COVID-19 ongoing thread part 2

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Re: COVID-19 ongoing thread part 2

Post by Bedlam »

mr friendly guy wrote: 2020-07-16 03:00am How do you know how long a vaccine protects you for? You can't tell by measuring antibodies, which is a common thing we do in clinical practice to prove someone is immune to a certain disease.
Could you reintroduce the antigen and then measure the speed of antibody production?

It would be a lot more complicated than a simple measure of the antibody, you'd presumably have to do it over an extended period but if you get a spike in a day or two vs a week or more the immune system seems more primed than you'd expect.
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Re: COVID-19 ongoing thread part 2

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Bedlam wrote: 2020-07-16 03:08am
mr friendly guy wrote: 2020-07-16 03:00am How do you know how long a vaccine protects you for? You can't tell by measuring antibodies, which is a common thing we do in clinical practice to prove someone is immune to a certain disease.
Could you reintroduce the antigen and then measure the speed of antibody production?

It would be a lot more complicated than a simple measure of the antibody, you'd presumably have to do it over an extended period but if you get a spike in a day or two vs a week or more the immune system seems more primed than you'd expect.
That's an interesting thought. Before quantiferon tests came out to test for TB exposure with antibodies, the old way was to do something like that with the mantoux test. Except the antigen was introduced on the skin, and we didn't measure antibodies, we observed the skin reaction.
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Re: COVID-19 ongoing thread part 2

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Another day, another COVID party.
https://torontosun.com/news/world/covid ... was-a-hoax
Believing the coronavirus was a hoax, a 30-year-old man has died after he attended a ‘COVID party’ when he was infected with the virus, according to a Texas hospital.

The man, who has not been identified, tagged along with an infected person to the gathering to test whether the coronavirus was real, said Dr. Jane Appleby, chief medical officer at Methodist Hospital in San Antonio, where the man died.

She did not say when the party took place, nor did she say how many people attended or how long after was the man hospitalized.

The crux of these COVID parties is to test whether the virus exists or to intentionally get exposed with the hopes of achieving immunity.
Before someone goes the Toronto sun is a tabloid, its also reported by other outlets like the NYT, but I can't read their article as its behind a paywall.
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Re: COVID-19 ongoing thread part 2

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I've also heard of these parties on legitimate news shows (CP24) so I'm not surprised.
I've been asked why I still follow a few of the people I know on Facebook with 'interesting political habits and view points'.

It's so when they comment on or approve of something, I know what pages to block/what not to vote for.
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Re: COVID-19 ongoing thread part 2

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Now the White House has announced that "science shouldn't stop schools reopening." Brought to you by the administration which denies climate change and has trade relations with Wakanda.

Presumably its not just a face saving measure from Trump, its supposed to get parents back to work instead of staying back to look after their kids to help boost the economy. Trump touted himself as great for the economy because he is a "businessman", albeit one that got bankrupted several times and had to be bailed out by daddy, but he does cultivate the appearance that he knows what to do to help the economy. So he has likely hinged his reelection prospects on getting the economy back on tract with a strong showing in Q4. Unfortunately if schools do reopen in fall when the virus is still not under control, its just going to make things worse.
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Re: COVID-19 ongoing thread part 2

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Maybe they're hoping that if school reopenings cause another disaster, it's after the election. Then it's either irrelevant because Trump got his second term, or a huge fuckup for Biden to fix.
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Re: COVID-19 ongoing thread part 2

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Everytime Trump announces a funding cut, Ebola comes back.

https://time.com/5847505/trump-withdrawl-who/

So, this was 3/6/2020

https://news.un.org/en/story/2020/07/1068521
Jun 1 Ebola comes back, outbreak announced this week.

Every SINGLE TIME.

The flare-up was supposed to have ended in June. Right as rain, when Trump petition withdrawal and moves to not PAY WHO dues, The outbreak flares up again... This happened in 2018 and 2019.

Yes. It's concidence. But fuck it if this isn't a sign of Nurgle worship.


So, amidst the exhausted stores, MSF and etc has to move back in and crush this outbreak again. Let just hope the US doesn't active sabotage PPE procurement, by outbidding them as it supposedly did to France and other countries.
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Re: COVID-19 ongoing thread part 2

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In news which should surprise no one since Trump took away power from the CDC (in my previous post)

https://www.cnbc.com/2020/07/16/us-coro ... o-hhs.html
Coronavirus data has already disappeared after Trump administration shifted control from CDC
PUBLISHED THU, JUL 16 20209:31 AM EDTUPDATED 5 HOURS AGO
Will Feuer
@WILLFOIA

Since the pandemic began, the CDC has regularly published data on availability of hospital beds and intensive care units across the country.
But Ryan Panchadsaram, who helps run a data-tracking site called Covid Exit Strategy, said that when he tried to collect the data from the CDC on Tuesday, it had disappeared.
When reached for comment Thursday by CNBC, HHS spokesman Michael Caputo said in a statement that the CDC was directed to make the data available again.

Previously public data has already disappeared from the Centers for Disease Control and Prevention’s website after the Trump administration quietly shifted control of the information to the Department of Health and Human Services.

Since the pandemic began, the CDC regularly published data on availability of hospital beds and intensive care units across the country. But Ryan Panchadsaram, who helps run a data-tracking site called Covid Exit Strategy, said that when he tried to collect the data from the CDC on Tuesday, it had disappeared.

“We were surprised because the modules that we normally go to were empty. The data wasn’t available and not there,” he said. “There was no warning.”

