COVID-19

[Legacy]

Some of the factors that determine the extent and severity of microorganisms are:

- Infectivity. The infectivity of an organism reflects the relative ease with which microorganisms establish themselves in a host species.

- Virulence. The virulence of an organism reflects the relative severity of disease produced by that agent.

- Toxicity. The toxicity of an organism reflects the relative severity of illness or incapacitation produced by a toxin.

- Pathogenicity. This reflects the capability of an infectious organism to cause disease in a susceptible host.

- Incubation Period. A sufficient number of microorganisms must penetrate the body to initiate infection (the infective dose), or intoxication (the intoxicating dose).

- Transmissibility. Some biological organism can be transmitted from person-to-person directly.

- Lethality. Lethality reflects the relative ease with which an organism causes death in a susceptible population.

While some of these have yet to be determined w.r.t. COVID 19, looking at the Kirkland nursing home infection can illustrate.

The Lethality of that susceptible population may be higher due to their decreased immune responses whether from age, chronic diseases, etc. In general, nursing home personnel do not use the usual personal protective devices like gloves in the same situations that hospital staff use them. Plus these are low-wage workers who come to work possibly with early signs because they must maintain an income.

The Incubation Period and ability of the virus to Transmit while staff are asymptomatic and the relative ease of Infectivity on those highly susceptible population through respiratory or contact as the virus outside of a host impacts interventions to contain its spread.

Should the causative organism have the ability to replicate quickly with community spread through hosts with no or minimal symptoms before diagnosis through available testing are factors that are constraints on containment and isolation.

I understand some staff at Life Care Center have now been diagnosed with it after symptoms have now appeared. Also, in the case of a cancer hospital, dialysis center or in individuals in the community with lower immune responses, the lethality would be higher.

Video-conferencing with physicians, if it's available, in case of symptoms and the availability of test kits for home diagnosis could help prevent the spread within an urgent care or emergency department.

 

[IrishLax]

Can anyone remember an outbreak/scare like this happening?

Guy at work said he can only think of the AIDS epidemic.

What's weird is that Swine Flu had infected 20+ million and killed tens of thousands before any state of emergency was declared. I remember that from college and it being a mere "wash your hands!" level of warning even after emergency was declared.

 

[Woneone]

What's weird is that Swine Flu had infected 20+ million and killed tens of thousands before any state of emergency was declared. I remember that from college and it being a mere "wash your hands!" level of warning even after emergency was declared.

On 12 April 2010, Keiji Fukuda, the WHO's top influenza expert, stated that the system leading to the declaration of a pandemic led to confusion about H1N1 circulating around the world, and he expressed concern that there was a failure to communicate in regard to uncertainties about the new virus, which turned out to be not as deadly as feared. WHO Director-General Margaret Chan has appointed 29 flu experts from outside the organization to conduct a review of WHO's handling of the H1N1 flu pandemic. She has told them, "We want a frank, critical, transparent, credible and independent review of our performance".

Good thing we've learned our lesson from back then....

 

[wizards8507]

That is not correct....

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/children-faq.html

That's basically what I said. They can get the infection, but it doesn't cause symptoms.

 

[NDBoiler]

That's basically what I said. They can get the infection, but it doesn't cause symptoms.

In all fairness Wiz, that’s not what is says either. It says they can get it and have symptoms, it’s just uncommon that kids have developed severe symptoms.

Two kids from the same school in a suburb here in the Indy area have tested positive for it in the past couple days.

 

[Irish YJ]

Well, oil was falling the last couple of weeks because the slowdown in worldwide demand due to the Coronavirus but that's not why it gapped down the way it did today. That was due to Russia giving OPEC the middle finger and the expectation that there will be not short term solutions to the weak demand. Also, some heavy speculation that many have wanted to drive the US shale producers out of business and now is a good time to do so.

Russia is crashing oil, which might last for a bit if they're taking a long term position against U.S. shale production.

For sure Russia owns some of this, but how about Saudi for dropping it's prices a ton?

One country that for sure is getting pummeled by this whole situation (virus + oil) is Iran.
It's a recipe for all kinds of "bad".

As far as trying to drive US shale producers out of business, I saw a piece not long ago that suggest it would be very hard to do that due to a mix of reasons. Do you have any good articles you'd suggest on the topic?

 

[Old Man Mike]

Supporting Boiler's post: CDC article definitely says that children can get symptoms. Thankfully SO FAR these are lesser in severity. But, scientifically, children with other health issues should be just as vulnerable as adults. This is not something to take lightly.

