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

  1. #1351
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    https://www.weforum.org/agenda/2020/...ared-outbreak/
    The reference above discusses the 1917 to 1920 pandemic, thinking that modern medicine will not allow the same consequences, such as WW2. But what about modern socioeconomics?
    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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    It's true that in the US, people are still only tested if they came into contact with someone with COVID-19. Symptoms alone don't get you a test, because you are expected to self isolate if you have the symptoms, so at some level the test is irrelevant. The problem is, this is taken from a behavioral and treatment perspective, rather than a data-gathering perspective. Also, I have heard it said that the test costs $1300, and most people that get one test get two or three. Obviously the healthcare system could not afford to test everyone three times, even if we had the tests (which we don't). Also, there is a backlog in being able to return the results-- it often takes days, and obviously that's not particularly useful. We had a high profile Congressional figure exposing other members of Congress for several days while waiting days for a test result that came back positive. Hopefully there will eventually be a lot more tests, that are faster and cheaper, or else we're still just treating symptoms and we are acting in a vacuum of information other than deaths.

  3. #1353
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    Quote Originally Posted by Ken G View Post
    It's true that in the US, people are still only tested if they came into contact with someone with COVID-19. Symptoms alone don't get you a test, because you are expected to self isolate if you have the symptoms, so at some level the test is irrelevant. The problem is, this is taken from a behavioral and treatment perspective, rather than a data-gathering perspective. Also, I have heard it said that the test costs $1300, and most people that get one test get two or three. Obviously the healthcare system could not afford to test everyone three times, even if we had the tests (which we don't). Also, there is a backlog in being able to return the results-- it often takes days, and obviously that's not particularly useful. We had a high profile Congressional figure exposing other members of Congress for several days while waiting days for a test result that came back positive. Hopefully there will eventually be a lot more tests, that are faster and cheaper, or else we're still just treating symptoms and we are acting in a vacuum of information other than deaths.
    The USA has about 11000 deaths per day, locally reported for the most part, but these Corvid deaths get all the attention. I hope the various antibody tests get validated so we can see how many have been exposed, despite the isolation. They should be as cheap as those glucose pin prick tests in time. Meanwhile one of the biggest global strategy tests is well under way, we stand to learn A lot about epidemics and economic policy.
    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 headrush View Post
    There is an unsubstantiated rumour that the reason Germany has such a low death rate is because they are only reporting deaths that are a direct result of Covid-19. Any deaths where an underlying condition is exacerbated by Covid-19 leading to death from that underlying condition are not reported as Covid-19 deaths in their figures.
    A journalist checked this: they are using the same definition as other countries like Italy, UK, etc.

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    Quote Originally Posted by Strange View Post
    A journalist checked this: they are using the same definition as other countries like Italy, UK, etc.
    Good. Do you have a reference? Need to combat rumour and falsehood directly when I see it.

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    Given the great increase, apparently, in the number of testing that will increase the number of new cases, the following is interesting and positive, IMO:

    Avg Case rates 7 countries.jpg

    I assume the great efforts to isolate everyone as much as possible is overcoming the extra level of new cases from the greater number of tests, thus producing a net decrease in the rate, at least for the countries selected (the 7 from the prior graphs). Hope it continues to decline.
    We know time flies, we just can't see its wings.

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    Quote Originally Posted by Jens View Post
    Some more updates on the increase rate of deaths

    53 7.4%
    54 8.8%
    55 6.4%
    56 14.9%
    57 7.1%
    58 10.4%
    59 10.6%
    60 12.0%
    61 13.7%
    62 14.3%
    63 13.5%

    Again, a continuation in the rise in the rate of increase. It was kind of at that level in China as they started to put strong measures in place, so it might be that that is sort of the natural increase and that as countries outside China strengthen their measures, it will start to go down again. But that's just guessing.
    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%.
    As above, so below