CDC Director Dr. Robert Redfield told reporters on a conference call Wednesday that states were told to stop sending hospital information to the National Healthcare Safety Network site, the CDC’s system for gathering data, beginning Wednesday. Instead, all data will now be reported through HHS’ reporting portal, officials said, adding that the decision was made to streamline data reporting and to provide HHS officials with real-time data.

Public health specialists and former health officials acknowledged that the CDC’s data reporting infrastructure was limited, and said it needs to be overhauled to meet the demands of the Covid-19 pandemic. However, they expressed concern in interviews with CNBC that the change could lead to less transparent data.

When reached for comment Thursday by CNBC, HHS spokesman Michael Caputo said in a statement that the CDC was directed to make the data available again. In the future, he said, HHS will provide “more powerful insights.”

“Yes, HHS is committed to being transparent with the American public about the information it is collecting on the coronavirus,” he said. “Therefore, HHS has directed CDC to re-establish the coronavirus dashboards it withdrew from the public on Wednesday.”

Representatives of the CDC did not immediately respond to CNBC’s request for comment. Later in the day, the CDC restored the site’s previous dashboards with data through Tuesday, saying: “This file will not be updated after July 14, 2020 and includes data from April 1 to July 14.”

The CDC’s web page for data on available hospital and ICU beds has added a note that reads: “Data displayed on this page was submitted directly to CDC’s National Healthcare Safety Network (NHSN) and does not include data submitted to other entities contracted by or within the federal government.”

“We don’t have this critical indicator anymore,” Panchadsaram said. “The intent of just switching the data streams towards HHS, that’s fine. But you got to keep the data that you’re sharing publicly still available and up to date.”

Panchadsaram said he and his team, which includes researchers from the Duke-Margolis Center for Health Policy and from Resolve to Save Lives, a public health initiative led by former CDC director Dr. Tom Frieden, have been tracking the data since April.

Panchadsaram thinks of the project as something of a “progress bar” as they grade different states on the overall progress they’ve made in fighting Covid-19. Available hospital beds and ICU capacity is a key indicator they use to assess state performance, he added.

“It’s disappointing. It happened a lot quicker than expected,” he said. “The picture that we’re presenting to the world is incomplete.”

Other coronavirus researchers and public health specialists expressed concern because the policy change was announced so suddenly in the midst of a public health crisis that appears to be worsening.

Dr. Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, which runs one of the most popular third-party coronavirus data dashboards, said the policy change won’t impact the Hopkins site because they’ve managed to source their data directly from states. She added, however, that the policy change raises questions about the transparency of the data and the role of the CDC in the ongoing U.S. response.

“What worries me is that we seem to be pushing rather suddenly in the midst of what feels like a very urgent time in terms of surging cases that we’re seeing across the country,” she told CNBC. “The question is, what are we going to lose in this transition, and in particular at a moment where we really don’t want to lose any ability to understand what’s happening in hospitals.”

Nuzzo expressed concern that the administration didn’t appear to fully plan out how the transition in data reporting would work and didn’t give hospitals or researchers a warning about the change or how it might affect them.

“I think it’s reasonable to worry that it could lead to erosion of capacities at a moment where we very much can’t afford to lose any abilities at this point,” she added. “I don’t fully understand how it’s going to work. That in and of itself is problematic.”

Dr. Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation, echoed Nuzzo’s concerns about the speed with which the decision has become policy. She added that the Trump administration has politicized the public health crisis for months, so the policy change raises concerns about the integrity of the data as well.

“It’s been such a critical source of information for everyone, for states, for researchers, for reporters, for the public to try to understand what’s happening,” she said. “The last thing you want is for data to be politicized. It just raises that concern. Will data being at HHS create a more politicized use of it, or maybe not. But again, it’s a concern that’s been raised.”

President Donald Trump and his administration have come under fire during the pandemic from critics who say the White House is undermining the country’s public health professionals. Last week, Trump criticized the CDC’s guidelines on reopening schools as too tough and expensive, and Vice President Mike Pence said the agency would issue additional recommendations.

“There’s been concerns raised about when CDC has the leeway to offer its advice as a public health agency, really based on the evidence and the data, and there’s been several examples where we’re not clear that that’s been the case,” Kates said. “I think that is a concern that many have; is there any political significance to this change?”
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Re: COVID-19 ongoing thread part 2

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As of today, worldometer measures Covid deaths in US as 141k.

Compared to 2017.

.Covid deaths is equivalent to 6% of the normal death toll.

It is the 2nd leading cause of death in the United States,having overtaken Lung Cancer.

Heart disease kills one person every 40 seconds or approximately 2 people every minute.



Given 199 days since Jan 1, Covid 19 has killed 29 people every hour. It's half a person every minute


Sean Hannity: it's just a bad flu.
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Re: COVID-19 ongoing thread part 2

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https://twitter.com/andishehnouraee/sta ... 61408?s=19
In just 15 days the total number of #COVID19 cases in Georgia is up 49%, but you wouldn’t know it from looking at the state’s data visualization map of cases. The first map is July 2. The second is today. Do you see a 50% case increase? Can you spot how they’re hiding it? 1/ https://t.co/wAgFRmtrPk

Kemp’s health department keeps changing the numbers on the map’s color legend to keep counties from getting darker blue or red. 2,961 cases was Red on July 2. Now a county needs 3,769 cases to show red. The result: an infographic that hides data instead of showing it. 2/

