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

[milk]

I'm now convinced that the ability of countries to "flatten the curve" or not will end up mostly irrelevant in the long run. We are talking about the positions of runners in the first 100m of a 10km marathon. This shit will outlast this year, and might even extend past the next if we are that unlucky.

No country will manage to regulate human nature for too much longer. Keep people in lockdown for too long and they'll start considering risking even taking a bullet to say fuck it and go do as they please. Contries with good numbers now have delayed the innevitable.

I don't even think herd immunity will be the end-game. This shit will run its course completely. Every fucking one will get it. You either die, or you don't. I won't waste time doing data masturbartion over what now seems clear to me.

Data tracking, by the way, is an utter mess. There is over reporting and under reporting happening all over the place. We will only start to get a clear picture of what has happened in 2020 and 2019 years from now.

 

[A1xLLcqAgt0qc2RyMz0y]

2019 Novel Coronavirus (SARS-CoV-2/COVID-19) for Dallas County Texas
https://www.dallascounty.org/departments/dchhs/2019-novel-coronavirus.php
https://www.dallascounty.org/Assets/uploads/docs/covid-19/press-releases/052020-PressRelease-DallasCountyReports186AdditionalPositiveCOVID-19Cases.pdf

May 20, 2020 - 8,090 confirmed cases - 196 deaths

8,090 confirmed cases up 186 over yesterday and five new deaths
those 186 new cases represent a 2.4% increase over the last day

Increases (by percent) over the last 55 days:
21.0%, 19.6%, 11.1%, 12.5%, 14.9%
-- Month of April 2020 --
15.8%, 13.7%, 10.8%, 10.2%, 9.6%, 3.9%, 9.2%, 5.0%, 8.2%, 7.3%, 7.0%, 4.8%, 3.8%, 5.0%, 5.8%,
4.0%, 6.0%, 6.1%, 4.5%, 3.5%, 3.6%, 3.1%, 3.0%, 2.6%, 2.6%, 3.6%, 3.0%, 4.3%, 3.5%, 5.3%
-- Month of May 2020 --
5.3%, 4.9%, 6.0%, 5.7%, 5.9%, 5.3%, 5.2%, 4.9%, 4.7%, 4.5%, 4.3%, 3.9%, 3.8%, 3.6%, 2.9%, 3.0%,
2.8%, 3.0%, 2.9% and now 2.4%

Increases (by count) over the last 55 days:
+64, +72, +49, +61, +82
-- Month of April 2020 --
+100, +100, +90, +94, +97. +43, +106, +63, +108, +105, +107, +79, +65, +89, +109,
+80, +124, +134, +104, +84, +90, +81, +80, +71, +75, +105, +91, +135, +112, +179
-- Month of May 2020 --
+187, +181, +234, +237, +253, +246, +251, +249, +250, +251, +253, +236, +243, +235, +199, +214,
+205, +224, +225 and now +186

FOR IMMEDIATE RELEASE
May 20, 2020

Dallas County Reports 186 Additional Positive 2019 Novel Coronavirus (COVID-19) Cases
DALLAS -- As of 11:00am May 20, 2020, Dallas County Health and Human Services is reporting 186 additional positive cases of 2019 novel coronavirus (COVID-19), bringing the total case count in Dallas County to 8,090, including 196 deaths.

The additional 5 deaths are being reported today include:

-A man in his 40’s who was a resident of the City of Irving and had been critically ill in an area hospital.
-A man in his 50’s who was a resident of the City of Farmers Branch and had been critically ill in an area hospital.
-A woman in her 70’s who was a resident of the City of Grand Prairie and had been critically ill in an area hospital.
-A man in his 70’s who was a resident of the City of Mesquite and had been critically ill in an area hospital.
-A man in his 70’s who was a resident of a long-term care facility in the City of Dallas and expired at an area hospital ED.

Of cases requiring hospitalization who reported employment, over 80% have been critical infrastructure workers, with a broad range of affected occupational sectors, including: healthcare, transportation, food and agriculture, public works, finance, communications, clergy, first responders and other essential functions. Of cases requiring hospitalization, two-thirds have been under 65 years of age, and about half do not have high-risk chronic health conditions. Diabetes has been an underlying high-risk health condition reported in about a third of all hospitalized patients with COVID-19. Of the 196 total deaths reported to date, over a third have been associated with long-term care facilities.

