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

  1. #1621
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    Quote Originally Posted by Grey View Post
    I think that here in the US, many restaurants have figured out that the food is only a smallish portion of the cost of delivering a meal in a restaurant, and so it's remarkably common for restaurants to try to make it seem like you're getting a "good deal" by giving you significantly more food than you can comfortably eat.
    And have you noticed how often a server will come by later and ask, verbatim, "are you still working on that?" I realize they need to know if they should take your plate or not, but if I owned a restaurant, the first thing I'd tell my servers is that eating at my restaurant is never work!

    It's funny how certain phrases get inducted into our culture without any effort to do so. I did phone sales for a short while (before the days of widespread caller ID) and it was a significant majority of everyone who picked up that said, verbatim, "I'm not interested." Never "no thanks," or "I don't need that," it was always about interest. And on HGTV, whenever anyone has their home redesigned and revealed to them, their first reaction is always, verbatim, "oh my god/gosh." Every time. But I digress, I don't know if any ubiquitous phrases have come out of COVID-19 yet, other than perhaps "we're all in it together", which is hard to find fault with (other than the fact that, if you are on an aircraft carrier or in a prison, you have a somewhat deeper understanding of the phrase...)
    Last edited by Ken G; 2020-Apr-08 at 04:51 PM.

  2. #1622
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    Quote Originally Posted by Ken G View Post
    I don't think there's much evidence that a huge number of people are asymptomatic, as far as I've seen it's about half. For any significant herd immunity without catastrophic failure to combat the disease, it would need to be more like 90% at least.
    But what is the evidence? There seems to be no useful antibody test yet and very little swab testing of random people. Germany is testing more than most, in Europe at least, and has far fewer deaths per case. Doesn’t that suggest the more you test the more you find, but serious cases shrink as a proportion.?
    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

  3. #1623
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    Quote Originally Posted by Ken G View Post
    And have you noticed how often a server will come by later and ask, verbatim, "are you still working on that?" I realize they need to know if they should take your plate or not, but if I owned a restaurant, the first thing I'd tell my servers is that eating at my restaurant is never work!
    I saw a comedian comment on this once. He answered, "I am finished working on this. And I think I did an excellent job!"
    A: "Things that are equal to the same are equal to each other"
    B: "The two sides of this triangle are things that are equal to the same"
    C: "If A and B are true, Z must be true"
    D: "If A and B and C are true, Z must be true"
    E: "If A and B and C and D are true, Z must be true"

    Therefore, Z: "The two sides of this triangle are equal to each other"

  4. #1624
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    Quote Originally Posted by Ken G View Post
    And have you noticed how often a server will come by later and ask, verbatim, "are you still working on that?" I realize they need to know if they should take your plate or not, but if I owned a restaurant, the first thing I'd tell my servers is that eating at my restaurant is never work!
    Friends who have worked as waitresses say that restaurants often have a limited supply of tableware vis-a-vis the number of customers being served. So there is a need to get the dirty tableware washed and back in service. Grabbing it back from customers as soon as possible is done diplomatically by presenting it as a service to them.

  5. #1625
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    Early data shows racial disparity in coronavirus deaths, black Americans die at higher rates than whites
    https://www.cnn.com/videos/us/2020/0...s/coronavirus/
    Do good work. —Virgil Ivan "Gus" Grissom

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    Quote Originally Posted by tashirosgt View Post
    Friends who have worked as waitresses say that restaurants often have a limited supply of tableware vis-a-vis the number of customers being served..
    Speaking of supplies. So many restaurants have closed or are closing, that for supplies, some, perhaps many, restaurant supply houses are over-stocked. I know of a person who purchased a relatively large quantity -- likely due to the minimum order size -- from a local supply house.
    We know time flies, we just can't see its wings.

