COVID-19

[7Wannabe5]

@EMJ:

I didn’t say extending vaccine trial was a good idea, just better than extensive self variolation experiment, because last 200 years science.

@Jason:

Get it straight. You will not be sitting with the other old people in the woods. My suggestion would have us each on our own 5 acres. Sign up soon or you might be stuck with a patch of desert outside of Reno with aging strippers for neighbors.

[Jason]

After all this time, you really don't know me, do you.

[slsdly]

Public Health Ontario is now discussing live their COVID modelling and such. They have emphasized not just the death rate aspect of why the measures must remain in place, but claim that the minimum impact to the economy will be realized by following through on the measures in place for as long as necessary, and not by abandoning them. They did not detail the basis for that claim, just that there has been research on this topic. Specifically "... and ultimately it will be the best way to help the economy bounce back" was the Public Health Ontario CEO's final remarks.

Edit: Their claim is actually worse. For the near future, by end of April we would have 6000 deaths if we had no measures in place, 1600 deaths if we continue at the current level, and 250 deaths with stricter methods. Over the course of pandemic, 100k deaths without measures, 3k-15k with present measures. They are also claiming the "full pandemic" will likely last 6 months to 2 years.

[George the original one]

Covid Trends has now included the option to view USA, Australia, Canada, and China by state/province.

USA plots show that only Alaska has left the COVID-19 trajectory with Washington, Oregon, & Arkansas on the cusp of leaving. New York is bending the trajectory, but still a long ways from leaving.

https://aatishb.com/covidtrends/?region ... Washington

[theanimal]

Article on how obesity and other health factors put most American adults at risk
https://www.nytimes.com/2020/03/30/opin ... virus.html

Despite common perceptions, it’s not just the elderly and frail who are at significant risk of a life-threatening complication. Data from China suggest that many chronic health problems increase the likelihood of a bad outcome, including cardiovascular disease, which affects nearly half the adults in the United States in some form, and diabetes, which affects about 10 percent. In Italy, 99 percent of the fatalities were people with pre-existing medical problems, especially hypertension.

Moreover, in the United States, obesity-related metabolic conditions may put the public at exceptional risk. Today, more than two of three adults have high body weight, and 42 percent have obesity, among the highest rates in the world. Almost two in 10 children have obesity. Excessive weight, and the poor-quality diet that causes it, is strongly associated with insulin resistance, chronic inflammation and other abnormalities that may lower immunity to viral respiratory infection or predispose to complications.

In a California study of the 2009 influenza pandemic, people with obesity were twice as likely to be hospitalized compared with the state population. Among those who were hospitalized, the risk of dying was significantly increased for people with severe obesity. A small study conducted in 2013 of the Middle East Respiratory Syndrome (MERS), caused by another coronavirus, reported a similar relationship.

We don’t know yet whether these preliminary findings will apply to Covid-19. However, the high prevalence of obesity-related chronic disease at all ages raises serious concern. Only 12 percent of Americans over age 20 are considered metabolically healthy — that is, with optimal measures for waist circumference, blood sugar, blood pressure and lipids, and not taking drugs to control these risk factors. Indeed, reports from the Centers for Disease Control and Prevention indicated that younger adults are being hospitalized for Covid-19 disease at alarming rates.

Only 12% considered metabolically healthy! Wow.

[George the original one]

Oregon Health Authority as of 8:00a Thur, Apr 2
- 826 Positives
- 15259 Negatives
- 21 Deaths

Cases by County
- 15 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 61 Clackamas (Oregon City)
- 3 Clatsop (Astoria)
- 1 Columbia (St. Helens)
- 32 Deschutes (Bend)
- 9 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 3 Hood River (Hood River)
- 27 Jackson (Medford)
- 12 Josephine (Grants Pass)
- 8 Klamath (Klamath Falls)
- 21 Lane (Eugene)
- 4 Lincoln (Newport)
- 37 Linn (Albany)
- 1 Malheur (Vale)
- 164 Marion (Salem)
- 1 Morrow (Heppner)
- 160 Multnomah (Portland)
- 18 Polk (Dallas)
- 3 Tillamook (Tillamook)
- 5 Umatilla (Pendleton)
- 3 Union (La Grande)
- 1 Wallowa (Enterprise)
- 7 Wasco (The Dalles)
- 211 Washington (Hillsboro)
- 18 Yamhill (McMinnville)

