SARS-CoV-2 and COVID-19 (2)
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1margd
Flatten the Curve
File:Covid-19-curves-graphic-social-v3.gif
https://commons.wikimedia.org/wiki/File:Covid-19-curves-graphic-social-v3.gif
File:Covid-19-curves-graphic-social-v3.gif
https://commons.wikimedia.org/wiki/File:Covid-19-curves-graphic-social-v3.gif
22wonderY
No!! There has got to be a better approach to this problem. Family visits are sometimes essential to assure adequate and appropriate care of patients. I speak from experience.
‘No More Visits’ Urges Nursing Home Industry in Wake of Virus
A variety of factors make nursing homes especially at risk to an epidemic: older residents often have weakened immune systems; many facilities are poorly staffed and have lax infection prevention — partly because visitors are constantly coming and going — allowing germs to spread. On top of that, residents, who live in proximity, often move back and forth to hospitals when they become acutely ill, and that makes them potential carriers of infection.
‘No More Visits’ Urges Nursing Home Industry in Wake of Virus
A variety of factors make nursing homes especially at risk to an epidemic: older residents often have weakened immune systems; many facilities are poorly staffed and have lax infection prevention — partly because visitors are constantly coming and going — allowing germs to spread. On top of that, residents, who live in proximity, often move back and forth to hospitals when they become acutely ill, and that makes them potential carriers of infection.
3margd
Scoop: Lab for coronavirus test kits may have been contaminated
Jonathan Swan, Caitlin Owens | Mar 1, 2020
A top federal scientist sounded the alarm about what he feared was contamination in an Atlanta lab where the government made test kits for the coronavirus, according to sources familiar with the situation in Atlanta.
Driving the news: The Trump administration has ordered an independent investigation of the Centers for Disease Control and Prevention lab, and manufacturing of the virus test kits has been moved, the sources said.
Why it matters: At the time the administration is under scrutiny for its early preparations for the virus, the potential problems at the lab became a top internal priority for some officials. But the Trump administration did not talk publicly about the Food and Drug Administration’s specific concerns about the Atlanta lab.
Senior officials are still not saying exactly what the FDA regulator found at the Atlanta lab.
The CDC lab in Atlanta developed the testing formula for the coronavirus test — which the government says works — and was manufacturing relatively small amounts of testing kits for laboratories around the country. This is where the lab ran into problems...
https://www.axios.com/cdc-lab-coronavirus-contaminated-6dc9726d-dea3-423f-b5ad-e...
Jonathan Swan, Caitlin Owens | Mar 1, 2020
A top federal scientist sounded the alarm about what he feared was contamination in an Atlanta lab where the government made test kits for the coronavirus, according to sources familiar with the situation in Atlanta.
Driving the news: The Trump administration has ordered an independent investigation of the Centers for Disease Control and Prevention lab, and manufacturing of the virus test kits has been moved, the sources said.
Why it matters: At the time the administration is under scrutiny for its early preparations for the virus, the potential problems at the lab became a top internal priority for some officials. But the Trump administration did not talk publicly about the Food and Drug Administration’s specific concerns about the Atlanta lab.
Senior officials are still not saying exactly what the FDA regulator found at the Atlanta lab.
The CDC lab in Atlanta developed the testing formula for the coronavirus test — which the government says works — and was manufacturing relatively small amounts of testing kits for laboratories around the country. This is where the lab ran into problems...
https://www.axios.com/cdc-lab-coronavirus-contaminated-6dc9726d-dea3-423f-b5ad-e...
4margd
How does the coronavirus outbreak end?
Brian Resnick | Mar 7, 2020
Governments’ failure to contain the coronavirus means it may be here to stay.
What might happen: A huge portion of the world could become infected
The nightmare scenario: A sudden huge spike in cases
The better scenario: Public health measures slow the spread and buy scientists time to work on treatments
The lucky scenario: Covid-19 naturally stops spreading as fast during the summer
How this outbreak could truly end: With a vaccine
Remember: Outbreaks harm more than the sick
...Outbreaks economically impact the people who have to take off from work for a quarantine, those who cannot afford medical care, and the groups that are unfairly targeted and stereotyped as being disease carriers. As the outbreak progresses, it will expose the cracks in our society and our preparedness for future outbreaks. We need to remember the lessons we learn over the next several months.
“I think that it’s going to end probably the way the 2009 H1N1 flu pandemic ended, which is that shortly after it’s over, people will lose memory of it and not worry about it,” Rasmussen says. “But it’s going to have tremendous — really negative and lasting effects — for the most vulnerable people who are either medically or economically vulnerable in our society.”
https://www.vox.com/science-and-health/2020/3/6/21161234/coronavirus-covid-19-sc...
Brian Resnick | Mar 7, 2020
Governments’ failure to contain the coronavirus means it may be here to stay.
What might happen: A huge portion of the world could become infected
The nightmare scenario: A sudden huge spike in cases
The better scenario: Public health measures slow the spread and buy scientists time to work on treatments
The lucky scenario: Covid-19 naturally stops spreading as fast during the summer
How this outbreak could truly end: With a vaccine
Remember: Outbreaks harm more than the sick
...Outbreaks economically impact the people who have to take off from work for a quarantine, those who cannot afford medical care, and the groups that are unfairly targeted and stereotyped as being disease carriers. As the outbreak progresses, it will expose the cracks in our society and our preparedness for future outbreaks. We need to remember the lessons we learn over the next several months.
“I think that it’s going to end probably the way the 2009 H1N1 flu pandemic ended, which is that shortly after it’s over, people will lose memory of it and not worry about it,” Rasmussen says. “But it’s going to have tremendous — really negative and lasting effects — for the most vulnerable people who are either medically or economically vulnerable in our society.”
https://www.vox.com/science-and-health/2020/3/6/21161234/coronavirus-covid-19-sc...
5jjwilson61
The lucky scenario isn't so lucky for the southern hemisphere
6stellarexplorer
South Korea appears to be having success with the measures they have employed, large scale social distancing strategies to buy time to develop new capabilities and to prevent everyone from getting sick at once. They are flattening the curve. They acted early and appear to have averted the severity occurring in Iran or Italy.
On the one hand, it is encouraging to consider that there may be a successful strategy. Speaking as an American, though this applies everywhere, I think, it is disheartening to face the fact that the outcome may depend as much on politics, political will, and leadership as on the nature of the virus itself.
On the one hand, it is encouraging to consider that there may be a successful strategy. Speaking as an American, though this applies everywhere, I think, it is disheartening to face the fact that the outcome may depend as much on politics, political will, and leadership as on the nature of the virus itself.
7John5918
These self-appointed coronavirus experts really need to pipe down (Guardian)
Donald Trump, Nigel Farage and the Twitterati should leave the public announcements to the epidemiologists...
I’m no financial expert, but – if you ask me – why not withdraw every last penny from your bank account, head to your nearest casino and put it all on red? You could literally double your money. Sure, something else could happen entirely. But all investments are risky, right? And, like I said, I’m no financial expert.
If you found this advice helpful, you may want to look to Twitter for the many nuggets of coronavirus wisdom currently being proffered by self-proclaimed non public health experts...
And one from a scientific source:
We don't know why so few covid-19 cases have been reported in Africa (New Scientist)
Experts still don’t know why so few cases of the new coronavirus have been reported in Africa, despite China – where the virus originated – being the continent’s top trading partner and the continent having a population of 1.3 billion people...
African countries are both vulnerable and potentially more resilient to the coronavirus. On the one hand, the population is much younger than in Europe and China. The median population age in the UK is 40.2 and in China it is 37, but this figure is 17.9 in Nigeria, Africa’s most populous country. “If you look at the statistics from China, the people that have worse prognosis are the older people, not necessarily the young”...
The flipside is healthcare systems are generally more fragile in many African countries... “If this outbreak comes in, it’s going to collapse the healthcare systems”...
The big risk is that fighting a coronavirus outbreak becomes a distraction for healthcare systems tackling other diseases that burden the region, including malaria and measles... He points to the 2014-16 Ebola outbreak, where many of the thousands of resulting deaths were due to resources being diverted away from other diseases.
And an update from Africa:
102 cases, 1 death confirmed in Africa from COVID-19 (Anadolu Agency)
The number of coronavirus cases in Africa has reached 102 confirmed with one death, said the African Union's Centers for Disease Control and Prevention (Africa CDC).
This came in an update Africa CDC head Dr. John Nkengasong gave to reporters at the African Union headquarters on Tuesday.
COVID-19 hit a number of northern, western and southern African countries since a first case was confirmed in Egypt on Feb. 14.
“As of today, there are about 102 cases in 10 African countries, with one death,” Nkengasong said, listing the affected countries as Algeria, Burkina Faso, Cameroon, Egypt, Morocco, Nigeria, Senegal, South Africa, Togo and Tunisia...
Donald Trump, Nigel Farage and the Twitterati should leave the public announcements to the epidemiologists...
I’m no financial expert, but – if you ask me – why not withdraw every last penny from your bank account, head to your nearest casino and put it all on red? You could literally double your money. Sure, something else could happen entirely. But all investments are risky, right? And, like I said, I’m no financial expert.
If you found this advice helpful, you may want to look to Twitter for the many nuggets of coronavirus wisdom currently being proffered by self-proclaimed non public health experts...
And one from a scientific source:
We don't know why so few covid-19 cases have been reported in Africa (New Scientist)
Experts still don’t know why so few cases of the new coronavirus have been reported in Africa, despite China – where the virus originated – being the continent’s top trading partner and the continent having a population of 1.3 billion people...
African countries are both vulnerable and potentially more resilient to the coronavirus. On the one hand, the population is much younger than in Europe and China. The median population age in the UK is 40.2 and in China it is 37, but this figure is 17.9 in Nigeria, Africa’s most populous country. “If you look at the statistics from China, the people that have worse prognosis are the older people, not necessarily the young”...
The flipside is healthcare systems are generally more fragile in many African countries... “If this outbreak comes in, it’s going to collapse the healthcare systems”...
The big risk is that fighting a coronavirus outbreak becomes a distraction for healthcare systems tackling other diseases that burden the region, including malaria and measles... He points to the 2014-16 Ebola outbreak, where many of the thousands of resulting deaths were due to resources being diverted away from other diseases.
And an update from Africa:
102 cases, 1 death confirmed in Africa from COVID-19 (Anadolu Agency)
The number of coronavirus cases in Africa has reached 102 confirmed with one death, said the African Union's Centers for Disease Control and Prevention (Africa CDC).
This came in an update Africa CDC head Dr. John Nkengasong gave to reporters at the African Union headquarters on Tuesday.
COVID-19 hit a number of northern, western and southern African countries since a first case was confirmed in Egypt on Feb. 14.
“As of today, there are about 102 cases in 10 African countries, with one death,” Nkengasong said, listing the affected countries as Algeria, Burkina Faso, Cameroon, Egypt, Morocco, Nigeria, Senegal, South Africa, Togo and Tunisia...
8davidgn
Song of the now.
https://www.youtube.com/watch?v=E3MNG11oynA
https://www.youtube.com/watch?v=E3MNG11oynA
9davidgn
And now the UK Health Minister's got it.
https://news.sky.com/story/nadine-dorries-health-minister-tests-positive-for-cor...
And death rates of 6% of known cases in Lombardy. Medical system completely overwhelmed.
https://www.wsj.com/articles/italy-with-elderly-population-has-worlds-highest-de...
https://news.sky.com/story/nadine-dorries-health-minister-tests-positive-for-cor...
And death rates of 6% of known cases in Lombardy. Medical system completely overwhelmed.
https://www.wsj.com/articles/italy-with-elderly-population-has-worlds-highest-de...
10margd
Jeremy COVID-19 IS NOT LIKE FLU Konyndyk @JeremyKonyndyk
https://twitter.com/JeremyKonyndyk (Pandemic prep & humanitarian aid @cgdev. Teach @Georgetownsfs. Ex-@USAID @theOFDA chief 2013-16.)
1:22 AM · Mar 11, 2020
(Excerpts from https://threadreaderapp.com/thread/1237609912412196865.html )
...The core objective, as I argued over weekend, is slowing spread enough to buy time for hospitals to stay on top of critical cases. Need a multi-track strategy to suppress the outbreak while expanding clinical bandwidth to treat. That's the ballgame.
...Biggest risk in coming weeks: US cities produce so many critical cases that hospitals are overwhelmed. This creates a doom loop in which care quality suffers and mortality spikes.
...Wuhan-level spread here would overwhelm our hospitals, and undermine intensive care for *everything*, not just COVID. That's already happening in Italy.
...So - how to achieve this? Need strategies that adapt broad shared priorities to local conditions and local epidemiology.
We won't have one monolithic US outbreak. We will have a series of interconnected locality-level outbreaks, each with their own dynamics.
Unifying idea everywhere is you have to trigger measures that seem too extreme for the current circumstances.
Far easier to overreact and dial back than to underreact and have to catch up. Catching up becomes disproportionately harder the longer you wait.
...Priority 1: Understand the epidemiology.
It is hard to fight what you can't see. Being at points 1, 2, or 3 on this curve has huge implications for strategy options, even if those points only differ in time by a matter of weeks.
...How you work to flatten the curve depends on where you are on it. But without aggressive surveillance and testing, it's hard to know that. So understanding the epi is the foundation.
Priority 2: Flatten the curve.
The further you are up the curve (point 3 vs point 2 or 1), the more aggressive and widespread the measures must be. At point 1, contact tracing and targeted quarantine are relevant; at points 2 and 3, they can't keep up.
...So as spread increases, contact tracing and targeted quarantines should be de-emphasized in order to focus on macro social distancing and promoting behavior change.
...Large gatherings, conferences, events, parades should be suspended. There is still debate about schools closures given uncertainty about how COVID behaves in kids. But halting large events is a no-brainer. And yes, this most likely mean playing March Madness to empty stadiums.
You - average citizen - have an important role here.
Begin promoting social distancing. Minimize travel.
Ask questions of your schools and workplaces (at our kids' school we found the kids weren't getting time to wash hands before eating; we complained loudly).
Make noise.
Call on public leaders to cancel events. Stop going to those events yourself (I'm skipping a long-planned 10k this weekend). Vote with your feet.
Priority 3: Targeted protection for high-risk groups.
Public health officials should review vulnerabilities and monitor for cases at every nursing home, prison, senior community.
Staff working travel screening should be refocused on this. That's a sideshow; this is main stage.
...But don't leave this to public authorities. Support this in your own community.
If you have loved ones or neighbors who are high risk, ask if there are ways you can help them in minimizing their forays beyond their home.
Protecting the high risk means fewer people in hospital.
Priority 4: Protect hospital bandwidth. The above priorities, if done comprehensively, can delay spread and reduce peak volumes. But depending on how late they are triggered, it may not be sufficient.
Also need to protect/expand hospital capacity.
Must reinforce training, PPE, and infection prevention to minimized damaging exposures of health workers.
And must find creative ways to expand ICU capacity and plan for in extremis patient volumes.
Excellent overview here...
Priority 5: Mitigate economic shocks and other second order impacts. Many social distancing measures have economic disincentives - e.g. it's hard for gig or hourly-wage workers to decide not to work, or decide to stop interacting with customers. Need targeted econ help.
Priority 6: Clear risk communication... Build trust through transparency over time. Don't hype the risk but don't downplay it artificially. Provide clear, actionable guidance that validates people's fear while channeling it into action instead of panic.
The specific tactics under each of these priorities will differ by community, depending on where they are along the curve and other local factors. But these are priorities that local leaders and local citizens can begin meaningfully taking forward.
Let's do this.
https://twitter.com/JeremyKonyndyk (Pandemic prep & humanitarian aid @cgdev. Teach @Georgetownsfs. Ex-@USAID @theOFDA chief 2013-16.)
1:22 AM · Mar 11, 2020
(Excerpts from https://threadreaderapp.com/thread/1237609912412196865.html )
...The core objective, as I argued over weekend, is slowing spread enough to buy time for hospitals to stay on top of critical cases. Need a multi-track strategy to suppress the outbreak while expanding clinical bandwidth to treat. That's the ballgame.
...Biggest risk in coming weeks: US cities produce so many critical cases that hospitals are overwhelmed. This creates a doom loop in which care quality suffers and mortality spikes.
...Wuhan-level spread here would overwhelm our hospitals, and undermine intensive care for *everything*, not just COVID. That's already happening in Italy.
...So - how to achieve this? Need strategies that adapt broad shared priorities to local conditions and local epidemiology.
We won't have one monolithic US outbreak. We will have a series of interconnected locality-level outbreaks, each with their own dynamics.
Unifying idea everywhere is you have to trigger measures that seem too extreme for the current circumstances.
Far easier to overreact and dial back than to underreact and have to catch up. Catching up becomes disproportionately harder the longer you wait.
...Priority 1: Understand the epidemiology.
It is hard to fight what you can't see. Being at points 1, 2, or 3 on this curve has huge implications for strategy options, even if those points only differ in time by a matter of weeks.
...How you work to flatten the curve depends on where you are on it. But without aggressive surveillance and testing, it's hard to know that. So understanding the epi is the foundation.
Priority 2: Flatten the curve.
The further you are up the curve (point 3 vs point 2 or 1), the more aggressive and widespread the measures must be. At point 1, contact tracing and targeted quarantine are relevant; at points 2 and 3, they can't keep up.
...So as spread increases, contact tracing and targeted quarantines should be de-emphasized in order to focus on macro social distancing and promoting behavior change.
...Large gatherings, conferences, events, parades should be suspended. There is still debate about schools closures given uncertainty about how COVID behaves in kids. But halting large events is a no-brainer. And yes, this most likely mean playing March Madness to empty stadiums.
You - average citizen - have an important role here.
Begin promoting social distancing. Minimize travel.
Ask questions of your schools and workplaces (at our kids' school we found the kids weren't getting time to wash hands before eating; we complained loudly).
Make noise.
Call on public leaders to cancel events. Stop going to those events yourself (I'm skipping a long-planned 10k this weekend). Vote with your feet.
Priority 3: Targeted protection for high-risk groups.
Public health officials should review vulnerabilities and monitor for cases at every nursing home, prison, senior community.
Staff working travel screening should be refocused on this. That's a sideshow; this is main stage.
...But don't leave this to public authorities. Support this in your own community.
If you have loved ones or neighbors who are high risk, ask if there are ways you can help them in minimizing their forays beyond their home.
Protecting the high risk means fewer people in hospital.
Priority 4: Protect hospital bandwidth. The above priorities, if done comprehensively, can delay spread and reduce peak volumes. But depending on how late they are triggered, it may not be sufficient.
Also need to protect/expand hospital capacity.
Must reinforce training, PPE, and infection prevention to minimized damaging exposures of health workers.
And must find creative ways to expand ICU capacity and plan for in extremis patient volumes.
Excellent overview here...
Priority 5: Mitigate economic shocks and other second order impacts. Many social distancing measures have economic disincentives - e.g. it's hard for gig or hourly-wage workers to decide not to work, or decide to stop interacting with customers. Need targeted econ help.
Priority 6: Clear risk communication... Build trust through transparency over time. Don't hype the risk but don't downplay it artificially. Provide clear, actionable guidance that validates people's fear while channeling it into action instead of panic.
The specific tactics under each of these priorities will differ by community, depending on where they are along the curve and other local factors. But these are priorities that local leaders and local citizens can begin meaningfully taking forward.
Let's do this.
11davidgn
You read it here first (https://www.librarything.com/topic/316600#7087320), but Liz Specht's analysis has now been written up in Stat.
What does the coronavirus mean for the U.S. health care system? Some simple math offers alarming answers
https://www.statnews.com/2020/03/10/simple-math-alarming-answers-covid-19/?fbcli...
What does the coronavirus mean for the U.S. health care system? Some simple math offers alarming answers
https://www.statnews.com/2020/03/10/simple-math-alarming-answers-covid-19/?fbcli...
12stellarexplorer
>10 margd: He’s right on target. Personally, I began work from home today. I am frustrated that they have not yet cancelled public schools in my area, so I contacted the Superintendent, School Board President, and PTA head to urge immediate bold action, explaining that proactive closure is a far better mitigation strategy than reactive closure, which we all know will be coming soon anyway. Why wait?
13davidgn
Ars Technica has weighed in. Haven't had a chance to read yet, but people are very enthusiastic.
https://arstechnica.com/science/2020/03/dont-panic-the-comprehensive-ars-technic...
https://arstechnica.com/science/2020/03/dont-panic-the-comprehensive-ars-technic...
14stellarexplorer
>11 davidgn: The contrast of human rationality and irrationality is staggering. This was clearly a runaway train coming our way for weeks now. I sold my stocks on February 6, for example, and began accumulating supplies for a long period of necessary isolation. Politics aside, just looking at the common person, I have sympathy for the idea that this is too terrible to accept. But at the same time that position is lethal. It’s more lethal when the notion is in the minds of leaders.
15davidgn
https://www.nbcnews.com/health/health-news/live-blog/coronavirus-updates-live-u-...
Congressional doctor expects 70M to 150M people in U.S. will contract coronavirus
The attending physician of Congress and the Supreme Court, Brian Monahan, briefed Senate staff on Tuesday afternoon in a closed-door meeting and said that he expects 70 million to 150 million people in the U.S. will contract the coronavirus, two sources tell NBC News.
The meeting didn't include any senators but was for administrative staff and personnel from both parties. Monahan briefed staff on how they can keep healthy and ways to prevent the virus from spreading, including not shaking hands, advice that is not being followed by some senators, as we’ve seen this week.
In addition to getting briefed on prevention and treatment, staffers asked questions, including if any travel restrictions should be put in place for members. On international travel, Monahan said members should not go if they don’t have to, whereas for domestic travel, no restrictions have been put in place.
Monahan also told staffers that, right now, coronavirus testing would be administered only to members of Congress, and that staff should go to their doctors if they are experiencing any symptoms.
Monahan also told staffers that ultimately, 80 percent of those who contract the coronavirus will be fine.
Congressional doctor expects 70M to 150M people in U.S. will contract coronavirus
The attending physician of Congress and the Supreme Court, Brian Monahan, briefed Senate staff on Tuesday afternoon in a closed-door meeting and said that he expects 70 million to 150 million people in the U.S. will contract the coronavirus, two sources tell NBC News.
The meeting didn't include any senators but was for administrative staff and personnel from both parties. Monahan briefed staff on how they can keep healthy and ways to prevent the virus from spreading, including not shaking hands, advice that is not being followed by some senators, as we’ve seen this week.
In addition to getting briefed on prevention and treatment, staffers asked questions, including if any travel restrictions should be put in place for members. On international travel, Monahan said members should not go if they don’t have to, whereas for domestic travel, no restrictions have been put in place.
Monahan also told staffers that, right now, coronavirus testing would be administered only to members of Congress, and that staff should go to their doctors if they are experiencing any symptoms.
Monahan also told staffers that ultimately, 80 percent of those who contract the coronavirus will be fine.
16aspirit
Eighty percent of people will be fine? The implication is that 14M to 30M people in the U.S. won't be. That lower estimate is more than the combined populations of New York City and Los Angeles. The higher estimate is more than the fourteen most populated cities in the U.S. That got me thinking....
I just learned that estimate is equivalent to the yearly number of people who are infected with symptomatic influenza. Infection with coronavirus doesn't seem to reduce the risk of a flu infection, which itself isn't looking good this season.
https://www.marketwatch.com/story/as-the-world-focuses-on-coronavirus-dont-forge...
I just learned that estimate is equivalent to the yearly number of people who are infected with symptomatic influenza. Infection with coronavirus doesn't seem to reduce the risk of a flu infection, which itself isn't looking good this season.
https://www.marketwatch.com/story/as-the-world-focuses-on-coronavirus-dont-forge...
Children’s and young adults’ hospitalization rates are currently higher than those observed at this time in recent flu seasons, the CDC says, despite overall flu hospitalization rates staying around the same level. More than half of specimens that tested positive for influenza this season have been in people younger than 25.
Influenza B, which impacts young people more severely, has been reported more often this season on a national level, according to the CDC’s most recent flu-surveillance report. But influenza A’s H1N1 subtype has been more commonly reported in recent weeks.
For everyone six months and older, the CDC says getting the yearly flu vaccine is “the single best way” to ward off the seasonal flu virus. People should also steer clear of close contact with sick people; stay home from work and school when they’re sick; cover their mouth and nose while sneezing or coughing; and clean their hands with soap and water or an alcohol-based sanitizer, the CDC says.
17RickHarsch
The main problems so far are:
1) fear of the economic effects of 'extreme' measures
2) the lack of visibility as the virus takes root among a population. (So, for example, while it was exploding in Italy and spreading rapidly outside of Italy throughout teh world, neighbor Slovenia had no cases til one week ago and now has 57, but is only closing one school, which has a teacher with the virus. So they do not see enough of a spike (though among 2 million people, going like this in successive days is dramatic: 1 person, 2, 8, 12, 17, 23, 34, 57by memory, so not precise). Tomorrow the number will more have doubled over 2 days. Children travel to school by bus and spend half days in crowded spaces. They should have been home perhaps 2 weeks ago.
1) fear of the economic effects of 'extreme' measures
2) the lack of visibility as the virus takes root among a population. (So, for example, while it was exploding in Italy and spreading rapidly outside of Italy throughout teh world, neighbor Slovenia had no cases til one week ago and now has 57, but is only closing one school, which has a teacher with the virus. So they do not see enough of a spike (though among 2 million people, going like this in successive days is dramatic: 1 person, 2, 8, 12, 17, 23, 34, 57by memory, so not precise). Tomorrow the number will more have doubled over 2 days. Children travel to school by bus and spend half days in crowded spaces. They should have been home perhaps 2 weeks ago.
18stellarexplorer
>17 RickHarsch: Agree, but where I am, I have to add another: plain old denial. The reality terrifies people. Many around me have become ostriches, burying their heads in the sand.
19aspirit
I have already forgotten where I read about the unusual incubation period of SARS-CoV2 but think it was in one of the links in this thread. The virus can take up to 24 days to manifest symptoms of the disease in each person? That's more than three weeks from exposure to the first coughs or fever. (A quick search resulted in the journal article that must've been the source of that number: https://jamanetwork.com/journals/jama/fullarticle/2762510.)
Meanwhile, the Trump Administration seems unconcerned about the inaccessibility of SARS testing, disease tracking, and nationwide actions to reduce the spread. The horrible response is mindboggling to me, even after seeing the mix apathy and hatred from the administrative departments during this presidency.
Meanwhile, the Trump Administration seems unconcerned about the inaccessibility of SARS testing, disease tracking, and nationwide actions to reduce the spread. The horrible response is mindboggling to me, even after seeing the mix apathy and hatred from the administrative departments during this presidency.
20margd
"The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes."
Chuan Qin, MD, et al. 2020. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clinical Infectious Diseases, ciaa248, Published:
12 March 2020. https://doi.org/10.1093/cid/ciaa248 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa248/5803306
Abstract
Background
In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China.
Methods
Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from January 10 to February 12, 2020, were collected and analyzed. The data of laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between severe and non-severe patients.
Results
Of the 452 patients with COVID-19 recruited, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough and myalgia. Severe cases tend to have lower lymphocytes counts, higher leukocytes counts and neutrophil-lymphocyte-ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients with COVID-19 were below normal levels, and lower level of helper T cells in severe group. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 also have lower level of regulatory T cells, and more obviously damaged in severe cases.
Conclusions
The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.
Chuan Qin, MD, et al. 2020. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clinical Infectious Diseases, ciaa248, Published:
12 March 2020. https://doi.org/10.1093/cid/ciaa248 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa248/5803306
Abstract
Background
In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China.
Methods
Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from January 10 to February 12, 2020, were collected and analyzed. The data of laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between severe and non-severe patients.
Results
Of the 452 patients with COVID-19 recruited, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough and myalgia. Severe cases tend to have lower lymphocytes counts, higher leukocytes counts and neutrophil-lymphocyte-ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients with COVID-19 were below normal levels, and lower level of helper T cells in severe group. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 also have lower level of regulatory T cells, and more obviously damaged in severe cases.
Conclusions
The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.
21davidgn
Just thought I might mention: I've decided to start prophylactically dosing with isoquercetin, 200 mg a day on a speculative basis. (This is the "quercetin derivative" championed by Michel Chrétien: https://www.macleans.ca/news/canada/a-made-in-canada-solution-to-the-coronavirus... )
It doesn't hurt that this is something I probably ought to have tried before now anyhow for various inflammatory conditions. I've got nothing to lose but the price.
Speaking of which, best pricing I've found is here:
(US site)
https://us.supersmart.com/en--immune-system-fatigue-infections--isoquercitrin-10...
(European site, with less attractive pricing: https://www.supersmart.com/en--immune-system-fatigue-infections--isoquercitrin-1... )
And here's the most relevant paper to the Maclean's article.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997876/
And for anyone wanting confirmation that this is the same thing:
"isoquercitin (IQ), a naturally occurring glycoside of quercetin also known as hirsutrin, isoquercetrin, quercetin-3-glucoside (Q3G), quercetin-3-O-β-D-glucoside"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826964/
It doesn't hurt that this is something I probably ought to have tried before now anyhow for various inflammatory conditions. I've got nothing to lose but the price.
Speaking of which, best pricing I've found is here:
(US site)
https://us.supersmart.com/en--immune-system-fatigue-infections--isoquercitrin-10...
(European site, with less attractive pricing: https://www.supersmart.com/en--immune-system-fatigue-infections--isoquercitrin-1... )
And here's the most relevant paper to the Maclean's article.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997876/
And for anyone wanting confirmation that this is the same thing:
"isoquercitin (IQ), a naturally occurring glycoside of quercetin also known as hirsutrin, isoquercetrin, quercetin-3-glucoside (Q3G), quercetin-3-O-β-D-glucoside"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826964/
22margd
Via AAAS, independent commentary on drug discovery and the pharma industry:
“we as a species”..."are going to be fighting (Covid-19) epidemic without any particularly amazing pharmacological weapons. Eventually we’ll have some, but I would advise people, pundits, and politicians not to get all excited about the prospects for some new therapies to come riding up over the hill to help us out. The odds of that happening in time to do anything about the current outbreak are very small. We will be going for months, years, with the therapeutic options we have right now..."
"I like the chances of (remdesivir from Gilead) more than anything else on this list, but it’s still unlikely to be a game-changer."
"the old antimalarial drug chloroquine seemed to be effective in vitro...it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed."
-------------------------------------------------------------------------------------------------------
Covid-19 Small Molecule Therapies Reviewed
Derek Lowe | 6 March, 2020
...remdesivir from Gilead...has been in development for a few years as an RNA virus therapy – it was originally developed for Ebola, and has been tried out against a whole list of single-strand RNA viruses. That includes the related coronaviruses SARS and MERS, so Covid-19 was an obvious fit.
There are five clinical trials underway...My personal opinion is that I like the chances of this drug more than anything else on this list, but it’s still unlikely to be a game-changer.
...RNA polymerase inhibitor (favipiravir) from Toyama...that’s in a trial in China. It’s a thought – a broad-spectrum agent of this sort would be the sort of thing to try. But unfortunately, from what I can see, it has already turned up as ineffective in in vitro tests.
...China...noted that the old antimalarial drug chloroquine seemed to be effective in vitro...Chloroquine has of course been taken for many decades as an antimalarial, but it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed. Just as with vaccine candidates, it’s possible to do more harm with a rushed treatment than the disease is doing itself.
...neuraminidase inhibitors such as oseltamivir (better known as Tamiflu) were tried against SARS and were ineffective; there is no reason to expect anything versus Covid-19 although these drugs are a component of some drug cocktail trials.
The HIV protease therapies such as darunavir and the combination therapy Kaletra are in trials, but that’s also a rather desperate long shot, since there’s no particular reason to think that they will have any such protease inhibition against what this new virus has to offer (and indeed, such agents weren’t much help against SARS in the end, either).
The classic interferon/ribavirin combination seems to have had some activity against SARS and MERS, and is in two trials from what I can see. That’s not an awful idea by any means, but it’s not a great one, either: if your viral disease has interferon/ribavirin as a front line therapy, it generally means that there’s nothing really good available.
...a few other repurposed-protease-inhibitors ideas out there, such as this one...TMPRSS2 protease is important for viral entry on the human-cell-side of the process, a pathway that has been noted for other coronaviruses. And it points out that there is a an approved inhibitor (in Japan) for this enzyme (camostat), so that would definitely seem to be worth a trial, probably in combination with remdesivir.
...That’s about it for the existing small molecules, from what I can see. What about new ones? Don’t hold your breath, is all I can say. A drug discovery program from scratch against a new pathogen is, as many readers here well know, not a trivial exercise.
...Phenotypic screens are perfectly reasonable against viral pathogens as well, but you’ll need to put time and effort into that assay up front, just as with any phenotypic effort, because as anyone who does that sort of work will tell you, a bad phenotypic screen is a complete waste of everyone’s time.
One of the key steps for either route is identifying an animal model...
...All this means that any new-target new-chemical-matter effort against Covid-19 (or any new pathogen) is going to take years, and there is just no way around that.
All this means that any new-target new-chemical-matter effort against Covid-19 (or any new pathogen) is going to take years, and there is just no way around that...This puts small molecules in a very bimodal distribution: you have the existing drugs that might be repurposed, and are presumably available right now. Nothing else is! At the other end, for completely new therapies you have the usual prospects of drug discovery: years from now, lots of money, low success rate, good luck to all of us. The gap between these two could in theory be filled by vaccines and antibody therapies (if everything goes really, really well)...