  7. #1627
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    Quote Originally Posted by grant hutchison View Post
    Quote Originally Posted by Ken G
    Meanwhile, the effects of smoking on COVID-19 are not coming out as expected. https://www.healio.com/primary-care/...id-19-severity reports that smoking does not increase death risk from COVID-19, perhaps because despite the obvious lung vulnerabilities associated with it, there are compensating benefits.
    There have been a few of these now. I posted a link to another such analysis earlier in the thread. We know that the lung changes of smoking make one more likely to be infected by a respiratory virus, so the fact that smokers are underrepresented among hospital admissions suggests that there must be a big undetected bunch who get mild disease. So ACE-2 upregulation with smoking may be protective against the ACE-2 downregulation caused by severe COVID-19.
    The study in the link presented by Ken G focuses on 'active' smoking. I am yet to see that term defined in any of these studies .. its automatically assumed that the reader 'knows' implicitly what this means.
    Cardiac failure, already known to be causally associated with a history of past smoking, also ends up being the same cause of death as with pandemic patients. These patients die in severe cardio-respiratory distress and ultimately, failure thereof.

    The chase is on to find anything which might divert any patient from this trajectory. This is also the focus of these studies, so the immediate status of a given patient's ACE-2 regulation draws attention.

    I know if/when I contract the virus, I want to go in with a healthy lung and have as few cormorbidity risks as I possibly can. Not smoking in the past was the best behavioral strategy to adopt, in order to achieve this.

    The elephant in the room, during this pandemic, is detrimental continued human behaviors, which we always shy away from (and paradoxically excuse). The evidence for the success of addressing such behaviors is the evidence emerging of the success of lockdowns in arresting the progress of virus transmission.

    There never is, or has been, a good health related (scientifically based) reason for taking up smoking .. now, in the past, or in the future.

  8. #1628
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    Quote Originally Posted by Selfsim View Post
    The study in the link presented by Ken G focuses on 'active' smoking. I am yet to see that term defined in any of these studies .. its automatically assumed that the reader 'knows' implicitly what this means.
    Active is the opposite of passive. Passive smoking is when you're exposed to someone else's cigarette smoke; active smoking is when you're inhaling the smoke of your own cigarette.

    Grant Hutchison

  9. #1629
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    Quote Originally Posted by profloater View Post
    But what is the evidence? There seems to be no useful antibody test yet and very little swab testing of random people. Germany is testing more than most, in Europe at least, and has far fewer deaths per case. Doesn’t that suggest the more you test the more you find, but serious cases shrink as a proportion.?
    Germany has so few cases to begin with it's rather odd. Why the death rate is so low is an equal mystery. In the US you pretty much always need symptoms to get tested, otherwise there's very few tests to go around. I know of a few cases where group testing was done without symptoms, like there was basketball team that was tested and found 4 positives without symptoms, and 1 later developed symptoms. That's pretty poor statistics. It shouldn't be that hard to know, we just need a body of tests that were not done based on symptoms, surely all nations have that kind of data. But do we hear about it? The dearth of important information amazes me, so much more should be known by now. Even the idea that you can lose your sense of taste is information that is barely trickling out, though it's obviously quite important.

  10. #1630
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    Quote Originally Posted by tashirosgt View Post
    Friends who have worked as waitresses say that restaurants often have a limited supply of tableware vis-a-vis the number of customers being served. So there is a need to get the dirty tableware washed and back in service. Grabbing it back from customers as soon as possible is done diplomatically by presenting it as a service to them.
    But that's just it-- if I had a restaurant, no one is serving my clients by taking away their food, they are serving them by giving them the food! The servers should apologize for having to end the experience, not act like they are doing the patrons a favor by ending their labors.