Cases by Age Group
- 15 19 or younger
- 89 20-29
- 112 30-39
- 157 40-49
- 159 50-59
- 144 60- 69
- 86 70-79
- 63 80 and over
- 1 Not available

Hospitalized by Age Group
- 1 19 or younger
- 8 20-29
- 8 30-39
- 30 40-49
- 32 50-59
- 46 60- 69
- 36 70-79
- 27 80 and over
- 0 Not available

Hospitalized
- 188 Yes
- 510 No
- 128 Not provided

Sex
- 448 Female
- 369 Male
- 9 Not available

Hospital Capacity
- pending Available adult ICU beds
- pending Available adult non-ICU beds
- pending Available pediatric NICU/PICU beds
- pending Available pediatric beds
- pending Available ventilators
- pending COVID-19 admissions
- pending COVID-19 patients on ventilators

73 new cases. Added Crook County.

Oregon Health Authority as of 8:00a Fri, Apr 3
- 899 Positives
- 16535 Negatives
- 22 Deaths

Cases by County
- 17 Benton (Corvallis) - Note two are actually in Washington state, though they're residents of Benton County.
- 66 Clackamas (Oregon City)
- 4 Clatsop (Astoria)
- 1 Columbia (St. Helens)
- 1 Crook (Prineville)
- 36 Deschutes (Bend)
- 9 Douglas (Roseburg)
- 1 Grant (Canyon City)
- 3 Hood River (Hood River)
- 27 Jackson (Medford)
- 12 Josephine (Grants Pass)
- 13 Klamath (Klamath Falls)
- 21 Lane (Eugene)
- 4 Lincoln (Newport)
- 37 Linn (Albany)
- 2 Malheur (Vale)
- 178 Marion (Salem)
- 2 Morrow (Heppner)
- 175 Multnomah (Portland)
- 20 Polk (Dallas)
- 3 Tillamook (Tillamook)
- 5 Umatilla (Pendleton)
- 3 Union (La Grande)
- 1 Wallowa (Enterprise)
- 7 Wasco (The Dalles)
- 228 Washington (Hillsboro)
- 23 Yamhill (McMinnville)

Cases by Age Group
- 18 19 or younger
- 92 20-29
- 131 30-39
- 169 40-49
- 170 50-59
- 161 60- 69
- 91 70-79
- 65 80 and over
- 2 Not available

Hospitalized by Age Group
- 1 19 or younger
- 10 20-29
- 10 30-39
- 32 40-49
- 32 50-59
- 52 60- 69
- 39 70-79
- 28 80 and over
- 0 Not available

Hospitalized
- 204 Yes
- 538 No
- 157 Not provided

Sex
- 486 Female
- 403 Male
- 10 Not available

Hospital Capacity
- pending Available adult ICU beds
- pending Available adult non-ICU beds
- pending Available pediatric NICU/PICU beds
- pending Available pediatric beds
- pending Available ventilators
- pending COVID-19 admissions
- pending COVID-19 patients on ventilators

[steveo73]

Most solutions outside of vaccination or the virus naturally running its course i.e. segregation of young vs. old is highly dystopian.

Maybe but I think it should just be a part of our lives. It's happened plenty of times in the past. You have to somehow stop the virus spreading and let it die out. The only alternative is a vaccine but we don't develop those quickly if at all. This virus is in a lot of ways relatively less bad than previous viruses that have been pandemics so I think people are questioning even to me mild social distancing practices.

What if the mortality demographic was worse than this one ? What if the virus killed 10% of people who were infected and it was completely indiscriminate ?

This to me is more like a deadly practice run. If you get it wrong it's pretty bad but if we can do the right thing we can manage this.