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    700,000 would be 1 person in 10,000, or about 0.01%. To keep the death toll at a level of other things we tolerate, this must only rise to about 1% by the time vaccines are widely available. It doesn't sound like we can count on the virus getting tamed by mutations, it seems to mutate rather slowly. So worldwide new infections that are serious enough to get reported must level off at something like a million a week, and perhaps 50,000 a week in the US. Right now it's at about 20,000 a week in the US, but it's not clear this is economically sustainable. Some people have predicted it will continue to rise for another month or even two, I don't think that's likely at all. Judging from how the virus abhors lockdowns, I suspect the US cases will begin to drop in only about another week or so, but then the real question will be-- what do you do next? Drop it all the way to zero like China claims to have done (and few seem to believe), or shoot for a steady rate that is quite high, like 50,000 a week? Probably we'll see local lockdowns rather than national ones, this is uncharted territory. At least there is now a test being made at the rate of 50,000 a day that only takes 5 minutes, and one hopes is cheap enough to use to gather data. The big question is still, what fraction of infected people remain so asymptomatic that they never even know they have it?

    Also, on an interview today the doctor who treated the first US patient flat out stated that "serious illness occurs when someone coughs tiny droplets that someone else inhales." That's what he said, he did not even mention if serious illness can occur from touching a surface and then touching one's face. I've not heard anyone else say that so unequivocally, if that's really true then people who live alone and can quarantine themselves if they have mild illness really have no reason to sterilize surfaces but they do have good reason to avoid people that could be sick. They might even be advised to seek out infected surfaces! Or if he's wrong and one can get seriously ill even just by rubbing one's eyes, then he should not have stated the exact opposite.

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    Has anyone thought about liquid breathing techniques?
    I wonder if Liqui-Vent might have a future use, since ventilators year up the lungs, so to speak

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    Quote Originally Posted by publiusr View Post
    Has anyone thought about liquid breathing techniques?
    People have been thinking about that for decades. Several theoretical advantages in "shock lung" type scenarios, but it has never really delivered much advantage in clinical trials in adults. So not much kit or expertise around in the general ICU setting--the very last thing you'd want to try to roll out in a worldwide crisis.

    Grant Hutchison

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    Quote Originally Posted by Ken G View Post
    Also, on an interview today the doctor who treated the first US patient flat out stated that "serious illness occurs when someone coughs tiny droplets that someone else inhales." That's what he said, he did not even mention if serious illness can occur from touching a surface and then touching one's face. I've not heard anyone else say that so unequivocally, if that's really true then people who live alone and can quarantine themselves if they have mild illness really have no reason to sterilize surfaces but they do have good reason to avoid people that could be sick. They might even be advised to seek out infected surfaces! Or if he's wrong and one can get seriously ill even just by rubbing one's eyes, then he should not have stated the exact opposite.
    It's impossible to defend such a claim with clinical data, since (for obvious reasons) we usually have no idea how a specific patient with severe disease actually acquired the viral load that infected them.

    Grant Hutchison

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    Quote Originally Posted by headrush View Post
    Good. Do you have a reference? Need to combat rumour and falsehood directly when I see it.
    The first source was Italian. There is this:
    https://twitter.com/afneil/status/1244235433694973952

    I'm sure I saw a new article about this, but can't find it again now.

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    Quote Originally Posted by Strange View Post
    The first source was Italian. There is this:
    https://twitter.com/afneil/status/1244235433694973952

    I'm sure I saw a new article about this, but can't find it again now.
    Thanks.

