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

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Another interesting analysis, also showing a number of things many have been discussing. Bottom line is the virus is spreading rapidly across the country and NY is just out in front and other states/cities are going to catch up when/if they start testing more. We're nowhere near through this yet, as most experts have been saying - and it's also why folks like Gov Cuomo and many other governors now are screaming for more Federal help on PPE/Ventilators and other supplies.
  • Lack of testing masking true case rates and making death rates appear worse than they truly are (Italy/Spain); also NY is likely the only state showing "true" case rate increases, since it's the only state doing very aggressive testing. As the article said. "There is a real threat of many more NY-style scenarios unfolding in other U.S. major metro areas, especially since only some of these states have state-wide lockdown orders in place."
  • By looking at death counts and backing out what that "should have" correlated to in terms of cases, the first graph below was created. It shows how South Korea has tested enough to actually have a likely 77% of actual cases tested and that the "U.S. is in the middle of the pack with ~15% of cases reported (82K on 3/26). If this analysis is accurate, this means U.S. has AT LEAST 500,000 cases as of today, or approximately 0.2% of population."
  • The "true" mortalilty rate (outside of factors like population age, cultural practices like multigenerational families, and hospitals being overwhelmed and not being able to treat everyone) is likely around 1.3%, as that’s what SK has migrated towards and we know they’ve done the most testing per capita.
  • The US case rate increases are the worst in the world right now, although the graphs in the link aren't on a per capita basis, so that could be deceiving.
  • Cool social distancing map keyed to cell phones (just like traffic).
https://www.linkedin.com/pulse/covid-19-update-march-26-2020-dmitry-shashkov/?trackingId=ac1U1SfKCvjIX2PAfar9zw==

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Yep, the other states are on a 1-3 week lag, just like NY lagged China and Europe.
 
Very insightful interview with one of the lead Chinese scientists who has been working on this epidemic since day one (and helped decode the virus's RNA sequence); Science has tried to interview George Gao, director-general of the Chinese Center for Disease Control and Prevention (CDC), for 2 months. Most interesting comment from him might be that he thinks our biggest mistake in the US and other Western countries has been not wearing masks to reduce the chances of infected people (many of whom are asymptomatic) infecting others in public. Been saying that for at least a month...

https://www.sciencemag.org/news/202...avirus-big-mistake-top-chinese-scientist-says
 
Crazy how 1 person can lead to so many cases. Patient 31 in SK who accounted for 1000+ cases. I'd like to think with all the social distancing measures taken the opportunity for another "patient 31" has come and gone and hopefully that kind of thing can't happen for now. Whenever the restrictions loosen up though I suppose that risk can be reintroduced to some extent.

From an article with graphics showing the spread in SK.

Patient 31
It’s not clear where Patient 31 became infected with the virus, but in the days before her diagnosis, she travelled to crowded spots in Daegu, as well as in the capital Seoul. On February 6 she was in a minor traffic accident in Daegu, and checked herself into an Oriental medicine hospital. While at that hospital, she attended services at the Daegu branch of the Shincheonji Church of Jesus, on February 9 and again on February 16.

In between those visits, on February 15, doctors at the hospital said they first suggested she be tested for the coronavirus, as she had a high fever. Instead, the woman went to a buffet lunch with a friend at a hotel. In an interview with local newspaper JoongAng Ilbo, the woman denied that doctors had advised her to be tested. As her symptoms worsened, however, doctors say they once again advised her to be tested. On February 17, she finally went to another hospital for the test. The next day, health authorities announced she was the country’s 31st confirmed case. In only a matter of days, those numbers had soared as hundreds of people at the Shincheonji Church and surrounding areas tested positive.

https://graphics.reuters.com/CHINA-HEALTH-SOUTHKOREA-CLUSTERS/0100B5G33SB/index.html

From another article:

In South Korea, where the virus first appeared on Jan. 20, public officials said the situation was largely under control for the first several weeks, as the first 30 infected people adhered to strict containment strategies.

