COVID-19 Pandemic: Transmissions, Deaths, Treatments, Vaccines, Interventions and More...

[Upstream]

And if I were going to "gamble" on an unproven therapy, I'd be giving the convalescent antibody-plasma therapy to every seriously ill patient today,

Column from former FDA commissioner Scott Gottlieb in the WSJ today (https://www.wsj.com/articles/bet-big-on-treatments-for-coronavirus-11586102963), in which he talks about different potential treatments. He notes that some antiviral drugs show some promise. But he says that antibody drugs "may be the best chance for a meaningful near-term success."

From his column:

Antibody drugs are based on the same scientific principles that make “convalescent plasma” one interim tactic for treating the sickest Covid-19 patients. Doctors are taking blood plasma from patients who have recovered from Covid-19 and infusing it into those who are critically ill. The plasma is laden with antibodies, and the approach shows some promise. The constraint: There isn’t enough plasma from recovered patients to go around.

Antibody drugs are engineered to do the same thing as convalescent plasma, but because they’re synthesized, they don’t depend on a supply of antibodies from healed patients. Biotech companies would manufacture them in large quantities using recombinant technology, the same approach behind highly effective drugs that target and prevent Ebola, respiratory syncytial virus and other infections. The antibodies can also be a prophylaxis given to those exposed to Covid-19, or to prevent infection in vulnerable patients, such as those on chemotherapy. These drugs could protect the public until a vaccine is available.​

 

[retired711]

The Philadelphia Inquirer says that a tiger in the Bronx Zoo has the virus, and apparently got it from a zoo employee. So people with symptoms ought to be careful about their pets. https://www.inquirer.com/health/cor...-zoo-tests-positive-coronavirus-20200405.html

 

[RU848789]

One more post tonight partially in honor of Worldometers adding testing data, which is great; now they just need to add columns for percent growth rate in cases and deaths per 1M. In comparing countries, looking at data normalized on a per capita basis is the only way to compare apples to apples for the most part. When looking at that, the US doesn't look nearly as bad as the worst countries, like Italy and Spain or even France and several other European countries.

However, most of those countries are further along in their outbreaks and are seeing deaths per day leveling off, while our deaths per day are still climbing significantly - we had 1321 deaths yesterday, but if we stay under 2000 per day, we'll remain at less than half the per capita death rate of Italy and Spain. That's the glass half-full perspective and in that scenario one could imagine seeing 40-50K US deaths (and ~5X that many serious cases) before we're into a decline in maybe 3-4 weeks. The glass half empty view is if we do even worse, reaching Italy/Spain numbers and maybe ending up with 80-100K or more deaths before we're well into a decline.

No matter what though, as many of us have been saying since late February we look absolutely horrible against South Korea, Taiwan, Singapore, Japan and a few others (and China, but I still don't trust their numbers), but South Korea is the most painful example, since we saw them have a major outbreak in late February and largely control it by early March and the playbook was obvious and fairly similar to China's without the draconian lockdown, featuring aggressive early testing, aggressive contact tracing/quarantining, and aggressive social distancing and mask wearing in public. If we had followed SK's model and ended up obtaining similar results of 3 deaths per 1M or even double that, we could have ended up with 1000-2000 deaths (although SK can't claim total victory until there is a cure/vaccine, as they could always have a major relapse, but I doubt it). And that makes me really sad and angry.

Numerous public health experts in the US knew that's what we should be pursuing, but our leadership failed at every turn, particularly on fixing the testing problem in mid-February and doing nothing to prepare our health care system for the coming onslaught (and yes, it was a bipartisan debacle 20 years in the making, but we should have started doing far more over a month ago). Instead the POTUS downplayed the coming epidemic and the Administration failed to do much beyond the travel ban on 2/2 (after 300K Chinese had traveled to the US in January). I love the technical and pharma innovations we're seeing (enabled by suspending FDA regs by the Administration), but so far we have no good treatments in place (despite claims to the contrary - if we had something great, our death rates would be lower given the numbers on HCQ); my guess is our one medical hope in the next 1-2 months is the antibody-plasma therapy that's underway with some very promising early results and maybe that could pay off soon if the promise is confirmed. It's about to get really bumpy now/soon, though...

https://www.worldometers.info/coronavirus/#countries

Some more on comparing countries from an apples to apples perspective, showing how important interventions like social distancing are and how important it is to implement them as soon as possible. Epidemiologists often look at data from beyond some common starting point, like days beyond having 10 in 1MM (or 1 in 100,000) cases in the overall population (it eliminates the "noise" in very early case data). In doing this for both Italy, generally considered the worst case (although Spain is in the running for that), their first day with over 10 in 1MM total cases was Feb 27th. For the US that day was March 14th.

Italy closed the Lombardy hotspot on March 9, 11 days after "Day 1," while In the U.S., local/state officials started shutting things down around March 16th (schools, restaurants, etc.) in NY, NJ and a few other locations that were hotspots (and New Rochelle, NY and Kirkland, Washington were shut down by about March 13th), which was basically 2 days after "Day 1," which is much earlier than in Italy. And the results look like they're reflecting that difference, especially with regard to deaths. One can debate "shutdown" vs. "closure" or "stay at home" but regardless all of these terms mean aggressive social distancing of some form - I'll use shutdown from here on.

The early deaths in both countries from before the shutdowns and probably through at least Day 15-20 or so after the shutdowns wouldn't be expected to be affected by the shutdowns, because it typically takes 2-3 weeks for deaths to start occurring after becoming symptomatic and the rate of people becoming symptomatic would likely only be reduced after the shutdowns. However, the death rates should eventually start to diverge significantly for the "early shutdown country" compared to the "late shutdown country."

The graphic below shows daily deaths per million population for Italy and the U.S., both measured from "Day 1." The graphic shows fairly well matched data for about 16-17 days after Day 1, which is not surprising, given that deaths on Day 17 likely were people who became symptomatic on Day 1 or before then, when there were no interventions. But then deaths per 1MM start to diverge significantly around Day 18, which is 7 days after the Lombardy shutdown (too soon for an effect), but 16 days after the regional US shutdowns, which would be expected to impact/reduce death rates in the US by then.

Let's hope this divergence is maintained past Day 23 on the chart below, which is 4/4 for the US and was 3/18 for Italy. If it is, then maybe we can achieve my hope in my quoted post above, that we can stay below 2000 US deaths per day (or 6 deaths per day per 1MM people). This is a little less than half the rate we see in Italy and this would likely translate to somewhere between 40-50MM US deaths - assuming we continue with aggressive social distancing (and ratchet it up on states doing little now). This would still suck but would be way less than the 100-200MM many are projecting from models. Also, keep in mind that the deaths in Italy are likely increased vs. the US somewhat because of their older population and their health care systems being overwhelmed. Of course, don't forget that significant hospitalizations would likely be about 4X the number of deaths, which is also an important factor, given that maybe 1/4 to 1/3 of those require ventilators.

