Coronavirus General Discussion

[dualstow]

The State of Pennsylvania has been shut down.
https://www.pennlive.com/news/2020/03/a ... -wolf.html

[Ad Orientem]

I feel like I have fallen into a Hollywood B horror movie.

[Ad Orientem]

This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.
. . .
That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.

Could the Covid-19 case fatality rate be that low? No, some say, pointing to the high rate in elderly people. However, even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter.

These “mild” coronaviruses may be implicated in several thousands of deaths every year worldwide, though the vast majority of them are not documented with precise testing. Instead, they are lost as noise among 60 million deaths from various causes every year.

link

The thing I keep thinking of as this goes on is:

"You know what I've noticed? Nobody panics when things go "according to plan." Even if the plan is horrifying! If, tomorrow, I tell the press that, like, a gang banger will get shot, or a truckload of soldiers will be blown up, nobody panics, because it's all "part of the plan". But when I say that one little old mayor will die, well then everyone loses their minds!"

I think one of the key factors determining how bad this is going to be is; how many people are going to get severely ill at roughly the same time? The reason Wuhan in China had a mortality rate that looks off the hook while much of the rest of China was much lower is that they quarantined Wuhan and the medical infrastructure collapsed under the weight of all the severe infections. Even if the true mortality rate is .5%, of those infected; if the rate of infection is anything much over 20% of the population in a compressed time frame, we are screwed. If California is right and they get hit with an infection rate of near 50% over the next eight weeks that would be catastrophic because the medical infrastructure can't handle that and the death rate will jump. If those figures are extended to much of the rest of the country... Forget toilet paper. There is going to be a critical shortage of coffins.

[Libertarian666]

California estimates appx 25 million residents will get covid-19 over the next 8 weeks.
https://www.cnbc.com/2020/03/19/corona ... weeks.html

If that's even close to true, then its pretty much game over. There isn't enough critical care hospital capacity in the entire country to handle 5% of that number. That Chloroquine better come through because this is rapidly starting to look like The Big One.

Yep.

Even if chloroquine doesn't produce better results for individual patients than ventilation, it can be supplied in large quantities very rapidly without destroying the medical system. So substituting it for ventilators would produce far better overall results.

[Tortoise]

So if the real death rate of this novel coronavirus is similar to, or even lower than, other viruses like standard strains of the flu, then is it correct to say that what makes it an emergency is its much, much higher contagiousness than the flu -- meaning it spreads much, much faster?

I'm just curious, because the standard flu seems pretty damn contagious.

[WiseOne]

California estimates appx 25 million residents will get covid-19 over the next 8 weeks.
https://www.cnbc.com/2020/03/19/corona ... weeks.html

If that's even close to true, then its pretty much game over. There isn't enough critical care hospital capacity in the entire country to handle 5% of that number. That Chloroquine better come through because this is rapidly starting to look like The Big One.

The problem I have with extrapolating from models like this is that predictions need to be reconciled with what we know about the Chinese experience, now that the virus has run its course there. Your 5% scenario is simply not consistent with what we already know.

This is NOT the 1918 flu or the Black Death. Thank heavens for that.

Note for Libertarian666: there was a promising early clinical trial result of chloroquine from France. It apparently shortens the disease course, which is nice. Hardly a cure though.

Back to reading Connie Willis' sci fi book about the Black Death....gives one a bit of perspective.

[dualstow]

I feel like I have fallen into a Hollywood B horror movie.

I hope we're not living in a future history textbook, anything more than a blurb on a page about something else.
I remember reading those books as a child and thinking some really bad stuff *used to* happen to people.
And then when I got older, ok it still happens, but not here.

[Libertarian666]

California estimates appx 25 million residents will get covid-19 over the next 8 weeks.
https://www.cnbc.com/2020/03/19/corona ... weeks.html

If that's even close to true, then its pretty much game over. There isn't enough critical care hospital capacity in the entire country to handle 5% of that number. That Chloroquine better come through because this is rapidly starting to look like The Big One.

