Page 57 of 172
Posted: Tue Mar 17, 2020 8:15 am
steveo73 wrote: ↑
Tue Mar 17, 2020 3:18 am
She is still getting paid but her boss is putting pressure on her to come into work. She has no problems refusing. It's work from home or sick leave. If they aren't cool with that she will quit.
She should stand firm and dare them to fire her, which they won't.
Posted: Tue Mar 17, 2020 9:00 am
More news from the Lancet on ibuprofen.
https://www.thelancet.com/journals/lanr ... 8/fulltext
Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels. The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs). Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.
Suggestions on alternatives to ibuprofen as a fever reducer that does not increase ACE2 expression?
Important Note: This is not a study. It is a hypothesis. Buyer beware.
ETA: I believe Turmeric is an ACE inhibitor so I have stopped adding it to my daily tea for the time being. I might be reading this wrong.
ETA2: No simple answers: http://www.nephjc.com/news/covidace2
Posted: Tue Mar 17, 2020 9:32 am
@Ego French MoH is suggesting acetaminophen as alternative.
Though there's also the school of thought you should avoid taking fever reducers when you're sick.
Posted: Tue Mar 17, 2020 9:35 am
Italy 2,158 dead out of 27,980 infected. 7.7% mortality rate. Yes, their population might be aged. But consider:
- The Lombardy region's health care system is close to the best there is in a world-wide context (unsure how it ranks in developed countries)
- Italy was Europe's first hotspot. Thus, there are still regions of the world which can assist with humanitarian shipments. No one is getting 31 tonnes of medical supplies from here on.
- So far, with the exception of Iran where we have no reliable figures, the hotspots have been either in developed, well-resourced nations (SK, IT, HK, SG) or, if you want to pull teeth about China, in a country which has a vast base of resources and the ability to mobilize it (I don't see anyone else shipping 10k medical personnel from another part of their country to a hotspot area, bulldozing roads to secure quarantine, or ordering producers of PPE to roll, or else).
Given this, I will not be surprised if developing countries come closer to a 10-15% cfr rather than the previously hypothesized 3.5%, or even Italy's 7.7%. This holds particularly true for developing countries with ageing populations, such as the former eastern bloc. I am still keeping my fingers crossed for Africa, India, Pakistan, etc., where healthcare infrastructure is weak but the population is on average younger.
Posted: Tue Mar 17, 2020 10:18 am
Consider that the numbers quoted are only detected cases, so mortality rate calculated by deaths/detected cases is way overstated. The more people become ill, the lower %age of them is tested and we might soon be in a situation when only the 15% who require hospitalization and go to the hospital are tested (since everyone else, i.e. the 85% with no to mild symptoms just stay home and self-isolate). So, if 'true' death rate is 3%, but you divide 3/15 and not by 100, you'll get a 20% mortality rate instead of 3%.
Posted: Tue Mar 17, 2020 10:46 am
Microsoft is tracking the cases in a nice map graph that’s being updated as they get new information:
Posted: Tue Mar 17, 2020 10:49 am
We can already estimate the true death rate in some circumstances based on South Korean numbers. However, until countries start doing random sampling of say 5000 people regardless of whether they're healthy or not, we won't know. Now, they're probably not going to do that because the answers they want now are more localized/the spread is still localized, so it would be a waste of tests. Anyway ... we'll know better in a couple of months or when the infection is fully saturated whether that's in controlled quarantine zones or entire countries if all they did was close the borders externally.
Here's my best estimate based on SK.
If the ICU system is not overwhelmed, then the true case fatality rate is 0.7% (for a country with SK demographics and health stats). We know this because SK has not dropped the ball and also tested widely and inexpensively. Since they have not tested everybody, this is of course an upper estimate, but it just might not be all that much lower than this(?)
Since only half of ICU patients survive, the fatality rate with an overwhelmed ICU system (most don't have access) is 1.4%.
Since 15-20% of those admitted to the hospital ends up in ICU, it kinda depends on what would have happened if they couldn't have have gone. That I don't know, so I can only give the possible range. If they all survived, then the true number stays at 1.4%. If they all died, the CFR increases to 7-9.3%.
The correct number of ultimate deaths for the countries where the system was/gets swamped would be somewhere between 1.4% and 9.3%.
That's out of everybody---if everybody could be tested---at the end of the day(*). Keep in mind that while 20 and 30 yos have a high survival rate, a non-trivial percentage still end up in the hospital insofar it's still available. If seriously sick, triage measures also prioritize the young and healthy, since they already have the best odds.
(*) The end of 2021 more likely.
Posted: Tue Mar 17, 2020 10:58 am
@Jacob, I think you are right with your estimate end of 2021! The outbreak can/will rebounce ( see China) Its helps to make good assumptions how things will develop. And then to make your (my) own plans based on a realistic outlook. It helps too to make yourself a realistic mental picture.
Posted: Tue Mar 17, 2020 11:09 am
@C_L- Curious where you see 41k on that site? The total tests given is showing ~27k on my end. Either way, happy things are trending upwards.
Posted: Tue Mar 17, 2020 11:11 am
Augustus wrote: ↑
Tue Mar 17, 2020 10:58 am
Can we clarify what you mean by hospitalization. Will they die without it? That would make the mortality rate 20% when hospitals are overloaded...
