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RE: Covid-19 considerations - stupac2 - 03-14-2020

(03-14-2020, 08:53 AM)OutsiderFan Wrote:  
(03-14-2020, 08:33 AM)cardcrimson Wrote:  Things can't be too bad in NYC as DeBlasio is intent to keep schools open:

https://abc7ny.com/education/covid-19-mayor-de-blasio-doubles-down-on-keeping-nyc-schools-open/6009426/

I have no words for how reckless and stupid NYC's Mayor is being. I understand he's concerned about kids getting meals, but there are other ways to make that happen. Every other school district in the country has figured out a way.

One complicating matter is a lot of times in disasters restaurant owners come to the aid of communities of people who need food, but now the restaurants themselves are sending out pleas to customers to continue coming in, so they can keep their staffs.  Little do they know it's going to eventually get to the point nobody is even allowed at restaurants. OMG is this getting very scary very fast.

Oakland is doing twice-weekly food pickups for kids who get lunches at school (or perhaps even all kids, it's not clear). Certain schools are designated pickup spots and you go during certain hours to get the food. Not perfect, but seems like a good way to get the kids food and while minimizing contagion.

Also, this was interesting: https://www.nytimes.com/2020/03/04/us/coronavirus-recovery.html. It includes an interview with the apocryphal asymptomatic case.

RE: Covid-19 considerations - M T - 03-14-2020

(03-14-2020, 08:53 AM)OutsiderFan Wrote:  Little do they know it's going to eventually get to the point nobody is even allowed at restaurants.

Santa Clara County's order limiting gatherings applies to confined indoor or outdoor spaces, including restaurants (but not Costco(etc)!!! nor airport, bus/train stations, etc.)
Gatherings of 101+ are banned.
As I understand it, if there are 35 to 100 people (including staff I think), then
  1. There must be room so everyone can spread out 6' (spreading is not required, so families can eat together)
  2. Hand hygiene must be available (it is not required of anyone)
  3. 24-hour prior notice to attendees of the COVID-19 risk  (?? at restaurants??)
  4. Cancellation fees must be waived
  5. Facility must disinfect surfaces before, during, & after.


Of the 91 confirmed cases in the county, 40 are presumed community transmission.  38 are hospitalized.  2 deaths.

Experience elsewhere indicates 20% of the total cases are serious.  If 38 are serious, that suggests around 190 cases in the county of which 91 are known.

RE: Covid-19 considerations - murky - 03-14-2020

(03-14-2020, 08:33 AM)cardcrimson Wrote:  Things can't be too bad in NYC as DeBlasio is intent to keep schools open:

https://abc7ny.com/education/covid-19-mayor-de-blasio-doubles-down-on-keeping-nyc-schools-open/6009426/

The state of Washington has closed K-12 schools until late April effective Monday.  Oregon public schools are closed as well.  And both states have outlawed gatherings of 250 or more people.

RE: Covid-19 considerations - fullmetal - 03-14-2020

Asymptomatic transmission is probably a big deal: https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

It's probably a big factor in why the R0 is so high.

Goose, the answer to your question is in that article:
Quote:Canadian, Dutch and Singaporean researchers looked at the same outbreaks in Tianjin and Singapore and found that infection was transmitted on average 2.55 days and 2.89 days before symptom onset respectively in each location.

"Our analysis would suggest that presymptomatic transmission is pretty commonplace," said the study's lead author, Caroline Colijn, who leads the mathematics, genomics and prediction in infection and evolution research group at Simon Fraser University in British Columbia.


RE: Covid-19 considerations - magnus - 03-14-2020

Apparently a child who got an autograph from Rudy Gobert last week (pre symptoms) has tested positive.   Health officials discount any connection I'm guessing because it was pre symptoms.   If fullmetal's post is proved correct,  they could very well be linked.

RE: Covid-19 considerations - Goose - 03-14-2020

(03-14-2020, 02:58 PM)fullmetal Wrote:  Asymptomatic transmission is probably a big deal: https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html



It's probably a big factor in why the R0 is so high.



