SARS-CoV2/COVID-10 Update 3-5-2020 — “As long as you remember to keep breathing and don’t fall asleep, it’s basically just like the flu.”

125 thoughts on “SARS-CoV2/COVID-10 Update 3-5-2020 — “As long as you remember to keep breathing and don’t fall asleep, it’s basically just like the flu.””

1. The summary of the above is — An infectious disease is spreading. Lots of us will get exposed to it. Some of us will get infected. A few of us will get really sick, and some will die.

   Serious question — Where are the bodies?

   Take China as the example, since that is where the disease was first noticed. On a normal day, about 25,000 human beings die in China. (Remember there are over a Billion people in China). Over the last 60 days, 1,500,000 Chinese people have died from all causes. About 3,000 of those deaths have been ascribed to coronavirus — 0.2% of the deaths.

   Since the virus seems mainly to be fatal to those of us who are old & sick, how many of those 3,000 deaths would have occurred anyway?

   The time for panic is over. Now let’s get sensible and deal with the problem.
   https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html

2. “In conversations with schools. Not recommending closures at this time unless there is a confirmed case.”
   That won’t last long, because as you say it’s so lethally stupid.

   The claim that the UAE leader has the virus has been denied, and the twitter account suspended. Does that mean it’s not true? I dunno.

   World leaders who have not appeared in public recently:
   Xi — nothing since Feb 10
   Slovak PM Peter Pellegrini — diagnosed with serious respiratory illness two weeks ago, not seen in public since
   Pope Francis — not seen since falling ill last week

3. 1 in 10 Northern Italy cases required an ICU bed.

   https://mailchi.mp/esicm/the-future-of-haemodynamic-monitoring-first-webinar-of-the-year-1009715

   Further analysis of the Seattle outbreak based on the genome sequences.

   https://twitter.com/trvrb/status/1234589598652784642

4. The problem with the lack of testing kits is that the severity and mortality data is badly skewed.

   Testing of kids in school, for example, should be easy if the kits are available. They are likely vectors for parents.

5. Well, S–t.

   Coronavirus Patient Zero in Italy Was Pakistani Migrant Who Refused to Self-Isolate

   https://summit.news/2020/03/05/coronavirus-patient-zero-in-italy-was-pakistani-migrant-who-refused-to-self-isolate/

   The man believed to be coronavirus patient zero in Italy is a Pakistani migrant refused to self-isolate after testing positive for the virus and continued to deliver food.

   Health authorities asked the man to quarantine himself at his home in the Pavia area for two weeks, but he ignored the request and continued to work at a Chinese restaurant.

   He then compounded the risk of spreading the virus by making home deliveries of Chinese food. Authorities were alerted to the situation and the military intervened to return the man to his home.

   “The Carabinieri have been busy reconstructing all the movements of the young man, in order to identify as many people as possible with whom he came into contact. In the meantime, the military has closed the Chinese restaurant,” reports Free West Media.

   The migrant now faces up to 3 months in jail for failing to self-isolate under article 650 of the Italian penal code. Italy has recorded a total of more than 3,000 cases of the coronavirus and 148 people have died. The country was the primary source of the virus spreading to numerous other European countries.

6. Some people are ignoring the Seattle Public Health Authorities.

   See:

   Seattle Coronavirus Updates
   @Seattle2019nCov
   ·
   3m
   SCHOOL UPDATE:
   @LakeWashSchools
   cancels all after school, evening and weekend events through March 18th, including volunteer programs and field trips

7. Joy.

   ==============
   CHINA

   Beijing hospital confirms nervous system infections by novel coronavirus

   Source: Xinhua| 2020-03-05 17:28:01|Editor: huaxia
   BEIJING, March 5 (Xinhua) ”” Chinese doctors have proved for the first time that the novel coronavirus can cause damage to patients’ central nervous system.

   Doctors from Beijing Ditan Hospital affiliated to Capital Medical University, a designated institution treating the novel coronavirus disease (COVID-19), announced Thursday that they have cured a male patient whose cerebrospinal fluid had the virus.

   Previous studies show that COVID-19 may attack multiple organs, including kidneys, livers and heart, but there are no records about the central nervous system damage.

   http://www.xinhuanet.com/english/2020-03/05/c_138846529.htm

8. This is going to leave a mark —

   Congress warned of possible coronavirus exposure that may have occurred at AIPAC conference
   CNBC ^ | March 4 | Lauren Hirsch

   WASHINGTON ”” The Office of Attending Physician notified some congressional staff members on Wednesday in an email of a possible coronavirus exposure that may have occurred among attendees at the recent American Israel Public Affairs Committee conference in Washington, D.C.

   https://www.cnbc.com/2020/03/04/congress-warned-possible-coronavirus-exposure-that-occurred-at-aipac.html

9. “…so long as you remember to breathe and don’t fall asleep.”

   Time to bring out the old iron lungs?

10. The title says it all.

    ===============
    Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany

    TO THE EDITOR:
    The novel coronavirus (2019-nCoV) from Wuhan is currently causing concern in the medical community as the virus is spreading around the world.1 Since identification of the virus in late December 2019, the number of cases from China that have been imported into other countries is on the rise, and the epidemiologic picture is changing on a daily basis. We are reporting a case of 2019-nCoV infection acquired outside Asia in which transmission appears to have occurred during the incubation period in the index patient.

    A 33-year-old otherwise healthy German businessman (Patient 1) became ill with a sore throat, chills, and myalgias on January 24, 2020. The following day, a fever of 39.1°C (102.4°F) developed, along with a productive cough. By the evening of the next day, he started feeling better and went back to work on January 27.

    Figure 1.

    Timeline of Exposure to Index Patient with Asymptomatic 2019-CoV Infection in Germany.

    Before the onset of symptoms, he had attended meetings with a Chinese business partner at his company near Munich on January 20 and 21. The business partner, a Shanghai resident, had visited Germany between January 19 and 22. During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China, where she tested positive for 2019-nCoV on January 26 (index patient in Figure 1) (see Supplementary Appendix, available at NEJM.org, for details on the timeline of symptom development leading to hospitalization).

    On January 27, she informed the company about her illness. Contact tracing was started, and the above-mentioned colleague was sent to the Division of Infectious Diseases and Tropical Medicine in Munich for further assessment. At presentation, he was afebrile and well. He reported no previous or chronic illnesses and had no history of foreign travel within 14 days before the onset of symptoms. Two nasopharyngeal swabs and one sputum sample were obtained and were found to be positive for 2019-nCoV on quantitative reverse-transcriptase–polymerase-chain-reaction (qRT-PCR) assay.2 Follow-up qRT-PCR assay revealed a high viral load of 108 copies per milliliter in his sputum during the following days, with the last available result on January 29.

    On January 28, three additional employees at the company tested positive for 2019-nCoV (Patients 2 through 4 in Figure 1). Of these patients, only Patient 2 had contact with the index patient; the other two patients had contact only with Patient 1. In accordance with the health authorities, all the patients with confirmed 2019-nCoV infection were admitted to a Munich infectious diseases unit for clinical monitoring and isolation. So far, none of the four confirmed patients show signs of severe clinical illness.

    This case of 2019-nCoV infection was diagnosed in Germany and transmitted outside Asia. However, it is notable that the infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific.3

    The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum viral load in a convalescent patient (Patient 1) arouse concern about prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019-nCoV detected on qRT-PCR in this patient remains to be proved by means of viral culture.

    Despite these concerns, all four patients who were seen in Munich have had mild cases and were hospitalized primarily for public health purposes. Since hospital capacities are limited ”” in particular, given the concurrent peak of the influenza season in the northern hemisphere ”” research is needed to determine whether such patients can be treated with appropriate guidance and oversight outside the hospital.

    March 5, 2020
    N Engl J Med 2020; 382:970-971
    DOI: 10.1056/NEJMc2001468
    https://www.nejm.org/doi/full/10.1056/NEJMc2001468

11. Kids can get COVID-19.

    The reason few did in China was the early closing of schools and robust testing for the virus.

    Unlike in the USA.

    #Faceondesk

    —–

    Study reveals sharp increase in COVID-19 in kids in Shenzhen
    Filed Under: COVID-19
    Mary Van Beusekom | News Writer | CIDRAP News | Mar 04, 2020

    http://www.cidrap.umn.edu/news-perspective/2020/03/study-reveals-sharp-increase-covid-19-kids-shenzhen

    “Shifting characteristics in Shenzhen
    Led by researchers at the Third People’s Hospital in Shenzhen, the study analyzed clinical and epidemiologic characteristics of the city’s first 365 COVID-19 patients with laboratory-confirmed disease, including 74 clusters of 183 cases. The median patient age was 46 years (range, 1 to 86 years), and the cases were split evenly between males and females.

    To investigate the shift of the epidemic, the researchers compared patient characteristics before Jan 24 with those from Jan 25 to Feb 5. “Compared with before Jan 24, the proportion of case-patients without definite exposure was much higher from Jan 25 through Feb 5 (11% vs. 6%; P < 0.001) and increased to 36% (12/33) on both Jan 31 and Feb 5," the authors wrote.