The graphic below is from Christopher Black, from his FB page today. I've been talking about these concepts for weeks now, so the discussion is mine.

 

[bac2therac]

The Philadelphia Inquirer says that a tiger in the Bronx Zoo has the virus, and apparently got it from a zoo employee. So people with symptoms ought to be careful about their pets. https://www.inquirer.com/health/cor...-zoo-tests-positive-coronavirus-20200405.html

What kinds of tests..are they specifically for animals..are they really using tests ok n animals?

And if these animals are already expected to recover then its evident that its not life threatening to animals

 

[RU848789]

Column from former FDA commissioner Scott Gottlieb in the WSJ today (https://www.wsj.com/articles/bet-big-on-treatments-for-coronavirus-11586102963), in which he talks about different potential treatments. He notes that some antiviral drugs show some promise. But he says that antibody drugs "may be the best chance for a meaningful near-term success."

From his column:

Antibody drugs are based on the same scientific principles that make “convalescent plasma” one interim tactic for treating the sickest Covid-19 patients. Doctors are taking blood plasma from patients who have recovered from Covid-19 and infusing it into those who are critically ill. The plasma is laden with antibodies, and the approach shows some promise. The constraint: There isn’t enough plasma from recovered patients to go around.

Antibody drugs are engineered to do the same thing as convalescent plasma, but because they’re synthesized, they don’t depend on a supply of antibodies from healed patients. Biotech companies would manufacture them in large quantities using recombinant technology, the same approach behind highly effective drugs that target and prevent Ebola, respiratory syncytial virus and other infections. The antibodies can also be a prophylaxis given to those exposed to Covid-19, or to prevent infection in vulnerable patients, such as those on chemotherapy. These drugs could protect the public until a vaccine is available.​

Thanks. As we discussed awhile back, Scott is very good - wish he were still at FDA.

 

[RU848789]

I guess I was lucky. I started my career in Pharma R&D and was heavily involved with three projects (also small involvement with many more). All three made it to market, one was the first drug approved to treat Alzheimer's, the second was and still is the largest selling drug of all-time and the third is still around selling billions of dollars annually. There is always hope.

Probably a function of the denominator, lol. Over my career, I was involved in or led process development and scaleup efforts for probably 40 new drug candidates (for the active ingredients mostly), of which about 10 eventually made it to manufacturing and the market. Most of the "new" candidates were in Phase I when they entered my area.

 

[Proud NJ Sports Fan]

I'd love to believe that there's already a huge percentage of the population that has been infected and recovered, but it just doesn't seem likely. Heck, my wife had an upper respiratory infection about a month ago. Would be great if that was a mild covid case and we are both now immune.

If we work back...the index case(s) of covid is believed to have occurred in the Wuhan area in mid to late November. It took 2 months for things to get bad enough that Wuhan was locked down. Now take NYC...cases really started exploding in mid-late March (say March 22). Go back 2 months and that takes us to mid-late January. So while it's likely that a few sporadic cases were imported into the US as far back as December, the main seeding probably occurred starting in mid January (and then over time we also got imports from Italy, Iran etc). This makes it relatively unlikely that anyone who experienced a severe flu-like illness in December or January had covid. Not impossible, but unlikely. If it was already widespread by January we would have seen the impact in the hospitals before mid March.

The Telluride study will be interesting. I checked one of the websites that lists cases by county and it looks like they have 9 confirmed cases (by the PCR method I assume). So if the 80/20 rule is accurate, i.e. 80% of cases are mild or asymptomatic (thus presumably not tested) that would suggest 45 total cases in the county. Right now they've got 8 solid positives with 12% tested which would work out to about 64 total. If all the indeterminate cases are actually positive that would work out to 248. Then 9/248 = 3.6% symptomatic and 96.4% asymptomatic. Of course, some of those could become symptomatic over time.

Hopefully they'll find a harder hit relatively small community somewhere in the NY area (maybe 10k pop) where they can run a similar test.

Yeah, it would be nice to know the % of the population that actually has been exposed already

Until then it's a guessing game

 

[DJ Spanky]

Folks, if you want to have a discussion about whether the coronavirus is a bio weapon, and you want to insult each other and discuss common ancestry with farm animals, feel free to do it in another thread. But do NOT hijack this thread with that discussion or the endless bickering that accompanies it. Otherwise you will be banned from this thread.

 

[cohwx]

It doesn't really matter where it came from, unless there is someone somewhere with a treatment or vaccine they're waiting to sell to the world. If that is not the case (and it's probably not), it makes no difference right now. We have the virus and we have to deal with it.

Later we can play the blame game.

 

[RU848789]

Summary of today's (4/4, so most recent data is for 4/3) presser by Cuomo...

• 284K tested in NY/125K in NYC to date; 24K/12K tested yesterday in NY/NYC (vs. 22K/9K tested the day before in NY/NYC, a bit of a bump up.
• The Earth hit 1.16MM cases on 4/3 vs. 1.01MM on 4/2, with 277K positive cases in the US (245K on 4/2)
• NY/NYC Cases: 113.7K, 102.8K, 92.3K, 83.7K, 75.7K, 66.5K positives in NY the last 6 days, meaning 10.8K, 10.5K, 8.6K, 8.0K, 9.2K new cases the past five days in NY; 63.3K, 57.1K, 51.8K, 47.4K, 43.1K, 38.0K in NYC the last 6 days, meaning 6.1K, 5.3K, 4.4K, 4.3K, 5.1K new cases the past five days in NYC. Over the last week or so, new cases are still increasing a bit in NY/NYC, but slowly.
• NJ (not in presser but added in): as of 4/4, total tests up to 75K, total positive cases up to 34K, with 4300 new cases and total deaths up to 846, with 200 new deaths.
• 3565 total deaths in NY, up 630 from yesterday; total deaths the previous three days were 2935, 2371, and 1941, so the daily death rate is still growing, as expected, as deaths lag hospitalizations by at least a week or so.
• Total of 15.9K currently hospitalized in NY vs. 14.8K yesterday for a net increase of 1100 and increases of 1400, 1200 and 1300 the previous three days. In previous reports, I’ve been saying these were “new hospitalizations” since that’s what the pressers say/show, but it turns out that these are net new.
  • So, if the “net new” is 1400 and 1600 were discharged that means there were actually 3000 new patients admitted for a net increase of 1400 in the hospital (not sure how deaths are being counted in this – if 1000 people die and are no longer in the hospital, that probably means 4000 admitted – 1600 discharged – 1000 deaths for an overall hospital population increase of 1400 – this is me guessing since those details have not been provided).
• Total of 4126 currently in ICU in NY (which means on ventilators, usually) vs. 3731 yesterday for an increase of 395 and vs increases of 335, 374 and 312 the previous three days.
• 10,500 cumulative to date discharged from hospitals in NY as of yesterday vs. 8886 the day before. This means that 1592 were discharged yesterday vs. 1452, 1292 and 1167 the previous three days.
• 277K cases in the US and over last 5 days here are the total cases for selected states: 113.7K/102.8K/92.3K/83.9K/75.9K in NY, 29.9K/25.6K/22.2K/18.7K/16.6K in NJ, 12.6K/11,000/9800/8500/7200 in CA, 12.7K/10,700/9300/7600/6500 in MI, 10.4K/9000/7700/6600/5800 in MA, 10.2K/9000/7800/ 6700/5700 in FL, 7000/6600/5800/5500/5200in WA (slowest growing state), 8900/7700/7000/6000/5100 in IL, 10.3K/9200/6400/5200/4000 in LA, 8400/7000/6000/5000/4100 in PA, and 6300/5400/4700/4100/3000 in GA.
• 7121 total deaths in the US vs. 6070 yesterday (up 1051) and here are total deaths for selected states: 3565 in NY, 647 in NJ, 478 in MI, 282 in CA, 192 in MA, 370 in LA, 169 in FL, 211, in IL, 102 in PA, and 293 in WA.
• Models now predicting the apex being in about 7 days, plus or minus a few days.
• China donated 1000 ventilators today, Oregon sending 140 ventilators (their apex is in May and NY will send them back, plus more), and 500 more found across state. Could still be a very close call on ventilators.