Nearly every day this month Kemp’s health dept has altered the numbers assigned to each color without ever saying so. I take screenshots. Georgia DPH is violating data visualization best practices in a way that’s hiding severity of the outbreak. 3/
Image

There is no coronavirus in Ba Sing Se.
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Re: COVID-19 ongoing thread part 2

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Interestingly looking at the twitter comments, people have attributed Georgia's handling to incompetence rather than malice. Ignoring for a moment if a US geopolitical rival did that we would be accusing them of hiding the data, how the hell do you have incompetence to change the colour code? You would actually have to do work, and decided new values to assign a particular colour onto it then colour it in according to the new code. If you are lazy, its easier to just colour it in according to the old colour code. They are actively changing things in this "incompetent" manner.
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Re: COVID-19 ongoing thread part 2

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mr friendly guy wrote: 2020-07-19 03:53am Interestingly looking at the twitter comments, people have attributed Georgia's handling to incompetence rather than malice. Ignoring for a moment if a US geopolitical rival did that we would be accusing them of hiding the data, how the hell do you have incompetence to change the colour code? You would actually have to do work, and decided new values to assign a particular colour onto it then colour it in according to the new code. If you are lazy, its easier to just colour it in according to the old colour code. They are actively changing things in this "incompetent" manner.
Nah, they've just used relative values, where red is always the top 15% of values in the dataset and dark blue is the next 15% etc. It's easy to see why someone would think that's a good idea when they have six colours to use and probably no training in visual data presentation and just unthinkingly follow the same process. Depending on the software you could probably even automate it.
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Re: COVID-19 ongoing thread part 2

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Vendetta wrote: 2020-07-19 05:42am
mr friendly guy wrote: 2020-07-19 03:53am Interestingly looking at the twitter comments, people have attributed Georgia's handling to incompetence rather than malice. Ignoring for a moment if a US geopolitical rival did that we would be accusing them of hiding the data, how the hell do you have incompetence to change the colour code? You would actually have to do work, and decided new values to assign a particular colour onto it then colour it in according to the new code. If you are lazy, its easier to just colour it in according to the old colour code. They are actively changing things in this "incompetent" manner.
Nah, they've just used relative values, where red is always the top 15% of values in the dataset and dark blue is the next 15% etc. It's easy to see why someone would think that's a good idea when they have six colours to use and probably no training in visual data presentation and just unthinkingly follow the same process. Depending on the software you could probably even automate it.
Yeah, but that's not how it's done.

It's why the Obesity map is now red, instead of just having higher concentrations of red in the South.

What should had happened is that you have a database, which can be done using Excel then update that database accordingly and graph it from there. Instead of plugging in data into a graphing software.

The US is the leader of medical information technology. If a state public health department fucked up so bad, then the rot in the US is irreversible with a simple election.
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Re: COVID-19 ongoing thread part 2

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Image

Carl Sagan says it best. If this is due to Georgia incompetence, then it means that America literally no longer has the brains to stand up against dictators and Idiocracy.
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Re: COVID-19 ongoing thread part 2

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PainRack wrote: 2020-07-19 08:08am Carl Sagan says it best. If this is due to Georgia incompetence, then it means that America literally no longer has the brains to stand up against dictators and Idiocracy.
I could've told you that almost 19 years ago.


Getting back on topic, some interesting things happened while scientists were doing research on cross-immunity between SARS and covid-19. Turns out that half their control group who'd all tested negative for both viruses somehow had an immune response to covid-19. Which means there might be a path to a lasting vaccine if we can figure out what's responsible for the immune response in the control group.
https://www.nature.com/articles/s41586- ... erence.pdf
SARS-CoV-2-specific T cells in SARS-CoV-1/2 unexposed donors

To explore this possibility, we tested NP- and NSP7/13-peptide-reactive IFN-γ responses in 37 SARS-CoV-1/2 unexposed donors. Donors were
Nature | www.nature.com | 3either sampled before July 2019 (n=26) or were serologically nega-tive for both SARS-CoV-2 neutralizing antibodies and SARS-CoV-2 NP antibodies23 (n=11). Different coronaviruses known to cause common colds in humans like OC43, HKU1, NL63 and 229E present different degrees of amino acid homology with SARS-CoV-2 (Extended Data Figs. 1 and 2) and recent data demonstrated the presence of SARS-CoV-2 cross-reactive CD4 T cells (mainly specific for Spike) in SARS-CoV-2 unexposed donors14. Remarkably, we detected SARS-CoV-2-specific IFN-γ responses in 19 out of 37 SARS-CoV-1/2 unexposed individu-als (Fig. 4a, b). The cumulative proportion of all studied individuals responding to peptides covering NP and ORF-1-coded NSP7 and 13 pro-teins is shown in Fig. 4b. SARS-CoV-1/2 unexposed individuals showed a distinct pattern of reactivity; whilst COVID-19 and SARS recovered donors reacted preferentially to NP peptide pools (66% COVID-19 and 91% SARS recovered individuals responded only to NP pools), the unex-posed group showed a mixed response to NP and NSP7/13 (Fig. 4a–c)
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Re: COVID-19 ongoing thread part 2

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Lesson from Israel about reopening schools too early.

https://www.thedailybeast.com/israeli-d ... down-gains
Israeli Data Show School Openings Were a Disaster That Wiped Out Lockdown Gains
GRADING ON THE CURVE
Of 1,400 Israelis diagnosed with COVID-19 last month, 657 (47 percent) were infected in schools. Now 2,026 students, teachers, and staff have it, and 28,147 are quarantined.


