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Thread: Disease and pandemics thread (because it's science)

  1. #1831
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    Yes, folks, now there is Quaranteaming, when you find friends you choose to live with, in one home, because you can't hack self-isolation from COVID-19.

    https://www.cnn.com/2020/04/17/us/qu...rnd/index.html

    Hope everyone is careful. Kind of like making your own family, only not.
    Do good work. —Virgil Ivan "Gus" Grissom

  2. #1832
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    Quote Originally Posted by Roger E. Moore View Post
    Yes, folks, now there is Quaranteaming, when you find friends you choose to live with, in one home, because you can't hack self-isolation from COVID-19.

    https://www.cnn.com/2020/04/17/us/qu...rnd/index.html
    Yay. Brilliant way to keep the case numbers up, guys. One can only pray that the team members don't start having tiffs and going off to join other teams.

    Grant Hutchison

  3. #1833
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    The worst of all worlds: COVID-19 in a psychiatric hospital. This hit home because I worked for 5 years at Central State Hospital in Louisville KY, 2005-2010. We got through the flu virus in 2009-2010 without anyone getting sick.

    https://www.nbcnews.com/health/menta...orlds-n1184266
    Do good work. —Virgil Ivan "Gus" Grissom

  4. #1834
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    Quote Originally Posted by grant hutchison View Post
    Yay. Brilliant way to keep the case numbers up, guys. One can only pray that the team members don't start having tiffs and going off to join other teams. Grant Hutchison
    I admit I laughed when I read the article. Could be worse, could be coronavirus deniers running around outdoors with no masks in big groups.
    Do good work. —Virgil Ivan "Gus" Grissom

  5. #1835
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    COVID-19 is most likely to be transmissible right before the sufferer begins to show symptoms. It is a "stealth" disease.

    https://www.nature.com/articles/s41591-020-0869-5
    Temporal dynamics in viral shedding and transmissibility of COVID-19
    Xi He, et al.
    Nature Medicine (2020), 15 April 2020
    We report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector–infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home. Disease control measures should be adjusted to account for probable substantial presymptomatic transmission.
    Do good work. —Virgil Ivan "Gus" Grissom

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    China raises its death toll figures from COVID-19, with a significant increase in deaths in Wuhan.

    https://www.cnn.com/2020/04/17/asia/...hnk/index.html

    QUOTE: "China has revised its official death toll from the novel coronavirus, raising the number of fatalities attributed to the pandemic by more than a third. Officials in Wuhan, where the virus was first reported late last year, on Friday added 1,290 coronavirus deaths to the city's toll. They also added 325 confirmed cases to the city tally. The total number of cases recorded in the city now stands at 50,333, with 3,869 deaths. The previous reported death toll for Wuhan was 2,579 -- so the revised figure marks a 50% increase in the number of deaths in the city from coronavirus. As of April 17, China's National Health Commission had reported 3,342 deaths nationally, before the revised Wuhan figures were published."
    Do good work. —Virgil Ivan "Gus" Grissom

  7. #1837
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    Quote Originally Posted by grant hutchison View Post
    Deaths per million is useful measure of the impact on society. But the trend in number of deaths pegged to a common datum is a useful measure of how well a society is flattening the curve--how long between the first fifty-death day and the first hundred-death day? Dividing that by the population just makes big nations look like they're doing well.
    Other useful measures are COVID hospital bed occupancy and ICU bed occupancy. These data are nationally reported at midnight in the UK, using a mechanism that's been in place for many decades, so they're immediate and pretty accurate (especially so for COVID, when one only needs to count the number of beds occupied in the area set aside for COVID), and (so long as resources are not overwhelmed) the case severities stay much the same from day to day.

