totm april 2020 Coronavirus

[Superfluous J]

8 minutes ago, kerbiloid said:

https://www.theguardian.com/uk-news/2020/mar/25/prince-charles-tests-positive-for-coronavirus

I love it when I can get the story from the link. Saves so much time. Like those movie trailers that tell the whole plot and save me having to watch the movie.

[tater]

6 hours ago, kerbiloid said:

Just thoughts.

The statistics confirms the obvious assumption that the coronaillness is more dangerous for old persons with weakened organism.
But it lacks (and probably will lack for ethical reasons) one more parameter.

Some old persons are just old, ill, and weak, but keep clear mind and will
Other even without the virus can stay alive only with external assistance just because they don't remember to fulfil their basic needs in time, they don't rule their body even without the virus problems.

Does the coronavirus mortality raise significantly in both groups or mostly in the second one?

That's been my argument for a while.

This chart is for France. It's the number out of 10,000 who die for each age:

For 60YO men it's 1% (100:10,000). By the mid 80s it's 10%. That's for each year, so you're in your 85th year and if you're among the 91% who live, then next year you have a 10% chance, and so forth. It's no accident that the old fall to this, they fall to everything, and this is a rough illness, so more will die than die to the common cold. That said, some small number die to the common cold.

[sevenperforce]

I understand the first U.S. death under age 18 (with no pre-existing conditions) happened yesterday.

Related:

https://fox40.com/news/covid-19-not-at-all-like-flu-say-doctors-treating-patients/

Quote

“Reading about it in the news, I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it’s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it’s a lot more frightening.”

The therapist said he’s been running ventilators for the sickest COVID-19 patients. According to him, many of his patients are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts.

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, holy s—, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth.”

It's basically a form of pneumonia that makes you bleed out through your lungs.

[tater]

Well, if you haven't been diagnosed yet with something else, and end up admitted, your chart will show no preexisting conditions. That doesn't mean you don't have any, it means they don't know about them. Not saying all will have them, some won't. Bottom line is that yes, younger people can get really sick, and indeed even die. The stats show this is an unlikely outcome.

All of a sudden, people are reading about terrible deaths in the ICU, even among young people. For those of us who know doctors who work in hospitals, particularly ICUs, that makes it—looks at calendar—Wednesday. This happens all the time. If the student from the U who died in some ICU 6 months had "not COVID-19" you never heard of them. We're going to hear about every dead "younger" person now, doesn't change the math (that their chances of death from this are small).

https://www.ssa.gov/oact/STATS/table4c6.html

This shows (2015 latest US data Social Security has on that chart) the % chance for death from all causes a given age has. It mirrors COVID-19 fairly well. For younger people obviously trauma will dominate, but for older people disease dominates. Yeah, COVID-19 for older people is on the same order as all-causes mortality, which will clearly result in excess deaths, concern is warranted. Regardless, think about those numbers. That's the % of people who actually died at a given age. Assume they died evenly throughout the year—if a pandemic of anything occurred early in the year, those same people are likely going to die from that.

RSV (which mostly kills children) has a CFR about like upper range COVID-19 estimates (2%) (in both cases CFR requires a positive test that doesn't happen all the time, so it's higher than actual mortality rates). RSV kills 14,000 in the US every year—how worried is everyone about RSV?

All I'm saying is calibrate concern, and don't get too worked up about the news, anxiety probably doesn't help your immune system any.

 

 

LOL:

 

[sh1pman]

29 minutes ago, tater said:

Yeah, COVID-19 for older people is on the same order as all-causes mortality, which will clearly result in excess deaths, concern is warranted. Regardless, think about those numbers. That's the % of people who actually died at a given age. Assume they died evenly throughout the year—if a pandemic of anything occurred early in the year, those same people are likely going to die from that.

 

Well, when you put it that way, doesn’t sound so bad. Maybe a home quarantine for people over 65 (and people with preexisting conditions) until everyone else gets the immunity is the right way.

In China, they might have stopped the epidemic in Wuhan. But the rest of the country is still susceptible to the virus since there’s a global pandemic. They’ll need to either keep the borders closed indefinitely (and risk getting more outbreaks) or let the virus spread  in a controlled way, keeping the vulnerable groups under home lockdown.

[tater]

2 minutes ago, sh1pman said:

Well, when you put it that way, doesn’t sound so bad. Maybe a home quarantine for people over 65 (and people with preexisting conditions) until everyone else gets the immunity is the right way.

I think that flattening the curve is a good idea, BTW, but buying time requires having some end game, and I think the end game is to slow it, then let the younger people go back to work. We need to protect the vulnerable people, and ramp up testing, ideally serologic tests that can tell who has antibodies (immunity).