Noga Tarnopolsky
Updated Jul. 14, 2020 9:09AM ET / Published Jul. 14, 2020 3:36AM ET

JERUSALEM—Israel’s unchecked resurgence of COVID-19 was propelled by the abrupt May 17 decision to reopen all schools, medical and public-health officials have told The Daily Beast.

“We know Israelis have terrible discipline, but now, it’s the leadership. ”
— Galia Rahav, Sheba Medical Center in Tel Aviv
The assessment of Israel’s trajectory has direct bearing on the heated debate underway in the United States between President Donald Trump, who is demanding a nationwide reopening of schools for what appear to be largely political reasons, and health authorities who caution it could put the wider population at risk.


Importantly, on May 17 in Israel it appeared the virus not only was under control, but defeated. Israel reported only 10 new cases of COVID-19 in the entire country that day. In the U.S., the debate often is about reopening schools where the disease is not only not in decline, but surging.

On Sunday, for instance, U.S. Education Secretary Betsy DeVos told Chris Wallace on Fox News Sunday, “There’s nothing in the data that suggests that kids being in school is in any way dangerous.” But that is not the case in Israel, where the data from June, the last month for which there is a full set of statistics, appear all too clear.

<snip the rest>
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Re: COVID-19 ongoing thread part 2

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Israel went from crushing wave one to breaching every single "red line" that was supposed to roll back to lockdown.

Unfortunately the government lost the mandate for a lockdown and who knows what will happen.
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Re: COVID-19 ongoing thread part 2

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Ace Pace wrote: 2020-07-20 04:10am Israel went from crushing wave one to breaching every single "red line" that was supposed to roll back to lockdown.

Unfortunately the government lost the mandate for a lockdown and who knows what will happen.
Can you explain the last bit about losing the mandate for a lockdown. I thought after months of negotiations the main parties agreed to form government, but I am not exactly well verse in Israeli politics.
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Re: COVID-19 ongoing thread part 2

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mr friendly guy wrote: 2020-07-20 04:50am
Ace Pace wrote: 2020-07-20 04:10am Israel went from crushing wave one to breaching every single "red line" that was supposed to roll back to lockdown.

Unfortunately the government lost the mandate for a lockdown and who knows what will happen.
Can you explain the last bit about losing the mandate for a lockdown. I thought after months of negotiations the main parties agreed to form government, but I am not exactly well verse in Israeli politics.
Having a government doesn't mean anyone cares about what the government says. Instead of polluting the thread with Israeli politic articles, I will try to TL;DR.

The coalition was formed by the main opposition parting splitting, one camp saying "You can't trust Bibi", the other noob camp saying "National emergency forces everyone to make sacrifices". This coalition also included a socialist party that basically shat on voter promises never to sit with Bibi. The coalition agreement also specified it's a lameduck coalition and so didn't start out in the best of situations.

Since then, the corona related measures went from "AHHH, Corona, LOCKDOWN, NOW" to "Nothing to worry about, go back to schools, open malls, keep safe but no one cares" to paternalistic "The population is not acting responsibly, we will be forced to implement measures". Now the government is acting in an entirely political manner, closing down beaches (despite no infections from there) but keeping religious places of worship open. Closing shops without providing economic backing, etc. This matched with economic decisions and medical decisions that are at odds with ministry of health and treasury recommendations.

A series of high profile resignations by senior officials in the ministry of health and treasury departments have also lead to a large distrust and mass feelings that the crisis is being abused for political and authoritarian gains. This alongside articles stating "More than 530 Israeli doctors signed an independent petition in the last few days, slamming the government’s handling of the coronavirus pandemic." have lead many Israelies to distrust official government advice regardless of whether it comes from political or professional figures.

All this leads to the following entirely predictable image.

Image
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Re: COVID-19 ongoing thread part 2

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https://khn.org/news/as-coronavirus-spr ... -icu-beds/

More than half the counties in America have no intensive care beds, posing a particular danger for more than 7 million people who are age 60 and up ― older patients who face the highest risk of serious illness or death from the rapid spread of COVID-19, a Kaiser Health News data analysis shows.





Intensive care units have sophisticated equipment, such as bedside machines to monitor a patient’s heart rate and ventilators to help them breathe. Even in communities with ICU beds, the numbers vary wildly ― with some having just one bed available for thousands of senior residents, according to the analysis based on a review of data hospitals report each year to the federal government.

Consider the homes of two midsize cities: The Louisville area of Jefferson County, Kentucky, for instance, has one ICU bed for every 442 people age 60 or older, while in Santa Cruz, California, that number stands at one bed for every 2,601 residents.



Differences are vast within each state as well: San Francisco, with one bed for every 532 older residents, and Los Angeles, with 847 residents per bed, both have greater bed availability than does Santa Cruz.



Even counties that rank in the top 10% for ICU bed count still have as many as 450 older people potentially competing for each bed.



The KHN findings put in stark relief a wrenching challenge hospitals in many communities — both urban and rural ― could face during the coronavirus pandemic: deciding how to ration scarce resources.



“This is just another example of geography determining access to health care,” Arthur Caplan, a bioethics professor at NYU Langone Medical Center, said when told of KHN’s findings.



Overall, 18 million people live in counties that have hospitals but no ICU, about a quarter of them 60 or older, the analysis shows. Nearly 11 million more Americans reside in counties with no hospital, some 2.7 million of them seniors.



