Coronavirus Pandemic (COVID-19) (SARS-CoV-2) [2020]

During the last 3 days in Portugal we went from a 9% growth of infected to 5.5%. Since we're not really counting the recovered, we may have already passed our peak and we're actually reducing the total number of infected.
So against most expectations, we might actually be entering a stage of suppression, instead of mitigation.

Which is good on one hand, but on the other there will be no herd immunity anytime soon, so we'll need to think of what to do next. Opening the doors will certainly cause infection spikes again, so we'll need something in between.
Strange times indeed.


sadly, until we get some high profile deaths, people will think they are invincible.
Funny story:
In Portugal, our second official coronavirus death was none other than the Chairman of the Portuguese branch of the Santander Bank.

This guy decided that the last week of February was a good time to go on a skying vacation to northern Italy, by the time the whole thing exploded.

I guess for many people, that was a real eye opener. All of a sudden this isn't a disease that only kills poor people, that anyone with access to top-notch treatments won't be affected by it. Rich people got worried, politicians got worried, entrepreneurs got worried, bosses got worried. Which was a nice end-result out of an obvious tragedy.
Perhaps this is one of the factors why the Portuguese behaved so well by respecting the isolation policies (together with watching the real-life horror stories from Italy and then Spain before we had a significant number of infected).


Hydroxychloroquine is so not the panacea he thinks it is! Has awful side-effects and there is no evidence to support it fights this at all.

DISCLAIMER: I am not a doctor, but my wife is a pharmacist with arthritis problems who once researched the drug for her own use and rejected the idea since the cost/benefit analysis was awful and my sister is a nurse practitioner who also told me it was a stupid and dangerous thing he's doing pushing a dangerous drug as if it's a miracle cure. Oh, and all the actual doctors on TV who explained it to me too.

Also I wish Boris Johnson the best and a speedy recover. I don't wish death on anyone anymore, last time I did it worked. :|

I have close family working in the hospital that started with the largest number of infected in the country.
Chloroquine is being pretty successful on many, many critical cases. However, it's only administered as an emergency because the drug as some potent side effects.

Regardless, don't dismiss the chloroquine's effectiveness just because Trump said good things about it. That's dangerous.
 
Which is good on one hand, but on the other there will be no herd immunity anytime soon, so we'll need to think of what to do next. Opening the doors will certainly cause infection spikes again, so we'll need something in between.
Every country is in the same boat. We can't allow the disease to spread fast enough to develop herd immunity, but can't lock down until it's died out. Hence we'll all be doing like Taiwan and following tight containment for the next 12-18 months or whatever until there's some sort of vaccine, I guess.
 
don't dismiss the chloroquine's effectiveness just because Trump said good things about it. That's dangerous.
I tried to go to extreme lengths to point out that I wasn't dismissing it because Trump is pushing it but because all the medical professional I know personally and see on the news say it's not been proven at all effective and the side affects are extreme.
 
I hope they're right. I was hoping they'd have an update on this, as the article was from Monday and now it's Wednesday. I suppose we'll know when looking at the end of the week numbers on Saturday.

https://www.cleveland.com/coronavir...this-week-without-overwhelming-hospitals.html

University of Washington: Latest projection says Ohio will reach coronavirus peak this week without overwhelming hospitals

CLEVELAND, Ohio – An updated model from the University of Washington’s Institute for Health Metrics and Evaluation predicts the coronavirus outbreak will peak this week in Ohio without overwhelming hospitals and intensive care units.

The IHME forecasting model projects that Ohio could reach peak resource use – the maximum number of hospital beds, ICU beds, and ventilators needed during the outbreak -- on Wednesday. The model also suggests Ohio will fall well short of running out of resources, even under a worst-case scenario.

Those projections are a contrast to those offered previously by Gov. Mike DeWine and Ohio Department of Health Director Dr. Amy Acton. They have used models from the Cleveland Clinic and Ohio State University to predict the state might need to double or triple the number of available hospital beds during the peak.

