Outside Topic Covid-19 considerations - Printable Version
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RE: Covid-19 considerations - akiddoc - 03-02-2020
As a physician on the front line, I have a few comments. I work 40% of my time in a Pediatric Urgent Care practice in an affluent part of the Bay Area and 60% of my time in a Federal Clinic in a rather disadvantaged area in the Bay Area. 90% of my exposure to sick patients occurs at that urgent care facility.
Every day in urgent care we see at least 30 children with high fever and cough. Over 200 per week. (We see only a tiny fraction of the sick kids in Alameda County.) Most of these febrile children in our clinic are tested for Influenza. Earlier in the season we were running 80% positive tests for flu. Now we are running about 50%. There are certainly false negatives with this test. The manufacturer actually designed the test that way so that we would have very few false positives. Every test that we use for viral identification either is designed for high specificity (few false positives) or for high sensitivity (few false negatives, but some false positives). I have no idea what the C19 test is designed for in this context, but I guarantee it is not 100%, or even 95%, accurate. If we ever get a test that we can use at the initial point of patient contact, I will know the answer to the sensitivity and specificity question. But getting to the actual point: we have no idea what half of these febrile children have. Very few have the other virus we can test for (RSV). A few have bacterial disease. There are a whole host of viral candidates, but I would be shocked if there is no C19 in this group of patients. 70% of the families we see have parents who were born in Asia. They are almost all in the tech industry. Large numbers of them were in China, Korea, Japan, India and Hong Kong over the Christmas holidays. If none of them have C19 it is an incredible stroke of luck. I spend a lot of my time assuring parents that their children are pretty safe. Their grandparents are not necessarily so lucky.
I want to be sure that people understand that only a few people in the USA are being tested. The CDC has shown itself to be incredibly incompetent in getting dependable testing kits manufactured and distributed. The CDC was the world's most respected organization for analyzing, preparing for and combating infectious diseases until 2016. What is happening now is a tragic farce. Only very sick individuals and their contacts are being tested. We should be testing tens of thousands of people (or more) every week to really understand what is going on. China did it. South Korea can do it. We cannot. Unfortunately, politics are very much part of this. The CDC has been decapitated by the scientifically illiterate know nothings who control the budget and top management of the organization and the federal government.
Other than HIV, there are no viruses that I am aware of that do not have a large number of silent infections that pass without symptoms (well, maybe Ebola and SARS). There are generally a good number of people who catch influenza, the common cold (Rhinovirus, classic human Coronaviruses), hand foot and mouth virus, etc who do not show recognizable symptoms to the infected or their acquaintances. The Chinese are reporting that large numbers of children who are infected have no symptoms at all. But they are contagious. And 80 - 85% of all age groups who are recognized as having the virus basically have the symptoms of the common cold. Therefore, for every case found out in the community in the USA (who are very sick), there are plenty of other individuals who are infected. We are not going to find them all and isolate them all. 1 sick person with the diagnosis likely represents 20 to100 other people with the virus. This will spread. It is spreading now.
We could probably reduce the eventual number of infected individuals, but that would require action that the Trump administration and state governments will not take. China has slowed the spread down considerably and might come out of this in good shape. The USA would have to take similar measures. Close every school. Close almost every business. Bring the country to a standstill. Not going to happen.
On the positive side, almost no children under 10 are going to die from this. They are better off getting Coronavirus than Influenza according to the current statistics. There won't be many deaths in the 10 - 39 year age group either. About the same rate of death as for Influenza. If you are 50 - 59, you'll die at about the same rate as if you catch measles. The anti-vaxxers find that to be an acceptable risk. If you are 60 - 65, your chance of making it another year will move from 98.5 or 99% to about 95% if you catch Coronavirus. No one needs us anyway. If you're over 65 - well, Social Security payouts by the feds will fall quite a bit. That should stave off Social Security insolvency for a while.
On the subject of masks: wearing a surgical mask will give you about 0% protection from the person with C19 standing next to you. Wearing an N95 will give you some protection if it has been properly fitted and you have no facial hair.
My suggestions for surviving: get enough sleep, eat really healthy food, get moderate exercise (not if you are sick), and do not work in a medical facility, especially in the ER or in urgent care. Or go live in rural Montana 100 miles from everyone else. Or be under 10 years old.