 

[Pops Freshenmeyer]

What's weird is that Swine Flu had infected 20+ million and killed tens of thousands before any state of emergency was declared. I remember that from college and it being a mere "wash your hands!" level of warning even after emergency was declared.

If you’re talking about the 2009 epidemic there were estimated to be 12,000-13,000 deaths in the US and a mortality rate below 0.1% (per Wikipedia’s sources).

 

[Prof K]

People are overreacting, if you ask me.

Amen, we likely have it already in every major city in America already. We just haven't noticed because we don't have the tests, and the fatality rate isn't that much different from any other flu. Their will be terrible panic when folks realize it is actually everywhere already, but in a month or two, after terrible economic damage, the press and everyone else will settle down.

 

[calvegas04]

Wondering how this could effect recruiting and spring games coming up

 

[Irishize]

I think the panic is justified, but I don't think its for the reasons you are saying. I don't think you should be worried about any serious illness from getting it, but what you should be worried about it spreading it to even more people if you get it. It might not effect you or anyone you spread it too, but the more people that have it the more likely it will be spread to the populations which it will effect. And the more people who do get seriously ill from it, the less effective our treatment is because we simply do not have the capacity to care for the numbers of people that would get seriously ill. Just look at what is happening in the locked down areas of Italy. They simply do not have enough spots in the ICUs or medical personnel to handle all of the cases. There are too many cases that require care for too long. What's worse is that it looks like we have an even lower capacity in the US so we will have an even worse response.

This is the concern my company shared w/ us. If even a small percentage get infected, they’re afraid the US doesn’t have the space to handle that in hospitals, etc.

 

[Whiskeyjack]

This is the concern my company shared w/ us. If even a small percentage get infected, they’re afraid the US doesn’t have the space to handle that in hospitals, etc.

Look at what's happening in Italy right now. They were laughing it off just a couple weeks ago and going about their lives as usual. Now their hospital system is on the verge of collapse and the entire country is on quarantine.

 

[NorthDakota]

What's weird is that Swine Flu had infected 20+ million and killed tens of thousands before any state of emergency was declared. I remember that from college and it being a mere "wash your hands!" level of warning even after emergency was declared.

Lmao yeah I remember one of my friends got it. I was in high school. We made fun of him. No one was concerned other than his mom and dad I'm pretty sure.

I'm not a scientist but I have a hard time getting worked up about a virus that doesnt seem to be the end of the world.

The thing that has cracked me up is some journos saying that it is racist to call it the "wuhan virus" even though a ton of these things are named after the place where the virus either started or gained notoriety.

 

[InKellyWeTrust]

3 things:
1) death rate seems to be trending toward a rate similar to influenza (which is down from the initial 3.4% estimate).
2) does not appear to affect children as severely
3) we should take it seriously (as we do with flu every year) but not overreact

 

[calvegas04]

I think the death rate being reported is higher than what it really is. They are hardly even testing anyone. I believe a lot more people have it than what can be reported.

 

[InKellyWeTrust]

I think the death rate being reported is higher than what it really is. They are hardly even testing anyone. I believe a lot more people have it than what can be reported.

Newer estimates put it at less than 1%.

 

[Ndaccountant]

I think the death rate being reported is higher than what it really is. They are hardly even testing anyone. I believe a lot more people have it than what can be reported.

Conversely, it's widely known that China fudged the death numbers, with the COD being listed as pneumonia, in place of COVID-19.

Regardless, if you look closely at the numbers, the death rate declined than stabilized as the number of cases increased than stabilized as well. That is for two reasons.....1) as you mentioned, the number of mild cases are factored in, bringing down the death rate & 2) the initial influx of patients stressed their capacity to provide the kind of round-the-clock intensive care needed for a patient with a critical case of COVID-19.

The lesson out of all of this is that to win the war, you must first stop the spread. The moment the spread gets out of control, you will see the death rates increase. Remember, based on the 100K cases worldwide at this point, approx. 15-20% require hospitalization, with 15-20% of those patients requiring ICU support. Those %'s have remained relatively consistent across the world, meaning that prevention of spread and strain on hospitals is the best way to prevent large scale deaths.

I personally don't think people should panic, but I do think people need to stop getting all of their freaking news from reddit, facebook and twitter. Once again, social media is helping create hysteria.

 

[InKellyWeTrust]

Conversely, it's widely known that China fudged the death numbers, with the COD being listed as pneumonia, in place of COVID-19.