The IHME model’s latest projections include two notable changes to its underlying methodology, IHME Director Christopher Murray said Monday in a conference call with media.

First, the early data from the U.S. Centers for Disease Control and Prevention suggested 11 percent of coronavirus patients may require hospitalization. The latest data indicates that might be closer to 5 to 7 percent, Murray said.

Second, the IHME model initially used data from the first major COVID-19 outbreak in Wuhan, China, to gauge the effect of social-distancing measures. Data from seven other locations in Italy and Spain suggest measures like Ohio’s stay-at-home order had a more significant impact than anticipated.

...
 
Here's an interesting report about the decisions made in the UK.

https://www.reuters.com/article/us-health-coronavirus-britain-path-speci-idUSKBN21P1VF

Ultimately, the scientific advisors knew it was likely to be shitshow quite early on in the piece (at the start of March) but, for some reason, were rather reticent in their warnings to the government and even downplayed the results of their modelling. In turn, the government didn't have the nouse to wonder why every other country was doing things differently to what was recommended by their advisors.

We obviously needed one of those maverick scientists you always see in disaster movies to change the course of the advice!

The fact that they didn't try to shut things down a week or two earlier because they didn't think the British public would accept a lockdown isn't particularly bright, especially with what was going on in Italy at the time.
 
Thing is if you do nothing it's 60 days untill the entire planet is infected so its not like "hey we've gotten over the worse go back to normal now"

he discussion may even have turned to 'we should have let the old and sick people die as we'd be better off than we are now.' Especially for the UK
Woah, we are not america
 
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That might be obvious now, but that's with hindsight into what the disease is and how unusual it is. the H1N1 fear prompted up-front preparations that were a complete waste, costing £1.2 billion for a risk that wasn't justified.

If the government had prepared big-time while it was a Wuhan localised problem, and the virus ended up being contained, people would criticise them for wasting money, affecting the economy, etc. Instead they chose to wait and use containment which should have worked if the disease didn't have asymptomatic spreaders. This time around, that was the wrong call, but no-one could have known. The whole world has responded in the same generally clueless way. You see different results in Asia only because of previous experience with SARS. The West didn't prepare for SARS to come here, and was right not to. It didn't prepare for MERS to come here, and was right not to.

Diseases are fundamentally difficult to work with. Things that may seem obvious now are only obvious once the situation has played had and you have enough info. Back in January and February, there just wasn't enough info to make informed choices and the only option then is best guesses, which can be wrong. As can informed choices for that matter, which are dependent on science and data gathering which are incomplete and imperfect. Science may point to one clear course of action which can end up being completely wrong. eg. Putting people onto mechanical breathing may have seemed the best choice to help their recovery based on scientific thinking, yet it has the adverse effect explained by further, deeper scientific investigation to get more info,
he would do better taking care of his people instead of worrying about the economy. The message was like: "If people has to die, let them die". The economy will improve, always does. In fact financial crisis clean up everything, and start anew.

I dont feel for him. I can feel for the people of the USA, could feel for Theresa May if she had the virus, but for the bolsonaro and johnsons of the world, I couldn't care less
 
Here's an interesting report about the decisions made in the UK.

https://www.reuters.com/article/us-health-coronavirus-britain-path-speci-idUSKBN21P1VF

Ultimately, the scientific advisors knew it was likely to be shitshow quite early on in the piece (at the start of March) but, for some reason, were rather reticent in their warnings to the government and even downplayed the results of their modelling. In turn, the government didn't have the nouse to wonder why every other country was doing things differently to what was recommended by their advisors.

We obviously needed one of those maverick scientists you always see in disaster movies to change the course of the advice!

The fact that they didn't try to shut things down a week or two earlier because they didn't think the British public would accept a lockdown isn't particularly bright, especially with what was going on in Italy at the time.
heheh, this reminds me of one of the most brilliant speeches ever. It was from a naturalist in the 1970s.