    They also reported a sharp increase in the proportion of infected children (2% before Jan 24 to 13% for Jan 25 to Feb 5; P < 0.001), meaning that increased exposure for children and familial transmission could contribute substantially to the epidemic.

    The researchers noted that the steep increase could be attributed to the low proportion of children exposed early in the outbreak; early detection for children who had had close contact with people with diagnosed or suspected infection after control measures were implemented; or failure to identify the relatively mild signs and symptoms in children, especially because resources were limited early in the Wuhan outbreak.

    The investigators caution that delays from infection to illness onset or onset to confirmation may have biased the comparisons.

    After Jan 17, infections increased substantially and peaked Jan 22 to 30. The authors said that the decline since then is probably due to both under-identification of cases of recent onset and delayed identification or reporting."

    …and some slight good news.

    "Serious symptoms unlikely in pregnancy, study finds
    In other research news, pregnant women are not at increased risk of having severe symptoms of COVID-19 infection, according to an analysis of 147 women in Wuhan published Friday by the World Health Organization and China.

    The analysis found that only 8% of the women had serious illness, and 1% were critically ill.

    This is in contrast to other respiratory infections that easily infect pregnant women and can cause serious illness, with long-lasting consequences for them and their babies. While long-term effects on the babies are unknown, a small study published in February in The Lancet showed that the newborns of women infected with COVID-19 appeared healthy and virus-free after cesarean delivery and isolation from their mothers."

    Pregnant women seem to be marginally protected in terms of getting milder cases than non-pregnant women.

12. Trent: or that the Wuhan numbers have always been BS, through some combination of fraudulent cover up, and people trying to avoid the brutal actions of the government–would you reveal your (one) kid was sick if it meant the government would take them away to one of their death camps?

13. from Italy:
    https://www.repubblica.it/cronaca/2020/03/01/news/coronavirus_in_italia_aggiornamento_ora_per_ora-249954540/
    “It is a race against time because this virus is developing at an impressive speed, even above our forecasts and data that came from China. On February 28th, so eight days ago, we had 50 people in intensive care and yesterday we had 244 of them. We are also making a huge run in opening new intensive care places, ” the Lombardy Region Welfare Councilor Giulio Gallera told Sky Start24 on ‘Start’ .
    “Every day – he added – we have two hundred people who come to the emergency room to be hospitalized with critical situations, so it means that every day we have to find two hundred more beds”

    Read this until you fully internalize the message [click through to see a link to an interesting and accessible 2009 paper, and a figure showing current exponential growth in Italy in hospitalizations]:
    https://medium.com/@cisba/hospitalization-a-clear-and-reliable-crisis-index-438fc6e9805e
    Hospitalization ”” a clear and reliable crisis index.
    The Case Fatality Rate is the ratio of deaths from a certain disease to the total number of people diagnosed with this disease. But it is misleading [2009, T. Garske, J. Legrand] at the beginning of a pandemic. Deaths can have various causes and the number of people diagnosed depends on how many tests are performed and how it is chosen who to test.
    As long as hospitals are able to accommodate patients, hospitalized people are the most reliable data. Every person with a severe shortness of breath or difficulty breathing is hospitalized and tested for the COVID-19 infection.
    In addition to providing a realistic picture of the rate of spread of the disease, they also indicate how close we are to the catastrophe of the health system.
    Below is a graph of people hospitalized in Italy from February 24. An Intensive Care Unit, is a special department of a hospital or health care facility that provides intensive treatment medicine for patients with a very severe disease.

14. Trent, a few weeks ago I watched some of a North Korean TV presentation on covid-19. I haven’t been able to find it again. In it, they mentioned that it can effect the nervous system. I wonder if they got a more thorough briefing on it from Beijing.

15. Sure, let’s shut down all the schools — because all those active kids are going to stay quietly in their homes and isolate themselves, right?

    China can shut down schools and ensure that the kids (up to adult-sized teenagers) stay shut in, same way they ensure the adults stay shut in. Most urban Chinese live in 30 story high apartment blocks — 1,000+ people in each block, with guards at the front door checking the temperature of everyone allowed in & out, and making sure that people leave only when authorized. No country in the West can do anything like that, simply because of the different housing patterns here.

    Panic is foolish — it is making things worse.

16. so it was a Pakistani immigrant, I thought it was Iranian sourced, that suggests it crossed over much faster from iran into pakistan, seattle public health, isn’t that an oxymoron,

    curious how they focus on aipac, where Israel was slow to develop and not the cluster of Iranian officials in munich, who were probably symptomatic, then chris murphy would be patient zero on capital hill,

17. Pregnant women seem to be marginally protected in terms of getting milder cases than non-pregnant women.

    Interesting as pregnant women are somewhat immunosuppressed. This epidemic may have begun with experiments in the Wuhan biowarfare lab to learn why bats are not harmed by the virus. Some viral diseases, like Polio for example, are less harmful when the immune system is weaker. Small children are asymptomatic with the Polio virus. Paralytic Polio is only in older children and adults.

    Maybe this virus is also asymptomatic in children for the same reason.

18. How another country is handling the coronavirus scare.

    A colleague in the UK says that his local hospital now has a large sign outside the doors, which essentially says: ‘If you think you may have been in contact with anyone who might possibly have been exposed to the coronavirus, DO NOT ENTER THIS HOSPITAL”.

    Looks like some countries will not have any problem with getting overburdened with virus cases.

19. I’m hoping that now that Trump has reversed the Obama regulation that states cannot develop their own testing kits, the testing will pick up and give us a better idea of severity and mortality.

    My grandson was home from school two days ago with fever and cough and sore throat. He is 14 and an athlete. Today I called and he went back to school. His father is an insulin dependent diabetic. It would be nice to know he is negative.

20. In an ideal world we’d test everyone tomorrow, that would give us a view of what’s going on. Of course that’s impossible, so given the limited testing capabilities we need to work on social distancing to prevent the virus from spreading rapidly. The breaking news that SXSW is cancelled is the sort of thing that needs to happen everywhere with events like that until we have some vague idea of how widespread it is already. Of course no one is going to propose being proactive about the most crowded nodes in society, the schools, because no one wants to be attacked for taking away today’s society’s primary day care provider.

21. Here’s someone knowledgeable about the state of drugs that might be a treatment:
    https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed

    Another thought; in the 80’s when AIDS was running rampant, there were no actual treatments for viral diseases. This was not for lack of trying. The story, of course, is that since then AIDS has gone from a death sentence to a manageable condition.

22. Background on why/how the FDA controlled testing. tl;dr: the FDA regulates everything medical anyway, but lawmakers were especially concerned with the possible effects of high false-negative tests at the start of pandemics.

    Note that this is not an Obama-era regulation, regardless of how many times Pence and Azar say it ”” it dates to the anthrax scare: Project Bioshield Act of 2004.

23. It isn’t hard to see that a test with a high false negative rate would be worse than useless. It would give a false sense of security while letting the disease continue to spread. Of course, they manged to generate the same false sense of security by doing virtually no tests until it was found out, again letting the disease spread unchecked.

24. https://usa-newnews.com/new-news/a-leaked-presentation-reveals-the-document-us-hospitals-are-using-to-prepare-for-a-major-coronavirus-outbreak-it-estimates-96-million-us-coronavirus-cases-and-480000-deaths/
    A leaked presentation reveals the document US hospitals are using to prepare for a major coronavirus outbreak. It estimates 96 million US coronavirus cases and 480,000 deaths.
    Those estimates come from Dr. James Lawler, a professor at the University of Nebraska Medical Center. They “represent his interpretation of the data available. It’s possible that forecast will change as more information becomes available,” a spokesman for Nebraska Medicine told Business Insider in an email.
    The American Hospital Association said the webinar reflects the views of the experts who spoke on it, not its own.
    Best Guess Epidemiology
    R0=2.5; Doubling time 7-10 days
    Community attack rate = 30-40%
    Cases requiring hospitalization = 5%
    Cases requiring ICU care = 1-2%
    Cases requiring ventilatory support = 1%
    CFR=0.5%
    Community epi wave 2 months
    US: 96 million cases
    US: 4.8 million admissions
    US: 1.9 million ICU
    US: 1 PPV
    US: 480,000 deaths
    PREPARE FOR DISEASE BURDEN ROUGHLY 10X SEVERE FLU SEASON

    (those all seem to be erring pretty strongly on the conservative side)

25. China’s recovery purportedly a fake from the bottom up:

    https://theweek.com/speedreads/900488/chinas-coronavirus-recovery-all-fake-whistleblowers-residents-claim

26. In 2018, 59,120 people died from flu in the US — making it the 8th largest cause of death.

    If the disease burden of the coronavirus this year is 10X that flu burden, it would amount to 590 Thousand deaths (in the same ballpark as Prof. Lawler’s estimate of 480 Thousand). That would still make it only the 3rd largest cause of death.

