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

  1. #991
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    Quote Originally Posted by parallaxicality View Post
    My government has decided it wants to kill me:

    Apparently I am one of the herd to be slaughtered/
    Only 20 posts after our final warning to refrain from political comments. What happened after this post is exactly why incensive political posting is prohibited here. Not again, please. Infraction issued.
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  2. #992
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    Why are men more likely to die from COVID-19? Perhaps because they smoke more than women. Immune system differences also likely. See BBC article. Suggests that air pollution is also a detriment.

    https://www.bbc.com/news/health-51774777
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    Some actual science, before I self-isolate from this thread:

    1) Every country is going to benefit from the onset of herd immunity in their population. That's how epidemics work. The more recovered people you have, the lower R0 gets. Combined with other measures, it helps you get R0 below one, and it happens naturally as an epidemic progresses. No-one ever suggested that pushing towards complete herd immunity in an uncontrolled way was a sensible or viable option. But every little helps, and the early stage of developing herd immunity needs to be incorporated into modelling.
    2) "Shutting down the country" can work for a month or two, but not for as long as this is going to take. The proportion of people in the world who have been infected by coronavirus is still tiny, so the virus can resurge as soon as draconian measures are lifted. We are going to see that, in China or someplace else, as people start to try to get back to normal life and economic activity after lock-down. So then, oops, you're back into lock-down.
    3) So what can you do? You need to choose between an epidemic "boom and bust", or a long, slow process that interferes with everyone's life but doesn't shut things down entirely. You need to make this choice because there's a thing called "behavioural fatigue" which means people start to default from draconian measures after only a month or two (anyone who's been on a rapid weight-loss diet knows about this), and because you simply can't run a society in extreme lock-down.
    4) How do you achieve the long, slow response? You start early with simple measures that have a big effect on R0, like hand-washing, social distancing and isolation of the infected. You don't shut schools (because children are at very low risk from this disease, because they'll mix outside school anyway, and because parental childcare removes vital people from the workforce and also limits their ability to care for the elderly and frail, who are most at risk); you don't shut down large events, because they have an absolutely minimal effect on R0, and because by doing so you drive people to socialize in other ways in which it's easier to transmit the virus; and you specifically protect the elderly and those with multiple other diseases, who are most at risk of dying or becoming severely ill and needing care in a stretched healthcare system. What you don't do is throw everything at the problem early, cripple your society, and then have to back off from the draconian measures while the virus is still around.
    5) The science in this has been gamed for a decade in the UK (and no doubt elsewhere), with increasingly sophisticated models that now include behavioural agents that model the behaviours of real people, the capacity of the health-care system, and the effect on R0 of all sorts of interventions.
    6) Disagreements about the nature of the necessary response are fundamentally disagreements about the scientific modelling (but modelling is all we have). No-one is "ignoring science".

    7, my own opinion) We need to avoid an international "purity spiral" in which everyone starts shutting down everything in an unsustainable way, just because people are panicking. But I think we're already seeing that.

    Grant Hutchison

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    I'm not sure I could find a herd that would have me, but that's just me.
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    I can understand the hoarding of face masks and hand sanitizer.

    But toilet paper? Does covid-19 cause severe diarrhea?
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    Thanks for your comments, Grant. I hope you will consider not completely self-isolating from the thread, and perhaps comment sometimes when there are major developments where you might have some important insight.

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    Quote Originally Posted by Van Rijn View Post
    Thanks for your comments, Grant. I hope you will consider not completely self-isolating from the thread, and perhaps comment sometimes when there are major developments where you might have some important insight.
    Said better than I could.


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    Quote Originally Posted by Van Rijn View Post
    Thanks for your comments, Grant. I hope you will consider not completely self-isolating from the thread, and perhaps comment sometimes when there are major developments where you might have some important insight.
    Agreed and seconded.

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    Quote Originally Posted by headrush View Post
    Agreed and seconded.
    Agreed. Learned a lot from you.
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    Quote Originally Posted by Roger E. Moore View Post
    Agreed. Learned a lot from you.
    Fourth.

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    I agree wholeheartedly as well. And by the way, just a bit of incredulity, but I looked at the WHO report today, and there are no new cases reported in the USA. And actually, I think the reason is that the CDC doesn’t make reports on the weekends. I know we shouldn’t be too draconian, but that seems a bit lackadaisical to me...
    As above, so below

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    Quote Originally Posted by Jens View Post
    I agree wholeheartedly as well. And by the way, just a bit of incredulity, but I looked at the WHO report today, and there are no new cases reported in the USA. And actually, I think the reason is that the CDC doesn’t make reports on the weekends. I know we shouldn’t be too draconian, but that seems a bit lackadaisical to me...
    I don't know about WHO, but there was a new case just in my county.
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    Quote Originally Posted by Swift View Post
    I don't know about WHO, but there was a new case just in my county.
    Yes, I am sure that local officials release information, but apparently the CDC does not. Their website says they update the number of cases in the US at noon Eastern time from Monday to Friday.
    As above, so below

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    Quote Originally Posted by Jens View Post
    Yes, I am sure that local officials release information, but apparently the CDC does not. Their website says they update the number of cases in the US at noon Eastern time from Monday to Friday.
    There is also an issue of who is doing the tests and coordinating reporting. Basically, the CDC was overwhelmed, state level and private labs are gearing up while the CDC is rapidly expanding and working out details too, but it will take time to coordinate and get the reporting process worked out.