Either way, the odds are that we (and I mean “we as a species” here) are going to be fighting this epidemic without any particularly amazing pharmacological weapons. Eventually we’ll have some, but I would advise people, pundits, and politicians not to get all excited about the prospects for some new therapies to come riding up over the hill to help us out. The odds of that happening in time to do anything about the current outbreak are very small. We will be going for months, years, with the therapeutic options we have right now...
https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecul...
* Phenotypic screening is a type of screening used in biological research and drug discovery to identify substances such as small molecules, peptides, or RNAi that alter the phenotype of a cell or an organism in a desired manner. Wikipedia | phe·no·type--the set of observable characteristics of an individual resulting from the interaction of its genotype with the environment. (Oxford) (margd: e.g., the Chinese-id'd structure that SARS-CoV-2 uses to penetrate human cell?)
“we as a species”..."are going to be fighting (Covid-19) epidemic without any particularly amazing pharmacological weapons. Eventually we’ll have some, but I would advise people, pundits, and politicians not to get all excited about the prospects for some new therapies to come riding up over the hill to help us out. The odds of that happening in time to do anything about the current outbreak are very small. We will be going for months, years, with the therapeutic options we have right now..."
"I like the chances of (remdesivir from Gilead) more than anything else on this list, but it’s still unlikely to be a game-changer."
"the old antimalarial drug chloroquine seemed to be effective in vitro...it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed."
-------------------------------------------------------------------------------------------------------
Covid-19 Small Molecule Therapies Reviewed
Derek Lowe | 6 March, 2020
...remdesivir from Gilead...has been in development for a few years as an RNA virus therapy – it was originally developed for Ebola, and has been tried out against a whole list of single-strand RNA viruses. That includes the related coronaviruses SARS and MERS, so Covid-19 was an obvious fit.
There are five clinical trials underway...My personal opinion is that I like the chances of this drug more than anything else on this list, but it’s still unlikely to be a game-changer.
...RNA polymerase inhibitor (favipiravir) from Toyama...that’s in a trial in China. It’s a thought – a broad-spectrum agent of this sort would be the sort of thing to try. But unfortunately, from what I can see, it has already turned up as ineffective in in vitro tests.
...China...noted that the old antimalarial drug chloroquine seemed to be effective in vitro...Chloroquine has of course been taken for many decades as an antimalarial, but it has a number of liabilities, including seizures, hearing damage, retinopathy and sudden effects on blood glucose. So it’s going to be important to establish just how effective it is and what doses will be needed. Just as with vaccine candidates, it’s possible to do more harm with a rushed treatment than the disease is doing itself.
...neuraminidase inhibitors such as oseltamivir (better known as Tamiflu) were tried against SARS and were ineffective; there is no reason to expect anything versus Covid-19 although these drugs are a component of some drug cocktail trials.
The HIV protease therapies such as darunavir and the combination therapy Kaletra are in trials, but that’s also a rather desperate long shot, since there’s no particular reason to think that they will have any such protease inhibition against what this new virus has to offer (and indeed, such agents weren’t much help against SARS in the end, either).
The classic interferon/ribavirin combination seems to have had some activity against SARS and MERS, and is in two trials from what I can see. That’s not an awful idea by any means, but it’s not a great one, either: if your viral disease has interferon/ribavirin as a front line therapy, it generally means that there’s nothing really good available.
...a few other repurposed-protease-inhibitors ideas out there, such as this one...TMPRSS2 protease is important for viral entry on the human-cell-side of the process, a pathway that has been noted for other coronaviruses. And it points out that there is a an approved inhibitor (in Japan) for this enzyme (camostat), so that would definitely seem to be worth a trial, probably in combination with remdesivir.
...That’s about it for the existing small molecules, from what I can see. What about new ones? Don’t hold your breath, is all I can say. A drug discovery program from scratch against a new pathogen is, as many readers here well know, not a trivial exercise.
...Phenotypic screens are perfectly reasonable against viral pathogens as well, but you’ll need to put time and effort into that assay up front, just as with any phenotypic effort, because as anyone who does that sort of work will tell you, a bad phenotypic screen is a complete waste of everyone’s time.
One of the key steps for either route is identifying an animal model...
...All this means that any new-target new-chemical-matter effort against Covid-19 (or any new pathogen) is going to take years, and there is just no way around that.
All this means that any new-target new-chemical-matter effort against Covid-19 (or any new pathogen) is going to take years, and there is just no way around that...This puts small molecules in a very bimodal distribution: you have the existing drugs that might be repurposed, and are presumably available right now. Nothing else is! At the other end, for completely new therapies you have the usual prospects of drug discovery: years from now, lots of money, low success rate, good luck to all of us. The gap between these two could in theory be filled by vaccines and antibody therapies (if everything goes really, really well)...
Either way, the odds are that we (and I mean “we as a species” here) are going to be fighting this epidemic without any particularly amazing pharmacological weapons. Eventually we’ll have some, but I would advise people, pundits, and politicians not to get all excited about the prospects for some new therapies to come riding up over the hill to help us out. The odds of that happening in time to do anything about the current outbreak are very small. We will be going for months, years, with the therapeutic options we have right now...
https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecul...
* Phenotypic screening is a type of screening used in biological research and drug discovery to identify substances such as small molecules, peptides, or RNAi that alter the phenotype of a cell or an organism in a desired manner. Wikipedia | phe·no·type--the set of observable characteristics of an individual resulting from the interaction of its genotype with the environment. (Oxford) (margd: e.g., the Chinese-id'd structure that SARS-CoV-2 uses to penetrate human cell?)
23margd
Ai-yi-yi! Let's flatten the curve, people!
If Covid-19 gets bad, triage will be needed. Are we ready for that?
Matthew K. Wynia and John L. Hick | March 10, 2020
...If there aren’t enough masks or ventilation machines available, what is an ethically defensible way to allocate them? Might it be ethically acceptable to remove one patient from a ventilator so another could use it? Should clinicians who are forced to make such choices be legally protected? And who should get priority access to vaccines if they become available?...
https://www.statnews.com/2020/03/10/covid-19-gets-bad-are-we-prepared-for-triage...
------------------------------------------------------------------------------------------
Hick, J. L., D. Hanfling, M. K. Wynia, and A. T. Pavia. 2020. Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2. NAM Perspectives. Discussion paper. National Academy of Medicine. Washington, DC. https://doi.org/10.31478/202003b https://nam.edu/duty-to-plan-health-care-crisis-standards-of-care-and-novel-coro...
ABSTRACT | The novel coronavirus SARS-CoV-2 and resulting disease state COVID-19 pose a direct threat to an over-burdened U.S. medical care system and supporting supply chains for medications and materials. The principles of crisis standards of care (CSC) initially framed by the Institute of Medicine in 2009 ensure fair processes are in place to make clinically informed decisions about scarce resource allocation during an epidemic. This may include strategies such as preparing, conserving, substituting, adapting, re-using, and re-allocating resources. In this discussion paper for health care planners and clinicians, the authors discuss the application of CSC principles to clinical care, including personal protective equipment, critical care, and outpatient and emergency department capacity challenges posed by a coronavirus or other major epidemic or pandemic event. Health care facilities should be developing tiered, proactive strategies using the best available clinical information and building on their existing surge capacity plans to optimize resource use in the event the current outbreak spreads and creates severe resource demands. Health care systems and providers must be prepared to obtain the most benefit from limited resources while mitigating harms to individuals, the health care system, and society.
________________________________________________________
How canceled events and self-quarantines save lives, in one chart
Eliza Barclay and Dylan Scott Mar 10, 2020
This is how we all help slow the spread of coronavirus.
https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellat...
If Covid-19 gets bad, triage will be needed. Are we ready for that?
Matthew K. Wynia and John L. Hick | March 10, 2020
...If there aren’t enough masks or ventilation machines available, what is an ethically defensible way to allocate them? Might it be ethically acceptable to remove one patient from a ventilator so another could use it? Should clinicians who are forced to make such choices be legally protected? And who should get priority access to vaccines if they become available?...
https://www.statnews.com/2020/03/10/covid-19-gets-bad-are-we-prepared-for-triage...
------------------------------------------------------------------------------------------
Hick, J. L., D. Hanfling, M. K. Wynia, and A. T. Pavia. 2020. Duty to Plan: Health Care, Crisis Standards of Care, and Novel Coronavirus SARS-CoV-2. NAM Perspectives. Discussion paper. National Academy of Medicine. Washington, DC. https://doi.org/10.31478/202003b https://nam.edu/duty-to-plan-health-care-crisis-standards-of-care-and-novel-coro...
ABSTRACT | The novel coronavirus SARS-CoV-2 and resulting disease state COVID-19 pose a direct threat to an over-burdened U.S. medical care system and supporting supply chains for medications and materials. The principles of crisis standards of care (CSC) initially framed by the Institute of Medicine in 2009 ensure fair processes are in place to make clinically informed decisions about scarce resource allocation during an epidemic. This may include strategies such as preparing, conserving, substituting, adapting, re-using, and re-allocating resources. In this discussion paper for health care planners and clinicians, the authors discuss the application of CSC principles to clinical care, including personal protective equipment, critical care, and outpatient and emergency department capacity challenges posed by a coronavirus or other major epidemic or pandemic event. Health care facilities should be developing tiered, proactive strategies using the best available clinical information and building on their existing surge capacity plans to optimize resource use in the event the current outbreak spreads and creates severe resource demands. Health care systems and providers must be prepared to obtain the most benefit from limited resources while mitigating harms to individuals, the health care system, and society.
________________________________________________________
How canceled events and self-quarantines save lives, in one chart
Eliza Barclay and Dylan Scott Mar 10, 2020
This is how we all help slow the spread of coronavirus.
https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellat...
24margd
Scott Gottlieb, MD @ScottGottliebMD | 7:03 AM · Mar 12, 2020:
THREAD: In U.S. we face two alternative but hard outlooks with #COVID19: that we follow a path similar to South Korea or one closer to Italy. We probably lost chance to have an outcome like South Korea. We must do everything to avert the tragic suffering being borne by Italy 1/10
1. It starts with aggressive screening to get people diagnosed. While testing capacity expands its not evenly distributed to places most needed, we’re far behind current caseloads. To many people still can’t get screened. So we can’t identify clusters and isolate disease 2/10
In some respects our fate rests on the entities that are capable of sharply ramping testing and distributing the services nationally. Academic labs can serve their institutions. Only big national clinical labs like LabCorp and Quest can fill the void. A lot rides on them now 3/10
These are great American companies led by outstanding management teams, staffed with deeply committed, public health mind people who live in communities hurt by this virus. The national interest turns on their efforts. We must scale their ability to sharply expand screening 4/10
That means getting diagnostic kits approved that the companies can run on their automated platforms to dramatically scale testing. Only these big national chains have throughput, scale, and ordering systems to fill the void that was created. We look to them now. We need them 5/10
Public health labs have been an outstanding pillar. They’re working around the clock. They’re the nation’s backbone of response. But they aren’t richly funded and are being maxed out against current facilities. Only clinical labs have ability to sharply scale the efforts. 6/10
2. Business is leading the way on mitigation and social distancing, filling a void left by policy makers. But shutting down NBA games is not enough. This must be practiced in places large and small. Small gatherings, parties, all should be postponed for the next month or two 7/10
3. We need to create surge capacity in hospitals. Congress must support the effort. Patients and providers can too. Elective procedures should be postponed for next few months. Hospitals should lower volumes everywhere they can. We need to prepare for an influx of cases. 8/10
4. Social separation works. Every day we delay hard decisions, every day leaders don’t demand collective action, the depth of epidemic will be larger. We must act now. We have narrow window to avert a worse outcome. The virus is firmly rooted in our cities. We’re losing time 9/10
We’ll get through this. It’ll end. We have two hard months ahead of us. We need to sacrifice some of the trappings of normal life to reduce the scope and severity of what’s ahead. We must protect the vulnerable. We must act collectively in common interest. We must work together.
THREAD: In U.S. we face two alternative but hard outlooks with #COVID19: that we follow a path similar to South Korea or one closer to Italy. We probably lost chance to have an outcome like South Korea. We must do everything to avert the tragic suffering being borne by Italy 1/10
1. It starts with aggressive screening to get people diagnosed. While testing capacity expands its not evenly distributed to places most needed, we’re far behind current caseloads. To many people still can’t get screened. So we can’t identify clusters and isolate disease 2/10
In some respects our fate rests on the entities that are capable of sharply ramping testing and distributing the services nationally. Academic labs can serve their institutions. Only big national clinical labs like LabCorp and Quest can fill the void. A lot rides on them now 3/10
These are great American companies led by outstanding management teams, staffed with deeply committed, public health mind people who live in communities hurt by this virus. The national interest turns on their efforts. We must scale their ability to sharply expand screening 4/10
That means getting diagnostic kits approved that the companies can run on their automated platforms to dramatically scale testing. Only these big national chains have throughput, scale, and ordering systems to fill the void that was created. We look to them now. We need them 5/10
Public health labs have been an outstanding pillar. They’re working around the clock. They’re the nation’s backbone of response. But they aren’t richly funded and are being maxed out against current facilities. Only clinical labs have ability to sharply scale the efforts. 6/10
2. Business is leading the way on mitigation and social distancing, filling a void left by policy makers. But shutting down NBA games is not enough. This must be practiced in places large and small. Small gatherings, parties, all should be postponed for the next month or two 7/10
3. We need to create surge capacity in hospitals. Congress must support the effort. Patients and providers can too. Elective procedures should be postponed for next few months. Hospitals should lower volumes everywhere they can. We need to prepare for an influx of cases. 8/10
4. Social separation works. Every day we delay hard decisions, every day leaders don’t demand collective action, the depth of epidemic will be larger. We must act now. We have narrow window to avert a worse outcome. The virus is firmly rooted in our cities. We’re losing time 9/10
We’ll get through this. It’ll end. We have two hard months ahead of us. We need to sacrifice some of the trappings of normal life to reduce the scope and severity of what’s ahead. We must protect the vulnerable. We must act collectively in common interest. We must work together.
25margd
Article has nice map of confirmed cases by state/province as of March 12.
(ETA, Michigan is now pale pink: 2, maybe 3, cases announced 3/11/2020. Several universities going online, cancelling events. Quite a run at Costco.) :
Hospitals warn they can’t cope if coronavirus outbreak worsens in Canada
Tonda MacCharles | Fri., March 6, 2020
Hospitals in Canada are warning the federal government that a health system already stretched thin may not be able to cope if the novel coronavirus outbreak continues to worsen here.
... they need help now to “dramatically scale up” respiratory virus testing, to collaborate on laboratory analysis to quickly share data with other hospitals, and to protect staff amid a COVID-19 outbreak that has arrived in flu season...
Add to that a run on masks and other personal protective equipment, a documented shortage of critical care beds, and a new federal warning to all persons entering Canada from anywhere in the world to “self-monitor” for symptoms of COVID-19, and you see a system that could quickly come to a breaking point...
https://www.thestar.com/politics/federal/2020/03/06/hospitals-warn-they-cant-cop...
(ETA, Michigan is now pale pink: 2, maybe 3, cases announced 3/11/2020. Several universities going online, cancelling events. Quite a run at Costco.) :
Hospitals warn they can’t cope if coronavirus outbreak worsens in Canada
Tonda MacCharles | Fri., March 6, 2020
Hospitals in Canada are warning the federal government that a health system already stretched thin may not be able to cope if the novel coronavirus outbreak continues to worsen here.
... they need help now to “dramatically scale up” respiratory virus testing, to collaborate on laboratory analysis to quickly share data with other hospitals, and to protect staff amid a COVID-19 outbreak that has arrived in flu season...
Add to that a run on masks and other personal protective equipment, a documented shortage of critical care beds, and a new federal warning to all persons entering Canada from anywhere in the world to “self-monitor” for symptoms of COVID-19, and you see a system that could quickly come to a breaking point...
https://www.thestar.com/politics/federal/2020/03/06/hospitals-warn-they-cant-cop...
26lriley
I wonder what a SAR2/Covid 19 election is going to look like. I mean people could take the option of mailing in ballots but even mailed in ballots have the potential to pass along the virus to anyone who handles them who could then pass it along to others.
I mean the Donald might have a for real rationale before the election takes place for calling a national emergency and suspending the election and thereby prolonging his own term and administration to some unknown future date.
.....and here is the Democratic Party and their newly chosen leader of leaders will be 76 year old Joe Biden who looks a little cognitively challenged and who says he would veto an M4A bill if one ever crossed his desk. Maybe it's time for him to rethink that one because when you have the most expensive health care system in the world--one that a good third or more of your population can't afford then IMO you're inviting epidemics/pandemics to stick around and stay for a while.
I mean the Donald might have a for real rationale before the election takes place for calling a national emergency and suspending the election and thereby prolonging his own term and administration to some unknown future date.
.....and here is the Democratic Party and their newly chosen leader of leaders will be 76 year old Joe Biden who looks a little cognitively challenged and who says he would veto an M4A bill if one ever crossed his desk. Maybe it's time for him to rethink that one because when you have the most expensive health care system in the world--one that a good third or more of your population can't afford then IMO you're inviting epidemics/pandemics to stick around and stay for a while.
27proximity1
(Note: free open-access interview) Making Sense podcast #191 - Early Thoughts on a Pandemic
A Conversation with Amesh Adalja* (10th March, 2020)
Sam Harris (S.H.): "So if you were going to bet on the proportion of people in America who are going to get this (Covid19) over the course of the next 18 months, what would you think that number is?"
Amesh Adalja (A.A.): "Probably thirty to fifty percent."
Sam Harris (S.H.): "So if we say fifty percent of three hundred and forty million people and a mortality-rate of--I mean, even, one percent, that would put us at 1.7 million dead, so if it was half of that (0.5%), it's still an enormous number of people dead from this virus.
Amesh Adalja (A.A.): "Yeah, I think it is going to be more than people will imagine but will it be cataclysmic? I don't think that's the case. The highest flu death-rate we have, I think, outside of a pandemic (i.e. a seasonal flu) is, I think, eighty-thousand in 2017 to 2018. So this is a magnitude higher than that. And I do think it's going to be disruptive and bad, but I think that---what I'm worried about is that people's actions and reactions and panic will actually make things worse, and really lead to this kind of cascading-effect where hospitals can't operate, where there is widespread social chaos going on and that's what really worries me more than the virus itself."
Sam Harris (S.H.): ... "So, you could well imagine that eight-hundred thousand people could die from this over the course of the next year based on what we currently know about the severity and contagiousness of the virus. That does not seem far-fetched."
Amesh Adalja (A.A.): "No, I don't think it seems far-fetched, and that's one of my scenarios that I've envisioned." ...
Sam Harris (S.H.): ... "What do recommend that people do if they're concerned that they might be sick with something?"
Amesh Adalja (A.A.): "The same things that you would do for something like influenza; if you are somebody that's in a high-risk group--you're older, you've got medical conditions--you really have to have a lower threshold to seek medical care. But the vast majority of people who get this infection are not going to need hospitalization; it can be managed at home with over-the-counter types of remedies. So we don't want all of those people showing up at emergency departments, urgent care centers, the doctors' offices, spreading the virus and making crowding even worse." ...
______________________________
* Doctor Adalja "is an infectious disease specialist at the Johns Hopkins University Center for Health Security. His work is focused on emerging infectious disease, pandemic preparedness, and biosecurity."
See also: (Johns Hopkins University) COVID-19 information
____________________________________
"Sher-REEEFFFFFF no like it!" ...
... “The European Union disapproves of the fact that the U.S. decision to impose a travel ban was taken unilaterally and without consultation,” EU Council President Charles Michel and European Commission President Ursula von der Leyen said in a statement. “The European Union is taking strong action to limit the spread of the virus.” ...
LOL!
Non-E.U. member-states don't have to "consult" with the E.U.'s member-state heads or their E.U. org administration prior to deciding such matters. Who knew? (The E.U., that's who!) Hence the advantages of not being beholden to that group for permission to act decisively in such urgent matters. As for this: "“The European Union is taking strong action to limit the spread of the virus, " what a load of baloney!
It isn't at all clear that Britain deserved to be made an exception to the travel-ban period.
________________________________________________
Speaking of Britain, a letter-to-the -Editor appears at The Guardian (London) website sent by Isabella Clarke of Northampton
She writes:
(LETTERS) Coronavirus and the risk to the homeless | The plight of people living on the streets during the coronavirus pandemic is highlighted by Isabella Clarke
(A homeless person sleeps on the street in Oxford. Photograph: Oxford_shot/)
(Image of homeless person not allowed. Somebody might become insensed.)
So look for it here: https://www.theguardian.com/society/2017/jul/26/oxford-homeless-people-face-fine...
"As the Covid-19 situation worsens, perhaps it would be both wise and ethical to consider a section of the population as yet unmentioned, always uncared for and at all times unable to self-isolate.
"Homeless people are vulnerable in general and, with the likelihood of poor nutrition and other possible health complications, at great risk of contracting the virus. Those who live on the streets have limited opportunities to wash their hands for 30 seconds numerous times a day and cannot be involved in the panic-buying of hand-sanitising gels, toilet rolls or pain relief.
"These citizens, with equal rights to dignity and social welfare, are quite literally left out in the cold. Even if one doesn’t have an appropriate ethical response to human suffering, one has to consider the spread of the coronavirus through and via an unmonitored part of the community.
"We have a duty of care to all people. And street-sleepers, who are unlikely to have brought the infection back from a foreign business trip or holiday, will be among those affected by the illness and will require medical care.
"Spreading information, providing easier access to washing facilities, and monitoring health would be a start. But, on a wider scale, this situation seems to shine a light on the ways in which, as a society, we forget about people among us who have nothing. Perhaps it’s time to reconsider the ethical base of our communities, and our social system. What moral nation can allow its citizens to live without shelter, safety or dignity?
"Rutger Bregman, in Utopia for Realists, mentioned a trial in London where £3,000 was given, no strings attached, to homeless people in the city. The effects were remarkable. Most turned their lives around – and the cost to society was less than had they remained on the streets.
"There will be a future after Covid-19 and surely this shock to the system should encourage us to want to make it better, fairer and more humane."
Isabella Clarke,
Northampton, Northants, England
28lriley
Actually we might have been smarter imposing a travel ban a couple weeks ago. To many on the right in the United States have not taken this very seriously. We have for instance terminal cancer Limburger telling people it's a hoax and there is this narrative that this is another attempt by democrats to impeach Trump. Makes no sense--what's going on in Italy for instance has nothing at all to do with Trump. The Donald for his part seems more worried about the stock market than the actual threat of the virus to the American population. Newsflash to Trump--the markets are going to plunge anyway and there's not much anyone can do about it--all travel's going to die for a while---sports is taking a vacation too---both the NBA and NHL have suspended their seasons. Donald either gets on top of containing this or he's going to likely get killed whenever the next election happens---I'm not convinced it will be in November either. The other thing he is in the age group most vulnerable to this illness and packing people into campaign rallies is not a good idea for him either---let's also remark that he's not a particularly healthy looking individual---he is at least somewhat obese.
29proximity1
>28 lriley:
What the fuck did Obama or Hillary Clinton do when, on their watch, as, for the past 17 years, as explained in the Sam Harris podcast, multiple cases of SARS/Corona viruses have occurred and neither the U.S. federal government, the U.S. Public Health services nor public or private hospitals or universities have, in all that time, taken the initiative to develop and prepare an antiviral agent against these pathogens?
I'll tell you what they did: fuck all. They just weren't that concerned. If they had been, this wouldn't have been left ignored until it took your whipping-boy, President Trunmp, to finally get fucking serious about it.
Listen to the podcast from time-marker 52 mins.: 14 secs. as Dr. Adalja recounts this sorry history.
You, meanwhile, care for nothing other than playing a blame-game as long as you can conveniently pin things on Donald Trump. Where the fuck were the people you tout over all that time?!
What the fuck did Obama or Hillary Clinton do when, on their watch, as, for the past 17 years, as explained in the Sam Harris podcast, multiple cases of SARS/Corona viruses have occurred and neither the U.S. federal government, the U.S. Public Health services nor public or private hospitals or universities have, in all that time, taken the initiative to develop and prepare an antiviral agent against these pathogens?
I'll tell you what they did: fuck all. They just weren't that concerned. If they had been, this wouldn't have been left ignored until it took your whipping-boy, President Trunmp, to finally get fucking serious about it.
Listen to the podcast from time-marker 52 mins.: 14 secs. as Dr. Adalja recounts this sorry history.
You, meanwhile, care for nothing other than playing a blame-game as long as you can conveniently pin things on Donald Trump. Where the fuck were the people you tout over all that time?!
30margd
Holy shit.
(Rep) Katie Porter holds the CDC Director (Redfield's) feet to the fire and
gets him to commit to FREE TESTING for coronavirus for ALL AMERICANS.
Watch every second of this.
(5:56 https://twitter.com/briantylercohen/status/1238155454108151808 )
From Rep. Katie Porter
- Brian Tyler Cohen @briantylercohen | 1:30 PM · Mar 12, 2020
______________________________________________________-
ETA
Dr. Fauci on testing: "It is a failing. I mean let's admit it."
(1:09 https://twitter.com/DoriToribio/status/1238138912817713152 )
From CSPAN
- Dori Toribio @DoriToribio | 12:24 PM · Mar 12, 2020
(Rep) Katie Porter holds the CDC Director (Redfield's) feet to the fire and
gets him to commit to FREE TESTING for coronavirus for ALL AMERICANS.
Watch every second of this.
(5:56 https://twitter.com/briantylercohen/status/1238155454108151808 )
From Rep. Katie Porter
- Brian Tyler Cohen @briantylercohen | 1:30 PM · Mar 12, 2020
______________________________________________________-
ETA
Dr. Fauci on testing: "It is a failing. I mean let's admit it."
(1:09 https://twitter.com/DoriToribio/status/1238138912817713152 )
From CSPAN
- Dori Toribio @DoriToribio | 12:24 PM · Mar 12, 2020
31davidgn
>30 margd: No time to watch, but I'm noting down the name. One to keep an eye on! Will watch later. (And so sad that leadership of this sort seems to be so rare now...)
32margd
>31 davidgn: Rep Katie Porter PERSISTED!
TESTGATE, contd.:
Key: members were floored as they learned that roughly just 11,000 Coronavirus tests TOTAL have been conducted
compared to the fact that in South Korea, 10,000 tests are conducted A DAY.
- Lauren Fox @FoxReports | 11:16 AM · Mar 12, 2020
'We are flying blind': Lawmakers fume amid lack of coronavirus testing and answers
Haley Byrd, Lauren Fox, Manu Raju and Ted Barrett | March 12, 2020
https://www.cnn.com/2020/03/12/politics/congress-outrage-testing-covid-19/index....
______________________________________________________________________
Update. The Cleveland Clinic has developed a COVID 19 test that gives results in 8 hours as opposed to the 2-3 days it takes for the other tests.
They developed the test in NINE days, I repeat nine. Scientists worked 24/7 once the CDC gave them the okay on 3/2.
The Cleveland hospitals are also developing drive thru testing centers.
Why on earth would the CDC wait till 3/2 to give the okay?
One would think they would have begged for all the resources they could get since President Jenius, MIT Nephew cut all their funding.
- Andrea R MD @AndreaR9Md | 7:12 PM · Mar 11, 2020
----------------------------------------------------------------------------------------------------------------
Never mind Cleveland Clinic, the WHO test the US turned down, see responses to Andrea R ( https://twitter.com/AndreaR9Md/status/1237879211840303104 ):
A 3 hour test (developed in Singapore), with 99% accuracy, has been out since early March. It's being used at the airport:
A few days ago, researchers at the University of the Philippines (my home uni) developed a COVID19 test kit with results in just 2 hours. And each kit costs only $30 (US dollars!).
Greetings from Europe, where test results take 4-6h
Vietnam has been able to produce 10,000 kits a day that give results in one hour for nearly a week now. Why are we not using these?
TESTGATE, contd.:
Key: members were floored as they learned that roughly just 11,000 Coronavirus tests TOTAL have been conducted
compared to the fact that in South Korea, 10,000 tests are conducted A DAY.
- Lauren Fox @FoxReports | 11:16 AM · Mar 12, 2020
'We are flying blind': Lawmakers fume amid lack of coronavirus testing and answers
Haley Byrd, Lauren Fox, Manu Raju and Ted Barrett | March 12, 2020
https://www.cnn.com/2020/03/12/politics/congress-outrage-testing-covid-19/index....
______________________________________________________________________
Update. The Cleveland Clinic has developed a COVID 19 test that gives results in 8 hours as opposed to the 2-3 days it takes for the other tests.
They developed the test in NINE days, I repeat nine. Scientists worked 24/7 once the CDC gave them the okay on 3/2.
The Cleveland hospitals are also developing drive thru testing centers.
Why on earth would the CDC wait till 3/2 to give the okay?
One would think they would have begged for all the resources they could get since President Jenius, MIT Nephew cut all their funding.
- Andrea R MD @AndreaR9Md | 7:12 PM · Mar 11, 2020
----------------------------------------------------------------------------------------------------------------
Never mind Cleveland Clinic, the WHO test the US turned down, see responses to Andrea R ( https://twitter.com/AndreaR9Md/status/1237879211840303104 ):
A 3 hour test (developed in Singapore), with 99% accuracy, has been out since early March. It's being used at the airport:
A few days ago, researchers at the University of the Philippines (my home uni) developed a COVID19 test kit with results in just 2 hours. And each kit costs only $30 (US dollars!).
Greetings from Europe, where test results take 4-6h
Vietnam has been able to produce 10,000 kits a day that give results in one hour for nearly a week now. Why are we not using these?
33lriley
#29--LOL--what a proportionate response. Are you in pain? Seems like you're in need of a headache pill. But......what Barack and Hillary were dealing with wasn't killing people left and right all around the globe either, was it? Neither did either of them gut the CDC and other medical and scientific programs like the current moron has. Your guy is the one who doesn't believe in science and will take the opinion of a radio shock jock or a goof ball like Gorka over that of an expert with real expertise.....and by the way researchers and scientists were working on a SARS vaccine some 18 years ago that got shelved when that outbreak way back then petered out.
If a buck can't be made off of something clown Donald is the one that isn't interested.
If a buck can't be made off of something clown Donald is the one that isn't interested.
34margd
Italy, With Aging Population, Has World’s Highest Daily Deaths From Virus
Coronavirus has killed 5% of known cases, even higher in the worst-affected region, versus a global average of 3.5%
Margherita Stancati | March 9, 2020
...In less than three weeks, Italy has gone from having just three coronavirus cases to the biggest outbreak after China...
By Monday, Italy’s total confirmed infections reached 9,172 of whom 463, or 5%, had died. In Lombardy, the worst-affected region, the death rate is 6%. Globally, about 3.5% out of 109,578 people with confirmed cases have died, according to the latest data from the World Health Organization. Many experts say the real mortality rate may well be lower, because many infection cases aren’t known.
...In Italy, which has the oldest population in the world after Japan, 58% of Covid-19 patients who died so far were over 80 years old, and a further 31% were in their 70s, according to the National Institute of Health, Italy’s disease-control agency.
“If we break it down by age group, our death rates are similar, or even lower, than those reported in China,” Giovanni Rezza, ...epidemiologist...Italy’s testing policy also contributes to a higher ratio of deaths compared with known infections...Italy has so far tested around 54,000 people, but is focusing tests on those with clear symptoms and known contacts with high-risk areas...
In contrast, South Korea ramped up mass testing soon after discovering its outbreak and hunted down those likely infected. Empowered by a broad infectious-disease law, the country’s health officials had access to an individual’s credit-card transactions, smartphone data and security-camera footage. South Korea’s government said it could test up to 10,000 people a day, erecting drive-through clinics and repurposing other medical facilities.
...But the number of sick (in Italy) is rising faster than the number of beds. In the worst-hit areas, doctors say that if new infections continue to increase at the current rate—by around 25% each day—hospitals may run out of beds within a week to treat all those who need intensive care. Around 60% of those in intensive care in Lombardy are over 65.
...Lombardy hasn’t yet reached the point where doctors are having to choose who gets intensive care and who doesn’t, said Alessandro Vergallo, who heads the intensive-care doctors’ union. “For now, we are performing acrobatics in order to manage,” he said. “If things carry on like this, it’s clear our capacity to resist is limited.”
Lombardy has already begun transferring some intensive-care patients to other regions.
Virologists say the coronavirus began spreading in towns southeast of Milan for about a month before it was detected on Feb. 20. Since then, new infections have continued to rise rapidly despite a first raft of measures aimed at restricting public gatherings.
That pushed the government to take drastic steps to curb the epidemic...the whole of Italy will be placed in lockdown from Tuesday, extending measures that were recently imposed on the country’s north. People are barred from leaving the quarantined areas unless they can prove necessity. Those who break the rules can face up to three months in prison.
Across Italy, schools, cinemas and museums have shut, and bars and restaurants must shut after 6 p.m.
...the government is buying thousands of new ventilators and has instructed health care officials across the country to expand by 50% the number of beds in intensive care units, of which there are currently around 5,000. Over 700 of them are already occupied by Covid-19 patients.
A bigger problem is personnel: There aren’t enough specialized doctors and nurses to staff intensive-care units...Doctors and nurses who are already dealing with the Covid-19 emergency are stretched to the limit, working overtime and often getting sick themselves. In Lombardy, medical staff make up around 12% of those infected...
https://www.wsj.com/articles/italy-with-elderly-population-has-worlds-highest-de...
Coronavirus has killed 5% of known cases, even higher in the worst-affected region, versus a global average of 3.5%
Margherita Stancati | March 9, 2020
...In less than three weeks, Italy has gone from having just three coronavirus cases to the biggest outbreak after China...