View embedded media

Summary of today's (4/5, so most recent data is for 4/4) presser by Cuomo...lots of promising news…

• Models now predicting the apex in cases being in 7 days or less and it’s possible we’ve started a plateau period, since it’s not clear if new cases per day plateau for a few days or a week or two, before the decline (in most countries, it has plateaued for a week or so).
• Looks like bed capacity is now likely to not be an issue in NY any more, but ventilators are still a major concern. Remains committed to sending supplies and staff to other states, should NY not hit the peak levels originally modeled.
• 4/5: 302K total tests in NY through 4/4; the previous three days were 284K, 260K and 239K, so the daily testing the last 3 days was 18K/24K/21K. And 133K total tests in NYC through 4/4; the previous three days were 125K, 119K and 113K , so the daily testing the last 3 days was 8K/6K/6K.
• The Earth hit 1.20MM cases on 4/4 vs. 1.12MM on 4/3, with 318K positive cases in the US (277K on 4/2)
• NY/NYC Cases: 122.0K, 113.7K, 102.8K, 92.3K, 83.7K, 75.7K positives in NY the last 6 days, meaning 8.3K, 10.8K, 10.5K, 8.6K, 8.0K, new cases the past five days in NY; 67.6K, 63.3K, 57.1K, 51.8K, 47.4K, 43.1K in NYC the last 6 days, meaning 4.3K, 6.1K, 5.3K, 4.4K, 4.3K, 5.1K new cases the past five days in NYC. Almost ready to say that new cases have peaked and plateaued, but would like to wait another 2 days before saying that with confidence.
• NJ (not in presser but added in): as of 4/5, total tests up to 82K (7K yesterday), total positive cases up to 37.5K (vs. 34.1K the day before), meaning 3400 new cases on 4/4 vs. 4300 new cases on 4/3, so the first significant daily drop off for NJ. Total deaths up to 917 (vs. 846 the day before), with only 71 new deaths on 4/4 vs. 200 on 4/3.
• 4159 total deaths in NY, up 594 from yesterday; total deaths the previous four days were 3565, 2935, 2371, and 1941, so the daily death rate has been 594, 630, 564, and 430 the past four days. Would be great if that new daily death rate is starting to level off, but too early to call that, as one would expect deaths to lag hospitalizations by at least a week or so.
• Total of 16.4K currently hospitalized in NY vs. 15.9K yesterday for a net increase of only 500 vs. increases of 1100, 1400, 1200 the previous three days. In previous reports, I’ve been saying these were “new hospitalizations” since that’s what the pressers say/show, but it turns out that these are “net new” (where net new must equal total admitted – total discharged – total deaths, although those details have not been provided by NY). Regardless a decrease in net increases is good – and 74% of all admitted to the hospital, overall have been discharged.
• Total of 4376 currently in ICU in NY (which means on ventilators, usually) vs. 4126 yesterday for an increase of only 250 and vs increases of 395, 335, and 374 the previous three days. First drop in awhile.
• 12,187 cumulative to date discharged from hospitals in NY as of yesterday vs. 10,500 the day before. This means that 1709 were discharged yesterday vs. 1592, 1452, and 1292 the previous three days. Going in the right direction.
• 318K cases in the US and over last 6 days here are the total cases for selected states: 122.0K, 113.7K, 102.8K, 92.3K, 83.9K, 75.9K in NY; 34.1K, 29.9K, 25.6K, 22.2K, 18.7K, 16.6K in NJ; 13.8K, 12.6K, 11.0K, 9.8K, 8.5K, 7.2K in CA; 14.2K, 12.7K, 10.7K, 9.3K, 7.6K, 6.5K in MI; 11.7K, 10.4K, 9.0K, 7.7K, 6.6K, 5.8K in MA; 11.5K, 10.2K, 9.0K, 7.8K, 6.7K, 5.7K in FL; 7.5K, 7.0K, 6.6K, 5.8K, 5.5K, 5.2K in WA (slowest growing state); 10.6K, 8.9K, 7.7K, 7.0K, 7.0K, 6.0K, 5.1K in IL; 12.5K, 10.3K, 9.2K, 6.4K, 5.2K, 4.0K in LA, 10.1K, 8.4K, 7.0K, 6.0K, 5.0K, 4.1K in PA; and 6.9K, 6.1K, 5.4K, 4.7K, 4.1K, 3.0K in GA, with Texas now up to 7.2K.
• 8451 total deaths in the US vs. 7121 yesterday (up 1330 yesterday vs. up 1045 the day before) and here are total deaths for selected states the past two days: 4159/3565 in NY, 847/647 in NJ, 540/478 in MI, 323/282 in CA, 216/192 in MA, 412/370 in LA, 194/169 in FL, 248/211, in IL, 139/102 in PA, and 318/293 in WA.
• NY/NYC participating in numerous clinical trials for convalescent plasma, HCQ, remdesivir, and vaccines

 

[ArminRU]

Sunday’s always seem to drop off. Would be surprised if it doesn’t rebound again tomorrow.

Anyone see this site yet? Has country and state by state projections.

https://covid19.healthdata.org/projections

 

[bac2therac]

Sunday’s always seem to drop off. Would be surprised if it doesn’t rebound again tomorrow.

Anyone see this site yet? Has country and state by state projections.

https://covid19.healthdata.org/projections

good site, thanks for posting. According to that site NJ would start having no deaths around May 1. Gotta get through 2 really tough weeks.

 

[RU848789]

good site, thanks for posting. According to that site NJ would start having no deaths around May 1. Gotta get through 2 really tough weeks.

That site is from the U of Washington, the same folks I've posted models from for the past few weeks, as they've seemed to have more realistic modeling scenarios. They keep saying they're going to update their models, but they've delayed it all weekend.