“Today’s number of cases is markedly lower than what we saw last week and now halfway through the week we’re seeing a healthy decline in the number of new positive cases. We have not seen an appreciable increase in testing yet in Dallas although there has been some increase in testing with the opening of some Walmart, Kroger Health and other sites. So this is somewhat of an apples to apples comparison over the last three weeks. We’ve seen an increase, then a plateau, and now we’re seeing a gradual decline. The doctors tell me to temper my optimism on this and that the key numbers to look at are ICU admissions, hospital beds and deaths but I’d rather see the number of new cases going down than up. Again, how well we do is dependent on the smart, personal decisions of all of us: avoiding unnecessary crowds, maintaining 6 foot distancing, wearing our face coverings on public transportation and at businesses, plus practicing good hygiene. As more and more businesses open, we must focus not on what is legal but on what is safe as advised by the doctors.

 

[WhiningKhan]

This shit will run its course completely. Every fucking one will get it.

Humanity has coexisted with even more contagious stuff like measles and smallpox for millenia without everyone getting infected. Everybody would not get infected even in total anarchy. In organized society, it is entirely possible to extinguish local outbreaks.

The world is full of diseases, lethal and not. In the bug picture, humanity will adapt and survive. On individual level, you indeed die or you don't if you catch the disease, but it is not inevitable for you to catch it to see how it goes.

 

[Shifty Geezer]

Humanity has coexisted with even more contagious stuff like measles and smallpox for millenia without everyone getting infected.

I think things like measles are experienced by everyone. Hence the need for vaccinations, and that's even with very significant herd immunity. Also, there was far less travel over those millennia than there is now, limiting spread to within local populaces. I think it highly likely everyone will be subjected to SARS-Cov2 in their lifetime just like they are all the other common coronaviruses. We won't extinguish it, so it'll be dependent on vaccines to artificially induce resistance. Perhaps, if the world got its act together, they could pull a Smallpox and vaccinate absolutely everyone and try and quash the disease outright, but chances of that happening seem low because the world can never get its act together.

 

[BRiT]

Perhaps, if the world got its act together, they could pull a Smallpox and vaccinate absolutely everyone and try and quash the disease outright, but chances of that happening seem low because the world can never get its act together.

Unfortunately, you will still have the likes of Anti-Vaxxers which allow the disease to return and in larger numbers like the past few years.

 

[milk]

Unfortunately, you will still have the likes of Anti-Vaxxers which allow the disease to return and in larger numbers like the past few years.

Anti-Vaxxers are a necessary evil in any moderately complex society. Dissidents and contrarians serve a role within a larger picture. Of course we have stupid contrarians and smarter ones, but that goes for all social roles. A society constituted entirely of compliant citizens is closer to the edge of doom than one with a healthy share of rebels.

 

[Shifty Geezer]

Normally, antivaxxers are few and far enough between that they shouldn't continue a spread. I guess the real question is how do diseases 'hibernate' such that when not present in the population, a resurgence occurs? Technically it should be impossible unless the diseases is present outside of humans awaiting a chance to infect one.

 

[BRiT]

Normally, antivaxxers are few and far enough between that they shouldn't continue a spread. I guess the real question is how do diseases 'hibernate' such that when not present in the population, a resurgence occurs? Technically it should be impossible unless the diseases is present outside of humans awaiting a chance to infect one.

I don't know that they're far enough between, as some seem to be community clusters that lead to the spread amongst themselves. Perhaps one could consider measles to be statistically eliminated but there shouldn't be even a one hundredth of the cases.

I suspect COVID-19 will spread even higher through those same communities.


Snippets from US CDC on Measles - https://www.cdc.gov/measles/cases-outbreaks.html

Spread of Measles

• The majority of people who got measles were unvaccinated.
• Measles is still common in many parts of the world.
• Travelers with measles continue to bring the disease into the U.S.
• Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.

Measles Cases in 2020
As of May 7, 2020, there have been 12 confirmed cases in 7 jurisdictions.

Measles Cases in 2019

• From January 1 to December 31, 2019, 1,282* individual cases of measles were confirmed in 31 states. Of these cases, 128 were hospitalized and 61 reported having complications, including pneumonia and encephalitis.
• This is the greatest number of cases reported in the U.S. since 1992. More than 73% of the cases were linked to recent outbreaks in New York. The majority of cases were among people who were not vaccinated against measles. Measles is more likely to spread and cause outbreaks in U.S. communities where groups of people are unvaccinated.
• All measles cases were caused by measles wild-type D8 or B3.

 

[Shifty Geezer]

How does it start though?? There are zero cases of measles in New York. Someone with the measles enters (why aren't they in bed?). They meet someone who hasn't been vaccinated who gets it, who meets a load of other people who aren't vaccinated who get it. But where does that first case originate? It's pretty obvious someone has measles!

