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

[Hards Alumni]

Well, maybe not the flu or traffic accidents:

Dr. Anthony Fauci says U.S. will have “millions of cases” of COVID-19 and more than 100,000 deaths. Fauci, the head of the National Institute of Allergy and Infectious Disease, is the U.S. government’s foremost infectious disease expert.

Well, unfortunately, there are vast tracts of the US that still aren't taking this seriously.

[Frenns Liquor Depot]

Unfortunately, WaPo seems to be one of the few newspapers that hasn't given free access to its stories about COVID-19. I subscribe to the NYTimes, and was happy to see that they are allowing everyone to read their stories on the outbreak.

So for us non-WaPo subscribers, could you provide a 30,000 foot summary?

Healthcare experts opining and essentially crowd sourcing how we set data metrics on a return to normal. Through this crowdsource there is a blueprint emerging. Central command and control required but state triggers based on data. 

Everyone wants economy open but there is no economy as long as health crisis persists

Four phases - shore up the medical system to address the wave. Gradually reduce social distancing restrictions.  Vaccine/treatments developed. Prepare for next pandemic. 

Phase two dependent on better testing and contact tracing for new cases and blood testing to ‘clear’ those that have the antibody. 

This is greatly simplified. I would just copy paste the article but won’t do that without the mods being ok (since they have asked us not to do that in the past)

[ZiggysFryBoy]

I thought you had stopped drinking.

Ban dis guy.  Completely inappropriate.  Attacking a guy in recovery.

[forgetful]

Interesting US map showing confirmed cases per capita, sorted by county. While some of the hotspot metro areas like NYC and N'awlins are understandably high, it's interesting that some rural areas in Utah, Idaho, Montana, Georgia and Arkansas have higher per capita rates than other notable hotspots like the Bay Area and Seattle.

https://www.cnbc.com/2020/03/29/coronavirus-heres-a-map-of-rural-counties-in-us-most-affected-by-pandemic.html

I think this is a "travel" effect. The most likely way to get infected a week or two ago was by flying, and going through airports, if one traveler from a small town got infected, per capita that is a lot. And when they would return, they would immediately run up and restock their fridges. Which means the one travel creates a Local Bubble of cases which numbers wise is larger comparatively.

[rocket surgeon]

Ban dis guy.  Completely inappropriate.  Attacking a guy in recovery.

Gotta be all the mercury in the fillings then, eyn’a?  Damn, still crazy after all (13) theses years.

[Hards Alumni]

https://madison365.com/coronavirus-to-peak-in-wisconsin-may-22-report-says/

Buckle up, buckaroos.  We are just at the beginning of this.

[The Hippie Satan of Hyperbole]

Ban dis guy.  Completely inappropriate.  Attacking a guy in recovery.

Wasn’t attacking him. I was concerned for him since his posts were nonsensical.

[cheebs09]

https://madison365.com/coronavirus-to-peak-in-wisconsin-may-22-report-says/

Buckle up, buckaroos.  We are just at the beginning of this.

I read that as a little more positive that Wisconsin is flattening the curve and that’s why it’s so far out. I have a hard time seeing how the peak would be two months away with the safer at home being in place for 2 months. Is that still due to the exponential nature of this, just that it is growing much slower?

[ZiggysFryBoy]

Wasn’t attacking him. I was concerned for him since his posts were nonsensical.

  

[GooooMarquette]

https://madison365.com/coronavirus-to-peak-in-wisconsin-may-22-report-says/

Buckle up, buckaroos.  We are just at the beginning of this.

Interesting and frightening.

However, when I scrolled to other states (notably my home of MN), the information seems to be inaccurate. It says that MN has "not implemented" a stay at home order, when in fact it has been in place for a couple of days now. And the empty streets and parking lots I saw when I went for a quick drive yesterday seem to indicate that people are taking it seriously, at least here in Rochester. In fact, the streets have been pretty quiet for a couple of weeks now.

Hopefully the numbers will decrease when they correct those assumptions (both here in MN, and other states that may have inaccuracies). Because the 1,280 projected deaths is mind-boggling.

[lostpassword]

I read that as a little more positive that Wisconsin is flattening the curve and that’s why it’s so far out. I have a hard time seeing how the peak would be two months away with the safer at home being in place for 2 months. Is that still due to the exponential nature of this, just that it is growing much slower?

I had the same initial reaction.  I paged thru every state and WI (May 22) had the furthest out peak in these models.  Florida was next with May 14 and I think there was only 1 or 2 others in May.  Most states were in next 3 weeks.