Dr. Karen Joynt Maddox, a professor at Washington University School of Medicine in St. Louis, said that hospitals with larger numbers of ICU beds tend to cluster in higher-income areas where many patients have private health insurance.



“Hospital beds and ICU beds have cropped up where the economics can support them,” she said. “We lack capacity everywhere, but there are pretty big differences in terms of per capita resources.”



Doctors in rural counties are bracing for the possibility they may run out of critical care beds. Northern Light Sebasticook Valley Hospital, in central Maine, has one ventilator and 25 beds. Two of those are “special care” beds that don’t meet full requirements for intensive care but are reserved for the sickest people. Such patients are often transferred elsewhere, perhaps to the city of Bangor, by ambulance or helicopter.



But that may not be possible if COVID-19 surges across the state “because they’re going to be hit just as hard if not harder than we will be,” said Dr. Robert Schlager, chief medical officer at the hospital in rural Pittsfield. “Just like the nation, we probably don’t have enough, but we’re doing the best we can.”



Hospitals also say they can quickly devise plans to transfer cases they can’t handle to other facilities, though some patients may be too ill to risk the move.



Certainly, being in a county with few or no ICU beds may not be as dire as it seems if that county abuts another county with a more robust supply of such beds.



In Michigan, health planners have determined that rural counties with few ICU beds, such as Livingston and Ionia, in the central part of the state, would be served by major facilities in nearby Lansing or Detroit in a major crisis.



Dr. Peter Graham, executive medical director for Physicians Health Plan in Michigan, is affiliated with Sparrow Health System in Lansing. He is making no assumptions. It’s possible central Michigan could take overflow COVID-19 patients from Detroit if that’s where the disease clusters, he said. Or patients might have to be transferred hundreds of miles away.



“It’s just obvious people are going to need to move” if local facilities are overwhelmed, he said. “If we’re able to find a ventilator bed in Indianapolis, in Chicago or Minneapolis or wherever, it is go, get them there!”



Yet experts warn that even areas comparatively rich in ICU beds could be overwhelmed with patients struggling to breathe, a common symptom of seriously ill COVID-19 patients.



“No matter how you look at it, the numbers [of ICU beds] are too small,” said Dr. Atul Grover, executive vice president of the Association of American Medical Colleges. “It’s scary.”



Lenard Kaye, director of the University of Maine Center on Aging, a state with a large older population and relatively few ICU beds, agreed. “The implications are tremendous and very troubling,” he said. “Individuals are going to reach out for help in an emergency, and those beds may well not be available.”



Health workers might need to resort to “triaging and tough decisions,” Kaye said, “on who beds are allocated to.”



That concern isn’t lost on Linnea Olsen, 60, who has lung cancer and knows she is especially vulnerable to any respiratory virus.



Olsen worries about a potential shortage of ventilators and ICU beds, which could lead doctors to ration critical care. Given her fragile health, she fears she wouldn’t make the cut.



“I’m worried that cancer patients will be a low priority,” said Olsen, a mother of three adult children, who lives in Amesbury, Massachusetts.



Olsen, who was diagnosed with lung cancer almost 15 years ago, has survived far longer than most people with the disease. She is now being treated with an experimental medication — which has never been tested before in humans ― in an early-stage clinical trial. It’s her fourth early clinical trial.



“I’m no longer young, but I still would argue that my life is worthwhile, and my three kids certainly want to keep me around,” she said.



She said she has “fought like hell to stay alive” and worries she won’t be given a fighting chance to survive COVID-19.



“Those of us with lung cancer are among the most vulnerable,” Olsen said, “but instead of being viewed as someone to be protected, we will be viewed as expendable. A lost cause.”



The total number of ICU beds nationally varies, depending on which source is consulted and which beds are counted. Hospitals reported 75,000 ICU beds in their most recent annual financial reports to the government, but that excludes Veterans Affairs’ facilities



Doctors in rural counties are bracing for the possibility they may run out of critical care beds. Northern Light Sebasticook Valley Hospital, in central Maine, has one ventilator and 25 beds. Two of those are “special care” beds that don’t meet full requirements for intensive care but are reserved for the sickest people. Such patients are often transferred elsewhere, perhaps to the city of Bangor, by ambulance or helicopter.



But that may not be possible if COVID-19 surges across the state “because they’re going to be hit just as hard if not harder than we will be,” said Dr. Robert Schlager, chief medical officer at the hospital in rural Pittsfield. “Just like the nation, we probably don’t have enough, but we’re doing the best we can.”



Hospitals also say they can quickly devise plans to transfer cases they can’t handle to other facilities, though some patients may be too ill to risk the move.



Certainly, being in a county with few or no ICU beds may not be as dire as it seems if that county abuts another county with a more robust supply of such beds.



In Michigan, health planners have determined that rural counties with few ICU beds, such as Livingston and Ionia, in the central part of the state, would be served by major facilities in nearby Lansing or Detroit in a major crisis.



Dr. Peter Graham, executive medical director for Physicians Health Plan in Michigan, is affiliated with Sparrow Health System in Lansing. He is making no assumptions. It’s possible central Michigan could take overflow COVID-19 patients from Detroit if that’s where the disease clusters, he said. Or patients might have to be transferred hundreds of miles away.



“It’s just obvious people are going to need to move” if local facilities are overwhelmed, he said. “If we’re able to find a ventilator bed in Indianapolis, in Chicago or Minneapolis or wherever, it is go, get them there!”



Yet experts warn that even areas comparatively rich in ICU beds could be overwhelmed with patients struggling to breathe, a common symptom of seriously ill COVID-19 patients.



