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Coronavirus Pandemic

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25 minutes ago, gottaplan said:

I think rest of the states will end up following Ohio and other states and issue "stay at home" orders for non essential workers.  My rumor mill circle told me someone who knows someone at Homeland Security said entire country will be on lock down by end of the week.

 

1.  How long does the "stay at home order" last?  2 weeks?  3 weeks?

 

2.  When do we truly know it's safe to interact at work, socially?

 

3.  What are the chances a real vaccine is developed in next 2 months before summer?

 

4.  Where is the bottom of this recession?  The way things are going, pretty much everyone is going on some sort of unemployment.  I can't see all these employers keeping full time employees on payroll with nobody working...

IMHO:

1. It will probably depend upon what's occurring on the ground locally and nationally (hospital bed demand/census, test results, M&M) and our ability to model or forecast impact

2. The spread is being managed via restrictions to minimize impact. The spread however is managed to occur in waves. We do not have "herd immunity," so as people are exposed and potentially acquire immunity, the numbers will fall off, restrictions will be removed and another wave of infections will be allowed to occur. The goal is to manage exposure until most of the global populace has been exposed and potentially acquired immunity via exposure or vaccination

3. "0%" chance. There are several types of vaccines in development but they require clinical trials. Best case scenario with an alert, responsive, expedited FDA review, 12 months

4. Who knows? We haven't experienced anything like this. I personally think this will last at least 6 -12 months as it works it's way through the populace. Much depends upon vaccine development and our ability to effectively manage the M&M so its impact is similar to that of a cold.

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27 minutes ago, E Rocc said:

 

A drug based allevation of the worst symptoms can be ready much sooner and make this definitely "no worse than the flu".

There are numerous drugs, currently in use for other indications, that are our best chance to get something quickly to market. Gilead Sciences, which specializes in highly effective antiretrovirals for HIV and Hepatitis, has remdesivir in development.  A vaccine is too far off and may not even prove effective in clinicals.

 

Since the chemistry/manufacturing/side effect-adverse reaction portions of these existing drugs NDAs have already been approved, dosing and safety & efficacy remain, but again they require clinical trials. FDA does however have a process for expedited review.

 

https://www.nytimes.com/2020/02/26/health/coronavirus-gilead-drug-trials.html

Edited by Frmr CLEder
Added link for remdesivir.

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29 minutes ago, seicer said:

A vaccine, at the fastest possible course, could be developed toward the end of the year. The article has good insights on the development of the vaccine.

 

Another view. This article suggests one could instead be ready for mass production by summer. But most epidemics go through the population and fade away before a vaccine can come to a Hollywood-style rescue. 

 

 

Scientists are moving at record speed to create new coronavirus vaccines—but they may come too late

https://www.sciencemag.org/news/2020/01/scientists-are-moving-record-speed-create-new-coronavirus-vaccines-they-may-come-too


"Nearly every problem that we have in the USA -- unaffordable health care, prison overpopulation, hyper militarization, climate change, racism, gun violence, poverty, poor education, urban sprawl and others -- cannot be positively addressed because bribery and conflicts of interest are legal under campaign finance laws which protect the uber-wealthy and the narrow self-interests who grossly benefit from our afflictions."

 

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7 minutes ago, KJP said:

 

Another view. This article suggests one could instead be ready for mass production by summer. But most epidemics go through the population and fade away before a vaccine can come to a Hollywood-style rescue. 

 

 

Scientists are moving at record speed to create new coronavirus vaccines—but they may come too late

https://www.sciencemag.org/news/2020/01/scientists-are-moving-record-speed-create-new-coronavirus-vaccines-they-may-come-too

Understand however that "ready for mass production by summer" means the ability to scale up (taking it from the laboratory to manufacturing plant), which sometimes has challenges, in order to manufacture in sufficient enough quantities to take to clinical trials.

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38 minutes ago, E Rocc said:

My rant after shopping this morning starts here:
 

 

 

 

What is with your obsession with eye contact? You do know that making eye contact with someone does not put you at risk of transmission right? People don't laser beam this through their eyes into your head. 

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A good way to think of this...

 

In Italy, there is something like 9,000 deaths per year from flu related illness. That extrapolates to about 25 deaths per day (know it probably spikes in certain times a bit higher, but that would probably be fairly consistent.)

 

Over the last approximately 30 days, Italy has had 5,500 deaths from Coronavirus. That is 185 deaths per day over that time period. It is only going to get worse in Italy as hopefully they have hit their peak and will start turning down soon.