By Monday, Italy’s total confirmed infections reached 9,172 of whom 463, or 5%, had died. In Lombardy, the worst-affected region, the death rate is 6%. Globally, about 3.5% out of 109,578 people with confirmed cases have died, according to the latest data from the World Health Organization. Many experts say the real mortality rate may well be lower, because many infection cases aren’t known.
...In Italy, which has the oldest population in the world after Japan, 58% of Covid-19 patients who died so far were over 80 years old, and a further 31% were in their 70s, according to the National Institute of Health, Italy’s disease-control agency.
“If we break it down by age group, our death rates are similar, or even lower, than those reported in China,” Giovanni Rezza, ...epidemiologist...Italy’s testing policy also contributes to a higher ratio of deaths compared with known infections...Italy has so far tested around 54,000 people, but is focusing tests on those with clear symptoms and known contacts with high-risk areas...
In contrast, South Korea ramped up mass testing soon after discovering its outbreak and hunted down those likely infected. Empowered by a broad infectious-disease law, the country’s health officials had access to an individual’s credit-card transactions, smartphone data and security-camera footage. South Korea’s government said it could test up to 10,000 people a day, erecting drive-through clinics and repurposing other medical facilities.
...But the number of sick (in Italy) is rising faster than the number of beds. In the worst-hit areas, doctors say that if new infections continue to increase at the current rate—by around 25% each day—hospitals may run out of beds within a week to treat all those who need intensive care. Around 60% of those in intensive care in Lombardy are over 65.
...Lombardy hasn’t yet reached the point where doctors are having to choose who gets intensive care and who doesn’t, said Alessandro Vergallo, who heads the intensive-care doctors’ union. “For now, we are performing acrobatics in order to manage,” he said. “If things carry on like this, it’s clear our capacity to resist is limited.”
Lombardy has already begun transferring some intensive-care patients to other regions.
Virologists say the coronavirus began spreading in towns southeast of Milan for about a month before it was detected on Feb. 20. Since then, new infections have continued to rise rapidly despite a first raft of measures aimed at restricting public gatherings.
That pushed the government to take drastic steps to curb the epidemic...the whole of Italy will be placed in lockdown from Tuesday, extending measures that were recently imposed on the country’s north. People are barred from leaving the quarantined areas unless they can prove necessity. Those who break the rules can face up to three months in prison.
Across Italy, schools, cinemas and museums have shut, and bars and restaurants must shut after 6 p.m.
...the government is buying thousands of new ventilators and has instructed health care officials across the country to expand by 50% the number of beds in intensive care units, of which there are currently around 5,000. Over 700 of them are already occupied by Covid-19 patients.
A bigger problem is personnel: There aren’t enough specialized doctors and nurses to staff intensive-care units...Doctors and nurses who are already dealing with the Covid-19 emergency are stretched to the limit, working overtime and often getting sick themselves. In Lombardy, medical staff make up around 12% of those infected...
https://www.wsj.com/articles/italy-with-elderly-population-has-worlds-highest-de...
35margd
Having a ready supply of isolated virus should speed "better diagnostic testing, treatments and vaccines" as well as
"a better understanding of SARS-CoV-2 biology, evolution and clinical shedding."
Research team has isolated (and cultured) the COVID-19 virus
Sunnybrook Research Institute | March 12, 2020
A team of researchers from Sunnybrook, McMaster University...and the University of Toronto...has isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for the ongoing outbreak of COVID-19.
Thanks to nimble collaboration, the team was able to culture the virus from two clinical specimens in a Level 3 containment facility.
...The isolated virus will help researchers in Canada and across the world develop better diagnostic testing, treatments and vaccines, and gain a better understanding of SARS-CoV-2 biology, evolution and clinical shedding...
https://sunnybrook.ca/research/media/item.asp
"a better understanding of SARS-CoV-2 biology, evolution and clinical shedding."
Research team has isolated (and cultured) the COVID-19 virus
Sunnybrook Research Institute | March 12, 2020
A team of researchers from Sunnybrook, McMaster University...and the University of Toronto...has isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for the ongoing outbreak of COVID-19.
Thanks to nimble collaboration, the team was able to culture the virus from two clinical specimens in a Level 3 containment facility.
...The isolated virus will help researchers in Canada and across the world develop better diagnostic testing, treatments and vaccines, and gain a better understanding of SARS-CoV-2 biology, evolution and clinical shedding...
https://sunnybrook.ca/research/media/item.asp
36margd
😡🦠💦🧽🙌😃
#WashYourHands #IWillSurviveChallenge on TikTok
Gloria Gaynor•Mar 12, 2020
It only takes 20 seconds to “SURVIVE”!
This is the video that I posted to my TikTok account this week
to help encourage everyone to stay safe & healthy
by washing their hands for 20 seconds or more several times each day!
https://www.youtube.com/watch?v=uvqP5NRXf8g
___________________________________________________________
"I Will Survive" Lyrics (Excerpt)
Gloria Gaynor
...Did you think I'd crumble?
Did you think I'd lay down and die?
Oh, no, not I
I will survive
Oh, as long as I know how to love I know I'll stay alive
I've got all my life to live
I've got all my love to give
And I'll survive
I will survive...
(Repeat? :D)
https://www.azlyrics.com/lyrics/gloriagaynor/iwillsurvive.html
https://www.tiktok.com/music/I-Will-Survive-6712590661838702593?lang=en
#WashYourHands #IWillSurviveChallenge on TikTok
Gloria Gaynor•Mar 12, 2020
It only takes 20 seconds to “SURVIVE”!
This is the video that I posted to my TikTok account this week
to help encourage everyone to stay safe & healthy
by washing their hands for 20 seconds or more several times each day!
https://www.youtube.com/watch?v=uvqP5NRXf8g
___________________________________________________________
"I Will Survive" Lyrics (Excerpt)
Gloria Gaynor
...Did you think I'd crumble?
Did you think I'd lay down and die?
Oh, no, not I
I will survive
Oh, as long as I know how to love I know I'll stay alive
I've got all my life to live
I've got all my love to give
And I'll survive
I will survive...
(Repeat? :D)
https://www.azlyrics.com/lyrics/gloriagaynor/iwillsurvive.html
https://www.tiktok.com/music/I-Will-Survive-6712590661838702593?lang=en
37lriley
Pretty much every sport around has shut down in the United States from pro to college to high school and here is Trump convincing Dana White to keep UFC events going wherever he can and in front of spectators. It's eyebrow raising denialist dumbfuckism.
This clown still doesn't get it.
This clown still doesn't get it.
38Molly3028
If Trump was a company CEO, he would be history after his
Wednesday night fiasco and its ramifications.
Because Trump refuses to face reality and/or be tested, I hope the
WH caretakers (people who have been on the job for decades) are
wearing masks and gloves as they go about their daily work
schedules.
Wednesday night fiasco and its ramifications.
Because Trump refuses to face reality and/or be tested, I hope the
WH caretakers (people who have been on the job for decades) are
wearing masks and gloves as they go about their daily work
schedules.
39margd
In Michigan, 2, maybe 3, cases a couple days ago. Yesterday, public schools closed until early April. Today, 10 cases. Most universities switched to online classes, and won't schedule any more gatherings until early April. Bet it will be later than that... Tests would be nice... Y'know, like the US was a first-world country, with great technological and financial resources... 😕
How Much Worse the Coronavirus Could Get, in (Interactive) Charts
Nicholas Kristof and Stuart A. Thompson | March 13, 2020
What’s at stake in this coronavirus pandemic? How many Americans can become infected? How many might die?
The answers depend on the actions we take — and, crucially, on when we take them. Working with infectious disease epidemiologists, we developed this interactive tool that lets you see what may lie ahead in the United States and how much of a difference it could make if officials act quickly. (The figures are for America, but the lessons are broadly applicable to any country.)...
https://www.nytimes.com/interactive/2020/03/13/opinion/coronavirus-trump-respons...
How Much Worse the Coronavirus Could Get, in (Interactive) Charts
Nicholas Kristof and Stuart A. Thompson | March 13, 2020
What’s at stake in this coronavirus pandemic? How many Americans can become infected? How many might die?
The answers depend on the actions we take — and, crucially, on when we take them. Working with infectious disease epidemiologists, we developed this interactive tool that lets you see what may lie ahead in the United States and how much of a difference it could make if officials act quickly. (The figures are for America, but the lessons are broadly applicable to any country.)...
https://www.nytimes.com/interactive/2020/03/13/opinion/coronavirus-trump-respons...
40margd
Doctor: How to reduce your vulnerability to coronavirus -- when sleeping
Bruce L. Davidson | March 13, 2020
...Coronavirus infects cells below the voice box, in the airways and deep in the lungs, unlike flu viruses which start with your nose and throat. Other than via tiny particles inhaled in air, coronavirus reaches those cells via fluid in the nose or throat that sneaks past your voice box (this is called aspiration) and slides down your windpipe, or trachea.
Studies have shown that at least half of normal people -- young, middle-aged, elderly -- aspirate at night during sleep. By the end of a week, probably we all have. After taking a sleeping pill or a couple beers or shots -- and sleeping more deeply -- the chance of aspiration is even higher. And as we age, ordinary swallowing often becomes less well coordinated.
If you have lung damage from smoking, swallowing saliva, which we all do while we sleep, can deliver even more aspirated throat contents into the lungs. The amount of fluid aspirated during sleep is enough to cause pneumonia -- in fact, it's how most pneumonia occurs.
...How can you limit your personal exposure to coronavirus?
...use avoidance to minimize virus particles deposited near your face.
...minimize the virus burden around and inside your face before you go to sleep.
Limit sedation before sleep during an epidemic. If you use a device at night for sleep apnea, make sure it remains away from where people could cough, sneeze and breathe on it, and clean it regularly...
https://www.cnn.com/2020/03/12/opinions/coronavirus-vulnerability-while-sleeping...
Bruce L. Davidson | March 13, 2020
...Coronavirus infects cells below the voice box, in the airways and deep in the lungs, unlike flu viruses which start with your nose and throat. Other than via tiny particles inhaled in air, coronavirus reaches those cells via fluid in the nose or throat that sneaks past your voice box (this is called aspiration) and slides down your windpipe, or trachea.
Studies have shown that at least half of normal people -- young, middle-aged, elderly -- aspirate at night during sleep. By the end of a week, probably we all have. After taking a sleeping pill or a couple beers or shots -- and sleeping more deeply -- the chance of aspiration is even higher. And as we age, ordinary swallowing often becomes less well coordinated.
If you have lung damage from smoking, swallowing saliva, which we all do while we sleep, can deliver even more aspirated throat contents into the lungs. The amount of fluid aspirated during sleep is enough to cause pneumonia -- in fact, it's how most pneumonia occurs.
...How can you limit your personal exposure to coronavirus?
...use avoidance to minimize virus particles deposited near your face.
...minimize the virus burden around and inside your face before you go to sleep.
Limit sedation before sleep during an epidemic. If you use a device at night for sleep apnea, make sure it remains away from where people could cough, sneeze and breathe on it, and clean it regularly...
https://www.cnn.com/2020/03/12/opinions/coronavirus-vulnerability-while-sleeping...
41margd
How to Make Your Own Hand Sanitizer (Gel AND Spray)
Boone Ashworth | 03.12.2020
... When disinfecting gel sells out everywhere, you can just make some yourself...
...Potency Matters
You’re going to need some alcohol. According to the Centers for Disease Control and Prevention, your sanitizer mix must be at least 60 percent alcohol to be effective....
The Quick (Gel) Recipe
Isopropyl alcohol
Aloe vera gel
Tea tree oil
Mix 3 parts isopropyl alcohol to 1 part aloe vera gel. Add a few drops of tea tree oil to give it a pleasant scent...
The Better (Spray) Recipe
...based on the mix recommended by the WHO*
1 2/3 c Isopropyl alcohol
2 t Glycerol
1T Hydrogen peroxide
1/4 c Distilled water
Spray bottle
...If you can't find glycerol, proceed with the rest of the recipe anyway and just remember to moisturize your hands after applying the sanitizer.
...Load the solution into spray bottles—this isn't a gel, it's a spray. You can wet a paper towel with it as well and use that as a wipe.
...you can add in a splash of essential oil to your concoction to make it smell nice. Just don’t use lavender. Everyone else uses lavender, and your sanitizer is superior.
https://www.wired.com/story/how-to-make-hand-sanitizer/
* https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf
Boone Ashworth | 03.12.2020
... When disinfecting gel sells out everywhere, you can just make some yourself...
...Potency Matters
You’re going to need some alcohol. According to the Centers for Disease Control and Prevention, your sanitizer mix must be at least 60 percent alcohol to be effective....
The Quick (Gel) Recipe
Isopropyl alcohol
Aloe vera gel
Tea tree oil
Mix 3 parts isopropyl alcohol to 1 part aloe vera gel. Add a few drops of tea tree oil to give it a pleasant scent...
The Better (Spray) Recipe
...based on the mix recommended by the WHO*
1 2/3 c Isopropyl alcohol
2 t Glycerol
1T Hydrogen peroxide
1/4 c Distilled water
Spray bottle
...If you can't find glycerol, proceed with the rest of the recipe anyway and just remember to moisturize your hands after applying the sanitizer.
...Load the solution into spray bottles—this isn't a gel, it's a spray. You can wet a paper towel with it as well and use that as a wipe.
...you can add in a splash of essential oil to your concoction to make it smell nice. Just don’t use lavender. Everyone else uses lavender, and your sanitizer is superior.
https://www.wired.com/story/how-to-make-hand-sanitizer/
* https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf
42John5918
First confirmed case here in Kenya. A Kenyan citizen, but ironically she almost certainly contracted it in the USA or UK - she just flew in from the USA via London - "This is an imported case, not a homegrown case..." Apparently she is recovering well.
COVID-19: Don't blame patient, she was responsible (Star)
She went straight to hospital when she started feeling unwell...
COVID-19: Don't blame patient, she was responsible (Star)
She went straight to hospital when she started feeling unwell...
43proximity1
>33 lriley:
... “what Barack and Hillary were dealing with wasn't killing people left and right all around the globe either, was it? ” … "and by the way researchers and scientists were working on a SARS vaccine some 18 years ago that got shelved when that outbreak way back then petered out
(from time-marker 51 mins. : 09 secs.)
Sam Harris (S.H.) : “So—and I see that we're getting to the end of our hour here—what's your level of concern about this 'big picture'? Do you think that this was the plague that we've been waiting for in infectious disease?—we're struggling to raise all the resources and make all the changes we need to respond to it— or are you cautiously optimistic that this is a mere 'dress-rehearsal' for the plague that we will one day need to respond to better than we've been responding to this one?
Dr. Amesh Adalja (A.A.): "I think it's a dress-rehearsal for a major plague because if you look for example at our avian flu viruses in China, the mortality-rate for some of those are 60%; they don't transmit efficiently from human to human but they are flu viruses. What if one of those 're-shuffled' and was able to transmit efficiently from human to human? That would be cataclysmic. This—we're dealing with a mortality-rate of less than one percent. This is something that is going to be very difficult for hospitals and health care systems to cope with but it really shows you just what a virus that kills less than one percent can do to a world. And I do think that this is a lesson that we're not doing this perfectly. And if we were to have an avian flu virus, have human to human transmissibility, all bets would be off. Because if we're having this much trouble dealing with a 0.6 percent mortality, imagine what would happen if there was a 60%-mortality flu virus circulating around. So I think (this virus) it's a 'dress-rehearsal'—this is going to be bad though, and there are going to be a lot of disruptions that we're going to have to deal with and it's going to be somewhat worse than H1-N1—H1-N1 was the closest we came to this kind of thing in the modern era, and even though most people are going to have a mild case (i.e. of Covid-19) and recover just fine, it is going to be a burden to work in hospitals and it's going to really—hopefully get people to think about how important infectious-disease-preparation is even when there's not a pandemic because some of this stuff could have been predicted back from 2003. We had a SARS outbreak, we saw what a corona-virus could do, and people wanted to make a vaccine for that—and really now seventeen years later, we have no corona-virus vaccines for humans, we have no corona-virus anti-viral, so this shows you what happens when there's complacency with these threats even though everyone in my (professional) community had been sounding the alarm about corona viruses since at least 2003 and some people even before that. ”
_______________________________________________
(emphasis added)
Barack Obama "served as the 44th president of the United States from 2009 to 2017." "U.S. Senator from Illinois (2005–08)"
(from Wikipedia (Barack Obama) ) " Committees:
"Obama held assignments on the Senate Committees for Foreign Relations, Environment and Public Works and Veterans' Affairs through December 2006.(n.174) In January 2007, he left the Environment and Public Works committee and took additional assignments with Health, Education, Labor and Pensions and Homeland Security and Governmental Affairs." ... (emphasis added)
(Wikipedia) "Legacy
...
"Obama's most significant legacy is generally considered to be the Patient Protection and Affordable Care Act (PPACA), provisions of which went into effect from 2010 to 2020. Many attempts by Senate Republicans to repeal the PPACA, including a "skinny repeal," have thus far failed.(515) Together with the Health Care and Education Reconciliation Act amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965." ...
________________________________________________
Hillary Clinton
First Lady of the United States
In role : January 20, 1993 – January 20, 2001
----->
(Wikipedia) ...
"Along with senators Ted Kennedy and Orrin Hatch, Clinton was a force behind the passage of the State Children's Health Insurance Program in 1997. This federal bill gave state support to children whose parents could not provide them health coverage. She conducted outreach efforts on behalf of enrolling children in the program once it became law.(171) She promoted nationwide immunization against childhood diseases and encouraged older women to get a mammogram for breast cancer screening, with coverage provided by Medicare.(172) She successfully sought to increase research funding for prostate cancer and childhood asthma at the National Institutes of Health. She worked to investigate reports of an illness that affected veterans of the Gulf War, which became known as the Gulf War syndrome." ...
United States Senator from New York
In office : January 3, 2001 – January 21, 2009
67th United States Secretary of State
In office : January 21, 2009 – February 1, 2013
_______________________________________________
SARS-Corona virus (Wikipedia)
"Severe acute respiratory syndrome coronavirus (SARS-CoV) is the strain of virus that causes severe acute respiratory syndrome (SARS).(n. 2) It is an enveloped, positive-sense, single-stranded RNA virus which infects the epithelial cells within the lungs.(n. 3) The virus enters the host cell by binding to the ACE2 receptor.4 It infects humans, bats, and palm civets.(5)(6)
"On April 16, 2003, following the outbreak of SARS in Asia and secondary cases elsewhere in the world, the World Health Organization (WHO) issued a press release stating that the coronavirus identified by a number of laboratories was the official cause of SARS. The Centers for Disease Control and Prevention (CDC) in the United States and National Microbiology Laboratory (NML) in Canada identified the SARS-CoV genome in April 2003.(7)(8) Scientists at Erasmus University in Rotterdam, the Netherlands demonstrated that the SARS coronavirus fulfilled Koch's postulates thereby confirming it as the causative agent. In the experiments, macaques infected with the virus developed the same symptoms as human SARS victims" (emphasis added)
________________________________________________
You got nuthin' to say. Nuthin'.
45John5918
International cricket is going the way of other sports...
Coronavirus: England Test series in Sri Lanka called-off (BBC)
England's Test series against Sri Lanka has been postponed because of the coronavirus pandemic...
the start of the 2020 Indian Premier League season has been delayed from 29 March to 15 April... while India's one-day international series against South Africa was also postponed... while the Pakistan Super League was shortened. Scotland's one-day international series against the United States and the United Arab Emirates, scheduled to take place in Florida in April, has also been postponed. Meanwhile, Australia will play their three one-day internationals against New Zealand behind closed doors.
Coronavirus: England Test series in Sri Lanka called-off (BBC)
England's Test series against Sri Lanka has been postponed because of the coronavirus pandemic...
the start of the 2020 Indian Premier League season has been delayed from 29 March to 15 April... while India's one-day international series against South Africa was also postponed... while the Pakistan Super League was shortened. Scotland's one-day international series against the United States and the United Arab Emirates, scheduled to take place in Florida in April, has also been postponed. Meanwhile, Australia will play their three one-day internationals against New Zealand behind closed doors.
46stellarexplorer
>43 proximity1: I wonder whether you caught the prologue to that Sam Harris podcast with Dr Adalja, in which Sam clarifies that Adalja’s seeming lesser concern than that of other people in similar positions stems from his own perspective. He focuses on civilization-threatening epidemics, and sees this one as just very bad. He is very measured, in my opinion to the detriment of delivering the info fairly. As experts go, his way of talking about it is the outlier.
47davidgn
Hot-air contribution by Drumpf at 3:00 PM ET. At least he's going to be declaring a national emergency.
https://www.cbsnews.com/live-updates/coronavirus-updates-cases-fears-deaths-us-l...
https://www.cbsnews.com/live-updates/coronavirus-updates-cases-fears-deaths-us-l...
48margd
>32 margd: test kits
China's richest man Jack Ma donates one million face masks and 500,000 coronavirus test kits to the US as Beijing and Washington accuse each other of being the origin of the disease
Billie Thomson | 13 March 2020
China's richest man is donating one million face masks and 500,000 coronavirus test kits to the United States to help the world's largest economy fight the outbreak, which has killed at least 5,000 people worldwide.
The tycoon's aid comes as Beijing and Washington spar over the origin of the deadly disease, known as COVID-19.
Jack Ma, worth £31.6billion, announced the decision on Friday through his account on Twitter-like Weibo.
...The 55-year-old tycoon said: 'Hopefully, these supplies can help some people in the United States'
The magnate has already donated millions of masks and test kits to Japan, South Korea, Iran and Europe to support their containment of the fast-spreading contagion...
https://www.dailymail.co.uk/news/article-8105199/Chinas-richest-man-Jack-Ma-dona...
--------------------------------------------------
(Response on Twitter was--GRATITUDE.)
China's richest man Jack Ma donates one million face masks and 500,000 coronavirus test kits to the US as Beijing and Washington accuse each other of being the origin of the disease
Billie Thomson | 13 March 2020
China's richest man is donating one million face masks and 500,000 coronavirus test kits to the United States to help the world's largest economy fight the outbreak, which has killed at least 5,000 people worldwide.
The tycoon's aid comes as Beijing and Washington spar over the origin of the deadly disease, known as COVID-19.
Jack Ma, worth £31.6billion, announced the decision on Friday through his account on Twitter-like Weibo.
...The 55-year-old tycoon said: 'Hopefully, these supplies can help some people in the United States'
The magnate has already donated millions of masks and test kits to Japan, South Korea, Iran and Europe to support their containment of the fast-spreading contagion...
https://www.dailymail.co.uk/news/article-8105199/Chinas-richest-man-Jack-Ma-dona...
--------------------------------------------------
(Response on Twitter was--GRATITUDE.)
49davidgn
Dr. Campbell says to please watch, so posting before even watching.
https://www.youtube.com/watch?v=BYTFk34nhoI
https://www.youtube.com/watch?v=BYTFk34nhoI
50aspirit
>48 margd: test kits have been offered to the CDC from within the United States but won't count for confirmed cases. I wonder what's the difference between those and Jack Ma's.
51lriley
Before they do anything else about this virus the Trump administration has to decide what kind of an effect it might have on their re-election chances. So it goes from a hoax, to a no big deal, to an attempt to undermine the Donald's chances, to a maybe and every step of the way they resist the real evidence and the real expertise from people with actual knowledge in these things in favor of their changing narratives, their goofball suppositions and their gut feelings. If anyone deserves a case of this virus it's Trump and his cabinet and the lackeys that are sucking on his you know what--actually I think they're sucking from both ends. I'm not a fan of Obama or Hillary but Trump's pathetic attempts to blame them for this is just more of the same of never in his life taking responsibility for anything and blaming others is past practice for him. It's always someone else's fault. Prox might not like it but he's an incompetent and self serving idiot and has been his entire life. He's not fit for the Presidency and never has been.
52davidgn
>51 lriley: If they get it, they'll have gotten it from Bolsonaro's people. Somehow fitting...
54margd
>50 aspirit: At this point I think it's up to state governors what tests they choose to manage the outbreak in their respective states. Nice for studies and reports if tests were standardized and calibrated but that's not a luxury we can now afford--besides "confirmed cases" might only be used to facilitate Mr. Trump's itty bitty case numbers with which he can boast "success" of his travel bans and walls against a "foreign" virus...
55stellarexplorer
>54 margd: Totally agree. That’s why the outcome in the US is likely to vary regionally based on state and local governance.
In case anyone is interested - I feel very strongly about this - I just made this video titled “Doctor explains how to stop the coronavirus pandemic” :
https://youtu.be/R70UicCuXu8
In case anyone is interested - I feel very strongly about this - I just made this video titled “Doctor explains how to stop the coronavirus pandemic” :
https://youtu.be/R70UicCuXu8
56clamairy
>55 stellarexplorer: Well done. I shared it on Facebook and Twitter.
57stellarexplorer
>56 clamairy: Thanks so much
58John5918
Coronavirus: Why systemic problems leave the US at risk (BBC)
As the coronavirus spreads across the US, tens of millions of Americans may not seek medical help either because they are uninsured or undocumented. That puts everyone in society at greater risk...
And two articles from Kenya:
Kenya bans public events after first case of coronavirus (Al Jazeera)
Coronavirus news triggers panic shopping in Nairobi (Star)
And one from Sudan:
Coronavirus: First case reported in Sudan (Middle East Eye)
Health ministry reports death of man who returned from UAE earlier this month...
As the coronavirus spreads across the US, tens of millions of Americans may not seek medical help either because they are uninsured or undocumented. That puts everyone in society at greater risk...
And two articles from Kenya:
Kenya bans public events after first case of coronavirus (Al Jazeera)
Coronavirus news triggers panic shopping in Nairobi (Star)
And one from Sudan:
Coronavirus: First case reported in Sudan (Middle East Eye)
Health ministry reports death of man who returned from UAE earlier this month...
59margd
>55 stellarexplorer: Kudos on video!
Those Italians bring such joie de vivre to the task :)
(I think I saw a similar clip of an empty street in China, echoing with music?)
Watch: Quarantined Italians are singing their hearts out. It's beautiful.
Emily Todd VanDerWerff | Mar 13, 2020
The resilience of the human spirit, evidenced by a bunch of Italians making music together on their balconies...
https://www.vox.com/culture/2020/3/13/21179293/coronavirus-italy-covid19-music-b...
-----------------------------------------------------------------------------------
ETA :)
During Italy's quarantine, Italian tenor Maurizio Marchini wanted to do something to spread joy amid all the sadness in Florence.
So climbed on to his balcony and serenaded the entire town.
Wow.
2:17 ( https://twitter.com/MuhammadLila/status/1238671011698151427 ) From Goodable
It ends with the words: "With the dawn, I will win."
Full performance here: https://m.facebook.com/story.php?story_fbid=241965436836788&id=7427311924754...
- Muhammad Lila @MuhammadLila | 11:39 PM · Mar 13, 2020
-----------------------------------------------------------------------------------
ETA
...The virus may be coming for all of us, but there is a fundamental difference between my two countries. In Italy, children stuck at home have been drawing signs with the words “Everything will be fine” and hanging them from windows all across the country. For a society as communal and physical in its affections as Italy, social distancing has been an extraordinary blow. And yet even with people locked up in their homes away from family and neighbors, a strong sense of solidarity has emerged. Italians know they’ll get through this because they have each other’s back. I am not sure we Americans can say that.
https://theintercept.com/2020/03/12/italy-coronavirus-united-states-preparedness...
____________________________________________________
ETA. We're going to need resolve, resilience...and kindness...
A hospital in Seattle area has sent out a note to staff, shared with me, suspending elective surgery and
warning that "our local COVID-19 trajectory is likely to be similar to that of Northern Italy."
The hospital is down to a four-day supply of gloves.
- Nicholas Kristof (NYT) @NickKristof | 8:12 PM · Mar 13, 2020
(margd: an emergency dr. at a Toronto hospital is raising similar alarm on FB, though TO isn't as far into epidemic as Seattle, I think(?) Everywhere, hospitals and healthcare workers are depending on us to "flatten the curve"...)
---------------------------------------------------------------
Alex Kapp @realalexkapp | 9:50 PM · Mar 13, 2020
I just spent hours waiting, outside, in the cold and rain, at Cedars Sinai Hospital in Los Angeles waiting to get my daughter tested for #coronavirus after a week of symptoms and the discovery of a recent exposure.
We were told to sit outside in the driveway of the ER in the rain for over two hours and only got into the tent after I went back into triage twice and frankly, kind of freaked out. When we finally got into the tent, we were treated respectfully and with kindness by the doctor.
But after a series of questions about exposure and my daughter's symptoms (cough, fever, shortness of breath), the doctor, who was respectful, sage, and honest, told us that their tests are being rationed. They simply don't have enough tests to test people with no pre-existing
health issues. It is not their fault. I felt bad for him and for the hard-working nurses and administrators who are basically flying blind. They have no real data. They have no tests. And he told us that even if we could test her, the test is incomplete and would have to be sent
to a lab, and that those results would take a week to come in. He told us to self-quarantine and rest. And that was it. We gave our insurance information, although I'm not sure how we could be charged for sitting outside in a driveway for two hours only to be refused-
But I am guessing we will be billed in some way, as the tent was outside the ER. And then we were released. All we are trying to do is prevent spread on the off chance that we have the virus. But we left the hospital after almost three hours with no more information
than we had before we got there. We are lucky enough to be healthy and not elderly. And we are lucky enough to have some kind of insurance. But there is an astounding lack of information, data, testing and reassurance coming from the federal government.
Please be kind to the doctors, nurses, administrators, and healthcare workers who are just as uniformed and unprepared as we are. They are at the mercy of the information being farmed out to them. And they are going to be under siege. The reality is...
If you are relatively healthy, under 65, and not showing symptoms, and frankly, even if you are showing symptoms, they more than likely won't test you. They have to save the few tests they have for the elderly and immuno-compromised.
Stay home. Self-quarantine. Be smart. And be kind. We are all in this together. Seriously. The whole world. So let's not go all Lord of the Flies and steal and hoard and accuse. This may be a while. So let's try to behave in a way that we can feel okay about when it's all over.
Those Italians bring such joie de vivre to the task :)
(I think I saw a similar clip of an empty street in China, echoing with music?)
Watch: Quarantined Italians are singing their hearts out. It's beautiful.
Emily Todd VanDerWerff | Mar 13, 2020
The resilience of the human spirit, evidenced by a bunch of Italians making music together on their balconies...
https://www.vox.com/culture/2020/3/13/21179293/coronavirus-italy-covid19-music-b...
-----------------------------------------------------------------------------------
ETA :)
During Italy's quarantine, Italian tenor Maurizio Marchini wanted to do something to spread joy amid all the sadness in Florence.
So climbed on to his balcony and serenaded the entire town.
Wow.
2:17 ( https://twitter.com/MuhammadLila/status/1238671011698151427 ) From Goodable
It ends with the words: "With the dawn, I will win."
Full performance here: https://m.facebook.com/story.php?story_fbid=241965436836788&id=7427311924754...
- Muhammad Lila @MuhammadLila | 11:39 PM · Mar 13, 2020
-----------------------------------------------------------------------------------
ETA
...The virus may be coming for all of us, but there is a fundamental difference between my two countries. In Italy, children stuck at home have been drawing signs with the words “Everything will be fine” and hanging them from windows all across the country. For a society as communal and physical in its affections as Italy, social distancing has been an extraordinary blow. And yet even with people locked up in their homes away from family and neighbors, a strong sense of solidarity has emerged. Italians know they’ll get through this because they have each other’s back. I am not sure we Americans can say that.
https://theintercept.com/2020/03/12/italy-coronavirus-united-states-preparedness...
____________________________________________________
ETA. We're going to need resolve, resilience...and kindness...
A hospital in Seattle area has sent out a note to staff, shared with me, suspending elective surgery and
warning that "our local COVID-19 trajectory is likely to be similar to that of Northern Italy."
The hospital is down to a four-day supply of gloves.
- Nicholas Kristof (NYT) @NickKristof | 8:12 PM · Mar 13, 2020
(margd: an emergency dr. at a Toronto hospital is raising similar alarm on FB, though TO isn't as far into epidemic as Seattle, I think(?) Everywhere, hospitals and healthcare workers are depending on us to "flatten the curve"...)
---------------------------------------------------------------
Alex Kapp @realalexkapp | 9:50 PM · Mar 13, 2020
I just spent hours waiting, outside, in the cold and rain, at Cedars Sinai Hospital in Los Angeles waiting to get my daughter tested for #coronavirus after a week of symptoms and the discovery of a recent exposure.
We were told to sit outside in the driveway of the ER in the rain for over two hours and only got into the tent after I went back into triage twice and frankly, kind of freaked out. When we finally got into the tent, we were treated respectfully and with kindness by the doctor.
But after a series of questions about exposure and my daughter's symptoms (cough, fever, shortness of breath), the doctor, who was respectful, sage, and honest, told us that their tests are being rationed. They simply don't have enough tests to test people with no pre-existing
health issues. It is not their fault. I felt bad for him and for the hard-working nurses and administrators who are basically flying blind. They have no real data. They have no tests. And he told us that even if we could test her, the test is incomplete and would have to be sent
to a lab, and that those results would take a week to come in. He told us to self-quarantine and rest. And that was it. We gave our insurance information, although I'm not sure how we could be charged for sitting outside in a driveway for two hours only to be refused-
But I am guessing we will be billed in some way, as the tent was outside the ER. And then we were released. All we are trying to do is prevent spread on the off chance that we have the virus. But we left the hospital after almost three hours with no more information
than we had before we got there. We are lucky enough to be healthy and not elderly. And we are lucky enough to have some kind of insurance. But there is an astounding lack of information, data, testing and reassurance coming from the federal government.