But patient 31 changed everything. “The situation here was not really serious until mid-February,” said Hwang Seung-sik, a spatio-temporal epidemiologist at Seoul National University, in an interview with Al-Jazeera. “It began to get very serious starting with patient 31.”

Patient 31 traveled extensively through South Korea, even after doctors had suggested she isolate herself due to a high likelihood that she had been infected. The Korean Center for Disease Control found that she ultimately had contact with approximately 1,160 people. There are now more than 7,800 confirmed cases in South Korea, and more than 60 people have died.

https://www.post-gazette.com/opinio...-Korea-social-distancing/stories/202003190019
 
Notes from today's presser by Cuomo. FYI, I've been doing these because there's no question NY and NYC are on the front lines of the biggest and earliest major wave of this epidemic, so what happens here will be very informative for what is likely to happen in many other locations (especially more densely populated cities) and what can hopefully be done to reduce transmission and the peak, as well as how to prepare the hospitals for potential peaks, among other things. Today's was fom the Javits Center, which has been retrofitted to be a 1000 bed hospital in 1 week by the Feds/Army Corps of Engineers/National Guard, along with 3 other 1000-bed sites (he said they did such a great job he’s asking for 4 more).
  • Testing: 138K total tested in NY/57K in NYC; 16K tested in NYyesterday/7K in NYC
  • Positive Cases: 45K total/7300 new; 25K total/4K new in NYC
  • Deaths: 519 total in NY, was 385 day before (134 yesterday) – will keep increasing, as deaths take 3+ weeks from symptoms and most new cases have been in the past week
  • Hospitalizations: 45K positive tests, 6480 are hospitalized and 1583 in ICU (+290 vs. yesterday) and 2045 discharged to date
  • Model apex (in ~21 days) being planned for: need 140K beds and had 53K but up to 93K now (all hospitals have increased beds by 50-100% via creativity and suspending hospital regs)
  • Model apex: need 40K ICU beds with ventilators and have 10K now; ventilator splitting approved
  • The hospitalization doubling rate slowed from every 2 days to every 4 days over past 9 days, so rate of increase is slowing (so interventions are working), but cases still going up.
    • My comment: assuming interventions are working, as I think they are, the modeled peak numbers will be significantly greater than what we actually see. However, I completely understand preparing for the modeled apex, since time is so short and if the interventions don't work well, the modeled numbers would make overwhelming the hospitals a given.
  • Stockpile of PPE/supplies probably good for a week or two, not enough for peak
  • Schools will likely go beyond 4/1 closing date to 4/15 and the 180-day waiver will extend
  • Support level is inspring: 10K medical staff volunteering in last few days – now up to 62K volunteers; 10K mental health volunteers
  • Made a very nice speech to the Feds/ACE/National Guard folks in attendance thanking them profusely and promising that together they were all going to go out and “kick the coronavirus’s ass.” Said 10 years from now, people will look back on this and despite the heartache and losses, people will be proud of what they accomplished, saving lives.
One more editorial comment. This better be a wakeup call to the world and the US, as we've been ignoring pandemic threats for decades (on both sides of the political aisle) and the next one could be just as contagious as this one with a 10% fatality rate, like SARS or even a 30% rate like MERS and it will be a real tragedy if we don't prepare for that possibility in the future by putting all of the infrastructure in place to support aggressive testing, quarantining, tracing of contacts, social distancing, establishing a mask culture, etc., as well as preparing our health care systems with regard to hospital capacity, hospital supplies (PPE, masks, gloves, ventilators, etc.), and funding more research on viruses, transmissions, and development of better/faster antibody treatment/diagnostic technologies and vaccine technologies.