Regardless, if you look closely at the numbers, the death rate declined than stabilized as the number of cases increased than stabilized as well. That is for two reasons.....1) as you mentioned, the number of mild cases are factored in, bringing down the death rate & 2) the initial influx of patients stressed their capacity to provide the kind of round-the-clock intensive care needed for a patient with a critical case of COVID-19.

The lesson out of all of this is that to win the war, you must first stop the spread. The moment the spread gets out of control, you will see the death rates increase. Remember, based on the 100K cases worldwide at this point, approx. 15-20% require hospitalization, with 15-20% of those patients requiring ICU support. Those %'s have remained relatively consistent across the world, meaning that prevention of spread and strain on hospitals is the best way to prevent large scale deaths.

I personally don't think people should panic, but I do think people need to stop getting all of their freaking news from reddit, facebook and twitter. Once again, social media is helping create hysteria.

For every one case that is identified there are probably 100 unidentified cases of mild disease. Nobody is going to go get tested for a stuffy nose. Until they can do large cross sectional seroconversion studies to get the denominator correct we wont know the true percentages. That is why we should not point to these percentages and extrapolate how many people will die/become severely ill and just stick with the absolutes.

 

[Ndaccountant]

For every one case that is identified there are probably 100 unidentified cases of mild disease. Nobody is going to go get tested for a stuffy nose. Until they can do large cross sectional seroconversion studies to get the denominator correct we wont know the true percentages. That is why we should not point to these percentages and extrapolate how many people will die/become severely ill and just stick with the absolutes.

Sure, but that doesn't change the fact that some people do become sick enough to require hospitalization, with some ICU. The goal needs to be prevent hospitals from being overwhelmed. If/when that happens, people should be concerned. Thus, focus on prevention of spread.

 

[InKellyWeTrust]

Sure, but that doesn't change the fact that some people do become sick enough to require hospitalization, with some ICU. The goal needs to be prevent hospitals from being overwhelmed. If/when that happens, people should be concerned. Thus, focus on prevention of spread.

That's why I mentioned we should focus on the absolutes. In not suggesting you are doing it but I've seen people try to take the initial rates and extrapolate. These can be off by factors of 10, 100, or even 1000. This is how panic and fear start. That's all I'm saying.

And unless you shut down all business and school and travel you cant stop this from spreading. This is nature taking its course and its trending to be similar to severe influenza.

The weather warming up will help

 

[Circa]

We Human beings are pretty resilient. Amazingly enough we all survived the last 100,000 years or so with no real chance of getting too lost in translation.

As BeauBenken stated earlier the old Nursery Rhyme comes back to life.
We'll be fine. It's a weird time to have another China (SARS) Virus...... inhabit our communities.
Election cycles are worldly now I reckon.

What will the media do when nobody cares anymore about life's peculiarities Is my worry. This should be everyone's worry. You never know what to believe anymore


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[InKellyWeTrust]

We Human beings are pretty resilient. Amazingly enough we all survived the last 100,000 years or so with no real chance of getting too lost in translation.

As BeauBenken stated earlier the old Nursery Rhyme comes back to life.
We'll be fine. It's a weird time to have another China (SARS) Virus...... inhabit our communities.
Election cycles are worldly now I reckon.

What will the media do when nobody cares anymore about news Is my worry. This should be everyone's worry. You never know what to believe anymore


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This

 

[T-Boone]

Imagine if the flu just invented itself now.

 

[Ndaccountant]

Imagine if the flu just invented itself now.

I am long removed from high school biology, but isn't that what antigenic drift is?

 

[SonofOahu]

Been away for more than a year. Glad to see nothing's changed; some of you are still idiots. COVID-19 has been, literally, the only thing we've been working on for the last two weeks. Some of you are completely missing the point, the real danger, because you watch too much Fox News. Some of you are probably going to die; it's been nice "knowing" you. Most of you will be fine.

Yes, COVID-19 is basically a cold, but it's a horrendous one because our herd immunity is nil. For most people, it's going to be like having a bad flu. Not a huge issue, normally. The real problem is the strain this is about to put on the healthcare system. The data we're seeing is that 25% of all hospitalized COVID-19 patients require ICU-level care. That's a serious problem. I'll walk you through the Hawaii model, and you can take that and apply it to where ever you are. There are not enough ICU suites, isolation ones at that, to handle that demand.