Please be kind to the doctors, nurses, administrators, and healthcare workers who are just as uniformed and unprepared as we are. They are at the mercy of the information being farmed out to them. And they are going to be under siege. The reality is...
If you are relatively healthy, under 65, and not showing symptoms, and frankly, even if you are showing symptoms, they more than likely won't test you. They have to save the few tests they have for the elderly and immuno-compromised.
Stay home. Self-quarantine. Be smart. And be kind. We are all in this together. Seriously. The whole world. So let's not go all Lord of the Flies and steal and hoard and accuse. This may be a while. So let's try to behave in a way that we can feel okay about when it's all over.
60margd
SARS-CoV-2 is a virus well-suited to spread--thank goodness it's not any more lethal!
Symptoms can take 14 days to appear, during which transmission may occur.
After symptoms appear, virus is shed for median of 20 days (8-37).
From the upper respiratory tract, it is easily spread by coughing.
It can remain viable for up to 24 hours on cardboard and up to three days on plastic and stainless steel (median 13-16 h). Only 4 h on copper.
Still, according to a Cornell U epidemiologist, it takes thousands or hundreds of thousands of viral particles to infect a human or animal.
CDC recommends 1/3 c bleach per gallon of water for sanitizing surfaces...
Coronavirus can stay infectious for days on surfaces. But it’s still okay to check your mail.
Joel Achenbach | March 13, 2020
https://www.washingtonpost.com/health/coronavirus-can-stay-infectious-for-days-o...
-----------------------------------------------------------------------------------------------------------
Fei Zhou et al. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. Published:March 11, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)30566-3 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fullt...
-----------------------------------------------------------------------------------------------------------
Neeltje van Doremalen et al. 2020. Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1. Not yet peer-reviewed submission to New England Journal of Medicine. https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v2 https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v1.full.pdf
Symptoms can take 14 days to appear, during which transmission may occur.
After symptoms appear, virus is shed for median of 20 days (8-37).
From the upper respiratory tract, it is easily spread by coughing.
It can remain viable for up to 24 hours on cardboard and up to three days on plastic and stainless steel (median 13-16 h). Only 4 h on copper.
Still, according to a Cornell U epidemiologist, it takes thousands or hundreds of thousands of viral particles to infect a human or animal.
CDC recommends 1/3 c bleach per gallon of water for sanitizing surfaces...
Coronavirus can stay infectious for days on surfaces. But it’s still okay to check your mail.
Joel Achenbach | March 13, 2020
https://www.washingtonpost.com/health/coronavirus-can-stay-infectious-for-days-o...
-----------------------------------------------------------------------------------------------------------
Fei Zhou et al. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. Published:March 11, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)30566-3 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fullt...
-----------------------------------------------------------------------------------------------------------
Neeltje van Doremalen et al. 2020. Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1. Not yet peer-reviewed submission to New England Journal of Medicine. https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v2 https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v1.full.pdf
61proximity1
>51 lriley:
"Before they do anything else about this virus the Trump administration has to decide what kind of an effect it might have on their re-election chances. So it goes from a hoax, to a no big deal," ....
(emphasis added)
Who called what a "hoax", when and how?
Surely you don't mean to dishonestly insinuate that President Trump ever claimed or suggested or even implied that the current Covid-19 (Corona virus) outbreak was itself a "hoax" or part of some "hoax", now, do you? Because to do that would be trafficking in a disgusting, vicious fucking LIE.
And you'd never do that—would you!?
(Channel 4 News (London) ) By Patrick Worrall
| 6 Mar 2020
"The Trump administration is under close scrutiny as it scrambles to respond to the threat from the Covid-19 virus.
At time of writing there are 293 confirmed cases in the US, and 14 people have died.
Some critics of President Donald Trump have accused of him of making false and confusing statements about the spread of the virus.
The president has accused his opponents of trying to make political capital out of the coronavirus. What exactly has Mr Trump been saying?
“We’re going very substantially down, not up.”
The president put a positive spin on figures for coronavirus cases in the US in a news conference last week, saying the number was going down and “within a couple of days is going to be down to close to zero”.
This was in direct contradiction to statements made in the same press conference by the Secretary of Health and Human Services, Alex Azar, and the Deputy Director of the Centers for Disease Control and Prevention, Dr Anne Schuchat.
Both officials said they expected to see more cases in the US.
“This is their new hoax.”
The US president used this phrase during a freewheeling speech at a rally in South Carolina last week.
Some journalists seized on the remark as evidence that the president was fuelling conspiracy theories about the virus itself being a hoax.
Mr Trump’s exact words (here at 3.55) were: “Now the Democrats are politicizing the coronavirus. You know that, right? Coronavirus. They’re politicizing it. We did one of the great jobs. (…)
“One of my people came up to me and said, ‘Mr. President, they tried to beat you on Russia, Russia, Russia. That didn’t work out too well. They couldn’t do it. They tried the impeachment hoax. (…)
“And this is their new hoax. But you know, we did something that’s been pretty amazing. We’re 15 people in this massive country.”
The president did not state that the virus itself was a hoax, and it seems clear from the reference to the 15 confirmed cases (accurate at the time) that he did not intend to call into question the actual existence of the disease.
Further on in the speech, Mr Trump said the virus could become a threat to life, although he played down the scale of the risk.
He later clarified that he used the word hoax “referring to the action that they take to try and pin this on somebody because we’ve done such a good job”.
He added: “The hoax is on them not… I’m not talking about what’s happening here. I’m talking what they’re doing. That’s the hoax.”
(Boldface and underlining emphasis added above)
62aspirit
>61 proximity1: the mental gymnastics involved to assert that DT did not refer to the threat of coronavirus as a Democrat hoax is astouding. "And this is their new hoax. But you know, we did something that’s been pretty amazing. We’re 15 people in this massive country." Then there's been his tweets. (Compare with former POTUS Barack Obama's tweets.)
What's amazing is the people refuse to recognize United States Administration's slow and incompetent responses to a viral outbreak. We've allowed someone who puts an incomprehensive "spin" on everything he says, while refusing to do his job, to oversee the efforts against the latest coronavirus.
He represents the branch of administrative government that includes the Department of Health and Human Services, yet he tours like a stage performer, boasting about when he does anything approaching the bare minimum of his elected position, all while spewing digusting lies that will result in preventable deaths.
People are feeling confused, scared, and angry. That only worsens when someone in an authority position lies to and guided to distrust all of the scientists, politicians, and educators who are working themselves sick to compensate for the withholding of test kits and the problems in healthcare systems. In simpler words, DT is doing a shitty job as POTUS. His inability to focus on that job impacts everyone. We have the right to complain when he's making situations worse.
What's amazing is the people refuse to recognize United States Administration's slow and incompetent responses to a viral outbreak. We've allowed someone who puts an incomprehensive "spin" on everything he says, while refusing to do his job, to oversee the efforts against the latest coronavirus.
He represents the branch of administrative government that includes the Department of Health and Human Services, yet he tours like a stage performer, boasting about when he does anything approaching the bare minimum of his elected position, all while spewing digusting lies that will result in preventable deaths.
People are feeling confused, scared, and angry. That only worsens when someone in an authority position lies to and guided to distrust all of the scientists, politicians, and educators who are working themselves sick to compensate for the withholding of test kits and the problems in healthcare systems. In simpler words, DT is doing a shitty job as POTUS. His inability to focus on that job impacts everyone. We have the right to complain when he's making situations worse.
63aspirit
>60 margd: "SARS-CoV-2 is a virus well-suited to spread--thank goodness it's not any more lethal!"
Not more lethal than what? Influenza? An estimated one-tenth of percent (0.1%) of people die from the flu each year. In addition to those deaths, anywhere from 1% to 5% of all documented cases of SARS-CoV-2 have been dying. (See one of the many mentions of those studies in the article linked below.)
https://www.washingtonpost.com/health/2020/03/04/coronavirus-flu-comparison/
We don't have vaccines for this coronavirus or understand the virus as well as flu. Medical reports showing how easily this spreads means that the 15% to 50% death rates for immunocompromised people makes SARS-CoV-2 a severe concern even where the vast majority of infected don't show symptoms.
Thank goodness people are taking measures to reduce community spread!
Not more lethal than what? Influenza? An estimated one-tenth of percent (0.1%) of people die from the flu each year. In addition to those deaths, anywhere from 1% to 5% of all documented cases of SARS-CoV-2 have been dying. (See one of the many mentions of those studies in the article linked below.)
https://www.washingtonpost.com/health/2020/03/04/coronavirus-flu-comparison/
We don't have vaccines for this coronavirus or understand the virus as well as flu. Medical reports showing how easily this spreads means that the 15% to 50% death rates for immunocompromised people makes SARS-CoV-2 a severe concern even where the vast majority of infected don't show symptoms.
Thank goodness people are taking measures to reduce community spread!
64margd
>63 aspirit: Well, yes. I should have been more specific.
I was thinking of related Corona viruses, which are even more lethal than SARS-CoV-2, but thankfully less contagious*:
"...SARS-CoV, SARS-CoV-2, and MERS-CoV (betaCoVs of the B and C lineage, respectively).
These cause epidemics with variable clinical severity featuring respiratory and extra-respiratory manifestations.
Concerning SARS-CoV, MERS-CoV, the mortality rates are up to 10% and 35%, respectively...
SARS-CoV-2 belongs to the betaCoVs... "
https://www.ncbi.nlm.nih.gov/books/NBK554776/
_________________________________________________________________
*ETA: or more easily contained
"SARS-CoV is transmitted by symptomatic individuals...asymptomatic infection poses no significant public health risk"
https://www.who.int/csr/resources/publications/WHO_CDS_CSR_ARO_2004_1/en/
"The MERS virus is transmitted primarily from animals to people, but transmission from people to people is also possible."
MERS: https://www.who.int/csr/disease/coronavirus_infections/faq/en/
I was thinking of related Corona viruses, which are even more lethal than SARS-CoV-2, but thankfully less contagious*:
"...SARS-CoV, SARS-CoV-2, and MERS-CoV (betaCoVs of the B and C lineage, respectively).
These cause epidemics with variable clinical severity featuring respiratory and extra-respiratory manifestations.
Concerning SARS-CoV, MERS-CoV, the mortality rates are up to 10% and 35%, respectively...
SARS-CoV-2 belongs to the betaCoVs... "
https://www.ncbi.nlm.nih.gov/books/NBK554776/
_________________________________________________________________
*ETA: or more easily contained
"SARS-CoV is transmitted by symptomatic individuals...asymptomatic infection poses no significant public health risk"
https://www.who.int/csr/resources/publications/WHO_CDS_CSR_ARO_2004_1/en/
"The MERS virus is transmitted primarily from animals to people, but transmission from people to people is also possible."
MERS: https://www.who.int/csr/disease/coronavirus_infections/faq/en/
65margd
Red Cross is anticipating blood shortages, so a very good thing to donate NOW if one is healthy:
"...Right now, the American Red Cross strongly urges healthy, eligible individuals to schedule a blood, platelet or AB Elite plasma donation appointment to help maintain a sufficient blood product supply and avoid any potential shortages. The Red Cross also urges organizations to maintain scheduled blood drives. Donating is a safe process and people should not hesitate to give or receive blood or platelets.
Cold and flu season has already impacted the nation’s ability to maintain its blood products supply. As the number of coronavirus cases grows in the U.S., the number of people eligible to give blood and platelets for patients in need could decrease further, which is why the Red Cross is urging all eligible, healthy donors to give now....
https://www.redcrossblood.org/donate-blood/dlp/coronavirus--covid-19--and-blood-...
---------------------------------------------------------------------------------------
Le Chang et al. 2020. Coronavirus Disease 2019: Coronaviruses and Blood Safety. Transfusion Medicine Reviews
Corrected proof. 21 February 2020. https://doi.org/10.1016/j.tmrv.2020.02.003 https://www.sciencedirect.com/science/article/pii/S0887796320300146
---------------------------------------------------------------------------------------
ETA
How coronavirus is upsetting the blood supply chain
Anna Nagurney | 3/13/2020
https://www.livescience.com/coronavirus-blood-supply-chain.html
"...Right now, the American Red Cross strongly urges healthy, eligible individuals to schedule a blood, platelet or AB Elite plasma donation appointment to help maintain a sufficient blood product supply and avoid any potential shortages. The Red Cross also urges organizations to maintain scheduled blood drives. Donating is a safe process and people should not hesitate to give or receive blood or platelets.
Cold and flu season has already impacted the nation’s ability to maintain its blood products supply. As the number of coronavirus cases grows in the U.S., the number of people eligible to give blood and platelets for patients in need could decrease further, which is why the Red Cross is urging all eligible, healthy donors to give now....
https://www.redcrossblood.org/donate-blood/dlp/coronavirus--covid-19--and-blood-...
---------------------------------------------------------------------------------------
Le Chang et al. 2020. Coronavirus Disease 2019: Coronaviruses and Blood Safety. Transfusion Medicine Reviews
Corrected proof. 21 February 2020. https://doi.org/10.1016/j.tmrv.2020.02.003 https://www.sciencedirect.com/science/article/pii/S0887796320300146
---------------------------------------------------------------------------------------
ETA
How coronavirus is upsetting the blood supply chain
Anna Nagurney | 3/13/2020
https://www.livescience.com/coronavirus-blood-supply-chain.html
66davidgn
>55 stellarexplorer: Thanks for the video. Very nice work.
67proximity1
>62 aspirit:
"What's amazing is the people refuse to recognize United States Administration's slow and incompetent responses to a viral outbreak."
No, here's what's "amazing" : you bring us no pertinent statistical data to offer even the most tenuous support for the claim that the Trump administration's responses were either "slow" or "incompetent." Why not? Are we supposed to simply take your word for that? Don't you have any factual data from actual objective facts to support your statement or do you rely simply on your personal feelings, biases and preconceptions about Trump as the basis for your claim?
Are you even aware of the facts in this matter?
Can you answer any of these questions accurately? I suspect that you have little or no idea of the correct answers and that, unless you look for these data, you have to guess at the answers; I suspect that your guesses shall be far off the mark:
1) When did scientists in China announce the discovery of a new (i.e. this current outbreak's) coronavirus?
2) When was the first confirmed case in the United States of the 2019–20 coronavirus pandemic announced?
3) When, in the present case, did President Donald Trump officially declare the pandemic a national emergency?
4) On what date did the World Health Organization (W.H.O.) director-general declare the coronavirus outbreak a "Public Health Emergency of International Concern"?
5) When did the United States government declare a Public Health Emergency due to the coronavirus, and closer its borders to all foreign nationals "who pose a threat of transmitting the virus from entering the country and would quarantining U.S. citizens returning from Hubei province in China for up to 14 days?
6) By what date was the U.S. government working to evacuate American citizens by arranging an evacuation flight out of Wuhan? At that date, what was the approximate known and announced (according to Western press) death toll within China's epicenter of the active disease?
7) True or False? : The U.S. Center for Disease Control and Prevention (USCDC) stated it was boosting staffing at 20 US airports that have quarantine facilities? If true, on what date did was this announced?
8) The USCDC issued a travel watch at Level 1 ("Practice usual precautions") with recommendations on washing hands and more specifically advising avoiding animals, animal markets, and contact with unwell people if travelling to Wuhan on what date?
9) How many days elapsed between 2) & 3), above?
10) The WHO declared an H1N1 pandemic, moving the alert level to phase 6, marking the first global pandemic since the 1968 Hong Kong flu. This occurred when?
11) U.S. President Barack Obama officially declared H1N1 a national emergency on what date? This is how many days after the W.H.O.'s declaration mentioned in 10), above?
_________________________________
There you are. Eleven questions on which to demonstrate your knowledge of the facts; facts which allow you to indicate that you are addressing us here from a position of informed awareness of them.
Well?
Tell us, please, how many of the above questions' correct answers you are sufficiently familiar with to hazard a guess without first looking up the answer.
If, after a fitting delay, you've failed to present any straight-forward reply to these questions, or, prior to that, you admit that you posted your views and claims without being aware of any of these facts, I'll return to this post and present the answers to the best of my knowledge for each.
________________________________
No reply.
No surprise, either. Fucking typical of Trump-critics. They don't know or don't care or neither know nor care.
Here, "aspirit", are the answers you couldn't provide or didn't care enough to provide even supposing that you had been able to do so.
1) When did scientists in China announce the discovery of a new (i.e. this current outbreak's) coronavirus?
A.: 8 January, 2020
The earliest known Wuhan case of this strain of virus dated from 17 November, 2019 (at which time, thanks to Democrats' obsession with undermining Trump's tenure, the president was into the second month of a three-month House “investigation” bent upon cooking up a pretense for his impeachment and removal from office.)
2) When was the first confirmed case in the United States of the 2019–20 coronavirus pandemic announced?
A. : In Washington state, 21 January, 2020
3) When did President Donald Trump officially declare the pandemic a national emergency?
A.: President Donald Trump officially declared the pandemic a national emergency
13 March, 2020.
4) On what date did the World Health Organization (W.H.O.) director-general declare the coronavirus outbreak a "Public Health Emergency of International Concern"?
A.: 30 January, 2020
5) When did the United States government declare a Public Health Emergency due to the coronavirus, and closer its borders to all foreign nationals "who pose a threat of transmitting the virus from entering the country and would quarantining U.S. citizens returning from Hubei province in China for up to 14 days?
A.: 31 January, 2020
6) By what date was the U.S. government working to evacuate American citizens by arranging an evacuation flight out of Wuhan? At that date, what was the approximate known and announced (according to Western press) death toll within China's epicenter of the active disease?
A.: 25 January, 2020
7) True or False? : The U.S. Center for Disease Control and Prevention (USCDC) stated it was boosting staffing at 20 US airports that have quarantine facilities? If true, on what date did was this announced?
A.: True. 28 January, 2020
8) The USCDC issued a travel watch at Level 1 ("Practice usual precautions") with recommendations on washing hands and more specifically advising avoiding animals, animal markets, and contact with unwell people if travelling to Wuhan on what date?
A.: 6 January, 2020
9) How many days elapsed between 2) & 3), above?
A.: 53 days.
10) The WHO declared an H1N1 pandemic, moving the alert level to phase 6, marking the first global pandemic since the 1968 Hong Kong flu. This occurred when?
A.: 11 June, 2009
11) U.S. President Barack Obama officially declared H1N1 a national emergency on what date?
A.: 25 October 2009.
This is how many days after the W.H.O.'s declaration mentioned in 10), above?
136 days.
_____________________________
https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1#2009_A(H1N1)_pandem...
https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States#cit...
https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%9320_coronavirus_pandem...
https://upload.wikimedia.org/wikipedia/commons/b/b3/COVID-19-outbreak-timeline.g...
Journal article (.pdf): ( from Emerging Microbes & Infections | ISSN: (Print) 2222-1751 | (Online) Journal homepage: https://www.tandfonline.com/loi/temi20 )
An emerging coronavirus causing pneumonia outbreak in Wuhan, China: calling for developing therapeutic and prophylactic strategies by by Shibo Jiang, Lanying Du & Zhengli Shi | (Full Terms & Conditions of access and use can be found athttps://www.tandfonline.com/action/journalInformation?journalCode=temi20)
68lriley
Here's the thing--State and local government's don't have a problem figuring out that this could be a real health crisis and are taking measures to slow the spread of it down. Sports leagues have shut down all over with the exception of UFC whose CEO Dana White after talking with Trump decided to keep his thing going--so there you have a clown listening to another clown. Many businesses and corporations are also taking measures--some not nice like laying people off---others having their employees work out of their homes. When the NBA and NHL are shutting down right before their playoffs and the NCAA right before March Madness that's a fucking clue that this is something serious.
Which leaves us with the federal govt. led by one dumbass knucklehead who from one moment to the next can't make up his mind on anything. He wants this so badly to be a hoax--at the same time he's terrified of the market falling and terrified of his own incompetency in the face of a nationwide health crisis--and as a germaphobe no doubt terrified of contracting the disease as well. Everybody else figured out some time ago this is serious except for him but Trump's inability to act rationally is hampering everybody. We don't have test kits because he's all fucked up--we can't free up federal funds because he's all fucked up. At least some people are going to die because of his self serving bullshit and inability to act. Trump is an incompetent and narcissistic fuckup. It's his job to coordinate some kind of rational response--to work with the various state govt.'s---to activate some national plan and give them the help the need. Instead all he's doing is getting in the way of everyone and making this like everything else about himself. Is he going to get blamed for the bad that comes out of this? Fuck yeah. He'll more than deserve it too.
Which leaves us with the federal govt. led by one dumbass knucklehead who from one moment to the next can't make up his mind on anything. He wants this so badly to be a hoax--at the same time he's terrified of the market falling and terrified of his own incompetency in the face of a nationwide health crisis--and as a germaphobe no doubt terrified of contracting the disease as well. Everybody else figured out some time ago this is serious except for him but Trump's inability to act rationally is hampering everybody. We don't have test kits because he's all fucked up--we can't free up federal funds because he's all fucked up. At least some people are going to die because of his self serving bullshit and inability to act. Trump is an incompetent and narcissistic fuckup. It's his job to coordinate some kind of rational response--to work with the various state govt.'s---to activate some national plan and give them the help the need. Instead all he's doing is getting in the way of everyone and making this like everything else about himself. Is he going to get blamed for the bad that comes out of this? Fuck yeah. He'll more than deserve it too.
69clamairy
>68 lriley: "Is he going to get blamed for the bad that comes out of this? Fuck yeah. He'll more than deserve it too."
I do hope you're right. I've learned never to underestimate the stupidity and blind allegiance of his supporters, though. Maybe there will be fewer of them come November because of this debacle. They seem less likely to be taking this as seriously as they should be.
I do hope you're right. I've learned never to underestimate the stupidity and blind allegiance of his supporters, though. Maybe there will be fewer of them come November because of this debacle. They seem less likely to be taking this as seriously as they should be.
70proximity1
>68 lriley: >69 clamairy:
LOL!
"Here's the thing", the federal govt. led by one 'dumbass knucklehead' beat your preferred candidates and is likely going to be re-elected while you stand around watching --because, among other things, compared to you lot, that 'dumbass knucklehead' looks so good.
71margd
Coronavirus in Canada: how to get tested, what the symptoms are, where to get help
Patricia Treble | March 12, 2020
A province-by-province breakdown of advice, requirements and who to call if you think you might have it—with information on who is most vulnerable...
https://www.macleans.ca/society/health/coronavirus-in-canada-how-to-get-tested-w...
Patricia Treble | March 12, 2020
A province-by-province breakdown of advice, requirements and who to call if you think you might have it—with information on who is most vulnerable...
https://www.macleans.ca/society/health/coronavirus-in-canada-how-to-get-tested-w...
72aspirit
>67 proximity1: (wooow.) I wasn't eagerly waiting in Pro & Con (or anywhere on LT) for your pop quiz. Promoting DT might be your job-- and I'm sorry if you're in that position, truly-- but engaging with you certainly isn't a priority in my day. I usually don't even see your posts.
Earlier, I had other things to take care of, including figuring out what my municipal governments are doing.
Thanks for the info, though? This is a good place for sharing links. Some of what you posted was even factual.
That part about President Obama's administration responding to the 2009 swine flu is apparently much loved by MAGAT sharers online; it's one of the most frequent talking points I've seen the past few days. Here's why it's annoying.
Swine flu, later given the name "H1N1", was first declared a national emergency in April, not October.
Press Briefing on Swine Influenza with Department of Homeland Security, Centers for Disease Control and Prevention, and White House
Influenza typically does not continue to spread through the summer the way H1N1 did. Obama's Secretary of Health and Human Services (in an administration that was reasonably staffed, unlike the high turnover offices with the qualifications problems) renewed that declaration in July and October of 2009.
The flu outbreak was getting worse, though. That's why on October 23, President Obama made a declaration of a national emergency to free up more resources.
https://obamawhitehouse.archives.gov/realitycheck/the-press-office/declaration-a...
A competent president hires qualified staff (as in, capable in their positions, not financially qualified to buy a way in). Then (s)he makes sure to know enough to troubleshoot and respond to problems.
Our federal govermment could have been one that learned from what happened more than ten years ago, continued to prepare for and minimize health threats, built a good relationship with the media, and ensured a quick response to this outbreak. But, no, that's obviously not what we have.
(There's three years of evidence that's not what we have for those readers who haven't been watching. "Prove it!" Janet said. And I gesture toward three excrutiating years of evidence on the internet. I don't think that's primarily what this thread is about.)
One of the biggest annoyances of "but Obama!" is that if a company's manager, or a school principal, or even the president of recreational club refuses to fully address a problem, his insisting that he's doing a good job because he's comparable to the person previously in that role, then everyone thinks he's a loser who needs to be replaced. Mindboggling how that attitude is supposed to be reassuring.
Also, H1N1 is a big medical concern again this year. I haven't heard anything about it. I think I posted a link about that in this thread already? I will I haven't, because I haven't seen the White House announce a plan for managing H1N1 this flu-and-coronavirus season.
Earlier, I had other things to take care of, including figuring out what my municipal governments are doing.
Thanks for the info, though? This is a good place for sharing links. Some of what you posted was even factual.
That part about President Obama's administration responding to the 2009 swine flu is apparently much loved by MAGAT sharers online; it's one of the most frequent talking points I've seen the past few days. Here's why it's annoying.
Swine flu, later given the name "H1N1", was first declared a national emergency in April, not October.
Press Briefing on Swine Influenza with Department of Homeland Security, Centers for Disease Control and Prevention, and White House
The first thing I want to announce today (April 26, 2009) is that the Department of Health and Human Services will declare today a public health emergency in the United States. That sounds more severe than really it is. This is standard operating procedure and allows us to free up federal, state, and local agencies and their resources for prevention and mitigation; it allows us to use medication and diagnostic tests that we might not otherwise be able to use, particularly on very young children; and it releases funds for the acquisition of additional antivirals.
Influenza typically does not continue to spread through the summer the way H1N1 did. Obama's Secretary of Health and Human Services (in an administration that was reasonably staffed, unlike the high turnover offices with the qualifications problems) renewed that declaration in July and October of 2009.
The flu outbreak was getting worse, though. That's why on October 23, President Obama made a declaration of a national emergency to free up more resources.
https://obamawhitehouse.archives.gov/realitycheck/the-press-office/declaration-a...
A competent president hires qualified staff (as in, capable in their positions, not financially qualified to buy a way in). Then (s)he makes sure to know enough to troubleshoot and respond to problems.
Our federal govermment could have been one that learned from what happened more than ten years ago, continued to prepare for and minimize health threats, built a good relationship with the media, and ensured a quick response to this outbreak. But, no, that's obviously not what we have.
(There's three years of evidence that's not what we have for those readers who haven't been watching. "Prove it!" Janet said. And I gesture toward three excrutiating years of evidence on the internet. I don't think that's primarily what this thread is about.)
One of the biggest annoyances of "but Obama!" is that if a company's manager, or a school principal, or even the president of recreational club refuses to fully address a problem, his insisting that he's doing a good job because he's comparable to the person previously in that role, then everyone thinks he's a loser who needs to be replaced. Mindboggling how that attitude is supposed to be reassuring.
Also, H1N1 is a big medical concern again this year. I haven't heard anything about it. I think I posted a link about that in this thread already? I will I haven't, because I haven't seen the White House announce a plan for managing H1N1 this flu-and-coronavirus season.
73stellarexplorer
>59 margd: >66 davidgn: Thank you both for giving it a look, and for the excellent information you’ve been providing here.
>69 clamairy: My thoughts as well
>69 clamairy: My thoughts as well
74margd
How You Can Kill Coronavirus in Your Car Without Damaging Interior Surfaces
Keith Barry | March 14, 2020
... Yanfeng (Automotive Interiors) is the world’s largest supplier of automotive interior parts, and works with almost every major automaker. If you’ve been in a car, you’ve probably seen or touched something Yanfeng has made—and it uses isopropyl alcohol for cleaning parts in its own factories.
“We will use that to clean smudges or any kind of last minute details before we ship the product,” Stout (executive director global innovation) says. All the company’s products—from plastic trim to painted chrome to imitation leather—have been tested to ensure they don’t degrade when exposed to pure isopropyl alcohol. Stout says that it’s even possible to rub the exterior surface of soft cloth upholstery with alcohol in order to clean it.
Whatever you do, don’t use bleach or hydrogen peroxide on the inside of your car. While they can both kill coronaviruses on surfaces, they will likely damage your car’s upholstery. And do not use ammonia-based cleaners on car touch screens, as they can damage their anti-glare and anti-fingerprint coatings.
...Most car leathers and imitation leathers have urethane coatings for protection, which is safe to clean with alcohol. But most leathers are dyed, and cleaning too vigorously can remove the dye.
...Both Stout and Kosilla recommend cleaning all surfaces with a microfiber cloth. That’s because they’re made of fabric that consists of tiny little loops that capture and sweep away dirt and dust particles before they can scratch delicate or shiny plastic surfaces. By comparison, the dirt and debris in your car can stick to even the cleanest paper towels or napkins and scratch surfaces—”like sandpaper,” Kosilla says.
Once you’re finished cleaning, don’t forget to wash your hands before and after driving. It’s a good habit to get into even outside of the spread of COVID-19, as it will keep your steering wheel and other frequently touched surfaces in your car from looking dingy...
https://www.consumerreports.org/tires-car-care/how-to-kill-coronavirus-in-your-c...
Keith Barry | March 14, 2020
... Yanfeng (Automotive Interiors) is the world’s largest supplier of automotive interior parts, and works with almost every major automaker. If you’ve been in a car, you’ve probably seen or touched something Yanfeng has made—and it uses isopropyl alcohol for cleaning parts in its own factories.
“We will use that to clean smudges or any kind of last minute details before we ship the product,” Stout (executive director global innovation) says. All the company’s products—from plastic trim to painted chrome to imitation leather—have been tested to ensure they don’t degrade when exposed to pure isopropyl alcohol. Stout says that it’s even possible to rub the exterior surface of soft cloth upholstery with alcohol in order to clean it.
Whatever you do, don’t use bleach or hydrogen peroxide on the inside of your car. While they can both kill coronaviruses on surfaces, they will likely damage your car’s upholstery. And do not use ammonia-based cleaners on car touch screens, as they can damage their anti-glare and anti-fingerprint coatings.
...Most car leathers and imitation leathers have urethane coatings for protection, which is safe to clean with alcohol. But most leathers are dyed, and cleaning too vigorously can remove the dye.
...Both Stout and Kosilla recommend cleaning all surfaces with a microfiber cloth. That’s because they’re made of fabric that consists of tiny little loops that capture and sweep away dirt and dust particles before they can scratch delicate or shiny plastic surfaces. By comparison, the dirt and debris in your car can stick to even the cleanest paper towels or napkins and scratch surfaces—”like sandpaper,” Kosilla says.
Once you’re finished cleaning, don’t forget to wash your hands before and after driving. It’s a good habit to get into even outside of the spread of COVID-19, as it will keep your steering wheel and other frequently touched surfaces in your car from looking dingy...
https://www.consumerreports.org/tires-car-care/how-to-kill-coronavirus-in-your-c...
75John5918
Coronavirus spreads to more African countries (Al Jazeera)
Kenya, Ethiopia, Sudan and Guinea announced their first confirmed cases of coronavirus on Friday as the disease has now spread to at least 18 countries in Africa. Other African countries that reported cases of the disease are Morocco, Tunisia, Egypt, Algeria, Senegal, Togo, Cameroon, Burkina Faso, the Democratic Republic of the Congo (DRC), South Africa, Nigeria, Ivory Coast, Gabon and Ghana. Most of the countries' totals are still in single figures...
Most of Africa's reported cases were foreigners or people who had travelled abroad...
Only five people have succumbed to coronavirus so far - all in North Africa - with the Sub-Saharan region recording no deaths and very low numbers of confirmed cases...
Kenya, Ethiopia, Sudan and Guinea announced their first confirmed cases of coronavirus on Friday as the disease has now spread to at least 18 countries in Africa. Other African countries that reported cases of the disease are Morocco, Tunisia, Egypt, Algeria, Senegal, Togo, Cameroon, Burkina Faso, the Democratic Republic of the Congo (DRC), South Africa, Nigeria, Ivory Coast, Gabon and Ghana. Most of the countries' totals are still in single figures...
Most of Africa's reported cases were foreigners or people who had travelled abroad...
Only five people have succumbed to coronavirus so far - all in North Africa - with the Sub-Saharan region recording no deaths and very low numbers of confirmed cases...
76John5918
America has no real public health system – coronavirus has a clear run (Guardian)
Dr Anthony S Fauci, director of the National Institute of Allergy and Infectious Diseases and just about the only official in the Trump administration trusted to tell the truth about the coronavirus, said last Thursday: “The system does not, is not really geared to what we need right now … It is a failing, let’s admit it.”
While we’re at it, let’s admit something more basic. The system would be failing even under a halfway competent president. The dirty little secret, which will soon become apparent to all, is that there is no real public health system in the United States...
Instead of a public health system, we have a private for-profit system for individuals lucky enough to afford it and a rickety social insurance system for people fortunate enough to have a full-time job. At their best, both systems respond to the needs of individuals rather than the needs of the public as a whole...
Dr Anthony S Fauci, director of the National Institute of Allergy and Infectious Diseases and just about the only official in the Trump administration trusted to tell the truth about the coronavirus, said last Thursday: “The system does not, is not really geared to what we need right now … It is a failing, let’s admit it.”
While we’re at it, let’s admit something more basic. The system would be failing even under a halfway competent president. The dirty little secret, which will soon become apparent to all, is that there is no real public health system in the United States...
Instead of a public health system, we have a private for-profit system for individuals lucky enough to afford it and a rickety social insurance system for people fortunate enough to have a full-time job. At their best, both systems respond to the needs of individuals rather than the needs of the public as a whole...