    Prof. Lawler’s analysis does not address one of the key questions — How many of those projected deaths would have happened this year anyway? We all die, but we all die only once. We know already that the people most susceptible to dying from this virus are the old (especially the very old) and those with significant pre-existing medical conditions.

27. The government is protecting us. Run away screaming.

    https://www.theatlantic.com/health/archive/2020/03/how-many-americans-have-been-tested-coronavirus/607597/

    “Exclusive: The Strongest Evidence Yet That America Is Botching Coronavirus Testing

    “I don’t know what went wrong,” a former CDC chief told The Atlantic.” …

28. No one will ever be punished for the federal government’s fatal screwups with CoVid-19 testing, yet public officials wonder why the public doesn’t trust them.

29. The current strategy of testing sick people in an area with a known outbreak is, to repeat the phrase used a couple of days ago about a different issue, lethally stupid. We know there are people sick with coronavirus in Seattle, NYC, etc. Testing more sick people and announcing they are sick each day is leading to headlines about the spread, when those people weren’t infected today, they were infected weeks ago! Meanwhile people who are asymptomatic are being told to go about their day completely normally, when we know that you can be extremely contagious for a long time without showing any symptoms at all, and we are doing basically nothing to reduce or eliminate the chances of spreading at mass gatherings.

    (As an aside, it seems interesting, does it not, that the country with the current most devastating outbreak we know about–although still basically zero news reports get out about Wuhan and environs–had very well publicized gigantic mass gatherings in early January? Things that make you go hmmm…)

    No one wants to be accused of “overreacting”, but “overreacting” today is going to be 10x less painful than “overreacting” in a few weeks. And “overreacting” a month ago would have been 1/10th as painful as “overreacting” today will be.

    (Another aside, comparison of death counts of coronavirus to the flu is getting more and more dangerous and detached from reality, as they are completely apples to oranges at this point–the only deaths being credited to coronavirus are ones that have been definitively tested, and we know for a fact that we are missing ones due to a few post-mortem tests that have been done, and are probably missing quite a lot, while flu death estimates are based on statistical modelling well after each year is over, because the flu is so incredibly bad at killing people that basically no one has it listed as their cause of death.)

30. Frieden Bloomberg’s soda czar, who let the ebola victims into the country, yes that’s very helpful,

31. Maybe Mike K can translate some of this jargon from an Italian doctor:
    https://twitter.com/MichelleNoelBoo/status/1236157362030944258

32. The problem with not having enough test kits is that your numbers will be terrifying. In BC we can test anyone who might need it, and our containment is still working. You skipped that and went straight to the community. Its also a good idea to not be Zinc deficient:https://www.youtube.com/watch?v=Eeh054-Hx1U

33. Seen on the Free Republic COVID-19 thread —

    “There are rumors that #SaudiArabia’s king died and that his son, Saudi Crown Prince Mohammed bin Salman, is about to assume the king’s position soon. That might explain the overnight detention of dozens of the royal family members to avoid any possible coup.”

    Given the personal meeting based nature of Saudi politics, the old king likely died of COVID-19.

34. “… the old king likely died of COVID-19.

    Good joke, Trent! Of course, we all know that the old king has been very old for a long time, and reportedly quite unhealthy too. One way or another, it is close to his time — if not now, then soon.

    The joke does raise an intriguing question. In among all the media fear-mongering, there are occasional reports of people being diagnosed with Covid-19 who have apparently had no contact — zero, nada — with any infected person. The most likely explanation is False Positives in the testing process. However, there is another possibility — namely that the virus has been with the human race for a long time already. What has changed is that now people with flu-like symptoms are getting tested for the presence of the virus, instead of simply being classified as having the flu. (Remember the number of people getting ordinary flu is at least two orders of magnitude higher than those being diagnosed with Covid-19).

    Are we seeing an exponential increase in people carrying the virus? Or is it an exponential increase in testing for the presence of a previously-unrecognized virus that was there all along?

35. This is an on the ground medical treatment report from Everett, Washington via the Free Republic COVID-19 Week End Live thread.

    It appears the Washington State Public Health officials are making bad CDC testing issues _worse_.

    And local hospital officials are treating local public health people like the CDC — ignoring them and using their best judgement.

    There seems to be more of that “ignoring Public Health Officials” stuff going around than COVID-19.

    —

    I was hospitalized for pancreatitis this week at Providence Regional Hospital in Everett, Washington.

    This is the hospital the first Covid-19 patient in the U.S. was treated in. This hospital is one of the few hospitals specially equipped with a lot of high tech stuff for this exact situation, which is one of the reasons he survived. I learned a bit about how it was done from the staff. Only a very small number of people can expect to get treatment like that.

    While I was hospitalized I talked with a LOT of doctors and nurses about this virus, ALL of whom were very willing/eager to talk about it, and are VERY concerned.

    Here’s a summary of what I learned:

    1. The staff described the hospital as in “crisis mode”.

    2. They are putting double the normal of nurses/staff on suspected patients, and working hard to protect the staff and other patients. Any staff member who shows symptoms is sent home to self isolate (not sure for how long, but possibly two weeks).

    3. They are paying extra for overtime and bonuses in order to attract more staff, but cannot get enough people no matter how hard they try. One of my nurses was flown in from Florida.

    4. They are working very hard to keep people like me far away from people they suspect have the virus. No one was allowed on my floor if they had any of the symptoms of Covid-19. However, they were NOT screening visitors, so who knows.

    5. They do NOT know how many of their patients have Covid-19. The CDC is partly responsible for this through their earlier failure to provide test kits that work, and their current failure to provide nearly enough test kits to cover the current situation.

    6. The state of Washington also shares some of the blame. The state issued rules that greatly restricted who could officially be considered a possible case. Almost no one met the state’s criteria, so even obviously suspicious cases could not be listed as a possible case. The hospital took things into their own hands and treated these people as if they DO have it. (Based on a few news reports, the state may have finally relented a bit on this, but I’m not sure.)

    7. The staff told me, unofficially of course, that they were 100% sure they would run out of supplies.

    8. I was sent home a day earlier than they would normally have sent someone like me home. The reason is that I have a severe lung condition that makes me a very high risk patient if I happen to catch this virus. The doctors emphasized multiple times that I needed to avoid hospitals and doctor’s offices as much as possible, and should practice social distancing.

    9. I was VERY impressed with every person I met at the hospital. They are under a lot of stress and in my opinion, doing a GREAT JOB.

    Many thanks to the entire staff at Providence Regional Hospital in Everett, Washington state.

36. More on CoVid19-related pulmonary fibrosis:

    https://www.news.com.au/lifestyle/health/health-problems/chinese-doctors-say-coronavirus-like-a-combination-of-sars-and-aids-can-cause-irreversible-lung-damage/news-story/f58f19c5eeae99b845c54e2d2b9305ca

37. Revised figures for CoVid-19 mortality by age, from this tweet by an epidemologist:

    https://twitter.com/AdamJKucharski?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1236275741597339648&ref_url=https%3A%2F%2Fhotair.com%2Farchives%2Fallahpundit%2F2020%2F03%2F07%2Fer-doctor-coronavirus-wont-severe%2F

    Overall – 1.6%

    Ages 0-9 – 0.0094%

    Ages 10-19 – 0.022%

    Ages 20-29 – 0.091%

    Ages 30-39 – 0.18%

    Ages 40-49 – 0.4%

    Ages 50-59 – 1.3%

    Ages 60-69 – 4.6%

    Ages 70-79 – 9.8%

    Ages 80+ – 18%

    Figures based solely on age at death, and include any co-morbidities such as diabetes and hypertension which are more prevalent as age increases. Basically the fatality rate for ages over 60 are much less for individuals without any co-morbidities, and much higher for those with them, and still higher for those with more than one co-morbidity (like me).

38. Italy health system starting to fail:
    https://twitter.com/DellAnnaLuca/status/1236440178031394816
    24/ “It can become necessary to put soon an age limit to enter ICU [”¦] to save scarse resources for who has the largest chances of survival”, says a horrifying document from the Italian Society of anesthesiology, reanimation and intensive care.

    It is not clear how a modern democracy is going to function under that sort of stress.

    Also:
    23/ It will be forbidden to enter / exit Lombardy and 11 provinces until the 3rd of April (except emergency situations).
    12 million people affected.

    Just the flu though.

    Every day of delay makes the steps that will be necessary to try to cope exponentially more extreme.

39. Brian, we’ll have to do what I will do – tell them I’m not likely to survive if I need intensive care, and might not survive hospitalization. I’ve already said that to my primary care physician at a routine appointment last Monday.

    There won’t be enough ordinary hospital beds for this thing. My guestimate is that demand will be three times greater than supply for the next year, perhaps starting in May and definitely by July-August.

    This is why I started extreme social distancing on Friday.

40. 4/ “It can become necessary to put soon an age limit to enter ICU [”¦] to save scarse resources for who has the largest chances of survival”, says a horrifying document from the Italian Society of anesthesiology, reanimation and intensive care.