  11. #1631
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    Quote Originally Posted by Ken G View Post
    It shouldn't be that hard to know, we just need a body of tests that were not done based on symptoms, surely all nations have that kind of data. But do we hear about it?
    I don't think that that exists in many cases. I think that Germany and South Korea did a lot of testing of asymptomatic people, but I think in many places the testing has basically been restricted to people who are symptomatic. That is likely one reason for the low death rate in those two countries.
    As above, so below

  12. #1632
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    Quote Originally Posted by Jens View Post
    And a few more updates:

    64 11.9%
    65 13.5%
    66 13.0%
    67 12.0%
    68 13.5%
    69 13.1%

    Judging from deaths, the pandemic seems to be growing at a fairly steady rate of about 13% per day. I'm not sure if it's good that it's not accelerating or bad that it isn't decreasing. The real issue for the healthcare system I suppose is how many people are being released (or dying...) versus how many new cases are emerging, and how many of those require hospitalization. We're now up to about 700,000 people infected worldwide, which means about one person in 70,000 has been infected, or about 0.007%.
    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.
    As above, so below

  13. #1633
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    Quote Originally Posted by Ken G View Post
    Germany has so few cases to begin with it's rather odd. Why the death rate is so low is an equal mystery. In the US you pretty much always need symptoms to get tested, otherwise there's very few tests to go around. I know of a few cases where group testing was done without symptoms, like there was basketball team that was tested and found 4 positives without symptoms, and 1 later developed symptoms. That's pretty poor statistics. It shouldn't be that hard to know, we just need a body of tests that were not done based on symptoms, surely all nations have that kind of data. But do we hear about it? The dearth of important information amazes me, so much more should be known by now. Even the idea that you can lose your sense of taste is information that is barely trickling out, though it's obviously quite important.
    From memory, Germany was well prepared compared to other European countries and like S Korea, implemented test , trace and quarantine policies which proved effective. They later agreed that this tended to involve a middle age spectrum of travellers and now it is spreading into an older group. So there may be an increase in death rates now. Germany had the facilities to get those early tests out fast, well ahead of other countries.
    Obviously the case numbers reflect testing while the deaths tend to reflect tested hospital patients, so deaths at home may be under-reported and asymptomatic numbers are just not known.
    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. #1634
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    I mentioned Japan before, did little except they all wear masks anyway and avoid contact, now taking action but hardly any deaths per day. Surely, knowing that those masks are not 100% effective, they have developed herd immunity and now they are testing, still seeing cases, but the total deaths remain low per capita. Does that not suggest dose is important in controlling serious cases?
    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 Jens View Post
    I don't think that that exists in many cases. I think that Germany and South Korea did a lot of testing of asymptomatic people, but I think in many places the testing has basically been restricted to people who are symptomatic. That is likely one reason for the low death rate in those two countries.
    Maybe so, and if so, how hard would it be to track the outcomes of asymptomatic people who tested positive? What fraction later develop symptoms? We know the order of events is, 1) detectable viral infection, 2) appearance of symptoms (or not), 3) worsening of symptoms (or not). So why don't we know the percentages for those three stages? The results from Germany and South Korea would be just fine.

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    Quote Originally Posted by profloater View Post
    I mentioned Japan before, did little except they all wear masks anyway and avoid contact, now taking action but hardly any deaths per day. Surely, knowing that those masks are not 100% effective, they have developed herd immunity and now they are testing, still seeing cases, but the total deaths remain low per capita. Does that not suggest dose is important in controlling serious cases?
    I would strongly doubt there is any significant herd immunity in Japan. Again it requires a very high proportion of asymptomatic cases, for which there is no support. Until there is support for that, herd immunity still equals catastrophe.

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    On the issue of something going on that we haven't figured out yet, I would point out that New Zealand has had 1239 reported cases, and 1 death. We need to know what that is, it has to be something very important. They locked down very early in the process, and have thus avoided a lot of cases, but why has that also meant few deaths? Australia has had 6109 and 51 deaths, which is low, but not astronomically low like New Zealand. There certainly may be some differences in how these things get reported, but come on-- 1 death from COVID-19? Some scientists need to get over there and figure out what is going on that is different from the US and western Europe, it's night and day.
    Last edited by Ken G; 2020-Apr-09 at 03:23 PM.

