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.

 

[ExiledInIllinois]

Can I post this Dr. here:

 

 

 

He explains the mechanics of what happens... Not exactlty family hour, few swear words... But its down to earth. Informative... He shoots from the hip.

 

If I needed bariatric surgery... I'd want this guy! LoL..

 

 

Edited March 31, 2020 by ExiledInIllinois

[SlimShady'sSpaceForce]

Dr. Anthony Fauci said on Tuesday that the US is starting to see "glimmers" that social distancing is having a dampening effect on the spread of the coronavirus. 

 

Fauci said that while people who survive the virus are likely to be immune, there won't be enough of them to provide "herd immunity" to prevent community spread. 

 

The US "will be much, much better prepared than we are right now" if the second wave of the virus comes again later this year. 

 

https://www.yahoo.com/news/top-infectious-disease-expert-us-151255400.html

[Hapless Bills Fan]

7 hours ago, thebandit27 said:

Paging @Hapless Bills Fan...

 

anything to this?

https://www.10tv.com/article/pandemic-scientist-says-his-team-has-discovered-potential-cure-covid-19-2020-mar

 

Short answer: probably something to it.  Every pharma company in the USA probably has something similar, but note this in text:

What is the next step?

We are sending [the antibodies] to the military for confirmation testing and to Charles River Laboratories for safety and tox characterization. We’ve partnered with two different companies that will help us scale up large batches of the antibody for production. We're in discussions to start human phase one/two trials that would happen at the end of the summer.  Pending good results - [if] we see the drug is safe and helpful means we could start releasing it for compassionate use in September.

would be late summer.

OK so what this chap is talking about, is making a human antibody that has been specifically designed to bind tightly to the virus, neutralize it and keep it from entering cells, and flag it for "trash removal services" by the human immune system. Making a monoclonal antibody is a standard tool for new pharmaceutical candidates, these days, and you CAN safely bet the rent that every pharma company in the US is doing likewise.  (When I used to work for one of them, part of this development process was literally one of my lanes.)  Our standard timeline then for binding assays to clinical trials was 8 months.  Why so long?  Well, the slowest step is that the antibodies are made by mammalian cells - usually Chinese Hamster Ovary or CHO cells - which take 24 hrs to double if you watch 'em, and 24 hrs to double if you don't.  So a lot of the time is just waiting to grow enough cells to spit out enough antibody so that you can purify it and start doing toxicology studies in animals and then safety studies in people.  If you make it a top priority, might be able to knock a month or 6 weeks off by overlapping some things that are ordinarily done sequentially.

 

What this company has done that shortens the timeline to where he's saying maybe 4 months, is that they had pre-existing anti-SARS monclonal antibody drug candidates and they've tested them to see if any of them work against covid-19 in vitro, in the test tube, and found that they do.   Depending upon what they did with them before, they may already have a CHO cell line able to spit the antibodies out and a cell bank of little vials from which they can grow up bioreactors full of the stuff.  That would lop off a couple of months, 2 or 3.  I think he may be a tad over-optimistic and he's likely talking 6 months with supply chain burbles and so forth.

But keep in mind, when he proudly announces "potential cure", he's once again talking about something that works in a test tube, and has never been tested for safety in people or shown to treat patients.

[thebandit27]

1 minute ago, Hapless Bills Fan said:

OK, needs to be shared but, please bear in mind this does NOT mean drinking water is or will be contaminated.  Waste water normally has all kinds of viruses and bacteria in it that get chemically treated to kill them then removed by filtration

 

https://www.bloomberg.com/news/articles/2020-03-31/coronavirus-in-sewage-portended-covid-19-outbreak-in-dutch-city

 

"Dutch scientists were able to find the coronavirus in a city’s wastewater before Covid-19 cases were reported, demonstrating a novel early warning system for the pneumonia-causing disease.  ....The so-called SARS-CoV-2 coronavirus is often excreted in an infected person’s stool. Although it’s unlikely that sewage will become an important route of transmission, the pathogen’s increasing circulation in communities will increase the amount of it flowing into sewer systems, Gertjan Medema and colleagues at the KWR Water Research Institute in Nieuwegein said on Monday....They detected genetic material from the coronavirus at a wastewater treatment plant in Amersfoort on March 5, before any cases had been reported in the city, located about 50 kilometers (32 miles) southeast of Amsterdam."

