COVID-19

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Ego
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Re: COVID-19

Post by Ego »

@jacob
I keep seeing accounts like that from anonymous sources but then look at the statistics of age/comorbidities and the two don't seem to compute. There is a lot of motivation to convince the young to go along with the lockdown. They are disproportionately paying the price for it. I've experienced some hysterics here already.

The proposed mechanism for relief has made me somewhat nervous...

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jacob
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Re: COVID-19

Post by jacob »

@Ego - Even with the comorbidities, there are bound to be some exceptions that are publishable. It's not inconceivable that these cases are being played up to change people's behavior (similar to the official advice that facemasks for the public are not needed). OTOH, it could also be that the number of young people most of whom didn't take it seriously 2-3 weeks ago is escalating rapidly because thinking themselves invulnerable they've been out socializing and spreading it to each other to a greater degree than the elderly.

I've seen the trillion dollar thing before. It's a way to get around congress's recurrent debt ceiling circus.
See https://en.wikipedia.org/wiki/Trillion-dollar_coin

Add: Also https://www.bloomberg.com/news/articles ... -it-can-be ... which bears out the Italian hospital numbers posted upthread. A significant number (20%) of those who are hospitalized are young people (<40yo). They are less likely to go into critical and almost all survive UNLESS they have underlying issues. From a triage perspective, this is good news if you're under 40, because you're more likely to get a ventilator.

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Sclass
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Re: COVID-19

Post by Sclass »

@jacob that was terrifying.

So nothing seems to compute. I’m completely confused about the CFR variation from country to country. It’s like it almost another strain hitting some places. Different immune histories or long term use if prescription meds like ACE inhibitors in some populations? So confusing.

Some get through it and get to talk about their symptoms being flu like. Then there’s this vacuum bottle of pink fluid thing. I saw some videos of ICUs in Italy and saw a vacuum bottle half filled with blood in the background...red not pink. It was like a pint had been sucked out of the guy. They blurred his face but not the bottle. Looked like Spanish flu. :o Part of me was hoping it was a transfusion but it sure looked like drainage.

jacob
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Re: COVID-19

Post by jacob »

Sclass wrote:
Sat Mar 21, 2020 3:21 pm
... the CFR variation from country to country. It’s like it almost another strain hitting some places. Different immune histories or long term use if prescription meds like ACE inhibitors in some populations? ...
The simplest explanation is different testing strategies/capabilities between different countries(*). This screws with the denominator. As testing facilities get overwhelmed priority moves accordingly: everybody > everybody who wants it > those with a history & clinical reasons and anyone they met > those with a history & reasons > hospital, etc. workers > those admitted to hospitals. Denmark moved very quickly (<1 week) from the start to the end of that list as they ran out of testing reagents... which are apparently on backorder from Roche => CFR going up. Conversely, the US didn't start testing much until recently due to regulations, etc. but them ramped up faster than the death count => CFR is going down.

What we really want to know is the mortality rate (what I called true CFR) which dead/(tested positive + tested negative + not tested). The CFR being bantered around is just dead/(tested positive), because more stats aren't being widely/consistently released.

This is why I prefer South Korean numbers (1.1%)(**). Alternatively, plague ship (1.2%), or Vo numbers (1.1%) which are all based on widely tested and contained numbers.

(*) Also because the critical/hospital ratio seems to be 15-20% in all countries whether or not they're overwhelmed as well as death/critical ~ 50%.
(**) I've been using 0.7% so far but just looked at the numbers again and updated accordingly.

Jin+Guice
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Re: COVID-19

Post by Jin+Guice »

@c_L: In response to your question about service industry workers, all of my friends that work in that industry told me they are doing ok. While a lot of their social network is experiencing the same thing, they all have friends who have salaried jobs they can rely on (for many it's there significant other). Evictions are also outlawed in New Orleans right now (or eviction court is suspended at least). Grocery stores are also hiring extra temporary workers, the city is running some relief programs and I think their employers are supposed to be giving them some sort of compensation. It will be interesting to see how this shakes out with small business owners, New Orleans is a small business city and those margins are razor thin.


Is anyone else starting to go insane from self-isolating? I thought a few weeks with my guitars, no air bnbers in my house (which also means an extra room so my girlfriend and I actually have our own space) would be the dream, but it looks like it only took me a week to crack.