[forgetful]

https://madison365.com/coronavirus-to-peak-in-wisconsin-may-22-report-says/

Buckle up, buckaroos.  We are just at the beginning of this.

Overall a neat resource, but there are flaws in their analysis. For one, the peak in cases/beds will not necessarily (and doesn't) align with peak ventilator and ICU needs. They have all the shortages calculated from the overall peak. There is more need for ICU and peak ventilators than they are calculating.

Honestly kind of a novice mistake in data analysis. Which concerns me that their models also have issues.

[Hards Alumni]

I had the same initial reaction.  I paged thru every state and WI (May 22) had the furthest out peak in these models.  Florida was next with May 14 and I think there was only 1 or 2 others in May.  Most states were in next 3 weeks.

No chance Florida peaks by May 14th.  Add a month to that.  They're doing all the wrong things.  They don't even have a state wide shelter at home yet.  Luckily some of the counties decided to take leadership and do it on their own.  This is the problem that it creates.

https://twitter.com/travisakers/status/1243990179557359616?s=20

Travis Akers
@travisakers
This picture is from 3pm today.

You can see exactly where Duval County ends and St. John’s County begins.

All beaches in Duval are closed, while St. John’s only blocked parking at the beach.

Gov. DeSantis needs to order a state-wide closure of all Florida beaches.

[Bo Ryan's Massage Therapist]

This is a University of Iowa Grand Rounds lecture on covid-19 done by a physician who has studied coronaviruses for years and an epidemiologist who has studied SARS and MERS.  It’s meant for healthcare workers and is 90 minutes long.

https://uicapture.hosted.panopto.com/Panopto/Pages/Embed.aspx?id=5bc821ca-ef05-4da9-8f0e-ab8400effdff


Key points that I learned:
Original transmission is bat- animal-to human. They are unsure what animal, initially thought pangolins but DNA of coronavirus only 99% identical.

Vaccine unlikely to help this year.  Biggest hope is a drug treatment.  Vaccine could help if virus returns next year.  Virus is mutating but much less than influenza. However, like flu a vaccine is a “holy grail.”  Too much variability in strains to completely protect.

Remdesivir is a promising antiviral but limited because it can only be given IV and works best if given before severe disease. Right now only being given to critically ill patients.

Chloroquine and azithromycin are promising but way more data/study needs to be done

This one freaked me out: kids actually may get infected as often as adults and be a vector for spread.  We don’t know because they are often asymptomatic or have really mild disease and are not tested.  Their young immune system is more effective than aging individuals.   The virus infects the ACE2 receptors and ACE2 activity falls as we age making us less able to cope with covid-19.

A large percentage of healthcare workers self contaminate when putting PPE on and off.  Part of this is the lack of PPE/gowns.  I only have one gown I reuse every day.

[TSmith34, Inc.]

The company declined to explain how a post proposing readers deliberately contract a virus that has rapidly killed tens of thousands of people does not meet that standard.

Because Zuckerberg is and always has been a greedy little asswipe

[Jockey]

No chance Florida peaks by May 14th.  Add a month to that.  They're doing all the wrong things.  They don't even have a state wide shelter at home yet.  Luckily some of the counties decided to take leadership and do it on their own.  This is the problem that it creates.

https://twitter.com/travisakers/status/1243990179557359616?s=20

Travis Akers
@travisakers
This picture is from 3pm today.

You can see exactly where Duval County ends and St. John’s County begins.

All beaches in Duval are closed, while St. John’s only blocked parking at the beach.

Gov. DeSantis needs to order a state-wide closure of all Florida beaches.

That is a frightening picture of man’s stupidity.

[Pakuni]

That is a frightening picture of man’s stupidity.

Speaking of stupid men...

https://www.nbcwashington.com/news/maryland-man-arrested-for-having-60-people-over-for-bonfire-violating-social-distancing-orders/2257130/

[statnik]

No chance Florida peaks by May 14th.  Add a month to that.  They're doing all the wrong things.  They don't even have a state wide shelter at home yet.  Luckily some of the counties decided to take leadership and do it on their own.  This is the problem that it creates.

https://twitter.com/travisakers/status/1243990179557359616?s=20

Travis Akers
@travisakers
This picture is from 3pm today.

You can see exactly where Duval County ends and St. John’s County begins.

All beaches in Duval are closed, while St. John’s only blocked parking at the beach.

Gov. DeSantis needs to order a state-wide closure of all Florida beaches.

