COVID-19 (f/k/a "the Coronavirus")

[pbiflyer]

I think people are working hard to find reasons beyond the obvious. Southern states have less buy in on things like wearing masks. The result, more cases.

I think that is reason number 1, particularly as it relates to young people who are a vector of spread.

There was an event here on Sunday that culminated with about 300 people in a bar (outdoor at least) celebrating without masks. And we had our highest reported cases day ever this past week for our county.  I suspect it will get higher in the coming weeks.

[shoothoops]

Wear a mask:


https://www.nytimes.com/2020/06/16/health/coronavirus-toilets-flushing.html#click=https://t.co/nQDCSbVeWu

[Frenns Liquor Depot]

All of these studies really make the rest of my non-corona life seem so much more disgusting

[mu03eng]

I think people are working hard to find reasons beyond the obvious. Southern states have less buy in on things like wearing masks. The result, more cases.

I think that is reason number 1, particularly as it relates to young people who are a vector of spread.

Now explain California and Washington state.

The point I'm making is this is a multi-faceted issue and the reductive nature of the discourse(its cause we opened up, yeah but protests, no it's really young people, etc. Etc etc) is part of the problem.

[shoothoops]

Checking in on Florida:

https://twitter.com/MikeVorkunov/status/1272924457393442818?s=19

[injuryBug]

We just need to learn to live with Covid-19.  It is not going away anytime soon and I do not see us going back to lockdown. 
This is where a unified country would be nice.   

Still cannot believe Trump did not come out for press conferences with a MAGA mask on.  That right there would have made this a whole different story

[forgetful]

Now explain California and Washington state.

The point I'm making is this is a multi-faceted issue and the reductive nature of the discourse(its cause we opened up, yeah but protests, no it's really young people, etc. Etc etc) is part of the problem.

I never said there was only 1 reason. But looking for things like AC to explain the south, is a stretch. There is an obvious reason for why the south is seeing increased cases.

For states like California and Washington, we need far more data than I have access to. I know some of the hot spots in California are in rural counties, where again buy in on masks is limited. You also have a large number of people that are now returning to work, that must take mass transit. There are a variety of factors at play and one needs very localized data on hot spots (which isn't always available) to discern the effects.

Large swaths of the south though have a glaring obvious answer. People refuse to wear masks, the single most effective way to limit the spread of the disease.

[The Hippie Satan of Hyperbole]

We just need to learn to live with Covid-19.  It is not going away anytime soon and I do not see us going back to lockdown. 
This is where a unified country would be nice. 

As long as the hospitals don't get overrun.

[MU82]

Wasn't the heat and sun supposed to eradicate this? I'm not saying this to be snarky. I know Trump and others were saying this as a fact when actually it was more hope than anything, but lots of "experts" were saying it, too.

And yet,  the worst situations right now when I look at my handy-dandy "coronavirus reopening map" seem to be in Arizona, Nevada, Arkansas, Alabama, South Carolina, Florida, North Carolina and Louisiana.

I don't think it's a coincidence that, by and large, this generally is "Eff the masks and social distancing" territory, but I allow that I could be wrong.

As someone pointed out, Wash and Oregon look to be trending worse, too, though their arrows aren't pointing up as sharply as the others.

[GooooMarquette]

Identifying the risk factors is actually really straight forward as you've largely identified them. As you have more risk factors and modified by your behavior that gives you an idea of what your risk is for A) contracting it and B) the likely impact if you do contract it. We have enough data to model that and basically do a risk calculator for people. I'd be very interested in a Google project or WebMD or something along those lines to allow me to go determine my risk model.

As to the blood type, if you read the article you linked and the supporting articles the blood type is very likely a correlation but not causation.

Correct - I never said otherwise. But if the correlation proves correct, it would still mean type A people are at higher risk of contracting the virus, and of more severe illness.