“No matter how you look at it, the numbers [of ICU beds] are too small,” said Dr. Atul Grover, executive vice president of the Association of American Medical Colleges. “It’s scary.”



Lenard Kaye, director of the University of Maine Center on Aging, a state with a large older population and relatively few ICU beds, agreed. “The implications are tremendous and very troubling,” he said. “Individuals are going to reach out for help in an emergency, and those beds may well not be available.”



Health workers might need to resort to “triaging and tough decisions,” Kaye said, “on who beds are allocated to.”



That concern isn’t lost on Linnea Olsen, 60, who has lung cancer and knows she is especially vulnerable to any respiratory virus.



Olsen worries about a potential shortage of ventilators and ICU beds, which could lead doctors to ration critical care. Given her fragile health, she fears she wouldn’t make the cut.



“I’m worried that cancer patients will be a low priority,” said Olsen, a mother of three adult children, who lives in Amesbury, Massachusetts.



Olsen, who was diagnosed with lung cancer almost 15 years ago, has survived far longer than most people with the disease. She is now being treated with an experimental medication — which has never been tested before in humans ― in an early-stage clinical trial. It’s her fourth early clinical trial.



“I’m no longer young, but I still would argue that my life is worthwhile, and my three kids certainly want to keep me around,” she said.



She said she has “fought like hell to stay alive” and worries she won’t be given a fighting chance to survive COVID-19.



“Those of us with lung cancer are among the most vulnerable,” Olsen said, “but instead of being viewed as someone to be protected, we will be viewed as expendable. A lost cause.”



The total number of ICU beds nationally varies, depending on which source is consulted and which beds are counted. Hospitals reported 75,000 ICU beds in their most recent annual financial reports to the government, but that excludes Veterans Affairs’ facilities


Article written by y Fred Schulte and Elizabeth Lucas and Jordan Rau and Liz Szabo and Jay Hancock MARCH 20, 2020



​published in full as per KHN copyright rules.



​The US has one of the world largest ICU beds capacity in total, but there a vast disparity in numbers when spread out across an entire continent.



​for comparison, Singapore has approximately 1 critical care bed per 131 elderly, although critical care beds aren't neccesarily ICU (high dependency beds included.


And as a funsie. 600 people died in the US of Covid on 20/7. That translates to one person every two minutes approximately.
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Re: COVID-19 ongoing thread part 2

Post by The Romulan Republic »

Cases starting to spike here too. Nowhere near as bad as the Fourth Reich South of the border, thank God, but BC reported 102 new cases (for an average of 34 per day) over the last three day period, the worst being Friday with 51. This is up from around a dozen per day a few weeks ago.

That reopening, not requiring masks in public, and letting airlines ignore social distancing to cram more passengers in having the exactly predictable effect.
"I know its easy to be defeatist here because nothing has seemingly reigned Trump in so far. But I will say this: every asshole succeeds until finally, they don't. Again, 18 months before he resigned, Nixon had a sky-high approval rating of 67%. Harvey Weinstein was winning Oscars until one day, he definitely wasn't."-John Oliver

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Re: COVID-19 ongoing thread part 2

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I think this is actually the best article I've yet read for articulating the covid state of mind, and its effects on psychology and daily living.

https://fivethirtyeight.com/features/ev ... -decision/
It has been a summer of compromises, a season of bending the rules. If I wear a mask and I keep my distance, I can go for a walk with a friend. Hand sanitizer is a bulwark that allows my kids to play on an otherwise empty jungle gym. I believe the backyard has magical properties that will, probably, make it just safe enough to see people and talk to them. In the sun and fresh breeze, we give each other air hugs from six-ish feet away.

Meanwhile, my hair grows, untrimmed, past my clavicle. When my friend, in some ways far more stringent on her social distancing and mask wearing than I am, told me about going in for her first cut since March, I winced involuntarily. I assume it’s roughly the same face that she made when I confessed my masked trip to a clothing store to buy some summer dresses. Both of us know the safest thing — the thing most likely to prevent the spread of COVID-19 — would be to stay at home, alone. But we know we won’t do that now. Can’t do it. The idea of sticking with the safest thing has become almost as unthinkable as indulging in the danger of a movie in a theater or a drink at the bar. But in between those extremes, life has become a sticky bog in which we wade through evidence and convenience, hoping we’re stepping on solid ground.

[Related: Where The Latest COVID-19 Models Think We’re Headed — And Why They Disagree]

We can’t live like we did before coronavirus. We won’t live like we did immediately after it appeared, either. Instead, we’re in the muddy middle, faced with choices that seem at once crucial and impossible, simple and massively complicated. These choices are an everyday occurrence, but they also carry a moral weight that makes them feel different than picking a pasta sauce or a pair of shoes. In a pandemic that’s been filled with unanswerable questions and unwinnable wars, this is our daily Kobayashi Maru. And no one can tell us exactly what we ought to do.

Not that there haven’t been attempts at providing structure.

Right now, you can go online and find multiple charts that will visually categorize what were once the activities of daily life by risk level. Some of these charts are evidence based, compiled by experts and (in my opinion) genuinely helpful. I particularly liked the one designed by epidemiologist Saskia Popescu and bioethecist Ezekiel Emanuel because it lays out not just the risk levels of various behaviors — getting a haircut, visiting the dentist, buying a new shirt — but also the underlying factors that can make an activity more or less risky. In general, research has shown that indoors is riskier than outside, long visits riskier than short ones, crowds riskier than individuals — and, look, just avoid situations where you’re being sneezed, yelled, coughed or sung at.