I wonder if asymptomatic carriers of diseases are actually commonplace? Could these viruses be being reproduced inside some people and spread around in non-disease forming manner until it some it turns into the disease? Could there be a 'dormant' phase where the disease spreads slowly without creating a diseases, which then turns into the aggressive, highly contagious disease version?

 

[AlNom]

hm...

The average incubation period for measles is 11–12 days [5], and the average interval between exposure and rash onset is 14 days, with a range of 7–21 days.[1, 6] Persons with measles are usually considered infectious from four days before until four days after onset of rash with the rash onset being considered as day zero.

https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html

e.g. person travels, is exposed, travels home, develops symptoms, but has potentially exposed others from a time a few days before the rash (big worry there) up until the rash is bad enough to warrant further action/isolation.

 

[BRiT]

https://www.theatlantic.com/health/...-test-data-pennsylvania-georgia-texas/611935/

‘How Could the CDC Make That Mistake?’
The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.

The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

 

[A1xLLcqAgt0qc2RyMz0y]

https://www.theatlantic.com/health/...-test-data-pennsylvania-georgia-texas/611935/

‘How Could the CDC Make That Mistake?’
The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.

The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.

Just F-ing Great

With the imbecile in the WH this is what we get - premature state openings and manipulation of testing results to justify said openings.

Texas, where the rate of new COVID-19 infections has stubbornly refused to fall, is one of the most worrying states (along with Georgia). The Texas Observer first reported last week that the state was lumping its viral and antibody results together. On Tuesday, Governor Greg Abbott denied that the state was blending the results, but the Dallas Observer reports that it is still doing so.

While the number of tests per day has increased in Texas, climbing to more than 20,000, the combined results mean that the testing data are essentially uninterpretable. It is impossible to know the true percentage of positive viral tests in Texas. It is impossible to know how many of the 718,000 negative results were not meant to diagnose a sick person. The state did not return a request for comment, nor has it produced data describing its antibody or viral results separately. (Some states, following guidelines from the Council of State and Territorial Epidemiologists, report antibody-test positives as “probable” COVID-19 cases without including them in their confirmed totals.)

 

[BRiT]

There's just so many things the Administration of Individual One is doing that is just sickening and it's done on purpose.

From that same news report article...

~~~~~
The CDC stopped publishing anything resembling a complete database of daily test results on February 29. When it resumed publishing test data last week, a page of its website explaining its new COVID Data Tracker said that only viral tests were included in its figures. “These data represent only viral tests. Antibody tests are not currently captured in these data,” the page said as recently as May 18.

Yesterday, that language was changed. All reference to disaggregating the two different types of tests disappeared. “These data are compiled from a number of sources,” the new version read. The text strongly implied that both types of tests were included in the count, but did not explicitly say so.

The CDC’s data have also become more favorable over the past several days.

~~~~~
The intermingling of viral and antibody tests suggests that some of those gains might be illusory. If even a third of the country’s gain in testing has come by expanding antibody tests, not viral tests, then its ability to detect an outbreak is much smaller than it seems. There is no way to ascertain how much of the recent increase in testing is from antibody tests until the most populous states in the country—among them Texas, Georgia, and Pennsylvania—show their residents everything in the data.

 

[BRiT]

Positive cases to tests is around 7.7% and along with increase in CDC Expanded Cases numbers indicates the testing is too limited by still requiring a doctor's recommendation to get tested. There should be no CDC Expanded Cases if you're able to test.

With the positive test percentages being as high as they are it's possible Ohio is not conflating their Currently Infected testing numbers with the AntiBody Tests, but then again their testing effort could be as pathetic as it was weeks ago and the higher numbers we're seeing are from the AntiBody Test.

Ohio's Trends is showing the second highest new cases from the past 3 weeks, an increase of over 250 from the previous day. No such thing as dropping and with the premature reopening the trend will begin to spike over the next few weeks.

Ohio did 9.4K tests for today's numbers which is a bit under half of the over 22K a day target, with previous days at 3.3K, 3.6K, 5.5K, 4.9K, 6.5K, 5.2K, 4.3K, 4.9K, 5.5K, 8.1K, 7.0K, 8.2K, 12.2K, 8.1K, 5.4K, 7.1K, 8K, 7.4K, 12.7K, 10.3K, 7.8K, 7.2K, 7.5K, 10K.

Ohio's numbers today, Confirmed: 30,167 (up from 29,436 ), Hospitalized: 5,295 (up from 5,198 ), and Deaths: 1,836 (up from 1,781 ).
CDC Expanded Cases and Deaths: 1993, 183
Confirmed Cuyahoga County: 3667 (up from 3,512 ) ~ 4.41 % increase.