The two biggest issues we see are the world-wide shortage of PPE and the amount of panic we're seeing in both the general population and front-line medical staff. Much of what we need to combat this disease is made in... the same region in China where COVID-19 started. There is a 3-6 month delay in n95 order-fulfillment. These goddamn masks used to cost less than $1 per. Now they're between $10-15. Ridiculous. There's been a run on everything from gloves, to gowns, to body bags. The lack of PPE leads to employee exposure, which leads to staff shortages, which leads to unnecessary deaths for other patients... you get the picture. Reading the case-files from China, and now Seattle, is depressing. Some of those medical professionals in China died from straight exhaustion. At the Kirkland nursing home, three (3) staff members showed up to work, once the infection started. They were afraid of dying, and self-preservation overrode their professional/para-professional duties. As a hospital administrator, that's what keeps me up at night.

So the public panic is already causing an increase in ED visits for cough/fever symptoms. This year's flu season is bad. It's still going, and it's kept our hospital (and morgue) full. When you add more patients to this mix, you're looking at some serious issues. For one thing, the CDC is still calling for hybrid droplet/airborne precautions with COVID-19 patients. Hospitals only have so many iso rooms; there's not an infinite supply of these. We always think that living in a 1st-world country ensures you access to top-level healthcare. Let me dispel that, right quick.

Using Oahu as a model for COVID-19 infection:

• Oahu population is 1,000,000
• At 10% infection = 100,000 patients
• 20% requires hospitalization = 20,000 patients
• 25% requires ICU = 5000 patients
• Divide by 365 = 14 ICU admits per day, average

Oahu has around 200 ICU beds, and let's say they remain about 65% utilized. That's an average daily census (ADC) of 130. The length of stay for the COVID-19 patient is probably going to be somewhere between 12-18 days, because you're talking about someone who is going to develop pneumonia and/or sepsis. Now let's stack up the patients using the numbers, and see how this builds:

130, 144, 158, 172, 186, 200, 214...

Unless you're discharging your ICU patients at a rate roughly half of the COVID-19 admissions, you're going to run out of space within a week. If you think the media is trying to scare you, you haven't seen anything, yet. This is the kind of shit the professionals are talking about, and this is why they're so tight-lipped with info. The simple truth is that our health system is not set up for a sudden and rapid rise in patients. Some of you may live in rural areas. I feel bad for you, your community better pray this doesn't hit you hard, because a lot of you may die if it does. If you get the flu and COVID-19 at the same time (which is possible), you will die. It won't matter how old you are, that's a real gang-bang on your kidneys. Get your goddamn flu vax, if you haven't already (this coming from a guy who never, ever, got flu shots.)

Here's my advice besides washing your hands: stop trimming your nose hairs. You need to prevent the virus from getting to your mucous membranes, nose hairs are there for that reason. This whole "don't touch your face" thing is unrealistic. Stop scratching your eyes, don't dig your nose, and stop putting fingers in your mouth. Also, if you decide to shove something up your ass, wash your hands both before and after.

 

[Redbar]

First presumptive case in Louisiana just announced by the Gov, patient is being treated in Orleans Parish (my guess is at Ochsner - Jefferson Highway Campus, but could be anywhere).

I'm just hoping my workplace starts encouraging people to work remotely. We already can and do most of our job remote anyways...

Heard they were being treated at the VA.

 

[deise mike]

People are starting to get very concerned here in Ireland. We only have 23 cases but all St Patrick’s day parades have been cancelled. The government suggests that 40-60% of population could infected. As an asthma sufferer in his 60’s I’m not so blasé as I was last week.

 

[PerthDomer]

Reports from Italy... https://threadreaderapp.com/thread/1237142891077697538.html

 

[InKellyWeTrust]

Using Oahu as a model for COVID-19 infection:

• Oahu population is 1,000,000
• At 10% infection = 100,000 patients
• 20% requires hospitalization = 20,000 patients
• 25% requires ICU = 5000 patients
• Divide by 365 = 14 ICU admits per day, average

Oahu has around 200 ICU beds, and let's say they remain about 65% utilized. That's an average daily census (ADC) of 130. The length of stay for the COVID-19 patient is probably going to be somewhere between 12-18 days, because you're talking about someone who is going to develop pneumonia and/or sepsis. Now let's stack up the patients using the numbers, and see how this builds:

130, 144, 158, 172, 186, 200, 214...
er.

Doomsday scenario with extrapolated math. It's good to be prepared for the worst but I am 95% confident those numbers will end up being way off.

 

[PerthDomer]

That's literally what happened in Wuhan and is happening in Italy and Iran. South Korea got ahead of it and the ICU's in Daegu are saturated...