Outside Topic Covid-19 considerations - Printable Version
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Langdude - Langdude - 03-04-2020
Seattle area. Our district just closed all schools indefinitely, beginning tomorrow. Transitioning to online teaching. This will be very difficult for those families that rely on school for childcare... We are lucky in that my wife and I have intentionally shaped our lives so that one of us can always be home with the kids (we have 4)...
-m.
RE: Langdude - Genuine Realist - 03-04-2020
That seems wild overkill, particularly because of the low incidence among children under 15.
(03-04-2020, 09:54 PM)Langdude Wrote: Seattle area. The district just closed all schools indefinitely, beginning tomorrow. Transitioning to online teaching. This will be very difficult for those families that rely on school for childcare... We are lucky in that my wife and I have intentionally shaped our lives so that one of us can always be home with the kids (we have 4)...
-m.
RE: Langdude - BostonCard - 03-04-2020
(03-04-2020, 10:04 PM)Genuine Realist Wrote: That seems wild overkill, particularly because of the low incidence among children under 15.
(03-04-2020, 09:54 PM)Langdude Wrote: Seattle area. The district just closed all schools indefinitely, beginning tomorrow. Transitioning to online teaching. This will be very difficult for those families that rely on school for childcare... We are lucky in that my wife and I have intentionally shaped our lives so that one of us can always be home with the kids (we have 4)...
-m.
It’s not about the mortality of the virus in kids, which is in fact very low, but because the kids are a perfect vector for spreading the disease. A kid with mild symptoms goes to school, spreads the virus to all his classmates, who then take it home and infect grandma and grandpa, who are much more susceptible.
BC
RE: Covid-19 considerations - Snorlax94 - 03-04-2020
I expect hardly any, if any, American youths under 30 will die of this without other issues (unknown heart defect, cancer). The point of closing schools is not to protect these children’s lives — they should be fine. The point of closing schools is to stop runny-nosed, paste eating, unhygienic kids from spreading sickness amongst themselves, sickening their parents so they are unable to work, and to save the lives of their grandparents. Elementary schools are massive sickness spreaders.
RE: Covid-19 considerations - magnus - 03-04-2020
Note, the school district that langdude mentions has one elementary school with a presumptive positive parent/volunteer, and another school with a staff member awaiting results from a test. So, unfortunately, it could already be spreading amongst the students or staff.
RE: Covid-19 considerations - burger - 03-04-2020
On school closings..a study of the 1918 Spanish flu found that school closings and banning public gatherings slowed the spread of the flu and reduced mortality. The earlier the measures were put into place, the more effective they were.
https://jamanetwork.com/journals/jama/fullarticle/208354
RE: Covid-19 considerations - cardcrimson - 03-04-2020
Just heard on the evening news that they've close the Menlo School for Covid-19 concerns. Wonderful, my daughter spent 5 hours there on Sunday. . . .She'll be fine. I'm in a high risk category. . . .
In case I don't make it. Get a new OC!
RE: Covid-19 considerations - M T - 03-05-2020
Santa Clara County's count of COVID-19 cases has risen to 14, 3 more than yesterday.
All males. #12 hospitalized, source under investigation. #13, #14 close contact to known case, at home. #11, #12 still under investigation.
| Total Cases | Travel-related | Community Transmission | New Cases Under Investigation | Close Contact to Known Cases | |
|---|---|---|---|---|---|
| Mar 3 | 11 | 4? | 2 | 2 | 3? |
| Mar 4 | 14 | 4 | 2 | 3 | 5 |
SCC's website indicates 7 are/were hospitalized, 5 are "isolated at home" or "self-isolating", 1 released from isolation, 1 who is listed as "never hospitalized or ill" without any mention of isolation.
No ages, no gender, no condition (critical, etc.), no city, no hospitals, no indication of how many are at home rather than being cared for by caregivers trained to not spread the disease, no genome.
You are just a number, Number Six.
RE: Covid-19 considerations - OutsiderFan - 03-05-2020
Things are getting a bit trickier now that there appears to be two strains of SARS-CoV-2.
https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463
The raw numbers of cases reported are going to shed no light on what strains positive infected have.
Apparently, the "S" strain is the one that initially transferred from animal to humans. Though it is still spreading, the "L" strain appears to have mutated once inside humans to be more ideally suited for human transmission and doing more damage. This could explain why some people have mild symptoms, and could explain the difference in severity between what is happening in South Korea vs. say Iran and Italy.
It's hard enough to figure out exactly what is happening with total data transparency. It's impossible by hiding it. The more transparency the better. Washington is studying gene sequences to track what is going on. This is helping public health planners decide what steps to take. Absent this information they would be operating in the dark, probably not taking the most prudent measures, and making things worse.