It's interesting how now when things are like this you realize that democracy and capitalism don't manage these types of risks well. Sure these societal ways of living are fantastic but they don't work great. You can't say Communism works any better so it's more a flaw in the current system than stating an alternative is better. To me it's just a risk management issue but it's massive in scope. I think we should realize that eating meat is dangerous in lots of different ways but that is a big change to manage. Do you just manage the fringe cases such as wet markets ? How do you manage people eating bats when it's hard to get other meat ? How do we work through contingency plans to better manage outbreaks that do slip through the cracks ?

[George the original one]

State of Washington published count as of 11:59p, Wed 1 Apr
- 6585 Positives
- 72833 Negatives
- 262 deaths

Cases by County (County seats)
- 20 Adams (Ritzville)
- 133 Benton (Prosser)
- 18 Chelan (Wenatchee)
- 7 Clallam (Port Angeles)
- 112 Clark (Vancouver)
- 1 Columbia (Dayton)
- 16 Cowlitz (Kelso)
- 6 Douglas (Waterville)
- 1 Ferry (Republic)
- 43 Franklin (Pasco)
- 68 Grant (Ephrata)
- 2 Grays Harbor (Montesano)
- 114 Island (Coupeville)
- 19 Jefferson (Port Townsend)
- 2609 King (Seattle)
- 85 Kitsap (Port Orchard)
- 9 Kittitas (Ellensburg)
- 8 Klickatat (Goldendale)
- 12 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 10 Mason (Shelton)
- 4 Okanogan (Okanogan)
- 368 Pierce (Tacoma)
- 5 San Juan (Friday Harbor)
- 148 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1266 Snohomish (Everett)
- 167 Spokane (Spokane)
- 5 Stevens (Colville)
- 49 Thurston (Olympia)
- 8 Walla Walla (Walla Walla)
- 124 Whatcom (Bellingham)
- 10 Whitman (Colfax)
- 216 Yakima (Yakima)
- 920 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 26% 20-39
- 34% 40-59
- 27% 60-79
- 11% 80+
- 0% Unknown

Deaths by Age
- 0% 0-19
- 1% 20-39
- 6% 40-59
- 37% 60-79
- 55% 80+
- 0% Unknown


Cases by Sex at Birth
- 50% Female
- 44% Male
- 5% Unknown

381 new cases. Added Asotin and Pend Orielle counties. Testing volume is so high that 1,008 cases have not been identified as to the correct county.


State of Washington published count as of 11:59p, Thu 2 Apr
- 6966 Positives
- 75633 Negatives
- 284 deaths

Cases by County (County seats)
- 20 Adams (Ritzville)
- 1 Asotin (Asotin)
- 136 Benton (Prosser)
- 19 Chelan (Wenatchee)
- 7 Clallam (Port Angeles)
- 122 Clark (Vancouver)
- 1 Columbia (Dayton)
- 17 Cowlitz (Kelso)
- 7 Douglas (Waterville)
- 1 Ferry (Republic)
- 45 Franklin (Pasco)
- 68 Grant (Ephrata)
- 3 Grays Harbor (Montesano)
- 119 Island (Coupeville)
- 19 Jefferson (Port Townsend)
- 2711 King (Seattle)
- 92 Kitsap (Port Orchard)
- 9 Kittitas (Ellensburg)
- 8 Klickatat (Goldendale)
- 12 Lewis (Chehalis)
- 1 Lincoln (Davenport)
- 11 Mason (Shelton)
- 4 Okanogan (Okanogan)
- 1 Pend Oreille (Newport)
- 433 Pierce (Tacoma)
- 6 San Juan (Friday Harbor)
- 150 Skagit (Mount Vernon)
- 1 Skamania (Stevenson)
- 1317 Snohomish (Everett)
- 177 Spokane (Spokane)
- 5 Stevens (Colville)
- 52 Thurston (Olympia)
- 8 Walla Walla (Walla Walla)
- 127 Whatcom (Bellingham)
- 10 Whitman (Colfax)
- 238 Yakima (Yakima)
- 1008 Unassigned (labs are having trouble keeping up and Dept of Health is working to determine the proper county)

Cases by Age
- 2% 0-19
- 26% 20-39
- 34% 40-59
- 26% 60-79
- 11% 80+
- 1% Unknown

Deaths by Age
- 0% 0-19
- 1% 20-39
- 6% 40-59
- 38% 60-79
- 55% 80+
- 0% Unknown


Cases by Sex at Birth
- 50% Female
- 44% Male
- 5% Unknown

[George the original one]

What if the mortality demographic was worse than this one ? What if the virus killed 10% of people who were infected and it was completely indiscriminate ?