Goose, the answer to your question is in that article:
Unfortunately, no, the answer to my question is not in the article, although it does have some attempts in that direction. The article shows that for some individuals "the test" can detect the virus before the individuals show symptoms. In other words, for some unknown n a test (the test was not designated as which test. One could assume the "German" test but it is not so stated) can sometimes detect the virus n days before symptoms where n is not known.

If somebody followed up on the four Israeli and one German patient and told us when (or even if) they showed symptoms, we would have maybe 5 data points for the "German" test, if that is what was used. Since the letter for the German national came out on 18 Feb, it is well past time for that patient to show symptoms, but the number was not available. What really bothers me is that by now one would hope there would be plenty of examples of this situation. Even with the current limited testing, you can test people who been exposed but do not show symptoms. How often has the test come up positive? If the 5 cases reported on in the article are all there are, "the test" is pretty useless as a predictor. Even in those cases, we don't get told how "early" the prediction was. Four of those cases may be too early to know, if n is > 2 days, but there should be other data points, lots of them.Perhaps the current tests are not generally useful in detecting disease in asymptomatic patients. That is why I asked the question in the first place. The Chinese protocol has the same attribute. It may be because the assumption is (was) you had to have symptoms to spread the disease that testing asymptomatic people was not generally done. However, it was done on lots of travelers fleeing areas where they had been exposed. Why no results in the public domain?
It is also true that there are many tests in use. Stanford is now deploying another, different test in California. Probably all these tests "work", but probably they don't work exactly the same. The complicates the question of "Can the test X be used for early detection of asymptomatic individuals?". It is still early days for this disease and the tests, but I am not encouraged by what I have seen in the press.

RE: Covid-19 considerations - fullmetal - 03-14-2020

Okay, I read you.  But at least you sort of have a floor for n, which is no lower than ~3 days as viral shedding at a contagious level would definitely be detectable by tests.

RE: Covid-19 considerations - cardcrimson - 03-14-2020

(03-14-2020, 03:39 PM)magnus Wrote:  Apparently a child who got an autograph from Rudy Gobert last week (pre symptoms) has tested positive.   Health officials discount any connection I'm guessing because it was pre symptoms.   If fullmetal's post is proved correct,  they could very well be linked.
I would imagine his teammate got it from him presymptoms or vice versa, as well.

RE: Covid-19 considerations - akiddoc - 03-14-2020

A little data about viral infection in general for those who may not know:

Viruses do not make you feel sick immediately. After initial infection, the viral load is way too small to cause the human host any discomfort. If you only have a few viral particles that get to you and they get past the body's initial resistance, it's going to take a little time to infect enough cells to have symptoms. Viruses do multiply quickly most of the time, so within 2 to 21 days (for most viruses - not HIV obviously) the host begins to have symptoms. We begin to shed virus from a variety of tissues at some point, usually from nasal mucosa, lung or bronchus tissue, or bowel lining at some point during that incubation period. It is not unusual at all for the viral load to be great enough for shedding prior to symptoms. That is why there is concern about being infectious prior to symptoms, but it's not a surprise at all if that is true. Since Corona viruses have a predilection for invading bronchial tissue, it can be aerosolized by an individual just by breathing. It does not have to be expelled forcefully by cough, although that will extend its reach. Some individuals are able to defeat viruses prior to the virus reaching a high enough load to make you feel sick - thus asymptomatic infection. Children seem to be very good at this for Covid-19 for reasons not yet understood. There have been quite a few kids testing positive in China without symptoms. If there are enough viral particles to test positive for C-19, there may be enough for that individual to be contagious.

RE: Covid-19 considerations - UltimateCard - 03-14-2020

Apparently, airports didn’t get the memo on social distancing. Americans returning on international flights are crammed like sardines getting through customs due to enhanced screening. Way to fatten (not flatten) the curve!

https://www.dallasnews.com/news/2020/03/15/travelers-returning-home-from-overseas-face-hours-long-waits-at-dfw-airport-due-to-enhanced-screening-procedures/

RE: Covid-19 considerations - akiddoc - 03-14-2020

Tobacco smoking is apparently an important risk factor for mortality and morbidity for C-19. Rates of smoking are really high among Chinese men. Chinese men are dying at a higher rate than women. Not a surprise considering that lung inflammation is what kills you with Corona Virus.