    Brian — That is not horrifying; that is how medical care has always worked. It is called triage. It starts when a First Responder arrives on the scene of an accident with multiple injured people. How do you think the First Responder decides who she will treat right now and who will have to wait?

    In England’s National Health Service, the related system is the Waiting List. Some people get treated quickly, and others have to wait (with some of them dying while they are on the waiting list). Do you imagine that treatment is done strictly on a first come, first served basis?

41. I don’t believe for a second that we have until May.

42. Brian,

    Hospital admission for CoVid-19 is conditioned upon successful testing for it as well as needing hospitalization. As of yesterday only 1,583 Americans had even been tested for CoVid-19. The testing is being slow-rolled. How long do you think the government can postpone filling up all American hospital beds by postpoing the testing for CoVid-19?

43. And, Brian, you might re-read my post. I said the demand for hospital beds might be THREE TIMES the number of hospital beds by May, and definitely would by July-August.

44. “How long do you think the government can postpone filling up all American hospital beds by postpoing the testing for CoVid-19?”
    Not long, when people in respiratory distress start flooding in. Doesn’t matter if you test for it or not.

45. Must read press release from the Kirkland Life Care Center: via https://twitter.com/EpsilonTheory/status/1236636030050148352
    Residents:
    Original Number of Residents on 2/19: 120
    Number Transferredd to Hospitals since 2/19: 54
    Number of Deaths since 2/19: 26
    *Note: we are an acute care facilty, in a typical month, we may have between 3-7 deaths
    Patients who have died in hospitals: 15
    – 13 of those 15 tested positive for COVID-19
    Patients who have died in our facility since 2/19: 11
    – We have no information on post-mortem tests of these patients

    So, to sum up, nearly a quarter of their residents have died in the past two weeks. You can bet that more will die, probably many more. And roughly half the deaths are not even being tested for coronavirus. “Our” response continues to be completely broken.

    New York state is starting to test more people, and of course more positives are being found, and the governor says that is a good thing, because it means we are getting a glimpse at the scale of the problem to know what we’re dealing with, etc. And yet NOTHING is being done to mitigate the spread. Abolutely nothing.

46. thread, clearly laying out from an expert what some of us internet crazies gave been saying for a month or more:
    https://twitter.com/Farzad_MD/status/1236393626760032257
    1/ I’m very worried that we don’t have a clear strategy for #COVID19 response
    We need to clearly define when the public health goal is containment-trying to keep the virus from circulating- and when the goal shifts to mitigation-working to reduce the peak impact of the outbreak

    A very interesting/worrying plot shown in this one:
    15/ This is what the ILI data in NYC looks like now.
    It looks like there is a clear signal now of increasing influenza-like illness (cough and fever) in NYC
    I don’t know if this is “worried well” or a resurgence of flu, or what the age distribution is, but those are answerable

47. You have the only for profit medical system in the first world. As it has responded rather badly to this virus, it may be the case that it will be finally exposed as the worst medical system, for your population.

    Our Canadian medical system has responded well to this and we are still in containment. This will probably fail at some point but the reason for this is really to spare the medical system, its self. The slower we can make this spread, the longer our system can respond, without being overwhelmed by the sheer numbers of affected people. Because of this its likely they will be able to take care of me, a 73 year old man, should I need it.

48. I think a lot of people are imagining that this test is something like a home pregnancy test that shows results immediately. This isn’t the case. The swabs taken have to be transported to a properly equipped lab where each one has to start a multi step process that takes several hours. The key step is called RT-PCR that stands for reverse transcriptase polymerase chain reaction where the nucleic acid from a few cells is amplified to a detectable level. Here’s the instructions, all 42 pages:
    https://www.fda.gov/media/134922/download

    Here they talk about developing a blood based test for the general population to determine exposure:
    https://www.cdc.gov/coronavirus/2019-ncov/about/testing.html

    Since there is no treatment other than symptomatic, it doesn’t make a lot of difference to the patient that the main use for these tests is keeping score. As far as I know, no one with respiratory distress is being denied treatment because they can’t prove they have the virus. A better test would be hugely useful to hospitals trying to prevent exposure to their other patients and personnel. It’s easy to say that anyone with the very common symptoms should be treated as having it until proven otherwise, the reality is that there just isn’t the capacity to do that. I’m sure a lot of post mortem samples are being preserved to process later.

    All this is mostly a matter of keeping score. Medical facilities will have to keep reacting to the patients that present as best they can.

    I’m sure that we are only seeing the start of the finger pointing and I expect it will only increase. I don’t know what the difference between our test and the one the rest of the world is using. Here’s a link that goes into some detail about the Chinese testing:
    https://www.channelnewsasia.com/news/asia/how-china-tests-for-covid-19-coronavirus-12438008

    They mention 8,000-10,000 tests per day. I haven’t seen anything authoritative about the false negative rate. It wouldn’t have to be too high to make the test useless as far as containing the outbreak. An equal problem would be a high false positive rate from cross contamination. I assume that running that many tests requires automation, preventing cross contamination where you are measuring picograms (0.000000000001g 1e-12g) is non trivial.

    The $64 question is when do we transition from containment with quarantine to coping with a general epidemic. My own suspicion is the we have already made the decision and are already in the coping phase, they just haven’t told the rest of us about it yet.

    As a final note: I find it interesting that San Francisco shows compassion for the homeless by letting them s#!t on the sidewalks but finds it necessary to deny a birth to a ship in distress. All the Captain has to do is declare an emergency and they will be obligated to allow the ship to dock.

49. The US governmental and institutional response has been mixed. However, it’s obvious that individuals are rapidly changing their behavior. Time will tell.

50. It appears President Trump was slimmed by COVID-19 at the CPAC convention.

    Via Twitter social media below:

    Colby Itkowitz
    @ColbyItkowitz
    ·
    4h
    CPAC chairman Matt Schlapp tells me he interacted with attendee who has tested positive for coronavirus. While the timeline is unknown, Schlapp shook Trump’s hand on stage the last day of the conference.

51. There is both good news and bad news on the US COVID-19 testing front.

    The Good news:

    VP Mike Pence, Mar 6:

    https://www.youtube.com/watch?v=0Qyu1XG-wnw

    tests:

    “We’ve been able to provide tests to all the state jurisdictions and labs that have requested it and.. all state labs have the test…State labs can actually conduct CV tests themselves. Beyond that, between Mar 2nd and 5th, we’ve distributed more than 900K tests across the country, including 200K that would allow 75,000 individual patients to be tested..By Saturday another 200K tests will be shipped and by the weekend another million tests will be shipped around the country. With the expectation by the end of next week another 4MM tests will be shipped.”

    “To meet future demand this week the President brought together the leading commercial labs in America and asked them to in effect partner with the US in developing tests for the American people.

    And I’m proud to say that just in the last 24 hours.. two of America’s leading commercial laboratories have announced that tests will be available by Monday of this week. The reason that’s important, the reason that meets future demand is because the enormous capacity of these commercial labs.. are precisely how we will make cv tests avail for your local doctor, available to your pharmacy and broadly available to the American public.”

    The problem is just because the Pence task force is pushing out tests doesn’t mean local public health authorities will actually use them.

    The following comment is from the Free Republic COVID-19 Live Update Thread where I got the above information:

    True.

    There are a few problems, however.

    The kits have been slow to arrive in most states””very slow.

    The outsourced labs are just getting up to speed on how to use them.

    Even though the Feds relaxed the standards to allow additional testing, it appears some states (like my CT) are intentionally slow walking their tests to keep the number of confirmed CV cases artificially low.

    Here in CT, a doctor worked in two different hospitals, met with patients, touched all sort of surfaces and then later got symptoms and tested positive for the CV.

    He probably infected dozens of people who have already infected dozens of more people, including new patients in the hospitals (which should have been closed until they were decontaminated but were kept open instead).

    So we probably have several hundred easily identifiable people who should be tested””the employees and patients of the two hospitals for starters.

    The state has conducted tests for a grand total of twelve people.

    I kid you not.

    So the bad news is, essentially, we do not have one CDC effing up.

    We have dozens and dozens at state and local level across the country doing so.

52. Various articles I’ve read today state that the major difference between the majority of minor cases of CoVid-19, and the minority of dangerous cases, is whether the infection stays in the upper respiratory tract or moves deep into the lungs. If it’s the latter, people like me (over 70, mild autoimmune disorder – dry eye, dry mouth and skin rashes – mild diabetes, long-term mild hypertension) are pretty much hosed. I have an additional very rare condition which makes that defnitely hosed for me.

    People in critical condition who need external ventilation are hosed because there are apparently only 95,000 intensive care beds in the entire country. A lucky few will get that care so it will be reserved only for those who will almost definitely survive if they get the ventilation. That pretty much excludes those over 70 (and probably those over 60) who are not in excellent health otherwise.

    People who in serious condition will be hosed simply because there just aren’t enough hospital beds in the whole country for the likely need, and that defnitely applies if more than 15 million people require hospitalization for CoVid-19 over the next year. China reports that the average period of hospitalization for CoVid-19 is a month.

