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

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Numbers ...how many people do you think are infected here in New Jersey ? Double the amount of reported confirmed positives ? Triple ? Ten times ?
Although you asked @RU848789 , I'll offer my take on the question.

I believe that NJ's testing criteria are still fairly restrictive, so only people with significant symptoms are getting tested.

For the most part, it seems that only those who fall into the category of the 10% most seriously ill are being tested in NJ, so the 427 cases in NJ (reported as of Wednesday afternoon) probably only represents about 10% of the symptomatic cases. So that means there are about 4270 symptomatic cases in NJ.

But since it takes about 3 days for test results to be confirmed, that is 4270 symptomatic cases as of 3 days ago. If the number of cases double in 3 days, that means there are more than 8500 symptomatic cases today. And since there is an expectation that half the people with the virus are asymptomatic, that means there are another 8500 asymptomatic people, for a total over 17,000 infected people in NJ today.

That is why it is so important to significantly ramp up testing. The only way to see if our actions are having an impact in reducing spread of disease is to test everyone with potential symptoms, along with large numbers of asymptomatic people. A state like NJ really needs to ramp up quickly to be able to test 5000-10,000 people every day.

The State also need to collect and report the total number of people tested, and the number that test negative, along with the number that have tested positive.
 
Numbers ...how many people do you think are infected here in New Jersey ? Double the amount of reported confirmed positives ? Triple ? Ten times ?
Rule of thumb in a low testing environment, like we're in is about 10X, so if the US has 8000 positive results, we likely have 80,000 infected people, half of whom are asymptomatic and many of them being contagious. I have links to the 10% number somewhere, but I posted the half asymptomatic links yesterday as that's hard data from the Diamond Princess and a recent Italian study.
 
Update from Medscape on the potential treatment "breakthrough" with the anti-malaria treatment HQC (and HQC with azithromycin antibiotic). Experts appear to be divided on this, since the French study by Raoult was open label, but it was controlled with placebo and showed some startling results. Some didn't like that the results were released on YouTube, but this guy Raoult ia a world virology expert, so shouldn't be dismissed.

Larger trials are needed, but for people who are at death's door, I would think they'd start screaming for his drug, if other options haven't worked; in addition, if it can greatly reduce/eliminate the virus, doctors will be screaming for it, so they can get patients out of the ICU. On the flip side, hope is good but false hope is very painful, so let's not celebrate yet, as there have been false starts before on "cures." First of 3 pages of article is reprinted below. Stay tuned.

https://www.medscape.com/viewarticle/927033

Could the old generic malaria drug hydroxychloroquine (Plaquenil, Sanofi-Aventis, among others), which is also used for the treatment of rheumatic disease, be an essential treatment for COVID-19?

This hypothesis, put forward by some, including Professor Didier Raoult of the IHU Méditerranée Infection in Marseille, was dismissed by other eminent infectious disease specialists and dismissed as fake news recently by the Ministry of Health.

Yet it resurfaced yesterday with the presentation on YouTube by Prof Raoult of positive results in a non-randomised, unblinded trial of 24 patients.

This follows encouraging in vitro results obtained by a Chinese team led by Xueting Yao, from Peking University Third Hospital, Beijing, China, which were published online by the journal Clinical Infectious Diseases on March 9th. However, the data were deemed insufficient by the infection community to recommend the compound as a treatment.


Moreover, chloroquine is not listed among the four treatments studied as part of the recently launched European clinical trial piloted by Inserm, which includes 3200 severe hospitalised patients, including 800 French patients.

Chloroquine was ruled out due to the risk of interactions with other medications for common comorbidities in infected patients, and because of possible adverse effects in patients undergoing resuscitation.

The Marseille Study
The European Union Clinical Trials Register shows that the Marseille study was accepted on 5th March by the National Medicines Safety Agency (ANSM). It could include up to 25 COVID-19 positive patients, comprising five aged 12–17 years, 10 aged 18–64 years, and 10 more aged 65 years or over.