RE: Covid-19 considerations - fullmetal - 03-14-2020

The European travel ban has extended its requirements such that Americans returning from the UK, Ireland, and Europe can only do so through one of 13 airports.  They'll go through enhanced entry screening before being asked to self-quarantine for 14 days after reaching their home destination.

I'm pretty sure I just saw an acquaintance just fly to London for a vacation two days ago and then post today about how the self-quarantine would probably not be enforced.  Sigh.

Not sure this travel ban does much except reduce the number of embers returning to the dry prairie. But hey, I'm seeing pictures of long lines at a local restaurant, at stores, and at bars. Mostly young adults, no surprise there.

RE: Covid-19 considerations - cardcrimson - 03-14-2020

(03-14-2020, 08:09 PM)akiddoc Wrote:  A little data about viral infection in general for those who may not know:

Viruses do not make you feel sick immediately. After initial infection, the viral load is way too small to cause the human host any discomfort. If you only have a few viral particles that get to you and they get past the body's initial resistance, it's going to take a little time to infect enough cells to have symptoms. Viruses do multiply quickly most of the time, so within 2 to 21 days (for most viruses - not HIV obviously) the host begins to have symptoms. We begin to shed virus from a variety of tissues at some point, usually from nasal mucosa, lung or bronchus tissue, or bowel lining at some point during that incubation period. It is not unusual at all for the viral load to be great enough for shedding prior to symptoms. That is why there is concern about being infectious prior to symptoms, but it's not a surprise at all if that is true. Since Corona viruses have a predilection for invading bronchial tissue, it can be aerosolized by an individual just by breathing. It does not have to be expelled forcefully by cough, although that will extend its reach. Some individuals are able to defeat viruses prior to the virus reaching a high enough load to make you feel sick - thus asymptomatic infection. Children seem to be very good at this for Covid-19 for reasons not yet understood. There have been quite a few kids testing positive in China without symptoms. If there are enough viral particles to test positive for C-19, there may be enough for that individual to be contagious.

Thanks for the continued insights. Stay healthy.
Pretty scary in Germany as well. Anecdotal, third hand info:

A friend/client's brother in Munich has it--fever and vomiting. Apparently at a meeting, he sat next to, and shared a pen with someone infected, tho had no symptoms. Fortunately, the brother is expected to completely recover. Unfortunately, the German healthcare system is teetering. 3 day wait to see a doctor; minimum 5 hour wait to speak with someone, tho many don't get through. . . .

RE: Covid-19 considerations - 2006alum - 03-14-2020

Apparently there's no Google website in the works, and the one that is, by its subsidiary, Verily, was originally intended primarily for healthcare workers, and will be rolled out slowly, starting with the Bay Area. The lies never cease. And some around here wonder why the rest of us are outraged by the ongoing, widespread misinformation.
(03-14-2020, 09:04 PM)fullmetal Wrote:  The European travel ban has extended its requirements such that Americans returning from the UK, Ireland, and Europe can only do so through one of 13 airports.  They'll go through enhanced entry screening before being asked to self-quarantine for 14 days after reaching their home destination.

I'm pretty sure I just saw an acquaintance just fly to London for a vacation two days ago and then post today about how the self-quarantine would probably not be enforced.  Sigh.

Not sure this travel ban does much except reduce the number of embers returning to the dry prairie.  But hey, I'm seeing pictures of long lines at a local restaurant, at stores, and at bars.  Mostly young adults, no surprise there.

Yeah, because this was rolled out so quickly, implementing additional questoinnaires has caused up to 6-hour lines to get through customs, which of course means the very people most likely to be contagious are all trapped in one gigantic room together for hours on end...:

[tweet]https://twitter.com/V2019N/status/1239008275216994305[/tweet]

[tweet]https://twitter.com/JasonWhitely/status/1238986444615618561[/tweet]

RE: Covid-19 considerations - here4WBB - 03-14-2020

Stanford undergrad tested positive and is self-isolating.  Students ordered off of campus by Wednesday 3/18 at 5pm.  https://sanfrancisco.cbslocal.com/2020/03/14/stanford-undergrad-positive-covid-19-students-leave-campus/

RE: Covid-19 considerations - Snorlax94 - 03-14-2020

Well Sh!t, that’s gonna do it. 