This would actually be a pretty test-effective screening tool for public health officials in anyplace without a known covid-19 outbreak and with a municipal wastewater system.  If you find the virus in the wastewater, then you KNOW it's in the community and social distancing precautions MUST be taken, as well as putting a push on to ask anyone with fever or other symptoms to stay home and perhaps get them testing and isolate their contacts. (if you don't find it, doesn't prove it is not there, might be below detection limits)

 

Now this one I can speak to...currently the only concern is leakage from septic tanks into an active aquifer.

 

NY State issued an order to start WW disinfection season now, so at most you’re looking at year-round disinfection as opposed to the typical April-October or May-November season.

[Sundancer]

Pretty good site tracking just NYS and NYC data. 

 

I've been wanting to tease out the NYS data from the US to see how much it's contributing the the numbers. 

 

https://gothamist.com/news/coronavirus-statistics-tracking-epidemic-new-york

[Hapless Bills Fan]

A couple of good videos

 

Not sure how well the first will work - might need a Facebook account?

Really good interview with Dr Sam Fink, MD.  He treated one of the first covid-19 disease clusters in LA: a group of 13 returning from a ski trip in Northern Italy

-13/13 became ill

-4/13 wound up in ICU

-3 of the 4 ICU patients were previously healthy YOUNG people with no pre-existing conditions.

He said right away when he saw that cluster of patients "this is really different".  Why?  Usually with flu, not THAT contagious - not 100% group infected; not THAT serious - not 1/4 of infected group require ICU and of those, most of them are previously healthy young people.

-Straight talk about maintaining the need for physical distancing over the next 2-3 months.

-Talks about IgM and IgG response, developing immunity

-Talks about serology vs RT-PCR testing and their different uses - need to find out if someone with RT-PCR positive is still infectious

-Testing results still being delayed - 10 days!!!! hoping to get down to 48-72 hrs

-Talks about caution with testing,  China false negative 30%, US believed 10% negative rate from RT-PCR testing, "false sense of security"

-Miss 1 out of 10 people - that's a huge number!!!!!!

-Is it necessary to disinfect groceries etc?  No proven transmission by that means, don't be crazy but extra precautions can't hurt.

-Masks - supplies must go to protect HCW first but if you have a mask, USE IT.  When he goes out, he wears a mask.  "I'm going with S. Korea on this"

-He does NOT trust numbers from China, Vietnam, Iran (communist and totalitarian states), their first priority is to protect the government.  Trusts numbers from S. Korea, Japan, Singapore etc.

 

Looooooong video from Dr David Fink of Weill Cornell Medical Center

Apologies to whomever posted this originally from Fox, which was generating some controversy, I'd like to credit you but don't remember who it was

[Hapless Bills Fan]

Comment from an epidemiologist on the effect of small breaches in social distancing.  Emphasis mine.
_______________________________________________________________________________________________________

 

A Short Explanation by Jonathan Smith, Yale University

Hey everybody, as an infectious disease epidemiologist (although a lowly one), at this point I feel morally obligated to provide some information on what we are seeing from a transmission dynamic perspective and how they apply to the social distancing measures. Like any good scientist I have noticed two things that are either not articulated or not present in the “literature” of social media.

Specifically, I want to make two aspects of these measures very clear and unambiguous.

First, we are in the very infancy of this epidemic’s trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn’t have to. This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. You will feel discouraged. You should. This is normal in chaos. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying around you. You may feel like giving in. Don’t.

Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with. This sounds silly, it’s not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain.