My guess is they're digesting all the new data, especially the observation that we might already be into the peak number of cases in NY and possibly NJ, meaning the peak deaths will come sooner and likely be at a lower peak than modeled so far, and that they're going to come out with lower estimated deaths for the US/NY/NJ than the ones below, which were from 4/1. Maybe down 20-30%, to perhaps 70K for the US vs. the current 93K (I was guessing maybe 50K). Or maybe there will be minimal change, since they're seeing more than I am, I'm sure.

We'll see - this is not too different from when I try to guess where the NWS is going to go based on new data that we all have access to, but I can be nimbler with the analysis than they can. Of course a huge difference is this is predicting deaths, which matter far more than the weather, so if they need some more time, they should take it.

Edit: turns out the first three graphs, below, from last night, were a mix of projections. The NY and US graphs were from the model run on 4/1, while the NJ graph is from the model run on 4/5 and the 9600 deaths shown are much higher than the ~2200 deaths from the model run on 4/1 (not shown). I added the 4/5 model projections for US/NY after these three. You can tell when the model was run from where the orange solid line ends and becomes dotted, also.

Edit: adding in the 4/5 model runs for the US and NY, below. The US projected deaths dropped from 96K to 82K, which is good (not the 70K I thought it might drop to) and the NY deaths projected dropped from 16.3K to 15.6K.

 

[satnom]

That site is from the U of Washington, the same folks I've posted models from for the past few weeks, as they've seemed to have more realistic modeling scenarios. They keep saying they're going to update their models, but they've delayed it all weekend.

My guess is they're digesting all the new data, especially the observation that we might already be into the peak number of cases in NY and possibly NJ, meaning the peak deaths will come sooner and likely be at a lower peak than modeled so far, and that they're going to come out with lower estimated deaths for the US/NY/NJ than the ones below, which were from 4/1. Maybe down 20-30%, to perhaps 70K for the US vs. the current 93K (I was guessing maybe 50K). Or maybe there will be minimal change, since they're seeing more than I am, I'm sure.

We'll see - this is not too different from when I try to guess where the NWS is going to go based on new data that we all have access to, but I can be nimbler with the analysis than they can. Of course a huge difference is this is predicting deaths, which matter far more than the weather, so if they need some more time, they should take it.

That site is from the U of Washington, the same folks I've posted models from for the past few weeks, as they've seemed to have more realistic modeling scenarios. They keep saying they're going to update their models, but they've delayed it all weekend.

My guess is they're digesting all the new data, especially the observation that we might already be into the peak number of cases in NY and possibly NJ, meaning the peak deaths will come sooner and likely be at a lower peak than modeled so far, and that they're going to come out with lower estimated deaths for the US/NY/NJ than the ones below, which were from 4/1. Maybe down 20-30%, to perhaps 70K for the US vs. the current 93K (I was guessing maybe 50K). Or maybe there will be minimal change, since they're seeing more than I am, I'm sure.

We'll see - this is not too different from when I try to guess where the NWS is going to go based on new data that we all have access to, but I can be nimbler with the analysis than they can. Of course a huge difference is this is predicting deaths, which matter far more than the weather, so if they need some more time, they should take it.

I’ve been looking at this site the past few days after a poster added link to this thread some days ago. It had NJ peaking on April 8th up until earlier on Sunday. Looks like it’s been updated and NJ is now peaking on April 15th with NY peaking on April 9th.

GO RU

 

[RU848789]

I’ve been looking at this site the past few days after a poster added link to this thread some days ago. It had NJ peaking on April 8th up until earlier on Sunday. Looks like it’s been updated and NJ is now peaking on April 15th with NY peaking on April 9th.

GO RU

Do you see where it says "last updated?" I've refreshed a few times and it still says April 1st. Maybe I need to restart, lol.

https://covid19.healthdata.org/projections

 

[RU848789]

Long post on whether we might actually have tens of millions infected already...

A perspective I haven't seen before is in the link below. Not sure I buy it, but the authors claim that we had 10 million cases (~3+% of the population) of symptomatic SARS-CoV-2 as of the week of 3/15, from looking back at CDC influenza tracking data on "Non-Influenza Influenza Like Illnesses," as there was a surge of such reports at that time - and they estimate the symptomatic case detection rate of the coronavirus as being only between 1/100 and 1/1000. I don't claim to understand all of their paper, as it's very math heavy and I wasn't about to try to check their calculations/models. Just thought it was interesting...

https://github.com/jsilve24/ili_surge/blob/master/Silverman_and_Washburne.pdf

If true, this would actually be fantastic, as it would mean we might have 5-10% (or more) of the population right now walking around with antibodies and likely immune, which would allow them to not worry about the virus and would mean any second wave would be deprived of a large number of targets. As per the post above, this is why doing antibody testing of a random, representative population is so important, so we can know what percentage of the general population is actually infected and likely immune (the Diamond Princess did show 19% of passengers with CV2, about half of which were asymptomatic). Or at least test every passenger from the DP for antibodies to get a good first guess of the total actual infection rate in the overall population.

This would also mean that the actual IFR (infection fatality rate) is way lower than the CFR (case fatality rate). In the US, for example, the CFR is 2.7% (8454 deaths per 311,600 positive cases), while if we had, say, 33MM infections by now (10% of the population), the IFR would only be 0.02%.

However, to make a meaningful comparison to something like the flu, we'd need the symptomatic illness fatality ratio, which is what the CDC tracks, which is roughly 35,000 deaths per year out of 35,000,000 symptomatic illnesses, which is where the 0.1% "fatality rate" we often see comes from. The CDC doesn't actually track and test all of these illnesses, obviously - they use models, which typically extrapolate from hospitalization rates.

https://www.cdc.gov/flu/about/burden/index.html

Getting back to COVID-19, we know the number of people with actual symptoms is far, far less than 33MM and a decent guess of how many have symptoms is probably the number of tests we've run, so far, since most areas are only testing symptomatic people (1.65MM tested so far). So 8454 deaths/1.65MM symptomatic cases (0.5% of the US population) would be 0.5%, which is about 5X the death rate for the flu. Most projections right now are guesstimating 70-200K deaths (mine has been ~85K) from the coronavirus, assuming fairly aggressive social distancing is maintained and 5X the flu death rate would be 175K deaths, which is in that range, so it's possible this theory isn't crazy.

On the flip side, the reason i'm skeptical is that, so far, the Telluride antibody test program, where they're testing the entire 8000 person county for free, is only showing 1% of the population with antibodies after testing 1000 people, although another 2% had indeterminate results and could be positive. Even at 1%, though, that's still a lot more than the positive case percentage in the US of 0.5% (and Colorado's 0.1% positive cases per capita), but 1% is also a far cry from 10% of the US infected.

https://www.cpr.org/2020/04/02/tell...e-positive-results-but-also-more-uncertainty/

Another issue I have with having so many infections in March, is why didn't we see a lot more infections and deaths in Feb or even Jan, since they can't all come at once in March into April? And then I thought maybe it's possible that we had 5K infected by the end of January and 50K infected by the end of February (with maybe a few hundred deaths in Jan/Feb being erroneously ascribed to flu, as we know we had COVID cases back then, looking back at samples and people with symptoms that weren't recognized as COVID) and we now have millions infected today, actually, (not the 311K positive cases). Maybe this is all crazy, I don't know. Having a hard time reconciling so much conflicting data, probably because we're simply missing so much data, which is not unusual in the first few months of a pandemic.