I don't think we know those numbers yet (because of the iceberg factor). At least I can't think of a way to extract them from the data. We should know soonish since countries which have run out of testing capacity and are pursuing a mitigation strategy ONLY tests those who make it to the hospital. Presuming that people don't die at home, we can extract the rate based on the "official number" vs the "shadow number".
Posted: Tue Mar 17, 2020 11:28 am
@AnalyticalEngine- The director of the virology lab at U of Padua (in Italy) suggests that as few as 10% of those infected show any symptoms. He tested over 3,000 people in one of the initial clusters.
Here is the translated summary of the report: https://threadreaderapp.com/thread/1239 ... 77760.html
According to Crisanti, the director of the virology lab of U Padua, as little as 10% of #COVID2019 carriers show any symptoms at all. He sampled repeatedly the entire 3k+ population of Vo ', one of the initial clusters.
He managed to virtually eliminate the disease in Vo', by testing not only the symptomatic patients to confirm they had the disease, but all of their contacts in the preceding days. These were then tested even if they did not show symptoms. And in fact 9/10 of positives did not
show any symptoms. It is these asymptomatic carriers that were doing the bulk of the spreading, at least after the initial measures were put in place. This means social isolation alone is not effective, or at least not efficient. He +- eliminated the disease in Vo' by :
1} confirming the disease in symptomatic walk-ins 2) testing all possible contacts, REGARDLESS OF THE PRESENCE OF SYMPTOMS 3) securely quaranteeing all positives. Now the only people in Vo' with Covid19 are asymptomatic carriers in isolation.
The original report in Italian: https://www.sanitainformazione.it/salut ... lo-veneto/
Posted: Tue Mar 17, 2020 11:35 am
Are any other countries doing this? <UK manufacturers to regear factories to build ventilators for NHS>
https://uk.finance.yahoo.com/news/uk-ma ... 09609.html
There are also plans to turn (soon empty anyway) hotels into hospitals. Also, all non-essential operations postponed for 3 months.
Posted: Tue Mar 17, 2020 11:55 am
What do you guys think about temperature and humidity?
It seems most cases are located within climates with lower temperatures: https://imgur.com/VjbZA0v
Summer in the northern hemisphere could help wipe it out.
https://papers.ssrn.com/sol3/papers.cfm ... id=3551767
Posted: Tue Mar 17, 2020 12:01 pm
A local comp sys grad has created a tracking site that does seem only Canada-focused at first, but he does provide global statistics as well in map and table form if you scroll about a third of the way down.
Posted: Tue Mar 17, 2020 12:10 pm
108 Indians have contracted the disease.
In tabular form https://www.mohfw.gov.in/
Posted: Tue Mar 17, 2020 12:41 pm
Thanks for the link, @theanimal. It would mean this disease behaves somewhat like polio if it were true. That being said, given this is in somewhat contradiction with other sources, I'm going to hold out until it's peer reviewed before I consider it to supersede other sources.
From a behavioral standpoint though, it's helpful to act as if everyone is an asymptomatic carrier and that you are also an asymptomatic carrier if you've been in public/exposed though. It really means one should practice extreme social distancing even if your friend etc isn't showing symptoms. And even if you catch an asymptomatic version, it's concerning because you wouldn't want to be a carrier and infect others.
Posted: Tue Mar 17, 2020 1:53 pm
thedollar wrote: ↑
Tue Mar 17, 2020 11:55 am
What do you guys think about temperature and humidity?
It might be an assist, but looking at the worldwide map of where cases are not stopping (Brazil, many countries in Africa), I don't think it will stop COVID-19 spread.
Posted: Tue Mar 17, 2020 1:59 pm
Augustus wrote: ↑
Tue Mar 17, 2020 10:58 am
Can we clarify what you mean by hospitalization. Will they die without it? That would make the mortality rate 20% when hospitals are overloaded, which seems much higher than what we're actually seeing. I'm not talking about seeing a Dr and getting medication, I mean actually needs to be in a hospital and will die without it.
To me, patients are hospitalized when the admitting physician determines they need help beyond bed rest. Some patients can, for instance, survive pneumonia on their own, but it's not easy and a physician is almost always going to admit a patient showing pneumonia symptoms. I believe the patients for COVID-19 that have breathing difficulties are the ones being admitted otherwise there's little reason to prescribe more treatment beyond bed rest.
Posted: Tue Mar 17, 2020 2:14 pm
Went for groceries this morning. Towards the end, while near the checkout registers, there was a couple hugging. As I passed by, I overheard him say, "I feel awful. I'm all hot and sweaty." Eeeek! We scurried home and washed. Twice. Yes, I think that was my last trip for groceries for the foreseeable future.
Safeway produce guy was setting things out and we chatted a bit. He says the lead time for ordering produce is 5 weeks and they're selling twice what they normally sell. His shelves are empty by the afternoon.
Orowheat bread guy was also setting loaves of bread on the shelves. He says their warehouse is empty and the supply chain is thin at this point, no trucks scheduled to arrive for a couple days. Not much help there if you want bread tomorrow and didn't buy today!
Posted: Tue Mar 17, 2020 2:23 pm
California governor Newsom decreed a moratorium on most foreclosures and evictions.