    Grant Hutchison
    I can see that being applied regionally as we face more selective lock down. If there are spare icu beds, plus the PPE of course, then the local area can move a little more. At a guess, oxygen and “proning” may be more helpful than ventilators, given the poor outcomes and intensity of ventilation techniques. If I catch it, in other words, I hope the system could deliver me oxygen cylinders rather than cart me into hospital. No idea if that is being discussed. But cylinders and regulators could be delivered by volunteers, plus perhaps finger oxygen sensors, track the actual need.
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

  8. #1838
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    In the several preceeding posts, a few read more like commentary than a discussion about the science of pandemics and therefore seem better suited for the OTB thread. Ordinarily, minor digressions like this are overlooked but these posts are immediately on the heels of a moderator's official purple post about staying on topic and after the recent creation of an OTB thread intended specifically for them. Let's keep the spoons and forks in their proper spots, shall we?
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  9. #1839
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    Quote Originally Posted by profloater View Post
    At a guess, oxygen and “proning” may be more helpful than ventilators, given the poor outcomes and intensity of ventilation techniques. If I catch it, in other words, I hope the system could deliver me oxygen cylinders rather than cart me into hospital. No idea if that is being discussed. But cylinders and regulators could be delivered by volunteers, plus perhaps finger oxygen sensors, track the actual need.
    Being "carted into hospital" doesn't mean that you're lined up for ventilation. No intensivist ever wants to put a patient on a ventilator, because the risks of mechanical ventilation are high compared to the wide range of ventilatory support techniques now available. The advantage of being in hospital to receive your oxygen is that it can be easily and appropriately adjusted up or down against haemoglobin oxygen saturation, and CPAP or BiPAP can be immediately started if required. You can also be appropriately monitored for cardiovascular side effects, either of the disease or the therapy.
    Home oxygen therapy is certainly a thing, but it requires training for those involved, and a stable low level of oxygen requirement. Handing out kit to random anxious families and potentially confused patients with evolving oxygen requirements doesn't seem like a good or safe use of resources, and I doubt it will ever happen.

    If I had needed oxygen, I'd have been into hospital like a shot.

    Grant Hutchison

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    U.S. states without stay-at-home orders and largely rural populations are seeing a sharp rise in cases. Guess this was predictable, huh?

    https://www.cnn.com/2020/04/17/polit...rus/index.html

    QUOTE: "In Iowa, for instance, two separate Tysons food processing plants have also closed due to outbreaks that have so far caused the deaths of two workers. And in South Dakota a large pork processing plant owned by Smithfield Foods has been closed after experiencing a massive outbreak among workers there that has contributed to the explosion of coronavirus cases in Sioux Falls."
    Do good work. —Virgil Ivan "Gus" Grissom

  11. #1841
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    My googling didn't pan out for a direct link at the moment, but there is a little known condition in ex-smokers which causes people to lose consciousness if their blood oxygen level get's to higher normal levels. I know this because a family member went through it in the past. Something to keep in mind with respect to self administered oxygen. In my case It was considered highly unlikely so the condition was not mitigated for sometime until a change of Doctor which ordered to stop administering oxygen if levels rose above (I think) 65%. This puled the patent out of coma.

    I think this is the condition:

    In individuals with chronic obstructive pulmonary disease and similar lung problems, the clinical features of oxygen toxicity are due to high carbon dioxide content in the blood (hypercapnia). This leads to drowsiness (narcosis), deranged acid-base balance due to respiratory acidosis, and death.
    https://en.wikipedia.org/wiki/Effect...monary_disease
    Last edited by a1call; 2020-Apr-17 at 05:54 PM.

  12. #1842
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    Since some of these countries are being discussed, perhaps these will help:

    7 country cases.jpg
    7 country deaths thru Apr 16.jpg

    Running 7 day average....
    Sweden 7 Day avg.jpg

    UK Apr 17.jpg
    US Apr to 16th.jpg
    We know time flies, we just can't see its wings.

  13. #1843
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    Quote Originally Posted by grant hutchison View Post
    Being "carted into hospital" doesn't mean that you're lined up for ventilation. No intensivist ever wants to put a patient on a ventilator, because the risks of mechanical ventilation are high compared to the wide range of ventilatory support techniques now available. The advantage of being in hospital to receive your oxygen is that it can be easily and appropriately adjusted up or down against haemoglobin oxygen saturation, and CPAP or BiPAP can be immediately started if required. You can also be appropriately monitored for cardiovascular side effects, either of the disease or the therapy.
    Home oxygen therapy is certainly a thing, but it requires training for those involved, and a stable low level of oxygen requirement. Handing out kit to random anxious families and potentially confused patients with evolving oxygen requirements doesn't seem like a good or safe use of resources, and I doubt it will ever happen.