The problem I have with extrapolating from models like this is that predictions need to be reconciled with what we know about the Chinese experience, now that the virus has run its course there. Your 5% scenario is simply not consistent with what we already know.

This is NOT the 1918 flu or the Black Death. Thank heavens for that.

Note for Libertarian666: there was a promising early clinical trial result of chloroquine from France. It apparently shortens the disease course, which is nice. Hardly a cure though.

Back to reading Connie Willis' sci fi book about the Black Death....gives one a bit of perspective.

I cannot believe that the Chinese number provides any hope. They welded people into their apartments, remember? Are we going to do that?

As for the French study, yes, I saw it (if it's the same one). Anything that keeps the virus from overwhelming the medical system is a big win.

[Ad Orientem]

This is NOT the 1918 flu or the Black Death. Thank heavens for that.

...Back to reading Connie Willis' sci fi book about the Black Death....gives one a bit of perspective.

The mortality began in Siena in May [1348]. It was a cruel and horrible thing; and I do not know where to begin to tell the cruelty and the pitiless ways. It seemed to almost everyone that one became stupefied by seeing the pain...Indeed on who did not see such horribleness can be called blessed. And the victims died almost immediately. They would swell beneath theirarmpits and in their groins, and fall over dead while talking. Father abandoned child, wife husband, one brother another...And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices [last rites]. Nor did the death bell sound. And in many places in Siena great pits were dug and piled deep with the multitude of dead.

And I, Agnolo di Tura, called the Fat, buried my five children with my own hands. And there were also those who were so sparsely covered with earth that dogs dragged them forth and devoured many bodies throughout the city.

There was no one who wept for any death, for all awaited death. And so many died that all believed that it was the end of the world.

[dualstow]

This is certainly making the rounds. Is it real?

F Scott Fitzgerald, quarantined in 1920 due to flu outbreak:

The officials have alerted us to ensure we have a month’s worth of necessities. Zelda and I have stocked up on red wine, whiskey, rum, vermouth, absinthe, white wine, sherry, gin, and lord, if we need it, brandy. Please pray for us.

Full quote: https://www.euroweeklynews.com/2020/03/ ... nQil5NKhp8

[WiseOne]

I cannot believe that the Chinese number provides any hope. They welded people into their apartments, remember? Are we going to do that?

They did that only after the virus was already hopelessly widespread. I don't know how much those actions actually moved the needle. The measures implemented here were done relatively earlier in the course, so they have some chance of being modestly effective - otherwise, we're paying an enormous economic price for nothing!

[vnatale]

The people who are really on the front lines here: nurses, ER staff, critical care specialists, internal medicine. I'm not any of those. My sister is an ER doc and I know she's a bit scared every time she heads into a shift. She's in a small hospital with very few cases, though...mine has over 200, which is about a quarter of its usual capacity.

Smith1776, your vitamin D story is new to me. I have to say I also think the stuff is a miracle in a jar. I was battling a bad sinus infection once, took a nice big 10,000 IU hit of vitamin D, and it literally dissolved away in about half a day. Incredible. I've even heard the notion floated that the reason flu & colds are so much worse in the winter is that people are indoors and therefore making less vitamin D.

If the currently investigative treatments aren't miracle cures, you will be on the front lines in a week or two. This is going to be all hands on deck for anyone even slightly qualified in the medical field.

I think after this is over, we will need a 7th branch of the armed forces (maybe not armed though): The Health Force. They will be reservist doctors, nurses, lab techs, and the like, whose training will be paid for by the government and kept in reserve for pandemics.

It's either that or ban international passenger air travel.

Pick one.

By the way, a C-Span caller today described how her husband is a cross country truck driver. She maintains isolation from him because he's all over the place. She plead for special protection for our truckers. She said there are a million truckers in this country. Don't know how accurate that is. If true, how many in the National Guards in total? I have no idea of that number.

Another caller thought that the planes not being used because of lack of need would be the perfect place to put infected people since they have all the facilities for living in it (I'd guess no showers?).

Vinny

[pmward]

Apparently CA just locked down the entire state as well.