I'd love to believe that there's already a huge percentage of the population that has been infected and recovered, but it just doesn't seem likely. Heck, my wife had an upper respiratory infection about a month ago. Would be great if that was a mild covid case and we are both now immune.

If we work back...the index case(s) of covid is believed to have occurred in the Wuhan area in mid to late November. It took 2 months for things to get bad enough that Wuhan was locked down. Now take NYC...cases really started exploding in mid-late March (say March 22). Go back 2 months and that takes us to mid-late January. So while it's likely that a few sporadic cases were imported into the US as far back as December, the main seeding probably occurred starting in mid January (and then over time we also got imports from Italy, Iran etc). This makes it relatively unlikely that anyone who experienced a severe flu-like illness in December or January had covid. Not impossible, but unlikely. If it was already widespread by January we would have seen the impact in the hospitals before mid March.

The Telluride study will be interesting. I checked one of the websites that lists cases by county and it looks like they have 9 confirmed cases (by the PCR method I assume). So if the 80/20 rule is accurate, i.e. 80% of cases are mild or asymptomatic (thus presumably not tested) that would suggest 45 total cases in the county. Right now they've got 8 solid positives with 12% tested which would work out to about 64 total. If all the indeterminate cases are actually positive that would work out to 248. Then 9/248 = 3.6% symptomatic and 96.4% asymptomatic. Of course, some of those could become symptomatic over time.

Hopefully they'll find a harder hit relatively small community somewhere in the NY area (maybe 10k pop) where they can run a similar test.

Starting to see more reports of underreporting deaths due to the coronavirus, both now and 1-2 months ago, as per the Times article. Not the most important thing in the world right now, but it lends credence to the thinking that COVID was running through the US much earlier than anyone knew - this is where having testing in place in early February would have been useful - as we know from the work of Dr. Chu in Seattle, there was community spread in that area in late January that wasn't discovered until late February since the CDC didn't give her permission to test the old flu samples she had (and she eventually ignored orders and tested the samples anyway, but too late to really help).

https://www.nytimes.com/2020/04/05/us/coronavirus-deaths-undercount.html

 

[rubaseball78]

Haven't posted in a while since I was getting feedback I was posting fake new. Here is the update I received this morning from work.

"Team...please find attached today's daily AM coronavirus monitor.

There are encouraging signs that global efforts against COVID-19 are having a positive impact. A drop in the number of new diagnoses to the lowest level in six days has prompted hope the outbreak has reached or is nearing a peak. There were 71,418 new cases of Covid-19 confirmed worldwide on Sunday. The total now stands at just under 1.3m. Deaths were also down from recent highs, with 4,737 fatalities.

In the US, the 25,316 cases added on Sunday were the lowest for five days, and more than 9,000 less than Saturday's peak. Currently, total active infections are at 310,416 with fatalities at 9,648.
Also in the US, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, noted Sunday night his belief that anywhere between 25-50% of those infected with COVID-19 may be asymptomatic.

Below is the daily Financial Times graphic highlighting the number of daily coronavirus deaths (7-day rolling average), by number of days since 3 daily deaths were first recorded.

 

[wisr01]

https://abc7.com/health/la-doctor-seeing-success-with-hydroxychloroquine-to-treat-covid-19/6079864/

"Every patient I've prescribed it to has been very, very ill and within 8 to 12 hours, they were basically symptom-free," Cardillo told Eyewitness News. "So clinically I am seeing a resolution."

He said he has found it only works if combined with zinc. The drug, he said, opens a channel for the zinc to enter the cell and block virus replication.

Watch this video to understand why:

 

[satnom]

Do you see where it says "last updated?" I've refreshed a few times and it still says April 1st. Maybe I need to restart, lol.

https://covid19.healthdata.org/projections

COVID-19 projections assuming full social distancing through May 2020
Last updated April 5, 2020.
FAQ | Update Notes | Article
New Jersey
Government-mandated social distancing
March 21, 2020
Stay at home order
March 18, 2020
Educational facilities closed
March 21, 2020
Non-essential services closed
Not implemented
Travel severely limited
Hospital resource use
9days
until peak resource use on
April 15, 2020
Resources needed for COVID-19 patients on peak date
All beds needed
24,702beds
All beds available
7,815beds
Bed shortage
16,887beds
ICU beds needed
4,992beds
ICU beds available
465beds
ICU bed shortage
4,527beds
Invasive ventilators needed
4,242ventilators
All resourcesAll bedsICU bedsInvasive ventilators
05k10k15k20k25k30k35k40k45k50k55k60kResource countMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

All beds available

All beds needed (projected)

ICU beds available

ICU beds needed (projected)

Invasive ventilators needed (projected)
Shaded areas indicate uncertainty
Deaths per day
10days
until projected peak in daily deaths
584COVID-19 deaths
projected on April 16, 2020
02004006008001k1.2k1.4k1.6k1.8k2k2.2k2.4k2.6k2.8kDeaths per dayMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

Deaths per day

Deaths per day (projected)
Shaded area indicates uncertainty
Total deaths
9,690COVID-19 deaths
projected by August 4, 2020
02k4k6k8k10k12k14k16kTotal deathsMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

Total deaths

Total deaths (projected)
Shaded area indicates uncertainty
Download the results (version 2020_04_05.05.us).

 

[Upstream]

COVID-19 projections assuming full social distancing through May 2020
Last updated April 5, 2020.
FAQ | Update Notes | Article
New Jersey
Government-mandated social distancing
March 21, 2020
Stay at home order
March 18, 2020
Educational facilities closed
March 21, 2020
Non-essential services closed
Not implemented
Travel severely limited
Hospital resource use
9days
until peak resource use on
April 15, 2020
Resources needed for COVID-19 patients on peak date
All beds needed
24,702beds
All beds available
7,815beds
Bed shortage
16,887beds
ICU beds needed
4,992beds
ICU beds available
465beds
ICU bed shortage
4,527beds
Invasive ventilators needed
4,242ventilators
All resourcesAll bedsICU bedsInvasive ventilators
05k10k15k20k25k30k35k40k45k50k55k60kResource countMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

All beds available

All beds needed (projected)

ICU beds available

ICU beds needed (projected)

Invasive ventilators needed (projected)
Shaded areas indicate uncertainty
Deaths per day
10days
until projected peak in daily deaths
584COVID-19 deaths
projected on April 16, 2020
02004006008001k1.2k1.4k1.6k1.8k2k2.2k2.4k2.6k2.8kDeaths per dayMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

Deaths per day

Deaths per day (projected)
Shaded area indicates uncertainty
Total deaths
9,690COVID-19 deaths
projected by August 4, 2020
02k4k6k8k10k12k14k16kTotal deathsMar 01Apr 01May 01Jun 01Jul 01Aug 01Date

Total deaths

Total deaths (projected)
Shaded area indicates uncertainty
Download the results (version 2020_04_05.05.us).