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    More on why men seem more vulnerable to COVID-19. Smoking and poor health have much to do with it.

    https://www.msn.com/en-us/health/med...te/ar-BB11Eln0
    Do good work. —Virgil Ivan "Gus" Grissom

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    Quote Originally Posted by Ken G View Post
    Also, on an interview today the doctor who treated the first US patient flat out stated that "serious illness occurs when someone coughs tiny droplets that someone else inhales." That's what he said, he did not even mention if serious illness can occur from touching a surface and then touching one's face. I've not heard anyone else say that so unequivocally, if that's really true then people who live alone and can quarantine themselves if they have mild illness really have no reason to sterilize surfaces but they do have good reason to avoid people that could be sick. They might even be advised to seek out infected surfaces! Or if he's wrong and one can get seriously ill even just by rubbing one's eyes, then he should not have stated the exact opposite.
    I suspect he didn't intend to imply that "serious illness only occurs...". He may have been thinking this is what was likely responsible for what happened in a nursing home, or something. He should have been wise to mention other means of infection, of course.
    We know time flies, we just can't see its wings.

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    Here is an update on the use hydroxychloroquine. I'm optimistic about this, perhaps taking advantage of my of the fact that I'm naive in these matters, if just to be optimistic about something.

    "The Food And Drug Administration (FDA) issued an emergency authorization Sunday for hydroxychloroquine, a drug already used to treat malaria and other ailments, which has shown anecdotal efficacy against coronavirus.
    "

    There was also news that France is already using it -- I assume meaning it is approved there as well --, which makes some sense because the first small study came from a French doctor on using this with z-pack.
    We know time flies, we just can't see its wings.

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    Quote Originally Posted by Roger E. Moore View Post
    More on why men seem more vulnerable to COVID-19. Smoking and poor health have much to do with it.

    https://www.msn.com/en-us/health/med...te/ar-BB11Eln0
    The mention that Type 2 diabetes is why I'm staying home as much as possible since my wife has this. Apparently, diabetes isn't normally a higher risk to viral infections, but, regardless if true, it is an issue here. I'm a little surprised that Type 2 and not Type 1 as well wasn't an equal problem, or perhaps it is but wasn't addressed properly.
    We know time flies, we just can't see its wings.

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    Quote Originally Posted by George View Post
    I suspect he didn't intend to imply that "serious illness only occurs...". He may have been thinking this is what was likely responsible for what happened in a nursing home, or something. He should have been wise to mention other means of infection, of course.
    "Serious injury will occur if you attempt to stop the movement of your chainsaw blade using fingers or genitalia." (Attrib. Husqvarna, apocryphal.)
    There are other causes of serious injury involving chainsaws.

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    "Serious injury will occur if you attempt to stop the movement of your chainsaw blade using fingers or genitalia." (Attrib. Husqvarna, apocryphal.)
    Yep... fact.

    There are other causes of serious injury involving chainsaws.
    Yep, especially when it's loud. Easily inferred but perhaps not relevant in the case of the last patient, not that I understand why the doctor failed to eschew obfuscation in how Covid is spread.
    We know time flies, we just can't see its wings.

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    Here is an update on the average rate of new cases for the 7 countries I've elected to monitor.

    [I only went to the 25th in the last one.]

    Attachment 25057
    We know time flies, we just can't see its wings.

  21. #1371
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    Link does not work for me.
    I am watching Italy, good news is that the deaths per day has fallen for two days. Bad news is that USA is still rising.
    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 George View Post
    ... not that I understand why the doctor failed to eschew obfuscation in how Covid is spread.
    I think, given that we'll never have any evidence that infection from a contaminated surface never leads to severe disease, we can understand the doctor's comments in various ways:
    1) An acknowledgement that delivering a dose of virus directly to the airways is a good way to give someone a large viral load, and therefore potentially severe disease
    2) A non-exclusive statement about how severe disease can be acquired
    3) A sentence composed with a meaning in mind that is not fully conveyed by the sentence itself

    I can't see that much can be read into the words beyond that.