RE: Covid-19 considerations - M T - 03-02-2020
(03-01-2020, 10:30 PM)cardcrimson Wrote: A couple of days ago, there was an in-depth discussion on a mineral collecting forum whether it was safe to import rocks from China, even though they'd be on a plane for at least a week. Irrational, probably. Sincere, absolutely. Political, not at all.Asking such a question doesn't seem irrational.
In case no one found any data, see this article Persistence of coronavirus on inanimate surfaces.
I don't claim to understand the details.
I believe SARS-CoV would be the closest virus and so might be used as a guideline. The longest persistence listed for it is 6-9 days on plastic at room temperature. Higher temperature generally means shorter persistence. Lower temperature gives longer persistence (the only two entries at 4 degrees C, for any virus, give persistence greater than 28 days).
I've heard of slow boats to China, but a 1 week trip on a plane, from China??
Oh, in case anyone asks, since packages are almost always shipped with paper or cardboard wrapping, the table in that article shows persistence on paper for a SARS-CoV strain as 4-5 days at room temperature. (Consider that probably several people handle the mail before it winds up at your house. You may want to wash your hands after opening your mail or reading your morning paper.)
RE: Covid-19 considerations - Snorlax94 - 03-02-2020
(03-02-2020, 12:33 AM)akiddoc Wrote: As a physician on the front line, I have a few comments. I work 40% of my time in a Pediatric Urgent Care practice in an affluent part of the Bay Area and 60% of my time in a Federal Clinic in a rather disadvantaged area in the Bay Area. 90% of my exposure to sick patients occurs at that urgent care facility.This is exactly the kind of information I was hoping to get. Other members may have other opinions, but I want to hear them, especially from qualified experts.
Every day in urgent care we see at least 30 children with high fever and cough. Over 200 per week. (We see only a tiny fraction of the sick kids in Alameda County.) Most of these febrile children in our clinic are tested for Influenza. Earlier in the season we were running 80% positive tests for flu. Now we are running about 50%. There are certainly false negatives with this test. The manufacturer actually designed the test that way so that we would have very few false positives. Every test that we use for viral identification either is designed for high specificity (few false positives) or for high sensitivity (few false negatives, but some false positives). I have no idea what the C19 test is designed for in this context, but I guarantee it is not 100%, or even 95%, accurate. If we ever get a test that we can use at the initial point of patient contact, I will know the answer to the sensitivity and specificity question. But getting to the actual point: we have no idea what half of these febrile children have. Very few have the other virus we can test for (RSV). A few have bacterial disease. There are a whole host of viral candidates, but I would be shocked if there is no C19 in this group of patients. 70% of the families we see have parents who were born in Asia. They are almost all in the tech industry. Large numbers of them were in China, Korea, Japan, India and Hong Kong over the Christmas holidays. If none of them have C19 it is an incredible stroke of luck. I spend a lot of my time assuring parents that their children are pretty safe. Their grandparents are not necessarily so lucky.
I want to be sure that people understand that only a few people in the USA are being tested. The CDC has shown itself to be incredibly incompetent in getting dependable testing kits manufactured and distributed. The CDC was the world's most respected organization for analyzing, preparing for and combating infectious diseases until 2016. What is happening now is a tragic farce. Only very sick individuals and their contacts are being tested. We should be testing tens of thousands of people (or more) every week to really understand what is going on. China did it. South Korea can do it. We cannot. Unfortunately, politics are very much part of this. The CDC has been decapitated by the scientifically illiterate know nothings who control the budget and top management of the organization and the federal government.
Other than HIV, there are no viruses that I am aware of that do not have a large number of silent infections that pass without symptoms (well, maybe Ebola and SARS). There are generally a good number of people who catch influenza, the common cold (Rhinovirus, classic human Coronaviruses), hand foot and mouth virus, etc who do not show recognizable symptoms to the infected or their acquaintances. The Chinese are reporting that large numbers of children who are infected have no symptoms at all. But they are contagious. And 80 - 85% of all age groups who are recognized as having the virus basically have the symptoms of the common cold. Therefore, for every case found out in the community in the USA (who are very sick), there are plenty of other individuals who are infected. We are not going to find them all and isolate them all. 1 sick person with the diagnosis likely represents 20 to100 other people with the virus. This will spread. It is spreading now.