[mu03eng]

Correct - I never said otherwise. But if the correlation proves correct, it would still mean type A people are at higher risk of contracting the virus, and of more severe illness.

I wake up every morning and the sun also rises in the east every morning, the correlation is correct but it don't mean $hit

[mu03eng]

I never said there was only 1 reason. But looking for things like AC to explain the south, is a stretch. There is an obvious reason for why the south is seeing increased cases.

For states like California and Washington, we need far more data than I have access to. I know some of the hot spots in California are in rural counties, where again buy in on masks is limited. You also have a large number of people that are now returning to work, that must take mass transit. There are a variety of factors at play and one needs very localized data on hot spots (which isn't always available) to discern the effects.

Large swaths of the south though have a glaring obvious answer. People refuse to wear masks, the single most effective way to limit the spread of the disease.

Here is where you lose me every time.....when the data sets match your hypothesis it's tied to a single root cause (masks) when the data sets don't match your hypothesis it's tied to all sorts of root causes that can't be separated ("variety of factors at play").

Maybe you don't realize it, but you can't separate your political narrative from your situational analysis (you have a conclusion in your head and you are fitting the data to match that conclusion)

[GooooMarquette]

I wake up every morning and the sun also rises in the east every morning, the correlation is correct but it don't mean $hit

You obviously don't understand medical risk factors. They are simply identifiable traits, behaviors or other factors that make someone more susceptible than the average person. So it doesn't matter if it's causative or correlative - a risk factor is a risk factor. And thus far, the data seems to show that having type A blood might be a risk factor for covid.

And seriously - do you think the person on his or her deathbed from covid really gives a $hit if he is about to die from covid because he was obese vs having type A blood? Seriously?

[mu03eng]

Wasn't the heat and sun supposed to eradicate this? I'm not saying this to be snarky. I know Trump and others were saying this as a fact when actually it was more hope than anything, but lots of "experts" were saying it, too.

And yet,  the worst situations right now when I look at my handy-dandy "coronavirus reopening map" seem to be in Arizona, Nevada, Arkansas, Alabama, South Carolina, Florida, North Carolina and Louisiana.

I don't think it's a coincidence that, by and large, this generally is "Eff the masks and social distancing" territory, but I allow that I could be wrong.

As someone pointed out, Wash and Oregon look to be trending worse, too, though their arrows aren't pointing up as sharply as the others.

Everyone is assuming that because if it isn't true the places where there were protests are unnatural carnal knowledge$D. Honestly, there is no evidence that outdoor transmission is much of a thing (mask protests, only one infection as the result of the Ozarks Memorial Day fiasco, beaches and parks being open for a couple of months, etc).

I honestly can't say why these regions are going up because the data we have access to is inconclusive or missing:
-The increase is both with early open states(Texas) and late open states (Washington)
-I've seen no data on the consistency/usage of masks
-I've seen no data on outbreaks from outdoor versus indoor sources
-Limited demographic breakdown of the current outbreak (ie who is getting infected and/or hospitalized).
etc

But ultimately this is why I'm fighting all the various narratives because we just don't know and the narratives are largely driven along political lines. A couple of hypothesis off the top of my head:
1. It takes at least 6 weeks from "paradigm shift" (re-opening, protests, etc) for it to show up in the infection/hospitalization rates
2. There are individual/localized hot spots that are triggering overall numbers to go up but not indicative of some paradigm shift
3. We've had a series of events that have created a growth funnel for infection that continually builds the infection rate (reopening, then memorial day weekend, then protests, then.....)
4. There is a mutated strain lose in these areas that is at least more infectious or resistant to our counter measures than we realize
5. Compliance exhaustion.....people are taking less and less precautions and being less diligent in their activities because it's been 4 months and/or they think it's passed/overblown.
6. Some combination of all of the above
7. Something I haven't thought of.