3800C6A9-D954-4D0F-867F-542A3FB71ACA.png.a7195483d441b98fe004129c415b0e98.png


https://www.governor.ny.gov/keywords/health

Shorter summary today. The good news is that the rate of increase in new cases is slowing a bit for NY/NYC and new hospitalizations and ICU cases yesterday actually decreased vs. Thursday, although we need more than 1 day's worth of date to have confidence that's not just a blip.
  • Testing: 155K tests in NY/65K in NYC, so far, and 17K/8K yesterday in NY/NYC
  • 52K positives in NY/30K in NYC, so far, and 7600/4300 new cases in NY/NYC yesterday
    • Note that it was 7300/4000 new cases in NY/NYC on Thursday, so the growth rate is declining (<10% increase yesterday vs. 20-30% for the past several days)
  • 728 deaths total in NY, up 209 from yesterday
  • 7328 hospitalized in total (847 new yesterday vs. 1100 new on Thursday); 2726 discharged
  • 1765 in ICU (w/ventilators) in total (172 new yesterday vs. 290 new on Thursday– nice improvement
  • Total cases elsewhere: 8800 in NJ, 4900 in CA and over 3000 in WA, MI, MA, FL, IL, LA
  • Apex in model is in 14-21 days and model is still indicating a need of 140K beds and 30K ICU/ventilators ($35K per ventilator); hopefully won't reach these, but could easily surpass the 53K beds/4K ventilators NY started with
  • Trump approved 4 more emergency medical sites for the Feds to build 4 more 1000 bed hospitals (now 1 in every borough)
  • NY approval for antibody tests from FDA to see who has recovered – in concert with plasma-antibody approach for treating serious cases, which starts Monday, I believe, at Mt. Sinai Hospital
https://www.governor.ny.gov/keywords/health
 
Trump considering enforceable quarantine on NY, NJ and parts of Connecticut. Not sure what that actually entails. Maybe can't leave the state, not sure how many residents are doing that currently anyway.

https://www.cnn.com/2020/03/28/politics/trump-new-york-new-jersey-quarantine-coronavirus/index.html

https://www.cnbc.com/2020/03/28/tru...e-in-new-york-new-jersey-and-connecticut.html

Ive been saying this should be an option..not sure how its carried about but we could possibly contain the spread out by keeping in
 
Ive been saying this should be an option..not sure how its carried about but we could possibly contain the spread out by keeping in
The number of people likely to leave NY is small compared to the number of cases in most states already, so my guess is this is for show. Having said that, people should be focused on staying at home (or practicing good social distancing when out), unless considered essential.

Just heard Gov Murphy say they broke up a DJ party in Mercer County last night that had 50 people in a 500 square foot space. Good work.
 
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Passing from nyc to nj...gee why do we have so many cases. Id line to control the hotspot in the country
Yea but what you're seeing now are effects from before not currently. The cases popping up now were contracted weeks ago. Right now outside out of state workers are there really many people travelling cross borders these days? Forget about just here I mean in many places across the country. I tend to think most are within a certain somewhat limited radius of their home.
 
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Yea but what you're seeing now are effects from before not currently. The cases popping up now were contracted weeks ago. Right now outside out of state workers are there really many people travelling cross borders these days? Forget about just here I mean in many places across the country. I tend to think most are within a certain somewhat limited radius of their home.
Yes, people trapped in apartment s in ny will look to get out...
 
Today (Friday) the state is reporting a total of 24,843 tests completed, an increase of 5479 since yesterday. As I have previously posted, I believe NJ needs to maintain this rate of at least 5000 per day in order to have a hope of having the data needed to control this virus. Ideally, the testing rate will continue to increase.

The percent positive is 33.4%, an increase from yesterday's 31.7%. The Governor indicates that is a good sign, because it indicates that we are testing the right people and not wasting tests on people without the virus. I disagree. I think the negative tests are a valuable part of tracking and controlling the disease. I believe an increasing rate of positive tests indicates that the testing criteria is too strict, or there is too much pent-up demand for testing among the symptomatic.