We could probably reduce the eventual number of infected individuals, but that would require action that the Trump administration and state governments will not take. China has slowed the spread down considerably and might come out of this in good shape. The USA would have to take similar measures. Close every school. Close almost every business. Bring the country to a standstill. Not going to happen.
On the positive side, almost no children under 10 are going to die from this. They are better off getting Coronavirus than Influenza according to the current statistics. There won't be many deaths in the 10 - 39 year age group either. About the same rate of death as for Influenza. If you are 50 - 59, you'll die at about the same rate as if you catch measles. The anti-vaxxers find that to be an acceptable risk. If you are 60 - 65, your chance of making it another year will move from 98.5 or 99% to about 95% if you catch Coronavirus. No one needs us anyway. If you're over 65 - well, Social Security payouts by the feds will fall quite a bit. That should stave off Social Security insolvency for a while.
On the subject of masks: wearing a surgical mask will give you about 0% protection from the person with C19 standing next to you. Wearing an N95 will give you some protection if it has been properly fitted and you have no facial hair.
My suggestions for surviving: get enough sleep, eat really healthy food, get moderate exercise (not if you are sick), and do not work in a medical facility, especially in the ER or in urgent care. Or go live in rural Montana 100 miles from everyone else. Or be under 10 years old.
Although some might complain that the post discusses and criticizes the CDC, I want to plead right now that I hope this post can stay up unedited. I think the purpose of the post is clearly to share one's expertise and experience and is a sincere attempt to help and inform cardboarders (i.e., the motive is clearly genuine and the intent is not political, personal, inflammatory or disingenuous)
RE: Covid-19 considerations - akiddoc - 03-02-2020
https://www.sfgate.com/news/article/Coronavirus-May-Have-Spread-in-U-S-for-Weeks-15096954.php
RE: Covid-19 considerations - M T - 03-02-2020
(03-02-2020, 01:49 AM)akiddoc Wrote: https://www.sfgate.com/news/article/Coronavirus-May-Have-Spread-in-U-S-for-Weeks-15096954.php
I feel frustrated that the genomes of the COVID-19 in earlier patients in Santa Clara county do not appear in the public GISAID database where this correlation was found. If it were found that Friday's patient's (Santa Clara #3) disease was similar to any of the earlier patients, or similar to any other US illness, it would be important for the public's understanding of whether the disease has been circulating, and so is wider spread than just 7 cases. Ditto for Santa Clara #5. Potentially the public health agencies are letting "recovered" patients go into the public too soon. (That is one hypothesis for Washington state; Santa Clara County has one recovered patient.)
RE: Covid-19 considerations - OutsiderFan - 03-02-2020
Welcome to the club, Florida!
https://www.tampabay.com/florida-politics/buzz/2020/03/02/first-patients-in-florida-test-positive-for-coronavirus/?clavis&utm_expid=.rZxRlJI0T86fmAabR1Jv8w.1&utm_referrer=https%3A%2F%2Fwww.google.com%2F
One case of man who had travelled to Italy. Another man with no travel to or known contacts to those who visited high risk countries. This means community spread in Florida. It simply isn't credible that this virus isn't spreading everywhere in the world, fast, and on a much larger scale than official numbers from all these countries collectively.
What the impacts are and what to do about it is an entirely different discussion. I'm actually coming to the conclusion that humanity might as well just stop even trying to contain it because it is so incredibly virulent and can hide so easily. I'm even beginning to wonder if it actually makes any sense to continue reporting cases, because this is just gonna cause more freakout.
It would seem whether we sequester ourselves or take no precautions to avoid transmission, the end result is gonna be something really bad and exceptionally painful. Basically, I think akiddoc and I are on the same page. We just sort of throw our hands up in the air, admit there are some things we as humans can't control, see what happens, and deal with the unavoidable consequences as they manifest.
Oh, and speaking of akkiddoc, that post:
![[Image: giphy.gif]](https://media.giphy.com/media/l3V0wkQ2KKcAeW8Cs/giphy.gif)
RE: Covid-19 considerations - terry - 03-02-2020
akiddoc, that's a very good post. Thanks.
RE: Covid-19 considerations - stupac2 - 03-02-2020
(03-02-2020, 12:33 AM)akiddoc Wrote: As a physician on the front line, I have a few comments. I work 40% of my time in a Pediatric Urgent Care practice in an affluent part of the Bay Area and 60% of my time in a Federal Clinic in a rather disadvantaged area in the Bay Area. 90% of my exposure to sick patients occurs at that urgent care facility.