    The next couple of weeks will be interesting. There is widespread belief that the number of cases reported will increase dramatically as testing expands, with the assumption that there are a lot of cases that exist but haven’t been able to be tested.

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    From Matador Travel Security March 16, 2020

    Latest developments:
    Over this weekend increasing numbers of countries have initiated border closures, bans on foreign travelers, and/or complete cessation of flights. This reinforces the importance of keeping up to date with the fast-changing situation. Examples include:
    Czech Republic: effective 16 March, ban on entry for all foreign nationals who do not have temporary or permanent resident status. Czech citizens and foreign residents are barred from leaving the country as part of the state of emergency. The only exceptions are lorry drivers, pilots and anyone who works within 31 miles (50km) of the Czech border, for example in Germany and Austria. International train traffic has been suspended.
    Denmark: effective 13 March borders will be temporarily closed until 14 April for all foreign travelers.
    Poland: stringent checks have been imposed at all border crossings for the coming ten days as of 13 March and borders will remain closed to all foreigners. All international flights and train connections will be suspended for ten days from 14 March. Local nationals arriving in Poland are ordered to undergo 14 days of quarantine.
    Spain: on March 14 2020 the Spanish government passed a two-week state of emergency order which came into action immediately and imposes a lockdown that requires all people to remain at home except to buy food, get medicines, see a doctor, leave the house for an emergency or go to work. Spain has the fifth-highest number of cases in the world, behind China, Italy, Iran and South Korea.
    Saudi Arabia: cancellation of all international flights from 11.00 (local time) on 15 March until 29 March. Exemptions will be made during this period for ‘exceptional cases’, though exactly what this will entail remains unclear.
    United Arab Emirates: The UAE will suspend visa issuance starting on March 17, the official news agency WAM has reported.
    India: India: all existing visas are suspended from 12.00 (local time) on 13 March until 15 April. Exceptions include visas issued to diplomats, officials, the UN and other international organisations, as well as employment and project visas. Visa-free travel granted to Overseas Citizenship of India (OCI) cardholders will be temporarily suspended for the same period. The government has advised that travelers affected by the aforementioned restrictions and with a 'compelling reason' to visit India should contact their nearest Indian diplomatic mission. The health ministry has advised Indian citizens to avoid non-essential travel abroad, while those currently abroad may be subject to quarantine for a minimum for 14 days upon returning to India. The government has further advised organisations to allow employees returning from overseas and affected by the quarantine order to work from home.
    Philippines: A 'community quarantine' is in effect over all of Luzon (previously only Metro Manila had been included) until 14 April. During this period, all domestic travel by air, land, or sea to and from Metro Manila is suspended and various restrictions, ranging from movement bans to mandatory quarantines, have been imposed throughout the country. A curfew is in place over Metro Manila from 20.00 to 05.00 (local time) until 14 April.
    Vietnam: effective from 12.00 (local time) on 15 March for 30 days, those with travel history to the UK and the Schengen Area in Europe within the past 14 days will be denied entry to Vietnam. Reports indicate that all visas for foreign nationals will be suspended from 15 March until 15 April, while those entering the country must declare their health status, which can be completed online prior to arrival in Vietnam.
    United States: a travel ban applying to travelers from countries which are members of the Schengen border-free travel area came into effect on Friday March 13 at midnight EDT. The ban applies to those even with only a connecting flight in those countries. During a news conference on March 14 President Trump announced the UK and Ireland have now been included.

    The global number of reported infections now stands at 169,387 with 6,513 fatalities:
    ​​​​​​​...
    Notable major statistics include:
    China: 81,020 cases with 3,213 fatalities.
    Outside of China: 88,367 cases with 3,300 fatalities.
    Italy: 24,747 cases with 1,809 fatalities. Effective March 10 2020 the government has placed the whole country under quarantine until at least April 3. Rome's Ciampino airport closed from Friday night March 13, and Terminal 1 will close at Rome's Fiumicino airport on Tuesday March 17.
    Iran: 13,938 cases with 724 fatalities.
    South Korea: 8,162 cases with 75 fatalities.
    North America: 3,774 recorded cases with 69 fatalities in the United States, 339 cases in Canada with 1 fatality, and 43 in Mexico with 0 fatalities.