In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they about societies working in unison. These measures also take a long time to see the results. It is hard (even for me) to conceptualize how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can’t cheat it. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.

Until we get a viable vaccine, this unprecedented outbreak will not be overcome in a grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months. This virus is unforgiving to unwise choices. My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn’t working and become paralyzed by fear, or to ‘cheat’ a little bit in the coming weeks. By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty

[Hapless Bills Fan]

Bill Gates gets it.  Key point he misses, assuring supplies of PPE and other needed medical supplies by:

1) immediately blocking all overseas sales and shipments

2) invoking DPA to allow federal government to set price caps and using Defense Logistics Agency to manage distribution

 

https://www.washingtonpost.com/opinions/bill-gates-heres-how-to-make-up-for-lost-time-on-covid-19/2020/03/31/ab5c3cf2-738c-11ea-85cb-8670579b863d_story.html

 

[JohnC]

Dr. Fauci is a 79 yr old hero and national treasure who is giving an inhuman effort. 

https://www.cnn.com/videos/health/2020/04/01/anthony-fauci-health-coronavirus-pandemic-cooper-vpx.cnn/video/playlists/coronavirus/

 

[BillsFan4]

How to “coronavirus-proof” your home:

 

https://www.cnn.com/interactive/2020/03/health/coronavirus-tipsheets/coronavirus-proof-your-home/index.html

 

Quote

Make a game plan

• Designate one person to be your errand-runner to limit your outside exposures
• Set up a disinfecting station — an area outside your home or in a room with low foot traffic where you can disinfect packaged food

 When you’re out

• Avoid coming within less than six feet of others
• Wipe handles on carts or baskets while shopping
• wash your hands frequently while you’re out and avoid touching your face 
• (I would add: use InstaCart or other services offered by stores. Walmart is offering free home delivery. Tops offers InstaCart. Avoid going in the store if possible)

 When you get back

• Wash your hands with soap and water for (at least a minimum of) 20 seconds (use surgical scrubbing technique or similar making sure you wash thoroughly)
• Disinfect takeout boxes and packaged foods at your disinfecting station
• Thoroughly wash produce before putting it in your kitchen

 Disinfect

• Disinfect everything you touch — doorknobs, light switches, keys, phone, keyboards, remotes, etc.
• Use EPA-approved disinfectants (these include Clorox Disinfecting Wipes and certain Lysol sprays) and leave surfaces wet for 3-5 minutes

 Delivery

• Ask workers to drop deliveries off on your doorstep or an area of your complex
• If they need you to come to the door, keep six feet of distance (if signing for a package, I ask them to leave clipboard, step back and then I use my own pen to sign. No face to face contact)
• Pay and tip online when possible
• After you pick up mail from your mailbox, wash your hands (I also leave mail in a bag for 24hrs after retrieving it from the mailbox before reading, just to be safe)

 Laundry

• Wash clothes, towels and linens regularly on the warmest setting
• Disinfect your laundry hamper, too, or place a removable liner inside it
• Don’t shake dirty laundry to avoid dispersing the virus in the air

 Guests

• You shouldn’t allow guests over right now (you know what precautions you’re taking. You Don’t know what precautions others are. Even those that say they’re taking it serious may not be. Their idea of “taking it serious” could be much different than yours)
• If you need to house a family member or friend, avoid shared living spaces as much as you can
• If they need to enter shared living spaces, ask them to keep six feet of distance 
• (I’d add: wipe down/disinfect any shared surfaces frequently)

 If someone in your home gets sick

• First, consult your doctor
• Isolate them in another room and ask them to use a separate restroom
• Disinfect frequently touched surfaces every day 
• Avoid sharing items with them 
• Wear gloves when washing their laundry
• Continue to wash your hands frequently
• Ask them to wear a face mask if they have one