[MU82]

Everyone is assuming that because if it isn't true the places where there were protests are unnatural carnal knowledge$D. Honestly, there is no evidence that outdoor transmission is much of a thing (mask protests, only one infection as the result of the Ozarks Memorial Day fiasco, beaches and parks being open for a couple of months, etc).

I honestly can't say why these regions are going up because the data we have access to is inconclusive or missing:
-The increase is both with early open states(Texas) and late open states (Washington)
-I've seen no data on the consistency/usage of masks
-I've seen no data on outbreaks from outdoor versus indoor sources
-Limited demographic breakdown of the current outbreak (ie who is getting infected and/or hospitalized).
etc

But ultimately this is why I'm fighting all the various narratives because we just don't know and the narratives are largely driven along political lines. A couple of hypothesis off the top of my head:
1. It takes at least 6 weeks from "paradigm shift" (re-opening, protests, etc) for it to show up in the infection/hospitalization rates
2. There are individual/localized hot spots that are triggering overall numbers to go up but not indicative of some paradigm shift
3. We've had a series of events that have created a growth funnel for infection that continually builds the infection rate (reopening, then memorial day weekend, then protests, then.....)
4. There is a mutated strain lose in these areas that is at least more infectious or resistant to our counter measures than we realize
5. Compliance exhaustion.....people are taking less and less precautions and being less diligent in their activities because it's been 4 months and/or they think it's passed/overblown.
6. Some combination of all of the above
7. Something I haven't thought of.

Nicely articulated, mu03.

I'm hoping there will be a point where we have more answers than questions ... if not for this pandemic, then the next one. Because there will be a next one.

[Frenns Liquor Depot]

Eng no one knows for certain — Your hypotheses probably have some truth in them.  If there is a group that should have a POV, it’s the CDC. 

Truthfully the only thing that keeps coming up everywhere as a risk reducer is wear a mask.

My guess is the doctors figure out better treatments before we figure out the best public policy to battle this. 

[mu03eng]

You obviously don't understand medical risk factors. They are simply identifiable traits, behaviors or other factors that make someone more susceptible than the average person. So it doesn't matter if it's causative or correlative - a risk factor is a risk factor. And thus far, the data seems to show that having type A blood might be a risk factor for covid.

And seriously - do you think the person on his or her deathbed from covid really gives a $hit if he is about to die from covid because he was obese vs having type A blood? Seriously?

Not sure what your last line has anything to do with anything I said, but I would find it unlikely that a dying patient will care.

medical risk factors are the same as any other risk factor....statistical probability that having condition A will result in outcome B.

My point is that there are so many mechanisms of risk that are encompassed in blood type it may not be blood type that determines the outcome or that a certain blood type has higher risk than another. As an example from the article, Type A people have Type B antigens and vice versa while Type O has both, and perhaps transmission from one person of a blood type to person of another type is less prevalent/severe than transmission between two people of the same blood type. In that scenario the fact that someone has Type A only matters in that if they get infected by someone with Type A blood their viral load or whatever is higher than if they were infected by someone with B or O types.

Simply put, I'm highly skeptical, based on the data analysis I've seen, that in the long run it will turn out that the virus attacks people with Type A more than any other blood type. Is there a mechanism based on blood type that impacts transmission in some way, seems logical but I haven't stayed in a Holiday Inn Express recently. This is why correlation versus causation is so important.

More people of Type A blood have been infected than others (of confirmed infections) is that because Type A is riskier or is that because more Type As came in contact with Type As or is there no difference is transmission and Type As for some reason experience worst outcomes than any other blood type (your theory). Don't know, but there is definitely not enough evidence to say anything conclusively and add it to the list of risk factors.

[mu03eng]

Eng no one knows for certain — Your hypotheses probably have some truth in them.  If there is a group that should have a POV, it’s the CDC. 

Truthfully the only thing that keeps coming up everywhere as a risk reducer is wear a mask.

My guess is the doctors figure out better treatments before we figure out the best public policy to battle this.