That's the thing. If we weren't doing social distance and the hospital capacity is over run, then death rate becomes higher. We already know this.

[thrifty++]

82 new cases in NZ, bringing the total actual and probable cases to 950.

Still only 1 death.

Still only 1 person in intensive care.

3631 tests done yesterday, for a total of 33,116 tests so far.

127 people have recovered

About 1 per cent of cases are from community transmission. So its largely coming in from overseas and overseas connections.

So we are clearly not on the flattening of he curve stage yet, and its everywhere. Although testing has been increasing every day so we are testing whats already there. So it might just be that we are not yet RECORDING the flattening of the curve that is already happening.

At least the death rate is low at 0.11% and the serious plus death rate is only 0.32%.

[Ego]

That's the thing. If we weren't doing social distance and the hospital capacity is over run, then death rate becomes higher. We already know this.

Wuhan data:

86% of Covid patients admitted to ICU, intubated and put on ventilators died.
79% of Covid patients admitted to ICU and put on non-invasive ventilation died.

https://www.thelancet.com/journals/lanr ... 7/fulltext

For the most vulnerable, death comes regardless of hospital overrun. They should be under strict quarantine now.

[George the original one]

For the most vulnerable, death comes regardless of hospital overrun. They should be under strict quarantine now.

I didn't see an age breakdown in the article.

Edit: and I don't disagree with you about the quarantine.

[Peanut]

@Ego: I saw these or similar stats referenced in a comment somewhere, and was shocked. The constant outcry about getting more ventilators everywhere is masking an uncomfortable truth: if you get infected and need a ventilator, you're already screwed.

---
Contra-rant to the criticism of young people not being responsible: I'm in a big city that is supposedly under lockdown. Every time I go out I see seniors 60+ and 70+ who are walking, running, shopping, at UPS, and not minding 6' spacing. I'll give a pass to the ones walking their dogs. But I have no idea how most of them can possibly justify their behavior to themselves.

[Chris]

Regarding letting the virus "just die out", what actually happened with the Spanish Flu, IIRC, was that it mutated into a less lethal form of the virus. That less-lethal strain then dominated, because natural selection favors less-lethal viruses (the hosts who spread the virus more aren't dead).

Over time, there will be more strains of COVID, and again, the milder strain should win out.

[classical_Liberal]

In my small (population) Midwestern state we are continuing to test liberally. Symptomatic and some asymptomatic at risk populations who were exposed by a known positive. At this point 0.76% of the entire state's population has been tested. We are still at about 97% negative rate in the PCR's. IMO this continues to not bode well for the extensive asymptomatic theory/model. Mortality rate currently 1.7%, with 26% of total cases aged 60+. They are not reporting mortality statistics by age.

Does anyone know if their state has a higher percentage of total population tested? I'd be curious to know those negative PCR rates.

[theanimal]

@c_l We have 0.81% of the population tested here. We are just over 97% negative as well. There have been 3 deaths, 2 individuals in their 60s and one in their 70s (happened in WA but still attributed to AK). That puts the rate at 1.9% and I believe last I saw there are 13 currently in the hospital (8%). 60% of the positive cases are individuals under 50 years old and 21% 60+.

Edit: Perhaps the high negative test rate in our states is more indicative of the lack of density and outside travel? Is there much travel into and out of ND besides oil fields? In other areas, like New York, they've tested over 1% of the population and tests are still coming back ~50% positive.

[classical_Liberal]

@theanimal
Obviously no where near as much travel as NYC or other hubs. Not as isolated as AK though either. It's this relative isolation in our states, and the fact we are behind the curve of infection from other areas, that makes them interesting labs for the model of mass infection spread due to asymptomatic carriers. The similar testing penetration rate, mortality, and negative result rates makes it even more interesting.