 Supplies you’ll need

• EPA-approved disinfectants
• If you don’t have disinfectants, make a bleach solution:
  • Mix four teaspoons bleach per quart of water; or
  • Use a 70% alcohol solution
• Laundry detergent
• Trash bags 
• Prescription medicines (you can mail order these) (I’d add: or use free delivery where available. Just ask delivery driver to step back when signing for meds, use your own pen then wash hands) 
• Canned foods — fruits, veggies, beans
• Dry goods — breads, pastas, nut butters
• Frozen foods — meats, veggies, fruits
• (I would add: disposable gloves, if available)

 Pets

• Supervise your pet in your backyard
• It’s OK to play with them outside — just keep your distance from other humans
• If you’re sick, ask someone you live with to take care of them while you recover
• If you must care for them while you’re sick, wash your hands frequently

I thought this was a pretty good list. I added the stuff in the parentheses+italics

[Sundancer]

This NYT site has really good numbers by state and county (with a click cases per 100K). The disparity between NYC and anywhere but the populous Italy Lombardy region is striking. 40% of America’s fatalities so far are in NYC. 
 

https://www.nytimes.com/interactive/2020/us/new-york-coronavirus-cases.html

 

It is too early to say if other big cities are lagging in time and will spike or if they are just different but PA was an early outbreak center and its deaths per day has been steady around 12 for 5 days running compared to NYC at 400 yesterday (Pa shut down a week before NY). 

 

NYC: 1374 (a few hundred more in nearest burbs)

Philadelphia: 74 (Tens more in nearest burbs)

Seattle: 166 (first major outbreak)

SF: 7

LA: 65

Miami: 11

Chicago: 95 (Tens more in nearest burbs)

Boston: 13

Edited April 2, 2020 by Sundancer

[BillsFanNC]

I'm intimately familiar with both companies. Great partnership.

 

FRANKLIN LAKES, N.J. MORRISVILLE, N.C., March 31, 2020 /PRNewswire/ -- BD (Becton, Dickinson and Company) (NYSE: BDX), a leading global medical technology company, and BioMedomics, a privately held, North Carolina-based clinical diagnostics company, today announced the release of a new point-of-care test that can detect antibodies in blood to confirm current or past exposure to COVID-19 in as little as 15 minutes.

BD BioMedomics COVID-19 Test Procedures
BD, BioMedomics announce the launch of a rapid serology test to detect exposure to COVID-19 at the point of care in 15 minutes. The test is completed in four, simple steps and will be available in April.

The new test, developed and manufactured by BioMedomics, will be available through BD and distributed exclusively by Henry Schein, Inc. to health care providers throughout the United States.

 

 

https://www.bd.com/en-us/company/news-and-media/press-releases/bd-biomedomics-announce-launch-of-rapid-serology-test-to-detect-exposure-to-covid-19

[Edit: this test is one of those described upthread as utilized widely in China and seeking FDA EUA in US, so Good that they've received permission to use it in USA.  There is another company in CA, Bodysphere, that has just received FDA EUA for their test (it is a lateral flow immunoassay, also reacts with both IgM and IgG, 2-10 min)
http://mybodysphere.com/sars2covid19.html

https://www.businesswire.com/news/home/20200331005420/en/FDA-Authorizes-New-Two-Minute-Serological-Test-Kit

 

To all, bear in mind the double-edged sword of serology testing:

-It will react if you are far enough into an infection, usually 7-14 days, to produce antibodies against it.  You can be infected and either not yet producing antibodies, or not producing enough to detect, so a negative test doesn't mean you're disease-free. 

-It also can't tell you if you're still INFECTIOUS - you could feel great (asymptomatic) or be recovered physically, but still be shedding virus from your nose and digestive track, and potentially able to infect others.]