But the trouble with the muddy middle is that a general idea of what is riskier isn’t the same thing as a clear delineation between right and wrong. These charts — even the best ones — aren’t absolute arbiters of safety: They’re the result of surveying experts. In the case of Popescu’s chart, the risk categorizations were assigned based on discussions among herself, Emanuel and Dr. James P. Phillips, the chief of disaster medicine at George Washington University Emergency Medicine. They each independently assigned a risk level to each activity, and then hashed out the ones on which they disagreed.

Take golf. How safe is it to go out to the links? Initially, the three experts had different risk levels assigned to this activity because they were all making different assumptions about what a game of golf naturally involved, Popescu said. “Are people doing it alone? If not, how many people are in a cart? Are they wearing masks? Are they drinking? …. those little variables that can increase the risk,” she told me.

Golf isn’t just golf. It’s how you golf that matters.

Those variables and assumptions aren’t trivial to calculating risk. Nor are they static. There’s different muck under your boggy feet in different parts of the country, at different times. For instance, how safe is it to eat outdoors with friends? Popescu’s chart ranks “outdoor picnic or porch dining” with people outside your household as low risk — a very validating categorization, personally. But a chart produced by the Texas Medical Association, based on a survey of its 53,000 physician members, rates “attending a backyard barbeque” as a moderate risk, a 5 on a scale in which 9 is the stuff most of us have no problem eschewing.

When we first noticed this apparent contradiction at FiveThirtyEight, some of us joked about how maybe a Texas barbecue wasn’t the same thing as a picnic in New York or Minnesota. Ha ha, everything’s bigger in Texas, even the guest list. But, come to find out, yeah, that’s actually exactly the deal.

“There’s not an ounce of social distancing. And different sauce,” said Mark Casanova, a Dallas palliative care specialist and member of the Texas Medical Association’s COVID-19 task force, summing up what makes a Texas barbecue different. When he rated a backyard barbecue, he was thinking of a crowded event, where people roam from indoors to out and back again, and masks are scarce. When he was ranking risk, he was trying to think about real-world behavior, not necessarily the way to do each activity most safely. “It’s like going to a bar and saying, ‘Well, I’ll just sit by myself.’” Casanova said.

Experts like Popescu and Casanova have focused on harm reduction — the same philosophy that leads thousands of American gym teachers to demonstrate putting condoms on bananas. We know, from basic understandings of human behavior, that people are going to do a thing (have sex, that is, not put condoms on a banana). So how can we help them be safer?

But we’re used to safer sex — we’re not used to safer daily existence. The muddy middle is frustrating not because we’ve never found ourselves in this type of quagmire before, but because the scale of the swamp is so vast and because, just yesterday, it was a garden.

We are faced with too many choices — not just what to do, but how to do it and when and where. The stakes are high, 140,000 people are dead in the U.S. and death rates are starting to climb again. And because of those stakes, we’ve assigned a morality to all these choices — something that psychology researchers have shown leads us to frame things as “all good” or “all bad” and lose sight of the gray areas all around us. We’re all bogged down and floundering, questioning our own goodness while we arch our eyebrows at our friends and argue over whose patch of muck is really solid ground.

In some ways, it would be easier to just not care, to be one of those people who see no difference among a park, a swamp and the rim of an active volcano, to be one of those people who is mentally living six months ago. Then I could cheerfully traipse from my backyard to a neighbor’s driveway and then on to a dark corner booth somewhere with no worries. No stress. It would hardly even be a decision. Maybe I could even get angry about stores and cities setting up rules and see something like a mask requirement as a violation of my freedoms. Then I could be oblivious to the far more terrible freedom of the muddy middle — where everything is a choice, and they’re all mine to make and to live with.
"I know its easy to be defeatist here because nothing has seemingly reigned Trump in so far. But I will say this: every asshole succeeds until finally, they don't. Again, 18 months before he resigned, Nixon had a sky-high approval rating of 67%. Harvey Weinstein was winning Oscars until one day, he definitely wasn't."-John Oliver

"The greatest enemy of a good plan is the dream of a perfect plan."-General Von Clauswitz, describing my opinion of Bernie or Busters and third partiers in a nutshell.

I SUPPORT A NATIONAL GENERAL STRIKE TO REMOVE TRUMP FROM OFFICE.
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Re: COVID-19 ongoing thread part 2

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https://www.medscape.com/viewarticle/93 ... 0267&faf=1
CDC to Urge Against Repeat Testing After COVID Illness Resolves
Alicia Ault

July 16, 2020

The US Centers for Disease Control and Prevention (CDC) is preparing guidance that will urge against repeated diagnostic testing for SARS-CoV-2 in individuals who have been infected and have had a resolution of symptoms.

"We need to decrease unnecessary testing," said Admiral Brett P. Giroir, MD, assistant secretary for health at the US Department of Health and Human Services, on a call with reporters. If someone has had COVID-19, it is not necessary "to be re-tested to prove that you’re no longer positive," said Giroir.

The CDC had recommended initially that cruise ship passengers or those under quarantine have two negative tests 24 hours apart to be able to leave quarantine, said Giroir.

But the science has advanced, and "we know that is no longer necessary," he said, adding that the CDC is close to making its new recommendation public.

"We know that if you are 10 days since the onset of your symptoms and at least 3 days [asymptomatic], and that may actually go down in the future, but 3 days asymptomatic, you are no longer contagious," Giroir said.