You do realize that not heeding the warnings means they will peak earlier than these projections, right?  The states with the later peaks tend to be the ones that will be able to flatten the curve better.  It’s unfortunate because it will be a double-edged sword either way.

[rocky_warrior]

Only in Oregon (and NJ?)  would you need to worry about the safety of people pumping their own gas.

https://www.oregonlive.com/news/2020/03/oregon-temporarily-lifts-prohibition-on-self-service-gas-in-response-to-coronavirus.html

I do wonder - how many people in Oregon have never left and never pumped their own gas?  This could lead to unmitigated ecological disaster!

[WarriorDad]

Because I know people from Wuhan, and they can report on the actual situation and the methods used to contain/suppress the spread.

They are consistent with what China's government reports, and they aren't fans of the Government.

Also, we aren't even reporting all the actual deaths. When a person dies of pneumonia despite testing negative for flu and other respiratory diseases, we are not testing for coronavirus. We say death by pneumonia. We don't even try to track down contacts and others that may have been infected. We just move on.

The British government believes the Chinese reports are between 15 to 40 times understated.  Our reporting of pneumonia deaths disparity is happening elsewhere, too.

https://www.businessinsider.com/coronavirus-boris-johnsons-government-reportedly-furious-with-china-2020-3

[rocky_warrior]

The British government believes the Chinese reports are between 15 to 40 times understated.  Our reporting of pneumonia deaths disparity is happening elsewhere, too.

https://www.businessinsider.com/coronavirus-boris-johnsons-government-reportedly-furious-with-china-2020-3

Why is this important?  Does it make you feel better about the US?  Curious.

[WarriorDad]

Why is this important?  Does it make you feel better about the US?  Curious.

My personal opinion is that a country like ours there is very little one can do without violating the basic freedoms we have as a nation and people.  Too many citizens oppose those tactics as well as leaders at the state and federal level. In my readings of messages here there appear to be a call to action as the Chinese have done to stop the spread, but more than likely even their heavy-handed approach has done very little to stop it.  If the solution as proposed by people here is to shut it all down, go door to door and it isn't working there then that data should be shared.

[MU82]

No chance Florida peaks by May 14th.  Add a month to that.  They're doing all the wrong things.  They don't even have a state wide shelter at home yet.  Luckily some of the counties decided to take leadership and do it on their own.  This is the problem that it creates.

https://twitter.com/travisakers/status/1243990179557359616?s=20

Travis Akers
@travisakers
This picture is from 3pm today.

You can see exactly where Duval County ends and St. John’s County begins.

All beaches in Duval are closed, while St. John’s only blocked parking at the beach.

Gov. DeSantis needs to order a state-wide closure of all Florida beaches.

DeSantis was in Trump's ear pushing for a quarantine on NY/NJ/Conn. He needs to clean up his own effen house!

Here in NC, things are getting exponentially worse.

https://www.charlotteobserver.com/news/coronavirus/article241585466.html?

Governor has issued a stay-at-home order that will go into effect tomorrow afternoon (Mon 3/30). But Mecklenburg County (biggest in state, and where I live) has been on such an order for a week now and many aren't heeding it. Weather last couple days has been very nice and the parks have been flooded with people -- little to no social distancing going on. So now they are talking about closing parks and trails, too.

This is gonna get so much worse before it gets better, not just in NC and Fla but all over the place. I'm an optimistic guy who has never been depressed, but this is testing me for sure.

[Pakuni]

At least he's focused on what really matters.

Donald J. Trump
@realDonaldTrump
“President Trump is a ratings hit. Since reviving the daily White House briefing Mr. Trump and his coronavirus updates have attracted an average audience of 8.5 million on cable news, roughly the viewership of the season finale of ‘The Bachelor.’ Numbers are continuing to rise..

[GB Warrior]

Overall a neat resource, but there are flaws in their analysis. For one, the peak in cases/beds will not necessarily (and doesn't) align with peak ventilator and ICU needs. They have all the shortages calculated from the overall peak. There is more need for ICU and peak ventilators than they are calculating.

Honestly kind of a novice mistake in data analysis. Which concerns me that their models also have issues.

Is there a better way to project acute ICU/vent needs, when said needs are unique to the patient pool? There's some smoothing here, and I agree an assumption that vent needs will occur evenly over time vs all at once is difficult to project. You could run the risk of taxing the system at any one time as you near the apex, but if you're staffed/equipped for the high point, it'd be an outlier.

Seems to me that they assume most acute needs (by volume, vs percentage of cases) will occur at the peak, which is the safest bet.