    An early indication of CoVid-19 moving into the lower lungs is a dry, hacking cough, along with significant shortness of breath.

    One thing which would help a lot is moving CoVid-19 testing out of hospitals into cleanable tents in hospital parking lots. 41% of CoVid-19 victims in China contracted it in hospitals. Moving the testing elsewhere, particularly into tents which can be disassembled and sterilized and then reassembled, would significantly reduce that source of infections.

    And us retired folks should start social distancing if at all possible, and especially extreme social-distancing. In my case that includes jury duty because the public restrooms in courthouses will be death traps due to fomites.

53. Is it unfair to wonder what bureaucrats do all day long. I know, I know, dummy me, I thought they were refining and updating contingency plans, too. They’ve only had since 9/11. I’ve watched a lot of documentaries on pandemics, biosecurity, and 1918; the experts pontificate about policies, procedures, and priorities but it looks like nobody has actually executed the recommendations over the last 18 years. Instead, the testing snafu seems to be the result of a bureaucratic snarl up. This is a government debacle, not the healthcare delivery system. As Balzac

54. I read through the instructions for the CDC test. The throughput looks to be about 1hr. 20min. to do 11 tests per machine. This works out to 198 tests per 24 hours per machine. I couldn’t find out how many of these 7500 Fast Dx Real-Time PCR Systems there are but they would seem to put a hard upper limit on the number of tests that could be performed in any period. I doubt that there are a lot of them sitting around in warehouses.

    I wonder how many hospital workers are more than 1 generation from a direct exposure. This has been running around loose for about three months at this point. We don’t know how long from exposure to positive test or contagion. When this is over, I expect that there will be plenty of people jumping up and down on the CDC. It will do exactly as much good as it ever does. We’re very good at making long list of what we should be preparing for and lousy at allocating the resources to actually address them.

55. Sorry, Balzac reminds us that bureaucracies are Leviathans managed by Pygmies. Or, Edward T
    Hall: the greatest impediment to progress is bureaucacy.

56. This before there’s even a real outbreak of the disease in NYC, which we all know is coming:
    https://www.nydailynews.com/new-york/ny-fdny-order-coronavirus-first-responders-20200307-yhxagu6yzzd6th23o4mqymma3q-story.html
    FDNY issues order pulling back firefighters from calls describing coronavirus symptoms; says it is prioritizing responses
    The FDNY is pulling firefighters from answering medical calls that describe symptoms associated with coronavirus, the Daily News has learned.
    A department order issued Friday says 911 calls for asthma attacks, fever, coughs and difficult breathing will be handled by the Emergency Medical Service.
    Fire companies with certified first responder training that would normally accompany ambulances are being told to stand down, the order said.

57. Why get so excited about testing? Testing individuals makes sense at an early stage when containment and isolation of the infected is still possible — but this coronavirus has clearly already escaped containment worldwide. Testing is mostly a waste of resources at this point. All testing is going to show is that Canada has as many infected people as Italy. Then what?

    We know from the Diamond Princess that 80% of us who are exposed to the virus are not going to catch the disease. And most of the minority who do catch the disease are going to have minimal or mild symptoms. We know the people who are at risk of serious effects — the old, and those with pre-existing medical conditions.

    Smart use of resources now would be to focus on helping those among the old & infirm who want to self-isolate for an indefinitely long period of time. Things like arranging for food deliveries, and treatment at home for their existing medical issues.

    A panicked mis-allocation of resources is simply going to make things worse than they need to be.

58. We should probably be happy that testing is the least destructive “something” they could do. They’re not trying to “lock down” Seattle at least.

    Sending an engine company with every ambulance call has always been a scam to get their run numbers up and justify more money for equipment that is being worn out. I’m sure that they’ll have the extra manpower when they need it and won’t have most of the fire department on extended paid self quarantine. Maybe they can use some of the money they save for more ambulances and crews so that they can get people to the hospital faster rather than having a truck and crew standing around waiting for the ambulance to arrive.

59. “They’re not trying to “lock down” Seattle at least.”
    Unfortunately I don’t think this is going to age very well.

60. I see PenGun is trolling again. I assume he prefers the Chinese medical system since we have the only “for profit” system in the world.

61. https://twitter.com/realDonaldTrump/status/1237027356314869761
    “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”

    Hands down the most catastrophically stupid and self-destructive thing Trump has ever tweeted.

62. “I assume he prefers the Chinese medical system since we have the only “for profit” system in the world.” Reading is important. I said “in the first world”.

    Yes the Chinese have done an amazing job and appear to have won the war, you are about to lose.

63. This opinion piece by Michael Fumento is worth reading.

64. “This opinion piece by Michael Fumento is worth reading.”
    No, sorry, it’s really not.
    Ctrl-F “ICU” yields no results.
    No mention of the sorts of things those who have been paying attention have seen in Wuhan, Iran, and Italy, with medical systems completely overwhelmed with critically sick patients.
    Taking Chinese numbers at face value, AND ignoring the tactics they employed to allegedly accomplish them (i.e., arresting anyone showing symptoms, welding people into their homes, etc.).
    But I suppose it’s a fine example of “just the flu” writing. Unfortunately the president probably read this very article.

65. Not worth reading because he doesn’t look at the same variables as you do in making predictions? Some of us might think that’s a reason to consider his argument. Not that you’re wrong – you may be right – but there is always value in checking out contrary views from thoughtful long-term observers of the same phenomena you are looking at (in this case, epidemics and mass-media).

66. It’s a fine example of “just the flu” writing, like I said. It leaves out everything that makes those of us who reject “just the flu” do so. Doesn’t even address it, let alone refute it, just ignores it. So I don’t think it should be pointed to as a useful resource.

    The main problem with the “just the flu” camp is their certainty that it is “just the flu”. From the very beginning this entire situation was a strange, hazy “fog of war” situation that seemed to have a distinct possibility that there was something horrifically scary going on in China, at odds with their official published numbers. The chances of catastrophe were large enough, and the implications were scary enough, that prudence was called for, even things that otherwise seem like complete overreactions. And now the “just the flu” folks claim that China (and to an extent South Korea) confirm that this is “just the flu”, while not advocating that we do anything like that either of those countries have done, and are completely ignoring the complete catastrophe that Iran is currently seeing, and mostly ignoring the growing disaster in Italy.

    In the fact, the more I read Fumento’s article, the angrier I get. He advocates doing NOTHING at all, in fact he claims that flu is WORSE than coronavirus. I’m sorry, you have to be either living under a rock, or downright maliciously evil, to write this.

67. “This opinion piece by Michael Fumento is worth reading””

    I can’t really agree.

    Even if the central idea is correct, that warm, humid weather will drop the transmission rate to near zero, we are still a month away from that in much of the US and more like 2.5 in the northern tier of the country. I hope it proves true, and there is evidence to support it

    Risking the lives of a million or three voters on the premise of an early spring seems… Unwise

68. Actually it’s not a “just the flu” argument. It’s an argument that Corona is likely to follow a similar pattern of spread to other epidemics including the flu. It’s an argument against hysteria. You are mischaracterizing it. Other readers can judge for themselves.

69. At some point, we have to look at the numbers.

    https://www.globaltimes.cn/content/1177725.shtml
    “An analysis led by Chinese scientists published in The Lancet Public Health in September 2019 found that there were 84,200 to 92,000 flu-related deaths in China each year, accounting for 8.2 percent of all deaths from respiratory diseases.”

    versus about 3,000 deaths this year from the coronavirus. (About 1/30th of the flu deaths).

    Maybe the Chinese should be calling this “Not Even The Flu”?

70. He makes several claims that flu is actually much worse than coronavirus–number of deaths (ignoring that he’s comparing statistical modelling of flu deaths in previous years vs. deaths proven by test to be those infected by coronavirus), “flu is vastly more contagious than the new coronavirus”, etc. I think “just the flu” is accurate, but of course all should as you say judge for themselves.

    PS. With 3 more dead today, now 29 of 120 residents at the Life Care Nursing Home in Kirkland have died since February 19.

71. The main problem with the “just the flu” camp is their certainty that it is “just the flu”. From the very beginning this entire situation was a strange, hazy “fog of war” situation that seemed to have a distinct possibility that there was something horrifically scary going on in China, at odds with their official published numbers.

    There are a number of rumors that may never be cleared up. This was unlikely to be a biowarfare weapon but it might be a virus that was being experimented with in that Wuhan lab and escaped. Perhaps some employee sold an infected animal to the “live market.” There has been interest in bats tolerance of the corona virus families.

    bats are speculated to be reservoirs of several emerging viruses including coronaviruses (CoVs) that cause serious disease in humans and agricultural animals. These include CoVs that cause severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), porcine epidemic diarrhea (PED) and severe acute diarrhea syndrome (SADS). Bats that are naturally infected or experimentally infected do not demonstrate clinical signs of disease. These observations have allowed researchers to speculate that bats are the likely reservoirs or ancestral hosts for several CoVs. In this review, we follow the CoV outbreaks that are speculated to have originated in bats.