While the data have not yet been published, and should therefore be interpreted with caution, this non-randomised, unblinded study showed a strong reduction in viral load with hydroxychloroquine.

After 6 days, the percentage of patients testing positive for COVID-19 who received hydroxychloroquine fell to 25% versus 90% for those who did not receive the treatment (a group of untreated COVID-19 patients from Nice and Avignon).

In addition, comparing untreated patients, those receiving hydroxychloroquine and those given hydroxychloroquine plus the antibiotic azithromycin, the results showed there was "a spectacular reduction in the number of positive cases" with the combination therapy, said Prof Raoult.

At 6 days, among patients given combination therapy, the percentage of cases still carrying SRAS-CoV-2 was no more than 5%.

Azithromycin was added because it is known to be effective against complications from bacterial lung disease but also because it has been shown to be effective in the laboratory against a large number of viruses, the infectious disease specialist explained.

"The aim is not to be right but that our patients get better. No treatment is magic and the publication of the results raises questions but between doing nothing and repositioning drugs based on their adverse effects, interactions, etc, we try things as we go."

Dr. Raoult issued the actual paper on HCQ/Azithromycin today (first link) and Mr. Rigano did a spot on Fox tonight (2nd link). Still some skepticism in the medical community, and I have to admit that Mr. Rigano, who is a lawyer, and an advisor to the Stanford School of Medicine, comes off like a salesman in the Fox video, but if Dr. Raoult is correct, this is a game changer.

The data are stunning - 100% virologically cured with the combo by Day 6 vs. 57% cured with just HCQ and 12% in the control. Was a small study (42 patients) though and 6 patients dropped out, which is why some are concerned. However, it should be simple to replicate this on a larger scale and it needs to be done ASAP. I also imagine doctors and patients are going to be demanding these drugs based on this and fortunately both are generic, but I don't know the supply chain landscape.

As an aside it's also way premature to be calling this the 2nd ever 100% virus cure based on that limited of a data set, which is why there's skepticism. It took Pharmasett (and then Gilead who bought them when Merck stupidly failed to buy them) quite some time to make those claims for sofosbuvir curing Hep C, which it has. As an aside, the two active ingredients for Merck's HCV antiviral Zepatier were first scaled up and optimized, before manufacturing and launch, in my group in 2014-2016, but alas, we got to market too late.

https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4eneY_IlWSHnGbj/view

 
I think it has to be exponentially higher. I know individuals who are sick and show some symptoms (dry cough, fever) and can’t approved for testing. Up until yesterday I think the state had only tested around 400 people, of which half came back positive. We do not have the testing capability to truly determine how bad this is which is worrisome.

What's the point of testing? Majority are fine, you stay home, self quarantine, self monitor and you get better.

I say this as someone who has symptoms. Could I get tested, sure. I don't see the point. If breathing becomes an issue I call my doctor and go to the ER. There is no magic here.
 
For those who keep holding on to the idea that this is only dangerous to the elderly...

https://www.nytimes.com/2020/03/17/health/coronavirus-childen.html
I mentioned a few times more than half of France’s ICU cases are people under 60. Just saw on the news here 40% of the people hospitalized in the US are people 20-54.

In NJ there’s that Freehold family where 7 members contracted it at a family gathering and now I believe 3 of them have passed. The mother who was in her 70s but also two of her kids in their 50s IIRC. 4 others still in hospital but 3 of those are still critical.

Edit:
https://www.nj.com/coronavirus/2020...-to-coronavirus-as-devastation-continues.html
 
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Rule of thumb in a low testing environment, like we're in is about 10X, so if the US has 8000 positive results, we likely have 80,000 infected people, half of whom are asymptomatic and many of them being contagious. I have links to the 10% number somewhere, but I posted the half asymptomatic links yesterday as that's hard data from the Diamond Princess and a recent Italian study.
While that is clearly bad from a transmission standpoint and adds to likelihood of exponential spread, isn't there a silver lining here in that perhaps many more people than we know may have been exposed, had the virus, and already recovered, thus beginning to create a large segment of the population with some level of immunity? Or will the virus mutate so much that immunity to the current version won't make a difference later?
 