RE: Covid-19 considerations - BostonCard - 03-05-2020
HIPAA
BC
RE: Covid-19 considerations - oldalum - 03-05-2020
(03-05-2020, 08:10 AM)BostonCard Wrote: HIPAA
Plus, need to know vs. want to know. I'm unclear what the "need to know" is. And must guard against misuse of/hysteria about the information. E.g., identification of a hospital treating an inpatient with coronavirus might have some unwarranted and adverse consequences (including adverse health consequences), vs. any benefit to releasing that information (I'm unclear as to what the benefits might be).
RE: Covid-19 considerations - burger - 03-05-2020
(03-05-2020, 09:21 AM)oldalum Wrote: Plus, need to know vs. want to know. I'm unclear what the "need to know" is. And must guard against misuse of/hysteria about the information. E.g., identification of a hospital treating an inpatient with coronavirus might have some unwarranted and adverse consequences (including adverse health consequences), vs. any benefit to releasing that information (I'm unclear as to what the benefits might be).Really? The need to know is so obvious that it shouldn't even have to be stated. Citizens can't take appropriate steps to safeguard their health without knowing how many infected people there are and where they are. The ages, sexes, and pre-existing conditions (even at a "yes/no" level) are relevant, too, for understanding how the virus is behaving (there is evidence of different strains now, as discussed above). All of that information can be released without individually identifying any patients.
More generally, the results of all testing (x positive tests, y negative tests) can be released without identifying anyone. Even at the state or US level this would be good to know.
RE: Covid-19 considerations - stupac2 - 03-05-2020
Regarding the insouciance of doctors, one of my friends is an infectious disease doctor in Oakland and is so far at the "mildly intrigued" level on this virus. Mostly he thinks it's boring. Very normal "wash your hands, take normal precautions" advice. Not sure what that's worth, but it does seem like most medical professionals aren't super worried.
RE: Covid-19 considerations - 2006alum - 03-05-2020
(03-05-2020, 09:37 AM)stupac2 Wrote: Regarding the insouciance of doctors, one of my friends is an infectious disease doctor in Oakland and is so far at the "mildly intrigued" level on this virus. Mostly he thinks it's boring. Very normal "wash your hands, take normal precautions" advice. Not sure what that's worth, but it does seem like most medical professionals aren't super worried.Given the high mortality rates in places like Iran and Italy, where the virus has been transmitting for longer, is your friend's view that this is just a more morbid version of the flu? When I see mortality rates in the 10-15% range for folks in their 70s and 80s, that worries me a lot, even if my own chance of serious complications remains very low. And it seems like even at the very lowest end of the estimated mortality rate that I've seen (approx. .3-.4% vs. the 3.4% the WHO reported) would be very serious on a nationwide scale. That's double the mortality rate of the flu, and would be coupled with the flu such that treating facilities would be even more strapped to provide high quality care than ordinary. There's also no herd immunity, so the likelihood of many older individuals getting it would seem much higher than with flu strains, which have been circulating and mutating for decades.
RE: Covid-19 considerations - oldalum - 03-05-2020
(03-05-2020, 09:35 AM)burger Wrote: Citizens can't take appropriate steps to safeguard their health without knowing how many infected people there are and where they are.
In the current absence of widespread testing, everyone should be assuming the virus is present in their communities and taking appropriate precautions. And a natural effect of identifying specifically where the infections are is that many people in areas where infections have not been identified will not take such precautions, when they should.
I'm not arguing against release of knowledge about the virus and how it is behaving and spreading in the population. I was responding to a post complaining about the lack of specific data about the individuals who have been infected. That's all. I am all for transparency except when the likely harms of releasing information are likely to outweigh the benefits. Releasing specific ages of confirmed patients rather than an age range (e.g., 50-60 years old), the hospitals where they are being treated, the cities, whether they are at home, all may lead to identification or misidentification of the affected people and ensuing adverse consequences. Those consequences must be weighed against the "need to know" specific information, which I would suggest is generally not present for the public. [The sexes were in fact released, as disclosed in the original post (all male), but could also be used in combination with other information to guess identities and locations.]
Knowing the genome and subtype of each virus isolated, as an example, is a "want to know" for the public, not a need to know. But no reason not to release such knowledge learned about the virus, how it spreads, etc.
RE: Covid-19 considerations - Goose - 03-05-2020
(03-05-2020, 09:53 AM)2006alum Wrote: That's double the mortality rate of the flu, and would be coupled with the flu such that treating facilities would be even more strapped to provide high quality care than ordinary. There's also no herd immunity, so the likelihood of many older individuals getting it would seem much higher than with flu strains, which have been circulating and mutating for decades.The fact this is a novel virus makes it much more dangerous. Right now, I believe it is probable that the statistics are incorrect for many of the reasons described here and elsewhere. The data is limited and in some cases of dubious accuracy. However, the lack of substantial community immunity built up over time can make this virus a much bigger problem than the other, somewhat similar virus we deal with all the time. Slowing down the spread of this virus will at least give health care systems the capacity to provide appropriate help to those who need it. More people will die than we would wish, but at least not because we were overwhelmed. That is all we can hope for at this point.
