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

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Regarding fatality rates, my wife's friend mentioned on a group text that her lab is part of a new study. Select wastewater treatment facilities are sampling viral loads in their inflows, and can spot the increases & decreases in COVID cases in their area up to 10 days before the human tests show same. With a little numerical modeling, they are able to make guesses as to how many people are infected with Sars-Cov-2. In short, the facility she works in is seeing viral loads for triple the number of reported confirmed cases. Obviously, the data model may be overpredicting cases, but if the number of actual infections is even double current confirmed cases, the fatality rate of COVID-19 would be way less too, since it seems everyone who dies gets tested already.

Viral levels in wastewater has been discussed a few times here (not that I would expect you to know every post in 170 pages!) and it's a very interesting topic. Completely agree they can be a good indicator before testing, as can the real-time on-line fever indicators that many wear.

With regard to infection fatality rates, however, they don't add any new info, really. As I've posted many times, we now have antibody results in whole state populations and some cities (and countries) that generally indicate that the number of people infected are about 5-10X the positive case rate by PCR viral test (NY had ~12% positive back in early May and had about 1.7% infected by viral test, for a ratio of ~7:1). And NY in early May had 24K deaths and 12% of their pop is 2.4MM, so an IFR of 1.0%.

NY and Spain, right now, have the best IFR data, since both have antibody data (and of course deaths) and both are in the 1.0-1.2% IFR range. This is why I keep repeating how worried I am about not continuing with interventions, like masks/social distancing (and testing/tracing/isolating cases), since failure to do so could result in over 1MM US deaths eventually (assuming no cure/vaccine, which I think we'll have and assuming no weakening of the virus and no built-in immunity in large % of the population; these are all to show the worst case estimate, which is credible). It's very simple math: 330MM x 55-80% infected (herd immunity level) x 0.5-1.0% IFR (being conservative assuming some drop-off) = 900K-2.6MM deaths actually is the range.
 
Technically , it's possible

Let's say he got a haircut on January 22

Some people only go every two months.

He was due for a cut on March 22.
Couldn't do so.

He would be coming up on 6 months in a few weeks
5 months...and the person in your hypothetical scenario should’ve had the foresight to get a haircut the weekend of the 15th. Personal responsibility!
 
I am the boat.
iu
 
This is unsurprising.

These 14 states just hit their highest 7-day average of Covi-19 cases:

Alaska
Arizona
Arkansas
California
Florida
Kentucky
New Mexico
North Carolina
Mississippi
Oregon
South Carolina
Tennessee
Texas
Utah

It's only surprising to the head-in-the-sand crowd who think the virus is "over" or "weakened" or whatever, which is ridiculous with only about 3-5% of the US population likely having been infected (with hotspots of up to 20% infected, like NYC and likely NE NJ adjacent to NYC) at this point and herd immunity being somewhere from 55-80% and certainly no signs of the virus weakening across much of the rest of the world where deaths are going up. US/Europe deaths have gone way down due to interventions, like lockdowns, social distancing, masks and more testing/better treatments, not due to any change in the virus.

Here's the WaPo article on this, although to be fair, these states aren't seeing exponential growth like we did in the DC-Boston corridor, but still, record new case rates are at least alarming and could indicate even worse numbers coming, if these states continue to have large numbers of people ignoring social distancing and mask wearing, as most of them have.

https://www.washingtonpost.com/heal...y-average-new-covid-19-infections-since-june/
 
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Here's the paper from Boulware in the NEJM. HCQ is not effective in hospitalized patients as per many, many studies and now it's not effective for post-exposure prophylaxis in a well-controlled trial. I suppose it's theoretically possible it would be effective in mildly symptomatic patients or could be a true prophylactic, but it's highly unlikely. I'd like to see us close the book on this failed experiment and start spending our precious clinical resources on treatments that might actually work.

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query=featured_home

RESULTS
We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported.

CONCLUSIONS
After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure.

And a second randomized, controlled, blinded clinical trial with 2300 patients is coming out shortly, which the study author says shows HCQ had no benefit in post-exposure prophylaxis (similar to the Boulware study). Obviously, need to see the results to make observations/conclusions, but it's certainly not looking like HCQ is effective in preventing infections (or knocking them out early) for patients who have been exposed to the virus.

https://www.sciencemag.org/news/202...roxychloroquine-can-treat-or-prevent-covid-19

A second large PEP trial has come up empty as well, its leader tells Science. Carried out in Barcelona, Spain, that study randomized more than 2300 people exposed to the virus to either hydroxychloroquine or the usual care. There was no significant difference between the number of people in each group who developed COVID-19, says Oriol Mitjà of the Germans Trias i Pujol University Hospital. Mitjà says he has submitted the results for publication.

Still awaiting some trials on pre-exposure prophylaxis, but I've always been very skeptical of those, since lupus patients on HCQ actually get infected at a higher rate than RA patients, in general. And we already know that HCQ is not effective in hospitalized settings based on most retrospective studies showing no benefit (although some do), but moreso on the "Recovery" trial results released the other day, in which a randomized, standard-of-care controlled trial (the "gold standard" in clinical medicine) showed no efficacy for HCQ.

https://rutgers.forums.rivals.com/t...entions-and-more.191275/page-149#post-4599886
 
5 months...and the person in your hypothetical scenario should’ve had the foresight to get a haircut the weekend of the 15th. Personal responsibility!
Foresight...has it been so long that you forget this temporary shutdown of the country was sold to us as a 2 week, maybe 3 weeks tops, event.
 
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