[D1984]

California estimates appx 25 million residents will get covid-19 over the next 8 weeks.
https://www.cnbc.com/2020/03/19/corona ... weeks.html

If that's even close to true, then its pretty much game over. There isn't enough critical care hospital capacity in the entire country to handle 5% of that number. That Chloroquine better come through because this is rapidly starting to look like The Big One.

One more point: if chloroquine does come through, Trump will have saved the country. No other President would have had the balls to tell the FDA to approve it on the spot.

I thought this was for hydroxychloroquine?

Did he tell the FDA to approve it (either chloroquine or hydroxychloroquine) for COVID-19 as generally approved as safe and effective for this disease or did he tell them to approve it as a compassionate use approval? Is it approved right now or does it still have to be prescribed off-label? AFAIK--the latest three news articles on this I've seen are from around 4 PM, 5 PM, and then about an hour and a half before right now today--are saying that he said it was approved or "essentially approved" whereas FDA Commissioner Hahn is saying they will still have to do the (admittedly speeded-up so as to take several months rather than a year or more) safety and efficacy tests and that will take several more months minimum.

Can a POTUS simply tell the FDA commissioner (and by extension the whole FDA) to approve a drug RIGHT NOW on the spot or be fired? This doesn't seem to be what happened: the FDA says they are still testing this and it is not generally approved yet for coronavirus despite what President Trump said. Bayer and Roche IIRC were saying they'd have several million pills of each (above and beyond beyond their usual production) available by mid-April but despite at this time the FDA has still not yet approved it via regular approval for COVID-19.

https://techcrunch.com/2020/03/19/fda-t ... -patients/

https://www.cnn.com/2020/03/19/politics ... index.html

https://abcnews.go.com/Politics/trump-a ... d=69693560


EDIT: Looks like this is indeed a Compassionate Use/Expanded Access Approval thing and not a regular full approval....same process Obama's FDA did for ZMapp and IIRC both Reagan, HW Bush's, and Clinton's FDA did for AIDS treatments. Still, good for him (and for Commissioner Hahn and presumably HHS Sec. Azar as well).

https://www.pharmacytimes.com/news/fda- ... g-covid-19

[Ad Orientem]

This is certainly making the rounds. Is it real?

F Scott Fitzgerald, quarantined in 1920 due to flu outbreak:

The officials have alerted us to ensure we have a month’s worth of necessities. Zelda and I have stocked up on red wine, whiskey, rum, vermouth, absinthe, white wine, sherry, gin, and lord, if we need it, brandy. Please pray for us.

Full quote: https://www.euroweeklynews.com/2020/03/ ... nQil5NKhp8

So much for prohibition.

[dualstow]

He was quarantined in France. They had none of that foolishness.

[Smith1776]

One of my friends recently graduated school and decided to make an international trip to explore the world. She booked her flights for early March. The dream trip turned into a nightmare and she has only just managed to scrape together a path home.

This is what she posted on Facebook just now.

hi friends, thought I’d post a lil update on my situation since a lot of you have reached out (bless ur hearts)...

I have finally been able to get an emergency flight home on Monday. I’m fully aware of what it’s like in Canada right now, and I’m shocked at the lack of effort we are putting forward in preventive measures. I know it may seem like we are doing our best and that this isn’t that scary, but believe me when I tell you we aren’t even scraping the surface of what we need to be doing. Things are changing for the worst extremely fast, and I don’t mean by the day, I mean by the hour. I have had to flee a country that was going on lockdown, where streets were being barricaded off and police are patrolling the streets. It’s terrifying. Once I got out and was safe again, in less than 24 hours, most borders around me had closed and my Canadian passport was no longer allowed entry to a lot of other countries, making it extremely difficult to find a flight home without a layover in a place I am banned from. Airlines have stopped running or reduced their flights, only to cancel most of the few flights they had promised to run. Today, Australia has closed their borders to foreigners, after JUST announcing that their international flights were stopping by April 5. I can no longer get back to sister, which was my last resort safety net. I have exhausted my resources with every border closing around me, trapping me in, and I am so relieved to have finally been able to get a flight home.