I'm not a statistician though, just drawing common sense conclusions of my own, which could be very wrong.

[horsewoman]

@Ego: I saw these or similar stats referenced in a comment somewhere, and was shocked. The constant outcry about getting more ventilators everywhere is masking an uncomfortable truth: if you get infected and need a ventilator, you're already screwed.

Yes and no. At least you have a chance of survival if you have access to an ventilator. A friend of mine is in critical condition in the ICU and has been ventilated for a week. He is not out of the woods but last night there were able to scale back the ventilation somewhat because his lungs took over more. His other stats have been shown slight improvement, too.

What this situation with my friend really drove home to me is that how dangerous this virus is, even though we have such a low death rate in Germany. This is the uncomfortable thruth many people have not yet realized. My friend is neither very old, nor obese and as far as I know he was reasonably healthy before and he still may not make it. When these numbers suddenly have a face you want to hit the "this is just a flu and we are killing our enonomy with the lock down" people over the head. We all agree that this can not go on forever, but German numbers show that an early and strict lock down works, in combination with a high number ob ICU beds/ventilators.

[Bankai]

All the early research suggests that once coronavirus patients are placed on a ventilator, they will probably need to stay on it for weeks. And the longer patients remain on a breathing machine, the more likely they are to die.

"We're not sure how much help ventilators are going to be," Osborn says. "They may help keep somebody alive in the short term. We're not sure if it's going to help keep someone alive in the long term."

Patients need a ventilator when their lungs can no longer deliver enough oxygen to keep the body going. And it's an extreme measure, Osborn says.

"We give sedation so the person goes to sleep. Then we provide a paralytic that stops their breathing," she says.

Next, a long plastic tube is inserted through the trachea and vocal cords. That allows a machine to deliver small puffs of highly oxygenated air to the lungs.

Unfortunately, Osborn says, "the ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs."

And coronavirus patients often need dangerously high levels of both pressure and oxygen because their lungs have so much inflammation.

Another risk from being on a ventilator is that the tube carrying air and extra oxygen to the lungs provides a pathway for dangerous germs. Many ventilated patients get a new lung infection, a problem known as ventilator-associated pneumonia.

Ventilators have been seen as critical to treating coronavirus patients because the devices are very successful when used to treat common forms of pneumonia, says Hajizadeh.

"We treat patients for several days, and then we get the antibiotics into the body and the patient recovers," she says. "Unfortunately with this COVID-associated pneumonia, there are no treatments that we know work for sure."

Also, the coronavirus often does a lot more damage to a person's lungs than pneumonia associated with the flu. "There is fluid and other toxic chemicals, cytokines we call them, raging throughout the lung tissue,"

In some patients, the damage is so bad that even ventilation won't help.

https://www.npr.org/sections/health-sho ... 5987239393

[Jason]

Further to the dystopian discussion, Italy is contemplating a "strong vs. weak" bifurcation based on biology i.e. antibodies. A "covid pass" will be issued. Seems Cuomo has floated the idea as well. This will inevitably result in an "old vs. young" Logan's Run type of scenario. The etymological play of the moral philosophers has begun - we are not "discriminating" we are "protecting." I assume the corpse of John Stuart Mill has sprung a raging utilitarian hard-on.

Leaders of societies, not the specialists, determine the allocation of ultimate ends when finding their backs up against the crisis wall. We actually vote them in on for these times, whether we were thinking about it or not the day we voted. It will ultimately be Trump, not Fauci who plays our big brother. We depend on specialists until shit hits the generalist fan. That being said, I understand the point, but once they make the call, it will never be fully dialed back.

https://www.nytimes.com/2020/04/04/worl ... e=Homepage

The difference between 2020 and 1918 is 100 years ago it started with the soldiers - young, healthy males and then spread to the rest of society. This led to more time spent on ineffective home made anti-pathogens than deliberating upon the moral quandaries. They just led it Keyser Soze until "poof, it was gone."

The good news? it looks like I'll be spending my remaining days in Reno with a bunch of old women who look like they tossed Bozo The Clown's salad.