77proximity1
Once again, a fucking load of irrelevant and evasive bullshit from a Trump-critic who lacks even the most basic sense of responsibility for his (or her) participation in a debate.
As usual and typical of your likes, you take refuge in this lame bullshit:
Exactly. You weren't expecting anyone to challenge you on what you actually know about what you're claiming here in your posts. In other words, you “don't know shit” concerning the pertinent facts. And that is what my questions to you were intended to demonstrate.
You reply that you “usually don't even see (my) posts.” That's really beside the point. We were already engaged in an exchange of posts. So what the fuck difference does it make if you “usually don't even see (my) posts”? You'd already “seen” and replied to one. Did you suppose that I shared your utterly irresponsible attitude about comment-and-reply here?
If you just don't give a shit—as seems to be the case—then I wonder: why don't you just fuck off as I address the rest of this review of your surrender-of-the-field-of-discussion to other readers?
“That part about President Obama's administration responding to the 2009 swine flu is apparently much loved by MAGAT (Sic) sharers online; ”...
So what? I wasn't aware of any of those. I found the data-points which I posted without reference to any such mentions and used them on my own initiative as part of my reply's argument. That others, people self-identifying as “MAGA”-supporters, also know of and make reference to this point is really beside any respectable point. But you don't even understand this.
----> The point, rather, would be: Is it valid, true and pertinent? "aspirit" doesn't bother to show us how my points fail in any of those respects. So it would seem that, as she sees it, the mere fact that “MAGA”-supporters reference it taints it beyond rehabilitation. That tells us a lot about her lack of intellectual integrity—something virtually absent in her posts.
I did what she never bothered to do: I went looking for facts, neither already sure of what I'd find nor certain, though I did suspect, that, when found, they'd bear out my own views and expose hers for the worthless crap that they are. So I looked up dates and events concerning both the present Covi(d)-(20)19 outbreak as well as Obama's administration's handling of similar pandemics.
Here, then.
“aspirit”, typical of the kind of Trump-critic he or she seems to be, writes,
“Earlier, I had other things to take care of, including figuring out what my municipal governments are doing.”
So what? She was challenged in this way:
So what if “aspirit” was 'busy'”? The question was, with how many of the facts concerning the eleven questions posed was she already familiar without having to look them up? In other words, what acquaintance with these facts did she have before, or by the time, she posted her comments?
This question still stood unanswered at the time she was able to return and post >72 aspirit:.
In light of her lame dodge, the answer is obvious: none, no acquaintance at all.
Rather than admit that forthrightly, she replied in bad-faith that she was “busy.”
I'll have more to post on this later, when time permits. (SEE "ETA", below.) Though, again, that shall be for other readers, not “aspirit”, who doesn't give enough of a damn to bother to read my posts. I'll be taking apart point-by-point the idiotic bullshit she offered as a case against Trump's administration's handling of this pandemic.
ETA:
THIS:
doesn't stand up to scrutiny.
First, “aspirit” 's post leaves the implication that the cited words in the report of what was a declaration of a public health emergency, not a declaration of a national emergency, were from President Obama; they were instead said by the then Secretary of the Department of Homeland Security, Janet Napolitano , one of those present at the briefing. There was, thus, no presidential declaration of a national emergency in April of 2009 for any epidemic. President Obama wasn't even present at the press briefing she cites.
She claimed, wrongly, that (quote) “Swine flu, later given the name "H1N1", was first declared a national emergency in April, not October.” It wasn't. (1) A “public health emergency”, which her cite indicates rather clearly as having been declared by the U.S. Dept. of Health and Human Services, rather than by president Obama, and a presidential declaration of a “national emergency” are neither synonymous nor administratively equivalent.*
In addition, healthcare professionals were aware of H1N1-type influenzas affecting both swine species and humans at least as early as
August 2007. (2) Thus, as already documented above (note the comments cited from Dr. Amesh Adalja @ >43 proximity1:) the dangers, the virulence, the potential harms, were being forewarned in the realm of emegent infectious disease specialists as long ago as 2003—well before the tenure of Barack Obama. Did he or anyone else in his two successive administrations take those repeated warnings seriously enough to actually act decisively on them? No, neither president Obama nor any others in his administration, acting on their own initiative or on Obama's orders did so.
Case closed.
__________________________
* Public health vs. national emergencies: what are they, when have they happened? |
Updated Jan 05, 2019; Posted Oct 26, 2017
(1) : "Declared National Emergencies Under the National Emergencies Act, 1978-2018 | (Emergencies that are still in effect today are shaded in the table below)" (.pdf)
(2) :
As usual and typical of your likes, you take refuge in this lame bullshit:
>72 aspirit:
“I wasn't eagerly waiting in Pro & Con (or anywhere on LT) for your pop quiz. Promoting DT might be your job-- and I'm sorry if you're in that position, truly-- but engaging with you certainly isn't a priority in my day. I usually don't even see your posts.”
Exactly. You weren't expecting anyone to challenge you on what you actually know about what you're claiming here in your posts. In other words, you “don't know shit” concerning the pertinent facts. And that is what my questions to you were intended to demonstrate.
You reply that you “usually don't even see (my) posts.” That's really beside the point. We were already engaged in an exchange of posts. So what the fuck difference does it make if you “usually don't even see (my) posts”? You'd already “seen” and replied to one. Did you suppose that I shared your utterly irresponsible attitude about comment-and-reply here?
If you just don't give a shit—as seems to be the case—then I wonder: why don't you just fuck off as I address the rest of this review of your surrender-of-the-field-of-discussion to other readers?
“That part about President Obama's administration responding to the 2009 swine flu is apparently much loved by MAGAT (Sic) sharers online; ”...
So what? I wasn't aware of any of those. I found the data-points which I posted without reference to any such mentions and used them on my own initiative as part of my reply's argument. That others, people self-identifying as “MAGA”-supporters, also know of and make reference to this point is really beside any respectable point. But you don't even understand this.
----> The point, rather, would be: Is it valid, true and pertinent? "aspirit" doesn't bother to show us how my points fail in any of those respects. So it would seem that, as she sees it, the mere fact that “MAGA”-supporters reference it taints it beyond rehabilitation. That tells us a lot about her lack of intellectual integrity—something virtually absent in her posts.
I did what she never bothered to do: I went looking for facts, neither already sure of what I'd find nor certain, though I did suspect, that, when found, they'd bear out my own views and expose hers for the worthless crap that they are. So I looked up dates and events concerning both the present Covi(d)-(20)19 outbreak as well as Obama's administration's handling of similar pandemics.
Here, then.
“aspirit”, typical of the kind of Trump-critic he or she seems to be, writes,
“Earlier, I had other things to take care of, including figuring out what my municipal governments are doing.”
So what? She was challenged in this way:
There you are. Eleven questions on which to demonstrate your knowledge of the facts; facts which allow you to indicate that you are addressing us here from a position of informed awareness of them.
Well?
Tell us, please, how many of the above questions' correct answers you are sufficiently familiar with to hazard a guess without first looking up the answer.
If, after a fitting delay, you've failed to present any straight-forward reply to these questions, or, prior to that, you admit that you posted your views and claims without being aware of any of these facts, I'll return to this post and present the answers to the best of my knowledge for each.
_________________
(emphasis added)
So what if “aspirit” was 'busy'”? The question was, with how many of the facts concerning the eleven questions posed was she already familiar without having to look them up? In other words, what acquaintance with these facts did she have before, or by the time, she posted her comments?
This question still stood unanswered at the time she was able to return and post >72 aspirit:.
In light of her lame dodge, the answer is obvious: none, no acquaintance at all.
Rather than admit that forthrightly, she replied in bad-faith that she was “busy.”
I'll have more to post on this later, when time permits. (SEE "ETA", below.) Though, again, that shall be for other readers, not “aspirit”, who doesn't give enough of a damn to bother to read my posts. I'll be taking apart point-by-point the idiotic bullshit she offered as a case against Trump's administration's handling of this pandemic.
ETA:
THIS:
Swine flu, later given the name "H1N1", was first declared a national emergency in April, not October.
Press Briefing on Swine Influenza with Department of Homeland Security, Centers for Disease Control and Prevention, and White House
'The first thing I want to announce today (April 26, 2009) is that the Department of Health and Human Services will declare today a public health emergency in the United States. That sounds more severe than really it is. This is standard operating procedure and allows us to free up federal, state, and local agencies and their resources for prevention and mitigation; it allows us to use medication and diagnostic tests that we might not otherwise be able to use, particularly on very young children; and it releases funds for the acquisition of additional antivirals.'
Influenza typically does not continue to spread through the summer the way H1N1 did. Obama's Secretary of Health and Human Services (in an administration that was reasonably staffed, unlike the high turnover offices with the qualifications problems) renewed that declaration in July and October of 2009.
The flu outbreak was getting worse, though. That's why on October 23, President Obama made a declaration of a national emergency to free up more resources.
https://obamawhitehouse.archives.gov/realitycheck/the-press-office/declaration-a....
A competent president hires qualified staff (as in, capable in their positions, not financially qualified to buy a way in). Then (s)he makes sure to know enough to troubleshoot and respond to problems.
doesn't stand up to scrutiny.
First, “aspirit” 's post leaves the implication that the cited words in the report of what was a declaration of a public health emergency, not a declaration of a national emergency, were from President Obama; they were instead said by the then Secretary of the Department of Homeland Security, Janet Napolitano , one of those present at the briefing. There was, thus, no presidential declaration of a national emergency in April of 2009 for any epidemic. President Obama wasn't even present at the press briefing she cites.
She claimed, wrongly, that (quote) “Swine flu, later given the name "H1N1", was first declared a national emergency in April, not October.” It wasn't. (1) A “public health emergency”, which her cite indicates rather clearly as having been declared by the U.S. Dept. of Health and Human Services, rather than by president Obama, and a presidential declaration of a “national emergency” are neither synonymous nor administratively equivalent.*
Obama Declares H1N1 a National Emergency |
by Peggy Peck, Executive Editor, MedPage | Today October 24, 2009
WASHINGTON -- President Obama has upped the ante in the battle to control the H1N1 flu by declaring it a national emergency, the second such declaration since the flu first emerged last spring.
The White House said the proclamation, which was signed late Friday, will allow public health agencies as well as doctors and hospitals to bypass certain requirements, but details about how that will transfer into clinical practice are not clear.
The proclamation notes that the declaration is a precautionary measure, "given that the rapid increase in illness across the Nation may overburden healthcare resources and that the temporary waiver of certain standard Federal requirements may be warranted in order to enable U.S. healthcare facilities to implement emergency operations plans."
At least one extraordinary step -- FDA permission to use the investigational antiviral peramivir to treat patients who are critically ill with H1N1 -- was also announced yesterday.
Last April, in the early days of the H1N1 outbreak, Homeland Security Secretary Janet Napolitano, speaking for the administration, declared a public health emergency. That declaration freed up supplies of oseltamivir (Tamiflu) and zanamivir (Relenza) from the national stockpile.
At a press briefing yesterday, CDC director Thomas Frieden, MD, said that H1N1 has thus far claimed more than 1,000 American lives, a death toll that includes about 100 children. Moreover, 46 states are reporting widespead flu activity.
(emphasis added)
In addition, healthcare professionals were aware of H1N1-type influenzas affecting both swine species and humans at least as early as
August 2007. (2) Thus, as already documented above (note the comments cited from Dr. Amesh Adalja @ >43 proximity1:) the dangers, the virulence, the potential harms, were being forewarned in the realm of emegent infectious disease specialists as long ago as 2003—well before the tenure of Barack Obama. Did he or anyone else in his two successive administrations take those repeated warnings seriously enough to actually act decisively on them? No, neither president Obama nor any others in his administration, acting on their own initiative or on Obama's orders did so.
Case closed.
__________________________
* Public health vs. national emergencies: what are they, when have they happened? |
Updated Jan 05, 2019; Posted Oct 26, 2017
(1) : "Declared National Emergencies Under the National Emergencies Act, 1978-2018 | (Emergencies that are still in effect today are shaded in the table below)" (.pdf)
(2) :
(Wikipedia) “Species affected
Swine
“Before being transmitted to humans, an H1N1 type virus is known to have circulated in swine. In August 2007, about 25 people and 160 pigs developed flu at a county fair in Ohio. Analysis showed they were infected with the same strain – an H1N1 type containing genes of human, bird and swine origin. A 2004 study found that in Iowa, 20 percent of swine veterinarians and 3 percent of meatpackers, but no university workers, had antibodies in their blood indicating they had been infected with swine flu. Another study, of 804 rural Iowans, found that pig farmers were 50 times more likely, and their spouses about 30 times more likely, than university workers to carry swine flu antibodies.50 Pigs are also known to have been infected by humans.(51)
Humans
“Humans have been affected since early 2009. The November 27, 2009 worldwide update by the U.N.'s World Health Organization (WHO) states that "more than 207 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including over 7,820 deaths". The WHO has also tracked more than 622,482 laboratory-confirmed cases of H1N1.(52) The symptoms of this virus are identical to that of seasonal influenza.”
(Wikipedia / (sources: (51)The Washington Post https://www.washingtonpost.com/wp-dyn/content/article/2009/04/24/AR2009042403852... ; (52) DC Swine Flu https://www.cdc.gov/flu/swine/pdf/brochure.pdf ) )
78lriley
Trump is deliberately being irresponsible when he encourages people to go on living their lives like they normally would. There is no doubt that this disease is here and that it's very contagious and that it can kill people. That is why so many things are shutting down. He is a narcissistic dumbfuck who is doing his level best to put people into dangerous to their health situations. Yet people like the above ^ continue to carry his water for him.
79Molly3028
The bar for the Trump administration is so low now, a D- effort in
any/all situations is considered to be a passing grade by 40-45%
of the people polled. And, in November millions of people will
vote to extend this nightmare into the middle of this decade.
The Trump administration is an indication of what the words "the
dumbing down of America" means.
any/all situations is considered to be a passing grade by 40-45%
of the people polled. And, in November millions of people will
vote to extend this nightmare into the middle of this decade.
The Trump administration is an indication of what the words "the
dumbing down of America" means.
80John5918
Africa v coronavirus: A challenge for the continent (BBC)
The coronavirus outbreak is no longer a threat for Africa, it is now a reality as more and more countries on the continent have cases... Most of the confirmed cases involve people arriving from Europe and North America. The WHO said while local transmission - that is people with no travel history - remains low, containment is the most appropriate strategy... Yet the relatively low numbers in Africa have baffled experts. Some suggest the tropical climate is less favourable to the new virus... One thing that put Africa a step ahead of the rest of the world was its early screening at airports and other ports of entry... This is because infrastructure was already in place and health workers at hand because of the outbreak of Ebola in the Democratic Republic of Congo, which now appears to be coming to an end... The continent has also had time to observe what other countries are doing to combat the new virus and prepare... Older people with pre-existing conditions are more vulnerable. "It's possible that with a predominantly young population, Africa may be spared widespread severe cases"...
Africa does not need to 'burn down the house' to defeat COVID-19 (Al Jazeera)
Rather than imposing damaging and ineffective travel bans, African authorities should focus on mitigating the pandemic...
The coronavirus outbreak is no longer a threat for Africa, it is now a reality as more and more countries on the continent have cases... Most of the confirmed cases involve people arriving from Europe and North America. The WHO said while local transmission - that is people with no travel history - remains low, containment is the most appropriate strategy... Yet the relatively low numbers in Africa have baffled experts. Some suggest the tropical climate is less favourable to the new virus... One thing that put Africa a step ahead of the rest of the world was its early screening at airports and other ports of entry... This is because infrastructure was already in place and health workers at hand because of the outbreak of Ebola in the Democratic Republic of Congo, which now appears to be coming to an end... The continent has also had time to observe what other countries are doing to combat the new virus and prepare... Older people with pre-existing conditions are more vulnerable. "It's possible that with a predominantly young population, Africa may be spared widespread severe cases"...
Africa does not need to 'burn down the house' to defeat COVID-19 (Al Jazeera)
Rather than imposing damaging and ineffective travel bans, African authorities should focus on mitigating the pandemic...
82davidgn
Hey, next Democratic administration: found your next Health and Human Services secretary. She's from Youngstown, Ohio, and her name is Dr. Amy Acton.
https://www.youtube.com/watch?v=rQDtdQmXoI0&feature=youtu.be&t=1816
As part of the press conference where the state of Ohio announces it is closing all restaurants and all bars going forward. (Illinois announced the same today)
https://www.dispatch.com/news/20200314/why-ohio-is-leading-us-coronavirus-respon...
https://www.cantonrep.com/news/20200315/amy-acton-ohios-calm-leader
https://www.youtube.com/watch?v=rQDtdQmXoI0&feature=youtu.be&t=1816
As part of the press conference where the state of Ohio announces it is closing all restaurants and all bars going forward. (Illinois announced the same today)
https://www.dispatch.com/news/20200314/why-ohio-is-leading-us-coronavirus-respon...
https://www.cantonrep.com/news/20200315/amy-acton-ohios-calm-leader
84davidgn
Coronavirus Conference Gets Canceled Because of Coronavirus
https://www.bloomberg.com/news/articles/2020-03-10/coronavirus-conference-gets-c...
https://www.bloomberg.com/news/articles/2020-03-10/coronavirus-conference-gets-c...
86John5918
Coronavirus: Africans accuse Europeans of 'coronising' continent (Middle East Eye)
The large number of Europeans being diagnosed with coronavirus in Africa has sparked debate and ridicule, with one Senegalese newspaper questioning whether France was out to “coronise” its former colony after two French nationals received a positive diagnosis.
With around 273 cases as of Sunday morning, Africa has been left relatively unscathed by the virus. However, governments there have come under intense pressure to put in place travel bans to stop Europeans bringing it in.
The situation has prompted some to speculate about the seeming reversal of fortunes between the two continents, with one analyst telling Middle East Eye that it was "ironic" that Europeans were attempting to travel to Africa when Africans refugees and migrants are virtually barred entry into Europe.
Some have pointed out also that many Europeans countries imposed restrictive bans during the Ebola crisis, including on African countries that had no cases...
AFRICAN NATIONS TURN THE TABLES, IMPOSING TRAVEL RESTRICTIONS AGAINST U.S., EUROPE, AND CHINA TO STAVE OFF CORONAVIRUS (The Intercept)
AS THE NOVEL coronavirus rages through the world and spreads rapidly in the U.S., Africa is the least-affected continent at the moment, with less than 300 reported cases in roughly half of its 54 countries so far. A number of media outlets have reacted with a confounded tone, surprised that Africa does not have more cases and wondering if the low numbers are due to a lack of testing.
Health officials say that the main reason the continent has thus far been spared major outbreaks is due to the infrastructure set up during the Ebola epidemic that is still in place, and lower overall international air travel rates...
And on the USA:
Fox anchor who dismissed coronavirus fears as plot to impeach Trump is removed from her prime-time slot (The Independent)
A Fox Business presenter who suggested the coronavirus crisis was part of a conspiracy to impeach Donald Trump again has been moved from her prime-time slot.
On Monday Trish Regan told viewers that the Democrats were trying to engineer a ”mass hysteria to encourage a market sell-off” and wanted “to demonize and destroy the president” in “another attempt to impeach” him...
And an interest snippet, also from The Independent in the UK:
Coronavirus: Isis tells followers not to travel to Europe for attacks because of outbreak
Isis has warned its followers to avoid travelling to Europe because of the coronavirus outbreak.
Reversing its previous calls for jihadists to target the area, the terrorist group advised supporters not to enter “the land of the epidemic”.
It also appeared to back guidance to the public to wash their hands regularly...
The large number of Europeans being diagnosed with coronavirus in Africa has sparked debate and ridicule, with one Senegalese newspaper questioning whether France was out to “coronise” its former colony after two French nationals received a positive diagnosis.
With around 273 cases as of Sunday morning, Africa has been left relatively unscathed by the virus. However, governments there have come under intense pressure to put in place travel bans to stop Europeans bringing it in.
The situation has prompted some to speculate about the seeming reversal of fortunes between the two continents, with one analyst telling Middle East Eye that it was "ironic" that Europeans were attempting to travel to Africa when Africans refugees and migrants are virtually barred entry into Europe.
Some have pointed out also that many Europeans countries imposed restrictive bans during the Ebola crisis, including on African countries that had no cases...
AFRICAN NATIONS TURN THE TABLES, IMPOSING TRAVEL RESTRICTIONS AGAINST U.S., EUROPE, AND CHINA TO STAVE OFF CORONAVIRUS (The Intercept)
AS THE NOVEL coronavirus rages through the world and spreads rapidly in the U.S., Africa is the least-affected continent at the moment, with less than 300 reported cases in roughly half of its 54 countries so far. A number of media outlets have reacted with a confounded tone, surprised that Africa does not have more cases and wondering if the low numbers are due to a lack of testing.
Health officials say that the main reason the continent has thus far been spared major outbreaks is due to the infrastructure set up during the Ebola epidemic that is still in place, and lower overall international air travel rates...
And on the USA:
Fox anchor who dismissed coronavirus fears as plot to impeach Trump is removed from her prime-time slot (The Independent)
A Fox Business presenter who suggested the coronavirus crisis was part of a conspiracy to impeach Donald Trump again has been moved from her prime-time slot.
On Monday Trish Regan told viewers that the Democrats were trying to engineer a ”mass hysteria to encourage a market sell-off” and wanted “to demonize and destroy the president” in “another attempt to impeach” him...
And an interest snippet, also from The Independent in the UK:
Coronavirus: Isis tells followers not to travel to Europe for attacks because of outbreak
Isis has warned its followers to avoid travelling to Europe because of the coronavirus outbreak.
Reversing its previous calls for jihadists to target the area, the terrorist group advised supporters not to enter “the land of the epidemic”.
It also appeared to back guidance to the public to wash their hands regularly...
87margd
>86 John5918: I assume Africa is seeing community transmission? Will there be no intrinsic protection other than youthful population?
I heard on the radio that Kenya is closing its schools and air travel(?)
South Africa has declared an emergency.
Are other countries similarly affected?
Excuse my ignorance, but I think of those two countries as more temperate.
South Africa because of latitude, and Kenya because of mountains?
With minimal medical infrastructure to flood, the main reason for a poor country to "flatten the curve" is in anticipation of therapies and vaccines.
Thus more economic cost and less survival benefit in social distancing, isolation?
I heard on the radio that Kenya is closing its schools and air travel(?)
South Africa has declared an emergency.
Are other countries similarly affected?
Excuse my ignorance, but I think of those two countries as more temperate.
South Africa because of latitude, and Kenya because of mountains?
With minimal medical infrastructure to flood, the main reason for a poor country to "flatten the curve" is in anticipation of therapies and vaccines.
Thus more economic cost and less survival benefit in social distancing, isolation?
88margd
The UK backs away from “herd immunity” coronavirus proposal amid blowback
Anya van Wagtendonkanyavw | Mar 15, 2020
The United Kingdom is previewing a new self-isolation plan for all people over 70 to address the spread of the novel coronavirus in the country, following backlash over a proposal to promote immunity by allowing up to 60 percent of its population to become infected.
...The argument behind achieving herd immunity is that doing so would minimize the risk of a coronavirus resurgence similar to the second wave* of the Spanish Flu of 1918. In a successful herd immunity scenario, a country’s population — the herd — would become infected with the virus, recover, and then have an immunity to it, making them resistant to reinfection.
For this to work in his country, according to Vallance, the virus would need to spread to about 60 percent of the UK.
With 66 million people living in the UK nations of England, Scotland, Wales and Northern Ireland, that strategy could lead to as many as 40 million people infected. Depending on the mortality rate — which depends on access to medical care and other factors but is estimated to be 1 percent globally — the death rate en route to improved immunity could range from 300,000 to more than a million.
That reality led to more than 200 scientists and medical professionals pushing back against the herd immunity strategy in an open letter Saturday. These experts argued that herd immunity does not “seem a viable option” because it could overwhelm the UK’s National Health Service with very sick patients. Instead, they called for strict social distancing measures of a more serious variety than the government has currently recommended....
https://www.vox.com/world/2020/3/15/21180414/coronavirus-uk-herd-immunity-vallan...
* Here is graph of "second wave of the Spanish Flu in 1918:
https://twitter.com/BallouxFrancois/status/1238837162340233216/photo/1
______________________________________________________________
Hope here in the US, absentee voting is an option for most by November. (It is in Michigan.)
Louisiana has postponed its primary from April 4 until June 20 ( https://www.politico.com/news/2020/03/13/louisiana-postpones-presidential-primar... )
Boris Johnson postpones local elections until 2021
Harry Yorke | 13 March 2020
Chief scientific adviser warns coronavirus likely to become 'annual virus'
Government advised to postpone local elections in May
£12bn relief package for small businesses 'may be too late'
14 MPs self-isolate amid calls for Parliament to be closed to visitors
Boris Johnson has suspended the local government and mayoral elections for 12 months following guidance from the Electoral Commission.
The Prime Minister has confirmed that the polls will now not take place until May 2021, amid fears that they would have coincided with the peak of the coronavirus outbreak.
The London mayoral election will also be delayed for a year.
It comes after the Electoral Commission wrote to the Government on Thursday advising that it postpone the elections.
The watchdog said that there were "growing risks to the delivery of the polls" and that "significant numbers" of people may not be able to cast their ballots...
https://www.telegraph.co.uk/politics/2020/03/13/politics-latest-news-boris-johns...
------------------------------------------------------------------------------------------------------
ETA
This seems like a good time to mention that Abraham Lincoln held a free and fair election in the middle of a civil freaking war.
- Elie Mystal @ElieNYC | 7:58 PM · Mar 15, 2020
France just held its local body elections today with paper ballots. Marked out 1m distances on the floor so people stood apart, asked them to bring their own pen (or gave them a new one to take with them), IDs checked but not handled. This is the same day they went on lockdown.
- NYCStat! @ArmIPunk | 10:42 PM · Mar 15, 2020
Vote by mail. Solved. We have it CO, WA, OR. Simple, secure, safe.... oh, yes... and there’s a paper trail
- Michael Markman @Mickeleh · 11h
We had elections during WWII. Just saying.
- NancyB @NancyB_653 · 11h
I’ve only left my house twice in the past 2 weeks but I will be going out to vote on Tuesday.
- Denize Bee @DBalistrer8:15 PM · Mar 15, 2020
Anya van Wagtendonkanyavw | Mar 15, 2020
The United Kingdom is previewing a new self-isolation plan for all people over 70 to address the spread of the novel coronavirus in the country, following backlash over a proposal to promote immunity by allowing up to 60 percent of its population to become infected.
...The argument behind achieving herd immunity is that doing so would minimize the risk of a coronavirus resurgence similar to the second wave* of the Spanish Flu of 1918. In a successful herd immunity scenario, a country’s population — the herd — would become infected with the virus, recover, and then have an immunity to it, making them resistant to reinfection.
For this to work in his country, according to Vallance, the virus would need to spread to about 60 percent of the UK.
With 66 million people living in the UK nations of England, Scotland, Wales and Northern Ireland, that strategy could lead to as many as 40 million people infected. Depending on the mortality rate — which depends on access to medical care and other factors but is estimated to be 1 percent globally — the death rate en route to improved immunity could range from 300,000 to more than a million.
That reality led to more than 200 scientists and medical professionals pushing back against the herd immunity strategy in an open letter Saturday. These experts argued that herd immunity does not “seem a viable option” because it could overwhelm the UK’s National Health Service with very sick patients. Instead, they called for strict social distancing measures of a more serious variety than the government has currently recommended....
https://www.vox.com/world/2020/3/15/21180414/coronavirus-uk-herd-immunity-vallan...
* Here is graph of "second wave of the Spanish Flu in 1918:
https://twitter.com/BallouxFrancois/status/1238837162340233216/photo/1
______________________________________________________________
Hope here in the US, absentee voting is an option for most by November. (It is in Michigan.)
Louisiana has postponed its primary from April 4 until June 20 ( https://www.politico.com/news/2020/03/13/louisiana-postpones-presidential-primar... )
Boris Johnson postpones local elections until 2021
Harry Yorke | 13 March 2020
Chief scientific adviser warns coronavirus likely to become 'annual virus'
Government advised to postpone local elections in May
£12bn relief package for small businesses 'may be too late'
14 MPs self-isolate amid calls for Parliament to be closed to visitors
Boris Johnson has suspended the local government and mayoral elections for 12 months following guidance from the Electoral Commission.
The Prime Minister has confirmed that the polls will now not take place until May 2021, amid fears that they would have coincided with the peak of the coronavirus outbreak.
The London mayoral election will also be delayed for a year.
It comes after the Electoral Commission wrote to the Government on Thursday advising that it postpone the elections.
The watchdog said that there were "growing risks to the delivery of the polls" and that "significant numbers" of people may not be able to cast their ballots...
https://www.telegraph.co.uk/politics/2020/03/13/politics-latest-news-boris-johns...
------------------------------------------------------------------------------------------------------
ETA
This seems like a good time to mention that Abraham Lincoln held a free and fair election in the middle of a civil freaking war.
- Elie Mystal @ElieNYC | 7:58 PM · Mar 15, 2020
France just held its local body elections today with paper ballots. Marked out 1m distances on the floor so people stood apart, asked them to bring their own pen (or gave them a new one to take with them), IDs checked but not handled. This is the same day they went on lockdown.
- NYCStat! @ArmIPunk | 10:42 PM · Mar 15, 2020
Vote by mail. Solved. We have it CO, WA, OR. Simple, secure, safe.... oh, yes... and there’s a paper trail
- Michael Markman @Mickeleh · 11h
We had elections during WWII. Just saying.
- NancyB @NancyB_653 · 11h
I’ve only left my house twice in the past 2 weeks but I will be going out to vote on Tuesday.
- Denize Bee @DBalistrer8:15 PM · Mar 15, 2020
89John5918
>87 margd:
Yes, there are many mitigating measures being taken in-country. Public events are banned. schools are closing, etc. There're also campaigns to educate people about hygiene, and about what to do if they get sick. If the number of cases does grow, the relatively weak medical infrastructure will be overstretched. Many parts of Africa are still thinly populated and quite isolated, and as we saw with ebola in the Democratic Republic of Congo, it doesn't spread far in those sort of areas, but on the other hand, as we saw with ebola in west Africa, in urban settings it can spread rapidly. And although ebola is a different beast from coronavirus, nevertheless a lot of lessons have been learned from ebola, and there is a degree of experience and infrastructure.
And yes, not all of sub-Saharan Africa is hot. South Africa has a cold winter, and you're right about the highlands of Kenya (and Ethiopia). We live at 1,900 metres above sea level and it can get pretty cold.
Yes, there are many mitigating measures being taken in-country. Public events are banned. schools are closing, etc. There're also campaigns to educate people about hygiene, and about what to do if they get sick. If the number of cases does grow, the relatively weak medical infrastructure will be overstretched. Many parts of Africa are still thinly populated and quite isolated, and as we saw with ebola in the Democratic Republic of Congo, it doesn't spread far in those sort of areas, but on the other hand, as we saw with ebola in west Africa, in urban settings it can spread rapidly. And although ebola is a different beast from coronavirus, nevertheless a lot of lessons have been learned from ebola, and there is a degree of experience and infrastructure.
And yes, not all of sub-Saharan Africa is hot. South Africa has a cold winter, and you're right about the highlands of Kenya (and Ethiopia). We live at 1,900 metres above sea level and it can get pretty cold.
90margd
>22 margd: chloroquine, contd.
Franck Touret and Xavier de Lamballerie. 2020. Of chloroquine and COVID-19 (Commentary). Antiviral Research Volume 177, May 2020, 104762
https://doi.org/10.1016/j.antiviral.2020.104762 https://www.sciencedirect.com/science/article/pii/S0166354220301145
Highlights
• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication.
• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models.
• Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
• The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.
• Peer review of the results and an independent assessment of the potential benefit for patients are essential.
Abstract
Recent publications have brought attention to the possible benefit of chloroquine, a broadly used antimalarial drug, in the treatment of patients infected by the novel emerged coronavirus (SARS-CoV-2). The scientific community should consider this information in light of previous experiments with chloroquine in the field of antiviral research.
...In conclusion, the option of using chloroquine in the treatment of SARS-CoV-2 should be examined with attention in light of the recent promising announcements, but also of the potential detrimental effect of the drug observed in previous attempts to treat acute viral diseases. We urge Chinese scientists to report the interim trial results currently running in China as soon as they are available. This should be preferentially done in a peer-reviewed publication with detailed information to allow the international scientific community to analyse the results, to confirm in prospective trials the efficacy of the proposed treatment and to guide future clinical practice.
Franck Touret and Xavier de Lamballerie. 2020. Of chloroquine and COVID-19 (Commentary). Antiviral Research Volume 177, May 2020, 104762
https://doi.org/10.1016/j.antiviral.2020.104762 https://www.sciencedirect.com/science/article/pii/S0166354220301145
Highlights
• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication.
• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models.
• Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
• The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.
• Peer review of the results and an independent assessment of the potential benefit for patients are essential.
Abstract
Recent publications have brought attention to the possible benefit of chloroquine, a broadly used antimalarial drug, in the treatment of patients infected by the novel emerged coronavirus (SARS-CoV-2). The scientific community should consider this information in light of previous experiments with chloroquine in the field of antiviral research.
...In conclusion, the option of using chloroquine in the treatment of SARS-CoV-2 should be examined with attention in light of the recent promising announcements, but also of the potential detrimental effect of the drug observed in previous attempts to treat acute viral diseases. We urge Chinese scientists to report the interim trial results currently running in China as soon as they are available. This should be preferentially done in a peer-reviewed publication with detailed information to allow the international scientific community to analyse the results, to confirm in prospective trials the efficacy of the proposed treatment and to guide future clinical practice.