I agree, universal mask wearing is critical, especially indoors. Look at the SportClips in Missouri or the fact that grocery stores aren't seeing significant outbreaks. It's also why I won't eat or drink indoors at a restaurant....that activity by definition increases the amount of mechanisms of transmissions (droplets and aerosol).

In the good news category, I do think doctors are starting to figure out how to treat this. Conversion of infections to hospitalizations (even when adjusting for testing volume) is lower now than it was in March and Conversion of hospitalizations to deaths is lower now than it was in March. I don't think it's because the virus is mutating but what do I know.

[Frenns Liquor Depot]

In the good news category, I do think doctors are starting to figure out how to treat this. Conversion of infections to hospitalizations (even when adjusting for testing volume) is lower now than it was in March and Conversion of hospitalizations to deaths is lower now than it was in March. I don't think it's because the virus is mutating but what do I know.

Scott Gottlieb has been super vocal that it is treatment based.  His opinion is the biggest learning/breakthrough thus far has been the early scanning for blood clots & immediate treatment with blood thinners, etc (of course steroids may make things better if proven effective). .

[GooooMarquette]

Not sure what your last line has anything to do with anything I said, but I would find it unlikely that a dying patient will care.

medical risk factors are the same as any other risk factor....statistical probability that having condition A will result in outcome B.

My point is that there are so many mechanisms of risk that are encompassed in blood type it may not be blood type that determines the outcome or that a certain blood type has higher risk than another. As an example from the article, Type A people have Type B antigens and vice versa while Type O has both, and perhaps transmission from one person of a blood type to person of another type is less prevalent/severe than transmission between two people of the same blood type. In that scenario the fact that someone has Type A only matters in that if they get infected by someone with Type A blood their viral load or whatever is higher than if they were infected by someone with B or O types.

Simply put, I'm highly skeptical, based on the data analysis I've seen, that in the long run it will turn out that the virus attacks people with Type A more than any other blood type. Is there a mechanism based on blood type that impacts transmission in some way, seems logical but I haven't stayed in a Holiday Inn Express recently. This is why correlation versus causation is so important.

More people of Type A blood have been infected than others (of confirmed infections) is that because Type A is riskier or is that because more Type As came in contact with Type As or is there no difference is transmission and Type As for some reason experience worst outcomes than any other blood type (your theory). Don't know, but there is definitely not enough evidence to say anything conclusively and add it to the list of risk factors.

I have said from the beginning that we don't yet have enough evidence...but if it proves to be true, the debate about correlation vs causation will be a distinction without a difference.

[GooooMarquette]

Scott Gottlieb has been super vocal that it is treatment based.  His opinion is the biggest learning/breakthrough thus far has been the early scanning for blood clots & immediate treatment with blood thinners, etc (of course steroids may make things better if proven effective). .

Absolutely. Those things, plus avoiding mechanical ventilation if at all possible, have very likely decreased the rates of death and other serious morbidity. And if the dexamethasone proves as helpful as it appeared in the British study, that will be another huge step forward.

[forgetful]

Here is where you lose me every time.....when the data sets match your hypothesis it's tied to a single root cause (masks) when the data sets don't match your hypothesis it's tied to all sorts of root causes that can't be separated ("variety of factors at play").

Maybe you don't realize it, but you can't separate your political narrative from your situational analysis (you have a conclusion in your head and you are fitting the data to match that conclusion)

From data I've seen, the best way to mitigate the spread of CoVID-19 is to have everyone wear masks. It is not a political narrative at all, it is sound scientifically guided models of spread.

No matter what state you are in, the most likely reason for increased spread is due to non-compliance and vigilance in mask wearing. It is also fact, that sadly, mask wearing has become a political issue, and in most states where we are seeing a rapid increase in cases, mask compliance is poor.