    Influenza most commonly originates in China, especially in ducks and pigs.

    The present epidemic seems to be causing an illness that resembles ARDS, a condition that often follows trauma in young people. That condition had an 85% mortality until modern respiratory care improved it. Fortunately, only about 14% of cases progress beyond the URI stage.

    Risking the lives of a million or three voters on the premise of an early spring seems”¦ Unwise

    What would you do ? Self isolation seems the easiest. Testing is not going to help much. The antiviral drugs seem to best treatment of severe cases.

    The New England Journal case suggests the treatment is effective.

    Contrary to PenGun’s affection for the Chinese, the drug is a US development and Peter Navarro announced that 4500 doses are available and 90,000 more have been ordered. Since the drug resolved the serious cases’ symptoms in 24 hours, the ICU bed crisis may be overblown

72. Mike K:
    https://www.marketwatch.com/story/these-nine-companies-are-working-on-coronavirus-treatments-or-vaccines-heres-where-things-stand-2020-03-06
    2. On March 3, Gilead said a randomized, open-label Phase 3 trial will evaluate remdesivir in 600 patients with moderate COVID-19. The trial is expected to start enrolling patients in March, with results to come in May.
    3. On March 3, Gilead said a randomized, open-label Phase 3 trial will evaluate remdesivir in 400 patients with severe COVID-19. The trial is expected to start enrolling patients in March, with results in May.

    They’ve got to move faster.

73. Not as bad news:

    http://www.freerepublic.com/focus/chat/3822786/posts?page=1145#1145

    “… The numbers from the Diamond Princess are “encouraging”. They tested virtually everybody (4061 tests). Of that number, 705 tested positive, or about 17%. IN a bad-case scenario, where nobody knew what was happening at the start, they had 17% spread, even when there were hundreds of people to spread it.

    More interestingly, of that number, it appears 400+ were asymptomatic, which means they would not have been tested if not for being on the ship. Seven have died so far.

    so, without full testing, you would have thought that about 300 people had it, and 7 of those died, for 2.3% death rate.

    But with 700 tested positive, the death rate is 0.99% …

    1,145 posted on 3/9/2020, 11:13:58 AM by CharlesWayneCT”

74. “But with 700 tested positive, the death rate is 0.99% ”¦”

    What the world learned from the Diamond Princess is that — if a person catches the disease, the chance of dying is about 1 in 100.

    And the world also learned that over 80% of people exposed to the virus do not catch it.

    The number that matters to most of us is that out of 1,000 people exposed to the virus, only 2 may die. 99.8% survival rate among the total population.

    And that was with people given a very high exposure to the virus through being confined on the cruise ship, and with a passenger list biased towards more susceptible old & infirm people. The real survival rate among the general population is likely to be significantly better than 99.8%.

    All this has been pointed out repeatedly. But it seems some people would rather panic than look at the data.

    Bottom line, the rational response is — for those who are getting up in years and/or have pre-existing medical conditions, self-isolate. For the rest of the human race, use sensible precautions (hand-washing, etc) and otherwise carry on. Unfortunately, that is not dramatic enough for the news media.

75. On March 3, Gilead said a randomized, open-label Phase 3 trial will evaluate remdesivir in 400 patients with severe COVID-19. The trial is expected to start enrolling patients in March, with results in May.

    They’ve got to move faster.

    So start the trial in February ? A bit late.

76. “Contrary to PenGun’s affection for the Chinese, the drug is a US development and Peter Navarro announced that 4500 doses are available and 90,000 more have been ordered. Since the drug resolved the serious cases’ symptoms in 24 hours, the ICU bed crisis may be overblown”

    Mike they are making virus vaccines and anti viral drugs all over the world now. It may be that remdesivir is effective and I certainly hope it is.

    What the Chinese have done is kill of the infection chain to a large degree. That is not even being contemplated in the US. Lets hope the Italian model does not apply to America.

77. CoVid-19 triage in Italy (jump to the last paragraph:

    http://www.freerepublic.com/focus/chat/3822786/posts?page=1607#1607

    https://twitter.com/jasonvanschoor/status/1237142891077697538

    2h
    Replying to
    @jasonvanschoor
    2/ First, Lumbardy is the most developed region in Italy and it has a extraordinary good healthcare, I have worked in Italy, UK and Aus and don’t make the mistake to think that what is happening is happening in a 3rd world country.
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    3/ The current situation is difficult to imagine and numbers do not explain things at all. Our hospitals are overwhelmed by Covid-19, they are running 200% capacity
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    4/ We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    6/ My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV. PLEASE STOP, READ THIS AGAIN AND THINK.
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    7/ We have seen the same pattern in different areas a week apart, and there is no reason that in a few weeks it won’t be the same everywhere, this is the pattern:
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    8/ 1)A few positive cases, first mild measures, people are told to avoid ED but still hang out in groups, everyone says not to panick

    2)Some moderate resp failures and a few severe ones that need tube, but regular access to ED is significantly reduced so everything looks great
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    9/ 3)Tons of patients with moderate resp failure, that overtime deteriorate to saturate ICUs first, then NIVs, then CPAP hoods, then even O2.

    4)Staff gets sick so it gets difficult to cover for shifts, mortality spikes also from all other causes that can’t be treated properly.
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    10/ Everything about how to treat them is online but the only things that will make a difference are: do not be afraid of massively strict measures to keep people safe,
    Jason Van Schoor
    @jasonvanschoor
    ·
    2h
    11/ if governments won’t do this at least keep your family safe, your loved ones with history of cancer or diabetes or any transplant will not be tubed if they need it even if they are young. By safe I mean YOU do not attend them and YOU decide who does and YOU teach them how to.

78. Tom:
    Funny, I was just about to post that thread. You should have included the last two posts:
    12/ Another typical attitude is read and listen to people saying things like this and think “that’s bad dude” and then go out for dinner because you think you’ll be safe.
    13/ We have seen it, you won’t be if you don’t take it seriously. I really hope it won’t be as bad as here but prepare.

79. At present the most likely ends of the CoVid-19 pandemic are, in order of likelihood by my opinion:

    1) It mutates into a form no more dangerous than ordinary flu. This is how the 1918 Spanish Flu ended around a year after its first major spread across America. That is less likely for CoVid-19 because it seems less virulent, and is much less lethal, than the 1918 Flu, though a mutation ending will still happen eventually, just not so soon.

    2) A successful treatment is found. See:

    https://www.nejm.org/doi/10.1056/NEJMoa2001191

    and

    https://www.en.etemaaddaily.com/world/international/china-starts-clinical-trial-for-remdesivir-medicine-in-coronavirus-treatment:70811

    for an example of possible success and an ongoing clinical trial. The successful use of remdesivir occured in January and the Chinese clinical trial began a few weeks ago. We might have results from the clinical trial by July or so. If it is successful, it will take months more to get enough production going to make more than a minor difference in treatment, i.e., mass use of remdesivir, if it works, probably won’t happen any earlier than December of this year. And some other successful treatment might come along but will be subject to the same delays in use.

    3) A successful vaccine is found and deployed en masse. The generally agreed period for this is 18-30 months for development of a vaccine and another six months to produce hundreds of millions of doses and deliver them to the public.

80. I can’t wait for more posts claiming that CoVid-19 is no more dangerous than ordinary flu.

    https://threadreaderapp.com/thread/1236933818654896129.html

81. I honestly don’t understand this:
    https://www.saccounty.net/news/latest-news/Pages/County-Announces-New-Mitigation-Efforts-COVID-19.aspx
    “Sacramento County announced today that it will shift its effort to community mitigation measures that will slow the spread of COVID-19 in the community, protect those who are most vulnerable to severe illness, and allow our health care system to prepare resources to take care of severely ill patients. These new measures will include cessation of 14-day quarantines.”

    They say they are stopping quarantines, and moving to “community mitigation measures”, but then they don’t actually propose anything except sick people stay home and self-manage as long as possible, and elderly/vulnerable people “consider staying home and away from crowded social gatherings”, schools/offices should basically proceed normally, and healthy people should not wear masks.

    Um, that’s not community mitigation, guys.

82. We might have results from the clinical trial by July or so. If it is successful, it will take months more to get enough production going to make more than a minor difference in treatment, i.e., mass use of remdesivir, if it works, probably won’t happen any earlier than December of this year.

    Peter Navarro, in a Hugh Hewitt interview a week ago, said that 4500 doses are available now for the clinical trial and 90,000 doses have been ordered at a cost of $200 million.

    The “clinical trial” is going to consist of the sick patients who are currently about 10% of the total symptomatic cases. Clinical trials are often ended early when results are obvious. We will not have to wait for December as the virus will probably decline in incidence with the summer weather.

83. The Chinese have claimed victory over the virus. They have it under control. No new cases outside of Wuhan in 4 days. They also have a lot of information about it and are sharing that widely.

    The virus can live in the air in environments for a half hour, and they have one instance where a man 15′ from the only source was infected. It can live at high temperatures on many surfaces for a long time, 2 or 3 days. It can survive in feces and bodily fluids for 5 days.