Summing up:
"
When you need appendicitis' surgery, you call a scientist, in this case a medic, a surgeon.

When you need to cure pneumonia, you use an antibiotic, which has been discovered by a scientist.

When we need to build a bridge, we call another scientist, an engineer.

BUT, when we need to take medium-term/long-term action, the man who decides is someone who generally has very little of a scientist.

It's a politician.

In the base of which politics there is philosophy, but very rarely science.

He has some advisers who are scientists who he may or may not listen to, but he listens to them based on the importance the advisement has for his campaign, or for his budget to achieve power or retain power.

(.....)

And..., for the politicians to stay and perpetuate themselves, they constantly NEED to increase the purchasing power of his citizens, and must remain on that tremendous material competition in which the western world is immersed, so the reports of the wise people will be useless.
"
 
May if she had the virus, but for the bolsonaro and johnsons of the world, I couldn't care less
Yeah, its not like onze Wiskes ill in the duwde, VUT in its a choice beteren HIM and Some other random 55 random old, i’ld prefer the other.
He’s worse than farage, at least farage actually wanted brexit, if for nothing else, than to wave his teeny flag around. With Boris he didn’t care if brexit happened or not, he only went along with it cause that was the path that gave him the bigger chance of becoming PM. Hey let’s create upheaval for millions for years cause I’m more likely to become Pm as the result. Top bloke.

I was just looking at the new numbers about 1000 cases, yet only 12 ppl in hospital? 200+ cured. A bit strange actually
 
Johnson is also the one who said about another person that they could eat a camel's butthole. You know... the level. :oops:
 
Power in usa is divided in such a way that president doesn't have absolute power. It might seem like trump has a lot of power because he makes a lot of noise but reality is different. He has trouble even building his wall.

when should those other powers act against Trump if need be? 'Cos he is a survivor.... Also, there is a new, and 4th, spokesperson under his mandate. Shouldn't they act because he is everywhere?

During the last 3 days in Portugal we went from a 9% growth of infected to 5.5%. Since we're not really counting the recovered, we may have already passed our peak and we're actually reducing the total number of infected.
So against most expectations, we might actually be entering a stage of suppression, instead of mitigation.

Which is good on one hand, but on the other there will be no herd immunity anytime soon, so we'll need to think of what to do next. Opening the doors will certainly cause infection spikes again, so we'll need something in between.
Strange times indeed.



Funny story:
In Portugal, our second official coronavirus death was none other than the Chairman of the Portuguese branch of the Santander Bank.

This guy decided that the last week of February was a good time to go on a skying vacation to northern Italy, by the time the whole thing exploded.

I guess for many people, that was a real eye opener. All of a sudden this isn't a disease that only kills poor people, that anyone with access to top-notch treatments won't be affected by it. Rich people got worried, politicians got worried, entrepreneurs got worried, bosses got worried. Which was a nice end-result out of an obvious tragedy.
Perhaps this is one of the factors why the Portuguese behaved so well by respecting the isolation policies (together with watching the real-life horror stories from Italy and then Spain before we had a significant number of infected).




I have close family working in the hospital that started with the largest number of infected in the country.
Chloroquine is being pretty successful on many, many critical cases. However, it's only administered as an emergency because the drug as some potent side effects.

Regardless, don't dismiss the chloroquine's effectiveness just because Trump said good things about it. That's dangerous.
Hope Portugal keep doing well like that.

As for those medicines that can be effective against coronavirus, some brasilian -or were them from Colombia? cant recall- scientists found out that an aids medicine was effective against coronavirus. I was impressed, then when I read the rest of the article... oh well.

The medicine has some side effects. Just like 4 or 5. Risk of organ failure, risk of death, risk or cardio respiratory arrest, and a couple more.
 