91margd
Zinc inhibits SARS virus. Might inhibit closely related virus responsible for COVID-19? Zinc can't hurt? Might help?
In video below, pulmonologist & critical care specialist Roger Seheult, MD, explains how the virus SARS-CoV-2 invades a cell in the disease COVID-19
Also excerpted below, Te Velthuis (2010) showed that zinc impairs the replication of closely related RNA virus, SARS-CoV (which causes SARS).
At the least, might be good idea for people deficient in zinc to take supplements before COVID-19 hits?
White spots on one's nails can signify Zn deficiency. The white spots are scar tissue, if I recall correctly, so may not respond as quickly as would zinc levels in plasma and lung tissue, i.e., you can quickly increase zinc in preparation for COVID-19, though it will take a couple weeks to grow out your nails.
(Zn lozenges may reduce the duration of colds, perhaps by a day or so, and may reduce the number of upper respiratory infections in children (webmd). Colds are related to COVID-19, though not as closely as SARS.)
Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19? (~20 minutes)
•Mar 6, 2020
MedCram - Medical Lectures Explained CLEARLY
Coronavirus (COVID-19) Update 32 with pulmonologist & critical care specialist Roger Seheult, MD of https://www.MedCram.com
South Korea has tested over 140,000 people for COVID-19 and their data may give the best insight into a more accurate fatality rate, and how quickly the new coronavirus can spread. Dr. Seheult illustrates how this coronavirus actually replicates within human cells - which is key to understanding how potential treatments and supplements such as zinc may aid in prevention.
https://www.youtube.com/watch?v=Eeh054-Hx1U
--------------------------------------------------------------------------
Aartjan J. W. te Velthuis et al. 2010. Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLOS. Published: November 4, 2010. https://doi.org/10.1371/journal.ppat.1001176 https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176
Abstract
Increasing the intracellular Zn2+ concentration with zinc-ionophores like pyrithione (PT) can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn2+ and PT at low concentrations (2 µM Zn2+ and 2 µM PT) inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus (EAV) in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp), which is the core enzyme of their multiprotein replication and transcription complex (RTC). Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV—thus eliminating the need for PT to transport Zn2+ across the plasma membrane—we show that Zn2+ efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9) purified from E. coli subsequently revealed that Zn2+ directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn2+ was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn2+ with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.
Discussion
...In summary, the combination of zinc ions and the zinc-ionophore PT efficiently inhibits nidovirus replication in cell culture. This provides an interesting basis for further studies into the use of zinc-ionophores as antiviral compounds, although systemic effects have to be considered and a water-soluble zinc-ionophore may be better suited, given the apparent lack of systemic toxicity of such a compound at concentrations that were effective against tumors in a mouse xenograft model. In vitro, the reversible inhibition of the RdRp by Zn2+ has also provided us with a convenient research tool to gain more insight into the molecular details of (nido)viral RNA synthesis, and revealed novel mechanistic differences between the RdRps of SARS-CoV and EAV.or.
In video below, pulmonologist & critical care specialist Roger Seheult, MD, explains how the virus SARS-CoV-2 invades a cell in the disease COVID-19
Also excerpted below, Te Velthuis (2010) showed that zinc impairs the replication of closely related RNA virus, SARS-CoV (which causes SARS).
At the least, might be good idea for people deficient in zinc to take supplements before COVID-19 hits?
White spots on one's nails can signify Zn deficiency. The white spots are scar tissue, if I recall correctly, so may not respond as quickly as would zinc levels in plasma and lung tissue, i.e., you can quickly increase zinc in preparation for COVID-19, though it will take a couple weeks to grow out your nails.
(Zn lozenges may reduce the duration of colds, perhaps by a day or so, and may reduce the number of upper respiratory infections in children (webmd). Colds are related to COVID-19, though not as closely as SARS.)
Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19? (~20 minutes)
•Mar 6, 2020
MedCram - Medical Lectures Explained CLEARLY
Coronavirus (COVID-19) Update 32 with pulmonologist & critical care specialist Roger Seheult, MD of https://www.MedCram.com
South Korea has tested over 140,000 people for COVID-19 and their data may give the best insight into a more accurate fatality rate, and how quickly the new coronavirus can spread. Dr. Seheult illustrates how this coronavirus actually replicates within human cells - which is key to understanding how potential treatments and supplements such as zinc may aid in prevention.
https://www.youtube.com/watch?v=Eeh054-Hx1U
--------------------------------------------------------------------------
Aartjan J. W. te Velthuis et al. 2010. Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLOS. Published: November 4, 2010. https://doi.org/10.1371/journal.ppat.1001176 https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176
Abstract
Increasing the intracellular Zn2+ concentration with zinc-ionophores like pyrithione (PT) can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn2+ and PT at low concentrations (2 µM Zn2+ and 2 µM PT) inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus (EAV) in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp), which is the core enzyme of their multiprotein replication and transcription complex (RTC). Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV—thus eliminating the need for PT to transport Zn2+ across the plasma membrane—we show that Zn2+ efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9) purified from E. coli subsequently revealed that Zn2+ directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn2+ was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn2+ with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.
Discussion
...In summary, the combination of zinc ions and the zinc-ionophore PT efficiently inhibits nidovirus replication in cell culture. This provides an interesting basis for further studies into the use of zinc-ionophores as antiviral compounds, although systemic effects have to be considered and a water-soluble zinc-ionophore may be better suited, given the apparent lack of systemic toxicity of such a compound at concentrations that were effective against tumors in a mouse xenograft model. In vitro, the reversible inhibition of the RdRp by Zn2+ has also provided us with a convenient research tool to gain more insight into the molecular details of (nido)viral RNA synthesis, and revealed novel mechanistic differences between the RdRps of SARS-CoV and EAV.or.
92John5918
In Burkina Faso, COVID-19 fight complicated by war, displacement (Al Jazeera)
Experts raise alarm over spread of coronavirus in a country plagued by conflict that has compromised healthcare system...
Experts raise alarm over spread of coronavirus in a country plagued by conflict that has compromised healthcare system...
93oregonobsessionz
Apologies if everyone has seen this. Vox has posted
9 charts that explain the coronavirus pandemic
Some of the charts have appeared elsewhere, but it is convenient to have them all in one place.
9 charts that explain the coronavirus pandemic
Some of the charts have appeared elsewhere, but it is convenient to have them all in one place.
94alco261
>32 margd: just an FYI - The Cleveland Clinic did not invent a new COVID-19 test. What they did do is become one of the first hospitals in the country to do in-house testing. Currently they can do 500 tests a day and are ramping up to 1000/day. They are working with other local providers to set up a drive-thru testing. As of their notice of 3/13 they hope to have it up and running some time this week. - All of this from an official 3/13 Cleveland Clinic announcement.
95Taphophile13
Coronavirus tracking website created by 17 year old in Seattle updates every few minutes:
https://ncov2019.live/
Interview here: https://www.rawstory.com/2020/03/meet-the-17-year-old-behind-a-website-tracking-...
https://ncov2019.live/
Interview here: https://www.rawstory.com/2020/03/meet-the-17-year-old-behind-a-website-tracking-...
96LolaWalser
The kid's great but last week he was lagging behind Johns Hopkins. If one must have a global tracker then theirs is a better pick:
https://coronavirus.jhu.edu/map.html
https://coronavirus.jhu.edu/map.html
97Taphophile13
More information is always better.
98davidgn
Modeling from Imperial suggests need for 18 months of more or less continuous lockdown.
https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-co...
https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-co...
Summary Report 9
The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Here we present the results of epidemiological modelling which has informed policymaking in the UK and other countries in recent weeks. In the absence of a COVID-19 vaccine, we assess the potential role of a number of public health measures – so-called non-pharmaceutical interventions (NPIs) – aimed at reducing contact rates in the population and thereby reducing transmission of the virus. In the results presented here, we apply a previously published microsimulation model to two countries: the UK (Great Britain specifically) and the US. We conclude that the effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission.
Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely. Each policy has major challenges. We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.
We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.
99John5918
Conceit and Contagion: How the Virus Shocked Europe (Quillette)
The World Health Organization announced last week that Europe is now the epicentre of the new coronavirus epidemic. As the announcement was made, many countries in Africa and Asia were imposing strict restrictions on the arrival of flights and visitors from Europe. It felt like a great historical reversal, one full of irony. Suddenly Europeans were being kept away, they who for so long fortified their borders against all the dangers—real or imagined—arriving from the developing world.
The coronavirus crisis in Europe is, before everything else, a public health crisis, but it also reflects profound changes in the way the continent sees itself...
And two about Africa from the BBC:
Coronavirus: Kenya introduces tight restrictions
Kenya has taken the opportunity of the coronavirus pandemic to promote cashless transactions, where it is already a pioneer. The East African state's largest mobile phone operator, Safaricom, has scrapped fees for mobile money transactions below 1,000 shillings ($10; £8) in order to encourage cashless payments...
This is just one of a raft of measures Kenya has put in place since reporting its first case on Friday... The country is in a partial lockdown after President Uhuru Kenyatta announced the closure of schools, and imposed sweeping travel restrictions...
South Africa suspends football and cricket
The World Health Organization announced last week that Europe is now the epicentre of the new coronavirus epidemic. As the announcement was made, many countries in Africa and Asia were imposing strict restrictions on the arrival of flights and visitors from Europe. It felt like a great historical reversal, one full of irony. Suddenly Europeans were being kept away, they who for so long fortified their borders against all the dangers—real or imagined—arriving from the developing world.
The coronavirus crisis in Europe is, before everything else, a public health crisis, but it also reflects profound changes in the way the continent sees itself...
And two about Africa from the BBC:
Coronavirus: Kenya introduces tight restrictions
Kenya has taken the opportunity of the coronavirus pandemic to promote cashless transactions, where it is already a pioneer. The East African state's largest mobile phone operator, Safaricom, has scrapped fees for mobile money transactions below 1,000 shillings ($10; £8) in order to encourage cashless payments...
This is just one of a raft of measures Kenya has put in place since reporting its first case on Friday... The country is in a partial lockdown after President Uhuru Kenyatta announced the closure of schools, and imposed sweeping travel restrictions...
South Africa suspends football and cricket
100stellarexplorer
>98 davidgn: This does seem to be where we are now. This modeling is being taking very seriously by experts. It will be very painful and costly. But every alternative to paying this high price will be even worse.
101margd
Air pollution is easing. Flights are being cancelled. Roads around here are quiet. I wonder if we might be jolted into the kinds of behaviours needed to curb climate change. Cost for govts to borrow is cheap right now, and they will want to curb unemployment. Maybe best not to reflexively bail out airlines, prop up oil prices, and mindlessly juice the economy etc.? Instead, invest in clean power, alternatives to C-intensive travel technology of the past. Some leadership in G7 would be needed, though... Greta? The flexion point young people need?
California is putting homeless into hotels. LA sheriff is releasing inmates and urging a pause in arrests.
Mail-in ballots may be more widely adopted?
At least for testing in a pandemic, healthcare is universal. In principle at least, assuming we have test kits. Surely triage decisions for who gets ventilator won't factor in "who can pay"?
California is putting homeless into hotels. LA sheriff is releasing inmates and urging a pause in arrests.
Mail-in ballots may be more widely adopted?
At least for testing in a pandemic, healthcare is universal. In principle at least, assuming we have test kits. Surely triage decisions for who gets ventilator won't factor in "who can pay"?
102krolik
>101 margd:
Surely triage decisions for who gets ventilator won't factor in "who can pay"?
We shall see.
This pandemic is also a stark and ugly social experiment which puts different healthcare systems and differing conceptions of solidarity to the test.
A year or so from now, we'll likely have the data to have learned something from this problem. Which systems and arrangements fared better, and which sustained the greatest losses.
I have my suspicions about how this is likely to turn out. Frankly I'm glad I don't live in the U.S. right now.
But time will tell. We shall see.
Surely triage decisions for who gets ventilator won't factor in "who can pay"?
We shall see.
This pandemic is also a stark and ugly social experiment which puts different healthcare systems and differing conceptions of solidarity to the test.
A year or so from now, we'll likely have the data to have learned something from this problem. Which systems and arrangements fared better, and which sustained the greatest losses.
I have my suspicions about how this is likely to turn out. Frankly I'm glad I don't live in the U.S. right now.
But time will tell. We shall see.
103margd
A virus that undeterred will clear out the old and the compromised leaving a young, immunized(?) work force unsaddled by our care and interests.
A Nazi germ. An autocrat's germ. A young person's germ? Okay boomer...
(Musing in the early morning hours, I say this as an elder (!!), with one son at least, especially vulnerable.)
A Nazi germ. An autocrat's germ. A young person's germ? Okay boomer...
(Musing in the early morning hours, I say this as an elder (!!), with one son at least, especially vulnerable.)
104margd
A Top Cancer Hospital Faces Mask Shortages As COVID-19 Cases Show Up In Staff And Patients
Rosalind Adams | Last updated on March 17, 2020
...One of the nation’s top cancer hospitals has informed its staff it has a shortage of masks and other personal protective equipment, even as at least five employees and three patients have been diagnosed with COVID-19.
The hospital, Memorial Sloan Kettering Cancer Center in New York, has only a week’s supply of masks on hand, according to a transcript of a staff meeting last Friday afternoon. The shortage, Kreg Kolford, senior vice president of supply chain and sustaining care, told employees, is due to production and distribution delays in China, where most personal protective equipment, or PPE, is manufactured.
Hospitals around the country have been wrestling with shortages of PPE, beds, and ventilators amid mounting numbers of infected patients. But the shortage is particularly troubling at Sloan Kettering, the country’s oldest and largest private cancer hospital, because cancer treatments like chemotherapy and radiation therapy can leave patients with compromised immune systems. Preliminary data out of China suggests that cancer patients face a 5.6% fatality rate if infected with the virus, compared to 0.9% in people with no underlying conditions...
https://www.buzzfeednews.com/article/rosalindadams/a-top-cancer-hospital-faces-m...
_____________________________________________________________
Old enough to remember when Irish sweepstakes was the only legal form of gambling...
Casinos ask Congress for emergency aid as coronavirus toll sweeps industry
Jeff Stein, Rachel Siegel and Jonathan O'Connell | March 16, 2020
Casinos have joined the airline industry in asking Congress for emergency financial help as Las Vegas and other tourist destinations take a severe financial hit from the coronavirus outbreak.
The requested aid for the casino companies, raised by lobbyists in recent days, could come in the form of a comprehensive bailout package, similar to what lawmakers may provide to airlines, cruise companies and the hospitality industry. Other possibilities include direct cash payments, deferred taxes or special bankruptcy protections, said two people with knowledge of the conversations who were not authorized to speak publicly.
One person said that on a strategy call Monday with members of the American Gaming Association, which represents the industry, a representative of Wynn Resorts raised the possibility of the industry seeking cash payments. Wynn Resorts was previously run by one of President Trump’s biggest political donors, Steve Wynn, who resigned his post in 2018...
The American Gaming Association (said) that with the $260 billion industry at a “near standstill,” additional funds are needed to support casino companies and their employees...
https://www.washingtonpost.com/business/2020/03/16/casino-bailout-coronavirus-co...
Rosalind Adams | Last updated on March 17, 2020
...One of the nation’s top cancer hospitals has informed its staff it has a shortage of masks and other personal protective equipment, even as at least five employees and three patients have been diagnosed with COVID-19.
The hospital, Memorial Sloan Kettering Cancer Center in New York, has only a week’s supply of masks on hand, according to a transcript of a staff meeting last Friday afternoon. The shortage, Kreg Kolford, senior vice president of supply chain and sustaining care, told employees, is due to production and distribution delays in China, where most personal protective equipment, or PPE, is manufactured.
Hospitals around the country have been wrestling with shortages of PPE, beds, and ventilators amid mounting numbers of infected patients. But the shortage is particularly troubling at Sloan Kettering, the country’s oldest and largest private cancer hospital, because cancer treatments like chemotherapy and radiation therapy can leave patients with compromised immune systems. Preliminary data out of China suggests that cancer patients face a 5.6% fatality rate if infected with the virus, compared to 0.9% in people with no underlying conditions...
https://www.buzzfeednews.com/article/rosalindadams/a-top-cancer-hospital-faces-m...
_____________________________________________________________
Old enough to remember when Irish sweepstakes was the only legal form of gambling...
Casinos ask Congress for emergency aid as coronavirus toll sweeps industry
Jeff Stein, Rachel Siegel and Jonathan O'Connell | March 16, 2020
Casinos have joined the airline industry in asking Congress for emergency financial help as Las Vegas and other tourist destinations take a severe financial hit from the coronavirus outbreak.
The requested aid for the casino companies, raised by lobbyists in recent days, could come in the form of a comprehensive bailout package, similar to what lawmakers may provide to airlines, cruise companies and the hospitality industry. Other possibilities include direct cash payments, deferred taxes or special bankruptcy protections, said two people with knowledge of the conversations who were not authorized to speak publicly.
One person said that on a strategy call Monday with members of the American Gaming Association, which represents the industry, a representative of Wynn Resorts raised the possibility of the industry seeking cash payments. Wynn Resorts was previously run by one of President Trump’s biggest political donors, Steve Wynn, who resigned his post in 2018...
The American Gaming Association (said) that with the $260 billion industry at a “near standstill,” additional funds are needed to support casino companies and their employees...
https://www.washingtonpost.com/business/2020/03/16/casino-bailout-coronavirus-co...
105margd
2012 article on ecology of disease, One Health Initiative: would that decision-makers--all of us--had listened.
(A cousin suffered for years with chikungunya, acquired in the Caribbean. Asian Tiger Mosquito invaded North America, possibly in water pooled in tires. A mutation allowed the virus to survive in tiger mosquitoes. Enter lightly clad tourist...)
The Ecology of Disease
Jim Robbins | July 14, 2012
...Diseases have always come out of the woods and wildlife and found their way into human populations — the plague and malaria are two examples. But emerging diseases have quadrupled in the last half-century, experts say, largely because of increasing human encroachment into habitat, especially in disease “hot spots” around the globe, mostly in tropical regions. And with modern air travel and a robust market in wildlife trafficking, the potential for a serious outbreak in large population centers is enormous.
The key to forecasting and preventing the next pandemic, experts say, is understanding what they call the “protective effects” of nature intact. In the Amazon, for example, one study showed an increase in deforestation by some 4 percent increased the incidence of malaria by nearly 50 percent, because mosquitoes, which transmit the disease, thrive in the right mix of sunlight and water in recently deforested areas. Developing the forest in the wrong way can be like opening Pandora’s box. These are the kinds of connections the new teams are unraveling.
Public health experts have begun to factor ecology into their models. Australia, for example, has just announced a multimillion-dollar effort to understand the ecology of the Hendra virus and bats.
IT’S not just the invasion of intact tropical landscapes that can cause disease. The West Nile virus came to the United States from Africa but spread here because one of its favored hosts is the American robin, which thrives in a world of lawns and agricultural fields. And mosquitoes, which spread the disease, find robins especially appealing. “The virus has had an important impact on human health in the United States because it took advantage of species that do well around people,” says Marm Kilpatrick, a biologist at the University of California, Santa Cruz. The pivotal role of the robin in West Nile has earned it the title “super spreader.”
And Lyme disease, the East Coast scourge, is very much a product of human changes to the environment: the reduction and fragmentation of large contiguous forests. Development chased off predators — wolves, foxes, owls and hawks. That has resulted in a fivefold increase in white-footed mice, which are great “reservoirs” for the Lyme bacteria, probably because they have poor immune systems. And they are terrible groomers. When possums or gray squirrels groom, they remove 90 percent of the larval ticks that spread the disease, while mice kill just half. “So mice are producing huge numbers of infected nymphs,” says the Lyme disease researcher Richard Ostfeld.
...The best way to prevent the next outbreak in humans, specialists say, is with what they call the One Health Initiative — a worldwide program, involving more than 600 scientists and other professionals, that advances the idea that human, animal and ecological health are inextricably linked and need to be studied and managed holistically...
https://www.nytimes.com/2012/07/15/sunday-review/the-ecology-of-disease.html
ETA: http://onehealthinitiative.com
On Twiter, ping @davidbruceconn .
(A cousin suffered for years with chikungunya, acquired in the Caribbean. Asian Tiger Mosquito invaded North America, possibly in water pooled in tires. A mutation allowed the virus to survive in tiger mosquitoes. Enter lightly clad tourist...)
The Ecology of Disease
Jim Robbins | July 14, 2012
...Diseases have always come out of the woods and wildlife and found their way into human populations — the plague and malaria are two examples. But emerging diseases have quadrupled in the last half-century, experts say, largely because of increasing human encroachment into habitat, especially in disease “hot spots” around the globe, mostly in tropical regions. And with modern air travel and a robust market in wildlife trafficking, the potential for a serious outbreak in large population centers is enormous.
The key to forecasting and preventing the next pandemic, experts say, is understanding what they call the “protective effects” of nature intact. In the Amazon, for example, one study showed an increase in deforestation by some 4 percent increased the incidence of malaria by nearly 50 percent, because mosquitoes, which transmit the disease, thrive in the right mix of sunlight and water in recently deforested areas. Developing the forest in the wrong way can be like opening Pandora’s box. These are the kinds of connections the new teams are unraveling.
Public health experts have begun to factor ecology into their models. Australia, for example, has just announced a multimillion-dollar effort to understand the ecology of the Hendra virus and bats.
IT’S not just the invasion of intact tropical landscapes that can cause disease. The West Nile virus came to the United States from Africa but spread here because one of its favored hosts is the American robin, which thrives in a world of lawns and agricultural fields. And mosquitoes, which spread the disease, find robins especially appealing. “The virus has had an important impact on human health in the United States because it took advantage of species that do well around people,” says Marm Kilpatrick, a biologist at the University of California, Santa Cruz. The pivotal role of the robin in West Nile has earned it the title “super spreader.”
And Lyme disease, the East Coast scourge, is very much a product of human changes to the environment: the reduction and fragmentation of large contiguous forests. Development chased off predators — wolves, foxes, owls and hawks. That has resulted in a fivefold increase in white-footed mice, which are great “reservoirs” for the Lyme bacteria, probably because they have poor immune systems. And they are terrible groomers. When possums or gray squirrels groom, they remove 90 percent of the larval ticks that spread the disease, while mice kill just half. “So mice are producing huge numbers of infected nymphs,” says the Lyme disease researcher Richard Ostfeld.
...The best way to prevent the next outbreak in humans, specialists say, is with what they call the One Health Initiative — a worldwide program, involving more than 600 scientists and other professionals, that advances the idea that human, animal and ecological health are inextricably linked and need to be studied and managed holistically...
https://www.nytimes.com/2012/07/15/sunday-review/the-ecology-of-disease.html
ETA: http://onehealthinitiative.com
On Twiter, ping @davidbruceconn .
106margd
Scientists find that up to 86 percent of coronavirus infections go undetected
Alan Boyle | March 16, 2020
...Computer modeling of the coronavirus outbreak’s course in China, in the weeks before a travel shutdown was imposed on Jan. 23, suggest that 86% of the infections went undocumented.
Those undocumented infections were about half as contagious as the documented cases, but were the source of two-thirds of the documented cases, according to a study published online today by the journal Science*...
https://www.geekwire.com/2020/scientists-find-86-percent-coronavirus-infections-...
----------------------------------------------------------------------------------------------------
* Ruiyun Li et al. 2020. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science 16 Mar 2020:
eabb3221 DOI: 10.1126/science.abb3221 https://science.sciencemag.org/content/early/2020/03/13/science.abb3221
Abstract
Estimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: 82%–90%) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections (46%–62%), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.
Alan Boyle | March 16, 2020
...Computer modeling of the coronavirus outbreak’s course in China, in the weeks before a travel shutdown was imposed on Jan. 23, suggest that 86% of the infections went undocumented.
Those undocumented infections were about half as contagious as the documented cases, but were the source of two-thirds of the documented cases, according to a study published online today by the journal Science*...
https://www.geekwire.com/2020/scientists-find-86-percent-coronavirus-infections-...
----------------------------------------------------------------------------------------------------
* Ruiyun Li et al. 2020. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science 16 Mar 2020:
eabb3221 DOI: 10.1126/science.abb3221 https://science.sciencemag.org/content/early/2020/03/13/science.abb3221
Abstract
Estimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: 82%–90%) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections (46%–62%), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.
107John5918
OCHA SUDAN Situation Report (OCHA)
The Humanitarian Country Team in Sudan is finalizing a COVID-19 response plan to support the Sudanese government’s national plan. On 16 March, the Transitional Sovereign Council announced the closure of all airports in the country until 31 March, except for those carrying humanitarian and commercial shipments... the Government of Sudan announced that government and private institutions should take measures to reduce congestion in the workplace... Two isolation centres have been established in Khartoum State to treat COVID-19 patients...
South Sudan halts flights to countries affected by coronavirus (Radio Tamazuj)
“The government has decided to take some measures to protect us from this disease coming into the country. This includes suspension of direct flights between South Sudan and those countries that have local infection and transmission like Egypt and United Arab Emirates...
The Humanitarian Country Team in Sudan is finalizing a COVID-19 response plan to support the Sudanese government’s national plan. On 16 March, the Transitional Sovereign Council announced the closure of all airports in the country until 31 March, except for those carrying humanitarian and commercial shipments... the Government of Sudan announced that government and private institutions should take measures to reduce congestion in the workplace... Two isolation centres have been established in Khartoum State to treat COVID-19 patients...
South Sudan halts flights to countries affected by coronavirus (Radio Tamazuj)
“The government has decided to take some measures to protect us from this disease coming into the country. This includes suspension of direct flights between South Sudan and those countries that have local infection and transmission like Egypt and United Arab Emirates...
108John5918
Another in the series of spoof "Honest Government Ad" videos, this one on the coronavirus...
Honest Government Ad | Coronavirus: Flatten The Curve (YouTube)
Honest Government Ad | Coronavirus: Flatten The Curve (YouTube)
109margd
New Yawk :)
italy: people singing
new york: people screaming GO THE FUCK HOME out their windows
i love this city
- Klaudia Amenábar @kaludiasays | 2:27 PM · Mar 16, 2020
Quote Tweet
Nick Brown @NickPBrown · Mar 15
Tensions are mounting as our social fabric frays.
In Brooklyn, these folks in apartment windows got in a shouting match with those down on the street.
“Flatten the curve, go home,” one chants. #coronavirus
0:07 ( https://twitter.com/NickPBrown/status/1239290707380183040 )
OTH, in responses:
Nice building
exactly
These people have no way of knowing if the pedestrians are getting groceries or on their way to work. There are reasons you do HAVE to leave the house.
Nick Brown @NickPBrown | 11:07 PM · Mar 16, 2020
1/2: Since people are reading, 2 quick points: 1. The mental health pros I’ve interviewed DO recommend getting fresh air. Helps promote mental health at time when that’s very fragile. Caveat: should NOT be done in way that conflicts w/ health experts’ guidance. Not a free-4-all
2/2: The Italy comparisons—how they sing while we yell—aren’t quite fair. Italy’s in lockdown, we still have choice. Maybe we shouldn’t but we do. Choice=conflict. I like to think, when chips down, NYC can harmonize like no other. Have we forgotten already?
https://www.youtube.com/watch?v=7KFSfqfAMlA
We are allowed to go outside in Italy but you are told: do what you need to do- groceries, walk the dog or exercise and go home immediately.
Everyone does a slightly awkward dance of keeping maximum distance possible from each other. This feels sane and reasonable.
- Jennie Zeiner @JennieZeiner | 9:12 AM · Mar 17, 2020
italy: people singing
new york: people screaming GO THE FUCK HOME out their windows
i love this city
- Klaudia Amenábar @kaludiasays | 2:27 PM · Mar 16, 2020
Quote Tweet
Nick Brown @NickPBrown · Mar 15
Tensions are mounting as our social fabric frays.
In Brooklyn, these folks in apartment windows got in a shouting match with those down on the street.
“Flatten the curve, go home,” one chants. #coronavirus
0:07 ( https://twitter.com/NickPBrown/status/1239290707380183040 )
OTH, in responses:
Nice building
exactly
These people have no way of knowing if the pedestrians are getting groceries or on their way to work. There are reasons you do HAVE to leave the house.
Nick Brown @NickPBrown | 11:07 PM · Mar 16, 2020
1/2: Since people are reading, 2 quick points: 1. The mental health pros I’ve interviewed DO recommend getting fresh air. Helps promote mental health at time when that’s very fragile. Caveat: should NOT be done in way that conflicts w/ health experts’ guidance. Not a free-4-all
2/2: The Italy comparisons—how they sing while we yell—aren’t quite fair. Italy’s in lockdown, we still have choice. Maybe we shouldn’t but we do. Choice=conflict. I like to think, when chips down, NYC can harmonize like no other. Have we forgotten already?
https://www.youtube.com/watch?v=7KFSfqfAMlA
We are allowed to go outside in Italy but you are told: do what you need to do- groceries, walk the dog or exercise and go home immediately.
Everyone does a slightly awkward dance of keeping maximum distance possible from each other. This feels sane and reasonable.
- Jennie Zeiner @JennieZeiner | 9:12 AM · Mar 17, 2020
1102wonderY
This is going the rounds online. I like it, though I can't source who Kitty O'Meara was.
“And the people stayed home. And read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still. And listened more deeply. Some meditated, some prayed, some danced. Some met their shadows. And the people began to think differently.
And the people healed. And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.
And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed."
~Kitty O'Meara~
“And the people stayed home. And read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still. And listened more deeply. Some meditated, some prayed, some danced. Some met their shadows. And the people began to think differently.
And the people healed. And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.
And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed."
~Kitty O'Meara~
111margd
>110 2wonderY: (like)
____________________________________
A message from me and my dad, @Melbrooks
#coronavirus #DontBeASpreader
0:44 ( https://twitter.com/maxbrooksauthor/status/1239624352305303552 )
- Max Brooks @maxbrooksauthor | 2:47 PM · Mar 16, 2020
____________________________________
A message from me and my dad, @Melbrooks
#coronavirus #DontBeASpreader
0:44 ( https://twitter.com/maxbrooksauthor/status/1239624352305303552 )
- Max Brooks @maxbrooksauthor | 2:47 PM · Mar 16, 2020
1122wonderY
#BoomerRemover ??
A Generational War Is Brewing Over Coronavirus
In a display of juvenile gallows humor, the hashtag #BoomerRemover, a nickname for the novel coronavirus, briefly trended on Twitter last weekend.
A Generational War Is Brewing Over Coronavirus
In a display of juvenile gallows humor, the hashtag #BoomerRemover, a nickname for the novel coronavirus, briefly trended on Twitter last weekend.
113margd
Neil M Ferguson et al. 16 March 2020. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College COVID-19 Response Team (20 p). DOI: https://doi.org/10.25561/77482 https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowsh...
Summary
The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Here we present the results of epidemiological modelling which has informed policy making in the UK and other countries in recent weeks. In the absence of a COVID-19 vaccine, we assess the potential role of a number of public health measures –so-called non-pharmaceutical interventions (NPIs) –aimed at reducing contact rates in the population and thereby reducing transmission of the virus. In the results presented here, we apply a previously published microsimulation model to two countries: the UK (Great Britain specifically) and the US. We conclude that the effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission.
Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread –reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.Each policy has major challenges. We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.
We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package –or something equivalently effective at reducing transmission –will need to be maintained until a vaccine becomes available (potentially 18 months or more) –given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.
(Discussion p 14-16...)
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowsh...
________________________________________________________
Kai Kupferschmidt @kakape | 7:24 PM · Mar 16, 2020:
Wow. Only now getting to read this #covid19 paper at the end of a busy day. But what a read. It Spells out the issues very clearly. Quick thread.
Quote Tweet Steven Riley | @SRileyIDD · 19h
Our Report 9 on #COVID19 shouldn't be a surprise, but its not an easy read. This virus is just too severe. Flattening the curve not so different from containment. As per @WHO, very strong social distancing needed as soon as health care system in danger. https://twitter.com/MRC_Outbreak/status/1239616254555623427
It starts with two basic strategies:
1. Suppression: Try to keep #SARSCov2 from spreading. Interrupt transmission and bring number of new cases all the way down. That’s what China did.
2. Mitigation: Accept that spread is inevitable, but try to slow it down and reduce impact.
"In this report, we consider the feasibility and implications of both strategies for #COVID19, looking at a range of NPI measures”.
‘NPI’ = non-pharmaceutical interventions. Since we don’t have a vaccine or drugs, that is all we have for now: quarantines, social distancing, etc.
Choice between 1 and 2 is terrible, as authors note: "Suppression, while successful to date in China and South Korea, carries with it enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term."
"Mitigation will never be able to completely protect those at risk from severe disease or death and the resulting mortality may therefore still be high.” Only advantage: Population slowly builds up immunity, which may eventually stop epidemic.
So the authors went ahead and simulated these two scenarios. A lot of assumptions about transmission and disease progression etc. that are obviously important, but it’s late and I’ll stick to results here for now. (Details in the paper.)
What happens if nothing is done: “We predict 81% of the GB and US populations would be infected over the course of the epidemic.” Peak in deaths after 3 months. “In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US."
"For an uncontrolled epidemic, we predict critical care bed capacity would be exceeded as early as the second week in April, with an eventual peak in ICU or critical care bed demand that is over 30 times greater than the maximum supply in both countries"
Please remember this is a model! And specifically one looking at what would happen, if we did nothing to stop #covid19.
So what about the two strategies. Well, basically, the report says, mitigation will not work. Even in the most optimistic scenario surge limits for beds in both general wards and ICUs would be exceeded at least 8-fold.