Every day in urgent care we see at least 30 children with high fever and cough. Over 200 per week. (We see only a tiny fraction of the sick kids in Alameda County.) Most of these febrile children in our clinic are tested for Influenza. Earlier in the season we were running 80% positive tests for flu. Now we are running about 50%. There are certainly false negatives with this test. The manufacturer actually designed the test that way so that we would have very few false positives. Every test that we use for viral identification either is designed for high specificity (few false positives) or for high sensitivity (few false negatives, but some false positives). I have no idea what the C19 test is designed for in this context, but I guarantee it is not 100%, or even 95%, accurate. If we ever get a test that we can use at the initial point of patient contact, I will know the answer to the sensitivity and specificity question. But getting to the actual point: we have no idea what half of these febrile children have. Very few have the other virus we can test for (RSV). A few have bacterial disease. There are a whole host of viral candidates, but I would be shocked if there is no C19 in this group of patients. 70% of the families we see have parents who were born in Asia. They are almost all in the tech industry. Large numbers of them were in China, Korea, Japan, India and Hong Kong over the Christmas holidays. If none of them have C19 it is an incredible stroke of luck. I spend a lot of my time assuring parents that their children are pretty safe. Their grandparents are not necessarily so lucky.
I want to be sure that people understand that only a few people in the USA are being tested. The CDC has shown itself to be incredibly incompetent in getting dependable testing kits manufactured and distributed. The CDC was the world's most respected organization for analyzing, preparing for and combating infectious diseases until 2016. What is happening now is a tragic farce. Only very sick individuals and their contacts are being tested. We should be testing tens of thousands of people (or more) every week to really understand what is going on. China did it. South Korea can do it. We cannot. Unfortunately, politics are very much part of this. The CDC has been decapitated by the scientifically illiterate know nothings who control the budget and top management of the organization and the federal government.
Other than HIV, there are no viruses that I am aware of that do not have a large number of silent infections that pass without symptoms (well, maybe Ebola and SARS). There are generally a good number of people who catch influenza, the common cold (Rhinovirus, classic human Coronaviruses), hand foot and mouth virus, etc who do not show recognizable symptoms to the infected or their acquaintances. The Chinese are reporting that large numbers of children who are infected have no symptoms at all. But they are contagious. And 80 - 85% of all age groups who are recognized as having the virus basically have the symptoms of the common cold. Therefore, for every case found out in the community in the USA (who are very sick), there are plenty of other individuals who are infected. We are not going to find them all and isolate them all. 1 sick person with the diagnosis likely represents 20 to100 other people with the virus. This will spread. It is spreading now.
We could probably reduce the eventual number of infected individuals, but that would require action that the Trump administration and state governments will not take. China has slowed the spread down considerably and might come out of this in good shape. The USA would have to take similar measures. Close every school. Close almost every business. Bring the country to a standstill. Not going to happen.
On the positive side, almost no children under 10 are going to die from this. They are better off getting Coronavirus than Influenza according to the current statistics. There won't be many deaths in the 10 - 39 year age group either. About the same rate of death as for Influenza. If you are 50 - 59, you'll die at about the same rate as if you catch measles. The anti-vaxxers find that to be an acceptable risk. If you are 60 - 65, your chance of making it another year will move from 98.5 or 99% to about 95% if you catch Coronavirus. No one needs us anyway. If you're over 65 - well, Social Security payouts by the feds will fall quite a bit. That should stave off Social Security insolvency for a while.
On the subject of masks: wearing a surgical mask will give you about 0% protection from the person with C19 standing next to you. Wearing an N95 will give you some protection if it has been properly fitted and you have no facial hair.
My suggestions for surviving: get enough sleep, eat really healthy food, get moderate exercise (not if you are sick), and do not work in a medical facility, especially in the ER or in urgent care. Or go live in rural Montana 100 miles from everyone else. Or be under 10 years old.
Bravo. One question for everyone here that has some personal relevance for me, what about pregnant women? So far we've seen that there doesn't seem to be any increased susceptibility outside of the inherent age effects, but it's based on tiny numbers. Any info there would be appreciated...