  18. #1638
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    Might just be timing - if most of the identified cases are recent, people wouldn’t have had time to get really sick yet.

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  19. #1639
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    Quote Originally Posted by Ken G View Post
    I would strongly doubt there is any significant herd immunity in Japan. Again it requires a very high proportion of asymptomatic cases, for which there is no support. Until there is support for that, herd immunity still equals catastrophe.
    Well the experiments are running. Rapid response, contact trace and quarantine is a kind of shutdown, and total shutdown must Also prevent herd immunity, but ignoring early signs will increase cases, which you don’t find without testing, I guess it suggests more deaths until herd immunity is high enough. New Zealand shut down as I understand it, Japan did not, we should know more in a couple of weeks.
    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

  20. #1640
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    Quote Originally Posted by Ken G View Post
    I would strongly doubt there is any significant herd immunity in Japan. Again it requires a very high proportion of asymptomatic cases, for which there is no support. Until there is support for that, herd immunity still equals catastrophe.
    Well suppose R0 is 4 made up of two cases which develop and two which don’t, All four remain infectious for several days but the asymptomatic pair do not self isolate, they carry on infecting people. They probably don’t get tested. In closed communities, herd immunity increases unseen. Of course there are other arithmetics which go exponential.
    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 Ken G View Post
    On the issue of something going on that we haven't figured out yet, I would point out that New Zealand has had 1239 reported cases, and 1 death. We need to know what that is, it has to be something very important. They locked down very early in the process, and have thus avoided a lot of cases, but why has that also meant few deaths? Australia has had 6109 and 51 deaths, which is low, but not astronomically low like New Zealand. There certainly may be some differences in how these things get reported, but come on-- 1 death from COVID-19? Some scientists need to get over there and figure out what is going on that is different from the US and western Europe, it's night and day.
    Certainly bears looking into, and could be a constellation of causes:
    More and wider testing?
    Faulty testing?
    Better testing?
    Varying CFR classifications? (This may be one of the more interesting data points - examined retrospectively - once the pandemic has settled down.)
    Selection bias of some kind?

  22. #1642
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    Quote Originally Posted by Van Rijn View Post
    Might just be timing - if most of the identified cases are recent, people wouldn’t have had time to get really sick yet.
    Can't be that recent-- NZ started their lockdown on March 23.

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    Quote Originally Posted by profloater View Post
    Well suppose R0 is 4 made up of two cases which develop and two which don’t, All four remain infectious for several days but the asymptomatic pair do not self isolate, they carry on infecting people. They probably don’t get tested. In closed communities, herd immunity increases unseen. Of course there are other arithmetics which go exponential.
    My point is, right now I don't think there's reason to think the asymptomatic fraction is close to 1, so assume it is 0.5. Then for every 100 who contract the disease, about 1 dies (that would be a 2% death rate among cases with symptoms). So to achieve even 10% herd immunity, which is just scratching the surface, you must tolerate 0.1% of your population to die. In the US, that's 300,000 people, and that's only for 10% immunity. You might need 5 times that, so you might need to tolerate over a million deaths. I don't think herd immunity is a realistic effect, unless there is a lot more asymptomatic cases than we currently have reason to expect.

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    Here's another issue. In the US, it's allergy season, and unfortunately allergy symptoms are an awful lot like COVID-19 symptoms (since fever is not as common with COVID-19 as they initially imagined, which is why so many sick people were able to fly in airplanes early on) So we might have people who think they are only suffering their normal allergies who are also in the early stages of COVID-19 but are not self quarantining.

    What's more, in my state, almost everything is closed, yet COVID-19 cases per day continue to rise. I can only assume that superspreader events are continuing, mostly by people who are still not taking it seriously enough.

