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

[manux]

The reason I keep nitpicking sweden is that trend there looks terrifying. It's not at all same kind of looking graph as in places where quarantines were applied. Swedes probably traveled during easter holidays(week ago) and it will be interesting to see how that shows up 1-2 weeks from now. Another proof point will be 1st of may and what happens 2.5-3 weeks after that.

 

[Davros]

half of people have already have it and are immune,

They are?

 

[BRiT]

Ohio's numbers today, Confirmed: 14694 (up from 14117 ), Hospitalized: 2960 (up from 2882 ), and Deaths: 656 (up from 610 ).
CDC Expanded Cases and Deaths: 552 (up from 508 ), 38 (up from 26)
Confirmed Cuyahoga County: 1768 (up from 1548 yesterday if that number was correct because they list only 22 new cases on Trends).

Percentage increase: 4.08%, 2.71%, 7.54%
Raw increase: 577, 78, 46

Ohio has total tests of 102,325 (up from 97,998) and tests per 1M population of 8789 (up from 8418) 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 using roughly 11.641482 million as the population of Ohio.

 

[MfA]

The reason I keep nitpicking sweden is that trend there looks terrifying.

Things can always get worse ... what if you get into Sweden's situation but you've already destroyed your economy with a shutdown and are stuck with a population which will not accept another one?

Sweden's government will mostly be forced out of office if they do a shutdown now, but it will flatten the curve. So Sweden has options, we've used our strongest option in a way which was in my opinion irresponsible at the time it was implemented.

We were in my opinion likely too late for containment and the bias to act from both governments and the WHO was irresponsible and insufficiently resisted. Just because New York should shut down doesn't mean some sparsely populated and isolated town should shut down, in fact it might very well mean they shouldn't.

 

[Shifty Geezer]

They are?

Probably not. Speak to people any pretty much everyone thinks they've already had it AFAICT. Antibody tests are suggesting way, awy more people, like 50x more, have had it than have been counted, but that's still all of 10% of a national population. The WHO says it's maybe 2-3% of the world population.

I guess if so, the current ~200,000 death figure would be 2% of the world, suggesting a total potential death toll of 5 million.

 

[Shifty Geezer]

Sweden's government will mostly be forced out of office if they do a shutdown now, but it will flatten the curve. So Sweden has options, we've used our strongest option in a way which was in my opinion irresponsible at the time it was implemented.

If the UK left it a bit later, we'd be dealing with 16,000 new cases a day instead of 4,000, which there's no way the medical services could cope with. Leaving it later probably isn't statistically possible to get a useful impact on the disease. Once you get that many new cases a day and there's no way to provide medical care, you may as well just throw the doors wide open and have everyone get it and forget trying to give medical care to the vast majority.

Acting when they did, there's lockdown now, then lower numbers, which might creep up until exploding once again, but a few months will have been bought to come up with cures and better treatments.

 

[MfA]

Once you get that many new cases a day and there's no way to provide medical care

There's levels of care. If you just need a nurse to come by every 30 minutes to help with positioning and adjust nasal oxygen you can stretch personnel a lot, your hospitals don't have enough free beds to deal with the ~35K extra beds you'd need for 16K cases a day but you could erect field hospitals.

Necessity is the mother of invention.

Acting when they did, there's lockdown now, then lower numbers, which might creep up until exploding once again, but a few months will have been bought to come up with cures and better treatments.

In my opinion that's too unlikely to gamble on.

In my opinion there's two good reasons for a shutdown, because you can still contain it but lack infrastructure for contact tracing, or for a month or two to flatten the curve on the way to herd immunity. In both cases, timing is everything.

There are wrong times to do a shut down, I think a lot of regions picked a wrong time. Partly because the WHO/politicians/epidemiologists in general refused and still refuse to openly and honestly discuss the best options which do not presume containment.

 

[Shifty Geezer]

In my opinion there's two good reasons for a shutdown, because you can still contain it but lack infrastructure for contact tracing, or for a month or two to flatten the curve on the way to herd immunity. In both cases, timing is everything.

What's wrong with the third option - that the first containment approach failed because the testing was botched (notably because the specifics of the disease were unknown) and you want to get daily cases down low enough to try again?

 

[MfA]

What's wrong with the third option - that the first containment approach failed because the testing was botched (notably because the specifics of the disease were unknown) and you want to get daily cases down low enough to try again?