    If I had needed oxygen, I'd have been into hospital like a shot.

    Grant Hutchison
    I just don’t want to waste precious resources
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

  14. #1844
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    Quote Originally Posted by a1call View Post
    My googling didn't pan out for a direct link at the moment, but there is a little known condition in ex-smokers which causes people to lose consciousness if their blood oxygen level get's to higher normal levels. I know this because a family member went through it in the past. Something to keep in mind with respect to self administered oxygen. In my case It was considered highly unlikely so the condition was not mitigated for sometime until a change of Doctor which ordered to stop administering oxygen if levels rose above (I think) 65%. This puled the patent out of coma.

    I think this is the condition:


    https://en.wikipedia.org/wiki/Effect...monary_disease
    Strange use of the word "toxicity".

    Since this thread is entitled "Diseases and pandemics ...", I presume I'm permitted to respond to a comment about a specific disease.

    it really has little to do with being an ex-smoker, per se. Many patients with severe chronic obstructive pulmonary disease (which may of course have been caused by smoking) tolerate low levels of circulating oxygen (hypoxaemia) and/or high levels of circulating carbon dioxide (hypercapnia). If they suffer an exacerbation of their COPD and are given supplemental oxygen that pushes their circulating oxygen above the levels they are used to, they may suffer an increase in carbon dioxide--this can become so severe that it causes adverse physiological effects including sedation or unconsciousness, and can lead to death.
    The mechanism is multifactorial, the contributions from various processes unclear, and the dominant cause probably varies from patient to patient and setting to setting. The wiki page is rather limited in its literature survey.

    1) Patients who are at risk of this problem have very significant lung disease, with a long history of breathing difficulty and a lot of drug treatment. It doesn't just come out of the blue (if you'll pardon the pun).
    2) It's a well-known problem and quite manageable, with monitoring of blood gases and haemoglobin oxygen saturation. The normal procedure is to tune the SpO2 measured by a finger probe to about 90%, and to intermittently monitor carbon dioxide by arterial sampling.
    3) If you have this problem, and you contract COVID-19, you will very quickly end up in hospital for management of your condition.

    Grant Hutchison

  15. #1845
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    I didn't want to put you on the spot by asking you for the clarification Grant.
    Thank you for taking the time to clarify.

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    This thread is now quite long .. so I'm not sure if this sub-topic has been dealt with before, (but it recently came up in the other OTB thread). It comes down to being about sequencing, so I'll post a response here.

    The questions about whether the virus escaped (or was engineered) from Wuhan bio-labs was covered quite nicely in Shi Zenghali's, (the Director(?) of the Wuhan Institute of Virology), story in the March 11 publication of Scientific American.

    At one stage, she became concerned that specimens collected during her research into bat pathogens (from caves) might have been improperly disposed, so they compared initial patient's virus sequences with those she had in her collection. The sequences were different:

    Shi instructed her team to repeat the tests and, at the same time, sent the samples to another laboratory to sequence the full viral genomes. Meanwhile she frantically went through her own laboratory’s records from the past few years to check for any mishandling of experimental materials, especially during disposal. Shi breathed a sigh of relief when the results came back: none of the sequences matched those of the viruses her team had sampled from bat caves. “That really took a load off my mind,” she says. “I had not slept a wink for days.”
    Whilst this may not be necessarily be 'slam-dunk proof', it shows that her motives, and that her line of self-query was consistent with a scientist being deeply concerned about the implications of an instance of accidental bio-hazard contamination. One might also think there are probably records in Wuhan to back up what she says happened over the initial days of the outbreak in Wuhan, also(?)