Those pix by 2006alum of people potentially flying in from the worst hot zones in the world like Italy and Spain, standing for hours shoulder-to-shoulder next to thousands of other people who also just flew in from Italy and Spain. 

When announcing a travel ban, would it be too much to expect an actual plan by the TSA and other agencies not to make things much, much worse?

Those thousands and thousands of people are now gonna go home and scatter everywhere, with the added bonus of being totally exhausted and weak.

If we didn’t already have a massive, massive outbreak, we do now.

RE: Covid-19 considerations - Griffins78 - 03-14-2020

(03-14-2020, 10:24 PM)Snorlax94 Wrote:  Well Sh!t, that’s gonna do it. 

Those pix by 2006alum of people potentially flying in from the worst hot zones in the world like Italy and Spain, standing for hours shoulder-to-shoulder next to thousands of other people who also just flew in from Italy and Spain. 

When announcing a travel ban, would it be too much to expect an actual plan by the TSA and other agencies not to make things much, much worse?

Those thousands and thousands of people are now gonna go home and scatter everywhere, with the added bonus of being totally exhausted and weak.

If we didn’t already have a massive, massive outbreak, we do now.
I agree. After thinking that we’ve done a pretty good job of cancelling just about everything and trying to work and stay at home as much as possible this happens. They proclaim that they’re going to protect America from people coming from other countries then they cram all these people coming from the “hot spots” for hours in close proximity without any protective measures and now they’re going to send them throughout the country.
Meanwhile, this is what we’re receiving...

Important COVID-19 notification from San Mateo Public Health.

On order of the health officer, gatherings of more than 50 individuals are prohibited in San Mateo County effective 12:01 a.m. Sunday, March 15, 2020. Gatherings between 10 and 50 individuals are prohibited unless specific mitigation measures are taken: 

RE: Covid-19 considerations - M T - 03-15-2020

(03-13-2020, 09:15 PM)Goose Wrote:  
(03-13-2020, 06:07 PM)M T Wrote:  
  • The attitude that you have to have symptoms in order to get tested scares me as those with the disease have been spreading it before they have symptoms (see my post early this morning for the medical article indicating the early massive virus shedding).  This attitude will lead to explosive growth.
Does anybody here know at what point in the process of getting sick the current test(s) can detect the disease fairly reliably? If T designates the first day with detectable symptoms, does the test indicate positive on day T - 1, T - 2, T -4, ...? If anybody knows, please enlighten us and share your info. It may be out there, but I haven't seen it.

The Feb 24 US-China Joint Mission final report indicated
Quote:According to preliminary data from Guangzhou CDC as of 20 February, virus can initially be detected in upper respiratory samples 1-2 days prior to symptom onset
However, I believe that is updated by newer data.

If you are asking about presymptomatic infection, then you may want to ask:
  1) How long after exposure does a swabbing give positive results?
  2) How long after exposure are you shedding virus sufficient to infect someone?
  3) How long after exposure do symptoms appear?
  4) How long after swabbing are the test results available?
I think aKidDoc answered parts of those, not necessarily with hard data.  If I understand correctly, for this disease, the answer to question 2 is pretty close to the answer to question 1.

Similar investigation in The serial interval of COVID-19 from publicly reported confirmed cases
Quote:The serial interval of COVID-19 is defined as the time duration between a primary case (infector) developing symptoms andsecondary case (infectee) developing symptoms. ...
We estimate a mean serial interval for COVID-19 of 3.96 [95% CI3.53-4.39] with a standard deviation of 4.75 [95% CI 4.46-5.07].  Notably, 59 of the 468 reports indicate that the infectee developed symptoms earlier than the infector.

Their minimum serial interval was -11, which would mean that the virus in patient A caused another infection more than 11 (around 15) days before symptoms appeared in patient A. Asymptomatic patients (there are some) would have an undefined value as they never show the symptoms.