    The people in China are pleased with their government, and grateful they have done such a good job with this disease. Who in their right mind would not be?

84. Mike, I’ve often heard the claim that CoVid-19 will decline this summer, because it’s warmer than winter, but have never heard any explanation beyond that is what ordinary influenza does. CoVid-19 is a coronavirus, and AFAIK flu is in a completely different “family” of viruses than coronaviruses.

    So, since flu and coronaviruses are NOT the same, why should CoVid-19 become less contagious during the summer? Do most or all coronaviruses also become less virulent in the summer? Please answer both questions.

85. It appears that Zinc will shut down the viruses replication. The problem is that Zinc has a hard time getting into cells where the replication takes place. The Chinese have been using Chloroquine, an anti malarial drug, to promote the entry of Zinc into cells. That is working quite well. They are using 500mg twice a day while the Koreans have been using that once a day. Both these countries are gaining control of the outbreak.

    So make sure your zinc levels are good and if you acquire the disease, demand Chloroquine.

86. PenGun, that is very helpful. Please continue giving us advice. Here is one I heard of today:

    When using an N-95 mask and nitrile gloves, don’t touch the mask with the gloves on. Put the mask on, and take if off, only with your bare hands. Don the gloves only when the mask is already on.

    The reason for this is that the nitrile gloves are SUPPOSED TO collect any CoVid-95 particles you might pick up by touching things, and keep those away from your skin. But, if you touch the mask with your gloved hands, you risk transferring those CoVid-95 particles to the exterior of the N-95 mask, and thereby overload the mask’s protective surface with dangerous particles, at least in the touched areas.

87. The medical article underlying PenGun’s last post about the Chloroquine treatment for CoVid-19:

    https://medicaldialogues.in/pulmonology/news/breakthrough-chloroquine-phosphate-shows-efficacy-in-covid-19-associated-pneumonia-63549

88. “The people in China are pleased with their government, and grateful they have done such a good job with this disease. Who in their right mind would not be?”

    The dead, the dying, their loved ones, the rest of the world that contracts the disease, and those who believe with some justification it escaped from a bio-weapons lab in Wuhan. Have I missed anybody?

89. Just the flu. Actually, no, not even close to as bad as the flu.
    https://twitter.com/DellAnnaLuca/status/1237538585210830849
    50/ If the stats of today look like we added less cases in ICU, it is because we ran out of beds (we’re adding a few with big effort). The patients who cannot be treated are left to die,
    said Bergamo mayor Giorgio Gori, a city in the red zone.

90. We are so, so, so screwed.
    https://twitter.com/GOPLeader/status/1237165063565447168
    Everything you need to know about the Chinese coronavirus can be found on one, regularly-updated website:

    https://twitter.com/SpeakerPelosi/status/1237513303720521728
    Bigoted statements which spread misinformation and blame Asians and the Asian American community for #coronavirus make us all less safe.
    @GOPLeader must delete this tweet and apologize immediately.

91. Mike K, fyi:
    Looks like some folks in government agree with me that the timelines presented previously for remdesivir aren’t going to cut it:
    https://www.militarytimes.com/news/your-military/2020/03/10/army-signs-agreement-with-drug-giant-gilead-on-experimental-covid-19-treatment/
    U.S. Army Medical Research and Development Command has signed an arrangement with Gilead Sciences to provide the company’s investigational coronavirus drug to U.S. troops confirmed to have the COVID-19 virus.
    …
    “Together with our government and industry partners, we are progressing at almost revolutionary rates to deliver effective treatment and prevention products that will protect the citizens of the world and preserve the readiness and lethality of our service members,” Army Brig. Gen. Michael Talley, commanding general of USAMRDC and Fort Detrick, Maryland, said in a statement Tuesday.

    Let’s not get too far ahead of ourselves with the “will protect” thing, but this does seem like A Good Thing. It’d be nicer to read about a moon shot vaccine program…

92. Raven. If you screw this up as badly, as it looks like you are going to, your people will not be happy. You can try to blame someone, its the American way, but I suspect many people would like to have Bernie’s universal health care instead. As the DNC appears to have successfully kneecapped Bernie, they may not have that option. That will make them even less happy.

93. The only reliable truth about China is everything they say is a lie.
    https://www.theguardian.com/world/video/2020/mar/06/chinese-official-heckled-by-wuhan-residents-video
    A top Chinese official has been heckled by residents as she inspected the work of a neighbourhood committee tasked with taking care of quarantined residents. Vice-premier Sun Chunlan toured a residential community in the Qingshan district of Wuhan on Thursday while residents appeared to shout ‘fake, fake’ as well as ‘it’s all fake’ and ‘we protest’ from their apartment windows. Since 12 February, all residential compounds in Wuhan have been put under lockdown, barring most residents from leaving their homes.

94. Brian if you believe all the Chinese numbers and info are lies, then you should just ignore them, and hope everything will be OK. ;)

95. I suspect many people would like to have Bernie’s universal health care instead.

    Sure, as long as they didn’t have to pay for it. Remember, you have not seen anything as expensive as free stuff.

    Ask Natasha Richardson. Oh wait….

96. Brain, “Moonshot vaccines” are a year away at least. This is an rna virus which has all kinds of replication errors, which means a new vaccine every season. Just like Flu.

    The studies of Remdesivir are now underway. We should know about effectiveness in 2 months or so. This is for severe cases, about 10% or so.

    I wish out CDC and FDA were more competent but that is the law of bureaucracies. Bigger is worse.

97. In South Korea they now have drive though testing, for anyone who wants it. Just let McDonalds take care of it. ;)

98. So I think even the “just the flu” bros by now have likely all given up on their “do nothing, don’t worry about it, it’s just the flu” plan of action recommendation prevailing (though it seems they still in general think this is all some sort of mass hysteria). So let me say what I think is going to happen now–serious social distancing measures are finally starting, though every single day is critically important. We will now be able to contain it in many places, though we still are going to have to deal with outbreaks across the country, and the world.
    And very soon you are going to start to see Western politicians, across the spectrum, depending on their particular political situations, say that they would have taken it more seriously if only China hadn’t been lying all along–that we “now” have evidence that there weren’t 3000 deaths in China–there were more like 30,000 (probably even 300,000). And the blowback against China is going to be really, really bad, and beyond that I have no insights, but it’s hard to see how the current global system is going to move on from this.
    First, though, we need to beat this thing, and we can do it, now that it’s finally being taken seriously. There will be pain that didn’t have to happen if we had taken more decisive action a month ago, but that’s just the way that people are.

99. I agree this will hurt China, especially the suspicion that the Wuhan bioweapons lab was involved. It is a harsh wakeup call to those who did not realize how much of our infrastructure had moved to China. Especially pharmaceuticals like penicillin. The US invented the deep fermentation method of making penicillin.

100. LOL. You are going to blame the people who showed you how to beat this pandemic, instead of your own absolutely awful response to it. Not unexpected. ;)

101. Not looking good, it appears that the Brazil communications secretary, who met Donald Trump, has coronavirus. He maybe should get a test, if he can find one.

102. https://twitter.com/DeItaOne/status/1238117969525383170
     CHINA FOREIGN MINISTRY SPOKESMAN TWEETS ‘IT MIGHT BE US ARMY WHO BROUGHT THE EPIDEMIC TO WUHAN’

     We’re in crazytown. Even if things magically resolve themselves (p.s., you can find proof online of new outbreaks in China, i.e., postings in new cities that only one family member per household may leave the house, only once per day, etc., if you know where to look…), China’s relation to the world is going to be nothing like it was before. And if things in most countries go bad, oh boy, the baying for vengeance is going to be out of control.

103. I see the trolls for the CCP have gotten their marching orders:

     De-Sinicizing the Virus: How CCP Propaganda Is Rewriting History.

     Oh well.

104. It is tiresome to have PenGun trolling this site. Hoping that Canada at long last catches the US.

     Trump has been tested after CPAC and I understand was negative.

     He can’t self isolate but is a well known germaphobe.

105. “It is tiresome to have PenGun trolling this site. Hoping that Canada at long last catches the US.” In what way? I am fascinated by the denial and attempt’s to blame China for everything, so understanding what we need to catch, and how, would help. I have mostly provided useful information.

     We have one case on Vancouver Island, anyone who coughs funny gets tested. We have a cluster on the mainland and expect more cases as we test more. You may now have tested more people that BC has. That was not the case, till very recently.