We've done a small amount of stocking up, but not much so far. Should probably grab some more staples, but we're waiting to hear on appraisal for replacing our foundation, so we can't throw 10-lb bags of rice into the basement like we normally can. I think there's roughly a zero percent chance of having to shelter in place for a large amount of time (would that order even be legal here?) so I'm not terribly worried about having to survive for weeks without leaving, but I've given some thought to how we'd handle daycare being closed. I'm personally a lot more worried about the reaction to the virus than I am about the virus itself, but then again my nuclear family is young. Of course, my 61-year-old asthmatic mother, or my wife's 80-year-old fail grandfather can't be quite so sanguine. Hopefully they're taking the sensible precautions...
RE: Covid-19 considerations - burger - 03-02-2020
(03-02-2020, 12:33 AM)akiddoc Wrote: We could probably reduce the eventual number of infected individuals, but that would require action that the Trump administration and state governments will not take. China has slowed the spread down considerably and might come out of this in good shape. The USA would have to take similar measures. Close every school. Close almost every business. Bring the country to a standstill. Not going to happen.I agree that China-style martial law is not going to happen. But I can definitely see a lot of mandatory "social distancing" happening: no more public sporting events or music concerts, closing bars and restaurants and schools and daycare. If the outbreak gets bad enough, a lot of it will happen naturally, and those businesses will not have enough paying customers to stay open regardless. I am sure that there will be increasing levels of school absenteeism starting right now (due to parents' pulling healthy kids out of school, not sick kids). At some point, if enough people get sick or die, there will be public support for more draconian measures. How governments will ultimately respond is a separate issue.
(03-02-2020, 12:33 AM)akiddoc Wrote: My suggestions for surviving: get enough sleep, eat really healthy food, get moderate exercise (not if you are sick), and do not work in a medical facility, especially in the ER or in urgent care. Or go live in rural Montana 100 miles from everyone else. Or be under 10 years old.Just curious...why no exercise if sick? My understanding is that moderate exercise, especially for people who already exercise, is not a problem for the immune system. More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911985/
I have read speculation that for covid19, exercise could be bad if it pulls viruses from the upper respiratory tract deep into the lungs, but I have no idea if that's true or not.
Also, thanks for the excellent post, @akiddoc. You are on the front lines in this--stay safe.
RE: Covid-19 considerations - M T - 03-02-2020
(03-02-2020, 07:25 AM)OutsiderFan Wrote: What the impacts are and what to do about it is an entirely different discussion. I'm actually coming to the conclusion that humanity might as well just stop even trying to contain it because it is so incredibly virulent and can hide so easily. I'm even beginning to wonder if it actually makes any sense to continue reporting cases, because this is just gonna cause more freakout
It would seem whether we sequester ourselves or take no precautions to avoid transmission, the end result is gonna be something really bad and exceptionally painful. Basically, I think akiddoc and I are on the same page. We just sort of throw our hands up in the air, admit there are some things we as humans can't control, see what happens, and deal with the unavoidable consequences as they manifest.
I don't know that it will happen until we see Wuhan-style death numbers, but suppose we quarantine everyone, would that do any good? If we're all going to someday get the disease, what good does it do?
In Wuhan (pop. 11M), the patient 0 got sick 1-Dec. They noticed something going on in late December. (We're getting to that point, except that I believe it has spread much wider in the US because of multiple infection sites & more travel.) About 3 weeks later (17 Jan), they shut the city down. About a month later (18 Feb) the number of patients in the hospital peaked (38,000 with 1500 deaths). As of 1-Mar, all the severity indices continue to fall. The deaths/(deaths + discharges) over the last 7 days is now just under 2%. New confirmed infections yesterday was under 200, far below the 1600+ at the peak. In China, outside of Wuhan, the numbers have always been less dramatic.
1) Without quarantine, the numbers exploded like run-away nuclear fission. So many people use "exponential" improperly, but it is exponential growth. A consequence of that is overwhelmed medical facilities and health care staff (who will be getting sick too). This isn't a Katarina with a fixed number of victims, however big. It keeps growing.
If we can put in dampening rods and reduce the multiplier to less than 1.0, then the growth is bounded. That day was Feb. 18 in Wuhan. The same number of people might get this illness in their lifetime, but if it is spread out enough, then the health system can handle each patient better.
PLEASE, EVERYONE, fight getting this disease like lives depend upon you! They do. Mine does.