    Updated figures can be found on Johns Hopkins University's coronavirus tracking map.​​​​​​​
    Those statistics are interesting. While the world outside China has shown an 800+% increase in cases over the last two weeks, China has increased only 1.24%. It looks like their efforts worked. And South Korea has been doing something right, They show an 88% increase but that's about half what it was the preceding two weeks. And their mortality rate is still under 1%.

    There has been a lot of talk that US hospitals may not be ready for what's coming. I know that many hospitals are setting up separate tent triage centers, and locally Methodist Hospital in Katy is finishing work on a wing to treat COVID patients exclusively.

    Strangely I haven't heard or read about the greatest resource the US has to address this need, the US Army Corp of Engineers. Part of their job description is building hospitals overnight. ("The difficult we do immediately. The impossible may take a little longer.")

    My company has instituted prescreening for all visitors to company locations. It's kind of honor system (Are you running a fever of 100.4F or more? Have you visited certain countries/areas or come in close, prolonged contact with someone exposed to COVID in the last 14 days?) for now.
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  16. #1006
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    Quote Originally Posted by Jim View Post
    There has been a lot of talk that US hospitals may not be ready for what's coming. I know that many hospitals are setting up separate tent triage centers, and locally Methodist Hospital in Katy is finishing work on a wing to treat COVID patients exclusively.
    My sister had to go to the local St. Francis hospital this weekend. It was a 2 hour wait for ER room (down from virtually no wait time normally). Temp testing before admittance. Masks-all. Gurneys lined up in the hallways. This area has no recorded cases of CoVID 19.
    "I'm planning to live forever. So far, that's working perfectly." Steven Wright

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    I can't help feeling we've gone from denial to overreaction in about a week. I guess time will tell.
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

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    Quote Originally Posted by Jim View Post
    My company has instituted prescreening for all visitors to company locations. It's kind of honor system (Are you running a fever of 100.4F or more? Have you visited certain countries/areas or come in close, prolonged contact with someone exposed to COVID in the last 14 days?) for now.
    The only people in our building at work are production (we have a small plant here) and lab techs and our QA people (who are working on stretched shifts so fewer at work at one time). Everyone else is working from home (or goofing off posting on CQ from home ) and no visitors allowed in building (not that there is anyone to visit).
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  19. #1009
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    Quote Originally Posted by Jim View Post
    Strangely I haven't heard or read about the greatest resource the US has to address this need, the US Army Corp of Engineers. Part of their job description is building hospitals overnight. ("The difficult we do immediately. The impossible may take a little longer.")
    The US Navy Seabees can get in on that action, too.

  20. #1010
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    Quote Originally Posted by grant hutchison View Post
    And eventually we're all going to need herd immunity.
    It is certainly true that COVID-19 is going to be out there, with all the other flus, from now on. But there's something I don't understand about "herd immunity." Isn't that something that will either take thousands of years to achieve, or else will require a horrendous death toll like the Spanish flu? I mean, there isn't really an intermediate possibility that I can see. For example, how close to herd immunity for SARS or MERS are we now? I frankly don't understand the claim that "flattening the curve" means "spread out the cases so the medical system is not overloaded, until herd immunity sets in." It seems to me it has to mean "reduce R0 so the disease dies down to the point that only a small fraction of humanity gets it over the next few centuries." Why are these two very different possibilities getting conflated?

    Put differently, it seems to me we have two important factors here, call them X and Y, where X is the fractional herd immunity (the fraction that cannot get COVID-19 because they already had it), and Y is the fraction who get it that die from it. It seems that if we want to reduce R0 by the factor X, then X cannot be tiny. But there is another important number here: N*X*Y, where N is the population of the society. Since Y is something like 1%, think about what NXY is if X is not tiny.

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    Quote Originally Posted by Ken G View Post
    It is certainly true that COVID-19 is going to be out there, with all the other flus, from now on. But there's something I don't understand about "herd immunity." Isn't that something that will either take thousands of years to achieve, or else will require a horrendous death toll like the Spanish flu? I mean, there isn't really an intermediate possibility that I can see. For example, how close to herd immunity for SARS or MERS are we now? I frankly don't understand the claim that "flattening the curve" means "spread out the cases so the medical system is not overloaded, until herd immunity sets in." It seems to me it has to mean "reduce R0 so the disease dies down to the point that only a small fraction of humanity gets it over the next few centuries." Why are these two very different possibilities getting conflated?