What’s worse: "even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US” And this is basically with the strategy the UK government seemed to be advocating last week.
So what happened? "In the UK, this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK” and with NHS providing more certainty about their hospital surge capacity.
So all that is left then is suppression: "We therefore conclude that epidemic suppression is the only viable strategy at the current time.”
"The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently."
This is a crucial point. If the strategy was mitigation the idea would be to target interventions in a time window around the peak of the epidemic. That seems to have been the rationale in the UK for waiting with some measures.
But: "For suppression, early action is important, and interventions need to be in place well before healthcare capacity is overwhelmed.” So we are basically back to plan A: throw the kitchen sink at this #covid19 epidemic. And do it now.
And suppression not only needs to start early, it needs to keep going for a long time: "To avoid a rebound in transmission, these policies will need to be maintained until large stocks of vaccine are available to immunise the population – which could be 18 months or more.”
As the authors emphasise: It "is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time.” That’s at the end of the paper.
Summary
The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Here we present the results of epidemiological modelling which has informed policy making in the UK and other countries in recent weeks. In the absence of a COVID-19 vaccine, we assess the potential role of a number of public health measures –so-called non-pharmaceutical interventions (NPIs) –aimed at reducing contact rates in the population and thereby reducing transmission of the virus. In the results presented here, we apply a previously published microsimulation model to two countries: the UK (Great Britain specifically) and the US. We conclude that the effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission.
Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread –reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.Each policy has major challenges. We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.
We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package –or something equivalently effective at reducing transmission –will need to be maintained until a vaccine becomes available (potentially 18 months or more) –given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.
(Discussion p 14-16...)
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowsh...
________________________________________________________
Kai Kupferschmidt @kakape | 7:24 PM · Mar 16, 2020:
Wow. Only now getting to read this #covid19 paper at the end of a busy day. But what a read. It Spells out the issues very clearly. Quick thread.
Quote Tweet Steven Riley | @SRileyIDD · 19h
Our Report 9 on #COVID19 shouldn't be a surprise, but its not an easy read. This virus is just too severe. Flattening the curve not so different from containment. As per @WHO, very strong social distancing needed as soon as health care system in danger. https://twitter.com/MRC_Outbreak/status/1239616254555623427
It starts with two basic strategies:
1. Suppression: Try to keep #SARSCov2 from spreading. Interrupt transmission and bring number of new cases all the way down. That’s what China did.
2. Mitigation: Accept that spread is inevitable, but try to slow it down and reduce impact.
"In this report, we consider the feasibility and implications of both strategies for #COVID19, looking at a range of NPI measures”.
‘NPI’ = non-pharmaceutical interventions. Since we don’t have a vaccine or drugs, that is all we have for now: quarantines, social distancing, etc.
Choice between 1 and 2 is terrible, as authors note: "Suppression, while successful to date in China and South Korea, carries with it enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term."
"Mitigation will never be able to completely protect those at risk from severe disease or death and the resulting mortality may therefore still be high.” Only advantage: Population slowly builds up immunity, which may eventually stop epidemic.
So the authors went ahead and simulated these two scenarios. A lot of assumptions about transmission and disease progression etc. that are obviously important, but it’s late and I’ll stick to results here for now. (Details in the paper.)
What happens if nothing is done: “We predict 81% of the GB and US populations would be infected over the course of the epidemic.” Peak in deaths after 3 months. “In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US."
"For an uncontrolled epidemic, we predict critical care bed capacity would be exceeded as early as the second week in April, with an eventual peak in ICU or critical care bed demand that is over 30 times greater than the maximum supply in both countries"
Please remember this is a model! And specifically one looking at what would happen, if we did nothing to stop #covid19.
So what about the two strategies. Well, basically, the report says, mitigation will not work. Even in the most optimistic scenario surge limits for beds in both general wards and ICUs would be exceeded at least 8-fold.
What’s worse: "even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US” And this is basically with the strategy the UK government seemed to be advocating last week.
So what happened? "In the UK, this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK” and with NHS providing more certainty about their hospital surge capacity.
So all that is left then is suppression: "We therefore conclude that epidemic suppression is the only viable strategy at the current time.”
"The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently."
This is a crucial point. If the strategy was mitigation the idea would be to target interventions in a time window around the peak of the epidemic. That seems to have been the rationale in the UK for waiting with some measures.
But: "For suppression, early action is important, and interventions need to be in place well before healthcare capacity is overwhelmed.” So we are basically back to plan A: throw the kitchen sink at this #covid19 epidemic. And do it now.
And suppression not only needs to start early, it needs to keep going for a long time: "To avoid a rebound in transmission, these policies will need to be maintained until large stocks of vaccine are available to immunise the population – which could be 18 months or more.”
As the authors emphasise: It "is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time.” That’s at the end of the paper.
114proximity1
Rich LOWRY, The New York Post 16 March, 2020 :
"Suddenly, the Left is Complaining that Trump Isn't Dictatorial Enough"
____________________________________
What happens when the supposed dictator won’t dictate?
This is the conundrum confronted by the harshest critics of President Trump, who have gone from warning he is a budding despot to complaining he hasn’t done enough to impose his will during the coronavirus crisis.
They can’t believe that he didn’t urge sports leagues to cancel their seasons, call for school systems to close or tell bars and restaurants to shutter before this wave of closures began.
As a New York Times report put it, Trump “has essentially become a bystander as school superintendents, sports commissioners, college presidents, governors and business owners across the country take it upon themselves to shut down much of American life.”
Ordinarily, tyrants aren’t bystanders. They don’t give other political players and civic institutions wide latitude to make their own decisions. They don’t have to be pushed to declare a national emergency unlocking various powers. They don’t have to be lobbied to call out the military to deal with a domestic problem.
Trump declared an emergency last week and has now issued national guidelines against gatherings of more than 10 people, but his initial instinct was to urge people to stay calm and carry on.
The reason that Trump’s conduct in this crisis hasn’t tracked with the “incipient-fascist” line of attack is that this criticism never made any sense.
The problem with Trump’s mode of governance isn’t that he is a would-be authoritarian. Rather, he has a highly personal view of the presidency and an abiding belief that he can talk his way out of any difficulty — including, initially, a public-health crisis not susceptible to spin.
This is a deeply flawed way of approaching his responsibilities that contributed to early stumbles in the coronavirus response, but it doesn’t make him a falangist.
What we are likely to find is that Trump ends up leading a characteristically American effort against the outbreak. As Yuval Levin of the American Enterprise Institute points out, we usually fumble around in the early stages of a national crisis before bringing to bear massive resources to wrestle it to the ground. ...
...
115clamairy
>110 2wonderY: That is wonderful. Thank you.
116proximity1
>110 2wonderY:
this is the kind of sentimental rot that is the hallmark of loopy "liberals" whose heads are filled with silly mush.
The virus is transitory--at least in the sense of its passing active-outbreaks (It may and indeed likely shall remain endemic in successive generations just as other Corona viruses (the "common cold" is a variant) have done.) Our species' most basic characteristics (social and well as physiological) have scores of millions of years of evolutionary back-ground to them--much of it evolved from non-human ancestor species, after all. When the successive virus crises pass, then, typically, everything we are used to about our ways of living shall resume.
If plagues could durably improve human nature, we'd have seen that happen repeatedly already. There have been many pandemics which wiped out huge portions of the civilized world's populations. Indeed, we have only recorded history to go on. There is no telling how many times widespread viruses or bacteria nearly wiped out all human life over large areas.
Perhaps a signal feature of prehistory's human civilizations was in their relatively sparse and isolated locations--in such conditions as epidemics, this would present a huge survival advantage for the species overall. Because many places were remote and never visited by outsiders, disease might ravage and wipe out all human encampments over areas, regions, but whatever the ruin, other isolated tribes, villages, remained untouched because there was neither human nor other non-human animal trade, commerce, social intercourse by which to transmit the pathogens. Such conditions no longer exist in our time and won't return unless and until technological society as we know and think of it is wiped out, replaced again by small, primitive and isolated groups of survivors.
These shall be obliged to once again submit to a Nature which is the master force in all aspects of human existence.
Notice that human nonsense, folly, and wildly ridiculous notions--these are all continuing to thrive in the midst of this pandemic. Some of this make-believe can even hold survival advantages of various kinds, thus, positively "selected for" in Darwinian terms.
this is the kind of sentimental rot that is the hallmark of loopy "liberals" whose heads are filled with silly mush.
The virus is transitory--at least in the sense of its passing active-outbreaks (It may and indeed likely shall remain endemic in successive generations just as other Corona viruses (the "common cold" is a variant) have done.) Our species' most basic characteristics (social and well as physiological) have scores of millions of years of evolutionary back-ground to them--much of it evolved from non-human ancestor species, after all. When the successive virus crises pass, then, typically, everything we are used to about our ways of living shall resume.
If plagues could durably improve human nature, we'd have seen that happen repeatedly already. There have been many pandemics which wiped out huge portions of the civilized world's populations. Indeed, we have only recorded history to go on. There is no telling how many times widespread viruses or bacteria nearly wiped out all human life over large areas.
Perhaps a signal feature of prehistory's human civilizations was in their relatively sparse and isolated locations--in such conditions as epidemics, this would present a huge survival advantage for the species overall. Because many places were remote and never visited by outsiders, disease might ravage and wipe out all human encampments over areas, regions, but whatever the ruin, other isolated tribes, villages, remained untouched because there was neither human nor other non-human animal trade, commerce, social intercourse by which to transmit the pathogens. Such conditions no longer exist in our time and won't return unless and until technological society as we know and think of it is wiped out, replaced again by small, primitive and isolated groups of survivors.
These shall be obliged to once again submit to a Nature which is the master force in all aspects of human existence.
Notice that human nonsense, folly, and wildly ridiculous notions--these are all continuing to thrive in the midst of this pandemic. Some of this make-believe can even hold survival advantages of various kinds, thus, positively "selected for" in Darwinian terms.
1172wonderY
Has this been posted here yet? A video from Italy - An unsettling new video features a group of Italians sharing what they would have told themselves 10 days ago about taking precautions to stop the spread of the coronavirus before it devastated the country.
Italians send chilling coronavirus warning to Americans in new video
Italians send chilling coronavirus warning to Americans in new video
118karenmarie
>117 2wonderY: Thanks for sharing, Ruth! And is it still true that so far there are no cases in WVA?
1192wonderY
A couple of good guy corporations not expecting the government to do all of the lifting -
Nordstrom is closing all of its stores in the US because of coronavirus, withdraws 2020 outlook
The Seattle-based chain will close all of its locations, including its off-price division Nordstrom Rack, in the U.S. and Canada beginning Tuesday, for two weeks. Nordstrom said it will continue to offer pay and benefits to store workers at this time.
…
"During this unprecedented period of uncertainty, we have in place the appropriate business continuity plans, operational framework and team," CEO Erik Nordstrom said in a statement. "This, in concert with ending 2019 with a solid financial position and healthy balance sheet, gives us the ability to weather this challenging moment in time."
-----------------------
And, not finding a link yet, but got a news release from Woda Cooper Development, one of our portfolio management companies. They own and operate multiple low-income rental projects in Ohio and West Virginia.
They've decided to divert the budget they had set for celebrating their 30 year anniversary to tenant relief efforts; waiving late fees and establishing a rental assistance fund for laid-off or furloughed workers affected by the coronavirus economic downturn.
Nordstrom is closing all of its stores in the US because of coronavirus, withdraws 2020 outlook
The Seattle-based chain will close all of its locations, including its off-price division Nordstrom Rack, in the U.S. and Canada beginning Tuesday, for two weeks. Nordstrom said it will continue to offer pay and benefits to store workers at this time.
…
"During this unprecedented period of uncertainty, we have in place the appropriate business continuity plans, operational framework and team," CEO Erik Nordstrom said in a statement. "This, in concert with ending 2019 with a solid financial position and healthy balance sheet, gives us the ability to weather this challenging moment in time."
-----------------------
And, not finding a link yet, but got a news release from Woda Cooper Development, one of our portfolio management companies. They own and operate multiple low-income rental projects in Ohio and West Virginia.
They've decided to divert the budget they had set for celebrating their 30 year anniversary to tenant relief efforts; waiving late fees and establishing a rental assistance fund for laid-off or furloughed workers affected by the coronavirus economic downturn.
1202wonderY
>118 karenmarie: There's a rumor of a possible case at Public Debt in Parkersburg. They shut down the entire building for deep cleaning. But the employee lives in Ohio.
West Virginia has administered less than 100 tests thus far.
West Virginia has administered less than 100 tests thus far.
121davidgn
>120 2wonderY: Poorer than nationally-poor surveillance is one issue. I would also guess that W. Va. people, statistically speaking, might be more reluctant to seek medical attention unless they're severely ill. And with no major ports or airports and rugged terrain, they're also less likely to get around quite as much. But I'm just throwing things at the wall here.
122margd
Hospital beds at varying infection rates and time lines for your area:
Are Hospitals Near Me Ready for Coronavirus? Here Are Nine Different Scenarios.
by Annie Waldman, Al Shaw, Ash Ngu, and Sean Campbell, March 17, 2020
Though the U.S. health care system is projected to be overwhelmed by an influx of patients infected with the novel coronavirus, the pressure on hospitals will vary dramatically across the country. That’s according to new data released by the Harvard Global Health Institute, which for the first time gives a sense of which regions will be particularly stressed and should be preparing most aggressively right now. The maps we’ve created based on the data shows why public health officials are so intent on “flattening the curve,” or slowing the spread of infections over a longer period of time, like 18 months instead of six...
https://projects.propublica.org/graphics/covid-hospitals
Are Hospitals Near Me Ready for Coronavirus? Here Are Nine Different Scenarios.
by Annie Waldman, Al Shaw, Ash Ngu, and Sean Campbell, March 17, 2020
Though the U.S. health care system is projected to be overwhelmed by an influx of patients infected with the novel coronavirus, the pressure on hospitals will vary dramatically across the country. That’s according to new data released by the Harvard Global Health Institute, which for the first time gives a sense of which regions will be particularly stressed and should be preparing most aggressively right now. The maps we’ve created based on the data shows why public health officials are so intent on “flattening the curve,” or slowing the spread of infections over a longer period of time, like 18 months instead of six...
https://projects.propublica.org/graphics/covid-hospitals
123stellarexplorer
>122 margd: Thanks for that
124davidgn
>122 margd: >123 stellarexplorer: Agreed. Great resource.
1252wonderY
>121 davidgn: All those factors play in. Interestingly, I saw a datum that we are in a fairly good spot with hospital beds because of high Medicare/Medicaid coverage rates, which says insurance coverage is a plus overall in a community. I recall having an argument with a physician who was of the opinion that Obama Care would have a profoundly negative effect on medical resources. Still scratching my head over that.
126margd
Children and Coronavirus: Research Finds Some Become Seriously Ill
Pam Belluck | March 17, 2020
The coronavirus raging around the globe has tended to tread gently with children, who account for the smallest percentage of the tens of thousands of infections identified so far.
Now, the largest study to date of children and the virus has found that while most develop mild or moderate symptoms, a small percentage — especially babies and preschoolers — can become seriously ill.
About half of the children had mild symptoms, such as fever, fatigue, cough, congestion and possibly nausea or diarrhea. More than a third — about 39 percent — became moderately sick, with additional symptoms including pneumonia or lung problems revealed by CT scan, but with no obvious shortness of breath. About 4 percent had no symptoms at all.
But there were 125 children — nearly 6 percent— who developed very serious illness, and one 14-year-old boy with confirmed coronavirus infection died...Thirteen of those were considered “critical," on the brink of respiratory or organ failure. The others were classified as “severe” because they had dire respiratory problems...
https://www.nytimes.com/2020/03/17/health/coronavirus-childen.html
-----------------------------------------------------------------------------------------
February 24, 2020
Zunyou Wu and Jennifer M. McGoogan. 2020. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648 https://jamanetwork.com/journals/jama/fullarticle/2762130
Pam Belluck | March 17, 2020
The coronavirus raging around the globe has tended to tread gently with children, who account for the smallest percentage of the tens of thousands of infections identified so far.
Now, the largest study to date of children and the virus has found that while most develop mild or moderate symptoms, a small percentage — especially babies and preschoolers — can become seriously ill.
About half of the children had mild symptoms, such as fever, fatigue, cough, congestion and possibly nausea or diarrhea. More than a third — about 39 percent — became moderately sick, with additional symptoms including pneumonia or lung problems revealed by CT scan, but with no obvious shortness of breath. About 4 percent had no symptoms at all.
But there were 125 children — nearly 6 percent— who developed very serious illness, and one 14-year-old boy with confirmed coronavirus infection died...Thirteen of those were considered “critical," on the brink of respiratory or organ failure. The others were classified as “severe” because they had dire respiratory problems...
https://www.nytimes.com/2020/03/17/health/coronavirus-childen.html
-----------------------------------------------------------------------------------------
February 24, 2020
Zunyou Wu and Jennifer M. McGoogan. 2020. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648 https://jamanetwork.com/journals/jama/fullarticle/2762130
127John5918
What we scientists have discovered about how each age group spreads Covid-19 (Guardian)
By Dr Petra Klepac, an assistant professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine.
By Dr Petra Klepac, an assistant professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine.
128davidgn
Chubbyemu (cf. https://www.librarything.com/topic/316600#7075604 ) has returned. In addition to a brand new podcast of COVID-19 case reports in his trademark style (https://www.youtube.com/watch?v=b4zely3ofBk), he presents his latest:
Things That Do Not Cure COVID-19 If Ingested
https://www.youtube.com/watch?v=BMSgoppbXiU
Things That Do Not Cure COVID-19 If Ingested
https://www.youtube.com/watch?v=BMSgoppbXiU
129margd
Flood, wildfire, locusts, pandemic--biblical.
Spritzing disinfectant on front door handle, it dawned on me that we've been here before: "PASSOVER!"
DH offered, helpfully, but inaccurately: "40 days and 40 nights." No-o-o!
Cleaning Routines to Keep Your Home Virus-Free
Follow this CDC advice to make sure your kitchen, bathroom and other high-traffic areas are clean and disinfected
Laura Gaskill | 3/17/2020
https://www.houzz.com/magazine/cleaning-routines-to-keep-your-home-virus-free-st...
(I need to up my towel game...)
Spritzing disinfectant on front door handle, it dawned on me that we've been here before: "PASSOVER!"
DH offered, helpfully, but inaccurately: "40 days and 40 nights." No-o-o!
Cleaning Routines to Keep Your Home Virus-Free
Follow this CDC advice to make sure your kitchen, bathroom and other high-traffic areas are clean and disinfected
Laura Gaskill | 3/17/2020
https://www.houzz.com/magazine/cleaning-routines-to-keep-your-home-virus-free-st...
(I need to up my towel game...)
1302wonderY
This reminds me of the absurd plans in the early 80s in case of national disaster. I worked for the USDA, which was theoretically tasked with securing the food supply. So, we, in the field offices, were told that we might have to stand in front of grocery stores and prevent the public from stampeding them.
131davidgn
Why Telling People They Don’t Need Masks Backfired
To help manage the shortage, the authorities sent a message that made them untrustworthy.
https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?utm_sourc...
To help manage the shortage, the authorities sent a message that made them untrustworthy.
https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?utm_sourc...
132margd
McConnell: Senate will pass House bill on Corona sick and family leave over next year, without change.
https://thehill.com/homenews/senate/488061-mcconnell-says-senate-will-pass-house...
Under the bill, "The labor department can exempt employers with fewer than 50 workers from having to pay these benefits if it “would jeopardize the viability of the business.” It is unclear how lenient the Trump administration will be with exemptions. About 35 million people work for small businesses in the United States. Currently, 12.6 million of those workers have no paid sick leave at all, and 30.5 million have no paid family leave, according to the Center for American Progress."
Employers are to be reimbursed by tax credit on employer's contribution to Social Security. However, "The bill also stipulates that Congress will put money into the Social Security Trust Funds to cover the costs of the program so there will not be any decline in Social Security funds." According to small-business groups, "restaurants and travel and hospitality companies have seen sales plummet. They do not have the cash on hand to start paying these benefits."
Fine to use Social Security vehicle except that Rs already threatening to reneger on its obligations to the Social Security Trust Fund...
( https://en.wikipedia.org/wiki/Social_Security_Trust_Fund )
Paid sick leave: Who gets it during the coronavirus outbreak
Heather Long | March 17, 2020
...If the bill is approved by the Senate and signed by Trump, it would grant two weeks of paid sick leave at 100 percent of the person’s normal salary, up to $511 per day. It would also provide up to 12 weeks of paid family and medical leave at 67 percent of the person’s normal pay, up to $200 per day.
But there is a catch: It does not cover everyone. And the loopholes became even larger after the House made major changes to the bill on Monday night...
https://www.washingtonpost.com/business/2020/03/16/paid-sick-leave-coronavirus-h...
https://thehill.com/homenews/senate/488061-mcconnell-says-senate-will-pass-house...
Under the bill, "The labor department can exempt employers with fewer than 50 workers from having to pay these benefits if it “would jeopardize the viability of the business.” It is unclear how lenient the Trump administration will be with exemptions. About 35 million people work for small businesses in the United States. Currently, 12.6 million of those workers have no paid sick leave at all, and 30.5 million have no paid family leave, according to the Center for American Progress."
Employers are to be reimbursed by tax credit on employer's contribution to Social Security. However, "The bill also stipulates that Congress will put money into the Social Security Trust Funds to cover the costs of the program so there will not be any decline in Social Security funds." According to small-business groups, "restaurants and travel and hospitality companies have seen sales plummet. They do not have the cash on hand to start paying these benefits."
Fine to use Social Security vehicle except that Rs already threatening to reneger on its obligations to the Social Security Trust Fund...
( https://en.wikipedia.org/wiki/Social_Security_Trust_Fund )
Paid sick leave: Who gets it during the coronavirus outbreak
Heather Long | March 17, 2020
...If the bill is approved by the Senate and signed by Trump, it would grant two weeks of paid sick leave at 100 percent of the person’s normal salary, up to $511 per day. It would also provide up to 12 weeks of paid family and medical leave at 67 percent of the person’s normal pay, up to $200 per day.
But there is a catch: It does not cover everyone. And the loopholes became even larger after the House made major changes to the bill on Monday night...
https://www.washingtonpost.com/business/2020/03/16/paid-sick-leave-coronavirus-h...
133davidgn
US-Canada border closed to "non-essential traffic."
https://www.washingtonpost.com/world/2020/03/18/coronavirus-latest-news/
https://www.washingtonpost.com/world/2020/03/18/coronavirus-latest-news/
1342wonderY
'People Are Dying Left and Right.' Inside Iran's Struggle to Contain Its Coronavirus Outbreak
Officially, COVID-19 has now sickened almost 15,000 Iranians, but medical staff in Tehran say those numbers are a significant underestimate. “There is absolutely no doubt that the number of sick people is much higher,” a pulmonologist at one of the capital’s leading private hospitals told TIME on his return to work from two weeks in self-quarantine after contracting the disease from a patient. “Realistically, at this point, you need to change the reported sick cases to 1 million.”
Officially, COVID-19 has now sickened almost 15,000 Iranians, but medical staff in Tehran say those numbers are a significant underestimate. “There is absolutely no doubt that the number of sick people is much higher,” a pulmonologist at one of the capital’s leading private hospitals told TIME on his return to work from two weeks in self-quarantine after contracting the disease from a patient. “Realistically, at this point, you need to change the reported sick cases to 1 million.”
135margd
>133 davidgn: "non-essential traffic"... both sides of the St Lawrence R depend on tourists and NY shops look for Canadian biz when the exchange rate is right. Both sides have had a tough go of it with floods 2017, 2019, and maybe this year(?) I have dual citizenship, but American DH surely won't be able to summer over there. Maybe they'll let us pop over to adjust solar panels--my "micro-business", but he's the one with the tech know how. Small price to pay, I know!
136margd
U.S. Virus Plan Anticipates 18-Month Pandemic and Widespread Shortages
Peter Baker and Eileen Sullivan | March 17, 2020. Updated March 18, 2020
The 100-page federal plan laid out a grim prognosis and outlined a response that would activate agencies across the government.
...pandemic “will last 18 months or longer” and could include “multiple waves,” resulting in widespread shortages that would strain consumers and the nation’s health care system.
The 100-page plan, dated Friday, the same day President Trump declared a national emergency, laid out a grim prognosis for the spread of the virus and outlined a response that would activate agencies across the government and potentially employ special presidential powers to mobilize the private sector.
Among the “additional key federal decisions” listed among the options for Mr. Trump was invoking the Defense Production Act of 1950, a Korean War-era law that authorizes a president to take extraordinary action to force American industry to ramp up production of critical equipment and supplies such as ventilators, respirators and protective gear for health care workers...
“Shortages of products may occur, impacting health care, emergency services, and other elements of critical infrastructure,” the plan warned. “This includes potentially critical shortages of diagnostics, medical supplies (including PPE and pharmaceuticals), and staffing in some locations.” P.P.E. refers to personal protective equipment...
https://www.nytimes.com/2020/03/17/us/politics/trump-coronavirus-plan.html
--------------------------------------------------------------------------------------------------
PanCAP Adapted U.S. Government COVID-19 Response Plan. March 13, 2020. 103 p.
https://int.nyt.com/data/documenthelper/6819-covid-19-response-plan/d367f758bec4...
Peter Baker and Eileen Sullivan | March 17, 2020. Updated March 18, 2020
The 100-page federal plan laid out a grim prognosis and outlined a response that would activate agencies across the government.
...pandemic “will last 18 months or longer” and could include “multiple waves,” resulting in widespread shortages that would strain consumers and the nation’s health care system.
The 100-page plan, dated Friday, the same day President Trump declared a national emergency, laid out a grim prognosis for the spread of the virus and outlined a response that would activate agencies across the government and potentially employ special presidential powers to mobilize the private sector.
Among the “additional key federal decisions” listed among the options for Mr. Trump was invoking the Defense Production Act of 1950, a Korean War-era law that authorizes a president to take extraordinary action to force American industry to ramp up production of critical equipment and supplies such as ventilators, respirators and protective gear for health care workers...
“Shortages of products may occur, impacting health care, emergency services, and other elements of critical infrastructure,” the plan warned. “This includes potentially critical shortages of diagnostics, medical supplies (including PPE and pharmaceuticals), and staffing in some locations.” P.P.E. refers to personal protective equipment...
https://www.nytimes.com/2020/03/17/us/politics/trump-coronavirus-plan.html
--------------------------------------------------------------------------------------------------
PanCAP Adapted U.S. Government COVID-19 Response Plan. March 13, 2020. 103 p.
https://int.nyt.com/data/documenthelper/6819-covid-19-response-plan/d367f758bec4...
137margd
Below is the Lancet research letter that prompted concerns (no proof) re ibuprofen (and ACE drugs).
However,
European Society of Cardiology Says Continue Hypertension Meds Despite COVID-19 Concern
Miriam E. Tucker | March 16, 2020
https://www.medscape.com/viewarticle/926838
-------------------------------------------------------------------------------------------------
Lei Fang et al. 2020. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020 (one page) Published Online March 11, 2020 https://doi.org/10.1016/PI https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930116-8
...Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus SARS-CoV and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.4 The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).4Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19
...A further aspect that should be investigated is the genetic predisposition for an increased risk of SARS-CoV-2 infection, which might be due to ACE2 polymorphisms that have been linked to diabetes mellitus, cerebral stroke, and hypertension, specifically in Asian populations. Summarising this information, the sensitivity of an individual might result from a combination of both therapy and ACE2 polymorphism.
We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients...
_______________________________________________________________
Excellent video from #91 explains the role of ACE2 in allowing SARS-CoV-2 into the lung cell (starting at 2:50):
Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19? (~20 minutes)
•Mar 6, 2020
MedCram - Medical Lectures Explained CLEARLY
Coronavirus (COVID-19) Update 32 with pulmonologist & critical care specialist Roger Seheult, MD of https://www.MedCram.com
South Korea has tested over 140,000 people for COVID-19 and their data may give the best insight into a more accurate fatality rate, and how quickly the new coronavirus can spread. Dr. Seheult illustrates how this coronavirus actually replicates within human cells - which is key to understanding how potential treatments and supplements such as zinc may aid in prevention.
https://www.youtube.com/watch?v=Eeh054-Hx1U
(BTW, white spots on nails can indicate Zn deficiency: if so, good idea to take ZN supplements. Zn inhibits other Corona viruses (SARS, common cold.))
However,
European Society of Cardiology Says Continue Hypertension Meds Despite COVID-19 Concern
Miriam E. Tucker | March 16, 2020
https://www.medscape.com/viewarticle/926838
-------------------------------------------------------------------------------------------------
Lei Fang et al. 2020. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020 (one page) Published Online March 11, 2020 https://doi.org/10.1016/PI https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930116-8
...Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus SARS-CoV and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.4 The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).4Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19
...A further aspect that should be investigated is the genetic predisposition for an increased risk of SARS-CoV-2 infection, which might be due to ACE2 polymorphisms that have been linked to diabetes mellitus, cerebral stroke, and hypertension, specifically in Asian populations. Summarising this information, the sensitivity of an individual might result from a combination of both therapy and ACE2 polymorphism.
We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients...
_______________________________________________________________
Excellent video from #91 explains the role of ACE2 in allowing SARS-CoV-2 into the lung cell (starting at 2:50):
Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19? (~20 minutes)
•Mar 6, 2020
MedCram - Medical Lectures Explained CLEARLY
Coronavirus (COVID-19) Update 32 with pulmonologist & critical care specialist Roger Seheult, MD of https://www.MedCram.com
South Korea has tested over 140,000 people for COVID-19 and their data may give the best insight into a more accurate fatality rate, and how quickly the new coronavirus can spread. Dr. Seheult illustrates how this coronavirus actually replicates within human cells - which is key to understanding how potential treatments and supplements such as zinc may aid in prevention.
https://www.youtube.com/watch?v=Eeh054-Hx1U
(BTW, white spots on nails can indicate Zn deficiency: if so, good idea to take ZN supplements. Zn inhibits other Corona viruses (SARS, common cold.))
138John5918
Coronavirus: Why washing hands is difficult in some countries (BBC)
As Europe and much of the developed world shuts down in the face of coronavirus, many millions of people haven't much hope in following the World Health Organization (WHO) advice on washing hands and keeping their distance.
About one billion people live in slum-like conditions, making up 30% of the world's urban population. These housing facilities tend to have very little ventilation, drainage and sewage facilities, with diseases spreading easily...
About half of the students cannot afford soap... "Self-quarantine is not possible in many places"... "it will be difficult to get clean water to wash our hands multiple times"...
Coronavirus in Sudan: Food and medical supplies in short supply (Al Jazeera)
Sudan has only one confirmed death from the coronavirus so far, but many fear they will not be able to afford a doctor if they catch the disease. The government has announced a state of emergency and closed borders, and food prices are rising as shortages worsen.
As Europe and much of the developed world shuts down in the face of coronavirus, many millions of people haven't much hope in following the World Health Organization (WHO) advice on washing hands and keeping their distance.
About one billion people live in slum-like conditions, making up 30% of the world's urban population. These housing facilities tend to have very little ventilation, drainage and sewage facilities, with diseases spreading easily...
About half of the students cannot afford soap... "Self-quarantine is not possible in many places"... "it will be difficult to get clean water to wash our hands multiple times"...
Coronavirus in Sudan: Food and medical supplies in short supply (Al Jazeera)
Sudan has only one confirmed death from the coronavirus so far, but many fear they will not be able to afford a doctor if they catch the disease. The government has announced a state of emergency and closed borders, and food prices are rising as shortages worsen.
139margd
>131 davidgn: "Why Telling People They Don’t Need Masks Backfired"
Geez, CDC actually recommends, "In settings where facemasks are not available, HCP (healthcare professionals) might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort." (below)
Also below, Aiello AE et al. (2012) find mask-wearing somewhat protective against flu in a residential (dorm) setting. Moreover, a mask may block a sick person's cough. Even a well person accompanying a patient to emergency rooms during flu or Corona outbreaks might want to wear a mask.
Googling around, I found patterns for homemade, washable "surgical" masks, some with Twist-ties to mold around bridge of nose and with pockets for non-woven inserts. Some studies on their efficcay (below), but I bet they are sufficient for personal use, especially if they free up PPE (personal protective equipment) for healthcare professionals and their patients. Shocking that on its COVID-19 page, CDC recommend bandanas and scarves as last resort for these folks!
CDC
Corona Virus Disease 2019 (COVID-19)
Strategies for Optimizing the Supply of Facemasks
...When No Facemasks Are Available, Options Include
Exclude HCP (healthcare profssional) at higher risk for severe illness from COVID-19 from contact with known or suspected COVID-19 patients.
During severe resource limitations, consider excluding HCP who may be at higher risk for severe illness from COVID-19, such as those of older age, those with chronic medical conditions, or those who may be pregnant, from caring for patients with confirmed or suspected COVID-19 infection.
Designate convalescent HCP for provision of care to known or suspected COVID-19 patients.
It may be possible to designate HCP who have clinically recovered from COVID-19 to preferentially provide care for additional patients with COVID-19. Individuals who have recovered from COVID-19 infection may have developed some protective immunity, but this has not yet been confirmed.
Use a face shield that covers the entire front (that extends to the chin or below) and sides of the face with no facemask.
Consider use of expedient patient isolation rooms for risk reduction.
Portable fan devices with high-efficiency particulate air (HEPA) filtration that are carefully placed can increase the effective air changes per hour of clean air to the patient room, reducing risk to individuals entering the room without respiratory protection. NIOSH has developed guidance for using portable HEPA filtration systems to create expedient patient isolation rooms. The expedient patient isolation room approach involves establishing a high-ventilation-rate, negative pressure, inner isolation zone that sits within a “clean” larger ventilated zone.