2) Doctors will gain experience with the disease. What works, what doesn't. What to watch out for that will make things tough for any particular patient. A patient that gets the disease today will get a lot of attention from doctors that don't yet know what works best. A patient that gets the disease in a month will be just one of many, and may actually have fewer doctors available for care. But the doctors will know better. A patient that gets the disease in 6 months will almost certainly have a much better prognosis because the doctors will know better what to do. Testing will be better.
3) Summer is coming. Apparently human resistance to such viruses is weaker in cold, dry weather. If you are lucky enough to avoid the illness for a couple of months, your body may fight it off better.
4) Potentially a vaccine may be developed. Just as we have a flu vaccine, maybe someone will assure themselves of a Nobel Prize by coming up with a vaccine.
5) Government will respond to this threat. I am not happy with what I've heard so far from all levels of government. I am confident this will change, perhaps not as quickly as I want or the people need, but it will respond. We may not build a hospital in 6 days, but we will get beds into the hospitals. Testing procedures will be streamlined and test kits distributed. Relevant medical information will get distributed.
I've focused a lot on the CFR, but consider the overall picture. At least until the past couple of weeks, Wuhan was the hardest hit area. The disease apparently spread widely before they got any kind of a handle on it. The city of 11M has had 2,227 deaths in a bit over 2 months. That's a lot (and it will rise), but that's a lot of survivors too. I expect that today or tomorrow, they will have more discharges than existing patients.
My gut feeling is that this disease will far surpass Hurricane Katrina in US deaths. It may well pass the death toll of the Galveston Hurricane of 1900. God willing, I hope it won't approach the death toll in the US or the world of the 1918 flu epidemic.
RE: lex24 - BostonCard - 03-02-2020
(03-01-2020, 09:50 PM)lex24 Wrote: Your right, Outsider, no one forces me to open this. And no one would force somebody to open a thread that went off on political issues either. But the board doesn’t have those. So I consider this a sports board - something I greatly appreciate about it. (As Cardcrimson notes, I know where to go for politics). And I come to it, in part, to get away from the shit going on in the every day world. So that’s just my thought process. I’m certainly not the boss of this board I just made a suggestion. I won’t dare do so again.
I think cardcrimson was being somewhat sarcastic; once upon a time there were "a forum where Stanford aficionados could discuss current events in a open, honest and intelligent manner". One forum may still discuss current events, but (at least when I last visited a few years ago) stopped really debating in an honest and intelligent manner. The other one (this forum) might have been headed in that direction when the power that be decided to cut off the problem. Perhaps in our current age having such a forum, even one made up of Stanford aficionados, is no longer possible, which is kind of sad.
BC
RE: lex24 - 2006alum - 03-02-2020
(03-02-2020, 11:33 AM)BostonCard Wrote:(03-01-2020, 09:50 PM)lex24 Wrote: Your right, Outsider, no one forces me to open this. And no one would force somebody to open a thread that went off on political issues either. But the board doesn’t have those. So I consider this a sports board - something I greatly appreciate about it. (As Cardcrimson notes, I know where to go for politics). And I come to it, in part, to get away from the shit going on in the every day world. So that’s just my thought process. I’m certainly not the boss of this board I just made a suggestion. I won’t dare do so again.
I think cardcrimson was being somewhat sarcastic; once upon a time there were "a forum where Stanford aficionados could discuss current events in a open, honest and intelligent manner". One forum may still discuss current events, but (at least when I last visited a few years ago) stopped really debating in an honest and intelligent manner. The other one (this forum) might have been headed in that direction when the power that be decided to cut off the problem. Perhaps in our current age having such a forum, even one made up of Stanford aficionados, is no longer possible, which is kind of sad.
BC
Speaking only for myself, sports has been one of my anxiety and stress solvents over the past few years. No matter how well intentioned Stanford sports fans may be, Cardboard debates about "What is Racism?", "Is Trump Making American Great Again?," etc. are unlikely to add much (if anything) that I can't find eloquently articulated ad nauseum elsewhere. Moreover, they even less likely to lower my blood pressure, and very likely to raise it.
OTOH, I can't find a more thoughtful and dedicated group of Stanford sports fans anywhere else. And no matter how we feel about racism, MAGA, and who uses what bathroom, we are all rooting for the Cardinal, and the risk of dissolving that common sense of purpose in the interest of carrying on half-baked intellectual debates about current affairs just ain't worth it to me.
My two cents.