The Heath Commissioner also indicated that because of backlogs in testing, a significant portion of the test results we are reporting today are from samples collected up to 7 days ago. I see this also as problematic, as that is way too long to wait for test results both in terms of individual patient care and also from an epidemiological perspective. Hopefully this can be remedied with increased lab capacity, along with ramping up of some of the faster tests that have been approved.
Today (Saturday), the State is reporting a total of 29882 tests performed, for an increase of 4979 tests since yesterday. That is a decline in the daily testing rate. (Note that the Health Commissioner says that only about 90% of the reported test results include both positive and negative tests, and the remaining 10% only include positive, so there is a small gap in the number total tests and the number of negative results.)

The State is also reporting that 34.99% of the tests were positive, a continued increase in positive rate. As I previously commented, I think this is an indication that there is pent-up demand for tests because testing criteria is too stringent and not enough tests are being performed.

I think the state needs to increase testing to at least 7500 tests per day by late next week. Hopefully some of the new testing protocols will enable an increase in testing, and also much faster turn-around in reporting results.
 
Yes, people trapped in apartment s in ny will look to get out...
It's s mistake to make hints at a quarantine. Will create a panic exodus of whoever is still in the city and has somewhere else to go. Better to announce it when you're ready and have the national guard, law enforcement, and military in place, ready to enforce.
 
News reports indicate he is projecting the need for ventilators over the next few weeks as the number of Covid-19 cases continues to grow exponentially, even if the state has enough to meet today's demand.
Cali.. if you were trying to make a case I'd suggest knowing the answer to your "question" before posting it. It was public knowledge. And while teh answer is reasonable.. that he is planning for future needs, stockpiling resources, it should be fairly simple for some real journalists to see if there are hospitals in NY in dire need of those 4000 ventilators in storage.. i.e. is Cuomo making excuses?
 
As good as the theory sounds, there were (and still are) subsets who did not/are not heed(ing) the advice. These people are the ones who will fvck up some of the potential for flattening that curve and will have a hand in pushing the healthcare system over the edge.
Sadly there is some truth to this. The amount of selfishness of some is amazing. It's a small percentage, but in a country of 330 million it's a substantial amount.
 
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Cali.. if you were trying to make a case I'd suggest knowing the answer to your "question" before posting it. It was public knowledge. And while teh answer is reasonable.. that he is planning for future needs, stockpiling resources, it should be fairly simple for some real journalists to see if there are hospitals in NY in dire need of those 4000 ventilators in storage.. i.e. is Cuomo making excuses?

How does this jive with video of the doctor saying they are currently worried about having no ventilators..just asking about her observation on the front line and ny actually having the stockpile currently..rewatched the video and the hospital and the nyc health dept seem at odds
 
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How does this jive with video of the doctor saying they are currently worried about having no ventilators..just asking about her observation on the front line and ny actually having the stockpile currently..rewatched the video and the hospital and the nyc health dept seem at odds
My guess is "the fog of war"
 
If we go to quarantine, will it be Conn, NJ and NY as one? Or will it mean people from NYC can't come here, also.
 
If we go to quarantine, will it be Conn, NJ and NY as one? Or will it mean people from NYC can't come here, also.

Cuomo just gave long interview and is vehemently against saying it was illegal and kill the economy

I think Trump floated this out as trial balloon to float and discussion and give cover to himself politically

Likely not hapoening
 
How does this jive with video of the doctor saying they are currently worried about having no ventilators..just asking about her observation on the front line and ny actually having the stockpile currently..rewatched the video and the hospital and the nyc health dept seem at odds
It's not hard math (except for the models) and the POTUS is playing politics with lives, when he needs to be running herd on manufacturers to make more ventilators for the whole country, including NY. The predicted peak from the models is somewhere between 30-40K ventilators (same as ICU beds) needed eventually for NY. NY now has 15K (they had 4K, the Feds sent 4K and NY has procured 7K), so they think they need 15-25K more. Also, note that splitting can help this situation a bit, but as @LETSGORU91 said, splitting only works in some (unknown) fraction of cases where flow/pressure needs are very similar. And right now NY has 1750 ICU/ventilator cases.