    Grant Hutchison

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    arXiv.org presents, quick searches for COVID-19 links! For bioRxiv.org and medRchiv.org

    https://arxiv.org/

    https://connect.biorxiv.org/relate/content/181
    Do good work. —Virgil Ivan "Gus" Grissom

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    Quote Originally Posted by grant hutchison View Post
    I think, given that we'll never have any evidence that infection from a contaminated surface never leads to severe disease, we can understand the doctor's comments in various ways:
    1) An acknowledgement that delivering a dose of virus directly to the airways is a good way to give someone a large viral load, and therefore potentially severe disease
    2) A non-exclusive statement about how severe disease can be acquired
    3) A sentence composed with a meaning in mind that is not fully conveyed by the sentence itself

    I can't see that much can be read into the words beyond that.
    Agreed. You correctly don't mention that one might "be advised to seek out infected surfaces!" Perhaps Ken stated this hyperbolically, but I didn't take it that way, at least to the extent he may have intended.
    Last edited by George; 2020-Mar-30 at 05:34 PM.
    We know time flies, we just can't see its wings.

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    Quote Originally Posted by Roger E. Moore View Post
    arXiv.org presents, quick searches for COVID-19 links! For bioRxiv.org and medRchiv.org

    https://connect.biorxiv.org/relate/content/181
    That site has a link to the use of chloroquine and hydrooxychloroquine.

    "Conclusions: There is theoretical, experimental, preclinical and clinical evidence of the effectiveness of chloroquine in patients affected with COVID-19."

    Also,

    "There is adequate evidence of drug safety from the long-time clinical use of chloroquine and hydroxychloroquine in other indications." I take this to mean that it is a low-risk drug so the benefit to risk ratio in administering their use is probably high, thus worth trying unless something better becomes available.
    We know time flies, we just can't see its wings.

  26. #1376
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    Quote Originally Posted by George View Post
    That site has a link to the use of chloroquine and hydrooxychloroquine.
    I wouldn't put too much faith in that article--the authors have a very strange idea of what a "systematic review" looks like, given that they include papers that are essentially opinions from other people.
    Here is a much better effort:
    The empirical evidence for the effectiveness of CQ/HCQ in COVID-19 is currently very limited. First clinical results were reported in a news briefing by the Chinese government in February 2020, revealing that the treatment of over 100 patients with chloroquine phosphate in China had resulted in significant improvements of pneumonia and lung imaging, with reductions in the duration of illness (9). No adverse events were reported.
    It appears that these findings were a result of combining data from several ongoing trials using a variety of study designs. No empirical data supporting these findings have been published so far.
    Cholorquine is, by the way, fearsomely toxic if not used correctly. People have already died from inadvertent overdoses as a result of misguided self-medication while trying to protect themselves from COVID-19.

    Grant Hutchison

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    Quote Originally Posted by George View Post
    I suspect he didn't intend to imply that "serious illness only occurs...". He may have been thinking this is what was likely responsible for what happened in a nursing home, or something. He should have been wise to mention other means of infection, of course.
    I actually think he was quite purposeful in meaning exactly that this is the source of serious illness. Whether he's right or not is another matter, but that's what he thinks. If I had to guess why he thinks that, I would say it is the combination of the high viral load in a droplet (as opposed to sitting on a surface for hours), along with direct delivery right to the deadly lung tissue. It seems that a key phase in "serious illness" is when the virus goes from the nose and throat into the lungs, and the longer that can be avoided, the longer the immune system has to build up its defenses. I don't know if this is a correct description, but it seems to me that when there is initial infection, a kind of race against time initiates-- a race between the time it takes the virus to find that deep and deadly lung tissue, and the time it takes the body to develop the necessary antibodies. Obviously that race will play out differently based on a host of factors, but not inhaling a large viral load directly into the lungs certainly seems to give a leg up to the immune system.

    If correct, this state of affairs clearly has important consequences for healthcare workers. It might be that being elderly slows the immune response, thereby losing the race even if there is not direct inhalation of a large viral load, but it might also be that even a young immune system in top form still loses that race if there is direct inhalation of a large viral load. If so, then it is easy to predict that almost all deaths in people under 60 who did not have any underlying conditions (even unknown ones) will be among either healthcare workers or family members tending to sick people at home.
    Last edited by Ken G; 2020-Mar-30 at 07:46 PM.