While that is clearly bad from a transmission standpoint and adds to likelihood of exponential spread, isn't there a silver lining here in that perhaps many more people than we know may have been exposed, had the virus, and already recovered, thus beginning to create a large segment of the population with some level of immunity? Or will the virus mutate so much that immunity to the current version won't make a difference later?
I've read that people have had it, recovered, tested negative, and then later tested positive again. Think something like 14% have had 2 seperate episodes, though I'm not sure how legit that was.

Ive also heard there are two different strains out there, one on the more mild side, one on the more serious side. Maybe this plays into the above?
 
What's the point of testing? Majority are fine, you stay home, self quarantine, self monitor and you get better.

I say this as someone who has symptoms. Could I get tested, sure. I don't see the point. If breathing becomes an issue I call my doctor and go to the ER. There is no magic here.


The point is that the appropriate measures to curtail this are still not being taken. Not everyone is home and a lot of people are still being called in to work. You also have the individuals who are asymptomatic or have minor symptoms that are then transmitting the virus without even knowing.

Adequate testing will give the government a better idea of how many people in our population are carrying the virus and pressure them to be more proactive.
 
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While that is clearly bad from a transmission standpoint and adds to likelihood of exponential spread, isn't there a silver lining here in that perhaps many more people than we know may have been exposed, had the virus, and already recovered, thus beginning to create a large segment of the population with some level of immunity? Or will the virus mutate so much that immunity to the current version won't make a difference later?

So far scientist have claimed that the virus is not the type that can mutate - at least unlike the way the flu mutates. Which means developing immunity and vaccines would be effective. Hopefully this is indeed the case.

And yes, the silver lining, if indeed more are possibly infected, is that the denominator for calculating the death rate would be much higher, and thus suggesting that it is not as potent as we thought for the general population. HOWEVER, there is Italy, so it is potent enough to warrant all necessary precaution. What would really help is a 14 day mandatory lockdown for everyone.
 
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The point is that the appropriate measures to curtail this are still not being taken. Not everyone is home and a lot of people are still being called in to work. You also have the individuals who are asymptomatic or have minor symptoms that are then transmitting the virus without even knowing.

Adequate testing will give the government a better idea of how many people in our population are carrying the virus and pressure them to be more proactive.

With some exceptions, I'm not sure how useful if would be to test those that are asymptomatic. Just because you test negative today means nothing tomorrow. Overall I think the clamor about testing is a distraction. Analysis of the spread of the virus does not require mass testing of the asymptomatic. We have statistical methods for that.
 
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I've read that people have had it, recovered, tested negative, and then later tested positive again. Think something like 14% have had 2 seperate episodes, though I'm not sure how legit that was.

Ive also heard there are two different strains out there, one on the more mild side, one on the more serious side. Maybe this plays into the above?

I believe the two strain hypothesis comes from trying to explain why Italy is such an outlier. There is no confirmation of it - hopefully that's the case. Otherwise, we will have to endure this for a very long time - like at least two years.
 
Dr. Raoult issued the actual paper on HCQ/Azithromycin today (first link) and Mr. Rigano did a spot on Fox tonight (2nd link). Still some skepticism in the medical community, and I have to admit that Mr. Rigano, who is a lawyer, and an advisor to the Stanford School of Medicine, comes off like a salesman in the Fox video, but if Dr. Raoult is correct, this is a game changer.

The data are stunning - 100% virologically cured with the combo by Day 6 vs. 57% cured with just HCQ and 12% in the control. Was a small study (42 patients) though and 6 patients dropped out, which is why some are concerned. However, it should be simple to replicate this on a larger scale and it needs to be done ASAP. I also imagine doctors and patients are going to be demanding these drugs based on this and fortunately both are generic, but I don't know the supply chain landscape.