Shutdown is costly to the point it can not be sustained for more than a couple months and doing multiple start/stop cycles almost certainly not an option at all politically, implementing it at the wrong time means you can't use it when you'd most want to use it.

Contact tracing and quarantine becomes increasingly hard the more of the population has antibodies from past infections.

 

[A1xLLcqAgt0qc2RyMz0y]

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

April 23, 2020 - 2,763 confirmed cases - 72 deaths

2,763 confirmed cases up 80 over yesterday and seven new deaths
those 80 new cases represent a 3.0% increase over the last day

Increases (by percent) over the last 28 days:
21.0%, 19.6%, 11.1%, 12.5%, 14.9%, 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% and now 3.0%

Increases (by count) over the last 28 days:
+64, +72, +49, +61, +82, +100, +100,
+90, +94, +97, +43, +106, +63, +108,
+105, +107, +79, +65, +89, +109, +80,
+124, +134, +104, +84, +90, +81 and now +80

As of 11:00 am April 23, 2020, DCHHS is reporting 80 additional positive cases of 2019 novel coronavirus (COVID-19), bringing the total case count in Dallas County to 2,763, including 72 deaths.

The 7 additional deaths being reported today include:

• A woman in her 70’s who was a resident of the City of Dallas and had been found deceased at home.
• A woman in her 60’s who was a resident of the City of Richardson 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 had been critically ill in an area hospital.
• 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 the City of Dallas and had been hospitalized in an area hospital.
• A woman in her 90’s who was a resident of the City of Dallas and had been hospitalized in an area hospital.
• A man in his 90’s who was a resident of the City of Dallas and had been critically ill in an area hospital.

Of cases requiring hospitalization, most 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 about a third of all hospitalized patients with COVID-19.

Of the 72 total deaths reported to date, about a third have been associated with long-term care facilities.

 

[A1xLLcqAgt0qc2RyMz0y]

State of Texas complete COVID-19 data breakdown

https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83

Data as of 4/23/2020 @ 11:30 AM:

Total Tests: 225,078 (Up +8,295)
Cases Reported: 21,944 (Up +875)
In Hospitals: 1,649 (Down -29)
Patients Recovered (Estimated*) : 8,025 (Up +684)
Fatalities: 561 (Up +18)

Texas tests per 1M population are 8,072 (Up +298) which places Texas as the 4th worst State. Texas moved down one place from yesterday. Ohio is four places better at 8,789 (Up +371) per 1M population.

Click this link: https://www.worldometers.info/coronavirus/country/us
and on the page click the Tests / 1M pop column to sort from worst to first

 

[Shifty Geezer]

Contact tracing and quarantine becomes increasingly hard the more of the population has antibodies from past infections.

I don't understand that. You'd use RNA tests for virus presence, not antibody tests. that's what Asia is using AFAIK and they're keeping a lid on it. Basically the plan is get number the number down low and contain, following South Korea's pattern...



They've managed to contain from 100-200 cases a day downwards to a handful a day. So the UK would stay in lockdown a few more weeks to get new case counts down to a few hundred a day, and use that time to install all the tracing and testing infrastructure needed to contain it after that.

 

[AlphaWolf]

There's levels of care. If you just need a nurse to come by every 30 minutes to help with positioning and adjust nasal oxygen you can stretch personnel a lot, your hospitals don't have enough free beds to deal with the ~35K extra beds you'd need for 16K cases a day but you could erect field hospitals.

Necessity is the mother of invention.

In my opinion that's too unlikely to gamble on.

In my opinion there's two good reasons for a shutdown, because you can still contain it but lack infrastructure for contact tracing, or for a month or two to flatten the curve on the way to herd immunity. In both cases, timing is everything.

There are wrong times to do a shut down, I think a lot of regions picked a wrong time. Partly because the WHO/politicians/epidemiologists in general refused and still refuse to openly and honestly discuss the best options which do not presume containment.

Where do the extra staff come from to staff these newly erected 'hospitals'? Homeless shelters?

And no a nurse can't just check on you every 30 minutes. There are other things that need to be done during care. Medication needs to be administered, vitals need to be monitored. Patients need sustenance and relief.