Alphaville
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Re: COVID-19

Post by Alphaville »

Jin+Guice wrote:
Sat Mar 21, 2020 6:32 pm
Is anyone else starting to go insane from self-isolating? I thought a few weeks with my guitars, no air bnbers in my house (which also means an extra room so my girlfriend and I actually have our own space) would be the dream, but it looks like it only took me a week to crack.
i cracked a bit yesterday, but mostly from the calculator overload of the too many what-ifs.

today we just chilled, tried not to think much, played computer games, cooked, streamed some shows, and gave ourselves license to just relax.

in other words, DISTRACTION is key. there are only so many alpacalypse scenarios one can intellectually gamify before going bananas. i don’t know what’s each person’s number or capacity, but i reached my personal limit last night.

“what if the virus mutates and turns into the andromeda strain. what if it’s really like that movie species. what if all production ceases and we starve.”

take a day off to make beignets or something ;)

mmmm, beignets... yum yum
Last edited by Alphaville on Sat Mar 21, 2020 9:26 pm, edited 1 time in total.

George the original one
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Re: COVID-19

Post by George the original one »

George the original one wrote:
Fri Mar 20, 2020 2:25 pm
Oregon Health Authority as of 8a Fri, Mar 20
- 124 Positives
- 2003 Negatives
- 3 Deaths
- 433 Pending

Cases by County
- 2 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 10 Clackamas (Oregon City)
- 8 Deschutes (Bend)
- 1 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 2 Jackson (Medford)
- 1 Klamath (Klamath Falls)
- 2 Lane (Eugene)
- 19 Linn (Albany)
- 17 Marion (Salem)
- 12 Multnomah (Portland)
- 1 Polk (Dallas)
- 2 Umatilla (Pendleton)
- 1 Union (La Grande)
- 31 Washington (Hillsboro)
- 4 Yamhill (McMinnville)

Cases by Age Group
- 4 17 or younger
- 4 18-24
- 6 25-34
- 34 35-54
- 66 55+
Yay, hospitalized case count returns to the stats! Boo, Washington County, home to Nike, Tektronix, & Intel, is leading the case count by far despite never having a nursing home incident. Traffic on the highway outside my house has a lot of daytrippers going to & from the beach; I'm really, really not wanting to go into town for a couple weeks until we know if Clatsop County residents start having cases.

Edit: Adding Josephine County completes the I-5 corridor in Oregon.

Oregon Health Authority as of 8a Sat, Mar 21
- 137 Positives
- 2338 Negatives
- 3 Deaths
- 437 Pending

Cases by County
- 2 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 11 Clackamas (Oregon City)
- 9 Deschutes (Bend)
- 1 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 2 Jackson (Medford)
- 1 Josephine (Grants Pass)
- 1 Klamath (Klamath Falls)
- 3 Lane (Eugene)
- 19 Linn (Albany)
- 19 Marion (Salem)
- 18 Multnomah (Portland)
- 1 Polk (Dallas)
- 2 Umatilla (Pendleton)
- 1 Union (La Grande)
- 42 Washington (Hillsboro)
- 4 Yamhill (McMinnville)

Cases by Age Group
- 4 17 or younger
- 4 18-24
- 13 25-34
- 41 35-54
- 75 55+

Hospitalized
- 43 Yes
- 82 No
- 12 Not provided
Last edited by George the original one on Sat Mar 21, 2020 7:29 pm, edited 1 time in total.

George the original one
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Re: COVID-19

Post by George the original one »

George the original one wrote:
Fri Mar 20, 2020 5:47 pm
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
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by 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.

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Ego
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Re: COVID-19

Post by Ego »

HT to Tim Ferriss

Study shows that ventilators can be split among two or four patients.
https://youtu.be/uClq978oohY
Ego wrote:
Sun Feb 16, 2020 10:18 pm
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 :lol:

FRx
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by steveo73 »

FRx wrote:
Sat Mar 21, 2020 9:38 pm
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
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Re: COVID-19

Post by 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/

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fiby41
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by 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
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Re: COVID-19

Post by Tyler9000 »

jacob wrote:
Sat Mar 21, 2020 3:37 pm
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/
Last edited by Tyler9000 on Sun Mar 22, 2020 10:28 am, edited 1 time in total.

George the original one
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Re: COVID-19

Post by George the original one »

Dead is dead.

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