2019 Novel Coronavirus (SARS-CoV-2/COVID-19) for Dallas County Texas
https://www.dallascounty.org/departments/dchhs/2019-novel-coronavirus.php

April 8, 2020 - 1324 confirmed cases - 20 deaths

1324 confirmed cases up 63 over yesterday and one new death
Those 63 new cases represent a 5.0% increase over the last day

Increases (by percent) over the last 13 days:
21%, 19.6%, 11.1%, 12.5%, 14.9%, 15.8%, 13.7%, 10.8%, 10.2%, 9.6%, 3.9%, 9.2% and now 5.0%

Increases (by count) over the last 13 days:
+64, +72, +49, +61, +82, +100, +100, +90, +94, +97, +43, +106 and now +63

Dallas County Health and Human Services is reporting 63 additional positive cases of COVID-19 today, bringing the total case count in Dallas County to 1,324. The 20th death was reported of a man in his 60's who was a resident of the City of Rowlett. This individual had been critically ill in an area hospital and had underlying health conditions. Of cases requiring hospitalization, about three-quarters (70%) have been either over 60 years of age or have had at least one known high-risk chronic health condition. Diabetes has been an underlying high-risk health condition reported in over a quarter (29%) of all hospitalized patients with COVID-19.
 
This is horrible.

After ICU, Coronavirus Patients' Ordeal Is Far From Over
https://www.msn.com/en-us/news/us/after-icu-coronavirus-patients-ordeal-is-far-from-over/ar-BB12kACI

After Jane Weinhaus was infected last month with the new coronavirus, the 63-year-old preschool teacher became so ill she was sedated and hooked up to a ventilator in Missouri Baptist Hospital.

Doctors tried to remove the breathing device six days later, but decided she wasn’t ready and reinserted it. She could finally breathe on her own after another three days. But her ordeal was far from over.

She was in bed three more days, confused “with no idea where she was,” said her husband, Mike Weinhaus. “It’s not like you’re taken off a ventilator and, oh, you’re back to normal,” he says. “That’s not the case.”

Thousands of critically ill Covid-19 patients have been admitted to intensive-care units and placed on ventilators, which pump oxygen into the lungs of those unable to breathe on their own.

The initial recovery can take weeks or months. Even years later, many survivors of critical illnesses, including those who had been on ventilators, are left with physical, emotional or cognitive problems, research shows. Patients can develop memory deficits similar to those with dementia, even those previously young and healthy. Other survivors suffer from flashbacks or post-traumatic stress, researchers say.

Early evidence suggests that many coronavirus patients may face lengthy stays on the ventilator of 15 to 20 days or more, much longer than the average ICU patient. Such long periods, combined with heavy sedation while on a ventilator, have been linked to greater risks of post-ICU health issues, medical researchers say.

“The effects of this pandemic are going to last beyond the initial ICU stays for hundreds of thousands of Americans and many more world-wide,” said Dr. Nathan Brummel, an Ohio State University pulmonologist who has studied post-ICU health issues.

It’s not necessarily the ventilator itself that can cause long-term health problems for patients, doctors said, but a constellation of factors including heavy use of sedation while hooked up to the machine and the severity of the illness that requires ventilation. Researchers have found similar long-term impacts on critically ill ICU patients who didn’t need a ventilator.

They even have a name for the broader condition: Post Intensive Care Syndrome.

“If you’re sick enough to be on the ventilator for a long period of time, you are unbelievably sick,” said Dr. Craig Coopersmith, interim director of the Emory Critical Care Center, which operates some 300 ICU beds in the Atlanta area. “Being unbelievably sick is what causes you to have long-term problems.”

Covid-19 patients face special challenges, doctors said. Many hospitals normally take steps in ICUs to minimize long-term health problems by reducing sedation, getting patients out of bed, and keeping family involved.

In this crisis, however, overworked medical staff may not have time to follow these steps. Many Covid patients can’t be awakened because of low oxygen levels. Families aren’t allowed in due to the risk of infection.