RE: Covid-19 considerations - M T - 03-02-2020
Regarding wearing masks or not.... Can anyone point to research that studied the use of masks and transmission of virus?
We hear US officials suggest that the masks do no good for protection of a healthy individual, but is that based on studies?
I noticed that China does recommend wearing disposable masks in many situations (excluding at home, outdoor, or at work in well-ventilated places)
I also noticed this picture in China 2/24 of the head of the WHO-China Joint Mission wearing a disposable mask as he presents results. (Maybe he wore that in deference to his hosts, even if he felt it added no protection.)
Same person, same chart, next day in Geneva, but with no mask
RE: Covid-19 considerations - BostonCard - 03-02-2020
Circumstances where masks will help:
If you are sick and want to protect others (this is the primary reason why China suggests it)
If you are caring for someone who is sick, but only if you use other protective equipment (gloves) and know how to use it (you are correctly fitted and you are used to avoiding touching your face after coming into contact with potentially contaminated people or surfaces, which is much harder than it sounds.
I have seen lots of people reach under their mask to scratch an itch around their mouth, which completely negates any benefit from the mask.
BC
RE: Covid-19 considerations - M T - 03-02-2020
(03-02-2020, 09:57 AM)stupac2 Wrote: One question for everyone here that has some personal relevance for me, what about pregnant women? So far we've seen that there doesn't seem to be any increased susceptibility outside of the inherent age effects, but it's based on tiny numbers. Any info there would be appreciated...
In all that I've read, I recall no mention of the impact on pregnant women. Specifically, pregnancy was not mentioned as a risk factor (articles 1, 2, 3, 4). As I'm sure you've seen, babies have gotten the disease. My recollection is the very young baby recovered. If the pregnant patient has risk factors, then maybe pregnancy will make things more difficult. I have NO idea if any of the treatments (anti-viral drugs, steroids for pneumonia, ...) are not recommended during pregnancy. I have no idea if the virus might transfer through the placenta and/or in breast milk. (The way things happened in my wife's pregnancy, I suggest you sit with her doctors and get all these questions answered before you are in a hospital room trying to decide on the mother and/or baby's treatments!)
Good luck!
Edit: I found this in the WHO-China Joint Mission report:
Quote:As opposed to Influenza A(H1N1)pdm09,pregnant women do not appear to be at higher risk of severe disease. In an investigation of 147 pregnant women (64 confirmed, 82 suspected and 1 asymptomatic), 8% had severe disease and 1% were critical.
RE: Covid-19 considerations - BostonCard - 03-02-2020
(03-02-2020, 07:25 AM)OutsiderFan Wrote: What the impacts are and what to do about it is an entirely different discussion. I'm actually coming to the conclusion that humanity might as well just stop even trying to contain it because it is so incredibly virulent and can hide so easily. I'm even beginning to wonder if it actually makes any sense to continue reporting cases, because this is just gonna cause more freakout.
You are right that we probably won't be able to contain it entirely. The virus has a lot of features that will make it very hard to contain, particularly the fact that kids are minimally symptomatic, so it can easily spread amongst the kiddos in schools and daycares more or less undetected and then be transmitted to more vulnerable individuals, as well as the high transmissability, longish incubation period, etc, and the fact that it does not seem to have particularly unique symptoms. For the public health officers at the front lines of trying to contain this the outbreak is a nightmare, I wish them the best of luck.
However, that doesn't mean that there isn't a very big advantage to slowing the spread as much as reasonably possible. For one, it makes a big difference to the healthcare system as a whole whether the cases come all at once or bit by bit. It is the difference between a stretched healthcare system and an overwhelmed healthcare system where we could literally be rationing ventilators and deciding whether you have to take someone of the ventilator in favor of someone else. Moreover, slowing the spread buys time. Working at breakneck pace, it is possible that an antiviral already in the pipeline (Gilead's remdesivir), which is about to enter clinical trials in patients with Covid-19, could work to reduce the severity of disease and decrease mortality. Results won't be available anytime soon, but it's possible that Gilead has an answer within a year. The second is that a vaccine is developed, and about a half a dozen companies are working on one (or, in GSK's case, providing technology to help others make one), and again, while it won't be ready immediately, it might be availble at some point in 2021. Lastly, we don't know the seasonal effects on Covid-19 transmission, and it is possible that as warmer weather hits, the transmissibility will go down and that the epidemic will slow down on its own.