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16 minutes ago, DEPACincy said:

 

 

What is with your obsession with eye contact? You do know that making eye contact with someone does not put you at risk of transmission right? People don't laser beam this through their eyes into your head. 

 

It encourages them to speak and makes you seem more "approachable".

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What is worrisome is a move towards martial law. As restrictions tighten, the National Guard is being called in some areas, and now there are reports that Italy is requesting assistance from the US Army.  This is all moving in that direction to enforce quarantines and to, as IMPOTUS put it, "prevent looting."

 

How did we get here?

Edited by Frmr CLEder

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13 minutes ago, Frmr CLEder said:

What is worrisome is a move towards martial law. As restrictions tighten, the National Guard is being called in some areas, and now there are reports that Italy is requesting assistance from the US Army.  This is all moving in that direction to enforce quarantines and to, as IMPOTUS put it, "prevent looting."

 

How did we get here?

Personally I'm not worried about looting.  Grocery stores & gas stations & such are still open.  People are driving around, walking, so it's not as "locked down" as it might seem.  I'm more worried about schools and kids educations.  Despite every parents' best efforts, very few are actually able to really maintain lesson plans & learning.  Kids need to be challenged, in positive learning environments with real teachers.  This online stuff can't be the answer for long.  I know it's temporary but what about kids with special needs like speech or language assistance?  what about kids that need special tutoring.  What about the kids who's parents just let them play video games 6 hrs a day or sleep in?  I think we'll see a big dip in standard test scores based on this closure...  that makes me sad for so many kids who need help

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18 minutes ago, gottaplan said:

Personally I'm not worried about looting.  Grocery stores & gas stations & such are still open.  People are driving around, walking, so it's not as "locked down" as it might seem.  I'm more worried about schools and kids educations.  Despite every parents' best efforts, very few are actually able to really maintain lesson plans & learning.  Kids need to be challenged, in positive learning environments with real teachers.  This online stuff can't be the answer for long.  I know it's temporary but what about kids with special needs like speech or language assistance?  what about kids that need special tutoring.  What about the kids who's parents just let them play video games 6 hrs a day or sleep in?  I think we'll see a big dip in standard test scores based on this closure...  that makes me sad for so many kids who need help

 

It is, however, quite appropriate to be worried about people being worried about looting, or other possible pretexts for actual martial law and, even more critically, the suspension of elections.  The big cancellation by DeWine that I understand as a matter of epidemic containment but personally would still have let go forward anyway was polling.  (I generally trust that DeWine isn't a closet autocrat but I don't like the precedent being set for other people who may not deserve the benefit of the doubt on that point.)

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1 hour ago, IAGuy39 said:

A good way to think of this...

 

In Italy, there is something like 9,000 deaths per year from flu related illness. That extrapolates to about 25 deaths per day (know it probably spikes in certain times a bit higher, but that would probably be fairly consistent.)

 

Over the last approximately 30 days, Italy has had 5,500 deaths from Coronavirus. That is 185 deaths per day over that time period. It is only going to get worse in Italy as hopefully they have hit their peak and will start turning down soon.

 

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2 hours ago, nickrctr said:

 

As a former NYC resident, familiar with the city's healthcare system, I also fear for the city and those who fly below the radar, but may contribute to the pandemic; the poor, the homeless, the incarcerated and mental health patients. COVID-19 does not discriminate. Improved access for these groups will help everyone.

Fortunately the NYC Health & Hospital Corporation is available to provide services, whereas many other cities lack comparable facilities.

Edited by Frmr CLEder

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https://www.reuters.com/article/us-health-coronavirus-china-cdc-exclusiv/exclusive-u-s-axed-cdc-expert-job-in-china-months-before-virus-outbreak-idUSKBN21910S

 

Quote

Several months before the coronavirus pandemic began, the Trump administration eliminated a key American public health position in Beijing intended to help detect disease outbreaks in China, Reuters has learned.

 


Very Stable Genius

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12 minutes ago, DarkandStormy said:

The administration has been criticized for this and the elimination of other key government epidemiological positions that existed for the 2009 Influenza-A H1N1 pandemic. DJT of course denies it and blows it off as something he knows nothing about.

 

For that pandemic, there was also testing available at the start of the pandemic in the US. Government infrastructure existed then to rapidly approve the Focus Diagnostics molecular assay. DJT has dismantled that infrastructure.

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Things that ARE working, at least to some extent:  Interferon, to boost immune system response, and the French reported cocktail of hydroxychloroquine and azithromycin.  They seem to work (i.e. ameliorate symptoms) in small trials and we know they are reasonably safe.