I see people (usually reporters) saying we can stop this entirely by a shutdown. Yeah, no. This is now more like flu (seasons/outbreaks) because there will now be a basal rate of infection that is non-trivial. Once the "stay home" lifts, instead of 1 person in a place with it starting a new spread from n=1, it will be millions of such seeds, and it will be n=100,000,000 in the same time frame that it does this in flu season (a few weeks?).

This is gonna happen until there is herd immunity. If it killed 0.6% of the people who get it, that's how many are going to die, shutdown or not. Mitigating it now just means preventing any deaths that might occur for lack of appropriate medical care. Anyone not thinking about triage of such care is being silly, frankly.

A friend has a parent in a nursing home for people with dementia. He thinks they should not be on lockdown, his mom doesn't know who anyone is, and hasn't for a few years now. All those patients should already be DNR/DNI, but many are not. What % of 80-+ people have advanced directives? My wife and I have had those since we had kids (under what conditions we'd not want extreme care, pretty much pegged to if we have no chance of survival, or if our mental function is not there and not going to return (being demented would count here)).

Anyway, a boilerplate DNR/DNI for older people might be a good thing to have available—do you want to be tortured to death, alone in an ICU?

 

2 minutes ago, sh1pman said:

In China, they might have stopped the epidemic in Wuhan. But the rest of the country is still susceptible to the virus since there’s a global pandemic. They’ll need to either keep the borders closed indefinitely (and risk getting more outbreaks) or let the virus spread  in a controlled way, keeping the vulnerable groups under home lockdown.

They haven't stopped it. They've banged it down, it will come back until there is herd immunity via most being infected, or a vaccine, whichever comes first.

[Shpaget]

1 hour ago, 5thHorseman said:

I love it when I can get the story from the link. Saves so much time. Like those movie trailers that tell the whole plot and save me having to watch the movie.

Sure as hell beats the alternative "You won't believe what this resident of Buckingham palace was told by the medical officials!"

[tater]

 

[sevenperforce]

1 hour ago, tater said:

All of a sudden, people are reading about terrible deaths in the ICU, even among young people. For those of us who know doctors who work in hospitals, particularly ICUs, that makes it—looks at calendar—Wednesday. This happens all the time. If the student from the U who died in some ICU 6 months had "not COVID-19" you never heard of them. We're going to hear about every dead "younger" person now, doesn't change the math (that their chances of death from this are small).

Eh, I think it's a little more than that.

I'm almost 31. I'm not in the best shape of my life but I'm reasonably healthy and a nonsmoker. 

Six months ago, there was no reasonably conceivable scenario in which I would end up choking to death on blood and cellular fluid leaking out of my lungs, absent some acute injury like a car crash. Today, the odds of that happening are no longer negligible. That's rather scary.

55 minutes ago, sh1pman said:

Well, when you put it that way, doesn’t sound so bad. Maybe a home quarantine for people over 65 (and people with preexisting conditions) until everyone else gets the immunity is the right way.

It is a mistake to conflate risk of death with risk of hospitalization (and I'm going to fight @tater on this one). This disease has a low kill rate for people under 65 without pre-existing conditions, but hospitals can still run out of ventilators due to volume even if all patients were under 65 because it leads to pneumonia so readily.

There is also no guarantee of immunity.

And home quarantine as you've described only works if there are no contacts between those quarantined and the rest of us. There are lot of people under 65 without pre-existing conditions who live with people over 65 or with people who have pre-existing conditions.

45 minutes ago, tater said:

I see people (usually reporters) saying we can stop this entirely by a shutdown. Yeah, no. This is now more like flu (seasons/outbreaks) because there will now be a basal rate of infection that is non-trivial. Once the "stay home" lifts, instead of 1 person in a place with it starting a new spread from n=1, it will be millions of such seeds...

If we did a full shutdown we would eventually starve the virus out. You could still get reintroduction by asymptomatic carriers like Rand Paul, but only if asymptomatic carriers never actually beat it, which seems unlikely.

[kerbiloid]

34 minutes ago, Shpaget said:

Sure as hell beats the alternative "You won't believe what this resident of Buckingham palace was told by the medical officials!"

"...,  now the special services are tracing all contacts since the year beginning."

Edited March 25, 2020 by kerbiloid

[sevenperforce]

Also, younger people getting it:

https://www.cnn.com/2020/03/25/health/georgia-coronavirus-girl-improving/index.html?utm_source=twCNN&utm_content=2020-03-25T16%3A30%3A07&utm_medium=social&utm_term=link

12 years old. No health conditions, no travel history.