Percentage increase: 2.48%, 1.87%, 3.09%
Raw increase: 731, 97, 55

Ohio has total tests of 297,085 (up from 287,609 ) and tests per 1M population of 25,416 (up from ~ 24,605 ) taken from https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/key-metrics/cases and https://www.worldometers.info/coronavirus/country/us/ [case numbers updated later]

They're now using roughly 11.689 million for population of Ohio.

 

[wco81]

I think things like measles are experienced by everyone. Hence the need for vaccinations, and that's even with very significant herd immunity. Also, there was far less travel over those millennia than there is now, limiting spread to within local populaces. I think it highly likely everyone will be subjected to SARS-Cov2 in their lifetime just like they are all the other common coronaviruses. We won't extinguish it, so it'll be dependent on vaccines to artificially induce resistance. Perhaps, if the world got its act together, they could pull a Smallpox and vaccinate absolutely everyone and try and quash the disease outright, but chances of that happening seem low because the world can never get its act together.

Well that's the Sweden strategy isn't it, that infection is inevitable?

We're less than 6 months into the pandemic and there are a lot of things we still don't know about this virus, such as immunity, possibility of reinfection. By that I mean scientifically conclusive studies of these and other questions.

People figure 80% of those infected recover on their own, doesn't require hospitalization. But if we accept that everyone will get infected, 20% of the global population needing hospital care, 5% ICU will basically blow up health care infrastructure.

On top of that, there are a lot of new things being discovered. Just in the past week or two, you have reports of more and more young children suffering Kawaski syndrome and then now, China is reporting that in its northern provinces, there are clusters of infections where symptoms don't present for 2 weeks rather than the median of 5 days, which makes efforts to detect and track infections difficult.

There is also uncertainty about possible long-term effects, from organ damage, which could mean reduced pulmonary function and increased need for dialysis.

So with so many uncertainties, the idea that most of the population will inevitably become infected so we might as well just let it happen is dubious.

Sweden is gambling that if they can accelerate infection, they will be better prepped for any second or third waves and that they won't have to deal with reopening their economy, which countries like New Zealand has to deal with after successfully suppressing infections. But if there are effective vaccines or drug therapies developed/discovered, it would mean that they accelerated infections and moved forward deaths needlessly, compared to its neighbors which have the fraction the fatalities.

 

[Shifty Geezer]

Yep. However, the complications come when you start rating those unwanted deaths in terms of quality. What if every single person who dies from Covid19 is going to die within 24 months anyway from other conditions? In that case, it's likely not worth the damage to society to save them.

It's not as simple as a numbers game. Lots of scientists and data crunchers are pulling apart the numbers because there's nothing else to work with, but the reality probably exists beyond our ability to model and calculate. Ultimately on a species level, we'll have different clusters taking different approaches and one or other will prevail. On a conscious level, about the most realistic, best solution is try to keep infection low and get a vaccine out ASAP.

 

[WhiningKhan]

Yep. However, the complications come when you start rating those unwanted deaths in terms of quality. What if every single person who dies from Covid19 is going to die within 24 months anyway from other conditions? In that case, it's likely not worth the damage to society to save them

That is a totally idiotic thing to suggest at this point when e.g. papers on fatal pulmonary embolisms induced by Covid-19 are published daily. You can't hide behind ignorance unless you have never heard of Pubmed. Or actually ignorance is precisely the right word in that case.

 

[Mariner]

Sweden's hopes/expectations of a rapid move towards herd immunity don't seem to be coming to fruition:

https://www.theguardian.com/world/2...dies-by-end-of-april-study-sweden-coronavirus

Around 7% instead of the 20%+expected by the Swedish authorities more recently (and the 33% originally expected a couple of months ago). For reference, tests in the UK indicate that perhaps 17% of those in London have antibodies. If correct, my guess is that it is the population density and the jam-packed public transport making the difference between the two cities.

Regarding the long term view on Covid-19, it is looking like it will be either vaccine or possibly a selection of effective treatments to make it less dangerous in the longer term. The genie is out of the bottle now so the virus will keep coming back and I think it unlikely that it will ever be eradicated. Perhaps super-fast diagnostic tests could be delivered to get us back to something like the previous status quo with widespread and relaxed travel and socialising, but otherwise, the social distancing 'new norm' will actually become pretty permanent unless everyone just shrugs and decides to let it run rife.

I do certainly think we should be doing as much as possible to keep it shut down rather than letting infection run free, but at some point, it may be that we have to give up hopes for a return to our carefree past.

 

[BRiT]

Speaking of possible preventions and treatments...