If the interventions in place, like social distancing, work reasonably well then the peak isn't reached and they'll have enough, but if the peak is reached, they clearly won't have enough, even with splitting probably, and then people will die unnecessarily. And there are scenarios in-between, where it'll likely be a close call. And right now, its nearly impossible to know what the peak is going to be. Based worldwide data, the ICU rate per total positive cases is around 5% (and is 3.5% in NY now, but will go up, as serious cases lag total cases; the 5% is from the Worldometer site), so if NY gets to 500,000 cases that's 25K ICU/ventilator cases.

I think 500K cases in NY is theoretically possible, given over 50K now, although I think it will be a bit less than 500K, as 500K is 2.5% of the 20MM population, which is well above what any other country has seen, but I'm not in charge - (Italy is at 0.15% now and Wuhan supposedly reached 0.5%, but I think it was 5-10X higher). 500K cases would roughly translate to 25K ventilators needed, so it's at least possible that the 15K in stock are not going to cut it, even with splitting. There would need to be about 800K cases to translate to 40K ventilators and I personally doubt we'll get there, but if you're the governor, whose most important job is protecting public health, you're absolutely going to want to plan for that scenario.

f it turns out that the 500-800K scenarios occur and you haven't planned for them, it could be too late to respond (especially when more need to be made for the US total demand vs. the entire Federal stockpile, which likely won't be enough for the country. The other thing Cuomo has promised is that since NY is going to see the first peak and other areas will likely see peaks 1-3 weeks after NY starts declining, he will commit to redeploying ventilators (and some seasoned medical staff and other supplies) to other states, which would hopefully mean the US might not need to supply/staff for every state's peak.

The reason why most of the ventilators are in storage is that it's inefficient to deploy them too far ahead of time if we don't know where, exactly, they're going to be needed, as that's wasted effort. It's much more efficient to track the need and deploy just ahead of the demand curve, when the delivery distance is so short. That will, though, on occasion, lead to some scrambling to get ventilators if the planning/delivery process isn't smooth.

https://www.marketwatch.com/story/g...es-to-provide-hundreds-to-new-york-2020-03-27
 
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One of the problems occurring in the North Country and parts of Vermont is people escaping the city and densely populated parts of downstate to their vacation homes. The hospitals in the Adirondacks and Vermont are small rural hospitals, ill-equipped for population increases.

Fortunately, Cuomo is starting to employ good old fashioned health planning that looks at resources from a regional/county perspective.
 
Sort of a switch-up: what's everyone doing with their groceries?

I'm contemplating buying an dorm sized fridge/freezer combo.

The idea would be to sequester groceries in a mud room and wait 3 days.

My wife is driving me up the wall wiping down the groceries and re-sanitizing the kitchen after every trip.
 
One of the problems occurring in the North Country and parts of Vermont is people escaping the city and densely populated parts of downstate to their vacation homes. The hospitals in the Adirondacks and Vermont are small rural hospitals, ill-equipped for population increases.

Fortunately, Cuomo is starting to employ good old fashioned health planning that looks at resources from a regional/county perspective.

Cuomo is doing a great job. Its interesting he is following the Trump model of levels of government working together where each levels shares big responsibility. I think Newsime this too. I hope some other governors also realize how this has to be carried out. Going to be key in tracking cases and containing them by county which will possibly help indentity the areas of the country which could be open first
 
Im just taking them in as normal and washing my hands thoroughly after putting them away. Its very low risk of spread from touching your groceries. Obviously everyone is entitled to their own risk assessment.
That's what I want to do.

But my work from home boss has other ideas.
 
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Sort of a switch-up: what's everyone doing with their groceries?

I'm contemplating buying an dorm sized fridge/freezer combo.

The idea would be to sequester groceries in a mud room and wait 3 days.