106. Brian. The churn involving the Chinese accusing the US of somehow being to blame, rests on evidence that some of the American cases may have earlier dates of infection than the Chinese cases. There is something behind this, perhaps it will tip toe out into the light. ;)

     Here’s a troll. Putin just destroyed your shale oil industry. Alberta too is destroyed by rates as low as $30, which the Russians claim they can handle for a decade. MbS is off the chain and the CIA will wack him. ;)

107. “Here’s a troll. Putin just destroyed your shale oil industry. Alberta too is destroyed by rates as low as $30, which the Russians claim they can handle for a decade. MbS is off the chain and the CIA will wack him. ;)”

     Penny thinks a drop in oil prices destroys the underlying oil producing asset value permanently. That $30/bbl oil will be at $20 PDQ. Probably last a year, then it will rise again. Nothing new in the
     Oil Business. Some frackers will cut back, some will become insolvent and be liquidated. The shale will still be underground and acquired by folks with some loose change in their pockets who can hold then for better times. I guess Penny never heard of creative destruction.

     It will be interesting to see who cries Uncle first, the Ruskies or the Arabs. Russia bet 1 mmbbl/day, the Arabs raised it to 3.5 mmbbl/day. Putin would have been better off sticking with OPEC. As for the US, if we lose 100,000, even 200,000 oil patch jobs, so what. Oil consumers here buying ~17 mmbbl/day are saving an enormous sum of money and unlike Canada, we are experiencing severe labor shortages.

     Later this year I expect that solid oil company stocks will be a good buy.

     Seriously Penny, anytime you write a post here with a $ sign in it, think twice, then delete it.

108. Raymondshaw, good advice but PenGun will not take it.

     China has bought a lot of US politicians, including Joe Biden and the Clintons. The tide began to turn with Trump in 2017 and the furious Democrat effort to stop him has held up progress but this will turn the ship much more quickly.

109. Putin just destroyed your shale oil industry.

     I thought it was the other way around.

110. “I thought it was the other way around.” You really don’t understand what’s happening do you? it will become clear with a bit more time.

111. In general trolls should just be ignored.
     There comes a time when they should be banned, though.

112. Is Trent ok? It’s been over a week without an update post from him, and it’s not like things have slowed down.

113. it will become clear with a bit more time.<

     Speaking of paranoia.

114. “Speaking of paranoia.” Does that scare you Mike? Trump just ordered the Strategic Reserve to buy American oil and the price spiked to … $36.

115. PenGun doesn’t get it. We want oil around $40. There have been suggestions that Trump set a tariff at $40 and over.

     The stock market also responded to the intense disappointment, if not rage, by the political left.

     You are hoping ,from your little perch, for disaster for America. The hatred by Democrats for America is matched, it seems by the intolerant left of Canada. The same intolerant left that was going to prosecute the girls in the wax salon for not wanting to wax a crazy trannie’s balls. The USA has plenty of crazies. We don’t need you .

     Bad news for America’s enemies, including China and Canadian trolls.

116. Your shale industry already has serious levels of debt. They cannot survive at $40 a barrel.

     The disaster is well under way and if it does turn out the Chinese have a point about the virus being in America first, it will be very bad indeed for America. I expect more stupidity and a lot of death

     Mike my dislike of America stems from suffering. The vast amount you have imposed upon the world for your own benefit is why I want America broken on the ash heap of history. The suffering of your people too I lay at the feet of your capitalistic system, which is designed to enrich the very few.

     I have a pile of Gold and Silver and its doing rather well these days. I expect to make quite a bit more as the financial system melts down. Your little bump will not last long. The trillion dollar put the Fed just made, is why you have your little bump. The Fed has a half a point left. ;)

117. Mike my dislike of America stems from suffering. The vast amount you have imposed upon the world for your own benefit is why I want America broken on the ash heap of history.

     Comrade Stalin would be proud of you if he was not on “The ash heap of History.”

     I won;t wish you good luck. I hope Canada gets what it deserves.

118. Oh that’s how it works. Everyone gets what they deserve. Its built into the fundamental structure of this universe. ;)

119. I have consistently argued against the idea that the Wuhan Virus was some sort of bio-weapon. Taking the Chinese epidemic numbers at face value and adding the recent statements of different Chinese government spokesroaches, I could easily be convinced that it is instead a successful attack by China on the rest of the world. A couple thousand casualties is a price hardly worth mentioning in the context.

     Pearl Harbor was a successful attack and I’m sure many toasts were made to the various “heroes” right up to the Battle of Midway. These overlooked the fact that Japan had no remotely plausible ability to exploit the victory on the mainland of North America. It cost the Pacific Basin a great deal but it cost the Japanese a great deal more.

     If I believed the numbers out of China, they would have demonstrated the predicate of an effective weapon, the ability to control and direct it. I would have very little choice but to believe that this was some sort of weapon released either deliberately or accidentally.

     The case for a deliberate attack is seriously hampered by a plausible means to exploit it. It is supported by the parallel with the Japanese position leading up to Pearl Harbor. They were in the process of losing their war in China because they were being denied resources, especially oil, by the Western Powers and saw no alternative to taking them by force. China found itself on the losing end of a trade war that hardly amounted to more than a skirmish, but showed their real vulnerability. If they though that that they had nothing more to lose, they will find themselves badly mistaken.

     The case for accident rests with the widespread incompetence and corruption of the Chinese government in general. This would seem to be countered by their remarkably successful containment, if you believe their reports.

     The number of cases that they report are entirely implausible give the experience in the rest of the world and the known fact that the virus had been circulating freely for months before any action was taken. The attempt to lay blame on us while crowing about their prowess is completely in line with their previous actions.

     Whatever the truth of my conjectures, they would do well to tread very carefully. The mere perception that this was brought about by the Chinese government’s deliberate act whether or not negligence was responsible for the actual release will hurt them as badly as the established fact.

120. I don’t think it was a bioweapon, but it probably did originate out of the Wuhan institute, a fluke, kind of like in the stand,

121. The weapon isn’t the pathogen, it’s the ability to direct and control it.

122. National Rolling Blackout Coming! Airborne Transmission of CoVid-19 Closing Nuclear Power Plants!

     This is from a friend who is a very reliable source on such issues. Here is what he got from another reliable source:

     ”I have reliable sources saying to prepare for a full shutdown of the US govt for 2 weeks min. very soon.

     Also to prepare for rolling blackouts. Energy companies today had a conference call with Trump about the grid not being able to handle the shutdown and to prepare for rolling blackouts to ease the burden.”

     My friend’s analysis of why the blackouts are purportedly coming focuses on airborne transmission of CoVid-19 and nuclear power plants.

     ”This shouldn’t be an issue, we’re not even into peak cooling season (summer) and factories will be idled as a quarantine/supply chain side effects.

     However, I went looking into it based on the following data that American medical tests showed COVID-19 is an airborne pathogen.

     [snip his data review]

     Power control rooms are by definition close contact for an airborne pathogen. Power companies have been cutting the control staffs for the grid and power generation plants past the bone for decades. Infection and Quarantine issues mean the availability of those control room staff is going to be shit.

     You can pencil whip a lot of power plant stuff, especially natural gas ones.

     But you can’t pencil whip nukes. About a quarter of our juice, and most base load power, comes from them. If not enough people are available to properly staff them, they’ll have to shut down under NRC regulations.”

123. One thing many have missed, is that this virus sheds into the throat almost immediately. That means the newly infected are very infectious indeed. This is quite different than SARS in that respect, and one reason this one is so dangerous..

     Your numbers are not even in the ball park, multiply by ten at least.

124. MCS: “I could easily be convinced that it is instead a successful attack by China on the rest of the world. A couple thousand casualties is a price hardly worth mentioning in the context.”

     A deliberate attack is certainly a possible explanation of the Chinese over-reaction to this low mortality virus. Although a deliberate attack is much lower probability than some other possible explanations, it cannot be totally ruled out. Certainly, China’s history of the Warring States period is full of examples of the successful use of deception — and releasing a not-very-dangerous virus on your own population first & then over-reacting would be a classic example of deception.

     Let’s play the game. If this were a deliberate economic attack on the West, what is the objective and what comes next? While the Chinese understand us much better than we understand them (look at how Western media has created panic!), we do know that China has long-range plans to make itself the dominant nation in the world.

     If we are thinking of economic war, China has already successfully destroyed much of the industrial capacity of the West. (Just think of our inability even to make medicines). Without dropping a single bomb, China has achieved what took the Allies several years of all-out war to accomplish in Germany. Maybe China’s intention now is to finish the job? — trigger an economic depression in the West as the full effects of supply chain disruption start to bite, then swoop in and buy up the West’s remaining industrial capacity (Airbus, Boeing, Microsoft, etc) at bargain basement prices and take the Intellectual Property and machinery back to China. There is very little risk to China of falling into the Japanese WWII trap of triggering an unbeatable military response. Europe is already functionally de-militarized, and an impoverished US will likely also have to pull back militarily.

     In the longer term, places like the US and Australia will be reduced to suppliers of food and raw materials to the Middle Kingdom, while the nicer parts of Europe become a living Disneyland for Chinese tourists and the rest reverts to nature. In a world in which President Bill Clinton authorized the sale of missile guidance technology to China, China’s rulers probably have no fear of most Western politicians getting in the way of their long-term plans.

     The above is all speculation. Who can say? Time will tell.

125. Jack Ma, the Chinese billionaire has just donated 1 million masks, which you are pretty well out of, and a half million test kits, to America.

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