-What it can do is identify people who have had the disease, and are therefore at low risk for infection and also able to donate plasma to treat others

 

 

 

 

 

[MJS]

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

 

 

[Edit: please see up-thread for similar graph without numbers.  The numbers in this graph appear to be based upon a model produced by the University of Washington's Institute for Health Metrics and Evaluation (IHME) which was requested to provide a model to the government.  Some key assumptions of this model are described in this news report:
-The president's guidelines are not what makes the difference because the president's recommendations are not binding. In states where governors haven't imposed strict social distancing rules of their own, it's not clear to what extent people are following the White House call to stay home as much as possible

-Governors who haven't issued statewide social distancing rules will do so in a week (that's a week from the original announcement of extended guidelines)

-States will keep the social distancing rules in place through June 1  By contrast, Trump's presidential guidelines apply through April 30 only.

-Technically, not an assumption of the model but a prediction:  If and when the current wave of infections is suppressed, the U.S. will remain vulnerable.  "Our rough guess is that come June, at least 95% of the U.S. will still be susceptible," says IHME's Murray. "That means, of course, it can come right back. And so then we really need to have a robust strategy in place to not have a second wave."]

Please note that the other Covid-19 thread is at your service for your opinions and discussion.  Posts from this thread may be linked in as a starting point.  Thanks!!!

Edited April 2, 2020 by Hapless Bills Fan
remove personal opining

[Cripple Creek]

Information on the therapeutic front.

 

https://www.drugtargetreview.com/news/58838/fda-and-barda-to-collaborate-with-grifols-on-covid-19-therapeutics/

 

"Grifols stated that it will use its network of FDA-approved plasma donor centres to test and qualify donors and collect their plasma; then process the plasma into hyperimmune globulin at its purpose-built facility in Clayton, North Carolina, US, and support pre-clinical and clinical studies to determine whether hyperimmune globulin made from the plasma of convalescent donors could be viable treatment for COVID-19 disease and as a platform for the treatment of future emerging infectious diseases."

Edit: Convalescent plasma is old therapy, but probably the surest-bet to work on severe cases.

Edited April 3, 2020 by Hapless Bills Fan
insert quote

[Foxx]

13 hours ago, Hapless Bills Fan said:

Not covid-19 per se, but if this is a factual guide to Federal programs helping small businesses, it deserves as broad distribution as can be.

If anyone has a better, I'll delete this and replace it with yours

 

https://www.schatz.senate.gov/press-releases/schatz-releases-coronavirus-federal-resource-guide-to-help-hawaii-small-businesses-access-new-funding-programs

the actual SBA website  https://www.sba.gov/funding-programs/disaster-assistance

[Hapless Bills Fan]

More about blood pressure medicines and covid-19.  DO NOT stop taking BP meds if you're on them except under an MD's advice!!!!!!!!  No hard evidence they harm; they may help.

NE Journal of Medicine article and Fig 1 from that source.

https://www.nejm.org/doi/full/10.1056/NEJMsr2005760

 

The blood pressure medicine Losartan is going to have clinical trials to see if it can reduce the severity of mild/moderate covid-19 infections:

https://www.startribune.com/university-of-minnesota-to-test-three-drugs-for-covid-patients/568766632/?refresh=true

"The second randomized trial will test the high blood pressure drug losartan on patients who test positive for the virus but whose symptoms are mild enough that they’re told to go home and recover instead of going to the hospital, Tolar said.

Some doctors theorize that the use of losartan will reduce how aggressive and deadly a COVID-19 infection is, by disrupting how the virus binds to the body at the molecular level."
 

6 hours ago, Nervous Guy said:

I've been following these studies for a few weeks since I take telmisartan, another ACE antagonist.  Intuitively, they may work...or make it worse,  I'll chose to be optimistic.  Incidentally, while both ACE inhibitors and ACE antagonists have excellent efficacy in treating high blood pressure, ACE inhibitors have a common side effect of a dry cough, ACE antagonists don't...coincidence or not?

https://onlinelibrary.wiley.com/doi/full/10.1002/ddr.21656

 

1 hour ago, OldTimeAFLGuy said:

...interesting and thank you for sharing friend....I'm on Lisinopril which is shown as another ACE antagonist....will follow you updates closely.....