So, right now, we are buying time.
BC
RE: Covid-19 considerations - Goose - 03-02-2020
(03-02-2020, 11:23 AM)M T Wrote: My gut feeling is that this disease will far surpass Hurricane Katrina in US deaths. It may well pass the death toll of the Galveston Hurricane of 1900. God willing, I hope it won't approach the death toll in the US or the world of the 1918 flu epidemic.FWIW, "The CDC estimates that as many as 56,000 people die from the flu or flu-like illness each year." (https://www.webmd.com/cold-and-flu/qa/how-many-people-die-from-the-flu-each-year-and-how-is-it-prevented). The Galveston Hurricane of 1900 killed 12,000, so I am pretty sure Covid-19 will surpass that, although maybe not this year. It seems probable that at best this virus will spread throughout the general population over time. It is doubtful that humanity can check this propagation. However, if it can be slowed down sufficiently medical facilities will not be saturated and soon this disease will become just one of many similar illnesses that already permeate the population. It sure would have been better if the spread could have been contained and the disease eradicated at the start, but that was probably never possible. By the time it was recognized as something new, too many people had carried it too far into the general world population to contain it fully.
RE: Covid-19 considerations - BostonCard - 03-02-2020
4 more deaths just announced in Washington State, bringing the total to 6. That means that it is likely that there are probably at least 300 undetected cases in the community.
Striking out my assumptions. Three of the deaths occurred in one nursing facility. Since we know that mortality increases substantially with age, an outbreak in a nursing facility would be expected to have a very high mortality rate so dividing it by a generic 2% mortality rate would be inappropriate.
BC
RE: Covid-19 considerations - OutsiderFan - 03-02-2020
My SO works in the corporate events industry. She produces them for internal clients who run various lines of business for a financial services company. She told me today she got a call from a client asking about options to have video conferencing instead of holding a physical event that is already planned and contracted. Right after this, I learned Twitter is cancelling its SXSW presence next week and banning all "non-essential" business travel.
Think of the impacts of this. Some contracts will include cancellation fees, but all the ancillary stuff for the hotel and restaurant businesses will not happen. What if most companies follow Twitter's lead? There are so many people living paycheck to paycheck who can't afford to lose their jobs that will lose them and not be able to pay rent if business travel is stopped in a significant way. Of course, if it's business as usual, sickness spreads and overwhelms medical system, that's gonna carry a cost as well.
There are really no good choices available.
RE: lex24 - CornFed - 03-02-2020
(03-02-2020, 11:58 AM)2006alum Wrote:(03-02-2020, 11:33 AM)BostonCard Wrote:(03-01-2020, 09:50 PM)lex24 Wrote: Your right, Outsider, no one forces me to open this. And no one would force somebody to open a thread that went off on political issues either. But the board doesn’t have those. So I consider this a sports board - something I greatly appreciate about it. (As Cardcrimson notes, I know where to go for politics). And I come to it, in part, to get away from the shit going on in the every day world. So that’s just my thought process. I’m certainly not the boss of this board I just made a suggestion. I won’t dare do so again.
I think cardcrimson was being somewhat sarcastic; once upon a time there were "a forum where Stanford aficionados could discuss current events in a open, honest and intelligent manner". One forum may still discuss current events, but (at least when I last visited a few years ago) stopped really debating in an honest and intelligent manner. The other one (this forum) might have been headed in that direction when the power that be decided to cut off the problem. Perhaps in our current age having such a forum, even one made up of Stanford aficionados, is no longer possible, which is kind of sad.
BC
Speaking only for myself, sports has been one of my anxiety and stress solvents over the past few years. No matter how well intentioned Stanford sports fans may be, Cardboard debates about "What is Racism?", "Is Trump Making American Great Again?," etc. are unlikely to add much (if anything) that I can't find eloquently articulated ad nauseum elsewhere. Moreover, they even less likely to lower my blood pressure, and very likely to raise it.
OTOH, I can't find a more thoughtful and dedicated group of Stanford sports fans anywhere else. And no matter how we feel about racism, MAGA, and who uses what bathroom, we are all rooting for the Cardinal, and the risk of dissolving that common sense of purpose in the interest of carrying on half-baked intellectual debates about current affairs just ain't worth it to me.
My two cents.
Well, other than a conversation about whether or not David Shaw is an excellent coach.