Scientists believe cannabis could help prevent and treat coronavirus

They have high hopes for a coronavirus breakthrough.

A team of Canadian scientists believes it has found strong strains of cannabis that could help prevent and then treat coronavirus infections, according to interviews and a study.

Researchers from the University of Lethbridge said that a study in April showed at least 13 cannabis plants high in CBD that appeared to affect the ACE2 pathways that the bug uses to access the body.

The results, printed in online journal Preprints, indicated hemp extracts high in CBD may help block proteins that provide a “gateway” for COVID-19 to enter host cells.

Kovalchuk’s husband, Igor, suggested cannabis could reduce the virus’ entry points by up to 70 percent. “Therefore, you have more chance to fight it,” he told CTV.

“Our work could have a huge influence — there aren’t many drugs that have the potential of reducing infection by 70 to 80 percent,” he told the Calgary Herald.

Stressing that more research was needed, the study gave hope that if proven to modulate the enzyme it “may prove a plausible strategy for decreasing disease susceptibility” as well as “become a useful and safe addition to the treatment of COVID-19 as an adjunct therapy.”​

https://nypost.com/2020/05/21/scientists-believe-cannabis-could-help-prevent-treat-coronavirus/

 

[A1xLLcqAgt0qc2RyMz0y]

2019 Novel Coronavirus (SARS-CoV-2/COVID-19) for Dallas County Texas
https://www.dallascounty.org/departments/dchhs/2019-novel-coronavirus.php

May 21, 2020 - 8,273 confirmed cases - 203 deaths

8,273 confirmed cases up 183 over yesterday and seven new deaths
those 183 new cases represent a 2.3% increase over the last day

Increases (by percent) over the last 56 days:
21.0%, 19.6%, 11.1%, 12.5%, 14.9%
-- Month of April 2020 --
15.8%, 13.7%, 10.8%, 10.2%, 9.6%, 3.9%, 9.2%, 5.0%, 8.2%, 7.3%, 7.0%, 4.8%, 3.8%, 5.0%, 5.8%,
4.0%, 6.0%, 6.1%, 4.5%, 3.5%, 3.6%, 3.1%, 3.0%, 2.6%, 2.6%, 3.6%, 3.0%, 4.3%, 3.5%, 5.3%
-- Month of May 2020 --
5.3%, 4.9%, 6.0%, 5.7%, 5.9%, 5.3%, 5.2%, 4.9%, 4.7%, 4.5%, 4.3%, 3.9%, 3.8%, 3.6%, 2.9%, 3.0%,
2.8%, 3.0%, 2.9%, 2.4% and now 2.3%

Increases (by count) over the last 56 days:
+64, +72, +49, +61, +82
-- Month of April 2020 --
+100, +100, +90, +94, +97. +43, +106, +63, +108, +105, +107, +79, +65, +89, +109,
+80, +124, +134, +104, +84, +90, +81, +80, +71, +75, +105, +91, +135, +112, +179
-- Month of May 2020 --
+187, +181, +234, +237, +253, +246, +251, +249, +250, +251, +253, +236, +243, +235, +199, +214,
+205, +224, +225, +186 and now +183

As of 11:00 am May 21, 2020, Dallas County Health and Human Services is reporting 183 additional positive cases of 2019 novel coronavirus (COVID-19), bringing the total case count in Dallas County to 8,273, including 203 deaths.

The additional 7 deaths are being reported today include:

• A man in his 50’s who was a resident of the City of Lancaster and had been hospitalized.
• A woman in her 50’s who was a resident of the City of Dallas and had been critically ill in an area hospital.
• A man in his 60’s who was a resident of the City of Dallas and was found deceased at home.
• A man in his 80’s who was a resident of the City of Dallas and had been critically ill in an area hospital.
• A woman in her 80’s who was a resident of a long-term care facility in the City of Mesquite and had been hospitalized.
• A woman in her 90’s who was a resident of a long-term care facility in the City of Dallas and had been hospitalized.
• A woman in her 90’s who was a resident of a long-term care facility in the City of Dallas and expired at the facility.

Of cases requiring hospitalization who reported employment, over 80% have been critical infrastructure workers, with a broad range of affected occupational sectors, including: healthcare, transportation, food and agriculture, public works, finance, communications, clergy, first responders and other essential functions.

Of cases requiring hospitalization, two-thirds have been under 65 years of age, and about half do not have high-risk chronic health conditions. Diabetes has been an underlying high-risk health condition reported in about a third of all hospitalized patients with COVID-19.

Of the 203 total deaths reported to date, over a third have been associated with long-term care facilities.