Edited April 4, 2020 by Hapless Bills Fan
add follow-ups from others

[Sundancer]

Hapless posted about the BCG vaccine before (the vaccine for TB). Sounds like there is some correlation between countries that still give it and lower infection rates of CV-19. 

 

Something to keep watching. I do keep wondering why the cases in India are not just exploding. 

 

https://www.bloomberg.com/news/articles/2020-04-02/fewer-coronavirus-deaths-seen-in-countries-that-mandate-tb-vaccine

Quote

 

The preliminary study posted on medRxiv, a site for unpublished medical research, finds a correlation between countries that require citizens to get the bacillus Calmette-Guerin (BCG) vaccine and those showing fewer number of confirmed cases and deaths from Covid-19. Though only a correlation, clinicians in at least six countries are running trials that involve giving frontline health workers and elderly people the BCG vaccine to see whether it can indeed provide some level of protection against the new coronavirus.

 

Gonzalo Otazu, assistant professor at the New York Institute of Technology and lead author of the study, started working on the analysis after noticing the low number of cases in Japan. The country had reported some of the earliest confirmed cases of coronavirus outside of China and it hadn’t instituted lockdown measures like so many other countries have done.

 

Otazu said he knew about studies showing the BCG vaccine provided protection against not just tuberculosis bacteria but also other types of contagions. So his team put together the data on what countries had universal BCG vaccine policies and when they were put in place. They then compared the number of confirmed cases and deaths from Covid-19 to find a strong correlation.

 

 

 

Here is Hapless's post. 

 

 

[Edit: Interesting find, Sundancer.  It seems worth pointing out that many of the countries with high BCG vaccination rates and early covid-19 exposure so that we get a better feel for how the epidemic is progressing there (eg Singapore, Taiwan, S. Korea, Japan) are also countries that have a strong tradition of public mask-wearing, and which advised citizens to wear masks early on in the outbreak.   There's the old "correlation is not causation" thing. 

Here's the actual article in .pdf form: https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v1.full.pdf
Here's the data on which countries have BCG vaccination policies: http://www.bcgatlas.org/

Keep in mind the disease originated and had quite a play in China, which does have mandatory BCG vaccination, and that Spain (stopped 1981), UK (stopped 2005) and France (stopped 2007) are quite hard-hit.  But certainly Italy and the US have never had widespread BCG vaccination.


India really doesn't have much in the way of testing and not necessarily much in the way of public health tracking and data collection, either.  I'm not sure what's going on.  If the "warm weather stops it" theory is correct, that might be in play. Or it might be simmering and have not blown up yet.]

Edited April 4, 2020 by Hapless Bills Fan
add links to article and BCG vaccination data

[Cripple Creek]

Some potentially promising vaccine information coming from Pitt. 

https://www.upmc.com/media/news/040220-falo-gambotto-sars-cov2-vaccine

[Sundancer]

Really good resource for metro data in the US

 

https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-metro-area-tracker.html?action=click&module=Spotlight&pgtype=Homepage
 

I will discuss this in the discussion thread when I have time. Looks like Detroit, Atlanta, and NO are the places to watch now. 

[Edit: promising that NY cases have gone from doubling every 6 days to doubling every 3, but I wish I felt confident that isn't an artifact of inadequate testing.  Deaths, on the other hand, are on the "doubling every 3 days" trajectory]

Edited April 4, 2020 by Hapless Bills Fan
comment on NYC trajectory

[ExiledInIllinois]

Hasn't been peer reviewed but, is credible since COVID-19 is SARS-Cov-2

 

https://nypost.com/2020/04/03/cats-can-infect-each-other-with-coronavirus-study-says/amp/

[Edit: Sounds as though people with indoor/outdoor cats, might want to keep them inside for now

Minor nit: SARS-Cov-2 is the virus that causes covid-19 disease.  I get what you mean, just explaining the official nomenclature]