COVID-19

[George the original one]

State of Washington published count as of 3:00p Thu, 19 Mar
- 1524 Positives
- 21719 Negatives
- 83 deaths

Cases by County (County seats)
- 2 Benton (Prosser)
- 2 Chelan (Wenatchee)
- 1 Clallam (Port Angeles)
- 6 Clark (Vancouver)
- 1 Columbia (Dayton)
- 1 Cowlitz (Kelso)
- 2 Franklin (Pasco)
- 8 Grant (Ephrata)
- 1 Grays Harbor (Montesano)
- 19 Island (Coupeville)
- 4 Jefferson (Port Townsend)
- 793 King (Seattle)
- 12 Kitsap (Port Orchard)
- 4 Kittitas (Ellensburg)
- 2 Klickatat (Goldendale)
- 1 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 1 Mason (Shelton)
- 83 Pierce (Tacoma)
- 25 Skagit (Mount Vernon)
- 385 Snohomish (Everett)
- 11 Spokane (Spokane)
- 6 Thurston (Olympia)
- 10 Whatcom (Bellingham)
- 10 Yakima (Yakima)
- 133 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 8% 0-29
- 13% 30-39
- 13% 40-49
- 16% 50-59
- 16% 60-69
- 16% 70-79
- 16% 80+

Cases by Sex at Birth
- 51% Female
- 46% Male
- 3% Unknown

269 new cases. Two new counties: San Juan (Friday Harbor) and Stevens (Colville). Still surprised they haven't begun a lockdown.

State of Washington published count as of 3:00p Thu, 19 Mar
- 1793 Positives
- 25328 Negatives
- 94 deaths

Cases by County (County seats)
- 7 Benton (Prosser)
- 3 Chelan (Wenatchee)
- 2 Clallam (Port Angeles)
- 9 Clark (Vancouver)
- 1 Columbia (Dayton)
- 2 Cowlitz (Kelso)
- 2 Franklin (Pasco)
- 11 Grant (Ephrata)
- 1 Grays Harbor (Montesano)
- 19 Island (Coupeville)
- 4 Jefferson (Port Townsend)
- 934 King (Seattle)
- 15 Kitsap (Port Orchard)
- 4 Kittitas (Ellensburg)
- 4 Klickatat (Goldendale)
- 2 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 1 Mason (Shelton)
- 95 Pierce (Tacoma)
- 1 San Juan (Friday Harbor)
- 28 Skagit (Mount Vernon)
- 447 Snohomish (Everett)
- 16 Spokane (Spokane)
- 1 Stevens (Colville)
- 9 Thurston (Olympia)
- 14 Whatcom (Bellingham)
- 13 Yakima (Yakima)
- 133 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 8% 0-29
- 14% 30-39
- 13% 40-49
- 17% 50-59
- 16% 60-69
- 15% 70-79
- 14% 80+

Cases by Sex at Birth
- 50% Female
- 45% Male
- 6% Unknown

[bigato]

Maybe it will be only a temporary withdrawal symptoms phase that will eventually be over? I suspect so.
I'm doing perfectly fine, but then again I started thursday night. But I'm used to staying put and indoors.

[classical_Liberal]

@J+G
I've been self isolating with the GF since last week, when the first case showed up in my hospital unit. I haven't had any symptoms, but figure if presymptomatic transmission is possible and I'm at high risk for exposure... I just don't want that on my conscious. I've been fine so far, but had been working, now in a period of off days and I'm getting a bit stir crazy, but not too bad. I alternate my activities between massive anxiety/predicting worst case scenarios, and distraction (TV, video games, reading). The GF is more social and it's taking its toll on her more than me. Plus she's not working since they cancelled all schedule surgeries. She's on a list to help out in other departments if it gets to the point they just need warm bodies with any medical experience, but hasn't gotten there yet regionally.

[Ego]

HT to Tim Ferriss

Study shows that ventilators can be split among two or four patients.
https://youtu.be/uClq978oohY

I thought I scored an oxygen concentrator for $4 but it turned out to be a c-pap machine. Hah!