[tater]

27 minutes ago, sevenperforce said:

Eh, I think it's a little more than that.

I'm almost 31. I'm not in the best shape of my life but I'm reasonably healthy and a nonsmoker. 

Six months ago, there was no reasonably conceivable scenario in which I would end up choking to death on blood and cellular fluid leaking out of my lungs, absent some acute injury like a car crash. Today, the odds of that happening are no longer negligible. That's rather scary.

Meh. Still tiny.

My wife and I were just talking while walking the dog. She said, "Everyone's not sick until they're sick." They seemed fine, started bleeding or something, went to ER, have cancer (whatever).

This is true all the time. Yeah, you (your age range) have a non-zero risk of COVID-19 death, it's still incredibly low. down in the n:10,000 range (where n is a single digit number). That's maybe an order of magnitude lower risk than an automobile fatality rate per year. Bump the actual chances of death for you from COVID-19 by an order of magnitude to be extra worried, and it's up there with getting killed by a car.

I hear about people dying more days than not given our "How was your day?" conversations at the dinner table, so maybe I'd jaded.

 

Quote

It is a mistake to conflate risk of death with risk of hospitalization (and I'm going to fight @tater on this one). This disease has a low kill rate for people under 65 without pre-existing conditions, but hospitals can still run out of ventilators due to volume even if all patients were under 65 because it leads to pneumonia so readily.

The hospitalization rate is possibly high, except we have no idea what the denominator is. We know a bunch of people who got really sick in February, for example... will be interesting to see antibody tests.

 

Quote

There is also no guarantee of immunity.

Not durable immunity, there seems to be immunity conferred from what I have read. If there is no immunity, then nothing we're discussing matters, people just get it over and over until everyone is dead, no need to worry about it .

The immunity might be not durable, so it only buys some time (years) to figure out treatment/vaccination. I'm not terribly concerned.

 

Quote

And home quarantine as you've described only works if there are no contacts between those quarantined and the rest of us. There are lot of people under 65 without pre-existing conditions who live with people over 65 or with people who have pre-existing conditions.

People have to leave their houses at some point. How long do you imagine "lockdown" being a thing, lol? Years?

 

Quote

If we did a full shutdown we would eventually starve the virus out. You could still get reintroduction by asymptomatic carriers like Rand Paul, but only if asymptomatic carriers never actually beat it, which seems unlikely.

Nope. It's now endemic. If you think this is true, then you presumably think that after a full lockdown the common cold will also cease to exist (multiple different viruses, but all will similarly go away with zero contact to new patients and even brief conferred immunity).

Asymptomatic or very mild cases ("colds") will continue forever. Viral load tests only show people shedding virus, so even testing everyone with a cold with an instant test, you only know if they are shedding NOW. They can test negative this afternoon, and positive by bedtime.

Antibody tests would work, clearly, but again, you have to test everyone, then what? Quarantine everyone without antibodies forever?

Edited March 25, 2020 by tater

[kerbiloid]

3 hours ago, 5thHorseman said:

I love it when I can get the story from the link. Saves so much time. Like those movie trailers that tell the whole plot and save me having to watch the movie.

Like you prefer

https://www.lalibre.be/planete/sante/un-tout-nouveau-test-de-depistage-du-coronavirus-en-15-minutes-voit-le-jour-en-belgique-5e7b443b7b50a6162bba611a

[mikegarrison]

1 hour ago, sevenperforce said:

younger people getting it

It is not surprising that younger people get infected and get the disease. But it is expected they will not have many complications. However, a few will -- as always.

[sevenperforce]

 

1 hour ago, tater said:

Quote

If we did a full shutdown we would eventually starve the virus out. You could still get reintroduction by asymptomatic carriers like Rand Paul, but only if asymptomatic carriers never actually beat it, which seems unlikely.

Nope. It's now endemic. If you think this is true, then you presumably think that after a full lockdown the common cold will also cease to exist (multiple different viruses, but all will similarly go away with zero contact to new patients and even brief conferred immunity).

Asymptomatic or very mild cases ("colds") will continue forever. Viral load tests only show people shedding virus, so even testing everyone with a cold with an instant test, you only know if they are shedding NOW. They can test negative this afternoon, and positive by bedtime.

Which is why I said this works only if asymptomatic carriers never beat it.

1 hour ago, tater said:

Not durable immunity, there seems to be immunity conferred from what I have read.

Seems to be, but we don't have good data on that yet. 

In reality, immunity is a function of a lot of variables, including the mutation rate of the virus and the types of antibodies produced.