The previously mentioned Transmission interval estimates suggest pre-symptomatic spread of COVID-19

Quote:The mean incubation period was 7.1 (6.13, 8.25) days for Singapore and 9 (7.92, 10.2)days for Tianjin. The mean serial interval was 4.56 (2.69, 6.42) days for Singapore and 4.22 (3.43, 5.01) for Tianjin.

For China, test results were available the same day (I believe I saw 3 hours).  Until recently, US tests had to go to CDC for testing, which involved shipping delays, resulting in possibly 48 hours for results.  I'm sure it is better now.  A number of metropolitan areas have test facilities.

The WHO-China report (dated Feb 24) also had this:
Quote:Overall, producers have the capacity to produce and distribute as many as 1,650,000 tests/week.
(03-14-2020, 09:51 PM)2006alum Wrote:  Yeah, because this was rolled out so quickly, implementing additional questoinnaires has caused up to 6-hour lines to get through customs, which of course means the very people most likely to be contagious are all trapped in one gigantic room together for hours on end...:

Whew, it is a good thing that Santa Clara County included this in the order limiting gatherings:
Quote:A "gathering" does not include normal operations at airports or spaces where persons may be in transit.

If those lines were at the San Jose airport, SCC wouldn't need to have the sheriff come in and cite the airport or the immigration authorities.

RE: Covid-19 considerations - OutsiderFan - 03-15-2020

I went on FlightAware last night and thought to myself “why am I making sure to sequester myself?” The amount of planes in the air was utterly shocking, not just internationally, but also within the U.S.

If Air Travel is going to be cut 40%, why not go a couple weeks grounding flights?  I mean ALL countries are facing this pandemic. And most are getting to the point of closing their cities, but let’s keep airports open and crowd people into international airports on fewer flights?

Maybe allow cargo only, but FFS, wouldn’t grounding planes for a couple weeks be smart at this point?

Now y’all can see why I have believed for a few weeks now that the U.S. would suffer the most damage from this outbreak of any country. The utter incompetence and negligence at the top ensures it. Some governors and local officials are handling well, but if the top of your leadership structure is terrible it will always undermine even competent people underneath. 

Of course, NYC is also an example of terrible leadership at the local level. I went on it’s website last night and saw Metro North will be running a weekend schedule starting Monday. Don’t worry about more people on fewer trains, they are doing extra cleaning! Hello, it’s not the trains to worry about, it’s the people who would be on them. So of course, let’s keep the trains running and spread disease all over the Tri-State area, only the most populated region in the country.

I’m not done with DeBlasio... He still hasn’t closed NYC schools. So now teachers are planning to stay ho,e, leaving masses of student in school potentially unsupervised. There still isn’t a ban on gatherings under 500, but Santa Clara County has banned any over 35 and basically closing restaurants, bars, gyms, theatres, etc. as Italy, France, and Spain. I’m seeing official NYC messages saying “remain calm” rather than prepare for war. I saw a tweet from Lauri Garrett who lives in New York where she said she was out walking the city for a few hours Saturday and saw just 5 people wearing masks and New Yorkers otherwise acting business as usual. 

Imagine what happens when Wall Street workers are slammed with infections and NYC turns into apocalypse.

RE: Covid-19 considerations - stupac2 - 03-15-2020

(03-15-2020, 03:46 AM)OutsiderFan Wrote:  I saw a tweet from Lauri Garrett who lives in New York where she said she was out walking the city for a few hours Saturday and saw just 5 people wearing masks and New Yorkers otherwise acting business as usual.

That's how it is here too. I've done a couple trips to the store to stock up on staples and it's not clear to me how many people are even aware that there's something happening. Multiple people got close to me for no good reason, it's bizarre. And traffic seems barely reduced, if it is at all.

There are no confirmed cases in Oakland, so maybe people are feeling a false sense of security? But there's just no way that Santa Clara is on fire, Berkeley has at least one case, and we're totally free. Maybe it has to do with the fact that Kaiser refuses to test anyone...