    Put differently, it seems to me we have two important factors here, call them X and Y, where X is the fractional herd immunity (the fraction that cannot get COVID-19 because they already had it), and Y is the fraction who get it that die from it. It seems that if we want to reduce R0 by the factor X, then X cannot be tiny. But there is another important number here: N*X*Y, where N is the population of the society. Since Y is something like 1%, think about what NXY is if X is not tiny.
    There doesn't have to be a horrendous death toll. The virus only kills those with underlying problems or the elderly who almost certainly have underlying problems. If the rest of the population get the virus and recover, there is no reservoir of active virus to infect the vulnerable people. This is why we need currently healthy people to carry on with their normal lives as far as possible, while isolating the at risk group. The death toll would be minimal if this were perfectly carried out because only the ones who are going to recover will be exposed. I realise that this is a difficult proposition but in the absence of a vaccine it is the best way forward.
    But, I'm not a doctor nor do I play one on TV.

    I don't think the same applies for SARS etc, because they were contained before reaching pandemic status. It won't take thousands of years. If each town is clear of infection (because all except the vulnerable have already caught it and recovered) then the vulnerable cannot get it. Extrapolate to a larger area.

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    What is the mechanism of recovery?

    In those that do recover from viral diseases, what is the mechanism of recovery?

    One possibility is that the virus's reproduction rate in some people's bodies isn't sufficient to sustain it and/or the body's reaction dilutes the virus that is present by expelling fluids.

    Another possibility is that the body develops some reaction to the virus that can actively destroy or resist it while it is still inside the body.

  23. #1013
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    Welp. Possible case in the county I live in, 1 dead:
    https://www.theindychannel.com/10-wh...vid-19-related

    10 White River Township firefighters quarantined after medical run believed to be COVID-19 related
    "I'm planning to live forever. So far, that's working perfectly." Steven Wright

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    Canada shut its borders. Dow down about 10% today. Recession possible. Brits told to stop all "non-essential contact."

    Wait. What kind of non-essential contact are those Brits doing? Cut it out!
    Last edited by Roger E. Moore; 2020-Mar-16 at 06:18 PM.
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    Quote Originally Posted by tashirosgt View Post
    In those that do recover from viral diseases, what is the mechanism of recovery?

    One possibility is that the virus's reproduction rate in some people's bodies isn't sufficient to sustain it and/or the body's reaction dilutes the virus that is present by expelling fluids.

    Another possibility is that the body develops some reaction to the virus that can actively destroy or resist it while it is still inside the body.
    Check out “the immune system” without it any virus would wipe us out. It’s a race between the virus multiplication rate within our cells and our immune system cells. The feeling of being unwell and needing to rest is exactly what it feels like when our immune system snaps into action.
    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

  26. #1016
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    Quote Originally Posted by Ken G View Post
    It is certainly true that COVID-19 is going to be out there, with all the other flus, from now on. But there's something I don't understand about "herd immunity." Isn't that something that will either take thousands of years to achieve, or else will require a horrendous death toll like the Spanish flu? I mean, there isn't really an intermediate possibility that I can see. For example, how close to herd immunity for SARS or MERS are we now? I frankly don't understand the claim that "flattening the curve" means "spread out the cases so the medical system is not overloaded, until herd immunity sets in." It seems to me it has to mean "reduce R0 so the disease dies down to the point that only a small fraction of humanity gets it over the next few centuries." Why are these two very different possibilities getting conflated?

    Put differently, it seems to me we have two important factors here, call them X and Y, where X is the fractional herd immunity (the fraction that cannot get COVID-19 because they already had it), and Y is the fraction who get it that die from it. It seems that if we want to reduce R0 by the factor X, then X cannot be tiny. But there is another important number here: N*X*Y, where N is the population of the society. Since Y is something like 1%, think about what NXY is if X is not tiny.
    This is the hard policy question. Closing everything down, as many countries are doing, reduces the infection rate but cripples small businesses so at some point you relax and then the rate goes up because herd immunity is low. The alternative is to isolate the vulnerable and try to keep businesses open. This produces a higher infection rate on the assumption most will recover and probably are then immune. For example UK schools are still open knowing that most children recover and child immunity will increase. If this one becomes endemic, it will kill people every year like the flu viruses without all this attention.

    By the way did you know the name flu derives from influence from the ancient belief that the flu was triggered by astrological influences?
    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

  27. #1017
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    Quote Originally Posted by Roger E. Moore View Post
    Canada shut its borders. Dow down about 10% today. Recession possible. Brits told to stop all "non-essential contact."

    Wait. What kind of non-essential contact are those Brits doing? Cut it out!
    We used to go the pub! We still have good pubs but this will hurt!
    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

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    Quote Originally Posted by Roger E. Moore View Post
    Canada shut its borders. Dow down about 10% today. Recession possible. Brits told to stop all "non-essential contact."
    Recession possible? It looks more like a global economic calamity to me.

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    I'm sorry, but in all the movies I watched about pandemics, a hero emerges that prevents catastrophe. Where is our hero?
    The moment an instant lasted forever, we were destined for the leading edge of eternity.

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    Where else? Still in the movies.
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