My wife is driving me up the wall wiping down the groceries and re-sanitizing the kitchen after every trip.
I only sanitize perishables, including produce, in a sink filled with warm soapy water (sink makes it a lot easier to contact all the surfaces) and do a really good water rinse; otherwise any surface viruses will last longer than 3 days in cold/frozen conditions. All non-perishables and packages and mail go on a table in the garage that has stuff separated by arrival date and we only open up any of these items after >72 hours (with no precautions, other than chucking all the packaging and washing hands well afterwards), since that's the longest documented (in a controlled study) time virus particles have been observed on stainless steel and polypropylene vs. 1 day on paper/cardboard.

For takeout, we only order warm food (much less likely to sustain any viruses and ingestion isn't a route of infection) and we decon the packaging and plate the food rather than eating out of the containers supplied and, of course we wash hands after plating. It's actually not that much work, especially with the 3-day thing, which greatly reduces sanitizing, as there's almost nothing we need immediately that's non-perishable (we'd sanitize on an exception basis). Also, for takeout, we call ahead and pay over the phone and call when we arrive and have them put the food in the trunk, so no contact occurs (good for both of us). We also get some supplies that way (milk, eggs, bread, lunchmeat, etc.) from the local deli - we order ahead and they drop it in the trunk, as I simply hate going to stores now, due to the risks (and will only go at very late hours when few are around and am trying to figure out how to get everything on line or from locals, but we don't have that 100% covered yet and this could be months for us.

And don't forget, all of the above is important, but not nearly as important as keeping 6+ feet away from people, as >95% of transmissions occur via person to person contact (sneezes, coughs and even breath); fyi, China found that about 80% of transmissions occurred in the household from close contact. Might make a separate thread on this, as the questions keep coming up.
 
Im just taking them in as normal and washing my hands thoroughly after putting them away. Its very low risk of spread from touching your groceries. Obviously everyone is entitled to their own risk assessment.
If it’s me buying the groceries myself I’ve done the same and just put them away and wash my hands after.

But I‘ve just started using delivery a couple times and those I’ve wiped down. From my Ring, I see the shoppers wearing gloves when they deliver. I’ve said before I see gloves as germ accumulators and that’s why I don’t wear them. So I treat those items like I would any other high touch traffic area like a checkout or freezer door or grocery cart handle since the shoppers have handled them with those “germ accumulating” gloves which they’ve probably been wearing the whole day or what not.
 
I only sanitize perishables, including produce, in a sink filled with warm soapy water (sink makes it a lot easier to contact all the surfaces) and do a really good water rinse; otherwise any surface viruses will last longer than 3 days in cold/frozen conditions. All non-perishables and packages and mail go on a table in the garage that has stuff separated by arrival date and we only open up any of these items after >72 hours (with no precautions, other than chucking all the packaging and washing hands well afterwards), since that's the longest documented (in a controlled study) time virus particles have been observed on stainless steel and polypropylene vs. 1 day on paper/cardboard.

For takeout, we only order warm food (much less likely to sustain any viruses and ingestion isn't a route of infection) and we decon the packaging and plate the food rather than eating out of the containers supplied and, of course we wash hands after plating. It's actually not that much work, especially with the 3-day thing, which greatly reduces sanitizing, as there's almost nothing we need immediately that's non-perishable (we'd sanitize on an exception basis). Also, for takeout, we call ahead and pay over the phone and call when we arrive and have them put the food in the trunk, so no contact occurs (good for both of us). We also get some supplies that way (milk, eggs, bread, lunchmeat, etc.) from the local deli - we order ahead and they drop it in the trunk, as I simply hate going to stores now, due to the risks (and will only go at very late hours when few are around and am trying to figure out how to get everything on line or from locals, but we don't have that 100% covered yet and this could be months for us.

And don't forget, all of the above is important, but not nearly as important as keeping 6+ feet away from people, as >95% of transmissions occur via person to person contact (sneezes, coughs and even breath); fyi, China found that about 80% of transmissions occurred in the household from close contact. Might make a separate thread on this, as the questions keep coming up.

I'd skip fresh fruit and veggies for the duration. Stick to canned and frozen and dehydrated etc.
 
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