san-miguel-county-colorado-to-be-first-in-nation-to-test-an-entire-county-for-covid-19-with-new-antibody-diagnostic-test

https://coloradosun.com/2020/03/20/telluride-san-miguel-county-coronavirus-covid19-testing/
They mention the Italian town of Vo (~3000 people), which had a pilot project to test everyone and identified asymptomatic carriers, who were isolated to help stop the outbreak.  But I believe Vo used rt-pcr testing; since antibodies take 10-14 days to develop, by the time asymptomatic carriers are identified by antibody testing, they've been infecting people for a good long while.

 

San Miguel county (home of Telluride ski resort) will partner with United Biomedical Group to test all 8,000 residents for anti-covid-19 antibodies.

 

The idea, of course, is to determine how many of the population have already been infected and had mild or no symptoms, or have recovered.  38 people in the county have covid-like symptoms but only 1 test result has been returned (positive).   

 

The information should still be very valuable.

 

For the lab science geeks, looks like their test is an ELISA for IgG. They claim 100% accuracy "10 days post-infection", 0% false positives  Test results take 2-3 hrs.  It has FDA approval.  http://www.unitedbiomedical.com/COVID-19/covid-19.html

Edit: and yes, this is a company that produces automated laboratory tests, they have been performing hundreds of thousands of these tests in China, but were just authorized under EUA to use them here.  The tests are manufactured in Long Island and testing is performed in CA.
 

3 hours ago, Limeaid said:

For those ex-Science Geeks ELISA is enzyme-linked immunosorbent assay and IgG is Immunoglobulin (antibodies).

I understand "enzyme-linked immunosorbent assay for Immunoglobulin" a lot more.

https://www.ncbi.nlm.nih.gov/pubmed/6389773

 

 

 

 

 

Edited March 29, 2020 by Hapless Bills Fan
I still can't spell ELISA correctly after 50 frickin' years

[Hapless Bills Fan]

This is an oldie but goodie Mythbusters.  Adam ruins your dinner party by showing how easily his simulated drippy nose managed to contaminate all the stuff at the table and all the guests at a dinner party.  One guest escaped contamination!

https://www.dmarge.com/2020/03/mythbusters-contamination-experiment.html?fbclid=IwAR0cqAv-nZMMDl9oDuykrkhpjcRkCuKZh04kRwlv6nY3ae6nGtsvFcXIta0

 

Now they were doing all sortsa stuff you're not supposed to do - touch face, shake hands, etc etc - but it shows how easy it is to break those rules and then....

[Hapless Bills Fan]

Some possible solutions to the PPE shortage for health care workers:
 

UF doctor has contrived a mask out of 2 layers of surgical wrap. Still working on details of construction.  The mask can be autoclaved

 

Ohio-based Battelle has received FDA approval for a process using vaporized hydrogen peroxide and alcohol to sterilize N95 masks.  The masks can't be wetted or cleaned effectively by spraying them, but vapor does the trick:

"The system- which was quickly invented and refined by the Ohio-based science and technology company Battelle- uses vaporized hydrogen peroxide and alcohol to clean and sanitize used masks that would have otherwise been tossed in biohazard bags after a single use. It received a rush “emergency” approval from the Food and Drug Administration after it was proven to be effective in sanitizing a single mask up to 20 times after use in contaminated conditions.

There are only four of them in the country now, and they’re expected to help or even end the shortage of masks for health care workers on the front lines of the COVID-19 pandemic. “The decontamination procedure is about 3 1/2 hours, followed by several hours of aeration to get to a level where staff can reenter that space,” said Will Richter, principal scientist at Battelle."

Duke is also doing this. 

 

 

 

 

[Hapless Bills Fan]

Edit:  a bunch of people have brought up news articles about a new, larger French study treating with hydroxychloroquinone and azythromycin.

I put the link and my comments (after a quick read) in the original post on the topic up-thread.

BLUF here:

1) The study does not demonstrate these drugs as a cure for serious covid-19 disease - 92% of the patients had low (not serious) scores on the French covid-19 metric.

2) The study does strengthen the case for these drugs as a means to clear virus from asymptomatic or mildly symptomatic people, which would be hugely helpful in breaking transmission chains.  It may also turn out to be a means to prevent mild disease from becoming serious, but this study did not really address that.

3) it is an open, unblinded, uncontrolled study.  There is a reason why the medical profession turned to double-blinded controlled studies.