  17. #1847
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    Study suggests that the coronavirus outbreak actually began in September 2019, and NOT in Wuhan, China, based on mutations.

    https://www.msn.com/en-us/health/hea...ay/ar-BB12MPqU
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  18. #1848
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    Quote Originally Posted by Roger E. Moore View Post
    Study suggests that the coronavirus outbreak actually began in September 2019, and NOT in Wuhan, China, based on mutations.

    https://www.msn.com/en-us/health/hea...ay/ar-BB12MPqU
    People may derive satisfaction from hypothesising about ways it may have gotten underway .. but the quest for a more detailed answer (than is already known) to this question is likely to more of a forlorn hope, rather than something which scientific investigation will necessarily reveal:
    Identifying the original source of the virus, Forster said, is necessary to ensure it does not happen again. Understanding the different types of virus and what role they play in the spread of COVID-19 is "one of the urgent questions to be looked at," he said.
    The question implied in his first statement is already answered: 'Recent human contact with remotely dwelling animals'.

    The second statement is a worthy area for scientific research, but the evidence is also already at hand for comparing Covid-19 with the propagation of other virus types. Looking at different mutations within the Coronavirus category, with the view to ascertaining propagation differences, will have to take into account the different sociological behaviors across different countries (and regions within a given country). How one could distinguish that from virus mutation properties, will be a doozy .. good luck on that front!

    The sustained elephant in the room is the objective evidence at hand, of the successful impact of social isolation within a given sub-population.
    Its clearly no mere co-incidence that New York is one of the most densely populated (and highly inter-related) sub-populations in the world, so the properties of the virus are more than sufficient for producing the very rapid spread in that sub-population. The before and after effects of social isolation on the spread in New York are still being recorded, and will form the basis for senstivity analyses now, and in the future.

  19. #1849
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    Quote Originally Posted by Jens View Post
    Here are the latest:

    70 10.7%
    71 10.0%
    72 11.5%
    73 12.1%
    74 10.6%
    75 13.2%
    76 10.2%
    77 7.7%
    78 7.4%
    79 9.2%

    The rate of increase in the number of deaths is pretty steady, but has perhaps fallen slightly. It seems to be around 10%/day now, while a week ago it was more like 13%/day.
    Here are some more. Again, this is simply the number of new deaths / the total number of deaths the day before. So basically just an index of how fast it is spreading.

    81 8.5%
    82 7.4%
    83 6.3%
    84 5.4%
    85 4.6%
    86 5.1%
    87 6.4%
    88 6.5%

    It seems to be slowing, though a 6.5% increase in one day is pretty big.
    As above, so below

  20. 2020-Apr-18, 10:26 PM
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    New Atlantis data seems very flawed

  21. #1850
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    Quote Originally Posted by Strange View Post
    This article uses a linear scale to compare covid-19 deaths to various other causes: https://www.thenewatlantis.com/publi...ashes-not-like
    You are right, the visual impact is higher. But you do lose detail at the low end of the y-axis.
    The following is an extrapolation of the dramatic graph you gave from your link (The New Atlantis article) showing the terrible growth for Covid-19 in the U.S. That was an eye-opener for me.

    Their curve for Covid matches my calculations (data from Johns Hopkins U.). I also checked a few of their other curve values – deaths by car accidents, from cancer and heart disease.

    The 11.8% I show is simply this current week’s average (3 days remaining to complete the next week), and it’s also the prior week’s average (11.9%). This is the no. of new daily deaths/total deaths from prior day.

    All curves were rearranged from the New Atlantis graph so they all begin, approx., on January 1st. This better represents the seasonal aspects for the other diseases, and it shows Covid isn’t behaving similarly, unfortunately, at least not yet.

    [Added: The following is a slightly corrected and improved version of the original (shown in the shaded area). I changed the x-axis to stretch it by limiting it to the end of June. These rates are daily so compounded and they are only applied to the next three days to reach the EOW (End of Week).]

    Covid comparison cut thru Jun.jpg

    [I had thought their data was in error, but apparently not.]