I am hoping that this model is overly pessimistic due to a possible data anomaly on Apr 4. The Apr 1 version of this model predicted a total of 2117 deaths in NJ, and that number increased more than four-fold to 9690 on the Apr 5 version of the model.

I am hoping that that increase is due to what I hope is a data anomaly of 200 deaths reported on Apr 4 in NJ. When reporting the 200 number, Gov Murphy noted that the number does not represent 200 people who passed away in the previous 24 hours, but it represents 200 Covid deaths reported in the previous 24 hours. Because of the time delay in getting testing results, earlier deaths are counted as Covid deaths when postmortem positive results are received.

On Apr 5, NJ reported only 71 Covid deaths. Over the past 7 days, NJ reported 37, 69, 88, 182, 109, 200, and 71 deaths. Those numbers are swinging wildly up and down, and that variation is probably more likely due to the timing of receipt of test results.

Also note that on Fri, Apr 3, the state reported that there were about 3000 hospitalized patients with confirmed Covid test results and another 3000 hospitalized patients under investigation, suspected of having Covid and awaiting test results. On Sat, Apr 4, the state reported that the confirmed hospitalizations were over 4000, and under investigation were over 2000. The drop in the under investigation number suggests that Sat, Apr 4, saw a significant number of test results reported.

 

[RU848789]

I am hoping that this model is overly pessimistic due to a possible data anomaly on Apr 4. The Apr 1 version of this model predicted a total of 2117 deaths in NJ, and that number increased more than four-fold to 9690 on the Apr 5 version of the model.

I am hoping that that increase is due to what I hope is a data anomaly of 200 deaths reported on Apr 4 in NJ. When reporting the 200 number, Gov Murphy noted that the number does not represent 200 people who passed away in the previous 24 hours, but it represents 200 Covid deaths reported in the previous 24 hours. Because of the time delay in getting testing results, earlier deaths are counted as Covid deaths when postmortem positive results are received.

On Apr 5, NJ reported only 71 Covid deaths. Over the past 7 days, NJ reported 37, 69, 88, 182, 109, 200, and 71 deaths. Those numbers are swinging wildly up and down, and that variation is probably more likely due to the timing of receipt of test results.

Also note that on Fri, Apr 3, the state reported that there were about 3000 hospitalized patients with confirmed Covid test results and another 3000 hospitalized patients under investigation, suspected of having Covid and awaiting test results. On Sat, Apr 4, the state reported that the confirmed hospitalizations were over 4000, and under investigation were over 2000. The drop in the under investigation number suggests that Sat, Apr 4, saw a significant number of test results reported.

Interestingly, the graphics I posted last night are a mixture: you can tell by where the data line is solid orange (actual data) vs. dashed orange (projection). The US and NY projections were from 4/1 and the NJ projection was from 4/5. Didn't even realize the NJ 4/1 projection was for only 2117 - great catch - and I agree that the jump to 9690 has to be due to the 200 person anomaly on 4/3 (not 4/4 - there were 71 deaths reported on 4/4 and those are not in the model yet - you can see the running total on the graphic and it ends at 856 deaths, not including the 71 on 4/4, so it must be the anomaly). Can you still access older projections? Didn't see a way to do that.

The US projections did drop from 93K to 82K - not as much as I thought they would, but still a significant drop. The NY projections dropped from 16.2K to 15.6K from 4/1 to 4/5 model runs. I added in the 4/5 model runs for the US/NY into my post above for completeness.

 

[Upstream]

Can you still access older projections? Didn't see a way to do that.

I don't know if there is a way to access older projections. I had made a note of the previous projection, so I was able to compare.

But on the website, under Release Notes, they do talk about the fluctuation in deaths for NJ resulting in the change in projection and the high uncertainty in the forecast:

Similar to Colorado, New Jersey’s projections have experienced more fluctuations over our model iterations. Today’s release shows a higher projected number of daily COVID-19 deaths, while the predicted peak date has not varied much over iterations of the model. The reason for the increased peak daily deaths projections is increasingly more deaths being reported in New Jersey over the last few days; by comparison, earlier releases of our projections included very few death counts.

As more data are reported, we will update our estimates and revise our projections to reflect the most recently available data.​

 

[wisr01]

We hope for the same things, but medical science shouldn't rely on hopes, but on controlled clinical studies. With the vast majority of people getting better on their own, it makes it very difficult to measure efficacy without large trials, as per the Chinese study I posted last week, where 14 of 15 patients that weren't seriously ill yet got better without HCQ and 13 of 15 got better with HCQ. Do we believe that study or the one you and I cited with 62 patients? The answer is neither.

The ongoing international (sponsored by WHO) and US (sponsored by the FDA) have \

The study you reference was practically useless as it did not treat with HCQ combined with zinc. It is understood that HCQ is an ionophore and aids in the cellular uptake of zinc which interferes with virus replication. Any study done without the additional treatment with zinc is worth less than zero. Bad science leads to wrong conclusions.

I will quote Dr Cardillo, who has had great succes with HCQ: He said he has found it only works if combined with zinc. The drug, he said, opens a channel for the zinc to enter the cell and block virus replication.

Watch his interview
https://abc11.com/coronavirus-drug-covid-19-malaria-hydroxychloroquine/6079864/

Not hopes it is science.

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176

 

[RU1993]

If you have to go out, you have to go out. Wear a mask, keep away from people, don't touch your face, wash your hands and/or use sanitizer.

It would be great if the whole country could just "stay in" (literally) for like 2 weeks but I don't think that's practical. But talk about mixed messages...they want everyone to say in yet liquors stores are still open, golf courses are still open, most restaurants are open for take out and delivery. Still, if you can stay in you should.

My wife and I haven't been out anywhere public in almost 2 weeks, but we stocked up pretty good before the panic buying started and we've used grocery delivery twice now to top up. She is in the immuno-compromised group so we're really trying to limit exposure.

I understand your point, but not everyone has the means to buy and stock up on weeks of food

 

[RU848789]

Watching Cuomo's presser now and they showed their new model projections plateauing right now with the peak around 20-25K in hospitals vs. the 110K model projection a few weeks ago and even the 50K projection from a week or so ago. This is great news, as it should mean the NY hospitals are not going to be overwhelmed, per se (but conditions are still very difficult there and elsewhere), but we can't let achieving a lower peak and seeing a decline mean we stop social distancing, as this virus will come back with a vengeance if we "go back to normal." We need to go back to work, but not "normal" and that's going to be a big challenge to figure out what the "new normal" looks like.

There's no way "normal" can be allowed anywhere until we either have herd immunity (50% infected?), which we won't have as the highest estimates I've seen are 5-10% infected now (vs. the 0.1-0.2% tested positive for the virus), or a very effective treatment that keeps people from getting very sick and dying once infected, as people might be willing to go back to normal if they knew there was a life-saving option out there (since the vast majority of people won't get appreciably ill).