 

 

[Hapless Bills Fan]

Genomic epidemiologist Trevor Bedford walks you through the differences between mutations and a strain in the context of a misleading article that appeared in USA Today.

(then he discusses how many mutations to the virus genome don't actually impact the surface the virus presents to your immune system, thus how well a vaccine would work)

 

(Hap sez: developers of candidate vaccines are certainly aware of this genomic analysis and performing this assay)

 

Better link: https://threadreaderapp.com/thread/1244750382338719745.html

[Hapless Bills Fan]

 

Deborah Birx interview.  Good listen.

 

https://www.today.com/video/dr-deborah-birx-predicts-up-to-200-000-deaths-if-we-do-things-almost-perfectly-81368133527

 

She is asked if Dr Fauci's estimate of 1.6-2.2 million cases and 100,000 to 200,000 deaths is kind of a "worst case" scenario.

She responds that is what we can achieve if we follow social distancing and hygiene practices very well (I think her words are "almost perfectly"

 

Her point near the end is that communities have to lock down before they see rising cases, because due to spread by asymptomatic and mildly ill people if you wait until you start to see hospitalizations and deaths, it will be "pretty far into your community"

[meazza]

2 hours ago, Hapless Bills Fan said:

 

Deborah Birx interview.  Good listen.

 

https://www.today.com/video/dr-deborah-birx-predicts-up-to-200-000-deaths-if-we-do-things-almost-perfectly-81368133527

 

She is asked if Dr Fauci's estimate of 1.6-2.2 million cases and 100,000 to 200,000 deaths is kind of a "worst case" scenario.

She responds that is what we can achieve if we follow social distancing and hygiene practices very well (I think her words are "almost perfectly"

 

Her point near the end is that communities have to lock down before they see rising cases, because due to spread by asymptomatic and mildly ill people if you wait until you start to see hospitalizations and deaths, it will be "pretty far into your community"

Thank you for the informative posts.

[Hapless Bills Fan]

Some direct evidence that the stay-at-home orders with bar/restaurant/school closures may be having an effect!  (Making social distancing recommendations and prohibiting large gatherings did not have an effect).  This does not mean that we're "out of the woods" BUT if people keep it up and stay the course...we may buy the time we need to get our collective national epidemic response together!
 

Background: Kinsa makes an internet-connected thermometer.  Purchasers can download an app, enter symptoms along with the fever, and obtain advice about whether to seek on-site medical assistance.  It's been known for a couple years that their fever map was ahead of CDC influenza outbreak reporting.  Now they have been able to model expected incidence of fevers, and thus show locations with fever in excess of expected.

 

From their website:

Update (3/24/2020): Due to widespread social distancing, school closures, stay-at-home orders, etc. feverish illness levels are dropping in many regions. This does not mean that COVID-19 cases are declining. In fact, we expect to see reported cases continue to surge in the near term, but it may indicate these measures are starting to slow the spread.



NYtimes article about it:  Kinsa’s thermometers upload the user’s temperature readings to a centralized database; the data enable the company to track fevers across the United States.  Owners of Kinsa’s thermometers can type other symptoms into a cellphone app after taking their temperature. The app offers basic advice on whether they should seek medical attention.  Kinsa has more than one million thermometers in circulation and has been getting up to 162,000 daily temperature readings since Covid-19 began spreading in the country.
(...)
As of noon Wednesday, the company’s live map showed fevers holding steady or dropping almost universally across the country, with two prominent exceptions. One was in a broad swath of New Mexico, where the governor had issued stay-at-home orders only the day before, and in adjacent counties in Southern Colorado.  The second was in a ring of Louisiana parishes surrounding New Orleans, but 100 to 150 miles away from it. That presumably was caused by the outward local spread of the explosion of infections in New Orleans, which officials believe was set off by crowding during Mardi Gras.
(...)
As of Monday morning, more than three-quarters of the country was deep blue. A separate display of the collective national fever trend, which had spiked upward to a peak on March 17, had fallen so far that it was actually below the band showing historical flu fever trends — which meant that the lockdown has cut not only Covid-19 transmission but flu transmission, too.
(...)

For some hard-hit cities (...) fever data plotted on a timeline of restrictions enacted by mayors or governors (..)showed that simply declaring a state of emergency or limiting the size of public gatherings did not affect the number of people reporting fevers.  But closing restaurants and bars and asking people to stay in their homes produced dramatic results in all three cities.

An internet connected thermometer.  I had no idea this was a thing.  Most of mine have mercury in 'em.  I feel old.