[tater]

28 minutes ago, sevenperforce said:

Which is why I said this works only if asymptomatic carriers never beat it.

No, they will continue to infect people, then move on, but at a low rate. Flu is seasonal, but the rate never hits zero, it just drops below concern—until it rises again, but since the low level that continues is a large number, it goes from seasonal lows to huge numbers in just a few weeks.

There's a preprint out of Oxford getting some press that suggests that a large % of people might have already had this. That's one possibility (it's either largely very mild, with a small number of really bad cases, or it's far less common, with a higher % of bad cases, but we have no good data yet. The real take away from that paper is that we need serological testing.

[sevenperforce]

12 minutes ago, tater said:

No, they will continue to infect people, then move on, but at a low rate. Flu is seasonal, but the rate never hits zero, it just drops below concern—until it rises again, but since the low level that continues is a large number, it goes from seasonal lows to huge numbers in just a few weeks.

Flu's seasonality means that it is always flu season somewhere, which is why it never hits zero. You could wipe out flu completely in the US and still import it.

12 minutes ago, tater said:

There's a preprint out of Oxford getting some press that suggests that a large % of people might have already had this. That's one possibility (it's either largely very mild, with a small number of really bad cases, or it's far less common, with a higher % of bad cases, but we have no good data yet. The real take away from that paper is that we need serological testing.

Agreed on serological testing.

[tater]

28 minutes ago, sevenperforce said:

Flu's seasonality means that it is always flu season somewhere, which is why it never hits zero. You could wipe out flu completely in the US and still import it.

You never wipe it out completely, anywhere, even during the summer (without imports). People think they have a cold, or allergies, or whatever in August. Some are still flu, but only ~1.5% of people with flu ever get tested for it. Flu is more complex because there are many strains, as well (and mutations). In reality, there is no lockdown on Earth that stops this globally, though, any "back to work" model means the planes start flying, and the first world seems 100% averse to stopping random people from coming in from anywhere, particularly from places without seasonal illness (warmer/tropical countries have low, but constant flu levels).

The coronavirus that causes ~20-30% of colds might be a better example. Also seasonal, but never zero over any large region (it could be zero in my house, or neighborhood, obviously, but someone in town always has a cold).

My point is that lockdown will not end this, it just locally delays things. The area under the flattened curve should basically be the same as the steep curve, in short. Whatever % are going to be infected are going to be infected, and what we prevent via flattening is deaths due to lack of care (exceeding capacity), not the deaths of people who will die even with care.

I'm not arguing this is nothing to worry about, but I am personally calibrating my personal concern to actual risk. I'm not arguing that trying to flatten the curve is a bad idea over some time period. I am saying that we still have lousy data, and that there are legit public health consequences to long term lockdown that are also poorly characterized. How many people will have lower life expectancy due to loss of employment, etc (the opioid crisis is often partially attributed to unemployment, right?) ? I have no idea except that the number is not zero.

Edited March 25, 2020 by tater

[Burning Kan]

for them the want to help but dosnt know how-

spend cpu time to save lifes (hopefully)

folding agains corona (like seti but for corona healing,simulations of COVID-19 proteins),tested with virus total 1say its a trojan!

so recommend to use a vm for it ,(or a cloudserver)on the site exist a link for a vmware config:                                  but can be a false arlarm

https://foldingathome.org/

https://flings.vmware.com/vmware-appliance-for-folding-home

regards BK

update:

 

Edited April 10, 2020 by Burning Kan

[Cavscout74]

3 hours ago, tater said:

My wife and I were just talking while walking the dog. She said, "Everyone's not sick until they're sick." They seemed fine, started bleeding or something, went to ER, have cancer (whatever).

This is true all the time. Yeah, you (your age range) have a non-zero risk of COVID-19 death, it's still incredibly low. down in the n:10,000 range (where n is a single digit number). That's maybe an order of magnitude lower risk than an automobile fatality rate per year. Bump the actual chances of death for you from COVID-19 by an order of magnitude to be extra worried, and it's up there with getting killed by a car.

I've actually told my wife the "I have a larger chance of dying in a car accident coming home from work than I do from Covid-19" when she was worrying about me still going to work.  Almost no one sits around thinking about all the risks they face on an average day - especially younger people.  Probably anyone who did would need hefty doses of anti-anxiety meds to function.  Everyone is scared of this because its new and its in the news 24/7.    In the next year or two, when the new is gone and we're getting some natural herd immunity and hopefully a vaccine, I think we'll be seeing something more like the seasonal flu and it will just be one more thing on the long list of natural causes that kills people in their 70's and older.