 

https://www.wsj.com/articles/these-drugs-are-helping-our-coronavirus-patients-11584899438

Edited by Dougal

There's nothing wrong with optimism, as long as you don't get your hopes up.

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I'm already seeing a growing chorus of Republicans and libertarians question whether it isn't better to just let a bunch of people die from the virus rather than let the economy tank.  

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2 minutes ago, jonoh81 said:

I'm already seeing a growing chorus of Republicans and libertarians question whether it isn't better to just let a bunch of people die from the virus rather than let the economy tank.  

 

POTUS, for example.


Very Stable Genius

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11 minutes ago, jonoh81 said:

I'm already seeing a growing chorus of Republicans and libertarians question whether it isn't better to just let a bunch of people die from the virus rather than let the economy tank.  

 

So, I know it's a bleak question - but this is peak "Intro to Ethics 101" in college:

 

Which is worse, losing the livelihoods of 60,000,000 or the lives of 100,000. 

 

Nonetheless, you can't claim to be Pro-Life is you choose the former

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Nate Silver summed it up in a succinct way:

 

 

To put it another way: it might help the economy in the short term to lift some restrictions and let people go about their business. But that will result in more infections and more deaths. And in the long run, that will hurt the economy more. So we're better off sucking it up and staying home in order to reduce the number of deaths.

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I'm having this irrational, morbid "hope" of seeing more total cases in the USA or order to lower the death percentage. For instance we were at .8 percent yesterday afternoon, then up to 1.3 percent at one point.

 

Right now, it's 467/39455 or 1.18 percent.  

 

and now it's 473/40,550, or 1.17 percent. 

 

I've got to stop looking at the worldometers site. This isn't healthy.

Edited by TBideon

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7 minutes ago, taestell said:

Nate Silver summed it up in a succinct way:

 

 

To put it another way: it might help the economy in the short term to lift some restrictions and let people go about their business. But that will result in more infections and more deaths. And in the long run, that will hurt the economy more. So we're better off sucking it up and staying home in order to reduce the number of deaths.

 

Agreed.

 

Also, while we shouldn't minimize the economic impacts of this, we shouldn't maximize them, either, because if you actually look at the Stay at Home Order, a lot of businesses are considered "Essential," on top of government functions that are also a considerable portion of the economy:

 

https://www.scribd.com/document/452781877/Ohio-Stay-At-Home-Order

 

(I didn't see if anyone had linked the actual order above, so sorry if that was a duplicate link.)

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As testing increases, the number of diagnoses will go up and the mortality rate come down. Initially it was at about 3.4% but appears to be settling around 1.5 - 1.7%.

 

If true, we could anticipate about 5+ Million deaths in the US before this is over. That's a lot!

Edited by Frmr CLEder

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5 minutes ago, TBideon said:

I'm having this irrational, morbid "hope" of seeing more total cases in the USA or order to lower the death percentage. For instance we were at .8 percent yesterday afternoon, then up to 1.3 percent at one point.

 

Right now, it's 467/39455 or 1.18 percent.  

 

and now it's 473/40,550, or 1.17 percent. 

 

I've got to stop looking at the worldometers site. This isn't healthy.

 

There are two ways to lower the body count: Reduce the infection/transmission rate and reduce the morbidity/fatality rate.

 

Both are important, but the former is more beneficial because there are plenty of bad outcomes possible short of death that happen to infected people.  If we could produce another million ventailators by tomorrow and get them all into every hospital system that needs or will need them, that would be great--but even better would be avoiding the need to put a million people on ventilators (even if that still beats the alternative of needing a million ventilators more than we have).

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9 minutes ago, Frmr CLEder said:

As testing increases, the number of diagnoses will go up and the mortality rate come down. Initially it was at about 3.4% but appears to be settling around 1.5 - 1.7%.

 

If true, we could anticipate about 5+ Million deaths in the US before this is over. That's a lot!

 

A truly heartbreaking part of this is that many of the deceased won't even have a proper funeral

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1 hour ago, Dougal said:

Things that ARE working, at least to some extent:  Interferon, to boost immune system response, and the French reported cocktail of hydroxychloroquine and azithromycin.  They seem to work (i.e. ameliorate symptoms) in small trials and we know they are reasonably safe.

 

https://www.wsj.com/articles/these-drugs-are-helping-our-coronavirus-patients-11584899438

NYS is utilizing hydrochloroquine + Z-pak, but New York State has it's own approval Authority. Elsewhere, as mentioned above, there are several marketed drugs that will need to seek COVID-19 as an additional indication; currently marketed drugs are the fastest way to obtain marketing approval for this indication.