As an aside it's also way premature to be calling this the 2nd ever 100% virus cure based on that limited of a data set, which is why there's skepticism. It took Pharmasett (and then Gilead who bought them when Merck stupidly failed to buy them) quite some time to make those claims for sofosbuvir curing Hep C, which it has. As an aside, the two active ingredients for Merck's HCV antiviral Zepatier were first scaled up and optimized, before manufacturing and launch, in my group in 2014-2016, but alas, we got to market too late.

https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4eneY_IlWSHnGbj/view


I'm not clear on why Mr. Rigano was interviewed on this. What's his connection to the study by Dr. Raoult?
Tucker said it right - we have to be skeptical, but if true this is huge news. Could change everything and end this disaster quickly.
 
With some exceptions, I'm not sure how useful if would be to test those that are asymptomatic. Just because you test negative today means nothing tomorrow. Overall I think the clamor about testing is a distraction. Analysis of the spread of the virus does not require mass testing of the asymptomatic. We have statistical methods for that.
You are missing the point. Let's say that due to the shortage in testing we have 5000 people with this virus as opposed to the reported 500. That number is going to continue to increase and get out of control. Eventually leading to an Italy-style lockdown. That's where this is heading imo, I think it would be smarter to be more proactive now rather than clean up the mess later.
 
You are missing the point. Let's say that due to the shortage in testing we have 5000 people with this virus as opposed to the reported 500. That number is going to continue to increase and get out of control. Eventually leading to an Italy-style lockdown. That's where this is heading imo, I think it would be smarter to be more proactive now rather than clean up the mess later.
I think we should assume that we have at least 10X the number of infected people that's been being reported as confirmed cases, and I'm pretty certain that our government leaders of all political stripes know this. I actually cringe every time the media breathlessly reports the updated number of cases. They should be reporting the CDC's estimated number of cases, if anything.

I'd prefer that they stop reporting actual numbers and switch to per capita infection, death, and survival rates.
 
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I think we should assume that we have at least 10X the number of infected people that's been being reported as confirmed cases, and I'm pretty certain that our government leaders of all political stripes know this. I actually cringe every time the media breathlessly reports the updated number of cases. They should be reporting the CDC's estimated number of cases, if anything.

I'd prefer that they stop reporting actual numbers and switch to per capita infection, death, and survival rates.

Ok so we have a similar train of thought. Where we differ is that I don't have the same amount of trust in the higher ups that you do. I'm thinking that in order to implement change quickly, the general public (employers, young adults, etc) will have to be on board- which imo is hard to do when the actual numbers are not being reported due to a lack in testing
 
With some exceptions, I'm not sure how useful if would be to test those that are asymptomatic. Just because you test negative today means nothing tomorrow. Overall I think the clamor about testing is a distraction. Analysis of the spread of the virus does not require mass testing of the asymptomatic. We have statistical methods for that.

Agree that a risk of extensive testing could give false security to those who test negative. Just because they are negative at the time of the test, does not mean that they cannot be infected later (or are already infected, but too soon for the test to show positive).

Disagree that statistical models can provide an analysis of the spread without extensive testing. Without extensive testing, there is not enough data to build a model around. To build a reliable model, you either need randomized testing (which is not happening if only severely symptomatic people are tested), or large population data.

That doesn't mean that everyone in NJ needs to be tested. But you need significant numbers, a magnitude greater than what we are seeing now.
 
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Just had our morning catch up at work via video conference, apparently they are now testing in Morristown, but you have to call and be confirmed with symptoms.
 
I keep reading and seeing on the news how long the virus stays on stainless steel, plastic, cardboard, and so on,
but I see nothing on clothing, what is the story on clothing?
Also when at home do we open a window ? I say yes, my wife says no your letting in germs.
I have children and grand children coming and going.
 
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A two to four week lockdown sounds great, until you realize how many people will not get paid, and how many businesses would not survive.
 
You are missing the point. Let's say that due to the shortage in testing we have 5000 people with this virus as opposed to the reported 500. That number is going to continue to increase and get out of control. Eventually leading to an Italy-style lockdown. That's where this is heading imo, I think it would be smarter to be more proactive now rather than clean up the mess later.