 

On an unrelated note, I'd really like to know why every single company I've ever purchased anything from feels the need to inform me of their Covid-19 plans.  Seriously, if I ordered something from you online 8 years ago, I don't care how many times a day you are cleaning your physical storefront.  I've never set foot in any of my credit cards corporate offices, so unless they are telling me I don't have to pay (and no interest) for the next few months, I don't care what they have to say either. (They didn't, so I don't)

The only one that might have been useful was my gym (YMCA) that emailed to inform me their facilities will not be available during this crisis.  No problem, I understand perfectly.  But why are they still billing my credit card?  And why is that not even mentioned in the email?  

Edited March 25, 2020 by Cavscout74

[Guest]

57 minutes ago, tater said:

In reality, there is no lockdown on Earth that stops this globally, though, any "back to work" model means the planes start flying, and the first world seems 100% averse to stopping random people from coming in from anywhere, particularly from places without seasonal illness (warmer/tropical countries have low, but constant flu levels).

The way I see it, the lockdowns will end once herd immunity is acquired one way or another. There are places in which the epidemic is already ending on its own. It's not unlikely likely that by the time a vaccine will become available, most people will be immune already, from having survived the disease. If planes only start flying after hardly anyone can catch the virus, it won't be much of a problem. 

3 minutes ago, Cavscout74 said:

On an unrelated note, I'd really like to know why every single company I've ever purchased anything from feels the need to inform me of their Covid-19 plans.  Seriously, if I ordered something from you online 8 years ago, I don't care how many times a day you are cleaning your physical storefront.  I've never set foot in any of my credit cards corporate offices, so unless they are telling me I don't have to pay (and no interest) for the next few months, I don't care what they have to say either. (They didn't, so I don't)

The only one that might have been useful was my gym (YMCA) that emailed to inform me their facilities will not be available during this crisis.  No problem, I understand perfectly.  But why are they still billing my credit card?  And why is that not even mentioned in the email?  

It's a cheap way of reminding people about a company existing and being "good guys" for taking COVID-19 precautions. Everyone is suddenly worried about your health, because it looks good to people. 

Also, while personal risk to younger people is certainly overrated by some, it has some beneficial side effects, namely slowing the spread of the disease. Young people are unlikely to die from COVID-19, or even require hospitalization, but they can very well spread it to those who are. This entire circus is about protecting our sick and elderly. As it happens, this group forms a large part of Western societies, and a large part of their leadership. By the time you're a head doctor, a veteran teacher, a professor or a high ranking civil servant, you're usually in the high risk group for COVID-19, and we can't really afford to lose these people.

[DDE]

 

[mikegarrison]

6 minutes ago, DDE said:

 

This has all the earmarks of "FOAF" folklore.

[mikegarrison]

At the current rate of deaths in the US:

We will pass 1000 today.

We will pass 10,000 about April 2.

We will pass 100,000 about April 10.

About 8 days for every 10x.

I hope "social distancing" measures will start to flatten the exponential growth rate.

[magnemoe]

2 hours ago, Cavscout74 said:

I've actually told my wife the "I have a larger chance of dying in a car accident coming home from work than I do from Covid-19" when she was worrying about me still going to work.  Almost no one sits around thinking about all the risks they face on an average day - especially younger people.  Probably anyone who did would need hefty doses of anti-anxiety meds to function.  Everyone is scared of this because its new and its in the news 24/7.    In the next year or two, when the new is gone and we're getting some natural herd immunity and hopefully a vaccine, I think we'll be seeing something more like the seasonal flu and it will just be one more thing on the long list of natural causes that kills people in their 70's and older.

 

On an unrelated note, I'd really like to know why every single company I've ever purchased anything from feels the need to inform me of their Covid-19 plans.  Seriously, if I ordered something from you online 8 years ago, I don't care how many times a day you are cleaning your physical storefront.  I've never set foot in any of my credit cards corporate offices, so unless they are telling me I don't have to pay (and no interest) for the next few months, I don't care what they have to say either. (They didn't, so I don't)

The only one that might have been useful was my gym (YMCA) that emailed to inform me their facilities will not be available during this crisis.  No problem, I understand perfectly.  But why are they still billing my credit card?  And why is that not even mentioned in the email?  

Well my boss who also is the main stockholder and founder of the company I work for is in his 70s, my mother is 81. 
Kind of glad my father just passed away two weeks ago as he was at an nursery home with terminal cancer. Couple of days later the nursery homes and hospitals went full lock-down. If you are not staff or patient you can not enter. For the nursery homes they tend to use the fire exits doors for meetings. However why are it stairs for the fire exit then most patients can not walk stairs? An ramp in an two floor building would make more sense.