Turns out someone hacked that exact cpap machine into a non-invasive PPV (positive-pressure ventilator).

https://youtu.be/n57u1NvXBgw

I also picked up a second-hand BVM a while ago so The Ego No Mercy Hospital is now complete

[FRx]

The propublica article Jacob posted is quite informative. But ARDS is ARDS - it can happen from tons of causes and we see quite a decent amount of it in the hospital, in the ICU's. ARDS presents in all sorts of manners in all different types of patients. And the act of ventilating someone alone can cause certain lung damage which is sometimes unavoidable but also sometimes simply overaggressive management.

In some of the clinical websites where I'm following case presentations (since my medical boards or medical bodies for some reason aren't sharing the statistics openly with us physicians) the definition of otherwise "healthy 30/40 yo" is quite different from what you guys and I define as healthy. The occasional smoker, daily drinker, once-a-month yogi, processed food eater, and obese person is considered normal. As in, they aren't on any medications so they are considered healthy.

This isn't to say that young people don't die of bacterial or viral pulmonary infections, sure they do. But these statistics and the reality have to be analyzed post-mortem. Again, the hospitals and healthcare industry isn't releasing this information which is blowing my mind every which way. How do I, as a community physician on the front lines, not have access to every single case file of any patient admitted or screened for COVID-19? I get the HIPAA argument but maybe as a profession we have gone the wrong direction with protected health information.

[steveo73]

How do I, as a community physician on the front lines, not have access to every single case file of any patient admitted or screened for COVID-19?

It's completely bonkers.

[George the original one]

New York's hospitalization rate is 15% (nearly 1-in-7), but I wonder if it will climb to the expected 20% (1-in-5) as cases begin to age. They're now testing more per capita than China or South Korea.

https://www.aol.com/article/news/2020/0 ... /23957395/

[fiby41]

Local trains (intercity) shutting from today midnight. Attendance requirement reduced to 5%.Today's janata curfew saw favourable response according to the view from my verandah.

[Will]

There's no lockdown here in the Netherlands yet, and the weather has been great this weekend. As a result the beaches and national parks are full, and authorities are now asking people to please stay home. The previously introduced rule to keep 1,5m distance from eachother is not maintained by many people. I hope they will introduce a lockdown very soon, infections are still growing exponentially here with no sign of slowing down. Even more worrying is that very few people are being tested, you basically have to be hospital material to become eligible for a COVID test. This urgently has to change, because at this pace our fate will match the situation of Italy, if not worse.

My wife is German and her parents are living there. I already floated the idea of leaving to Germany if Germany announces a lockdown before the Netherlands does. As a bonus, Germany has more hospital capacity and tests much more than here. My wife doesn't want to because she's not sure if she can manage being with her parents for more than a week, though it might be the safer option.

[George the original one]

Oregon & Washington tourists have been flowing into the beach communities the past couple of days. Generally daytrippers, though some probably are keeping their spring break reservations. Warrenton (about 13 miles north of my town of Seaside and next to Astoria) passed a resolution Saturday night that makes it illegal for people who live outside the city limits to stay the night, including the several hundred campground sites.

"The situation meets every definition of a clear and present danger," Warrenton Mayor Henry Balensifer told the Statesman Journal. "We had people flooding our shores and town from areas that are hotspots for the virus(*), treating it like a normal spring break."
[...]
The order does not outlaw people from visiting the city during the day, "although we strongly discourage it right now," Balensifer said.

https://www.msn.com/en-us/news/us/coron ... r-BB11wxhE

(*) Washington County, home of Intel, Nike, & Tektronix, has 31% of Oregon's 137 cases. It is next door to Portland.

[avanishk]

There seemed to be a great response to Janata curfew proposed by PM across India. Hope this helps flatten the curve.
Karnataka and couple of other states across India have either implemented lock down or are in process of doing that.

[Tyler9000]

The simplest explanation is different testing strategies/capabilities between different countries(*). This screws with the denominator.... The CFR being bantered around is just dead/(tested positive)

Good point. And supporting that, here's some interesting data about how Italy's numbers may be inflated because of how they track COVID-19 deaths.

But Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities.

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.

“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity - many had two or three,” he says.

https://www.telegraph.co.uk/global-heal ... ied-italy/

[George the original one]

Dead is dead.

[Ego]

We are seeing some absolutely crazy proposals for the economic crisis from serious people who are practicing the, "throw it against the wall and see what sticks" method of problem solving.

We don't have signatures here but I think I will be adopting my favorite quote as my signature for the near future.

"The chief cause of problems is solutions", Eric Sevareid

[ertyu]

On TV in my country: a special on how successful China was with dealing with the virus and how now they are sending medical teams and humanitarian aid to other affected countries + how their industry is restarting (and presumably ready to export). In addition to humanitarian aid, the Chinese embassy has offered supposedly preferential rates on PPE etc. should we want to buy it from them.

Tbh I admire the 4d chess. The US dropped the ball on this one, both domestically and geopolitically. Americans are too busy navel-gazing - and will soon be too busy with the sheer scale of what will come - but I wonder if they will manage to regain their position as a world leader after the trump presidency + this botched pandemic response. China is playing this very very intelligently.

[20sharkall03]

Coming from NE Wisconsin the results are varied in terms of what measures are being implemented individually.

My workplace is taking this very seriously. All meetings have been cancelled or reworked to be held remotely. Social distancing is enforced and working from home went from 0% to 70% in less than two weeks time. Given that we manufacture some of our own product 100% is not possible. I actually purchased a new computer yesterday (our iMac was 11 years old) in order to have most modern APP and OS specs if I am forced to run remotely. I am less concerned about catching the virus than the economic ramifications that will burden society. Having started with my current employer 4 weeks ago still going through my training program for my project management position does produce some light anxiety.

Personally I have limited my interactions as much as possible in my workplace but I am still venturing out weekly for groceries and basic household supplies. Children are off from school and my wife is an educator so she is home all day. Their risk of catching anything is nearly 100% related to my actions. DW and children have not interacted with anyone outside a couple close friends for two weeks unless they face time grandparents.

Cases in Wisconsin are much like the rest of the United States: increasing quickly and hospitals are at 98% capacity.

Side note: Last week I ate something that caused food poisoning. No cough, no runny nose or anything but was diuretic for 7 days and had a 101 fever for two days. Went to the urgent care after 7 days to be told to go home drink lots of fluids. Very little concern from staff that I had contracted COVID given that I have not travelled more than 10 mile from home in probably 2 months.

[Toska2]

Dead is dead.

I dislike that sentiment. It confounds who had weeks to live and who had decades. As bad as the data is, labeling a death due to the final moment is obscuring the truth. Might as well say drunk driving doesnt kill people, its the sudden stop.

[Seppia]

The US dropped the ball on this one, both domestically and geopolitically. Americans are too busy navel-gazing - and will soon be too busy with the sheer scale of what will come - but I wonder if they will manage to regain their position as a world leader after the trump presidency + this botched pandemic response. China is playing this very very intelligently.

Indeed
China has been sending containers of masks for free, and a team of specialists from Wuhan landed in Milan about a week ago to help.
They are trying to do the exact opposite of what Trump has been doing for his whole presidency.
Smart propaganda, which will probably have long lasting effects.
I think some Americans are underestimating how destructive for the USA brand president Trump has been. I would think it is very reversible in case of a very clear loss in the election*, but a second term may make the damage irreparable.

*europeans still know what to choose between a capitalist democracy and a communist dictatorship.

[ertyu]

Also, notice that China singlehandedly repositioned itself as the export powerhouse of the world when most of the developed world is still under quarantine. Two months ago (before covid started) they were fucked. Now they just might not be. I wonder what the global macro implications will be here.

[Jason]

Andrew Cuomo has secured his position as a (possibly "the") Democratic frontrunner in 2020 (if Biden wins he has stated he will be one term). New York now has 5% of the world's total cases and he is working this like Guiliani did 9/11.