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    From Matador Travel Security
    Latest developments: March 30, 2020

    The United States (143,025) and Italy (97,689) have surpassed China (82,061) as the countries with the most reported cases. Spain (80,110) is close behind.

    In the United States health authorities have urged millions of residents of the New York region to avoid non-essential travel due to surging coronavirus infections there, which have now passed 1,000 - some 40% of all fatalities in the country. The initial advisory late on March 28 that applies to New York City, the hardest-hit US municipality, and the states of New York, New Jersey and Connecticut has been extended until April 30. Local or state proclamations vary across the country and continue to evolve rapidly. Click here to view the New York Times' interactive map for updates.

    Argentina has extended a nationwide quarantine until mid-April. The mandatory measures were due to expire at the end of March. The lockdown will be lifted or extended on April 12.

    Australia has announced that all travelers arriving in the country will be required to undergo a mandatory 14-day self-isolation at a designated facility beginning at 11:59 PM on March 28. According to the announcement, authorities will transport travelers directly to designated facilities after appropriate immigration, customs, and enhanced health checks. Designated facilities will be determined by the relevant state or territory government and will likely be located in the city of entry where the traveler has cleared immigration. New rules limiting public gatherings to just two people in Australia will come into effect at midnight on March 30, with the states of New South Wales and Victoria introducing hefty fines for people violating those restrictions.

    In Japan, all visitors from the United States, China, South Korea and most of Europe will be denied entry under new rules to curb coronavirus infections, according to the Asahi newspaper. Citing government sources, Asahi said Japan's foreign ministry is expected to also advise Japanese nationals to refrain from travelling to those countries. Tokyo's Governor has requested residents in the capital and surrounding regions to avoid non-essential, non-urgent outings until April 12.

    Turkey has suspended all intercity trains and limited domestic flights as part of measures to contain a fast-growing coronavirus outbreak, as the number of cases jumped by a third in a day to 5,698, with 92 dead. In a notice detailing the travel restrictions, the Interior Ministry said all citizens must remain in the cities they reside and would only be allowed to leave with a doctor's note, in the event of the death of a close family member or if they have no accommodation. While stopping short of declaring a lockdown, Turkish President Recep Tayyip Erdogan also announced the suspension of all international flights to and from Turkey.

    The global number of reported infections now stands at 723,740 with 34,081 fatalities. 152,042 people are reported to have recovered, these figures are up 9,942 on yesterday. This is the third consecutive day that the number of reported daily recoveries has increased on previous records.

    Updated figures can be found on Johns Hopkins University's coronavirus tracking map.​​​​​​
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    Quote Originally Posted by Roger E. Moore View Post
    arXiv.org presents, quick searches for COVID-19 links! For bioRxiv.org and medRchiv.org

    https://arxiv.org/

    https://connect.biorxiv.org/relate/content/181
    I realized this link was a mixed blessing, but it was worth a try. Let me know if anything good pops out.
    Do good work. —Virgil Ivan "Gus" Grissom

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    Quote Originally Posted by George View Post
    The mention that Type 2 diabetes is why I'm staying home as much as possible since my wife has this. Apparently, diabetes isn't normally a higher risk to viral infections, but, regardless if true, it is an issue here. I'm a little surprised that Type 2 and not Type 1 as well wasn't an equal problem, or perhaps it is but wasn't addressed properly.
    I'm not sure, but just offering some speculations: one is that type 2 diabetes is more prevalent in older people, while type 1 doesn't have that curve. So the fact that the disease is more serious among people with type 2 diabetes might be partly because type 2 diabetes is a marker for age. And secondly, people with type 2 diabetes tend to have other co-morbidities, like hypertension and cardiovascular disease.
    As above, so below

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