I know we aren’t currently working, but if Canada doesn’t step up its game right now, we are going to be in an extremely unpleasant predicament in a month’s time, it’s the purge out here okay no one wants to live like this I promise you- it’s like a movie but like, a really shitty one. so please please please do not go to any restaurants, malls, or whatever public places that are still open, and stop hanging out with your friends. its going to be boring but I am SO excited to get home and be bored rather than being in a situation like this.

on a more positive note, oh my GOD THE DOGS HERE ARE SO CUTE AND THEY ARE EVERYWHERE. LITERALLY EVERYWHERE.

[dualstow]

That is truly hair-curling. The speed of this is like a wildfire. The border & travel problems really do make it seem like a movie.
The last line— um, I hope she’s really talking about dogs, and it’s not some Bird Box effect that drove her insane. It’s a rather strange way to close the narrative.

[Smith1776]

https://9gag.com/gag/ax7w5zL

[Smith1776]

That is truly hair-curling. The speed of this is like a wildfire. The border & travel problems really do make it seem like a movie.
The last line— um, I hope she’s really talking about dogs, and it’s not some Bird Box effect that drove her insane. It’s a rather strange way to close the narrative.

Yet to watch Bird Box... I've only seen the memes.

Added to the list!

[Dieter]

https://9gag.com/gag/ax7w5zL

That is so me. Although two computers - one for work, one to pay bills.

And misses using the phone to read FB, news, forums...

[Mountaineer]

The video at the link seems just as relevant today as it was when produced (~1948). Enjoy!

"A slightly comedic piece written to a secular audience at the height of the Cold War. This was published shortly after Soviet Russia had enslaved the populations of Eastern Europe, and three years after atomic bombs dropped on Hiroshima and Nagasaki."

https://www.youtube.com/watch?v=oxFmkg5 ... COPY_01%29

[barrett]

Indiana schools now officially online only through May 1.

But the real tragedy is that the chances of holding the Indy 500 (world's largest single-day sporting event) on May 24 are getting slimmer and slimmer. Realistically they are probably zero, but nothing official yet.

Without looking it up, I would venture to say that the world's largest single day sporting event is a soccer game, either the annual Champions League final in June or the quadrennial World Cup final. This year's Champions League final is in serious doubt currently.

Really? There's no way you can get as many people around a soccer field as a racetrack. The Indy racetrack seats 250,000.

Xan is almost certainly correct. I did see a soccer game in Brazil in 1982 at The Maracanã. Before the seating was reconfigured in that stadium, the seating capacity was nearly 200,000.

[barrett]

A few thoughts...

I think people are correct to question the numbers coming out of China regarding new CV cases and deaths, but it seems clear that the trends there are at least positive. Factories are up and running and many people are back at work. Cars are back on the street. Health workers appear to be leaving Wuhan in droves.

The numbers (new cases, deaths, people recovered) are also encouraging in Singapore, Taiwan, Hong Kong, South Korea & Japan.

Cases are on the rise in hot countries like Thailand & Malaysia but death rates seem to be lower so far than what we are seeing in Europe.

All of the above are really positive developments, right?

On an another topic, I am really baffled about the painfully slow pace of Americans to adopt widespread use of face masks. When people start flying here again, are we really going to not wear face masks? What about for Broadway & Vegas shows or NBA games? It seems a small price to pay.

We'd obviously need to be producing masks in the hundreds of millions at least, but that seems like small potatoes when the alternative would be to continue to crash the economy.

[dualstow]

..
All of the above are really positive developments, right?

On an another topic, I am really baffled about the painfully slow pace of Americans to adopt widespread use of face masks.
...

Positive developments.

When masks are widely available again, I hope the authorities send out a message reversing the guideline of "masks are for the sick."
Even before they said that, there seems to be a cultural aspect: you see someone on the street wearing a mask and your gut reaction may be that this person is sick. Complicating things, the person wearing the mask on the street (in the U.S.) is more likely Chinese than not.
That's because it is common in places like Taiwan to wear a mask. They even wear a mask for pollution when on motorcycles. No stigma.

So, I think someone needs to tell us to wear masks. Maybe the flight attendants should even hand them out.