  25. #1645
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    Quote Originally Posted by Ken G View Post
    On the issue of something going on that we haven't figured out yet, I would point out that New Zealand has had 1239 reported cases, and 1 death. We need to know what that is, it has to be something very important. They locked down very early in the process, and have thus avoided a lot of cases, but why has that also meant few deaths? Australia has had 6109 and 51 deaths, which is low, but not astronomically low like New Zealand. There certainly may be some differences in how these things get reported, but come on-- 1 death from COVID-19? Some scientists need to get over there and figure out what is going on that is different from the US and western Europe, it's night and day.
    This might interest you as well. But recall that earlier Germany had a CFR of 0.14% (~ 1500 cases; 2 deaths) and their CFR has increased by 15x as of yesterday.

    Low CFR countries.jpg

    [I think my search was for >1000 cases per country]
    We know time flies, we just can't see its wings.

  26. #1646
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    Recovered coronavirus patients will likely be immune if second wave hits in fall. Anthony Fauci said the coronavirus that causes COVID-19 has not mutated much, so people who develop immunity will likely maintain it. Still, instances of reinfections have been reported in several countries.
    https://thehill.com/changing-america...ts-will-likely
    Do good work. —Virgil Ivan "Gus" Grissom

  27. #1647
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    Quote Originally Posted by Ken G View Post
    Here's another issue. In the US, it's allergy season, and unfortunately allergy symptoms are an awful lot like COVID-19 symptoms (since fever is not as common with COVID-19 as they initially imagined, which is why so many sick people were able to fly in airplanes early on) So we might have people who think they are only suffering their normal allergies who are also in the early stages of COVID-19 but are not self quarantining.

    What's more, in my state, almost everything is closed, yet COVID-19 cases per day continue to rise. I can only assume that superspreader events are continuing, mostly by people who are still not taking it seriously enough.
    Fever is not usually an allergy sign, but while I do not want to go on about it, the experiments continue. Sweden is in effect on a herd immunity course, very controversial and they are seeing more deaths than their neighbours. But if their death rate levels off in the next two weeks, they will be vindicated. The downside is continuing, escalating deaths.
    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

  28. #1648
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    Quote Originally Posted by Ken G View Post
    What's more, in my state, almost everything is closed, yet COVID-19 cases per day continue to rise. I can only assume that superspreader events are continuing, mostly by people who are still not taking it seriously enough.
    Well, even if you confined everyone forcibly to their own households, cases would continue to rise for at least three weeks. Person incubating the disease confined with uninfected family members; passes it on to a family member after a week; family member takes a week to develop symptoms; another week of symptoms before a health-care contact and test.

    Grant Hutchison

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    Quote Originally Posted by Ken G View Post
    Here's another issue. In the US, it's allergy season, and unfortunately allergy symptoms are an awful lot like COVID-19 symptoms (since fever is not as common with COVID-19 as they initially imagined, which is why so many sick people were able to fly in airplanes early on) So we might have people who think they are only suffering their normal allergies who are also in the early stages of COVID-19 but are not self quarantining.
    Yes, this is my story. My allergies almost every year can lead to a respiratory infection, but this year I had a set of somewhat different circumstances: worse wheezing in the lungs, more coughing, one day of a temperature, one day of diarrhea and my wife following me with Lysol due to her, justifiable, self-concerns.

    What's more, in my state, almost everything is closed, yet COVID-19 cases per day continue to rise. I can only assume that superspreader events are continuing, mostly by people who are still not taking it seriously enough.
    But couldn't this be explained by a few things like the increase in testing, perhaps folks like me that may only think they had it. The coming sereological tests may make a difference. [I assume positive results for these tests will increase the no. of cases.]
    We know time flies, we just can't see its wings.

  30. #1650
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    I did not want to see this. COVID-19 simulation video shows how cough can cross two grocery aisles for ‘several minutes’
    https://www.al.com/coronavirus/2020/...l-minutes.html
    Do good work. —Virgil Ivan "Gus" Grissom

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