    [Added: The graph shows an end of April for the end of the next "week", but actually it ends on April 20th.]
    Attached Images Attached Images
    Last edited by George; 2020-Apr-19 at 12:47 AM.
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    Interesting article on a model estimating when states can ease off stay at home rules. For my California and a fair number of states, another month. Some earlier, others going into June. Lighter is better:

    https://www.geekwire.com/2020/anothe...hutdowns-last/

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    Quote Originally Posted by Van Rijn View Post
    Interesting article on a model estimating when states can ease off stay at home rules. For my California and a fair number of states, another month. Some earlier, others going into June. Lighter is better:

    https://www.geekwire.com/2020/anothe...hutdowns-last/
    Have to take those predictions with a grain of salt .. So many unknowns!?

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    Quote Originally Posted by Roger E. Moore View Post
    CNN article on what it is like to lose your senses of smell and taste... then not get them back, thanks to COVID-19.

    https://www.cnn.com/2020/04/12/healt...gbr/index.html
    I seem to remember some zinc related over-the-counter swabs or something having a similar effect a few years ago—I wonder if some study on that side effect might play a role here...
    Last edited by publiusr; 2020-Apr-19 at 06:47 AM.

  25. #1854
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    Quote Originally Posted by Selfsim View Post
    Have to take those predictions with a grain of salt .. So many unknowns!?
    Sure, but it gives an idea of how long US stay at home times rules will likely last. Actual dates will depend on updates to medical/technical knowledge as well as political and economic considerations. I am looking forward to seeing the panic buying phase run out (which has lasted longer than I expected it would).

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    Quote Originally Posted by Rolling Stone View Post
    A few weeks ago, it looked like this thing was under control in Singapore, but then it increased dramatically.

    In the current wave, most of the people infected are foreign workers. There are a lot of foreign construction workers, living in shared facilities, close quarters, etc. Ideal setting for the spread of a virus.

    https://www.channelnewsasia.com/news...rkers-12652286
    This is pretty much what CNN says, too, comparing Singapore with Hong Kong below.
    https://www.cnn.com/2020/04/18/asia/...hnk/index.html
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  27. #1856
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    Quote Originally Posted by publiusr View Post
    I seem to remember some zinc related over-the-counter swabs or something having a similar effect a few years ago—I wonder if some study on that side effect might play a role here...
    Zinc nasal spray. For instance:

    https://www.rn.com/headlines-in-health/zicam-alert/

    I would hate to lose my sense of taste or especially smell permanently. Among other things, eating food would be more of a chore rather than something to enjoy.

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    Quote Originally Posted by Roger E. Moore View Post
    This is pretty much what CNN says, too, comparing Singapore with Hong Kong below.
    https://www.cnn.com/2020/04/18/asia/...hnk/index.html
    Also similar points in the article I linked to in my post back here:

    https://forum.cosmoquest.org/showthr...40#post2510640

    Singapore had a system that could work with a limited number of cases, but they didn’t sufficiently take the foreign workers into consideration that are living in crowded substandard conditions. There were other issues too, like not realizing just how fast exponential growth could get get away from them once it exceeded what the test/trace/quarantine procedure could handle.

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    BBC Future article on why men are at greater risk than women who it comes to COVID-19 consequences. Women may have far better immune systems, for one thing.

    https://www.bbc.com/future/article/2...-men-and-women
    Do good work. —Virgil Ivan "Gus" Grissom

  30. #1859
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    Quote Originally Posted by Van Rijn View Post
    Sure, but it gives an idea of how long US stay at home times rules will likely last. Actual dates will depend on updates to medical/technical knowledge as well as political and economic considerations. I am looking forward to seeing the panic buying phase run out (which has lasted longer than I expected it would).
    I would say the 'actual dates' depends entirely on how seriously given sub-populations under stay-at-home orders take them, (ie: in terms of displays of how strictly they follow them).

    The panic buying we see is classic example of a sub-population behavior and its duration, may well be a better indicator of willingness (or otherwise) as to what must be done in order to stabilise community grocery supplies .. and as a measure of when community lockdowns might be undone.

    See, the behavior with respect to lockdowns is key to just about everything going forward and the numbers in these models, merely report on it.

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    How fast is COVID-19 spreading in your state? Try these interactive graphs from Johns Hopkins.

    https://www.npr.org/sections/health-...rus-in-the-u-s
    Do good work. —Virgil Ivan "Gus" Grissom

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