Edited by Frmr CLEder

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25 minutes ago, YABO713 said:

 

So, I know it's a bleak question - but this is peak "Intro to Ethics 101" in college:

 

Which is worse, losing the livelihoods of 60,000,000 or the lives of 100,000. 

 

Nonetheless, you can't claim to be Pro-Life is you choose the former

 

I don't think it's that hard, really.  It would be way more than 100,000 if we did nothing, and economic conditions can recover.  You can't recover from death.  

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14 minutes ago, Frmr CLEder said:

As testing increases, the number of diagnoses will go up and the mortality rate come down. Initially it was at about 3.4% but appears to be settling around 1.5 - 1.7%.

 

If true, we could anticipate about 5+ Million deaths in the US before this is over. That's a lot!

 

In the U.S., yes.  Crude death rate worldwide continues to hover around 4.3%, though of course we don't know for sure until most of those infected currently recover.

 

This is likely due to the two different strains - the L strain and the S strain, and which one has hit more vulnerable populations (e.g. Italy).

Edited by DarkandStormy

Very Stable Genius

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i think its too early to say a percentage is settling in due to the onset of symptoms and 2-3 week fight patients put up.  We are still only not even two weeks into this since the panic button was hit.  

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Someone was throwing this chart around the internet yesterday. That has to be wrong, are those government tests? I thought clinic and UH were administering 500-1000 per day?

1387F57E-8B89-4CD6-90C9-A8D463DAE31E.jpeg

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9 minutes ago, DarkandStormy said:

 

In the U.S., yes.  Crude death rate worldwide continues to hover around 4.3%, though of course we don't know for sure until most of those infected currently recover.

 

This is likely due to the two different strains - the L strain and the S strain, and which one has hit more vulnerable populations (e.g. Italy).

We also don't know if that's accurate because mortality rate is driven by testing and number of confirmed cases. Italy is the worldwide driver of the high world mortality rate, but there's no reason to suspect that 4.3% is the true global mortality rate.

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They don't really know what the mortality rate since only sick people are getting tested, really.

 

That said about the economy, it seems people fail to realize that you can't buy a new car if you are paying for a funeral. It would legitimately be WAY worse the economy to have high levels of death and hospitalizations than keeping that low. 

 

Italy's death rate is so high because their hospitals were overrun. A lot of those people could have lived if they weren't so overrun. It could be the same thing here as well as getting more drugs actually developed to fight it, and getting closer to a vaccine.

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21 minutes ago, BelievelandD1 said:

Someone was throwing this chart around the internet yesterday. That has to be wrong, are those government tests? I thought clinic and UH were administering 500-1000 per day?

1387F57E-8B89-4CD6-90C9-A8D463DAE31E.jpeg

 

You've gotta be correct. I know CC alone has administered over 3,000 tests. 

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38 minutes ago, jonoh81 said:

 

I don't think it's that hard, really.  It would be way more than 100,000 if we did nothing, and economic conditions can recover.  You can't recover from death.  

They are erroneously assuming that economy will just be fine if we go back to work. I don't think the precious economy will do well with overwhelmed deaths and serious illness. 

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I saw a study that broke down the Italian deaths by how many other illnesses the people had.  It showed 1.2% of people died that had no other none health issue. The bulk of people dying in Italy had multiple health issues.  It was also mentioned that people were found dead in their homes in January and they were not counted but likely also had Covid-19. The point being that the virus was in Lombardy for a longer period undetected than people realize. So it could be that Italy is closer to 3 weeks ahead. 

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AUDIDAVE

As I mentioned upthread, the same is true here in the US. A research physician in Seattle diagnosed a patient in January, realizing that community spread was there and it was already everywhere.

Edited by Frmr CLEder

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42 minutes ago, YABO713 said:

 

You've gotta be correct. I know CC alone has administered over 3,000 tests. 

 

Rumor has it Ohio is one of two states that is not reporting negative results to the CDC.

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We still haven't gotten to the "doubling every six days" that DeWine and Acton talked about early on, but we did see a decrease in the # of new cases reported today, which correlates with a sub-30% daily increase.  This stuff was mostly baked in - we, in theory, *should* see even more of a drop off as a lot of these measures have been in place over the last 7-10 days.


Very Stable Genius

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8 minutes ago, DarkandStormy said:

 

Trump First, America Last.

Trump 3 days ago: this is a war, I'm a war president

Trump Today: this is too hard.  Let's quit.

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