----------------

His week on the ventilator was one of the most disturbing things he’s ever experienced, Mr. Vanderhoof said. Though sedated, he was aware of the tube down his throat, and was racked by anxiety and a feeling of choking. He said he chewed through the tube in his mouth several times, and had to be put on antianxiety medication. “I remember seeing my life flash before my eyes,” he said.

Sheila Richburg, a 51-year-old educational consultant in Katy, Texas, said her sedation for the initial tube insertion didn’t work as intended. She was on a ventilator in November for a severe respiratory disorder similar to those faced by Covid-19 patients. The sedation paralyzed all her muscles but she was completely awake.

She compared the experience to “being buried alive.” Ms. Richburg said she “fought and fought but I couldn’t move and couldn’t get their attention.” She added: “Nothing will scare me worse.”

After she came off the ventilator nine days later, Ms. Richburg had hallucinations and paranoia. She was so weak she couldn’t touch her nose or brush her teeth. She suffered damaged vocal cords, and now has anxiety that the coronavirus could put her back in the ICU.

“I never thought the recovery would be so much harder than the illness,” she said.

Post-ICU patients can suffer physical deficits even five years after they leave the hospital, according to Canadian researchers who examined patients with acute respiratory distress syndrome, a condition similar to what severely ill Covid-19 patients experience. The patients in the study were on ventilators a median of 21 days.

Five years later, most had normal to near-normal lung function but many couldn’t walk nearly as far as healthy peers in a six-minute test, according to the 2011 study, published in the New England Journal of Medicine.

Between one-third and one-half of post-ICU patients have “meaningful difficulties they didn’t have before” with cognitive functioning, which can prevent them from holding a job or performing basic living tasks, said James C. Jackson, a psychologist at Vanderbilt University Medical Center in Nashville, a leading center of research on Post Intensive Care Syndrome.

---------------------------

Researchers don’t know exactly why critical illness causes brain problems, but some believe it may be linked to delirium in the ICU, which can be caused by medication, infection or a disruption in sleep-wake cycles.

Amanda Grow, a 35-year-old Utah mother of four, was on a ventilator for nearly a week two years ago following a rare complication during childbirth.

After getting off the ventilator, she had several days of delirium, in which she believed doctors and nurses were trying to kill her. Her illness was so severe she needed speech therapy to relearn how to swallow, and for several weeks needed a walker.

Ms. Grow quickly realized her brain wasn’t the same after her time in the ICU. She owned a test-preparation business for high-school students with a dozen employees, but decided to close it after she struggled to quickly identify illustrations of animals such as a camel and a buffalo during a cognition test.

She fell into a deep depression nine months after leaving the hospital. “I realized I didn’t have energy to do the things I wanted to do for my family,” Ms. Grow said. “I descended into a deep dark place. I honestly wished I had died in the incident.”

Now recovered from that, she still struggles with memory and stamina. “There is no normal again,” she said.
 
The chronology, as lived here from my point of view:

- China's first cases.

- Some time afterwards, first italian patient with a pneumonia of unknown origin. It spreads to his doctors/nurses and begins to spread in Italy.

- Atalanta vs Valencia, soccer match. An italian minister called it "a biological bomb".

- Valencia has great communication with Madrid, people move from one city to the other in no time. It starts to spread in Madrid.

- March 8th, Women Day. Big demonstration in Madrid. A pregnant minister, Irene Montero, goes and gets infected. (she is young and doing fine)

- Some people from Madrid start to leave the city to their second residence in other parts of the country.
Big mistake. You're just spreading it.

- Because of that, in my autonomous region, a green rainy place most similar to Scotland/Ireland, the virus reaches the highest peak of my region, the Ancares mountains (some people from Madrid have a 2nd residence there)

- Then the state of alarm is declared and now things are getting under control, but this is a slow process.
 
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