 

[Mariner]

It has been reported that the 'Nightingale' hospital in London has had to turn away patients due to a lack of nursing staff. I'd imagine the situation will be the same at the other similar hospitals built elsewhere in the UK. I think they are window-dressing, truth be told, to show they are trying to do something. The NHS was already short of staff before the pandemic began so there were never going to be enough during these impossible times.

I think that's going to be the biggest issue, really. After the initial wave of deaths, how will the exhausted medical staff cope with future waves should they appear? A lot of talk about PTSD amongst medical workers already.

 

[MfA]

Where do the extra staff come from to staff these newly erected 'hospitals'?

Overtime, military, retirement, postponement of surgeries and when necessary the massive reduction in injuries and transmitted diseases due to a shutdown.

35K beds is a lot for the UK, around a third of their total, but it's not on an different level of magnitude.

And no a nurse can't just check on you every 30 minutes.

Yes, for non intensive care they do it a lot less. As I said, there's levels of care ... and triage.

 

[dobwal]

Seeing the headlines for this as well as some of the conclusions that are being drawn annoys me.

https://www.msn.com/en-us/news/us/a...us-fatality-in-us/ar-BB134epU?ocid=spartanntp

So, someone who died Feb. 6th has been posthumously identified as having had Covid-19. And their death is now being attributed to Covid-19, but I don't think the death was due to that. I think the original diagnosis for the cause of death (heart attack) is far likelier. Perhaps Covid-19 contributed in some way, but AFAIK you don't suddenly drop dead from Covid-19. It's usually a situation where the symptoms become increasingly dire until something in the body fails.

In this case, she was in apparent recovery when she suddenly died. It seems like those in charge in some locations are quick to label any death as being caused by Covid-19 if there is any trace of it in the persons body. And I think that's wrong and a disservice to trying to understand the full scope of the virus and its impact.

Regards,
SB

Death from COVID might not be strictly due to respiratory failure. There are reports that some autopsies are showing micro clotting in the lungs which may break off and make their way to the heart or brain.

There is a case of a leg amputation due to a clotting from a CoVID infection.

 

[AlphaWolf]

Overtime, military, retirement, postponement of surgeries and when necessary the massive reduction in injuries and transmitted diseases due to a shutdown.

35K beds is a lot for the UK, around a third of their total, but it's not on an different level of magnitude.

A lot of that is already being done. Much of those reserves have been used. Many of them working at already unsustainable levels.

Yes, for non intensive care they do it a lot less. As I said, there's levels of care ... and triage.

It is clear you have an extremely limited understanding of what goes on in a hospital. Nurses looking after patients who do not need extensive observation are already watching a lot more patients than an ICU nurse. And any patient who is infectious takes a much bigger toll on their time because of the protocols to avoid spreading.

Your triage ultimately would wind up being someone trenching a ditch to pile the bodies in.

 

[dobwal]

I don't understand that. You'd use RNA tests for virus presence, not antibody tests. that's what Asia is using AFAIK and they're keeping a lid on it. Basically the plan is get number the number down low and contain, following South Korea's pattern...

View attachment 3814

They've managed to contain from 100-200 cases a day downwards to a handful a day. So the UK would stay in lockdown a few more weeks to get new case counts down to a few hundred a day, and use that time to install all the tracing and testing infrastructure needed to contain it after that.

PCR testing is used because it more sensitive than other tests and can detect the virus in beginning stages of infection. It takes time for you to build up enough antibodies to be readily detected by serological testing. It’s the main reason why you can’t use serological testing to rule out an infection.

 

[Shifty Geezer]

PCR testing is used because it more sensitive than other tests and can detect the virus in beginning stages of infection. It takes time for you to build up enough antibodies to be readily detected by serological testing.

Yes. For containment, you'd want an RNA test.

It’s the main reason why you can’t use serological testing to rule out an infection.

Neither test is even close to 100% accurate. Whatever South Korea is doing seems to be working though.

 

[dobwal]

Yes. For containment, you'd want an RNA test.
Neither test is even close to 100% accurate. Whatever South Korea is doing seems to be working though.

It’s not about accuracy per se, it’s that serological testing is not really suitable for virus detection of the newly infected. The immune system must identified the infection and then produce an antibody to fight the infection. This can take up to two weeks.

It’s this reason that a serological test as an initial result has to be backed by a PCR test and/or viral culture to rule out an infection.