Consider use of ventilated headboards
NIOSH has developed the ventilated headboard that draws exhaled air from a patient in bed into a HEPA filter, decreasing risk of HCP exposure to patient-generated aerosol. This technology consists of lightweight, sturdy, and adjustable aluminum framing with a retractable plastic canopy. The ventilated headboard can be deployed in combination with HEPA fan/filter units to provide surge isolation capacity within a variety of environments, from traditional patient rooms to triage stations, and emergency medical shelters.
HCP use of homemade masks:
In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
_______________________________________________________________
Aiello AE et al. (2012) Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial. PLoS ONE 7(1): e29744. https://doi.org/10.1371/journal.pone.0029744 https://www.researchgate.net/publication/221796236_Facemasks_Hand_Hygiene_and_In...
Abstract
Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007–2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio RR = 0.25, 95% CI, 0.07 to 0.87). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic.
________________________________________________________________
Can DIY Masks Protect Us from Coronavirus?
Paddy Robertson | 2020-03-04
Even "a single layer of cotton clothing or a tea towel can remove around 50-60% of virus-sized particles (c.f. compared with 80% for the surgical mask.) Wearing the homemade masks for 3 hours had no significant effect on the filtration efficiency."
"DIY masks also work for children, but they are less effective on kids than they are on adults" (probably due to difficulties with fit)...
https://smartairfilters.com/en/blog/diy-homemade-mask-protect-virus-coronavirus/
---------------------------------------------------------------------------------------------------------
Anna Davies et al. 2013. Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? Disaster Medicine and Public Health Preparedness 7(4):413-418 · August 2013. DOI: 10.1017/dmp.2013.43 https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homem...
Abstract
This study examined homemade masks as an alternative to commercial face masks. Several household materials were evaluated for the capacity to block bacterial and viral aerosols. Twenty-one healthy volunteers made their own face masks from cotton t-shirts; the masks were then tested for fit. The number of microorganisms isolated from coughs of healthy volunteers wearing their homemade mask, a surgical mask, or no mask was compared using several air-sampling techniques. The median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.
Geez, CDC actually recommends, "In settings where facemasks are not available, HCP (healthcare professionals) might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort." (below)
Also below, Aiello AE et al. (2012) find mask-wearing somewhat protective against flu in a residential (dorm) setting. Moreover, a mask may block a sick person's cough. Even a well person accompanying a patient to emergency rooms during flu or Corona outbreaks might want to wear a mask.
Googling around, I found patterns for homemade, washable "surgical" masks, some with Twist-ties to mold around bridge of nose and with pockets for non-woven inserts. Some studies on their efficcay (below), but I bet they are sufficient for personal use, especially if they free up PPE (personal protective equipment) for healthcare professionals and their patients. Shocking that on its COVID-19 page, CDC recommend bandanas and scarves as last resort for these folks!
CDC
Corona Virus Disease 2019 (COVID-19)
Strategies for Optimizing the Supply of Facemasks
...When No Facemasks Are Available, Options Include
Exclude HCP (healthcare profssional) at higher risk for severe illness from COVID-19 from contact with known or suspected COVID-19 patients.
During severe resource limitations, consider excluding HCP who may be at higher risk for severe illness from COVID-19, such as those of older age, those with chronic medical conditions, or those who may be pregnant, from caring for patients with confirmed or suspected COVID-19 infection.
Designate convalescent HCP for provision of care to known or suspected COVID-19 patients.
It may be possible to designate HCP who have clinically recovered from COVID-19 to preferentially provide care for additional patients with COVID-19. Individuals who have recovered from COVID-19 infection may have developed some protective immunity, but this has not yet been confirmed.
Use a face shield that covers the entire front (that extends to the chin or below) and sides of the face with no facemask.
Consider use of expedient patient isolation rooms for risk reduction.
Portable fan devices with high-efficiency particulate air (HEPA) filtration that are carefully placed can increase the effective air changes per hour of clean air to the patient room, reducing risk to individuals entering the room without respiratory protection. NIOSH has developed guidance for using portable HEPA filtration systems to create expedient patient isolation rooms. The expedient patient isolation room approach involves establishing a high-ventilation-rate, negative pressure, inner isolation zone that sits within a “clean” larger ventilated zone.
Consider use of ventilated headboards
NIOSH has developed the ventilated headboard that draws exhaled air from a patient in bed into a HEPA filter, decreasing risk of HCP exposure to patient-generated aerosol. This technology consists of lightweight, sturdy, and adjustable aluminum framing with a retractable plastic canopy. The ventilated headboard can be deployed in combination with HEPA fan/filter units to provide surge isolation capacity within a variety of environments, from traditional patient rooms to triage stations, and emergency medical shelters.
HCP use of homemade masks:
In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
_______________________________________________________________
Aiello AE et al. (2012) Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial. PLoS ONE 7(1): e29744. https://doi.org/10.1371/journal.pone.0029744 https://www.researchgate.net/publication/221796236_Facemasks_Hand_Hygiene_and_In...
Abstract
Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007–2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio RR = 0.25, 95% CI, 0.07 to 0.87). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic.
________________________________________________________________
Can DIY Masks Protect Us from Coronavirus?
Paddy Robertson | 2020-03-04
Even "a single layer of cotton clothing or a tea towel can remove around 50-60% of virus-sized particles (c.f. compared with 80% for the surgical mask.) Wearing the homemade masks for 3 hours had no significant effect on the filtration efficiency."
"DIY masks also work for children, but they are less effective on kids than they are on adults" (probably due to difficulties with fit)...
https://smartairfilters.com/en/blog/diy-homemade-mask-protect-virus-coronavirus/
---------------------------------------------------------------------------------------------------------
Anna Davies et al. 2013. Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? Disaster Medicine and Public Health Preparedness 7(4):413-418 · August 2013. DOI: 10.1017/dmp.2013.43 https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homem...
Abstract
This study examined homemade masks as an alternative to commercial face masks. Several household materials were evaluated for the capacity to block bacterial and viral aerosols. Twenty-one healthy volunteers made their own face masks from cotton t-shirts; the masks were then tested for fit. The number of microorganisms isolated from coughs of healthy volunteers wearing their homemade mask, a surgical mask, or no mask was compared using several air-sampling techniques. The median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.
140margd
ADA Calls Upon Dentists to Postpone Elective Procedures
March 16, 2020
Contact Information: mediarelations@ada.org
The American Dental Association (ADA) recognizes the unprecedented and extraordinary circumstances dentists and all health care professionals face related to growing concern about COVID-19. The ADA is deeply concerned for the health and well-being of the public and the dental team.
In order for dentistry to do its part to mitigate the spread of COVID-19, the ADA recommends dentists nationwide postpone elective procedures for the next three weeks. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.
As health care professionals, it is up to dentists to make well-informed decisions about their patients and practices. The ADA is committed to providing the latest information to the profession in a useful and timely manner.
The ADA is continually evaluating and will update its recommendation on an ongoing basis as new information becomes available. Please visit ADA.org/virus for the latest information.
https://www.ada.org/en/press-room/news-releases/2020-archives/march/ada-calls-up...
March 16, 2020
Contact Information: mediarelations@ada.org
The American Dental Association (ADA) recognizes the unprecedented and extraordinary circumstances dentists and all health care professionals face related to growing concern about COVID-19. The ADA is deeply concerned for the health and well-being of the public and the dental team.
In order for dentistry to do its part to mitigate the spread of COVID-19, the ADA recommends dentists nationwide postpone elective procedures for the next three weeks. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.
As health care professionals, it is up to dentists to make well-informed decisions about their patients and practices. The ADA is committed to providing the latest information to the profession in a useful and timely manner.
The ADA is continually evaluating and will update its recommendation on an ongoing basis as new information becomes available. Please visit ADA.org/virus for the latest information.
https://www.ada.org/en/press-room/news-releases/2020-archives/march/ada-calls-up...
141John5918
WHO head tells Africa to 'wake up' to coronavirus threat (BBC)
Africa must "wake up" to the coronavirus threat and prepare for the worst, the head of the World Health Organization (WHO) has said. The continent should learn from how the spread of virus has sped up elsewhere, Tedros Adhanom Ghebreyesus said. He warned that while Africa's confirmed cases were currently low - around 640 - there was no reason for complacency. "Africa should wake up, my continent should wake up," said the Ethiopian, the WHO's first African head...
Africa must "wake up" to the coronavirus threat and prepare for the worst, the head of the World Health Organization (WHO) has said. The continent should learn from how the spread of virus has sped up elsewhere, Tedros Adhanom Ghebreyesus said. He warned that while Africa's confirmed cases were currently low - around 640 - there was no reason for complacency. "Africa should wake up, my continent should wake up," said the Ethiopian, the WHO's first African head...
142margd
>137 margd:
Advice From France To Avoid Ibuprofen For COVID-19 Leaves Experts Baffled
Maria Godoy | March 18, 2020
...The questions about ibuprofen's safety for COVID-19 patients seem to have stemmed, in part, from a letter published in The Lancet last week hypothesizing the ways various medications could, perhaps, increase the risk of infection with the coronavirus. Research has shown that the virus attaches itself to cells in the lungs by way of an enzyme — angiotensin-converting enzyme 2 (ACE2). The Lancet commentary suggested that taking ibuprofen might increase the number of ACE2 receptors on a cell, which could make someone taking the drug more vulnerable to infection.
But just because you have more ACE2 receptors doesn't mean you're more susceptible to infection, says Rachel Graham, a virologist at the University of North Carolina Gillings School of Global Public Health. She's one of the researchers who discovered how the coronavirus binds to cells.
"You can have low levels of ACE2 and still be susceptible," Graham says. What's more, she adds, the evidence that taking ibuprofen increases these receptors is almost nonexistent.
"This is why we have clinical trials to inform our medical decision-making," rather than relying on a few anecdotal cases, says Dr. Krutika Kuppalli, an infectious disease physician and fellow with the Johns Hopkins University Center for Health Security. Kuppalli says she doesn't see the Lancet letter as a reason to avoid ibuprofen for COVID-19, though she always tells her patients to use Tylenol for fever "because its mechanism is thought to affect the temperature regulating center of the brain."
Dr. Angela Rogers, a pulmonologist at the Stanford University Medical Center and chair of its intensive care unit's COVID-19 task force, notes that Tylenol is the go-to medication for patients who are sick enough to be hospitalized for any infection. That's because these patients are at higher risk of damage to internal organs, including kidneys. And kidney damage can be a side effect of ibuprofen for some patients who use it long-term in higher doses, says Rogers, whose research focuses on the kind of acute respiratory distress experienced by the most severe COVID-19 cases.
Of course Tylenol, like any medicine, isn't risk-free either; Rogers notes that acetaminophen can cause serious liver damage in high doses. In low doses, though, she says, Tylenol is "very effective" for reducing fever and "very safe."...
https://www.npr.org/sections/health-shots/2020/03/18/818026613/advice-from-franc...
Advice From France To Avoid Ibuprofen For COVID-19 Leaves Experts Baffled
Maria Godoy | March 18, 2020
...The questions about ibuprofen's safety for COVID-19 patients seem to have stemmed, in part, from a letter published in The Lancet last week hypothesizing the ways various medications could, perhaps, increase the risk of infection with the coronavirus. Research has shown that the virus attaches itself to cells in the lungs by way of an enzyme — angiotensin-converting enzyme 2 (ACE2). The Lancet commentary suggested that taking ibuprofen might increase the number of ACE2 receptors on a cell, which could make someone taking the drug more vulnerable to infection.
But just because you have more ACE2 receptors doesn't mean you're more susceptible to infection, says Rachel Graham, a virologist at the University of North Carolina Gillings School of Global Public Health. She's one of the researchers who discovered how the coronavirus binds to cells.
"You can have low levels of ACE2 and still be susceptible," Graham says. What's more, she adds, the evidence that taking ibuprofen increases these receptors is almost nonexistent.
"This is why we have clinical trials to inform our medical decision-making," rather than relying on a few anecdotal cases, says Dr. Krutika Kuppalli, an infectious disease physician and fellow with the Johns Hopkins University Center for Health Security. Kuppalli says she doesn't see the Lancet letter as a reason to avoid ibuprofen for COVID-19, though she always tells her patients to use Tylenol for fever "because its mechanism is thought to affect the temperature regulating center of the brain."
Dr. Angela Rogers, a pulmonologist at the Stanford University Medical Center and chair of its intensive care unit's COVID-19 task force, notes that Tylenol is the go-to medication for patients who are sick enough to be hospitalized for any infection. That's because these patients are at higher risk of damage to internal organs, including kidneys. And kidney damage can be a side effect of ibuprofen for some patients who use it long-term in higher doses, says Rogers, whose research focuses on the kind of acute respiratory distress experienced by the most severe COVID-19 cases.
Of course Tylenol, like any medicine, isn't risk-free either; Rogers notes that acetaminophen can cause serious liver damage in high doses. In low doses, though, she says, Tylenol is "very effective" for reducing fever and "very safe."...
https://www.npr.org/sections/health-shots/2020/03/18/818026613/advice-from-franc...
143John5918
From the Strategic Initiative for Women in the Horn of Africa:
CORONAVIRUS DOS AND DON'TS ARE BLIND TO URBAN POOR WOMEN'S REALITIES
CORONAVIRUS DOS AND DON'TS ARE BLIND TO URBAN POOR WOMEN'S REALITIES
SIHA Network is a regional network that operates among women in urban slum communities and IDP and migrant women and girls across the greater Horn of Africa.
The latest global warnings and protection guidance regarding Coronavirus (COVID-19) has been, in our view, largely a conversation among the privileged. The risk mitigation afforded by these prevention measures leaves out those who do not have access or only have limited access to 1) information 2) sanitizers/disinfectants, and 3) soap and clean water. These global proclamations further show a callous indifference to the fact that much of the world’s population lives in a state of precarity which does not permit them to continue to access food and an income in the event of widespread public shutdown. Meaning that if complementary measures are not taken, the implementation of social distancing would destroy the livelihoods of urban slum communities across the Greater Horn of Africa region.
In light of the spread of coronavirus, we are very concerned about women street vendors, domestic workers, alcohol brewers and all other women in the highly diverse but often invisible informal economy across the region. SIHA works with hundreds of women and girls who are involved in group activities and whose livelihoods are inseparable from their presence among crowds and congested areas. If these women do not go to work or if their customers disappear due to self-quarantining, the survival of these women and their families will be at serious risk.
Special attention must also be paid to women and girls who are migrants, refugees, and prisoners as the circumstances in which they live often significantly compromise their access to soap, clean water, and the ability to implement safe social distancing. These populations, like the women living in urban slum communities and working in the informal labor sector, have different needs in the face of a coronavirus pandemic which must be understood and met by local, national, and international actors who all have a responsibility to contribute to the health and safety of these women...
144margd
>131 davidgn: >139 margd: Masks, contd.
N95 Masks vs. Surgical Masks: Which Is Better at Preventing The Coronavirus?
Thomas Talhelm | 2020-03-01
The Surgical Mask vs. N95 Mask Test
Scientists tested this question by randomly assigning over 2,000 nurses to wear N95 or surgical masks. Then they tracked how many of them caught the flu. (Rates of infection were the same.)
https://smartairfilters.com/en/blog/n95-mask-surgical-prevent-transmission-coron...
---------------------------------------------------------------------------------------------------------------
Lewis J. Radonovich Jr t al. 2019. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care PersonnelA Randomized Clinical Trial. JAMA. September 3, 2019;322(9):824-833. doi:10.1001/jama.2019.11645 https://jamanetwork.com/journals/jama/article-abstract/2749214
Question Is the use of N95 respirators or medical masks more effective in preventing influenza infection among outpatient health care personnel in close contact with patients with suspected respiratory illness?
Findings In this pragmatic, cluster randomized clinical trial involving 2862 health care personnel, there was no significant difference in the incidence of laboratory-confirmed influenza among health care personnel with the use of N95 respirators (8.2%) vs medical masks (7.2%).
Meaning As worn by health care personnel in this trial, use of N95 respirators, compared with medical masks, in the outpatient setting resulted in no significant difference in the rates of laboratory-confirmed influenza.
-----------------------------------------------------------------------------------------------------------------
Thomas R. Talbot and Hilary M. Babcock. 2019. Respiratory Protection of Health Care Personnel to Prevent Respiratory Viral Transmission ( Editorial)
JAMA. September 3, 2019;322(9):817-819. doi:10.1001/jama.2019.11644 https://jamanetwork.com/journals/jama/article-abstract/2749198
Influenza and other respiratory viruses continue to cause patient morbidity and mortality, including health care utilization for outpatient visits and inpatient and intensive care unit care. Occupational health and infection-prevention programs partner to prevent these infections among health care personnel (HCP) and their patients through a multifaceted approach that includes comprehensive strategies to achieve high rates of influenza vaccination, rational sick leave and attendance policies that do not reward coming to work while ill (presenteeism), early identification and isolation of possibly infected patients, and appropriate use of personal protective equipment (PPE). While influenza still gets the most attention, these efforts also protect HCP from other respiratory infections...
------------------------------------------------------------------------------------------------------------------
C. Raina MacIntyre et al. 2009, Face Mask Use and Control of Respiratory Virus Transmission in Households. Emerging Infectious Diseases. Volume 15, Number 2—February 2009. https://wwwnc.cdc.gov/eid/article/15/2/08-1167_article
Abstract
Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but
N95 Masks vs. Surgical Masks: Which Is Better at Preventing The Coronavirus?
Thomas Talhelm | 2020-03-01
The Surgical Mask vs. N95 Mask Test
Scientists tested this question by randomly assigning over 2,000 nurses to wear N95 or surgical masks. Then they tracked how many of them caught the flu. (Rates of infection were the same.)
https://smartairfilters.com/en/blog/n95-mask-surgical-prevent-transmission-coron...
---------------------------------------------------------------------------------------------------------------
Lewis J. Radonovich Jr t al. 2019. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care PersonnelA Randomized Clinical Trial. JAMA. September 3, 2019;322(9):824-833. doi:10.1001/jama.2019.11645 https://jamanetwork.com/journals/jama/article-abstract/2749214
Question Is the use of N95 respirators or medical masks more effective in preventing influenza infection among outpatient health care personnel in close contact with patients with suspected respiratory illness?
Findings In this pragmatic, cluster randomized clinical trial involving 2862 health care personnel, there was no significant difference in the incidence of laboratory-confirmed influenza among health care personnel with the use of N95 respirators (8.2%) vs medical masks (7.2%).
Meaning As worn by health care personnel in this trial, use of N95 respirators, compared with medical masks, in the outpatient setting resulted in no significant difference in the rates of laboratory-confirmed influenza.
-----------------------------------------------------------------------------------------------------------------
Thomas R. Talbot and Hilary M. Babcock. 2019. Respiratory Protection of Health Care Personnel to Prevent Respiratory Viral Transmission ( Editorial)
JAMA. September 3, 2019;322(9):817-819. doi:10.1001/jama.2019.11644 https://jamanetwork.com/journals/jama/article-abstract/2749198
Influenza and other respiratory viruses continue to cause patient morbidity and mortality, including health care utilization for outpatient visits and inpatient and intensive care unit care. Occupational health and infection-prevention programs partner to prevent these infections among health care personnel (HCP) and their patients through a multifaceted approach that includes comprehensive strategies to achieve high rates of influenza vaccination, rational sick leave and attendance policies that do not reward coming to work while ill (presenteeism), early identification and isolation of possibly infected patients, and appropriate use of personal protective equipment (PPE). While influenza still gets the most attention, these efforts also protect HCP from other respiratory infections...
------------------------------------------------------------------------------------------------------------------
C. Raina MacIntyre et al. 2009, Face Mask Use and Control of Respiratory Virus Transmission in Households. Emerging Infectious Diseases. Volume 15, Number 2—February 2009. https://wwwnc.cdc.gov/eid/article/15/2/08-1167_article
Abstract
Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but
145margd
>139 margd: >144 margd:
What Are The Best Materials for Making DIY Masks?
2020-03-08 Paddy Robertson
...the dish towel and vacuum cleaner bag were the top-performing materials. However, the researchers (Davies et al. 2013 in >139 margd:) didn’t choose these as the best materials for DIY masks:
Pillowcase and cotton t-shirt best for homemade DIY mask
Instead, they concluded the pillowcase and the 100% cotton t-shirt are the best materials for DIY masks. Why?
The answer lies in breathability. How easy it is to breathe through your mask is an important factor that will affect how comfortable it is. And comfort isn’t merely a luxury. Comfort will influence how long you can wear your mask...
https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/
____________________________________________________________
DIY Masks: Is Paper Towel Effective at Blocking Viruses?
Paddy Robertson | 2020-03-08
...results weren’t great. A single layer of kitchen paper captured just 23% particles. Adding an extra layer only increased particle capture to 33%.
...Bottom line: Paper towel captured fewer particles than other DIY mask materials tested by researchers at Cambridge. However, if it is the only material you have, it is better than nothing...
...Studies Find Mask Leakage Has Small Effect on Flu Virus Transmission
Although surgical masks (and presumably DIY masks) are more leaky than N95 masks, randomized studies that have tracked infection rates have found that surgical masks are just as effective as N95 masks at preventing the transmission of viruses (Radonovich et al 2019 in >144 margd:). Researchers don’t know the exact reason for this. However, some scientists hypothesize that masks help, in part, because they prevent us from touching our face. That helps keeps us from “planting” viruses our mouth, nose, and eyes...
https://smartairfilters.com/en/blog/paper-towel-effective-against-viruses-diy-ma...
What Are The Best Materials for Making DIY Masks?
2020-03-08 Paddy Robertson
...the dish towel and vacuum cleaner bag were the top-performing materials. However, the researchers (Davies et al. 2013 in >139 margd:) didn’t choose these as the best materials for DIY masks:
Pillowcase and cotton t-shirt best for homemade DIY mask
Instead, they concluded the pillowcase and the 100% cotton t-shirt are the best materials for DIY masks. Why?
The answer lies in breathability. How easy it is to breathe through your mask is an important factor that will affect how comfortable it is. And comfort isn’t merely a luxury. Comfort will influence how long you can wear your mask...
https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/
____________________________________________________________
DIY Masks: Is Paper Towel Effective at Blocking Viruses?
Paddy Robertson | 2020-03-08
...results weren’t great. A single layer of kitchen paper captured just 23% particles. Adding an extra layer only increased particle capture to 33%.
...Bottom line: Paper towel captured fewer particles than other DIY mask materials tested by researchers at Cambridge. However, if it is the only material you have, it is better than nothing...
...Studies Find Mask Leakage Has Small Effect on Flu Virus Transmission
Although surgical masks (and presumably DIY masks) are more leaky than N95 masks, randomized studies that have tracked infection rates have found that surgical masks are just as effective as N95 masks at preventing the transmission of viruses (Radonovich et al 2019 in >144 margd:). Researchers don’t know the exact reason for this. However, some scientists hypothesize that masks help, in part, because they prevent us from touching our face. That helps keeps us from “planting” viruses our mouth, nose, and eyes...
https://smartairfilters.com/en/blog/paper-towel-effective-against-viruses-diy-ma...
146margd
Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S.
Pam Belluck | March 18, 2020
New C.D.C. data showed that nearly 40 percent of patients sick enough to be hospitalized were aged 20 to 54. But the risk of dying was significantly higher in older people.
...The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported.
“I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University’s Mailman School of Public Health. “It’s not just going to be the elderly. There will be people age 20 and up. They do have to be careful, even if they think that they’re young and healthy.”...
https://www.nytimes.com/2020/03/18/health/coronavirus-young-people.html
*Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep. ePub: 18 March 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2 https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
Pam Belluck | March 18, 2020
New C.D.C. data showed that nearly 40 percent of patients sick enough to be hospitalized were aged 20 to 54. But the risk of dying was significantly higher in older people.
...The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported.
“I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University’s Mailman School of Public Health. “It’s not just going to be the elderly. There will be people age 20 and up. They do have to be careful, even if they think that they’re young and healthy.”...
https://www.nytimes.com/2020/03/18/health/coronavirus-young-people.html
*Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep. ePub: 18 March 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2 https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
147margd
Interesting: I take the last drug mentioned (Losartan) for hypertension.
DH and I are beginning to think we may have already had COVID-19, based on symptoms and incubation times after Jan 16 when he visited an emergency dept. in St Augustine, FL filled with people he thought had the flu. The good news--if we 67YOs had COVID-19--is that intensity was similar to bad bout of flu that didn't send one to MD, but duration was longer. The course of COVID-2019, if that's what it was, didn't differ between us much, though I was on Losartan. (N=1, so anecdotal!) Both of us were vaccinated last fall for flu.
Another good aspect to our COVID-19 experience, if that's what it was, is that exposure doesn't necessarily result in infection. Our 26YO son's cut hand was reason DH was in the St Augustine emergency room, and son (vaxxed) did not seem to have been infected--there at least. (He had a cough today on the phone.) Neither was our 31YO son (unvaxxed) who lives with us in Michigan and was thus exposed to full course of my illness and post-fever last half of DH's. We tried to stay away from him, using separate bathroom, etc.
Sure wish we could be tested for antibodies. If we knew we were now immune, we could dispense with social distancing and be more of a help.
(Stuff we took during our illnesses: zinc lozenges, elderberry, acetaminophen, expectorant (Mucinex/guafesin).)
A Promising Treatment for Coronavirus Fails
Denise Grady | March 18, 2020
Antiviral drugs that had held promise as a potential treatment for the coronavirus did not work in one of the first major studies in seriously ill patients, researchers from China reported on Wednesday.
“No benefit was observed,” the researchers wrote in The New England Journal of Medicine.
The study tested Kaletra, a combination of two antiviral medicines, lopinavir and ritonavir, that are normally used to treat H.I.V.
Even though the results were disappointing, the researchers said that this one study was not the last word, and suggested that more studies might determine whether the drugs would work if given earlier in the illness or in combination with other medicines...
hydroxychloroquine...
Gilead’s experimental antiviral drug remdesivir...
tocilizumab...
losartan...The third study will use an old, safe drug called losartan, normally given to treat high blood pressure, to find out whether it can prevent mild coronavirus infections from turning more serious. The drug blocks the receptor that the virus uses to get into cells, so researchers think it might stop or slow the illness...
https://www.nytimes.com/2020/03/18/health/coronavirus-antiviral-drugs-fail.html
DH and I are beginning to think we may have already had COVID-19, based on symptoms and incubation times after Jan 16 when he visited an emergency dept. in St Augustine, FL filled with people he thought had the flu. The good news--if we 67YOs had COVID-19--is that intensity was similar to bad bout of flu that didn't send one to MD, but duration was longer. The course of COVID-2019, if that's what it was, didn't differ between us much, though I was on Losartan. (N=1, so anecdotal!) Both of us were vaccinated last fall for flu.
Another good aspect to our COVID-19 experience, if that's what it was, is that exposure doesn't necessarily result in infection. Our 26YO son's cut hand was reason DH was in the St Augustine emergency room, and son (vaxxed) did not seem to have been infected--there at least. (He had a cough today on the phone.) Neither was our 31YO son (unvaxxed) who lives with us in Michigan and was thus exposed to full course of my illness and post-fever last half of DH's. We tried to stay away from him, using separate bathroom, etc.
Sure wish we could be tested for antibodies. If we knew we were now immune, we could dispense with social distancing and be more of a help.
(Stuff we took during our illnesses: zinc lozenges, elderberry, acetaminophen, expectorant (Mucinex/guafesin).)
A Promising Treatment for Coronavirus Fails
Denise Grady | March 18, 2020
Antiviral drugs that had held promise as a potential treatment for the coronavirus did not work in one of the first major studies in seriously ill patients, researchers from China reported on Wednesday.
“No benefit was observed,” the researchers wrote in The New England Journal of Medicine.
The study tested Kaletra, a combination of two antiviral medicines, lopinavir and ritonavir, that are normally used to treat H.I.V.
Even though the results were disappointing, the researchers said that this one study was not the last word, and suggested that more studies might determine whether the drugs would work if given earlier in the illness or in combination with other medicines...
hydroxychloroquine...
Gilead’s experimental antiviral drug remdesivir...
tocilizumab...
losartan...The third study will use an old, safe drug called losartan, normally given to treat high blood pressure, to find out whether it can prevent mild coronavirus infections from turning more serious. The drug blocks the receptor that the virus uses to get into cells, so researchers think it might stop or slow the illness...
https://www.nytimes.com/2020/03/18/health/coronavirus-antiviral-drugs-fail.html
148Marissa_Doyle
>147 margd: I'll be interested to see what results are had with hydroxychloroquine, as I'm on it for rheumatoid arthritis. It's fairly widely prescribed for that.
149clamairy
I found this info on a number or websites. It's not reason to panic if you're not type O.
(I am, and so are both of my children, and I only feel slightly less terrified now.)
"China COVID-19 study: blood type O are more resistant, type A are more susceptible to infection"
https://www.msn.com/en-sg/news/world/china-covid-19-study-blood-type-o-are-more-...
(I am, and so are both of my children, and I only feel slightly less terrified now.)
"China COVID-19 study: blood type O are more resistant, type A are more susceptible to infection"
https://www.msn.com/en-sg/news/world/china-covid-19-study-blood-type-o-are-more-...
150RickHarsch
I just read that in Bergamo, Italy, which may have the highest death rate of medium to large cities in the country, doctors had been coming across odd cases of pneumonia as far back as November, maybe even before. Such anecdotal evidence supports the notion that far too little is known about this virus to draw any conclusions other than that it is highly contagious and potentially fatal. I'm not surprised that a high percentage of cases in the US has stricken a younger population, as the first information was that virtually no one 'young' was dying from it. One result of that could be that younger people have been more careless when it has come to heeding warnings. We don't even know that the virus originated in China. If it did, the next question would be why/how it reached Italy so early (maybe).
151margd
>148 Marissa_Doyle: Great that our meds may help people battle this virus. Could greatly increase demand though--hope supplies are up to it!
152lriley
Just a warning. People should be careful about clicking into a livemap for Coronavirus Covid-19 cases purported to be from Johns Hopkins. An alert over at my hockey site has that map site infecting those who click on it with something called a AZORult trojan.
153oregonobsessionz
>139 margd:
It makes sense that fabrics that are more effective at blocking the virus are also harder to breathe through. Cotton seems to be moderately effective. That tracks with info showing that the virus is long lasting on hard surfaces, especially plastic, and less so on rough/porous surfaces like cardboard.
Hmmm, I am thinking that pima cotton (very thin fibers / high thread count fabric) should be more effective than T-shirts or pillowcases, without the thickness and air resistance of a tea towel. Outer layer of pima cotton, with a liner made from T-shirts, might trap droplets on the outer surface, while being comfortable to wear. Cotton tolerates washing in very hot water, so make several and change them frequently.
It makes sense that fabrics that are more effective at blocking the virus are also harder to breathe through. Cotton seems to be moderately effective. That tracks with info showing that the virus is long lasting on hard surfaces, especially plastic, and less so on rough/porous surfaces like cardboard.
Hmmm, I am thinking that pima cotton (very thin fibers / high thread count fabric) should be more effective than T-shirts or pillowcases, without the thickness and air resistance of a tea towel. Outer layer of pima cotton, with a liner made from T-shirts, might trap droplets on the outer surface, while being comfortable to wear. Cotton tolerates washing in very hot water, so make several and change them frequently.
154oregonobsessionz
>150 RickHarsch:
I don't like that news from Bergamo. I am reasonably healthy, and have not had even a cold in many years. But in mid November, I was housebound in bed for nearly a week, totally exhausted and with a tight dry cough that still lingers. I had a few sniffles early on, and vomited several times, but no fever or body aches, so assumed it was just a cold and not flu.
Now I am wondering if there is any chance that cold might have been COVID-19. The first case diagnosed in Oregon, late in February, was someone who works in my county. I hope I was not walking around spreading this virus! As mitigating factors, I have a large personal "no-fly" zone, and am mildly germophobic, so the current recommendations for social distancing and hand washing were already SOP for me. I should go and get tested once the pent up demand subsides. If I have immunity, I could do something useful - deliver food to people in isolation, or whatever.
I don't like that news from Bergamo. I am reasonably healthy, and have not had even a cold in many years. But in mid November, I was housebound in bed for nearly a week, totally exhausted and with a tight dry cough that still lingers. I had a few sniffles early on, and vomited several times, but no fever or body aches, so assumed it was just a cold and not flu.
Now I am wondering if there is any chance that cold might have been COVID-19. The first case diagnosed in Oregon, late in February, was someone who works in my county. I hope I was not walking around spreading this virus! As mitigating factors, I have a large personal "no-fly" zone, and am mildly germophobic, so the current recommendations for social distancing and hand washing were already SOP for me. I should go and get tested once the pent up demand subsides. If I have immunity, I could do something useful - deliver food to people in isolation, or whatever.
155oregonobsessionz
Washington Post reports that rural areas may be the most vulnerable to COVID-19. Death rates are higher in absolute numbers in urban areas, but % rates are higher in rural areas.
https://www.washingtonpost.com/nation/2020/03/19/rural-areas-may-be-most-vulnera...
https://www.washingtonpost.com/nation/2020/03/19/rural-areas-may-be-most-vulnera...
156John5918
Coronavirus: How bad information goes viral (BBC)
There's a huge amount of misleading information circulating online about coronavirus - from dodgy health tips to speculation about government plans. This is the story of how one post went viral...
There's a huge amount of misleading information circulating online about coronavirus - from dodgy health tips to speculation about government plans. This is the story of how one post went viral...
This topic was continued by SARS-CoV-2 and COVID-19 (3).