In my opinion, the only short term (available in maybe a month if the trials come back positive - we already have blood collection and plasma distribution systems in place - we'd just need to get the plasma to the right patients) hope for that is the plasma-antibody therapy if it pans out as well as it has looked in very, very small, uncontrolled applications. That could easily be scaled to treat tens of thousands of people at a time (there are only about 9000 seriously ill right now in the US, although we'd probably want to be able to treat 10X that to prevent people from getting seriously ill).

I'm almost certain that HCQ isn''t the answer as we'd know it by now, given how many are on it and there's been no obvious death rate decrease. Beyond that the engineered antibody approaches will be ready by late summer and they hold great promise. I just don't see vaccines being ready before the end of the year, though.

And I doubt any of the other treatments will work well enough to give people confidence to go back to normal. Maybe some of the engineered antibody approaches could be in place by late summer, from what I've read and a vaccine is at least 11-12 months away, so the prospects for allowing large crowds are very low right now.

 

[RU848789]

The study you reference was practically useless as it did not treat with HCQ combined with zinc. It is understood that HCQ is an ionophore and aids in the cellular uptake of zinc which interferes with virus replication. Any study done without the additional treatment with zinc is worth less than zero. Bad science leads to wrong conclusions.

I will quote Dr Cardillo, who has had great succes with HCQ: He said he has found it only works if combined with zinc. The drug, he said, opens a channel for the zinc to enter the cell and block virus replication.

Watch his interview
https://abc11.com/coronavirus-drug-covid-19-malaria-hydroxychloroquine/6079864/

Not hopes it is science.

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176

Sounds anecdotal still. Would be nice for him to share his data and it would be fantastic if what he says is clinically true (without controlled trials he can't say that). I'm always suspicious of people who go to the media before going to their medical peers, like Raoult and the NJ guy. Also, the study you showed is certainly science, but it's in vitro data from 2010 and there are plenty of drugs that inhibit coronaviruses in vitro - having them work in humans is a huge, huge step up in complexity.

 

[wisr01]

I'm almost certain that HCQ isn''t the answer as we'd know it by now, given how many are on it and there's been no obvious death rate decrease. Beyond that the engineered antibody approaches will be ready by late summer and they hold great promise. I just don't see vaccines being ready before the end of the year, though.

Based on what? Studies where they did not administer zinc with HCQ? Many of the clinicals I have seen are not combining zinc therapy. Do we even have an ongoing study that includes zinc? HCQ role is a facilitator to cell uptake of zinc which has been shown to inhibit virus replication. Any study of HCQ without including zinc is WORTHLESS as it ignores the science behind why it might work.

 

[Ronnie_B]

Watching Cuomo's presser now and they showed their new model projections plateauing right now with the peak around 20-25K in hospitals vs. the 110K model projection a few weeks ago and even the 50K projection from a week or so ago. This is great news, as it should mean the NY hospitals are not going to be overwhelmed, per se (but conditions are still very difficult there and elsewhere), but we can't let achieving a lower peak and seeing a decline mean we stop social distancing, as this virus will come back with a vengeance if we "go back to normal." We need to go back to work, but not "normal" and that's going to be a big challenge to figure out what the "new normal" looks like.

There's no way "normal" can be allowed anywhere until we either have herd immunity (50% infected?), which we won't have as the highest estimates I've seen are 5-10% infected now (vs. the 0.1-0.2% tested positive for the virus), or a very effective treatment that keeps people from getting very sick and dying once infected, as people might be willing to go back to normal if they knew there was a life-saving option out there (since the vast majority of people won't get appreciably ill).

In my opinion, the only short term (available in maybe a month if the trials come back positive - we already have blood collection and plasma distribution systems in place - we'd just need to get the plasma to the right patients) hope for that is the plasma-antibody therapy if it pans out as well as it has looked in very, very small, uncontrolled applications. That could easily be scaled to treat tens of thousands of people at a time (there are only about 9000 seriously ill right now in the US, although we'd probably want to be able to treat 10X that to prevent people from getting seriously ill).

I'm almost certain that HCQ isn''t the answer as we'd know it by now, given how many are on it and there's been no obvious death rate decrease. Beyond that the engineered antibody approaches will be ready by late summer and they hold great promise. I just don't see vaccines being ready before the end of the year, though.

And I doubt any of the other treatments will work well enough to give people confidence to go back to normal. Maybe some of the engineered antibody approaches could be in place by late summer, from what I've read and a vaccine is at least 11-12 months away, so the prospects for allowing large crowds are very low right now.

My biggest fear is say the numbers decrease significantly this week that the same knuckleheads that helped drive the numbers up and are now adhering to the social distancing measures will think the coast is clear and return to their detrimental ways.

 

[cohwx]

I understand your point, but not everyone has the means to buy and stock up on weeks of food

That's why you wear a mask, avoid people, wash your hands if you have to go out.

 

[cohwx]

I'm almost certain that HCQ isn''t the answer as we'd know it by now, given how many are on it and there's been no obvious death rate decrease. Beyond that the engineered antibody approaches will be ready by late summer and they hold great promise. I just don't see vaccines being ready before the end of the year, though.

And I doubt any of the other treatments will work well enough to give people confidence to go back to normal. Maybe some of the engineered antibody approaches could be in place by late summer, from what I've read and a vaccine is at least 11-12 months away, so the prospects for allowing large crowds are very low right now.

I'm not optimistic about the HCQ either. Just saw a study yesterday claiming poor results, though it was a very small group of patients. I don't think they were using zinc and am not sure how many of the trials are using zinc, sounds like most are using HCQ+zpack. We should know soon enough though since info should start coming out from the China studies. I'm really hoping the remdesivir shows some positive results.

Interestingly, I've been reading a book about the 1918 pandemic and there are so many similarities to what we're going through now. Government and media were downplaying the severity, though in fairness they kept doing that even as the deaths were piling up. At least this time people have mostly come around to realize the severity of what is going on. The other interesting aspect was that they were touting quinine water as a cure ("it works for malaria") and there were doctors claiming miraculous results with it and other crazy treatments. How far we've come in 100 years!

 

[Scarlet16E]

Its important to remember as we go forward, that the reason we shut the country down was to try to flatten the curve and reduce the strain on the hospitals at the apex. That does appear to be happening. By definition if NY is in a plateau, then we have flattened the curve.

We do not need to shut the economy down forever. Once the peak of the crisis is past, then some phasing in of "normal" activity must happen. If this is done slowly and carefully we can begin to acquire a herd immunity, while having kept the apex of the crisis within the limits of our healthcare system.