This country isn't Italy and their health care system is 3rd world. And i am not downplaying i am just saying Italy is a poor comparison for several reasons
 
I keep reading and seeing on the news how long the virus stays on stainless steel, plastic, cardboard, and so on,
but I see nothing on clothing, what is the story on clothing?

Not alot of specific studies. Use common sense. If you are out somewhere where you have alot of contact with people, change when you get home and wash your hands
 
Not alot of specific studies. Use common sense. If you are out somewhere where you have alot of contact with people, change when you get home and wash your hands
No. First you shouldn't be "out somewhere where you have a lot of contact with people," and if you are, while yes you should decontaminate yourself as best as you can, by far the more important thing you should then realize is that you are now potentially infected and should absolutely self-quarantine and not infect others.
 
This country isn't Italy and their health care system is 3rd world. And i am not downplaying i am just saying Italy is a poor comparison for several reasons

Time will tell, I know nurses at ER’s that have told me the situation is much worse than what is being reported and that they are being completely inundated in north jersey. This is only going to get worse. Will be interesting to see where we are two weeks from now.
 
No. First you shouldn't be "out somewhere where you have a lot of contact with people," and if you are, while yes you should decontaminate yourself as best as you can, by far the more important thing you should then realize is that you are now potentially infected and should absolutely self-quarantine and not infect others.

Dude people have to run errands like grocery store or go to a bank

I realize you are doing the boy in the plastic bubble routine and that is fine but most every else has to get supplies and yes gasp...some people actually have to go to ****ing work in offices and buildings..holy moly
 
Last night as I was watching the news, I just kept getting angry. How can the government not just mass produce everything? How is testing still an issue? They need to switch over anything they can to make protective gear, test kits, ventilators, oxygen etc.

I am on board with the amount of people "confirmed" is complete and utter BS. It's definitely vastly under reported and the fact that we aren't capable/ willing to test everything that may be positive is crazy. I know this first hand, sick people told to stay at home if not critical with no tests.

We need to lockdown everyone simultaneously, this slow march to it will do nothing. After the lockdown we will need everyone to wear masks to keep transmission down. (is this crazy, maybe?)

Sorry for the rant, I just see the tidal wave of sick coming and all the promises of "this (insert test kits, hospital beds etc)is coming" etc is making me mad.
 
NY's Gov Cuomo just said NY will likely need 30,000 ventilators and only have 5000 and said every governor on the conference call feels they don't have anywhere near enough ventilators (or ICU beds or masks and some don't have enough test kits yet and even nasal swabs are an issue). Continues to think that the Feds need to address this (I agree) by repurposing domestic manufacturing capacity to make these supplies.

Mandated that all employers only allow 25% of them to work outside the home, keeping 75% of their non-essential workforce at home: if the R0 (transmission rate) is 3 meaning every infected person can infect 3 others if there is no social distancing, then, reducing that R0 to below 1 by social distancing is what's required and that would require at least 2 of 3 people (66%, so he's calling for 75% knowing some will ignore the guidance) not interacting with any other people.

And here's the latest data from NY - clearly they've ramped up testing which is great, as that can identify positive cases, so they can self-quarantine and not infect others (and be treated earlier if needed).
  • COVID-19 cases up to 4,152 across New York state; 2,469 cases in New York City
  • 777 cases hospitalized out of 4,152 total cases, or 19% hospitalization rate in New York
  • 22,284 total tested in New York state thus far
Really impressed with his press conferences...

https://www.pix11.com/news/coronavi...ill-for-new-yorkers-under-covid-19-quarantine
 
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Dude people have to run errands like grocery store or go to a bank

I realize you are doing the boy in the plastic bubble routine and that is fine but most every else has to get supplies and yes gasp...some people actually have to go to ****ing work in offices and buildings..holy moly
You said it like it was a social situation: "have a lot of contact with people." Even going out to get supplies can be done without close contact, as people can shop or go to a bank/ATM and not come within 6 feet of each other (if symptomatic; 3 feet if not) or like you and I and others have been doing, going out at off hours. And if we're having only essential people in offices, they ought to be able to have a low enough density to keep people at reasonable distances from each other - and in your job, you don't have to come in close contact with anyone - get paid electronically or if it's cash/check, have them leave it at an agreed to spot.