Regarding Washington and California. Right now the worst regions of Washington in terms of case increases, is in Eastern Washington, where political demographics contrast that of western Washington/Seattle. In California, they have also seen severe increases in rural red-counties, but LA county has also been hit hard.

In most states where increases have been significantly noted, you also see a shift in the demographics of the people being infected. With most new cases in the under 30 crowd. Those individuals are also more likely to disregard mask wearing, and head out to bars/other festive crowded events. There it is not political at all, simply they don't think they are at risk, and mask wearing complicates social activities.

My comment on, no single sole cause, is because that is certainly true. In some areas a single super spreader event can drive significant spread. But the bottom line is, mask compliance is number 1, because science says so. We can have relatively safe openings if everyone wears a mask. If too many people don't, we get increases. Whether the reasons for not wearing masks is political, or young people feeling immune, is immaterial.

[GooooMarquette]

I'll just leave this here, and let others add the obligatory Buzz jokes....

Flushing the Toilet May Fling Coronavirus Aerosols All Over

https://www.nytimes.com/2020/06/16/health/coronavirus-toilets-flushing.html?action=click&block=more_in_recirc&impression_id=530718539&index=4&name=STYLN_more_in_reopening&pgtype=Article&region=footer&variant=2_variant

[GBPhoenix1993]

So one good trend that I check almost daily is the 7 day Covid Death average for the US on Worldometer.  Just to clarify, that means the average number of deaths per day in the past 7 days.  In mid April, the 7 day average was well over 2000+ deaths per day.  I checked tonight and the 7 day average is just over 700 deaths a day now so things really have been steadily moving in the right direction.  Don't get me wrong, 700+ is way too high and basically about 4 times as bad as a really bad flu season, so we're not out of the woods yet by any means. 

My own personal opinion, I want to see that deaths per day go down below 225 as at that point, it's reached a level of a bad flu season.  I wholeheartedly agree with those who say this is NOT the flu, it really is much much worse especially in how quickly it can hit a geographical region like it did in New York.  If we're able to get the death per day count under 225 a day, then it finally can be compared to the flu at that point in terms of deadliness, but we've got a ways to go before we get there. 

[MU82]

This should be an interesting "contest" -- health and well-being of American citizens vs. the satiation of Trump's massive ego.

https://www.nytimes.com/2020/06/16/us/politics/trump-coronavirus-rally.html?campaign_id=56&emc=edit_cn_20200617&instance_id=19463&nl=on-politics-with-lisa-lerer&regi_id=108420427&segment_id=31116&te=1&user_id=d36dcf821462fdd16ec3636710a855fa

WASHINGTON — Officials in Tulsa, Okla., are warning that President Trump’s planned campaign rally on Saturday — his first in over three months — is likely to worsen an already troubling spike in coronavirus infections and could become a disastrous “super spreader.”

They are pleading with the Trump campaign to cancel the event, slated for a 20,000-person indoor arena — or at least move it outdoors.

“It’s the perfect storm of potential over-the-top disease transmission,” said Bruce Dart, the executive director of the Tulsa health department. “It’s a perfect storm that we can’t afford to have.”

Tulsa County, which includes the city of Tulsa, tallied 89 new coronavirus cases on Monday, its one-day high since the virus’s outbreak, according to the Tulsa Area Emergency Management Agency. The number of active coronavirus cases climbed to 532 from 188 in a one-week period, a 182 percent increase; hospitalizations with Covid-19 almost doubled.

That spike has local officials and public health experts concerned about welcoming the nation’s first indoor mass gathering since Mr. Trump declared a national emergency in mid-March, an influx of thousands of people interacting inside and outside, amounting to a sprawling coronavirus petri dish.

“There’s just nothing good about this, and particularly in an enclosed arena,” said Karen Keith, a Tulsa County commissioner who oversees the area where the rally is supposed to take place. “I don’t want people to lose a parent. I don’t want them to lose a grandma. I don’t want them to lose a family member over this.”