It would have been nice if humanity had been able to keep this virus completely contained. Under those conditions it could have died out in the human population. Unfortunately it appears that is not possible at this point. It would have been asking a lot to immediately recognize this new disease when it first emerged and asking even more that radical steps be taken to contain it. New diseases have emerged in the past and will continue to do so in the future. What is different today is the rate at which they can spread. Population density is higher and transportation is much better. It would be nice if humanity increased it's ability to respond. However, with all our other more pressing issues, I doubt we will.
RE: Covid-19 considerations - Erika - 03-05-2020
"In the current absence of widespread testing, everyone should be assuming the virus is present in their communities and taking appropriate precautions. And a natural effect of identifying specifically where the infections are is that many people in areas where infections have not been identified will not take such precautions, when they should."
Here in Seattle some great progress has been made on developing and implementing testing ...
"Within 48 hours of receiving permission from the FDA to conduct tests on Feb. 29, the UW laboratory began processing 100 tests a day, and it expects soon to reach more than 1,000 a day."
Link is here:
https://www.fredhutch.org/en/news/center-news/2020/03/new-covid19-lab-test.html
RE: Covid-19 considerations - OutsiderFan - 03-05-2020
There is now community spread in San Francisco. Two cases confirmed today with no connection to any known infected person and no travel to high infection areas. A 90 yo man and a 40 yo woman, not related in any way.
Just hope the heath care workers have proper protection, not just for themselves, but how easily they can infect others.
I find it absurd that any health care professional wouldn't be alarmed by what is happening. It's not the case fatality rate (with proper care) that is the concern. It's the potential of overrunning hospitals with sick people needing significant medical intervention. I read yesterday people are on waiting lists for hospital beds in South Korea. How many are gonna die who would have been saved if not for inundated hospitals?
This is why taking drastic measures to stop spread even when it doesn't appear the outbreak is that big, makes sense.
RE: Covid-19 considerations - burger - 03-05-2020
Interesting post on a virology forum (though posted by a virus scientist/statistician): it sounds like the paper reporting that there are two strains of the virus jumped to conclusions not supported by evidence:
Quote:However, they further claim that these two types have differing transmission rates: “Thus far, we found that, although the L type is derived from the S type, L (~70%) is more prevalent than S (~30%) among the sequenced SARS-CoV-2 genomes we examined. This pattern suggests that L has a higher transmission rate than the S type.” The abstract of the paper goes even further, stating outright that: “the S type, which is evolutionarily older and less aggressive…”
It is, however, important to appreciate that finding a majority of samples with a particular mutation is not evidence that viruses with that mutation transmit more readily. To make this claim would, at very minimum, require a comparison to be made to expectations under a null distribution assuming equal transmission rates. As this has not been performed by the authors, I believe there is insufficient evidence to make this suggestion, and that it is incorrect (and irresponsible) to state that there is any difference in transmission rates. Differences in the observed numbers of samples with and without this mutation are far more likely to be due to stochastic epidemiological effects.
tldr: there is no evidence for aggressive/non-aggressive strains
http://virological.org/t/response-to-on-the-origin-and-continuing-evolution-of-sars-cov-2/418
RE: Covid-19 considerations - M T - 03-05-2020
(03-05-2020, 08:10 AM)OutsiderFan Wrote: Things are getting a bit trickier now that there appears to be two strains of SARS-CoV-2.
https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463
The raw numbers of cases reported are going to shed no light on what strains positive infected have.
Apparently, the "S" strain is the one that initially transferred from animal to humans. Though it is still spreading, the "L" strain appears to have mutated once inside humans to be more ideally suited for human transmission and doing more damage. This could explain why some people have mild symptoms, and could explain the difference in severity between what is happening in South Korea vs. say Iran and Italy.
It's hard enough to figure out exactly what is happening with total data transparency. It's impossible by hiding it. The more transparency the better. Washington is studying gene sequences to track what is going on. This is helping public health planners decide what steps to take. Absent this information they would be operating in the dark, probably not taking the most prudent measures, and making things worse.
In the GSAID display, the older S-type are the bottom portion, while the L type are the ones in the upper 2/3s. The Washington state cases are shown at the top of the S-type (earliest case 1/31, next in the data 2/20, latest 3/1). (The authors suggest some patients may have both L and S.)
I haven't seen evidence yet that mild vs severe may be related to L vs S. Maybe I'm naive but localities would likely be mostly one type. If some country had all mild and another country had all severe cases, then I'd believe that. I could believe the fatality rate may be different.
The authors suggest transmissibility may be different: "L type, which might be more aggressive and spread more quickly."
Other than the Washington State cases, I don't see how many deaths are occurring with each type. I would expect that data to be available somewhere.
Edit: i defer to the response in the link in the previous post (which I didn't see before I posted)