He added that some individuals are being tested three or six times, which is not necessary, at least for the average individual who has been isolating at home.

Repeat testing will still be recommended for the critically ill and individuals with immunosuppression or immune deficiencies, said Giroir. People who fall into a grey area will need to consult with their clinicians, he said.

The repeat tests are "clogging up the system," Giroir said. He also added that they can be a "disservice" to some people, as they might stay out of work longer if they continue to test positive when they are no longer infectious.

When asked whether the forthcoming CDC guidance is a means of preserving test supplies and capacity, Giroir took issue, and said he "didn’t like the implications" of the question.

The CDC recommendation will be based on medical science, and is "not a result of shortages," said Giroir.

Repeat testing is not medically necessary, he said: "If we thought it was necessary to re-test people we would say so."

Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including Smithsonian.com, the New York Times, and the Washington Post. You can find her on Twitter @aliciaault.
This is interesting. In WA someone gets retested on day 11 as I just found out the other day when a whole family presented to the GP practice instead of the covid clinic (they are negative by the way). From the Chinese experience with hospitalisations they test twice after symptoms have improved, and there is still some who die from "reinfection" but this may simply be they didn't clear it completely despite what the test shows (operator error, limits of tech etc). Which prompted some to suggest 3 tests, which would make a total of 4 including the initial test.

What this article is suggesting applies to less sick patients, mainly those being isolated without requiring hospitalisation. Some people are being tested 3 to 6 times as per the article. To which I ask, why not just test 2 to 3, the first one to diagnosed, and 1 or 2 tests to see if you have cleared the virus. Someone was being tested six times?
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Re: COVID-19 ongoing thread part 2

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https://www.reuters.com/article/us-heal ... SKCN24M1NK
People are more likely to contract COVID-19 at home, study finds
Sangmi Cha
2 MIN READ

SEOUL (Reuters) - South Korean epidemiologists have found that people were more likely to contract the new coronavirus from members of their own households than from contacts outside the home.

A study published in the U.S. Centers for Disease Control and Prevention (CDC) on July 16 looked in detail at 5,706 “index patients” who had tested positive for the coronavirus and more than 59,000 people who came into contact with them.

The findings showed just two out of 100 infected people had caught the virus from non-household contacts, while one in 10 had contracted the disease from their own families.

By age group, the infection rate within the household was higher when the first confirmed cases were teenagers or people in their 60s and 70s.

“This is probably because these age groups are more likely to be in close contact with family members as the group is in more need of protection or support,” Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention (KCDC) and one of the authors of the study, told a briefing.

Children aged nine and under were least likely to be the index patient, said Dr. Choe Young-june, a Hallym University College of Medicine assistant professor who co-led the work, although he noted that the sample size of 29 was small compared to the 1,695 20-to-29-year-olds studied.

Children with COVID-19 were also more likely to be asymptomatic than adults, which made it harder to identify index cases within that group.

“The difference in age group has no huge significance when it comes to contracting COVID-19. Children could be less likely to transmit the virus, but our data is not enough to confirm this hypothesis,” said Choe.

Data for the study was collected between Jan. 20 and March 27, when the new coronavirus was spreading exponentially and as daily infections in South Korea reached their peak.

KCDC has reported 45 new infections as of Monday, bringing the country’s total cases to 13,816 with 296 deaths.
This suggests that its more prudent to isolate positive cases away from family. China did this to break transmission in converted convention centres or sports stadiums. I should note in the first COVID thread the NYT criticised them for doing this. :lol:
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Re: COVID-19 ongoing thread part 2

Post by mr friendly guy »

Browsing my youtube subscriptions, and the David Pakman shows has a video on how one governor is just out of ideas and just asking for prayers and fasting to cure the coronavirus. So searching around, I can't seem to find much on the first few pages of google aside from Fox and some religious news sites

https://www.catholicweekly.com.au/us-go ... d-fasting/
An entire US state is asked to pray for end to COVID-19
Louisiana’s governor will be skipping lunch next week, and is encouraging Louisianans of all faiths to do the same.

The governor has called for three days of prayer and fasting for people affected by coronavirus. New Orleans’ archbishop says he hopes Catholics of the state will join in.

During a press conference on Thursday to discuss the south eastern US state’s response to COVID-10, Governor John Bel Edwards acknowledged that his latest attempt to stop the spread of coronavirus is “a little bit unusual”, but said he believes it will bear fruit for the state.

“IF YOU’RE INCLINED, PLEASE JOIN ME AND THE FIRST LADY AND FAITH LEADERS OF LOUISIANA, REGARDLESS OF YOUR DENOMINATION OR YOUR RELIGION”

“I’m going to call for three days of fasting and prayer for our state, for July 20 through the 22nd,” said Edwards, explaining that he received a request for the spiritual practice during a call with religious leaders from across the state.

Prayer and fasting are “a spiritual diet and exercise that I as a Catholic Christian believe is very important, anyway,” said Governor Edwards.

The governor said he will be fasting from lunch Monday through Wednesday of next week, and “praying for the people of Louisiana,” especially the sick, their caretakers, and the families of those who have died from COVID-19.
Praying is bullshit, but most probably not harmful in an of itself. Fasting could be a problem if you're a diabetic, or if you actually have the coronavirus you most likely need food to provide energy so you can fight it.
Never apologise for being a geek, because they won't apologise to you for being an arsehole. John Barrowman - 22 June 2014 Perth Supernova.

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