My bigger point was if someone is coming in close contact with others, just washing hands and clothes is nowhere near enough - they should self-quarantine or at the very least, if out and about, not come near anyone else. It's why those fukking clips of people partying on the beach is so galling.
 
Dude people have to run errands like grocery store or go to a bank

I realize you are doing the boy in the plastic bubble routine and that is fine but most every else has to get supplies and yes gasp...some people actually have to go to ****ing work in offices and buildings..holy moly
I wouldn't characterize groceries or the bank as interacting with large groups like you described. And while some people may have to go to offices or buildings, at this point most do not (and should not per guidance).
 
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I'm not clear on why Mr. Rigano was interviewed on this. What's his connection to the study by Dr. Raoult?
Tucker said it right - we have to be skeptical, but if true this is huge news. Could change everything and end this disaster quickly.

Adding to this...
I'm wondering if regular use of this, or similar drugs, as a malaria prophylactic, is one reason why India seems to be doing so well in this pandemic. Despite their huge, densely packed, population, they have a relatively low number of cases and more importantly (because testing rates may be suspect), deaths.
 
The point is that the appropriate measures to curtail this are still not being taken. Not everyone is home and a lot of people are still being called in to work. You also have the individuals who are asymptomatic or have minor symptoms that are then transmitting the virus without even knowing.

Adequate testing will give the government a better idea of how many people in our population are carrying the virus and pressure them to be more proactive.

Most people will get this virus in the US by the end of this year. The goal right now is to not overwhelm the hospitals. People need to stay home and stay home even when they have symptoms unless their symptoms are such where their lungs are severely restricted.
 
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SIAP, but here are a couple of the reports which reportedly has been influential in moving the needle in a very large way for the Federal Government over the past few days. Also, the first link, from MIT is a great place to find the latest breaking news/info from a largely technology perspective.

https://www.technologyreview.com/collection/coronavirus/

https://www.imperial.ac.uk/media/im...-College-COVID19-NPI-modelling-16-03-2020.pdf

https://www.technologyreview.com/s/...l-distancing-18-months/?set=615328&set=615328

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/

 
Most people will get this virus in the US by the end of this year. The goal right now is to not overwhelm the hospitals. People need to stay home and stay home even when they have symptoms unless their symptoms are such where their lungs are severely restricted.
The "most people" one is still an interesting scientific question, as Levitt and others have argued that the likely cap for infections is more like 20%, based on there being some level of natural immunity to the virus and based heavily on the Diamond Princess "experiment" in which only 17% of passengers tested positive for the virus, despite there being an 11-day period where conditions should have been ripe for transmission (no restrictions, close quarters, communal eating, etc.).

This is still a very high number compared to what we're seeing even in the worst cases, where no country has yet exceeded 0.1% of its population being infected (and China has <0.01% being infected, if you believe their totals and I don't to be honest, but even if it were 10X as much it would only by 0.1% infected or 1MM not the almost 100K reported) but 20% is certainly not the 50-70% figure many of the modelers are using.

Having said all that, Italy is at 0.05% of its population known to be infected and they're being overwhelmed from a health care perspective and having ~500 people dying per day (above flu death rates) and if "only" 20% of the US became infected (60MM people) and "only" ~1% died (likely the "true" mortality rate vs. infections), then that would be 600,000 deaths vs. the ~35,000 average flu deaths per year - and we'd have way higher numbers of serious/ICU cases too.

I've stated these numbers for a few weeks now, as have many others, but it's worth being reminded of how this could easily be way worse than the flu if we weren't doing what we're doing now (and will need to do).

https://www.calcalistech.com/ctech/articles/0,7340,L-3800632,00.html
 
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