 

[Wolv RU]

Starting to see more reports of underreporting deaths due to the coronavirus, both now and 1-2 months ago, as per the Times article. Not the most important thing in the world right now, but it lends credence to the thinking that COVID was running through the US much earlier than anyone knew - this is where having testing in place in early February would have been useful - as we know from the work of Dr. Chu in Seattle, there was community spread in that area in late January that wasn't discovered until late February since the CDC didn't give her permission to test the old flu samples she had (and she eventually ignored orders and tested the samples anyway, but too late to really help).

https://www.nytimes.com/2020/04/05/us/coronavirus-deaths-undercount.html

I've seen in more than one place that there is also over-reporting, as if a patient has COVID and then dies for another reason it is counted as a COVID death. Perhaps the best thing that can be done is to compare total deaths in a location in March 2020 compared to March 2019 for example (or whatever the appropriate baseline comparison is).

Since China is much further along, this is probably one of the most helpful pieces of information they could provide everyone else, if they were truly being honest with their data (which I personally don't believe their reported numbers are even worth considering). How many more people died in Wuhan/China in Jan or Feb or March 2020 compared to 2019?

 

[RU848789]

Based on what? Studies where they did not administer zinc with HCQ? Many of the clinicals I have seen are not combining zinc therapy. Do we even have an ongoing study that includes zinc? HCQ role is a facilitator to cell uptake of zinc which has been shown to inhibit virus replication. Any study of HCQ without including zinc is WORTHLESS as it ignores the science behind why it might work.

View embedded media

That's a nice tutorial on how the virus works, but it contains no data on whether or not HCQ + Zn would work in COVID patients. There are clinical trials going on with HCQ and Zn, so we'll hopefully see whether that has any efficacy.

My skepticism on HCQ and HCQ/azithromycin is based on lack of controlled clinical data and the small studies that have been published to date are inconclusive for various reasons (too small, not randomized, etc.). That plus the fact that I've seen reports of 25-50% of COVID patients being given some form of HCQ in various countries and the fatality rate has only gone up, in general, over the last month or so. That's not proof, but if HCQ was any kind of "cure" I'd expect to see some amazing reduction in deaths, but we're not seeing that.

By the way, if anyone is curious, despite reports to the contrary including the POTUS speculating HCQ might be preventing those with lupus from getting the virus, there does not appear to be any protective benefit of taking HCQ in lupus patients, as per below.

“Based on early data currently available in our registry, we are not able to report any evidence of a protective effect from hydroxychloroquine against COVID-19. A randomized, controlled trial would be the only way to study this to get a reliable answer to this question.”

In addition, here is more of Dr. Trump speculating on medical science inappropriately:

“They should look at the lupus thing. I don’t know what it says, but there’s a rumor out there that because it takes care of lupus very effectively as I understand it, and it’s a, you know, a drug (HCQ) that’s used for lupus,” President Trump said during the briefing. “So there’s a study out there that says people that have lupus haven’t been catching this virus. Maybe it’s true, maybe it’s not.”

It is not true.

https://creakyjoints.org/symptoms/lupus-patients-do-get-coronavirus/

 

[Wolv RU]

I am hoping that this model is overly pessimistic due to a possible data anomaly on Apr 4. The Apr 1 version of this model predicted a total of 2117 deaths in NJ, and that number increased more than four-fold to 9690 on the Apr 5 version of the model.

I am hoping that that increase is due to what I hope is a data anomaly of 200 deaths reported on Apr 4 in NJ. When reporting the 200 number, Gov Murphy noted that the number does not represent 200 people who passed away in the previous 24 hours, but it represents 200 Covid deaths reported in the previous 24 hours. Because of the time delay in getting testing results, earlier deaths are counted as Covid deaths when postmortem positive results are received.

On Apr 5, NJ reported only 71 Covid deaths. Over the past 7 days, NJ reported 37, 69, 88, 182, 109, 200, and 71 deaths. Those numbers are swinging wildly up and down, and that variation is probably more likely due to the timing of receipt of test results.

Also note that on Fri, Apr 3, the state reported that there were about 3000 hospitalized patients with confirmed Covid test results and another 3000 hospitalized patients under investigation, suspected of having Covid and awaiting test results. On Sat, Apr 4, the state reported that the confirmed hospitalizations were over 4000, and under investigation were over 2000. The drop in the under investigation number suggests that Sat, Apr 4, saw a significant number of test results reported.

Good point. There would be a lot more to go on if more information was provided. More important than raw numbers reported are the reasons that those numbers are changing.

 

[RU848789]

My biggest fear is say the numbers decrease significantly this week that the same knuckleheads that helped drive the numbers up and are now adhering to the social distancing measures will think the coast is clear and return to their detrimental ways.

And some will, but hopefully only a small percentage...

 

[wisr01]

That's a nice tutorial on how the virus works, but it contains no data on whether or not HCQ + Zn would work in COVID patients. There are clinical trials going on with HCQ and Zn, so we'll hopefully see whether that has any efficacy.

My skepticism on HCQ and HCQ/azithromycin is based on lack of controlled clinical data and the small studies that have been published to date are inconclusive for various reasons (too small, not randomized, etc.). That plus the fact that I've seen reports of 25-50% of COVID patients being given some form of HCQ in various countries and the fatality rate has only gone up, in general, over the last month or so. That's not proof, but if HCQ was any kind of "cure" I'd expect to see some amazing reduction in deaths, but we're not seeing that.

By the way, if anyone is curious, despite reports to the contrary including the POTUS speculating HCQ might be preventing those with lupus from getting the virus, there does not appear to be any protective benefit of taking HCQ in lupus patients, as per below.

“Based on early data currently available in our registry, we are not able to report any evidence of a protective effect from hydroxychloroquine against COVID-19. A randomized, controlled trial would be the only way to study this to get a reliable answer to this question.”

In addition, here is more of Dr. Trump speculating on medical science inappropriately:

“They should look at the lupus thing. I don’t know what it says, but there’s a rumor out there that because it takes care of lupus very effectively as I understand it, and it’s a, you know, a drug (HCQ) that’s used for lupus,” President Trump said during the briefing. “So there’s a study out there that says people that have lupus haven’t been catching this virus. Maybe it’s true, maybe it’s not.”

It is not true.

https://creakyjoints.org/symptoms/lupus-patients-do-get-coronavirus/

I looked on Clinicaltrials.gov and could not find a studt that included zinc. Do you have a link for that study? I would like to review it's design.

 

[Upstream]

I looked on Clinicaltrials.gov and could not find a studt that included zinc. Do you have a link for that study? I would like to review it's design.

https://clinicaltrials.gov/ct2/results?term=hydroxychloroquine+zinc

 

[wisr01]

https://clinicaltrials.gov/ct2/results?term=hydroxychloroquine+zinc

I was looking for Active studies, so no studies ongoing as of yet.

 

[ashokan]

This doctor working on CV19 patients thinks the disease is different from what staff expected. He thinks the ventilators - while needed - might be making people worse. He says he's not seeing pneumonia but something more like oxygen deprivation/ altitude sickness

 

[Upstream]

I was looking for Active studies, so no studies ongoing as of yet.

Oh. OK. I was interested in your insight regarding study design.